Cold Season Primer

Cold symptoms can lead to uncertainty about treatment and progression. Read on for cold season coping strategies and guidelines for diagnosis and treatment.

By Diana Price

We’ve all heard the bad news: there is no cure for the common cold. But how do you know if you have a run-of-the-mill viral cold or something more serious? When should you seek medical attention? And what are the best treatments for the symptoms of a cold?

Defining A Cold

When we talk about a “common cold,” we’re talking about a virus (most often a rhinovirus), which triggers symptoms that may start with a sore throat and runny nose and can include coughing, sneez­ing, watery eyes, headaches, and body aches.1 These symptoms last about seven to 10 days, and most adults average two or three colds per year (children can have more).1 While the symptoms can be annoying and may result in a few missed days of work, most adults who come down with a cold will recover within that 10-day window.

Managing Symptoms

If you have a viral cold, there is no miracle remedy, but there are steps you can take to feel more comfortable. Wanda Filer, MD, MBA, FAAFP, president of the American Academy of Family Physicians, says the best approach is to treat symptoms and get ade­quate rest. Though the most effec­tive strategies will vary depend­ing on the severity of your various symptoms (see chart on page 46), maintaining adequate hydration should be a primary objective.

“Dehydration can come with a cold or flu because you’re con­gested, it hurts to swallow, or you’re stuck in bed,” Dr. Filer says. Though you may think that because you’re not active you’re not in need of as much water, the opposite is true. Symptoms of a cold can result in “insensible losses” of fluid, Dr. Filer says: “When you’re sick with a low-grade fever, you perspire more; when you’re congested you breathe faster and lose fluid by more rapid in­spiration and expiration; when you’re sick you lose fluid more rapidly than is typical.”

Maintaining hydration in these cases is important be­cause it helps move mucus through your sinuses and chest, allowing you to clear the con­gestion and avoid more-serious infection. To help ensure that you are getting enough liquid, Dr. Filer advises, “Keep an eye on your urine; if it’s dark yel­low, you’re dehydrated.” Clear liquids (water and tea) are ideal, she adds, though sports drinks can also be helpful.

Hydration and rest are im­portant steps regardless of your symptoms, as is patience, Dr. Filer says. A cold can last as long as 10 days, and a cough from a cold can linger longer—up to several weeks. Ultimately, she says, “there is no magic answer—time is the treat­ment for most common viral cold symptoms.”

To See The MD Or Not To See The MD, That Is The Question

There is no doubt that a nasty cold can lay you low, and we’ve all had that moment of wondering if what started as a cold has progressed to something that requires a visit to the doctor. Dr. Filer says that, as a general rule, if you’ve been sick for less than two weeks, your fever has remained below 102 degrees, and you haven’t developed shortness of breath or severe body aches, manag­ing your symptoms and getting rest is likely a good call.

If, however, you develop a high fe­ver, significant aches, or very local­ized sinus or headache symptoms, a call or visit to your provider is a good idea. And if you have a com­promised immune system or any existing chronic condition, such as asthma or chronic obstructive pul­monary disease, it is always better to play it safe and seek medical care at the onset of symptoms.

Cold Versus Flu

In some cases, symptoms that you might initially think are related to a cold may actually be the begin­ning stages of an influenza virus, or the flu. The difference in symp­toms, Dr. Filer says, is the severity: “If you’re running a fever higher than 102 degrees, accompanied by intense body aches (especially in the back, arms, and legs) and sig­nificant discomfort in your chest (influenza is a lung infection), you may have flu.”

The key to treating the flu, Dr. Filer says, is getting to the doctor early on in the progression of the illness—ideally within the first 48 hours. “There are anti-flu medi­cations,” she says, “but the faster we can see you, the better, as they really need to be delivered within the first 48 to 72 hours.”

The most effective strategy to avoid being hit by the flu is to get a flu shot—a dose of flu vaccine. While it’s ideal to get a flu shot early on in the fall when the vac­cine first becomes available, Dr. Filer notes that it’s never too late in flu season to get the vaccine.


 

Cold Medicine Is Not Recommended For Young Children

It is hard to see your child come down with cold symptoms. Stuffy nose, cough, sore throat—all symp­toms we know are uncomfortable and get in the way of kids’ school schedules and activities. But while it may make a parent feel better to offer up fruity cough syrup or similar over-the-counter med­ications, Dr. Filer says that consensus among physi­cians is that the potentially harmful side effects of these medications, which are often overdosed by parents wanting to alleviate their children’s discom­fort, outweigh their benefit.

“There is no evidence to show that over-the-counter cough and cold medicines are good for kids; in fact, there’s advice against giving kids these medicines,” she says. “We generally don’t recom­mend them for children.”


 

Antibiotics Will Not Cure A Cold

Antibiotics are not an effective treatment for a cold virus. “The majority of head colds are viruses, and we know that antibiotics do not work on viruses,” Dr. Filer says. Antibiotics treat bacterial infections, which can develop as secondary infections in the wake of a cold but are not the same.

Dr. Filer says that often a red flag in determining whether a cold has become a bacterial infec­tion is “double sickening”—when you feel your health was actually improving but are then hit hard again by worsening symptoms. “That sequence tells me you may have moved from a viral infection to a secondary bacterial infection,” she says. In that case, antibiotics may be prescribed after a thor­ough examination and, sometimes, lab tests to confirm the bacterial diagnosis.


 

Cold and Flu Symptom Tracker 

Symptom Symptom Management Stay Home And Seek Medical Care Take Note
Cough
  • Hydration—ideally clear liquids
  • Rest
  • Over-the-counter medications can suppress a cough. Dr. Filer encourages consumers to read the labels; don’t take medications for symptoms you don’t have. The following “active ingredients” can be effective:
    • Guaifenesin is an expectorant (Mucinex®, Robitussin®); it loosens cough, breaks up mucus, and is not sedating, so it is a good option if you have to work or drive.
    • Dextromethorphan is a cough suppressant (Mucinex DM, Robitussin DM); it is nonprescription but is sold behind the counter because it can be sedating and there is some abuse potential.

If you are not sure which medication is best, ask for a recommendation from a pharmacist or your doctor.

  • Fever higher than 102 degrees that lasts more than 48 hours
  • Shortness of breath
  • If you have an underlying chronic condition, such as chronic obstructive pulmonary disease, emphysema, or cancer
  • Cover your cough, either with your upper arm (not your hand) or with a tissue.
  • Wash your hands frequently, especially after coughing or blowing your nose.
Congestion
  • Hydration—ideally clear liquids
  • Rest
  • Neti Pot—a container designed to rinse mucus from your nasal passages
  • Over-the-counter medication:
    • Pseudoephedrine is a decongestant, or drying agent (Afrinol®, Sudafed®); it can raise blood pressure or make people feel hyper.
  • Severe, one-sided headache
  • Mucus that isn’t moving at all
  • Very tender in localized, specific sinus area
Sore Throat
  • Hydration—ideally clear liquids
  • Rest
  • Over-the-counter medications:
    • Acetaminophen (Tylenol®)
    • Ibuprofen (Advil®)
  • Severe sore throat, with fever, swollen glands, and bright red or white puss in the back of the throat, which might indicate strep
Fever
  • Over-the-counter medications:
    • Acetaminophen (Tylenol) for aches and pains (sore throat, earache, low grade fever)
    • Ibuprofen: (Advil)
  • Higher than 102 degrees

 

Reference

  1. Common Colds: Protect Yourself and Oth­ers. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/Fea­tures/Rhinoviruses/index.html. Accessed Oc­tober 16, 2015.