Common cold: treatment, infection, prognosis

A cold is an infection of the upper respiratory tract. The causes are different types of viruses. Typically, symptoms such as sore throat, colds, coughs or even fever occur. Here you can read about the differences between the flu and the common cold, how to protect yourself from infection and what you can do if you do catch it.

Brief overview

• Description: Infection of the upper respiratory tract (especially nose, throat, bronchi), caused by many different types of viruses
• Difference flu/cold: cold: creeping onset (sore throat, cold, cough, no or moderate fever), flu: rapid progression (higher fever, aching limbs, severe feeling of illness)
• Symptoms: Sore throat, cold, cough, possibly slight fever, limpness, headache
• Causes: numerous virus types, higher risk in dry air, cold, weakened immune system
• Treatment: Alleviation of symptoms by nose drops, antipyretic medication, cough suppressants, inhalation, sparing – causal treatment not possible,
• Prognosis: usually unproblematic course with a duration of about one week, sometimes complications and second infections (sinusitis, middle ear, pneumonia); especially in case of overexertion inflammation of the heart is possible

Cold: Description

A cold (flu-like infection) is an infection of the upper respiratory tract. Colds are caused by countless types of cold viruses, which are also constantly changing. They mainly affect the mucous membranes of the nose, throat and bronchi. A cold is very contagious and therefore frequent: school children get sick seven to ten times a year, adults about two to five times.

Colds usually begin with a scratchy throat and shivering, followed by a cold and cough. Sometimes a slight fever also occurs. In most cases a cold is harmless. After about one week it is usually over.

Flu and cold – the differences

A cold, also known as a flu-like infection, is confused by many with the flu. However, the real flu is caused by other types of viruses (influenza viruses) and is usually much more severe than a cold. It can be life-threatening for elderly, immunocompromised or chronically ill people.

The symptoms of flu and cold overlap partially. But there are also characteristic differences:

• Course: In the case of a cold, the symptoms often develop insidiously over several days. In the case of influenza, the symptoms usually set in very suddenly and with full force.
• Fever: When you have a cold, the temperature often remains normal or increases only slightly. Fever is rare. In case of flu, the temperature usually rises quickly to high fever above 39 degrees.
• Sniffles: A severe cold is typical especially for colds. Flu patients only get the flu sometimes.
• Coughing: A severe, agonizing, dry, irritable cough is common with influenza and can be very painful. Coughing often occurs later and is then less pronounced.
• Feeling ill: People with flu feel very ill very quickly. They suffer from loss of appetite, weakness and circulatory problems. In the case of a cold, the feeling of illness is usually less pronounced.
• Pain in the limbs: Pain in the limbs is much more severe in influenza than in a cold. Often muscle pain is added.
• Headaches: Headaches are also different for colds and flu. In case of a cold they are less strong and rather dull. Flu patients often suffer from severe headaches.
• Sweating and shivering: In general, sweating and shivering are less pronounced with a cold, and with influenza they accompany the fever.
• Length of illness: A cold is usually over after one week. In the case of influenza, it can sometimes take several weeks until the person affected has fully recovered.

Allergy or cold?

The symptoms of allergy and cold are often very similar. Even in the case of an allergy, sniffles, a stuffy nose or sneezing can occur. But there are differences.

• In the case of an allergy, the eyes are often irritated and sneezing fits occur more frequently.
• Cough, hoarseness and fever, on the other hand, indicate a cold.
• In addition, patients with an allergy often do not feel as ill as people with a cold.
• An allergic rhinitis occurs very quickly after contact with the trigger. When you have a cold, the symptoms develop insidiously.
• Unlike colds, allergies often occur preferentially in certain places or at certain times (hay fever outside and during pollen flight, house dust especially in the morning because of the allergens in bedding.

Cold: Symptoms

A cold usually begins with a scratchy throat, followed by a cold or a stuffy nose. From there, the viruses migrate down the respiratory tract via the throat and attack the mucous membranes of the bronchi. The pathogens can also enter the paranasal sinuses and cause sinusitis.

