Common cold: Difference between revisions
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{{DiseaseDisorder infobox |
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| Name = Common cold |
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| Image = Rhinovirus.PNG |
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| Caption = [[Rhinovirus]]es cause most common colds |
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| ICD10 = {{ICD10|J|00|0|j|00}} |
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| ICD9 = {{ICD9|460}} |
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| DiseasesDB = 31088 |
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| MedlinePlus = 000678 |
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| eMedicineSubj = aaem |
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| eMedicineTopic = 118 |
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| eMedicine_mult = {{eMedicine2|med|2339}} |
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| MeshID = D003139 |
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}} |
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'''Acute viral rhinopharyngitis,''' or '''acute coryza''', usually known as the '''common cold''', is a highly contagious, [[virus (biology)|viral]] [[infectious disease]] of the upper [[respiratory system]], primarily caused by [[picornavirus]]es (including [[rhinovirus]]es) or [[coronavirus]]es. |
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Common symptoms are [[Pharyngitis|sore throat]], [[rhinitis|runny nose]], [[nasal congestion]], [[sneeze|sneezing]] and [[cough]]ing; sometimes accompanied by [[conjunctivitis|'pink eye']], [[myalgia|muscle aches]], [[fatigue (medical)|fatigue]], [[malaise]], [[headache]]s, [[muscle weakness]], uncontrollable [[shivering]], and [[Anorexia (symptom)|loss of appetite]]. [[Fever]] and extreme [[fatigue (medical)|exhaustion]] are rare during a cold and are more usual in [[influenza]]. The symptoms of a cold usually resolve after about one week, but can last up to two. Symptoms may be more severe in infants and young children. Although the disease is generally mild and self-limiting, patients with common colds often seek professional medical help, use [[over-the-counter drug]]s, and may miss school or work days. The annual cumulative societal cost of the common cold in developed countries is considerable in terms of money spent on remedies, and hours of lost productivity. |
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There are no [[antiviral]] drugs approved to treat or cure the infection; all medications used are [[palliative care|palliative]] and treat symptoms only. Though some alternative treatments such as [[Vitamin C megadosage]], [[echinacea]], and [[zinc]] have been proposed, none of them have been shown to decrease the duration of the illness, and thus none of them are approved by the [[Food and Drug Administration]] or [[European Medicines Agency]]. To prevent infection, washing or disinfecting hands has been found effective, as this minimizes person-to-person transmission of the virus. |
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{{TOClimit|limit=3}} |
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==Symptoms== |
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After initial infection, the viral replication cycle begins within 8 to 12 hours.<ref name="coldorg">{{cite web | author = Gwaltney, JM, Hayden, FG | title = Understanding Colds |year=2006 | url = http://www.commoncold.org/index.htm | accessdate = 2007-07-03}}</ref> Symptoms can occur shortly thereafter, and usually begin within 2 to 5 days after infection, although occasionally in as little as 10 hours after infection.<ref>{{cite web | author = Patsy Hamilton | url = http://www.healthguidance.org/entry/6125/1/Facts-about-the-Common-Cold-Incubation-Period.html |title=Facts about the Common Cold Incubation Period | accessdate = 2007-07-03}}</ref> The first indication of a cold is often a [[Pharyngitis|sore or scratchy throat]]. Other common symptoms are [[rhinorrhea|runny nose]], [[Nasal congestion|congestion]], [[sneeze|sneezing]] and [[cough]]. These are sometimes accompanied by [[myalgia|muscle aches]], [[Fatigue (medical)|fatigue]], [[malaise]], [[headache]], [[Muscle weakness|weakness]], or [[anorexia (symptom)|loss of appetite]].<ref name="CCCentre">{{cite web | url = http://www.cardiff.ac.uk/biosi/subsites/cold/commoncold.html | title = Common Cold Centre | accessdate = 2007-09-06 |year=2006 | publisher = Cardiff University }}</ref> The symptoms usually resolve spontaneously in 7 to 10 days but some can last for up to three weeks.<ref name=Heik2003/> Symptoms may be more severe in infants, young children and tobacco users/smokers, and may include fever and [[urticaria|hives]].<ref name="Nordenberg1999">{{cite web | last = Nordenberg | first = Tamar | title = Colds and Flu: Time Only Sure Cure | publisher = [[Food and Drug Administration]] |month=May | year=1999 | url = http://www.fda.gov/fdac/features/896_flu.html | accessdate = 2007-06-13}}</ref><ref name="NIAID2006">{{cite web | title = Common Cold | publisher = [[National Institute of Allergy and Infectious Diseases]] | date = [[2006-11-27]] | url = http://www3.niaid.nih.gov/healthscience/healthtopics/colds/ | accessdate = 2007-06-11}}</ref><ref name="ALA2005">{{cite web | title = A Survival Guide for Preventing and Treating Influenza and the Common Cold | publisher = [[American Lung Association]] |month=August | year=2005 | url = http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35873#done | accessdate = 2007-06-11}}</ref><ref name="HivesACAAI">{{cite web | url = http://www.acaai.org/public/advice/urtic.htm | title = Hives | accessdate = 2007-11-24 | publisher = [[American College of Allergy, Asthma & Immunology]]}}</ref><ref name=CLA>{{cite web | url = http://www.lung.ca/diseases-maladies/a-z/cold-rhume/index_e.php | title = Common Cold | publisher = Canadian Lung Association | date = [[2006-09-28]] | accessdate = 2007-07-16 }}</ref><ref name=CPS2>{{cite web | title = Colds in children | publisher = Canadian Pediatric Society |month=October | year=2005 | url = http://www.cps.ca/caringforkids/whensick/colds.htm | accessdate = 2007-07-16 }}</ref> |
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==Cause and susceptibility== |
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The common cold is most often caused by infection with one of the more than 100 [[serovar|serotypes]] of [[rhinovirus]], a type of [[picornavirus]]. Other viruses causing colds are [[coronavirus]], [[human parainfluenza viruses]], [[human respiratory syncytial virus]], [[Adenoviridae|adenoviruses]], [[enterovirus]]es, or [[metapneumovirus]].<ref name="Merck">{{cite web | title = Common Cold (Upper Respiratory Infection) | work = The Merck Manual Online | publisher = [[Merck & Co.]] |month=November | year=2005 | url = http://www.merck.com/mmpe/sec14/ch188/ch188c.html | accessdate = 2007-06-13}}</ref><ref name="CKS">{{cite web | author = CKS | year = 2007 | title = Common Cold (Topic Review) | publisher = Clinical Knowledge Summaries Service | url = http://www.cks.library.nhs.uk/common_cold/view_whole_topic_review | accessdate = 2007-07-21}}</ref> Due to the many different types of viruses and their tendency for continuous mutation, it is impossible to gain complete immunity to the common cold. |
