Common cold

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Common cold
Other namesCold, acute viral nasopharyngitis, nasopharyngitis, viral rhinitis, rhinopharyngitis, acute coryza, head cold, [1] upper respiratory tract infection (URTI) [2]
Rhinovirus isosurface.png
A representation of the molecular surface of one variant of human rhinovirus
Specialty Infectious disease
Symptoms Cough, sore throat, runny nose, fever [3] [4]
Complications Usually none, but occasionally otitis media, sinusitis, pneumonia and sepsis can occur [5]
Usual onset~2 days from exposure [6]
Duration1–3 weeks [3] [7]
Causes Viral (usually rhinovirus) [8]
Diagnostic method Based on symptoms
Differential diagnosis Allergic rhinitis, bronchitis, bronchiolitis, [9] pertussis, sinusitis [5]
Prevention Hand washing, cough etiquette, social distancing, vitamin C [3] [10]
Treatment Symptomatic therapy, [3] zinc [11]
Medication NSAIDs [12]
Frequency2–3 per year (adults)
6–8 per year (children) [13]

The common cold or the cold is a viral infectious disease of the upper respiratory tract that primarily affects the respiratory mucosa of the nose, throat, sinuses, and larynx. [6] [8] Signs and symptoms may appear in as little as two days after exposure to the virus. [6] These may include coughing, sore throat, runny nose, sneezing, headache, and fever. [3] [4] People usually recover in seven to ten days, [3] but some symptoms may last up to three weeks. [7] Occasionally, those with other health problems may develop pneumonia. [3]

Contents

Well over 200 virus strains are implicated in causing the common cold, with rhinoviruses, coronaviruses, adenoviruses and enteroviruses being the most common. [14] They spread through the air or indirectly through contact with objects in the environment, followed by transfer to the mouth or nose. [3] Risk factors include going to child care facilities, not sleeping well, and psychological stress. [6] The symptoms are mostly due to the body's immune response to the infection rather than to tissue destruction by the viruses themselves. [15] The symptoms of influenza are similar to those of a cold, although usually more severe and less likely to include a runny nose. [6] [16]

There is no vaccine for the common cold. [3] This is due to the rapid mutation and wide variation of viruses that cause the common cold. [17] The primary methods of prevention are hand washing; not touching the eyes, nose or mouth with unwashed hands; and staying away from sick people. [3] People are considered contagious as long as the symptoms are still present. [18] Some evidence supports the use of face masks. [10] There is also no cure, but the symptoms can be treated. [3] Zinc may reduce the duration and severity of symptoms if started shortly after the onset of symptoms. [11] Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may help with pain. [12] Antibiotics, however, should not be used, as all colds are caused by viruses. [19] There is no good evidence that cough medicines are effective. [6] [20]

The common cold is the most frequent infectious disease in humans. [21] Under normal circumstances, the average adult gets two to three colds a year, while the average child may get six to eight colds a year. [8] [13] Infections occur more commonly during the winter. [3] These infections have existed throughout human history. [22]

Signs and symptoms

Woman with symptoms of the common cold A lady suffering from the Common Cold.png
Woman with symptoms of the common cold

The typical symptoms of a cold include cough, runny nose, sneezing, nasal congestion, and a sore throat, sometimes accompanied by muscle ache, fatigue, headache, and loss of appetite. [23] A sore throat is present in about 40% of cases, a cough in about 50%, [8] and muscle aches in about 50%. [4] In adults, a fever is generally not present but it is common in infants and young children. [4] The cough is usually mild compared to that accompanying influenza. [4] While a cough and a fever indicate a higher likelihood of influenza in adults, a great deal of similarity exists between these two conditions. [24] A number of the viruses that cause the common cold may also result in asymptomatic infections. [25] [26]

The color of the mucus or nasal secretion may vary from clear to yellow to green and does not indicate the class of agent causing the infection. [27]