Common cold: symptoms in the early stages

Viruses that cause a cold usually enter the body through the mucous membranes of the nose or throat. That is why the first signs of a cold also appear here.

Sore throat

A sore throat is usually the first symptom of a cold. As a rule, they do not last longer than two to three days. If the sore throat persists beyond this period, it may be a bacterial inflammation of the pharyngeal tonsils (tonsillitis). You should then see a doctor. The first few days often show chills or headaches and aching limbs.

Sniffles and stuffy nose

Typical for a cold is an inflammation of the nasal mucous membranes (rhinitis). The nose swells up, is congested and may tickle or burn. Frequently, a cold is accompanied by symptoms such as a constant sneezing stimulus and a pain in the head caused by pressure. Clear-white, watery secretion only emerges when you blow your nose. Later it becomes more viscous. Yellowish to greenish mucus is mainly formed when bacteria are involved. These symptoms peak on the second day after the onset of the cold.

Nosebleed

Nosebleeds can occur in the course of a cold. A small blood vessel in the nose bursts. On the one hand, the nasal mucous membranes are irritated by the virus anyway. On the other hand, high pressure builds up in the nose during nose blowing.

Frequent nosebleeds can also indicate high blood pressure, abscesses or even malignant tumours of the nose. If you still suffer from frequently recurring nosebleeds even after a cold, you should have yourself examined by a doctor.

Diarrhoea and nausea

A slight nausea is normal with colds, the same applies to diarrhoea. However, if nausea and diarrhoea persist over a longer period of time when you have a cold, you should see a doctor. He may conduct further tests and prescribe antibiotics in case of a bacterial infection.

In order not to aggravate symptoms such as nausea and diarrhoea when you have a cold, you should avoid fatty foods or drinks (e.g. cocoa) and avoid caffeine and alcohol. It is best to drink tea, water and broth. You should rather eat dry foods such as bread, rice, jacket potatoes, rusks or rolls. Avoid yoghurt, ice cream or sweets if possible.

Cold: symptoms in the further course

In the further course of a cold, additional symptoms are added.

Weakness and feeling ill

Some patients develop a distinct feeling of illness when they have a cold. You feel listless and weak. However, the fatigue is usually less pronounced than with a real flu.

Fever

For some people, the common cold is accompanied by an increased temperature (from 37.5 degrees) or fever (from 38.1 degrees). Fever is a defensive reaction of the body to the infection. Tolerating a slight fever can promote the healing process. However, high fever tends to weaken, as the body consumes more oxygen and energy. You can alleviate it with antipyretic medication or calf compresses.

Limb and back pain

Pain in the limbs often accompanies the cold, which can also manifest itself in the form of back pain.

Severe back pain can also be caused by inflammation of the pleura (pleuritis) caused by a cold. If the back pain persists after the general cold symptoms have subsided, you should consult a doctor.

Cough

In the further course of the disease, a cold also causes symptoms such as dry cough or dry cough or even hoarseness. Usually they disappear again after a few days. If it lasts longer than two weeks, you should consult a doctor.

In order not to aggravate cold symptoms, you should definitely avoid tobacco and other irritants for the throat. The neck often reacts sensitively, even weeks after the cold.

Voice gone?

A small percentage of colds patients literally lose their voice during the course of the disease. This can be indicated by a scratchy and rough feeling in the throat. Usually, affected persons can only speak with effort, at some point even not at all.

If the voice actually disappears completely, this indicates an inflammation of the vocal folds and larynx (laryngitis). Further symptoms are then often a dry, nagging cough, extreme sore throat and high fever.

If your voice is completely absent when you have a cold, you should definitely consult a doctor. Untreated laryngitis can cause permanent damage to the vocal chords and larynx. Children in particular must then be treated quickly. With them a threatening pseudo croup can develop.