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===Sleep=== |
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Lack of sleep has been associated with the common cold. Those who sleep less than 7 hours per night were three times more likely to develop an infection when exposed to a rhinovirus when compared to those who sleep more than 8 hours per night.<ref>{{cite journal |author=Cohen S, Doyle WJ, Alper CM, Janicki-Deverts D, Turner RB |title=Sleep habits and susceptibility to the common cold |journal=Arch. Intern. Med. |volume=169 |issue=1 |pages=62–7 |year=2009 |month=January |pmid=19139325 |doi=10.1001/archinternmed.2008.505 |url=}}</ref> |
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===Exposure to cold weather=== |
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[[Image:Snowstorm.jpg|thumb|Exposure to cold weather has not been proven to increase the likelihood of "catching" a cold]] |
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An ancient myth still common today claims that a cold can be "caught" by prolonged exposure to cold weather such as rain or winter conditions.<ref>Zuger, Abigail [http://query.nytimes.com/gst/fullpage.html?res=9D02E1DD163FF937A35750C0A9659C8B63 'You'll Catch Your Death!' An Old Wives' Tale? Well . . .] ''[[The New York Times]]'' (March 4, 2003). Retrieved on 12-17-08. </ref> Although common colds are seasonal, with more occurring during winter, experiments so far have failed to produce evidence that short-term exposure to cold weather or direct chilling increases susceptibility to infection, implying that the seasonal variation is instead due to a change in behaviors such as increased time spent indoors at close proximity to others.<ref name="NIAID2006"/><ref name="pmid13559211">{{cite journal | author = Dowling HF, Jackson GG, Spiesman IG, Inouye T | title = Transmission of the common cold to volunteers under controlled conditions. III. The effect of chilling of the subjects upon susceptibility | journal = American journal of hygiene | volume = 68 | issue = 1 | pages = 59–65 | year = 1958 | pmid = 13559211}}</ref><ref name="pmid12357708">{{cite journal | author = Eccles R | title = Acute cooling of the body surface and the common cold | journal = Rhinology | volume = 40 | issue = 3 | pages = 109–14 | year = 2002 | pmid = 12357708}}</ref><ref>{{cite journal | author = Douglas, R.G.Jr, K.M. Lindgren, and R.B. Couch | title = Exposure to cold environment and rhinovirus common cold. Failure to demonstrate effect | journal = New Engl. J. Med | volume = 279 | year = 1968}}<!-- Please confirm, was the follow ref the correct one?--></ref><ref>{{cite journal |author=Douglas RC, Couch RB, Lindgren KM |title=Cold doesn't affect the "common cold" in study of rhinovirus infections |journal=JAMA |volume=199 |issue=7 |pages=29–30 |year=1967 |pmid=4289651 |doi= 10.1001/jama.199.7.29|url=}}</ref> |
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With respect to the causation of cold-like ''symptoms'', researchers at the Common Cold Centre at [[Cardiff University]]<ref name="CCCentre"/> conducted a study to "test the hypothesis that acute cooling of the feet causes the onset of common cold symptoms."<ref name="pmid16286463">{{cite journal | author = Johnson C, Eccles R | title = Acute cooling of the feet and the onset of common cold symptoms | journal = Family Practice | volume = 22 | issue = 6 | pages = 608–13 | year = 2005 | pmid = 16286463 | doi = 10.1093/fampra/cmi072 | url = http://fampra.oxfordjournals.org/cgi/content/full/22/6/608}}</ref><ref>[http://news.bbc.co.uk/2/hi/uk_news/wales/4433496.stm ''Mothers 'were right' over colds''], [[BBC News]], 14 November 2005</ref><ref>[http://www.medpagetoday.com/Pulmonary/URIstheFlu/tb/2136 ''Cold Feet? Aah-Choo!''], Michael Smith, Medical News: Flu & URI, Medpagetoday, November 14, 2005</ref> The study measured the subjects' self-reported cold symptoms, and belief they had a cold, but not whether an actual respiratory infection developed. It found that a significantly greater number of those subjects chilled developed cold symptoms 4 or 5 days after the chilling. It concludes that the onset of common cold ''symptoms'' can be caused by acute chilling of the feet. Some possible explanations were suggested for the symptoms, such as placebo, or constriction of blood vessels of the nasal passages which might lead to reduced immunity, however "further studies are needed to determine the relationship of symptom generation to any respiratory infection." |
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Another possibility which remains to be explored involves the role that proteins of the complement system play in the prevention of a sustained infection. Decreased temperature may result in a drop in tissue permeability and, as a result, may lead to reduced plasma leakage. Among the many proteins suspended in plasma are complement proteins (e.g. C3) which serve to disable, destroy, or tag for destruction foreign particulate (in this case viral [[capsid]]s). Thus, sustained exposure to cold may inhibit the effectiveness of the complement system and allow the virus a better chance of establishing a state of infection. |
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==Pathophysiology== |
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[[Image:Illu conducting passages.jpg|thumb|The common cold is a disease of the [[upper respiratory tract]]]] |
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The common cold virus is transmitted between people by one of two mechanisms: |
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Mainly from contact with the saliva or nasal secretions of an infected person, either directly in [[aerosol]] form generated by coughing and sneezing, or from contaminated surfaces.<ref>{{citation | url = http://www.nytimes.com/2007/12/05/health/research/05flu.html | title = Study Shows Why the Flu Likes Winter | author = Gina Kolata | date = December 5, 2007 | publisher = New York Times}}</ref> |
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Symptoms are not necessary for viral shedding or transmission, as a percentage of asymptomatic subjects exhibit viruses in nasal swabs.<ref name=gsacc>{{cite web | url=http://dh.sa.gov.au/pehs/Youve-got-what/ygw-common-cold.pdf |type = pdf | title=Common Cold | publisher=Department of Health, Government of South Australia | year=2005 | accessdate=2007-06-20|format=PDF}}</ref> |