Progression

Cold symptoms over time Cold symptoms cdc.jpg
Cold symptoms over time

A cold usually begins with fatigue, a feeling of being chilled, sneezing, and a headache, followed in a couple of days by a runny nose and cough. [23] Symptoms may begin within sixteen hours of exposure [28] and typically peak two to four days after onset. [4] [29] They usually resolve in seven to ten days, but some can last for up to three weeks. [7] The average duration of cough is eighteen days [30] and in some cases people develop a post-viral cough which can linger after the infection is gone. [31] In children, the cough lasts for more than ten days in 35–40% of cases and continues for more than 25 days in 10%. [32]

Causes

Viruses

Coronaviruses are a group of viruses known for causing the common cold. They have a halo or crown-like (corona) appearance when viewed under an electron microscope. Coronaviruses 004 lores.jpg
Coronaviruses are a group of viruses known for causing the common cold. They have a halo or crown-like (corona) appearance when viewed under an electron microscope.

The common cold is an infection of the upper respiratory tract which can be caused by many different viruses. The most commonly implicated is a rhinovirus (30–80%), a type of picornavirus with 99 known serotypes. [33] Other commonly implicated viruses include coronaviruses, adenoviruses, enteroviruses, parainfluenza and RSV. [34] Frequently more than one virus is present. [35] In total, more than 200 viral types are associated with colds. [4] The viral cause of some common colds (20–30%) is unknown. [34]

Transmission

The common cold virus is typically transmitted via airborne droplets, direct contact with infected nasal secretions, or fomites (contaminated objects). [8] [36] Which of these routes is of primary importance has not been determined. [37] As with all respiratory pathogens once presumed to transmit via respiratory droplets, it is highly likely to be carried by the aerosols generated during routine breathing, talking, and singing. [38] The viruses may survive for prolonged periods in the environment (over 18 hours for rhinoviruses) and can be picked up by people's hands and subsequently carried to their eyes or noses where infection occurs. [36] Transmission from animals is considered highly unlikely; an outbreak documented at a British scientific base on Adelaide Island after seventeen weeks of isolation was thought to have been caused by transmission from a contaminated object or an asymptomatic human carrier, rather than from the husky dogs which were also present at the base. [39]

Transmission is common in daycare and schools due to the proximity of many children with little immunity and poor hygiene. [40] These infections are then brought home to other members of the family. [40] There is no evidence that recirculated air during commercial flight is a method of transmission. [36] People sitting close to each other appear to be at greater risk of infection. [37]

Other

Herd immunity, generated from previous exposure to cold viruses, plays an important role in limiting viral spread, as seen with younger populations that have greater rates of respiratory infections. [41] Poor immune function is a risk factor for disease. [41] [42] Insufficient sleep and malnutrition have been associated with a greater risk of developing infection following rhinovirus exposure; this is believed to be due to their effects on immune function. [43] [44] Breast feeding decreases the risk of acute otitis media and lower respiratory tract infections among other diseases, [45] and it is recommended that breast feeding be continued when an infant has a cold. [46] In the developed world breast feeding may not be protective against the common cold in and of itself. [47]

Pathophysiology

The common cold is a disease of the upper respiratory tract. Illu conducting passages.svg
The common cold is a disease of the upper respiratory tract.

The symptoms of the common cold are believed to be primarily related to the immune response to the virus. [15] The mechanism of this immune response is virus-specific. For example, the rhinovirus is typically acquired by direct contact; it binds to humans via ICAM-1 receptors and the CDHR3 receptor through unknown mechanisms to trigger the release of inflammatory mediators. [15] These inflammatory mediators then produce the symptoms. [15] It does not generally cause damage to the nasal epithelium. [4] The respiratory syncytial virus (RSV), on the other hand, is contracted by direct contact and airborne droplets. It then replicates in the nose and throat before spreading to the lower respiratory tract. [48] RSV does cause epithelium damage. [48] Human parainfluenza virus typically results in inflammation of the nose, throat, and bronchi. [49] In young children, when it affects the trachea, it may produce the symptoms of croup, due to the small size of their airways. [49]

