Common cold

its about common cold
Risk factors, symptoms, treatment

1. NAME: AKALYA ATPUTHANANTHAN
GROUP NO : 605

2. INTRODUCTION
The common cold is a viral
infection of your nose and throat
(upper respiratory tract). It's usually
harmless. Many types of viruses
can cause a common cold.

3. Risk factors
These factors can increase your chances of getting a cold:
•Age. Children younger than six are at greatest risk of colds,
Weakened immune system. Having a chronic illness or
otherwise weakened immune system increases your risk.
•Time of year. Both children and adults are more
susceptible to colds in fall and winter
•Smoking. You're more likely to catch a cold and to have
more severe colds if you smoke.
•Exposure. If you're around many people, such as at school
or on an airplane, you're likely to be exposed to viruses that
cause colds.

4. Symptoms: the common cold
Day 1: sore or “scratchy” throat, +/- low grade fever
Day 2-3: nasal obstruction, rhinorrhea, sneezing
• thick purulent nasal discharge does NOT mean
bacterial sinusitis!
Day 4-5: cough becomes bothersome, nasal symptoms less
severe
• Average duration: 3-7 days
• Virus-induced changes in airway reactivity can persist for
up to 4 weeks

5. Symptoms: the common cold*
Day 1

6. Symptoms: the common cold*
Day 2 to 3

7. Symptoms: the common
cold*
Day 4 to 5
• thick
purulent
nasal
discharge
does NOT
mean
bacterial
sinusitis!

8. 50%
15%
15%
5%
5%
10%
Rhinovirus
Coronavirus
Influenza
RSV
Parainfluenza
Adeno, Entero
Virology

9. Seasonal Patterns
Fall, late spring : Rhinovirus
Parainfluenza
Winter, spring: RSV, coronavirus
Summer: Enterovirus (year)
Adenovirus: Outbreaks in Military facilities
daycare centers, hospital

10. Facts: the common cold
• Incubation period 24 to 72
hours
•Average duration 3 – 7
days
•Virus-induced changes in
airway reactivity can
persist for up to 4 weeks
(Rhinovirus )
• 2 to 3 episodes /per year

11. FACTS: transmission
• Hand –to- hand
• most efficient = direct contact
• virus can survive for 2 hours on human skin
• also aerosol
• NOT via saliva – kissing is OK!
(in 90% of people with colds, no
detectable virus in saliva)

12. But how do I know it’s just a cold?
COLD INFLUENZA
Fever Rare 39-40
o
Headache Rare Usual
Myalgia Mild Severe
Malaise Mild May last 3 wks
Extreme fatigueUnusual Usual
Nasal congestionCommon Common
Sneezing Common Sometimes
Sore throat Common Common
Chest discomfort/
cough
Mild Mod-Severe

13. When to see a doctor
For adults — seek medical attention if you
have:
•Fever greater than 101.3 F (38.5 C)
•Fever lasting five days or more or
returning after a fever-free period
•Shortness of breath
•Wheezing
•Severe sore throat, headache or sinus pain

14. Diagnosis
•Symptoms and a physical examination are all the doctor
needs to diagnose the common cold.
•Usually, no blood tests or X-ray are necessary.
•During the physical examination, the doctor will pay
careful attention to the head, neck, and chest.
•Examine the eyes, ears, throat, and chest to help
determine if a bacterial source is causing the illness.

15. Diferential diagnosis: the common cold
•Allergic or seasonal
rhinitis
•Bacterial pharyngitis or
tonsillitis (Centor
criteria)
•Sinusitis
•Influenza

16. Treatment: the common cold
• the ONLY “A”
recommendation is
NOT to use
antibiotics to treat
the common cold.
• everything else is
“B” (inconsistent or
limited quality
evidence)

17. Treatment: what might work
NASAL CONGESTION:
• topical or oral decongestant – phenylephrine or pseudoephedrine
• small benefit of single dose, NO benefit of repeated use over
several days
• topical intranasal spray - oxymetazoline and phenylephrine
•humidified air and fluid intake *3
• inconsistent results, but no harm!
•PAIN RELIEVERS