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The major entry point for the virus is normally the nose, but can also be the eyes (in this case drainage into the [[nasopharynx]] would occur through the [[nasolacrimal duct]]). From there, it is transported to the back of the nose and the [[adenoid]] area. The virus then attaches to a receptor, [[ICAM-1]], which is located on the surface of [[cell (biology)|cells]] of the lining of the nasopharynx. The receptor fits into a docking port on the surface of the virus. Large amounts of virus receptor are present on cells of the adenoid. After attachment to the receptor, virus is taken into the cell, where it starts an infection. <ref name="coldorg">{{cite web | author = Gwaltney, JM, Hayden, FG | title = Understanding the Common Cold: How Cold Virus Infection Occurs |year=2007| url = http://www.commoncold.org/undrstn3.htm }}</ref> |
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==Complications== |
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The common cold can lead to [[Opportunistic infection|opportunistic]] [[coinfection]]s or [[superinfection]]s such as [[acute bronchitis]], [[bronchiolitis]], [[croup]], [[pneumonia]], [[sinusitis]], [[otitis media]], or [[strep throat]]. People with chronic lung diseases such as [[asthma]] and [[COPD]] are especially vulnerable. Colds may cause acute exacerbations of [[asthma]], [[emphysema]] or [[chronic bronchitis]].<ref name="coldorg"/><ref name="Merck"/><ref name="CKS"/> |
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==Treatment== |
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[[Image:Pneumonia strikes like a man eating shark.jpg|thumb|Poster encouraging citizens to "Consult your Physician" for treatment of the common cold]] |
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The common cold usually resolves spontaneously in 7 to 10 days but some symptoms can last for up to three weeks.<ref name=Heik2003>{{cite journal |author=Heikkinen T, Järvinen A |title=The common cold |journal=Lancet |volume=361 |issue=9351 |pages=51–9 |year=2003 |month=January |pmid=12517470 |doi=10.1016/S0140-6736(03)12162-9 |url=}}</ref> There are no medications or herbal remedies proven to shorten the duration of illness. Treatment often is given via symptomatic supportive options, maximizing the comfort of the patient, and limiting complications and harmful [[sequelae]]. |
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The common cold is self-limiting, and the host's [[immune system]] effectively deals with the infection. Within a few days, the body's [[humoral]] immune response begins producing specific [[antibodies]] that can prevent the virus from infecting cells. Additionally, as part of the cell-mediated immune response, [[leukocytes]] destroy the virus through [[phagocytosis]] and destroy infected cells to prevent further viral replication. In healthy, immunocompetent individuals, the common cold resolves in seven days on average.<ref name="coldorg"/> |
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===Conservative management=== |
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The [[National Institute of Allergy and Infectious Diseases]] suggests getting plenty of rest, drinking fluids to maintain hydration, [[gargling]] with warm salt water, using cough drops, throat sprays, or [[over-the-counter drug|over-the-counter]] pain or cold medicines.<ref name="NIAID2006"/> Saline nasal drops may help alleviate congestion.<ref name=PDRCC>{{cite web| title = Common Cold| work = PDRHealth| publisher = Thomson Healthcare| url = http://www.pdrhealth.com/disease/disease-mono.aspx?contentFileName=BHG01ID25.xml&contentName=Common+Cold&contentId=30| accessdate = 2007-07-11}}</ref> |
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Treatment that may help alleviate symptoms include: [[analgesics]], [[decongestants]], and [[cough suppressant]]s.{{Fact|date=February 2009}} |
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First-generation [[anti-histamine]]s such as [[brompheniramine]], [[chlorpheniramine]], [[diphenhydramine]] and [[clemastine]] (which reduce mucus gland secretion and thus combat blocked/runny noses but also may make the user drowsy). Second-generation anti-histamines do not have a useful effect on colds.<ref name=CPS1>{{cite web | title = Using over-the-counter drugs to treat cold symptoms | publisher = Canadian Pediatric Society | month = March | year = 2005 | url = http://www.cps.ca/caringforkids/whensick/otc_drugs.htm | accessdate = 2007-07-16 }}</ref> |
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===Antibiotics=== |
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[[Antibiotics]] only target [[bacteria]] and thus do not have any beneficial effect against the common cold. |
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===Antivirals=== |
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There are no approved [[antiviral drug]]s for the common cold. |
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[[ViroPharma]] and [[Schering-Plough]] are developing an antiviral drug, [[pleconaril]], that targets [[Picornaviridae|picornaviruses]], the viruses that cause the majority of common colds. [[Pleconaril]] has been shown to be effective in an [[Route of administration|oral]] form.<ref>{{cite journal| last = Pevear| first = Daniel C.| coauthors = Tina M. Tull, Martin E. Seipel, James M. Groarke| year = 1999| month = September| title = Activity of Pleconaril against Enteroviruses| journal = Antimicrobial Agents and Chemotherapy| volume = 43| issue = 9| pages = 2109–2115| url = http://aac.asm.org/cgi/content/full/43/9/2109| language =| pmid = 10471549| date = 1999-09-01}}</ref><ref>{{cite journal| quotes =| last = McConnell| first = J.| date = [[2 October]] [[1999]] | title = Enteroviruses succumb to new drug| journal = The Lancet | volume = 354 | issue = 9185 | pages = 1185 | doi = 10.1016/S0140-6736(05)75393-9}}</ref> |
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[[Schering-Plough]] is developing an [[Route of administration|intra-nasal]] formulation that may have fewer adverse effects.<ref name="CTgov">{{cite web| url = http://www.clinicaltrials.gov/ct/gui/show/NCT00394914| title = Effects of Pleconaril Nasal Spray on Common Cold Symptoms and Asthma Exacerbations Following Rhinovirus Exposure (Study P04295AM2)| month = March| year = 2007| accessdate = 2007-04-10| publisher = U.S. [[National Institutes of Health]]| work = ClinicalTrials.gov}}</ref> |
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===Alternative treatments=== |
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{{main|Alternative treatments used for the common cold}} |
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Many herbal remedies have been suggested to treat the common cold. None, however, has been shown to be effective.<ref name="ALA2005"/> |
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==Prevention== |