Diagnosis

The distinction between viral upper respiratory tract infections is loosely based on the location of symptoms, with the common cold affecting primarily the nose (rhinitis), throat (pharyngitis), and lungs (bronchitis). [8] There can be significant overlap, and more than one area can be affected. [8] Self-diagnosis is frequent. [4] Isolation of the viral agent involved is rarely performed, [50] and it is generally not possible to identify the virus type through symptoms. [4]

Prevention

The only useful ways to reduce the spread of cold viruses are physical and engineering measures [10] such as using correct hand washing technique, respirators, and improvement of indoor air. In the healthcare environment, gowns and disposable gloves are also used. [10] Droplet precautions cannot reliably protect against inhalation of common-cold-laden aerosols. Instead, airborne precautions such as respirators, ventilation, and HEPA/high MERV filters, are the only reliable protection against cold-laden aerosols. [38] Isolation or quarantine is not used as the disease is so widespread and symptoms are non-specific. There is no vaccine to protect against the common cold. [51] Vaccination has proven difficult as there are so many viruses involved and because they mutate rapidly. [10] [52] Creation of a broadly effective vaccine is, therefore, highly improbable. [53]

Regular hand washing appears to be effective in reducing the transmission of cold viruses, especially among children. [54] Whether the addition of antivirals or antibacterials to normal hand washing provides greater benefit is unknown. [54] Wearing face masks when around people who are infected may be beneficial; however, there is insufficient evidence for maintaining a greater social distance. [54]

It is unclear whether zinc supplements affect the likelihood of contracting a cold. [55]

Management

Poster from 1937 encouraging citizens to "consult your physician" for treatment of the common cold Pneumonia strikes like a man eating shark.jpg
Poster from 1937 encouraging citizens to "consult your physician" for treatment of the common cold

Treatments of the common cold primarily involve medications and other therapies for symptomatic relief. [13] Getting plenty of rest, drinking fluids to maintain hydration, and gargling with warm salt water are reasonable conservative measures. [56] Much of the benefit from symptomatic treatment is, however, attributed to the placebo effect. [57] As of 2010, no medications or herbal remedies had been conclusively demonstrated to shorten the duration of infection. [58]

Symptomatic

Various treatments for the common cold - liquid and pill cold medicine, tea, throat lozenges, and over-the-counter decongestants. Treatments for the Common Cold (37652567755).jpg
Various treatments for the common cold - liquid and pill cold medicine, tea, throat lozenges, and over-the-counter decongestants.

Treatments that may help with symptoms include pain medication and medications for fevers such as ibuprofen [12] and acetaminophen (paracetamol). [59] However, it is not clear whether acetaminophen helps with symptoms. [60] It is not known if over-the-counter cough medications are effective for treating an acute cough. [61] Cough medicines are not recommended for use in children due to a lack of evidence supporting effectiveness and the potential for harm. [62] [63] In 2009, Canada restricted the use of over-the-counter cough and cold medication in children six years and under due to concerns regarding risks and unproven benefits. [62] The misuse of dextromethorphan (an over-the-counter cough medicine) has led to its ban in a number of countries. [64] Intranasal corticosteroids have not been found to be useful. [65]

In adults, short term use of nasal decongestants may have a small benefit. [66] Antihistamines may improve symptoms in the first day or two; however, there is no longer-term benefit and they have adverse effects such as drowsiness. [67] Other decongestants such as pseudoephedrine appear effective in adults. [68] [66] Combined oral analgesics, antihistaminics, and decongestants are generally effective for older children and adults. [69] Ipratropium nasal spray may reduce the symptoms of a runny nose but has little effect on stuffiness. [70] Ipratropium may also help with coughs in adults. [71] The safety and effectiveness of nasal decongestant use in children is unclear. [66]

Due to lack of studies, it is not known whether increased fluid intake improves symptoms or shortens respiratory illness. [72] As of 2017, heated and humidified air, such as via RhinoTherm, is of unclear benefit. [73] One study has found chest vapor rub to provide some relief of nocturnal cough, congestion, and sleep difficulty. [74]

Some experts advise against physical exercise if there are symptoms such as fever, widespread muscle aches or fatigue. [75] [76] It is regarded as safe to perform moderate exercise if the symptoms are confined to the head, including runny nose, nasal congestion, sneezing, or a minor sore throat. [75] [76] There is a popular belief that having a hot drink can help with cold symptoms, but evidence to support this is very limited. [77]

