Medicine:Common cold

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Short description: Common viral infection of the upper respiratory tract
Common cold
Other namesCold, acute viral nasopharyngitis, nasopharyngitis, viral rhinitis, rhinopharyngitis, acute coryza, head cold,[1] upper respiratory tract infection (URTI)[2]
Rhinovirus isosurface.png
A representation of the molecular surface of one variant of human rhinovirus
SpecialtyInfectious disease
SymptomsCough, sore throat, runny nose, fever[3][4]
ComplicationsUsually none, but occasionally otitis media, sinusitis, pneumonia and sepsis can occur[5]
Usual onset~2 days from exposure[6]
Duration1–3 weeks[3][7]
CausesViral (usually rhinovirus)[8]
Diagnostic methodBased on symptoms
Differential diagnosisAllergic rhinitis, bronchitis, bronchiolitis,[9] pertussis, sinusitis[5]
PreventionHand washing, cough etiquette, social distancing, vitamin C[3][10]
TreatmentSymptomatic therapy,[3] zinc[11]
MedicationNSAIDs[12]
Frequency2–3 per year (adults)
6–8 per year (children)[13]

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

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

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

The common cold is the most frequent infectious disease in humans.[19] Under normal circumstances, the average adult gets two to three colds a year, while the average child may get six to eight.[8][13] Infections occur more commonly during the winter.[3] These infections have existed throughout human history.[20]

Signs and symptoms

Woman with symptoms of the common cold

The typical symptoms of a cold include cough, runny nose, sneezing, nasal congestion, and a sore throat, sometimes accompanied by muscle ache, fatigue, headache, and loss of appetite.[21] A sore throat is present in about 40% of cases, a cough in about 50%,[8] and muscle ache likewise in about 50%.[4] In adults, a fever is generally not present but it is common in infants and young children.[4] The cough is usually mild compared to that accompanying influenza.[4] While a cough and a fever indicate a higher likelihood of influenza in adults, a great deal of similarity exists between these two conditions.[22] A number of the viruses that cause the common cold may also result in asymptomatic infections.[23][24]

The color of the mucus or nasal secretion may vary from clear to yellow to green and does not indicate the class of agent causing the infection.[25]

Progression

Cold symptoms over time

A cold usually begins with fatigue, a feeling of being chilled, sneezing, and a headache, followed in a couple of days by a runny nose and cough.[21] Symptoms may begin within sixteen hours of exposure[26] and typically peak two to four days after onset.[4][27] They usually resolve in seven to ten days, but some can last for up to three weeks.[7] The average duration of cough is eighteen days[28] and in some cases people develop a post-viral cough which can linger after the infection is gone.[29] In children, the cough lasts for more than ten days in 35–40% of cases and continues for more than 25 days in 10%.[30]

Causes

Viruses

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

The common cold is an infection of the upper respiratory tract which can be caused by many different viruses. The most commonly implicated is a rhinovirus (30–80%), a type of picornavirus with 99 known serotypes.[31] Other commonly implicated viruses include adenoviruses, enteroviruses, parainfluenza and RSV.[32] Frequently more than one virus is present.[33] In total, more than 200 viral types are associated with colds.[4] The viral cause of some common colds (20-30%) is unknown.[32]

Transmission

The common cold virus is typically transmitted via airborne droplets (aerosols), direct contact with infected nasal secretions, or fomites (contaminated objects).[8][34] Which of these routes is of primary importance has not been determined.[35] The viruses may survive for prolonged periods in the environment (over 18 hours for rhinoviruses) and can be picked up by people's hands and subsequently carried to their eyes or nose where infection occurs.[34] Transmission from animals is considered highly unlikely; an outbreak documented at a British scientific base on Adelaide Island after seventeen weeks of isolation was thought to have been caused by transmission from a contaminated object or an asymptomatic human carrier, rather than from the husky dogs which were also present at the base.[36]