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The best way to avoid a cold is to avoid close contact with existing sufferers; to wash hands thoroughly and regularly; and to avoid touching the eyes, nose, mouth, and face. Anti-bacterial soaps have no effect on the cold virus; it is the mechanical action of hand washing with the soap that removes the virus particles.<ref>{{cite web |url=http://www.phac-aspc.gc.ca/chn-rcs/handwash-eng.php |title=Staying healthy is in your hands - Public Health Agency Canada |format= |work= |accessdate=2008-05-05|date=2008-04-17}}</ref> |
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In 2002, the [[Centers for Disease Control|Centers for Disease Control and Prevention]] recommended alcohol-based hand gels as an effective method for reducing infectious viruses on the hands of health care workers.<ref>{{cite journal |
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| last = Boyce |
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| first = John M. |
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| coauthors = Didier Pittet |
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| title = Guideline for Hand Hygiene in Health-Care Settings: Guideline for Hand Hygiene in Health-Care Settings Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force |
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| journal = [[Morbidity and Mortality Weekly Report]] |
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| date = [[2002-10-25]] |
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| volume = 51 |
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| issue = RR-16 |
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| url = http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf |
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| format = pdf |
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| pmid = 12418624 |
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| accessdate = 2007-06-21 |
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}}</ref> |
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As with hand washing with soap and water, alcohol gels provide no residual protection from re-infection. |
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The common cold is caused by a large variety of viruses, which mutate quite frequently during reproduction, resulting in constantly changing virus strains. Thus, successful [[immunization]] is highly improbable. |
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==Epidemiology== |
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Upper respiratory tract infections are the most common infectious diseases among adults and teens, who have two to four respiratory infections annually.<ref name="pmid4014285">{{cite journal | author = Garibaldi RA | title = Epidemiology of community-acquired respiratory tract infections in adults. Incidence, etiology, and impact | journal = Am. J. Med. | volume = 78 | issue = 6B | pages = 32–7 | year = 1985 | pmid = 4014285 | doi = 10.1016/0002-9343(85)90361-4}}</ref> Children may have six to ten colds a year (and up to 12 colds a year for school children).<ref name="NIAID2006"/><ref name="pmid17323712">{{cite journal | author = Simasek M, Blandino DA | title = Treatment of the common cold | journal = American family physician | volume = 75 | issue = 4 | pages = 515–20 | year = 2007 | pmid = 17323712 | url = http://www.aafp.org/afp/20070215/515.html | doi = 10.1002/14651858.CD000980.pub3<br | doi_brokendate = 2008-06-26}}</ref> In the United States, the incidence of colds is higher in the fall (autumn) and winter, with most infections occurring between September and April. The seasonality may be due to the start of the school year, or due to people spending more time indoors (thus in closer proximity with each other) increasing the chance of transmission of the virus.<ref name="NIAID2006"/> |
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==Economic cost== |
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[[Image:The Cost Of The Common Cold & Influenza.jpg|thumb|An [[United States|American]] poster from [[World War II]] describing the cost of the common cold]] |
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{{Globalize/USA}} |
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===United States=== |
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In the United States, the common cold leads to 75 to 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 symptomatic relief.<ref name="pmid4014285"/><ref name="pmid12588210">{{cite journal | author = Fendrick AM, Monto AS, Nightengale B, Sarnes M | title = The economic burden of non-influenza-related viral respiratory tract infection in the United States | journal = Arch. Intern. Med. | volume = 163 | issue = 4 | pages = 487–94 | year = 2003 | pmid = 12588210 | url = http://archinte.ama-assn.org/cgi/content/full/163/4/487 | doi = 10.1001/archinte.163.4.487}}</ref> |
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More than one-third of patients who saw a doctor received an antibiotic prescription, which has implications for antibiotic resistance from overuse of such drugs.<ref name="pmid12588210"/> |
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An estimated 22 to 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 suffering from a cold, the total economic impact of cold-related work loss exceeds $20 billion per year.<ref name="NIAID2006"/><ref name="pmid4014285"/><ref name="pmid12588210"/> |
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==History== |
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[[Image:Definition of a Cold by Benjamin Franklin Page 1.jpg|thumb|"Definition of a Cold." [[Benjamin Franklin]]'s notes for a paper he intended to write on the common cold.]] |
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The name "common cold" came into use in the 16th century, due to the similarity between its symptoms and those of exposure to cold weather.<ref>{{cite web | publisher=Online Etymology Dictionary | url=http://www.etymonline.com/index.php?term=cold | title=Cold | accessdate=2008-01-12 }}</ref> Norman Moore relates in his history of the Study of Medicine that [[James I of England|James I]] continually suffered from nasal colds, which were then thought to be caused by [[Polyp (medicine)|polypi]], [[sinus]] trouble, or [http://cancerweb.ncl.ac.uk/cgi-bin/omd?autotoxaemia autotoxaemia].<ref>{{cite journal | author = Wylie, A, | title = Rhinology and laryngology in literature and Folk-Lore | journal = The Journal of Laryngology & Otology | volume = 42 | issue = 2 | pages = 81–87 | year = 1927 | doi = 10.1017/S0022215100029959}}</ref> |
