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COMMON COLD - Coggle Diagram
COMMON COLD
DIFFERENTIALS
Meningitis
Upper airway obstruction
A nasal foreign body
COVID-19
Influenza
Streptococcal pharyngitis
Allergic rhinitis
Glandular fever
Whooping cough
VIRUS CAUSING COMMON COLD
Rhinoviruses
Coronaviruses
Influenza viruses
Respiratory syncytial virus
Parainfluenza viruses
Adenoviruses
Enteroviruses
Metapneumovirus
DEFINITION
The common cold is the conventional term used to describe a mild, self-limiting, upper respiratory tract infection characterized by nasal stuffiness and discharge, sneezing, sore throat, and cough.
The common cold can be caused by a wide range of viruses from several different families. This has prevented the development of preventative/curative treatments for the common cold.
TRANSMISSION:
Direct contact — the virus is passed directly by skin contact or hand contact with a shared object. Once the hand is contaminated, autoinoculation may occur through contact with the nose or eyes.
Small-particle aerosols — these linger in the air and can be highly infectious. This is the most important route of transmission of the influenza virus, although rhinoviruses can also be transmitted by this route.
Large-particle aerosols — these can be formed when sneezing or coughing, but their importance in common cold transmission is less well documented. As many as one million virions may be present in 1 mL of nasal wash
PROGNOSIS
COMPLICATIONS
Lower respiratory tract infections — including acute bronchitis, acute exacerbation of asthma or chronic obstructive pulmonary disease (COPD), and community-acquired pneumonia.
Acute otitis media — the most common complication in younger children, where it follows about 20% of common colds
Complications are more common in people who are immunocompromised, who smoke, and with comorbidities such as diabetes mellitus, congestive heart failure, asthma, chronic obstructive pulmonary disease, cystic fibrosis, and sickle-cell disease
Sinusitis — characterized by prolonged nasal congestion and facial pain, which has been estimated to follow on from the common cold in 0.5–2.0% of cases
The common cold is a self-limiting illness, and no known treatment improves the time course of infection.
The onset of symptoms after infection is sudden. Studies using artificial inoculation with rhinovirus indicate that the incubation period may be as short as 10–12 hours, although it may be longer in normal settings.
Symptoms tend to peak within 2–3 days, then decrease in intensity. Symptoms usually last around 1 week in adults and older children, although they may last longer. In particular, cough can last for up to 3 weeks.
n younger children, symptoms typically last 10–14 days.
Smokers tend to have more severe respiratory symptoms such as cough, and infection is more likely to be prolonged in smokers than in non-smokers. In addition, smokers have double the risk of developing a lower respiratory tract infection compared with non-smokers.
Symptom recurrence is common, although it is not clear whether the causative pathogen is the same virus, a subtype, or a different pathogen.
DIAGNOSIS
Most adults and older children reliably self-diagnose the common cold within a day of developing symptoms. The diagnosis is clinical based on history.
Common symptoms include:
Sore or irritated throat — often the first symptom, typically has a sudden onset and resolves rapidly.
Nasal irritation, congestion, nasal discharge (rhinorrhoea), and sneezing — nasal discharge is often profuse and clear, but may become thicker and darker as the infection progresses (although this does not usually indicate that bacterial infection is present).
Cough develops in about 30% of people, typically after nasal symptoms have cleared.
Hoarse voice caused by associated laryngitis.
General malaise.
Other symptoms are less common and may include:
Fever — this is unusual in adults and is typically low grade.
Headache and myalgia — more often associated with influenza rather than the common cold.
Loss of taste and smell, eye irritability, and a feeling of pressure in the ears or sinuses (due to obstruction or mucosal swelling).
MANAGEMENT
If the person is at risk of complications because of pre-existing comorbidity or other risk factors arrange follow up at an interval according to clinical judgement.
Reassure the person or carer that although symptoms may be distressing, the common cold is self-limiting and complications are rare.
The natural history of the common cold is rapid onset, with symptoms peaking after 2–3 days, and typically resolving after 7 days in adults and 14 days in younger children, although a mild cough may persist for 3 weeks.
No treatments are available that can cure the common cold and most treatments are not effective at relieving symptoms.
Explain that symptom relief and rest are the most appropriate management. Advise people that:
Antibiotics and antihistamines are ineffective and may cause adverse effects.
Adequate fluid should be taken during the course of the illness.
Healthy food is recommended, although no specific diet or mineral or vitamin supplementation is necessary — reassure parents that it is common for children to lose their appetite for a few days when they have a cold, and children with colds should eat only when they are hungry.
Adequate rest is advised — although staying off work or school is normally not necessary. Normal activity will not prolong the illness.
Advise the person or carer to use paracetamol or ibuprofen as an antipyretic and/or analgesic if needed for the following:
Adults and children aged 5 years and over, if the person has a headache, muscle pain, or fever.
Children aged under 5 years, if the child has a fever and appears distressed. When using paracetamol or ibuprofen in children with fever, advise the carer to:
Continue only as long as the child appears distressed.
Consider changing to the other agent if the child's distress is not alleviated.
Not to give both agents simultaneously.
Only consider alternating these agents if the distress persists or recurs before the next dose is due.
PRESCRIBING
mportant aspects of prescribing information relevant to primary healthcare are covered in this section specifically for the drugs recommended in this CKS topic. For further information on contraindications, cautions, drug interactions, and adverse effects, see the electronic Medicines Compendium (eMC), or the British National Formulary (BNF).
Paracetamol
Ibuprofen