Cold sweats

Excessive sweating also occurs frequently when you have a cold. Most patents sweat especially at night. However, sweating can also occur very suddenly during the day, especially during physical activity.

Common cold dizziness

Dizziness is often accompanied by sweating when a cold occurs. Dizziness with a cold also occurs frequently when the cold is accompanied by inflammation of the middle or inner ear. However, dizziness can also indicate organ involvement, for example, pneumonia or heart muscle inflammation. Here a visit to a doctor is necessary. Treat your body to consistent protection. In this way you prevent such dangerous complications.

Pressure on the ears when you have a cold

The nasopharynx is connected to the middle ear via the so-called Eustachian tube. They can allow bacteria and viruses to enter the ear and cause an inflammation. The Eustachian tube is normally used to equalize pressure when speaking, coughing or sneezing. If you have pressure on your ears during a cold, the Eustachian tube is usually swollen and pressure equalisation is no longer possible. Flying with a cold can be very painful and even damage the ear, especially the eardrum.

Earache for colds

Earaches with a cold are rather unusual. If they do occur, viruses or bacteria (as part of a secondary infection) have migrated up from the mucous membranes in the nasopharynx.

A painful middle ear infection affects children and adolescents in particular. It is rather rare in adults. In some cases, pus accumulates in the middle ear, which makes the earache even worse. So if you suspect an inflammation of the middle ear, you should see your doctor. If the infection is not treated or treated incorrectly, the infection can spread further and even cause hearing damage.

Loss of smell and taste with colds

No taste? This phenomenon is not uncommon with colds. The reason is usually a stuffy, irritated nose – because the aromas from eating are mainly perceived through the nose. The tongue itself only recognizes sweet, sour, salty, bitter and spicy (umami). When the nose recovers, the taste sensation usually returns.

In some cases, however, when the olfactory nerves are affected, it takes weeks and months for them to recover completely. Very rarely do the sense of taste and smell not return at all.

Common cold: symptoms of complications

In the case of a cold, the mucous membranes in the nose and throat area are weakened by the virus attack and are more susceptible to other pathogens. Thus, additional bacteria can attack the body. The most common accompanying inflammation is an inflammation of the paranasal sinuses (sinusitis), the pharyngeal tonsils (tonsillitis) or the lungs (pneumonia).

Influenza: symptoms of sinusitis

If you feel toothache when you have a cold, it is usually not from the teeth. In fact, it is often an infection of the paranasal sinuses. Then the cold viruses have spread or further virus types have attacked the sinus mucosa. Bacterial superinfection is also possible. Mostly the area above the teeth hurts, which can easily be confused with toothache. In addition, affected persons notice a purulent nasal secretion and they feel a feeling of pressure in the area of the paranasal sinuses.

Common cold: symptoms of tonsillitis

Inflammation of the pharyngeal tonsils is primarily manifested by symptoms such as difficulty swallowing and pain in the throat and when speaking. The tonsils are reddened and swollen. Bad breath often develops in the process. Tonsillitis can usually be treated well with irrigations and gargling. If it is caused by bacteria, a therapy with antibiotics is useful.

Influenza: symptoms of pneumonia

Under certain circumstances, bronchitis or even pneumonia (pneumonia) may develop in the course of a cold. Symptoms are then severe cough, fever or diffuse back pain.

The sputum is usually white-glass in bronchitis caused by viruses. Bacteria, on the other hand, cause a purulent yellow colour, which can also appear greenish in pneumonia. Especially in the case of pneumonia, patients feel very weak, breathe heavily and usually get a higher fever than with bronchitis. Pneumonia can be very dangerous and should be treated quickly, especially in children and the elderly.

Neck pain

Frequently, neck pain is added to the classic symptoms of a cold. Neck pain is not primarily caused by the viruses. They are more likely to occur because the entire body is tensed. Especially in the case of severe pain in the limbs, headaches or toothaches, this is done by taking care of the body. To relieve the other parts of the body, especially the head, the neck is often extremely tense.