Transmission is common in daycare and at school due to the proximity of many children with little immunity and frequently poor hygiene.[37] These infections are then brought home to other members of the family.[37] There is no evidence that recirculated air during commercial flight is a method of transmission.[34] People sitting close to each other appear to be at greater risk of infection.[35]

Rhinovirus-caused colds are most infectious during the first three days of symptoms; they are much less infectious afterwards.[38]

Other

Herd immunity, generated from previous exposure to cold viruses, plays an important role in limiting viral spread, as seen with younger populations that have greater rates of respiratory infections.[39] Poor immune function is a risk factor for disease.[39][40] Insufficient sleep and malnutrition have been associated with a greater risk of developing infection following rhinovirus exposure; this is believed to be due to their effects on immune function.[41][42] Breast feeding decreases the risk of acute otitis media and lower respiratory tract infections among other diseases,[43] and it is recommended that breast feeding be continued when an infant has a cold.[44] In the developed world breast feeding may not be protective against the common cold in and of itself.[45]

Pathophysiology

The common cold is a disease of the upper respiratory tract.

The symptoms of the common cold are believed to be primarily related to the immune response to the virus.[15] The mechanism of this immune response is virus-specific. For example, the rhinovirus is typically acquired by direct contact; it binds to humans via ICAM-1 receptors and the CDHR3 receptor through unknown mechanisms to trigger the release of inflammatory mediators.[15] These inflammatory mediators then produce the symptoms.[15] It does not generally cause damage to the nasal epithelium.[4] The respiratory syncytial virus (RSV), on the other hand, is contracted by direct contact and airborne droplets. It then replicates in the nose and throat before frequently spreading to the lower respiratory tract.[46] RSV does cause epithelium damage.[46] Human parainfluenza virus typically results in inflammation of the nose, throat, and bronchi.[47] In young children, when it affects the trachea, it may produce the symptoms of croup, due to the small size of their airways.[47]

Diagnosis

The distinction between viral upper respiratory tract infections is loosely based on the location of symptoms, with the common cold affecting primarily the nose (rhinitis), throat (pharyngitis), and lungs (bronchitis).[8] There can be significant overlap, and more than one area can be affected.[8] Self-diagnosis is frequent.[4] Isolation of the viral agent involved is rarely performed,[48] and it is generally not possible to identify the virus type through symptoms.[4]

Prevention

The only useful ways to reduce the spread of cold viruses are physical measures[10] such as using correct hand washing technique and face masks; in the healthcare environment, gowns and disposable gloves are also used.[10] Isolation or quarantine is not used as the disease is so widespread and symptoms are non-specific. There is no vaccine to protect against the common cold.[49] Vaccination has proven difficult as there are many viruses involved and they mutate rapidly.[10][50] Creation of a broadly effective vaccine is, therefore, highly improbable.[51]

Regular hand washing appears to be effective in reducing the transmission of cold viruses, especially among children.[52] Whether the addition of antivirals or antibacterials to normal hand washing provides greater benefit is unknown.[52] Wearing face masks when around people who are infected may be beneficial; however, there is insufficient evidence for maintaining a greater social distance.[52]

It is unclear whether zinc supplements affect the likelihood of contracting a cold.[53] Routine vitamin C supplements do not reduce the risk or severity of the common cold, though they may reduce its duration.[54]

Management

Poster from 1937 encouraging citizens to "consult your physician" for treatment of the common cold

Treatments of the common cold primarily involve medications and other therapies for symptomatic relief.[13] Getting plenty of rest, drinking fluids to maintain hydration, and gargling with warm salt water are reasonable conservative measures.[55] Much of the benefit from symptomatic treatment is, however, attributed to the placebo effect.[56] (As of 2010) no medications or herbal remedies had been conclusively demonstrated to shorten the duration of infection.[57]

Symptomatic

Various treatments for the common cold - liquid and pill cold medicine, tea, throat lozenges, and over-the-counter decongestants.