18. Treatment: what might work
COUGH:
• dextromethorphan
(DM) – cough
suppressant
•guaifenesin (Benylin E,
Robitussin) – expectorant

19. Treatment: the common cold
COMPLEMENTARY/ ALTERNATIVE:
• Vitamin C
• no effect if started after onset of symptoms
• inconsistent results if started before: may slightly
decrease cold duration if 200mg daily

20. Treatment: the common cold
COMPLEMENTARY/ ALTERNATIVE:
• Echinacea
• no evidence in well-designed studies
• Zinc
• inhibits viral growth in vitro
• inconsistent study results
Zinc side effects include a bad taste and nausea.

21. Complications
•Acute ear infection (otitis media). This occurs when bacteria or
viruses enter the space behind the eardrum. Typical signs and
symptoms include earaches and, in some cases, a green or yellow
discharge from the nose or the return of a fever following a
common cold.
•Asthma. A cold can trigger an asthma attack.
•Acute sinusitis. In adults or children, a common cold that doesn't
resolve can lead to inflammation and infection of the sinuses
(sinusitis).
•Other secondary infections. These include strep throat
(streptococcal pharyngitis), pneumonia, and croup or bronchiolitis
in children. These infections need to be treated by a doctor.

22. FACTS: the common cold
• you can be re-infected by
the same virus, but
subsequent illness will be
milder and shorter
• NO evidence that cold
climate increases
susceptibility to respiratory
illness

23. FACTS: the common cold
• huge economic burden
• annual work absence in the US = 23 million lost
days/ year
Therefore …
• huge potential for drug companies to make big money!!
• 1 in 4 US adults had taken a cough or cold medication
in the last 7 days
• in Canada, >700 OTC cough and cold medications

24. CASE: Mr. Sniffle, 35 y.o. male
• complaining of feeling tired and
achy for few days
• today: congested, thick yellow
nasal discharge
• non-productive cough started this
morning
• no fever
• requesting an antibiotic
• wants to know what OTC products
will work for his symptoms

25. QUIZ
What is the most likely diagnosis?
a. influenza
b. acute bacterial sinusitis
c. the common cold
d. pneumonia
e. asthma

26. QUIZ
What is the most likely diagnosis?
a. influenza
b. acute bacterial sinusitis
c. the common cold
d. pneumonia
e. asthma

27. QUIZ: the common cold
What is the most common culprit?
a. rotavirus
b. coronavirus
c. rhinovirus
d. echovirus
e. influenza virus

28. QUIZ: the common cold
What is the most common culprit?
a. rotavirus
b. coronavirus
c. rhinovirus
d. echovirus
e. influenza virus

29. QUIZ: the common cold
Mr. Sniffles wants to know if his girlfriend will catch
this if he kisses her. You tell him the virus is:
a.Likely to transmit by kissing
b.Unlikely to transmit by kissing

30. QUIZ: the common cold
Mr. Sniffles wants to know if his girlfriend will catch
this if he kisses her. You tell him the virus is:
a.Likely to transmit by kissing
b.Unlikely to transmit by kissing*

31. QUIZ: the common cold
Mr. Sniffles only wants to spend his money on
treatments that he can be sure will help his
symptoms. What do you suggest?
a.Antibiotics
b.Antihistamine
c.Codeine
d.Dextromethorphan
e.Pseudoephedrine
f.D. or E.
g.None of the above – just rest and fluids

32. QUIZ: the common cold
Mr. Sniffles only wants to spend his money on
treatments that he can be sure will help his
symptoms. What do you suggest?
a.Antibiotics
b.Antihistamine
c.Codeine
d.Dextromethorphan
e.Pseudoephedrine
f.D. or E.
g.None of the above – just rest and fluids

33. Case Conclusion: Mr. Sniffle
• you reassure Mr. Sniffle that he has just
a common cold
• you educate him about why antibiotics
are not a good idea
• after you expound upon the evidence
(or lack of) for various remedies, he
chooses to try intranasal atrovent
• you also suggest hydration, rest, and
not to waste his money on OTC products

34. THANK
YOU