In addition, the defence cells themselves cause pain. They release certain messenger substances that irritate the nervous system. Neck pain, but also headaches and aching limbs in general, show that the infection is being actively combated.

Delayed cold: Symptoms

It becomes dangerous if you do not take it easy during the acute phase of the cold. If we speak of a delayed cold, this means that you have not got rid of the cold completely.

Indications of a delayed cold are primarily the temporal factor: If symptoms of a cold do not subside after about a week, or after ten days at the latest, a delayed cold is probably present.

Yellow-green slime formation indicates secondary infection

If green mucus appears during a cold, when you cough or sneeze, this is an almost certain sign that the current symptoms are due to a bacterial infection. If (light) yellow mucus appears when coughing or sneezing in a cold, viruses are probably the cause.

Sinusitis

If a headache occurs during a cold, this is often a sign of paranasal sinus involvement. (e.g. sphenoid sinus and frontal sinusitis).

Jaw pain

Another sign of a delayed cold with complications is jaw pain. Cold and flu are not usually accompanied by jaw pain. They occur when the maxillary sinuses are inflamed. Sinusitis can also be caused by bacteria and is a sign of a delayed cold.

When to see a doctor

Symptoms such as high fever or chest pain also mean that you should consult a doctor. If, in addition to the classic cold, there is also a bacterial infection, antibiotics can usually be used to control it.

So in any case, when you have a cold, you should closely observe the symptoms that occur. If you feel worse, if symptoms last longer than usual when you have a cold, or if you experience symptoms that you have never had before with a flu-like infection, you should consult a doctor. Even a cold described as “simple” can otherwise have serious consequences such as heart muscle inflammation.

Common cold: causes and risk factors

A flu-like infection can be caused by over 200 different types of viruses. The viruses are transmitted to other people (droplet infection) in small droplets of saliva that are produced when speaking, coughing or sneezing. Smear infections via hand contact with sick people or dirty objects such as door handles are also possible.

After the viruses have entered the body, they first attack the mucous membranes of the nose and throat, and later also the bronchial tubes or paranasal sinuses.

The following viruses, among others, are possible triggers for a cold:

• Rhinoviruses (about 40 percent)
• RSV (10-15 percent)
• Corona viruses (10-25 percent)

After rhinoviruses, the human metapneumo virus (HMPV) is the most common trigger of a cold in small children. Virus strains that cause colds mutate easily. So after a single infection you are not necessarily immune to a particular virus. You can get infected again and again.

Incubation period

There are usually about two to four days between the infection and the onset of the cold (incubation period). During this time, no symptoms of illness appear, although the viruses are already in the body. Even without symptoms you can infect other people during this time.

Washing hands helps

Cold viruses survive for several hours on human skin. The viruses can thus be transmitted to objects or other people (smear infection). Particularly in children, infection (cold or flu) occurs quickly through shared toys. So be sure to wash your hands thoroughly after every nose blowing or sneezing.

Cold by cold temperatures?

Again and again the connection between cold and common cold is discussed. In the past, it was thought that exposure to cold for too long alone could cause a cold. However, it is more likely that prolonged exposure to cold will weaken the immune system and make it easier for the viruses to enter the body – or dry heating air that strains the mucous membranes. In addition, the mucous membrane, such as that of the nose, is less well supplied with blood in cold weather. This makes them more susceptible to infections.

For detailed information on how you can prevent a flu-like infection, read the article “Preventing colds”.

Cold in the summer?

Most colds occur in the autumn and winter months. But even in summer you can catch a cold.

Risk factors for a cold in summer are strong temperature fluctuations as well as physical exertion and long stays in the sun, which stress the immune system. Even those who stay in cool water for too long or wear wet swimwear for too long will strain their immune system.