Antibiotics and antivirals

Antibiotics have no effect against viral infections, including the common cold. [78] Due to their side effects, antibiotics cause overall harm but nevertheless are still frequently prescribed. [78] [79] Some of the reasons that antibiotics are so commonly prescribed include people's expectations for them, physicians' desire to help, and the difficulty in excluding complications that may be amenable to antibiotics. [80] There are no effective antiviral drugs for the common cold even though some preliminary research has shown benefits. [13] [81]

Zinc

Zinc supplements may shorten the duration of colds by up to 33% and reduce the severity of symptoms if supplementation begins within 24 hours of the onset of symptoms. [11] [55] [82] [83] [84] Some zinc remedies directly applied to the inside of the nose have led to the loss of the sense of smell. [11] [85] A 2017 review did not recommend the use of zinc for the common cold for various reasons; [20] whereas a 2017 and 2018 review both recommended the use of zinc, but also advocated further research on the topic. [82] [83]

Alternative medicine

While there are many alternative medicines and Chinese herbal medicines supposed to treat the common cold, there is insufficient scientific evidence to support their use. [13] [86] As of 2015, there is weak evidence to support nasal irrigation with saline. [87] There is no firm evidence that Echinacea products or garlic provide any meaningful benefit in treating or preventing colds. [88] [89]

Vitamins C and D

Vitamin C supplementation does not affect the incidence of the common cold, but may reduce its duration if taken on a regular basis. [90] There is no conclusive evidence that vitamin D supplementation is efficacious in the prevention or treatment of respiratory tract infections. [91]

Prognosis

The common cold is generally mild and self-limiting with most symptoms generally improving in a week. [8] In children, half of cases resolve in 10 days and 90% in 15 days. [92] Severe complications, if they occur, are usually in the very old, the very young, or those who are immunosuppressed. [21] Secondary bacterial infections may occur resulting in sinusitis, pharyngitis, or an ear infection. [93] It is estimated that sinusitis occurs in 8% and ear infection in 30% of cases. [94]

Epidemiology

The common cold is the most common human disease [21] and affects people all over the globe. [40] Adults typically have two to three infections annually, [8] and children may have six to ten colds a year (and up to twelve colds a year for school children). [13] Rates of symptomatic infections increase in the elderly due to declining immunity. [41]

Weather

A common misconception is that one can "catch a cold" merely through prolonged exposure to cold weather. [95] Although it is now known that colds are viral infections, the prevalence of many such viruses are indeed seasonal, occurring more frequently during cold weather. [96] The reason for the seasonality has not been conclusively determined. [97] Possible explanations may include cold temperature-induced changes in the respiratory system, [98] decreased immune response, [99] and low humidity causing an increase in viral transmission rates, perhaps due to dry air allowing small viral droplets to disperse farther and stay in the air longer. [100]

The apparent seasonality may also be due to social factors, such as people spending more time indoors near infected people, [98] and especially children at school. [40] [97] Although normal exposure to cold does not increase one's risk of infection, severe exposure leading to significant reduction of body temperature (hypothermia) may put one at a greater risk for the common cold: although controversial, the majority of evidence suggests that it may increase susceptibility to infection. [99]

History

A British poster from World War II describing the cost of the common cold The Cost Of The Common Cold & Influenza.jpg
A British poster from World War II describing the cost of the common cold

While the cause of the common cold was identified in the 1950s, the disease appears to have been with humanity since its early history. [22] Its symptoms and treatment are described in the Egyptian Ebers papyrus, the oldest existing medical text, written before the 16th century BCE. [102] The name "cold" came into use in the 16th century, due to the similarity between its symptoms and those of exposure to cold weather. [103]