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In the 18th century, [[Benjamin Franklin]] considered the causes and prevention of the common cold. After several years of research he concluded: "People often catch cold from one another when shut up together in small close rooms, coaches, etc. and when sitting near and conversing so as to breathe in each other's transpiration." Although viruses had not yet been discovered, Franklin hypothesized that the common cold was passed between people through the air. He recommended exercise, bathing, and moderation in food and drink consumption to avoid the common cold.<ref>{{cite web | url = http://www.loc.gov/exhibits/treasures/franklin-scientist.html | title = Scientist and Inventor: Benjamin Franklin: In His Own Words... (AmericanTreasures of the Library of Congress) | accessdate = 2007-12-23}}</ref> Franklin's theory on the transmission of the cold was confirmed some 150 years later.<ref name="pmid14795755">{{cite journal | author = Andrewes CH, Lovelock JE, Sommerville T | title = An experiment on the transmission of colds | journal = Lancet | volume = 1 | issue = 1 | pages = 25–7 | year = 1951 | pmid = 14795755 | doi =10.1016/S0140-6736(51)93497-6 }}</ref> |
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===Common Cold Unit=== |
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{{main|Common Cold Unit}} |
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In the [[United Kingdom]], the [[Common Cold Unit]] was set up by the [[Medical Research Council (UK)|Medical Research Council]] in 1946. The unit worked with volunteers who were infected with various viruses.<ref>{{cite book | title = Das Buch der verrückten Experimente (Broschiert) | author = Reto U. Schneider | year = 2004 | isbn = 344215393X | url = http://www.verrueckte-experimente.de/index_e.html}}</ref> The [[rhinovirus]] was discovered there.<ref name="pmid2849371">{{cite journal |
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|author=Tyrrell DA |
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|title=Hot news on the common cold |
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|journal=Annu. Rev. Microbiol. |
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|volume=42 |
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|issue= |
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|pages=35–47 |
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|year=1988 |
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|pmid=2849371 |
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|doi=10.1146/annurev.mi.42.100188.000343 |
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}}</ref> In the late 1950s, researchers were able to grow one of these cold viruses in a [[tissue culture]], as it would not grow in fertilized chicken eggs, the method used for many other viruses. In the 1970s, the CCU demonstrated that treatment with [[interferon]] during the incubation phase of rhinovirus infection protects somewhat against the disease<ref name="pmid2438740">{{cite journal |
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|author=Tyrrell DA |
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|title=Interferons and their clinical value |
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|journal=Rev. Infect. Dis. |
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|volume=9 |
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|issue=2 |
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|pages=243–9 |
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|year=1987 |
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|pmid=2438740 |
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|doi= |
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}}</ref>, 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 prophylaxis and treatment of rhinovirus colds, the only successful treatment in the history of the unit.<ref>{{cite journal |
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| journal = J Antimicrob Chemother. |
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| year = 1987 |
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| month = December |
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| volume = 20 |
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| issue = 6 |
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| pages = 893–901 |
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| title = Prophylaxis and treatment of rhinovirus colds with zinc gluconate lozenges |
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| last = Al-Nakib |
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| first = W |
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| coauthors = Higgins PG, Barrow I, Batstone G, Tyrrell DA. |
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| pmid = 3440773 |
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| doi = 10.1093/jac/20.6.893 |
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}}</ref> |
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==See also== |
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* [[Vitamin C and the common cold]] |
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==References== |
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{{refs|3}} |
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{{Respiratory pathology}} |
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{{Viral diseases}} |
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{{Common Cold}} |
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[[Category:Sexually_transmitted_diseases_and_infections]] |
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[[Category:Viruses]] |
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[[Category:Viral diseases]] |
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[[Category:Inflammations|Nasopharyngitis]] |
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[[ar:زكام]] |
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[[ay:Thayjata]] |
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[[az:Zökəm]] |
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Revision as of 20:36, 9 March 2009
| Common cold | |
|---|---|
| Specialty | Family medicine, infectious diseases, otorhinolaryngology  |
Acute viral rhinopharyngitis, or acute coryza, usually known as the common cold, is a highly contagious, viral infectious disease of the upper respiratory system, primarily caused by picornaviruses (including rhinoviruses) or coronaviruses.
Common symptoms are sore throat, runny nose, nasal congestion, sneezing and coughing; sometimes accompanied by 'pink eye', muscle aches, fatigue, malaise, headaches, muscle weakness, uncontrollable shivering, and loss of appetite. Fever and extreme exhaustion are rare during a cold and are more usual in influenza. The symptoms of a cold usually resolve after about one week, but can last up to two. Symptoms may be more severe in infants and young children. Although the disease is generally mild and self-limiting, patients with common colds often seek professional medical help, use over-the-counter drugs, and may miss school or work days. The annual cumulative societal cost of the common cold in developed countries is considerable in terms of money spent on remedies, and hours of lost productivity.