Treatments that may help with symptoms include simple pain medication and medications for fevers such as ibuprofen[12] and acetaminophen (paracetamol).[58] However, it is not clear whether acetaminophen helps with symptoms.[59] It is not known if over-the-counter cough medications are effective for treating an acute cough.[60] Cough medicines are not recommended for use in children due to a lack of evidence supporting effectiveness and the potential for harm.[61][62] In 2009, Canada restricted the use of over-the-counter cough and cold medication in children six years and under due to concerns regarding risks and unproven benefits.[61] The misuse of dextromethorphan (an over-the-counter cough medicine) has led to its ban in a number of countries.[63] Intranasal corticosteroids have not been found to be useful.[64]

In adults, short term use of nasal decongestants may have a small benefit.[65] Antihistamines may improve symptoms in the first day or two; however, there is no longer-term benefit and they have adverse effects such as drowsiness.[66] Other decongestants such as pseudoephedrine appear effective in adults.[67][65] Combined oral analgesics, antihistaminics and decongestants are generally effective for older children and adults.[68] Ipratropium nasal spray may reduce the symptoms of a runny nose but has little effect on stuffiness.[69] Ipratropium may also help with cough in adults.[70] The safety and effectiveness of nasal decongestant use in children is unclear.[65]

Due to lack of studies, it is not known whether increased fluid intake improves symptoms or shortens respiratory illness.[71] As of 2017, heated and humidified air, such as via RhinoTherm, is of unclear benefit.[72] One study has found chest vapor rub to provide some relief of nocturnal cough, congestion, and sleep difficulty.[73]

Some advise to avoid physical exercise if there are symptoms such as fever, widespread muscle aches or fatigue.[74][75] It is regarded as safe to perform moderate exercise if the symptoms are confined to the head, including runny nose, nasal congestion, sneezing, or a minor sore throat.[74][75] There is a popular belief that having a hot drink can help with cold symptoms, but evidence to support this is very limited.[76]

Antibiotics and antivirals

Antibiotics have no effect against viral infections, including the common cold.[77] Due to their side effects, antibiotics cause overall harm but are still frequently prescribed.[77][78] Some of the reasons that antibiotics are so commonly prescribed include people's expectations for them, physicians' desire to help, and the difficulty in excluding complications that may be amenable to antibiotics.[79] There are no effective antiviral drugs for the common cold even though some preliminary research has shown benefits.[13][80]

Zinc

Main page: Chemistry:Zinc and the common cold

Zinc supplements may shorten the duration of colds by up to 33% and reduce the severity of symptoms if supplementation begins within 24 hours of the onset of symptoms.[11][53][81][82][83] Some zinc remedies directly applied to the inside of the nose have led to the loss of the sense of smell.[11][84] A 2017 review did not recommend the use of zinc for the common cold for various reasons;[18] whereas a 2017 and 2018 review both recommended the use of zinc, but also advocated further research on the topic.[81][82]

Alternative medicine

Main page: Unsolved:Alternative treatments used for the common cold

While there are many alternative medicines and Chinese herbal medicines supposed to treat the common cold, there is insufficient scientific evidence to support their use.[13][85] As of 2015, there is weak evidence to support nasal irrigation with saline.[86] There is no firm evidence that Echinacea products or garlic provide any meaningful benefit in treating or preventing colds.[87][88]

Vitamins C and D

Main page: Chemistry:Vitamin C and the common cold
Main page: Biology:Vitamin D and respiratory tract infections

Vitamin C supplementation does not affect the incidence of the common cold, but may reduce its duration.[54] There is no conclusive evidence that vitamin D supplementation is efficacious in the prevention or treatment of respiratory tract infections.[89]

Prognosis

The common cold is generally mild and self-limiting with most symptoms generally improving in a week.[8] In children, half of cases go away in 10 days and 90% in 15 days.[90] Severe complications, if they occur, are usually in the very old, the very young, or those who are immunosuppressed.[19] Secondary bacterial infections may occur resulting in sinusitis, pharyngitis, or an ear infection.[91] It is estimated that sinusitis occurs in 8% and ear infection in 30% of cases.[92]