In the United Kingdom, the Common Cold Unit (CCU) was set up by the Medical Research Council in 1946 and it was where the rhinovirus was discovered in 1956. [104] In the 1970s, the CCU demonstrated that treatment with interferon during the incubation phase of rhinovirus infection protects somewhat against the disease, [105] but no practical treatment could be developed. The unit was closed in 1989, two years after it completed research of zinc gluconate lozenges in the prevention and treatment of rhinovirus colds, the only successful treatment in the history of the unit. [106]

Research directions

Antivirals have been tested for effectiveness in the common cold; as of 2009, none had been both found effective and licensed for use. [81] There are trials of the anti-viral drug pleconaril which shows promise against picornaviruses as well as trials of BTA-798. [107] The oral form of pleconaril had safety issues and an aerosol form is being studied. [107] The genomes of all known human rhinovirus strains have been sequenced. [108]

Societal impact

The economic impact of the common cold is not well understood in much of the world. [94] In the United States, the common cold leads to 75–100 million physician visits annually at a conservative cost estimate of $7.7 billion per year. Americans spend $2.9 billion on over-the-counter drugs and another $400 million on prescription medicines for symptom relief. [109] More than one-third of people who saw a doctor received an antibiotic prescription, which has implications for antibiotic resistance. [109] An estimated 22–189 million school days are missed annually due to a cold. As a result, parents missed 126 million workdays to stay home to care for their children. When added to the 150 million workdays missed by employees who have a cold, the total economic impact of cold-related work loss exceeds $20 billion per year. [56] [109] This accounts for 40% of time lost from work in the United States. [110]

Related Research Articles

<span class="mw-page-title-main">Sinusitis</span> Inflammation of the inner lining of the sinuses

Sinusitis, also known as rhinosinusitis, is an inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include production of thick nasal mucus, nasal congestion, facial congestion, facial pain, facial pressure, loss of smell, or fever.

<span class="mw-page-title-main">Asthma</span> Long-term inflammatory disease of the airways of the lungs

Asthma is a common long-term inflammatory disease of the airways of the lungs. Asthma occurs when allergens, pollen, dust, or other particles, are inhaled into the lungs, causing the bronchioles to constrict and produce mucus, which then restricts oxygen flow to the alveoli. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath. These may occur a few times a day or a few times per week. Depending on the person, asthma symptoms may become worse at night or with exercise.

<span class="mw-page-title-main">Pneumonia</span> Inflammation of the alveoli of the lungs

Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severity of the condition is variable.

<span class="mw-page-title-main">Rhinovirus</span> Genus of viruses (Enterovirus)

The rhinovirus is a positive-sense, single-stranded RNA virus belonging to the genus Enterovirus in the family Picornaviridae. Rhinovirus is the most common viral infectious agent in humans and is the predominant cause of the common cold.

<span class="mw-page-title-main">Cough</span> Sudden expulsion of air from the lungs as a reflex to clear irritants

A cough is a sudden expulsion of air through the large breathing passages which can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three phases: an inhalation, a forced exhalation against a closed glottis, and a violent release of air from the lungs following opening of the glottis, usually accompanied by a distinctive sound.

<span class="mw-page-title-main">Otitis media</span> Inflammation of the middle ear

Otitis media is a group of inflammatory diseases of the middle ear. One of the two main types is acute otitis media (AOM), an infection of rapid onset that usually presents with ear pain. In young children this may result in pulling at the ear, increased crying, and poor sleep. Decreased eating and a fever may also be present. The other main type is otitis media with effusion (OME), typically not associated with symptoms, although occasionally a feeling of fullness is described; it is defined as the presence of non-infectious fluid in the middle ear which may persist for weeks or months often after an episode of acute otitis media. Chronic suppurative otitis media (CSOM) is middle ear inflammation that results in a perforated tympanic membrane with discharge from the ear for more than six weeks. It may be a complication of acute otitis media. Pain is rarely present. All three types of otitis media may be associated with hearing loss. If children with hearing loss due to OME do not learn sign language, it may affect their ability to learn.

<span class="mw-page-title-main">Pharyngitis</span> Inflammation of the back of the throat

Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, difficulty swallowing, swollen lymph nodes, and a hoarse voice. Symptoms usually last 3–5 days, but can be longer depending on cause. Complications can include sinusitis and acute otitis media. Pharyngitis is a type of upper respiratory tract infection.