There are no antiviral drugs approved to treat or cure the infection; all medications used are palliative and treat symptoms only. Though some alternative treatments such as Vitamin C megadosage, echinacea, and zinc have been proposed, none of them have been shown to decrease the duration of the illness, and thus none of them are approved by the Food and Drug Administration or European Medicines Agency. To prevent infection, washing or disinfecting hands has been found effective, as this minimizes person-to-person transmission of the virus.
Symptoms
After initial infection, the viral replication cycle begins within 8 to 12 hours.[1] Symptoms can occur shortly thereafter, and usually begin within 2 to 5 days after infection, although occasionally in as little as 10 hours after infection.[2] The first indication of a cold is often a sore or scratchy throat. Other common symptoms are runny nose, congestion, sneezing and cough. These are sometimes accompanied by muscle aches, fatigue, malaise, headache, weakness, or loss of appetite.[3] The symptoms usually resolve spontaneously in 7 to 10 days but some can last for up to three weeks.[4] Symptoms may be more severe in infants, young children and tobacco users/smokers, and may include fever and hives.[5][6][7][8][9][10]
Cause and susceptibility
The common cold is most often caused by infection with one of the more than 100 serotypes of rhinovirus, a type of picornavirus. Other viruses causing colds are coronavirus, human parainfluenza viruses, human respiratory syncytial virus, adenoviruses, enteroviruses, or metapneumovirus.[11][12] Due to the many different types of viruses and their tendency for continuous mutation, it is impossible to gain complete immunity to the common cold.
Sleep
Lack of sleep has been associated with the common cold. Those who sleep less than 7 hours per night were three times more likely to develop an infection when exposed to a rhinovirus when compared to those who sleep more than 8 hours per night.[13]
Exposure to cold weather
An ancient myth still common today claims that a cold can be "caught" by prolonged exposure to cold weather such as rain or winter conditions.[14] Although common colds are seasonal, with more occurring during winter, experiments so far have failed to produce evidence that short-term exposure to cold weather or direct chilling increases susceptibility to infection, implying that the seasonal variation is instead due to a change in behaviors such as increased time spent indoors at close proximity to others.[6][15][16][17][18]
With respect to the causation of cold-like symptoms, researchers at the Common Cold Centre at Cardiff University[3] conducted a study to "test the hypothesis that acute cooling of the feet causes the onset of common cold symptoms."[19][20][21] The study measured the subjects' self-reported cold symptoms, and belief they had a cold, but not whether an actual respiratory infection developed. It found that a significantly greater number of those subjects chilled developed cold symptoms 4 or 5 days after the chilling. It concludes that the onset of common cold symptoms can be caused by acute chilling of the feet. Some possible explanations were suggested for the symptoms, such as placebo, or constriction of blood vessels of the nasal passages which might lead to reduced immunity, however "further studies are needed to determine the relationship of symptom generation to any respiratory infection."
Another possibility which remains to be explored involves the role that proteins of the complement system play in the prevention of a sustained infection. Decreased temperature may result in a drop in tissue permeability and, as a result, may lead to reduced plasma leakage. Among the many proteins suspended in plasma are complement proteins (e.g. C3) which serve to disable, destroy, or tag for destruction foreign particulate (in this case viral capsids). Thus, sustained exposure to cold may inhibit the effectiveness of the complement system and allow the virus a better chance of establishing a state of infection.
Pathophysiology
The common cold virus is transmitted between people by one of two mechanisms: Mainly from contact with the saliva or nasal secretions of an infected person, either directly in aerosol form generated by coughing and sneezing, or from contaminated surfaces.[22]
Symptoms are not necessary for viral shedding or transmission, as a percentage of asymptomatic subjects exhibit viruses in nasal swabs.[23]
The major entry point for the virus is normally the nose, but can also be the eyes (in this case drainage into the nasopharynx would occur through the nasolacrimal duct). From there, it is transported to the back of the nose and the adenoid area. The virus then attaches to a receptor, ICAM-1, which is located on the surface of cells of the lining of the nasopharynx. The receptor fits into a docking port on the surface of the virus. Large amounts of virus receptor are present on cells of the adenoid. After attachment to the receptor, virus is taken into the cell, where it starts an infection. [1]
Complications
The common cold can lead to opportunistic coinfections or superinfections such as acute bronchitis, bronchiolitis, croup, pneumonia, sinusitis, otitis media, or strep throat. People with chronic lung diseases such as asthma and COPD are especially vulnerable. Colds may cause acute exacerbations of asthma, emphysema or chronic bronchitis.[1][11][12]
Treatment
The common cold usually resolves spontaneously in 7 to 10 days but some symptoms can last for up to three weeks.[4] There are no medications or herbal remedies proven to shorten the duration of illness. Treatment often is given via symptomatic supportive options, maximizing the comfort of the patient, and limiting complications and harmful sequelae.
The common cold is self-limiting, and the host's immune system effectively deals with the infection. Within a few days, the body's humoral immune response begins producing specific antibodies that can prevent the virus from infecting cells. Additionally, as part of the cell-mediated immune response, leukocytes destroy the virus through phagocytosis and destroy infected cells to prevent further viral replication. In healthy, immunocompetent individuals, the common cold resolves in seven days on average.[1]
Conservative management
The National Institute of Allergy and Infectious Diseases suggests getting plenty of rest, drinking fluids to maintain hydration, gargling with warm salt water, using cough drops, throat sprays, or over-the-counter pain or cold medicines.[6] Saline nasal drops may help alleviate congestion.[24]
Treatment that may help alleviate symptoms include: analgesics, decongestants, and cough suppressants.[citation needed]
First-generation anti-histamines such as brompheniramine, chlorpheniramine, diphenhydramine and clemastine (which reduce mucus gland secretion and thus combat blocked/runny noses but also may make the user drowsy). Second-generation anti-histamines do not have a useful effect on colds.[25]
Antibiotics
Antibiotics only target bacteria and thus do not have any beneficial effect against the common cold.