Epidemiology

The common cold is the most common human disease[19] and affects people all over the globe.[37] Adults typically have two to three infections annually,[8] and children may have six to ten colds a year (and up to twelve colds a year for school children).[13] Rates of symptomatic infections increase in the elderly due to declining immunity.[39]

Weather

A common misconception is that one can "catch a cold" merely through prolonged exposure to cold weather.[93] Although it is now known that colds are viral infections, the prevalence of many such viruses are indeed seasonal, occurring more frequently during cold weather.[94] The reason for the seasonality has not been conclusively determined.[95] Possible explanations may include cold temperature-induced changes in the respiratory system,[96] decreased immune response,[97] and low humidity causing an increase in viral transmission rates, perhaps due to dry air allowing small viral droplets to disperse farther and stay in the air longer.[98]

The apparent seasonality may also be due to social factors, such as people spending more time indoors, near infected people,[96] and specifically children at school.[37][95] Although normal exposure to cold does not increase one's risk of infection, severe exposure leading to significant reduction of body temperature (hypothermia) may put one at a greater risk for the common cold; although controversial, the majority of evidence suggests that it may increase susceptibility to infection.[97]

History

A British poster from World War II describing the cost of the common cold[99]

While the cause of the common cold was identified in the 1950s, the disease appears to have been with humanity since its early history.[20] Its symptoms and treatment are described in the Egyptian Ebers papyrus, the oldest existing medical text, written before the 16th century BCE.[100] The name "cold" came into use in the 16th century, due to the similarity between its symptoms and those of exposure to cold weather.[101]

In the United Kingdom, the Common Cold Unit (CCU) was set up by the Medical Research Council in 1946 and it was where the rhinovirus was discovered in 1956.[102] In the 1970s, the CCU demonstrated that treatment with interferon during the incubation phase of rhinovirus infection protects somewhat against the disease,[103] but no practical treatment could be developed. The unit was closed in 1989, two years after it completed research of zinc gluconate lozenges in the prevention and treatment of rhinovirus colds, the only successful treatment in the history of the unit.[104]

Research directions

Antivirals have been tested for effectiveness in the common cold; as of 2009, none had been both found effective and licensed for use.[80] There are trials of the anti-viral drug pleconaril which shows promise against picornaviruses as well as trials of BTA-798.[105] The oral form of pleconaril had safety issues and an aerosol form is being studied.[105] The genomes of all known human rhinovirus strains have been sequenced.[106]

Societal impact

The economic impact of the common cold is not well understood in much of the world.[92] In the United States, the common cold leads to 75–100 million physician visits annually at a conservative cost estimate of $7.7 billion per year. Americans spend $2.9 billion on over-the-counter drugs and another $400 million on prescription medicines for symptom relief.[107] More than one-third of people who saw a doctor received an antibiotic prescription, which has implications for antibiotic resistance.[107] An estimated 22–189 million school days are missed annually due to a cold. As a result, parents missed 126 million workdays to stay home to care for their children. When added to the 150 million workdays missed by employees who have a cold, the total economic impact of cold-related work loss exceeds $20 billion per year.[55][107] This accounts for 40% of time lost from work in the United States.[108]

