Most Americans will encounter 4-6 upper respiratory tract infections per year. 98% of these infections will resolve in 7-10 days without antibiotic management. A typical cold begins with symptoms of itching, sneezing and watery drainage. Fever and malaise are possible. After 3 or 4 days, the watery nasal drainage becomes thicker and often discolored. It begins to drain down the back of the throat and often results in a cough. The cough may linger beyond a week, even after the nasal symptoms have resolved. Antibiotic therapy may be prescribed by your physician if you have symptoms extending beyond a week, if symptoms are severe, or if you have a compromised immune system.
Influenza is a special type of cold that can result in severe, life-threatening pneumonia. Influenza kills more adults each year than HIV/AIDS. The 2009 outbreak of H1N1 influenza was particularly frightening because of the incidence of death among previously healthy school age children. Fortunately, the aggressive intervention of the Virginia department of health, in cooperation with local vaccination sites such as Richmond ENT, succeeded in an historic vaccination program that greatly limited the spread of this epidemic – saving thousands of lives. If your cold should attack suddenly, with high fever, chills and aching, go directly to your family doctor or urgent care center. A quick screen and appropriate diagnosis can lead to prompt antiviral treatment that shortens the course and severity of your illness.
Remedies for the Common Cold
While none of the antiviral medications to date have proven effective in ordinary common colds, there are several fundamental treatments that are available at home and over-the-counter to reduce your symptoms while you are ill. Many of the treatments described below are available in combination form. Symptoms will occur at different times during your illness and you may wish to have several individual medications available rather than one combination treatment that is designed for symptoms that may not be present at this time.
1. Rest, fluids, and good nutrition are critical to maintaining maximum immune function in combating any medical illness. Although there is limited evidence supporting the use of large doses of vitamins, it is very clear that vitamin and other nutritional deficiencies can significantly impair immune function.
2. Antihistamines are most commonly indicated for patients with allergies. These medications tend to dry nasal secretions and may suppress itching and sneezing during the first few days of upper respiratory tract infections. There are several brands available on the market. Loratadine (Claritin), cetirizine (Zyrtec) and fexofenadine (Allegra) are less sedating than the older generic antihistamines such as Benadryl.
3. Decongestants open the nasal passages so that you can breathe more freely and secretions can drain more easily. Topical decongestants like Afrin (oxymetazoline) and Neo-Synephrine (phenylephrine) have a risk of rebound nasal congestion. They can become habit forming if used for longer than five days. Sudafed (pseudoephedrine) is an oral decongestant that has less rebound potential, but does have a higher potential to raise blood pressure or cause urinary retention.
4. Guaifenesin (Mucinex and Robitussin) is an expectorant used to promote increased nasal secretions. This will loosen thick nasal or bronchial secretions and allow better drainage. Guaifenesin is only effective if you drink adequate water, usually at least two glasses of water with every meal. Mucinex and Robitussin are commonly combined with other symptomatic products, such as cough suppressants, decongestants and antihistamines.
5. Non-medicated nasal saline is available over-the-counter or can be mixed at home by adding one-half teaspoon of salt and one-half teaspoon of baking soda to 8 ounces of warm water. This may be sniffed or sprayed into the nose using a Netti Pot, Sinus Rinse bottle, or even a Water-Pik with a Grossan adaptor, or to dissolve and wash away germs and thickened sections. Nasal saline spray may be used liberally regardless of other medical conditions. It is simply good hygiene to wash your nose out when you are sick.
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6. Cough suppressants usually contain dextromethorphan or another mild narcotic. Common brands include Robitussin, Mucinex, Nyquil, Delsym and others. These are not habit forming unless used in high doses for extended periods of time. Intentional overdosing with these medication can be dangerous. Prolonged coughing could be an indication of a serious medical disorder. Coughing that persists for longer than two weeks should always be evaluated by a physician.
7. Analgesics such as acetaminophen, ibuprofen and naproxen can greatly reduce the aches and pains of a respiratory tract infection, reduce fever and enhance a general sense of wellness. Some of these are combined with caffeine as an additional stimulant.
Although these drugs are very useful for helping you to get going and accomplish what needs to be done during the day, plenty of rest, fluids and good nutrition will strengthen your immune system more than any of these other symptomatic medications. If your symptoms are getting worse after a week, or are not improving after ten days, please consult your physician for possible sinusitis. If you have sudden onset of fever over 101°F, shortness of breath or severe aches and pains, go directly to your doctor or to an urgent care facility – it may be influenza.