The following tips will keep a summer nap away from them:

• Be careful not to cool down in the water.
• It is better to take a break when you feel cold and dry yourself off well.
• Change damp or even sweaty clothing as quickly as possible.
• You should also avoid air conditioning in the car and draughts in the house.
• Always have a light jacket with you even in summer. Especially in the evening the air cools down quickly.
• Drink plenty of water. Liquid also keeps the mucous membranes moist, which is the only way to fulfil their function as a natural protective shield against pathogens.

Common cold: examinations and diagnosis

The diagnosis “cold” or “flu-like infection” is made by the doctor on the basis of the symptoms and a physical examination.

However, you do not necessarily need to see a doctor if you have a cold. You can also cure a slight cold yourself.

When to see a doctor with a cold?

A visit to the doctor is advisable if symptoms occur that are not classically associated with a cold. These include pain, a strong feeling of illness and high fever.

In addition, the following groups of people should always consult a doctor, as even a simple cold can be dangerous to them:

• People with immunodeficiency (congenital or acquired, for example through medication during cancer therapy)
• People with other existing illnesses (especially bronchial asthma or COPD and blood and heart diseases)
• People who have been traveling long distances lately
• older people
• Infants and small children

Anamnesis by the doctor

First of all, the doctor takes the medical history (anamnesis). You will have the opportunity to describe your symptoms in detail. The doctor may also ask questions such as:

• How long have you had these symptoms?
• Do you have chills too?
• Is the mucus when coughing or the nasal secretion rather greenish, yellowish or brownish?
• Do you have a raised temperature or fever?

Physical examination

This is followed by a physical examination. During this procedure, the doctor listens to the lungs (auscultation) in order to rule out other diseases that are favoured by a cold (e.g. pneumonia).

When a cold occurs, sometimes a bacterial infection is added to the viral one. Doctors speak of a super or secondary infection. Bacteria can be treated with antibiotics, but viruses cannot.

Flu or cold?

It is important to determine exactly whether you have a cold or a real flu. A flu is usually much more severe than a normal cold. It can be life-threatening for small children, the elderly or people whose immune system is weakened. The doctor can usually tell the difference between a flu or a cold by looking at the medical history. The physical examination can confirm the suspicion. The following signs are indicative of an influenza (influenza):

• With influenza, the symptoms usually appear very suddenly and worsen rapidly.
• Cold only occurs sporadically, but the body temperature can rise to over 41 degrees. The high fever is usually accompanied by chills, sweating and tiredness.
• Frequently there is also loss of appetite, weakness and circulatory problems.
• People affected by influenza often suffer from severe sore throats combined with a dry, irritable cough. Those affected suffer from much more severe headaches and aching limbs than with a cold.
• Sometimes flu patients also suffer from gastrointestinal complaints such as nausea, vomiting or diarrhoea. These accompanying symptoms are less common with colds.

Only special tests offer certainty that it is an influenza, such as an influenza rapid test, which the doctor can carry out directly in the practice using a mucous membrane swab, or a blood test, which must be sent to the laboratory.

Cold: Treatment

Whether with or without medication – it usually takes about a week until the cold is largely overcome. Special active ingredients that directly combat the cold viruses and shorten the duration of the disease are not used. Antibiotics, for example, only help with bacterial infections.

But there are some things you can do to relieve your cold symptoms. Taking it easy on the body also reduces the risk of the viruses spreading in the body and attacking the lungs, ears or even the heart. It also helps to prevent additional infections with other viruses and bacteria.

Spare, drink, care for mucous membranes

Besides physical protection, it is important to drink a lot (e.g. water, herbal teas) and to calm the mucous membranes in the nasopharynx area (inhalation, seawater nasal spray, possibly decongestant nasal drops).

Hygiene protects against infection

Your fellow human beings will protect you from infection if, instead of coughing or sneezing into the crook of your arm, you wash your hands thoroughly after blowing your nose and dispose of handkerchiefs after a single use. Good hand hygiene can also protect you from infection.