References

Notes

  1. ↑ Textbook of Oral Medicine. Jaypee Brothers Publishers. 2008. p. 336. ISBN 978-81-8061-562-7. https://books.google.com/books?id=8_jWY8wOGEsC&pg=PA336. 
  2. ↑ "Eunkyosan for the common cold: A PRISMA-compliment systematic review of randomised, controlled trials". Medicine 99 (31): e21415. July 2020. doi:10.1097/MD.0000000000021415. PMID 32756141. 
  3. ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 "Common Colds: Protect Yourself and Others". 6 October 2015. https://www.cdc.gov/features/rhinoviruses/. 
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 "Understanding the symptoms of the common cold and influenza". The Lancet. Infectious Diseases 5 (11): 718–25. November 2005. doi:10.1016/S1473-3099(05)70270-X. PMID 16253889. 
  5. ↑ 5.0 5.1 (in en) Principles and Practice of Infectious Diseases. Elsevier Health Sciences. 2014. p. 750. ISBN 978-1-4557-4801-3. https://books.google.com/books?id=BseNCgAAQBAJ&pg=PA750. 
  6. ↑ 6.0 6.1 6.2 6.3 6.4 6.5 "Prevention and treatment of the common cold: making sense of the evidence". CMAJ 186 (3): 190–9. February 2014. doi:10.1503/cmaj.121442. PMID 24468694. 
  7. ↑ 7.0 7.1 7.2 "The common cold". Lancet 361 (9351): 51–9. January 2003. doi:10.1016/S0140-6736(03)12162-9. PMID 12517470. 
  8. ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 "Common cold". BMJ Clinical Evidence 2011 (3): 1510. March 2011. PMID 21406124. "Common colds are defined as upper respiratory tract infections that affect the predominantly nasal part of the respiratory mucosa". 
  9. ↑ "Bronchiolitis: Symptoms and Causes". https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565. 
  10. ↑ 10.0 10.1 10.2 10.3 10.4 Eccles p. 209
  11. ↑ 11.0 11.1 11.2 11.3 "Zinc – Fact Sheet for Health Professionals". Office of Dietary Supplements, US National Institutes of Health. 10 July 2019. https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional. "Although studies examining the effect of zinc treatment on cold symptoms have had somewhat conflicting results, overall zinc appears to be beneficial under certain circumstances.... In September of 2007, Caruso and colleagues published a structured review of the effects of zinc lozenges, nasal sprays, and nasal gels on the common cold [69]. Of the 14 randomized, placebo-controlled studies included, 7 (5 using zinc lozenges, 2 using a nasal gel) showed that the zinc treatment had a beneficial effect and 7 (5 using zinc lozenges, 1 using a nasal spray, and 1 using lozenges and a nasal spray) showed no effect. More recently, a Cochrane review concluded that "zinc (lozenges or syrup) is beneficial in reducing the duration and severity of the common cold in healthy people, when taken within 24 hours of onset of symptoms" [73]. The author of another review completed in 2004 also concluded that zinc can reduce the duration and severity of cold symptoms [68]. However, more research is needed to determine the optimal dosage, zinc formulation and duration of treatment before a general recommendation for zinc in the treatment of the common cold can be made [73]. As previously noted, the safety of intranasal zinc has been called into question because of numerous reports of anosmia (loss of smell), in some cases long-lasting or permanent, from the use of zinc-containing nasal gels or sprays [17–19]." 