Antivirals
There are no approved antiviral drugs for the common cold.
ViroPharma and Schering-Plough are developing an antiviral drug, pleconaril, that targets picornaviruses, the viruses that cause the majority of common colds. Pleconaril has been shown to be effective in an oral form.[26][27] Schering-Plough is developing an intra-nasal formulation that may have fewer adverse effects.[28]
Alternative treatments
Many herbal remedies have been suggested to treat the common cold. None, however, has been shown to be effective.[7]
Prevention
The best way to avoid a cold is to avoid close contact with existing sufferers; to wash hands thoroughly and regularly; and to avoid touching the eyes, nose, mouth, and face. Anti-bacterial soaps have no effect on the cold virus; it is the mechanical action of hand washing with the soap that removes the virus particles.[29]
In 2002, the Centers for Disease Control and Prevention recommended alcohol-based hand gels as an effective method for reducing infectious viruses on the hands of health care workers.[30] As with hand washing with soap and water, alcohol gels provide no residual protection from re-infection.
The common cold is caused by a large variety of viruses, which mutate quite frequently during reproduction, resulting in constantly changing virus strains. Thus, successful immunization is highly improbable.
Epidemiology
Upper respiratory tract infections are the most common infectious diseases among adults and teens, who have two to four respiratory infections annually.[31] Children may have six to ten colds a year (and up to 12 colds a year for school children).[6][32] In the United States, the incidence of colds is higher in the fall (autumn) and winter, with most infections occurring between September and April. The seasonality may be due to the start of the school year, or due to people spending more time indoors (thus in closer proximity with each other) increasing the chance of transmission of the virus.[6]
Economic cost
United States
In the United States, the common cold leads to 75 to 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 symptomatic relief.[31][33]
More than one-third of patients who saw a doctor received an antibiotic prescription, which has implications for antibiotic resistance from overuse of such drugs.[33]
An estimated 22 to 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 suffering from a cold, the total economic impact of cold-related work loss exceeds $20 billion per year.[6][31][33]
History
The name "common cold" came into use in the 16th century, due to the similarity between its symptoms and those of exposure to cold weather.[34] Norman Moore relates in his history of the Study of Medicine that James I continually suffered from nasal colds, which were then thought to be caused by polypi, sinus trouble, or autotoxaemia.[35]
In the 18th century, Benjamin Franklin considered the causes and prevention of the common cold. After several years of research he concluded: "People often catch cold from one another when shut up together in small close rooms, coaches, etc. and when sitting near and conversing so as to breathe in each other's transpiration." Although viruses had not yet been discovered, Franklin hypothesized that the common cold was passed between people through the air. He recommended exercise, bathing, and moderation in food and drink consumption to avoid the common cold.[36] Franklin's theory on the transmission of the cold was confirmed some 150 years later.[37]
Common Cold Unit
In the United Kingdom, the Common Cold Unit was set up by the Medical Research Council in 1946. The unit worked with volunteers who were infected with various viruses.[38] The rhinovirus was discovered there.[39] In the late 1950s, researchers were able to grow one of these cold viruses in a tissue culture, as it would not grow in fertilized chicken eggs, the method used for many other viruses. In the 1970s, the CCU demonstrated that treatment with interferon during the incubation phase of rhinovirus infection protects somewhat against the disease[40], 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 prophylaxis and treatment of rhinovirus colds, the only successful treatment in the history of the unit.[41]
See also
References
- ^ a b c d Gwaltney, JM, Hayden, FG (2006). "Understanding Colds". Retrieved 2007-07-03.
{{cite web}}: CS1 maint: multiple names: authors list (link) Cite error: The named reference "coldorg" was defined multiple times with different content (see the help page). - ^ Patsy Hamilton. "Facts about the Common Cold Incubation Period". Retrieved 2007-07-03.
- ^ a b "Common Cold Centre". Cardiff University. 2006. Retrieved 2007-09-06.
- ^ a b Heikkinen T, Järvinen A (2003). "The common cold". Lancet. 361 (9351): 51–9. doi:10.1016/S0140-6736(03)12162-9. PMID 12517470.
{{cite journal}}: Unknown parameter|month=ignored (help) - ^ Nordenberg, Tamar (1999). "Colds and Flu: Time Only Sure Cure". Food and Drug Administration. Retrieved 2007-06-13.
{{cite web}}: Unknown parameter|month=ignored (help) - ^ a b c d e f "Common Cold". National Institute of Allergy and Infectious Diseases. 2006-11-27. Retrieved 2007-06-11.
{{cite web}}: Check date values in:|date=(help) - ^ a b "A Survival Guide for Preventing and Treating Influenza and the Common Cold". American Lung Association. 2005. Retrieved 2007-06-11.
{{cite web}}: Unknown parameter|month=ignored (help) - ^ "Hives". American College of Allergy, Asthma & Immunology. Retrieved 2007-11-24.
- ^ "Common Cold". Canadian Lung Association. 2006-09-28. Retrieved 2007-07-16.
{{cite web}}: Check date values in:|date=(help) - ^ "Colds in children". Canadian Pediatric Society. 2005. Retrieved 2007-07-16.
{{cite web}}: Unknown parameter|month=ignored (help) - ^ a b "Common Cold (Upper Respiratory Infection)". The Merck Manual Online. Merck & Co. 2005. Retrieved 2007-06-13.
{{cite web}}: Unknown parameter|month=ignored (help) - ^ a b CKS (2007). "Common Cold (Topic Review)". Clinical Knowledge Summaries Service. Retrieved 2007-07-21.