Cure at home!

If you have a severe cold, you should stay at home for a few days and, depending on how you feel, stay in bed. This is especially true if you feel very weak or have a fever. But it is particularly important to avoid overexertion, whether at work or at home. Sport is a taboo in these times.

If you have a high fever and a strong feeling of illness, but also if other symptoms such as pain occur or the symptoms persist for more than ten days, you should have a doctor examine you.

For detailed information on how to treat a cold, see the article “What helps against colds?”

Cold remedy

There are also a number of home remedies that can relieve symptoms of a cold. You can find out what these are and how to use them correctly in the article “Home remedies for colds”.

Common cold: course of disease and prognosis

A cold is usually harmless. Serious cases are the exception rather than the rule. However, second infections or complications can occur, especially if you do not cure yourself properly.

Duration of colds

Usually the symptoms last for about a week. In exceptional cases, a cold can last longer. This is the case, for example, if you are infected with other germs during a cold, for example due to lack of hygiene.

The cold can also spread more easily if you do not take sufficient care of yourself. The body, which is already susceptible anyway, is then particularly susceptible to secondary infections.

Viruses mutate very quickly. However, the body forms very specific substances to defend itself against only one type of virus that has attacked the body when it has a cold. If another or mutated virus is added, a cold can therefore break out again.

More detailed information on the duration of colds can be found in the article “Colds: duration and course”.

Chronic colds

There is no such thing as a chronic cold in the true sense of the word. In some cases, however, patients catch colds again and again or colds are particularly persistent in them. This concerns among other things

• older patients,
• People with various chronic pre-existing conditions,
• or when taking immunosuppressive drugs.

Even if the patient does not recover properly, the disease drags on. In a delayed cold, the pathogens in the body are not completely eliminated by the immune system. The affected persons then have a cold practically all the time. Conservation is therefore important!

Chronic rhinitis

However, doctors sometimes speak of chronic rhinitis. This is usually a chronic inflammation of the paranasal sinuses.

Changes of the anatomy

One cause is anatomical changes in the nose, which can either be congenital or have occurred in the course of life. Examples are curvatures of the nasal septum, polyps, tumours or damage to the nasal concha. In addition, the nasal concha can swell chronically, for example through excessive use of nasal sprays, but also during pregnancy or as a side effect of some drugs (blood pressure medication).

Pollutants

Pollutants such as tobacco smoke, exhaust fumes and drugs can irritate and damage the nose, causing chronic rhinitis. Some people are naturally particularly sensitive to such irritants. Also with them the nose runs then fast.

Allergies

Of course an allergic reaction can also cause chronic rhinitis. Observe whether the nose running gets better or worse again in certain situations. If in doubt, an ear, nose and throat doctor or an allergist can help you.

Granulomatosis with polyangiitis

Sometimes chronic rhinitis is also a serious disease. Granulomatosis with polyangiitis (formerly Wegener’s disease), for example, manifests itself like a chronic cold. Patients complain of a constantly running nose with possibly borkig-bloody mucus. If your nasal secretion is also very discoloured, you should therefore consult a doctor.

Complications and secondary infections

Complications occur rather rarely with a cold. Sometimes the viruses can spread, infecting other parts of the body and causing severe disease progression. Due to the viruses, the mucous membranes are weakened and more susceptible to other pathogens, which then cause complications as secondary infections.

Typical examples are inflammations of the eyes, paranasal sinuses, middle ear, throat, bronchial tubes or lungs. In such a case, consult a doctor. He can treat a bacterial infection with antibiotics if necessary.

Sport for colds is risky

Never do sport if you have a cold! Do not start again too early with sports activities! Due to the increased stress in combination with the virus attack, the heart muscle (myocarditis) or the pericardium (pericarditis) can become infected. This can result in irreparable heart damage such as heart failure and can even be life-threatening.

More detailed information about doing sports for colds can be found in the article “Sports for colds”.