  12. ↑ 12.0 12.1 12.2 "Non-steroidal anti-inflammatory drugs for the common cold". The Cochrane Database of Systematic Reviews 2015 (9): CD006362. September 2015. doi:10.1002/14651858.CD006362.pub4. PMID 26387658. 
  13. ↑ 13.0 13.1 13.2 13.3 13.4 13.5 "Treatment of the common cold". American Family Physician 75 (4): 515–20. February 2007. PMID 17323712. http://www.aafp.org/afp/20070215/515.html. 
  14. ↑ "Common Cold". Centers for Disease Control and Prevention. https://www.cdc.gov/getsmart/community/for-patients/common-illnesses/colds.html. 
  15. ↑ 15.0 15.1 15.2 15.3 Eccles p. 112
  16. ↑ "Cold Versus Flu". 11 August 2016. https://www.cdc.gov/flu/about/qa/coldflu.htm. 
  17. ↑ "Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention". Annals of Internal Medicine 164 (6): 425–34. March 2016. doi:10.7326/M15-1840. PMID 26785402. 
  18. ↑ 18.0 18.1 "Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold: CHEST Expert Panel Report". Chest 152 (5): 1021–1037. November 2017. doi:10.1016/j.chest.2017.08.009. PMID 28837801. "A suggestion for the use of zinc lozenges in healthy adults with cough due to common cold was considered by the expert panel. However, due to weak evidence, the potential side effects of zinc, and the relatively benign and common nature of the condition being treated, the panel did not approve inclusion of this suggestion.". 
  19. ↑ 19.0 19.1 19.2 Eccles p. 1
  20. ↑ 20.0 20.1 Common cold. Basel: Birkhäuser. 2009. p. 3. ISBN 978-3-7643-9894-1. https://books.google.com/books?id=rRIdiGE42IEC&pg=PA3. 
  21. ↑ 21.0 21.1 Eccles p. 24
  22. ↑ Eccles p. 26
  23. ↑ Eccles p. 129
  24. ↑ Eccles p. 50
  25. ↑ Eccles p. 30
  26. ↑ Textbook of therapeutics: drug and disease management (8. ed.). Philadelphia, Pa. [u.a.]: Lippincott Williams & Wilkins. 2006. p. 1882. ISBN 978-0-7817-5734-8. https://books.google.com/books?id=aVmRWrknaWgC&pg=PA1882. 
  27. ↑ "Rhinovirus". Viral Infections and Treatment. New York: CRC Press. 2003. p. 111. ISBN 978-0-8247-4247-8. https://books.google.com/books?id=AltZnmbIhbwC&pg=PA111. 
  28. ↑ "How long does a cough last? Comparing patients' expectations with data from a systematic review of the literature". Annals of Family Medicine 11 (1): 5–13. 2013. doi:10.1370/afm.1430. PMID 23319500. 
  29. ↑ "Cough: an unmet clinical need". British Journal of Pharmacology 163 (1): 116–24. May 2011. doi:10.1111/j.1476-5381.2010.01198.x. PMID 21198555. 
  30. ↑ "Cough in the pediatric population". The Journal of Pediatrics 156 (3): 352–8. March 2010. doi:10.1016/j.jpeds.2009.12.004. PMID 20176183. 
  31. ↑ "Sequencing and analyses of all known human rhinovirus genomes reveal structure and evolution". Science 324 (5923): 55–9. April 2009. doi:10.1126/science.1165557. PMID 19213880. Bibcode: 2009Sci...324...55P. 
  32. ↑ 32.0 32.1 "Common Cold: Cause". Encyclopedia of Behavioral Medicine (2nd ed.). Springer. 2020. p. 504. doi:10.1007/978-3-030-39903-0_795. ISBN 978-3-030-39901-6. 
  33. ↑ Eccles p. 107
  34. ↑ 34.0 34.1 34.2 Common cold (Online-Ausg. ed.). Basel: Birkhäuser. 2009. p. 197. ISBN 978-3-7643-9894-1. https://books.google.com/books?id=rRIdiGE42IEC&pg=PA197. 
  35. ↑ 35.0 35.1 Eccles pp. 211, 215
  36. ↑ "An outbreak of common colds at an Antarctic base after seventeen weeks of complete isolation". The Journal of Hygiene 71 (4): 657–67. December 1973. doi:10.1017/s0022172400022920. PMID 4520509. 