- ^ Cohen S, Doyle WJ, Alper CM, Janicki-Deverts D, Turner RB (2009). "Sleep habits and susceptibility to the common cold". Arch. Intern. Med. 169 (1): 62–7. doi:10.1001/archinternmed.2008.505. PMID 19139325.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ Zuger, Abigail 'You'll Catch Your Death!' An Old Wives' Tale? Well . . . The New York Times (March 4, 2003). Retrieved on 12-17-08.
- ^ Dowling HF, Jackson GG, Spiesman IG, Inouye T (1958). "Transmission of the common cold to volunteers under controlled conditions. III. The effect of chilling of the subjects upon susceptibility". American journal of hygiene. 68 (1): 59–65. PMID 13559211.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Eccles R (2002). "Acute cooling of the body surface and the common cold". Rhinology. 40 (3): 109–14. PMID 12357708.
- ^ Douglas, R.G.Jr, K.M. Lindgren, and R.B. Couch (1968). "Exposure to cold environment and rhinovirus common cold. Failure to demonstrate effect". New Engl. J. Med. 279.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Douglas RC, Couch RB, Lindgren KM (1967). "Cold doesn't affect the "common cold" in study of rhinovirus infections". JAMA. 199 (7): 29–30. doi:10.1001/jama.199.7.29. PMID 4289651.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Johnson C, Eccles R (2005). "Acute cooling of the feet and the onset of common cold symptoms". Family Practice. 22 (6): 608–13. doi:10.1093/fampra/cmi072. PMID 16286463.
- ^ Mothers 'were right' over colds, BBC News, 14 November 2005
- ^ Cold Feet? Aah-Choo!, Michael Smith, Medical News: Flu & URI, Medpagetoday, November 14, 2005
- ^ Gina Kolata (December 5, 2007), Study Shows Why the Flu Likes Winter, New York Times
- ^ "Common Cold" (PDF) (pdf). Department of Health, Government of South Australia. 2005. Retrieved 2007-06-20.
- ^ "Common Cold". PDRHealth. Thomson Healthcare. Retrieved 2007-07-11.
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{{cite web}}: Unknown parameter|month=ignored (help) - ^ Pevear, Daniel C. (1999-09-01). "Activity of Pleconaril against Enteroviruses". Antimicrobial Agents and Chemotherapy. 43 (9): 2109–2115. PMID 10471549.
{{cite journal}}: Unknown parameter|coauthors=ignored (|author=suggested) (help); Unknown parameter|month=ignored (help)CS1 maint: date and year (link) - ^ McConnell, J. (2 October 1999). "Enteroviruses succumb to new drug". The Lancet. 354 (9185): 1185. doi:10.1016/S0140-6736(05)75393-9.
{{cite journal}}: Check date values in:|date=(help); Cite has empty unknown parameter:|quotes=(help) - ^ "Effects of Pleconaril Nasal Spray on Common Cold Symptoms and Asthma Exacerbations Following Rhinovirus Exposure (Study P04295AM2)". ClinicalTrials.gov. U.S. National Institutes of Health. 2007. Retrieved 2007-04-10.
{{cite web}}: Unknown parameter|month=ignored (help) - ^ "Staying healthy is in your hands - Public Health Agency Canada". 2008-04-17. Retrieved 2008-05-05.
- ^ Boyce, John M. (2002-10-25). "Guideline for Hand Hygiene in Health-Care Settings: Guideline for Hand Hygiene in Health-Care Settings Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force" (pdf). Morbidity and Mortality Weekly Report. 51 (RR-16). PMID 12418624. Retrieved 2007-06-21.
{{cite journal}}: Check date values in:|date=(help); Unknown parameter|coauthors=ignored (|author=suggested) (help) - ^ a b c Garibaldi RA (1985). "Epidemiology of community-acquired respiratory tract infections in adults. Incidence, etiology, and impact". Am. J. Med. 78 (6B): 32–7. doi:10.1016/0002-9343(85)90361-4. PMID 4014285.
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{{cite journal}}: Unknown parameter|doi_brokendate=ignored (|doi-broken-date=suggested) (help) - ^ a b c Fendrick AM, Monto AS, Nightengale B, Sarnes M (2003). "The economic burden of non-influenza-related viral respiratory tract infection in the United States". Arch. Intern. Med. 163 (4): 487–94. doi:10.1001/archinte.163.4.487. PMID 12588210.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ "Cold". Online Etymology Dictionary. Retrieved 2008-01-12.
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{{cite journal}}: CS1 maint: extra punctuation (link) CS1 maint: multiple names: authors list (link) - ^ "Scientist and Inventor: Benjamin Franklin: In His Own Words... (AmericanTreasures of the Library of Congress)". Retrieved 2007-12-23.
- ^ Andrewes CH, Lovelock JE, Sommerville T (1951). "An experiment on the transmission of colds". Lancet. 1 (1): 25–7. doi:10.1016/S0140-6736(51)93497-6. PMID 14795755.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Reto U. Schneider (2004). Das Buch der verrückten Experimente (Broschiert). ISBN 344215393X.
- ^ Tyrrell DA (1988). "Hot news on the common cold". Annu. Rev. Microbiol. 42: 35–47. doi:10.1146/annurev.mi.42.100188.000343. PMID 2849371.
- ^ Tyrrell DA (1987). "Interferons and their clinical value". Rev. Infect. Dis. 9 (2): 243–9. PMID 2438740.
- ^ Al-Nakib, W (1987). "Prophylaxis and treatment of rhinovirus colds with zinc gluconate lozenges". J Antimicrob Chemother. 20 (6): 893–901. doi:10.1093/jac/20.6.893. PMID 3440773.
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