<span class="mw-page-title-main">Cold medicine</span> Medication taken to relieve cold symptoms

Cold medicines are a group of medications taken individually or in combination as a treatment for the symptoms of the common cold and similar conditions of the upper respiratory tract. The term encompasses a broad array of drugs, including analgesics, antihistamines and decongestants, among many others. It also includes drugs which are marketed as cough suppressants or antitussives, but their effectiveness in reducing cough symptoms is unclear or minimal.

<span class="mw-page-title-main">Acute bronchitis</span> Medical condition

Acute bronchitis, also known as a chest cold, is short-term bronchitis – inflammation of the bronchi of the lungs. The most common symptom is a cough. Other symptoms include coughing up mucus, wheezing, shortness of breath, fever, and chest discomfort. The infection may last from a few to ten days. The cough may persist for several weeks afterward with the total duration of symptoms usually around three weeks. Some have symptoms for up to six weeks.

<span class="mw-page-title-main">Sore throat</span> Pain of the throat

Sore throat, also known as throat pain, is pain or irritation of the throat. The majority of sore throats are caused by a virus, for which antibiotics are not helpful.

<span class="mw-page-title-main">Croup</span> Respiratory infection often caused by a virus

Croup, also known as croupy cough, is a type of respiratory infection that is usually caused by a virus. The infection leads to swelling inside the trachea, which interferes with normal breathing and produces the classic symptoms of "barking/brassy" cough, inspiratory stridor and a hoarse voice. Fever and runny nose may also be present. These symptoms may be mild, moderate, or severe. Often it starts or is worse at night and normally lasts one to two days.

<span class="mw-page-title-main">Bronchiolitis</span> Inflammation of the small airways in the lungs

Bronchiolitis is inflammation of the small airways also known as the bronchioles in the lungs. Acute bronchiolitis is caused by a viral infection, usually affecting children younger than two years of age. Symptoms may include fever, cough, runny nose or rhinorrhea, and wheezing. More severe cases may be associated with nasal flaring, grunting, or respiratory distress. If the child has not been able to feed properly due to the illness, signs of dehydration may be present.

<span class="mw-page-title-main">Respiratory syncytial virus</span> Species of virus

Respiratory syncytial virus (RSV), also called human respiratory syncytial virus (hRSV) and human orthopneumovirus, is a contagious virus that causes infections of the respiratory tract. It is a negative-sense, single-stranded RNA virus. Its name is derived from the large cells known as syncytia that form when infected cells fuse.

<span class="mw-page-title-main">Upper respiratory tract infection</span> Infection of the nose, sinuses, pharynx, larynx or trachea

An upper respiratory tract infection (URTI) is an illness caused by an acute infection, which involves the upper respiratory tract, including the nose, sinuses, pharynx, larynx or trachea. This commonly includes nasal obstruction, sore throat, tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, and the common cold. Most infections are viral in nature, and in other instances, the cause is bacterial. URTIs can also be fungal or helminthic in origin, but these are less common.

<span class="mw-page-title-main">Lower respiratory tract infection</span> Medical term

Lower respiratory tract infection (LRTI) is a term often used as a synonym for pneumonia but can also be applied to other types of infection including lung abscess and acute bronchitis. Symptoms include shortness of breath, weakness, fever, coughing and fatigue. A routine chest X-ray is not always necessary for people who have symptoms of a lower respiratory tract infection.

<span class="mw-page-title-main">Respiratory tract infection</span> Infectious disease affecting nose, throat and lungs

Respiratory tract infections (RTIs) are infectious diseases involving the lower or upper respiratory tract. An infection of this type usually is further classified as an upper respiratory tract infection or a lower respiratory tract infection. Lower respiratory infections, such as pneumonia, tend to be far more severe than upper respiratory infections, such as the common cold.

<span class="mw-page-title-main">Bronchitis</span> Inflammation of the large airways in the lungs

Bronchitis is inflammation of the bronchi in the lungs that causes coughing. Bronchitis usually begins as an infection in the nose, ears, throat, or sinuses. The infection then makes its way down to the bronchi. Symptoms include coughing up sputum, wheezing, shortness of breath, and chest pain. Bronchitis can be acute or chronic.

