The Evolution of the Common Cold

12/7/2022

Is it a cold, flu, sinus infection or COVID-19? When should you call the doctor?

The common cold is the number one reason for lost work and school time throughout the industrialized world. The average adult will get two or three colds each year, while children can go through 5 to 10 cycles. The typical cold starts with sore throat and runny nose, followed by sneezing and coughing. Most people will recover fully within a week or ten days.

“There are over 200 different viruses that can cause a cold, the most common being the rhinovirus,” says Dr. Yanick Ekortarh, a family medicine specialist with Primary Care Associates of Laredo. “While a cold can vary in intensity from mildly annoying to quite severe, it’s important to note that they are still viruses. Antibiotics will have no effect – you can treat the symptoms but just have to wait it out.”

Perhaps the question asked most frequently in primary and urgent care offices across the country is, “Do I have a cold, COVID-19, sinus infection or the flu?”

While your physician and local walk-in clinic no doubt can rule out things like the flu, strep throat and COVID-19 in minutes with a simple swab test, determining between a cold and sinus infection is trickier – and in many cases, irrelevant.

“The flu and common cold are both contagious respiratory illnesses, but they are caused by different viruses. Influenza viruses are the reason for the flu. Different viruses – including rhinoviruses, parainfluenza and seasonal coronaviruses – can cause the common cold. SARS-CoV-2 is the virus that causes COVID-19, and it should not be confused with seasonal coronaviruses,” says Dr. Ekortarh.

Only a small number of cases involving cold- and flu-like symptoms are bacterial in nature. Therefore, the vast majority of cases will not respond to antibiotics. This leaves most patients with no course of action but to try and get through the virus with minimal pain and suffering. We’ll focus on those efforts here.

• Manage a fever. A fever is rare with a cold, in both adults and children. One of the best ways to distinguish a cold from a suspected case of flu or COVID-19 is by a fever. If you or your child experiences a fever of 101 or higher for more than a day, it’s best to get a flu and COVID-19 test just to be safe. Otherwise, acetaminophen is the preferred method for reducing fever – just be very mindful of dosing instructions, and don’t take more than one medicine at a time containing acetaminophen. Ibuprofen can also be used, but avoid aspirin and NEVER give it to a child under age 12.
• Stop a runny nose/post-nasal drip. Your sore throat (if not a strep infection or COVID-19) is most likely being caused by nasal discharge dripping down your throat. The best way to dry it up is with antihistamines, which can make some people very sleepy, so plan accordingly.
• Un-clog your nose. A stuffed nose is a terrible feeling, and can prevent you from sleeping for several nights in a row during a cold. Talk to your doctor or the pharmacist about the best over-the-counter decongestant choice for you, and be cautious not to overuse.
• Relieve sinus pressure and pain. Nasal steroids, both over the counter and prescription, can relieve cold symptoms and seasonal allergies.
• Loosen cough or mucus. If you can’t kick the cough and move the mucus out, try an expectorant to help thin the thick drainage and move it out through nose and mouth.
• Reduce coughing. For many people, the cough is the worst part of a cold. Try an antitussive or another product with dextromethorphan to help suppress the cough and get some sleep.
• Relieve a sore throat. Gargle with warm salty water a couple of times per day, and try throat lozenges or an analgesic at bedtime. Monitor your throat for white or yellow spots or severe/increasing pain that may indicate a strep infection. A sore throat is also a possible symptom of COVID-19.
• Get some ZZZZZ’s. Your immune system needs sleep to fight back. Nighttime over-the-counter products should be used judiciously, but can provide much relief. Be sure to read labels and find products safe for you, especially if you have high blood pressure or other medical conditions, or are taking other products with similar ingredients.

One of the most confusing parts of diagnosing a cold is the multitude of symptoms. For instance, you may be diagnosed with an inner ear infection, a lower respiratory tract infection, or sinusitis. However, the majority of all of these cases, too, are viral in nature – not bacterial. Thus antibiotics will still be ineffective in treating or shortening the illness.

It’s important, however, to see your physician if your symptoms move beyond the basic ones listed above. A lower respiratory infection can take harbor in the lungs and turn into pneumonia, and sinusitis left untreated can result in a bacterial infection.

Your doctor is the best resource to distinguish between a viral and bacterial condition, and to recommend the appropriate course of treatment, if any.

“While frustrating, there isn’t much we can do to avoid getting colds altogether,” said Dr. Ekortarh. "Keep your immune system strong with proper diet and exercise, practice good hygiene to avoid catching the viruses others are carrying, and get your vaccines for the flu and COVID-19 to reduce your odds of a more severe illness and complications.”

For the times when the common cold turns into something more complex, it’s important to have a primary care physician who knows you and your history, and can quickly evaluate and treat you appropriately.

If you need to be connected with a personal or family physician with same-day appointments, contact Primary Care Associates of Laredo at http://bit.ly/3XYoI6j. For after-hours walk-in care and flu shots, contact Laredo CareClinic at http://bit.ly/3gJrSKl.

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