<span class="mw-page-title-main">Zinc and the common cold</span> Overview of the relationship between Zinc and the common cold

Zinc supplements are a group of dietary supplements that are commonly used in an attempt to treat the common cold. Evidence suggests that zinc does not prevent colds but may reduce their duration, with minimal or no impact on symptom severity. Adverse effects with zinc supplements by mouth include bad taste and nausea. The intranasal use of zinc-containing nasal sprays has been associated with the loss of the sense of smell; consequently, in June 2009, the United States Food and Drug Administration (USFDA) warned consumers to stop using intranasal zinc.

In clinical guidelines chronic cough is defined as a cough lasting more than 8 weeks in adults and more than 4 weeks in children. there are studies suggest that a chronic cough must persist upwards of three months. The prevalence of chronic cough is about 10% although the prevalence may differ depending on definition and geographic area. Chronic cough is a common symptom in several different respiratory diseases like COPD or pulmonary fibrosis but in non-smokers with a normal chest x-ray chronic cough are often associated with asthma, rhinosinusitis, and gastroesophageal reflux disease or could be idiopathic. Generally, a cough, for example after an upper respiratory tract infection, lasts around one to two weeks; however, chronic cough can persist for an extended period of time, several years in some cases. The current theory about the cause of chronic cough, independent of associated condition, is that it is caused by a hypersensitivity in the cough sensory nerves, called cough hypersensitivity syndrome. There are a number of treatments available, depending on the associated disease but the clinical management of the patients remains a challenge. Risk factors include exposure to cigarette smoke, and exposure to pollution, especially particulates.

References

Notes

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  4. 1 2 3 4 5 6 7 8 9 10 Eccles R (November 2005). "Understanding the symptoms of the common cold and influenza". The Lancet. Infectious Diseases. 5 (11): 718–25. doi:10.1016/S1473-3099(05)70270-X. PMC   7185637 . PMID   16253889.
  5. 1 2 Bennett JE, Dolin R, Blaser MJ (2014). Principles and Practice of Infectious Diseases. Elsevier Health Sciences. p. 750. ISBN   978-1-4557-4801-3. Archived from the original on 8 September 2017.
  6. 1 2 3 4 5 6 Allan GM, Arroll B (February 2014). "Prevention and treatment of the common cold: making sense of the evidence". CMAJ. 186 (3): 190–9. doi:10.1503/cmaj.121442. PMC   3928210 . PMID   24468694.
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  11. 1 2 3 4 "Zinc – Fact Sheet for Health Professionals". Office of Dietary Supplements, US National Institutes of Health. 10 July 2019. Archived from the original on 25 March 2021. Retrieved 27 December 2019. Although studies examining the effect of zinc treatment on cold symptoms have had somewhat conflicting results, overall zinc appears to be beneficial under certain circumstances.... In September of 2007, Caruso and colleagues published a structured review of the effects of zinc lozenges, nasal sprays, and nasal gels on the common cold [69]. Of the 14 randomized, placebo-controlled studies included, 7 (5 using zinc lozenges, 2 using a nasal gel) showed that the zinc treatment had a beneficial effect and 7 (5 using zinc lozenges, 1 using a nasal spray, and 1 using lozenges and a nasal spray) showed no effect. More recently, a Cochrane review concluded that "zinc (lozenges or syrup) is beneficial in reducing the duration and severity of the common cold in healthy people, when taken within 24 hours of onset of symptoms" [73]. The author of another review completed in 2004 also concluded that zinc can reduce the duration and severity of cold symptoms [68]. However, more research is needed to determine the optimal dosage, zinc formulation and duration of treatment before a general recommendation for zinc in the treatment of the common cold can be made [73]. As previously noted, the safety of intranasal zinc has been called into question because of numerous reports of anosmia (loss of smell), in some cases long-lasting or permanent, from the use of zinc-containing nasal gels or sprays [17–19].
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