  37. ↑ 37.0 37.1 37.2 37.3 "Rhinoviruses". Principles and Practice of Clinical Virology (6th ed.). John Wiley & Sons. 2009. p. 496. ISBN 978-0-470-74139-9. https://books.google.com/books?id=4il2mF7JG1sC&pg=PR3. 
  38. ↑ "Contagiousness of the common cold". Journal of the American Medical Association 278 (3): 256–57. 16 July 1997. doi:10.1001/jama.1997.03550030096050. 
  39. ↑ 39.0 39.1 39.2 Eccles p. 78
  40. ↑ Eccles p. 166
  41. ↑ "Sleep habits and susceptibility to the common cold". Archives of Internal Medicine 169 (1): 62–7. January 2009. doi:10.1001/archinternmed.2008.505. PMID 19139325. 
  42. ↑ Eccles pp. 160–65
  43. ↑ "What are the risks associated with formula feeding? A re-analysis and review". Breastfeeding Review 18 (2): 25–32. July 2010. PMID 20879657. 
  44. ↑ Breastfeeding: A guide for the medical profession (7th ed.). Maryland Heights, Mo.: Mosby/Elsevier. 2010. p. 478. ISBN 978-1-4377-3590-1. https://books.google.com/books?id=c4BnozBW3EMC&pg=PA478. 
  45. ↑ Infectious Disease Epidemiology: Theory and Practice (2nd ed.), Jones & Bartlett Learning, 2007, pp. 724–, ISBN 978-0-7637-2879-3, https://books.google.com/books?id=o_j-G4zJ4cQC&pg=PA724 
  46. ↑ 46.0 46.1 Eccles p. 116
  47. ↑ 47.0 47.1 Eccles p. 122
  48. ↑ Eccles pp. 51–52
  49. ↑ CDC (11 February 2019). "Common Colds" (in en-us). http://www.cdc.gov/features/rhinoviruses/index.html. 
  50. ↑ Montesinos-Guevara, Camila; Buitrago-Garcia, Diana; Felix, Maria L.; Guerra, Claudia V.; Hidalgo, Ricardo; Martinez-Zapata, Maria José; Simancas-Racines, Daniel (14 December 2022). "Vaccines for the common cold". The Cochrane Database of Systematic Reviews 2022 (12): CD002190. doi:10.1002/14651858.CD002190.pub6. ISSN 1469-493X. PMID 36515550. 
  51. ↑ "Gene studies shed light on rhinovirus diversity". Lancet Infect Dis 9 (5): 278. 2009. doi:10.1016/S1473-3099(09)70123-9. 
  52. ↑ 52.0 52.1 52.2 Jefferson, Tom; Dooley, Liz; Ferroni, Eliana; Al-Ansary, Lubna A.; van Driel, Mieke L.; Bawazeer, Ghada A.; Jones, Mark A.; Hoffmann, Tammy C. et al. (30 January 2023). "Physical interventions to interrupt or reduce the spread of respiratory viruses". The Cochrane Database of Systematic Reviews 1 (1): CD006207. doi:10.1002/14651858.CD006207.pub6. ISSN 1469-493X. PMID 36715243. 
  53. ↑ 53.0 53.1 "Zinc for the common cold". The Cochrane Database of Systematic Reviews (6): CD001364. June 2013. doi:10.1002/14651858.CD001364.pub4. PMID 23775705.  (Retracted)
  54. ↑ 54.0 54.1 "Vitamin C for preventing and treating the common cold". The Cochrane Database of Systematic Reviews 1 (1): CD000980. January 2013. doi:10.1002/14651858.CD000980.pub4. PMID 23440782. 
  55. ↑ 55.0 55.1 "Common Cold". National Institute of Allergy and Infectious Diseases. 27 November 2006. http://www3.niaid.nih.gov/healthscience/healthtopics/colds/. 
  56. ↑ Eccles p. 261
  57. ↑ "Common Cold: Treatments and Drugs". Mayo Clinic. http://www.mayoclinic.com/health/common-cold/DS00056/DSECTION=treatments-and-drugs. 
  58. ↑ "Efficacy and safety of over-the-counter analgesics in the treatment of common cold and flu". Journal of Clinical Pharmacy and Therapeutics 31 (4): 309–19. August 2006. doi:10.1111/j.1365-2710.2006.00754.x. PMID 16882099. 
  59. ↑ "Acetaminophen (paracetamol) for the common cold in adults". The Cochrane Database of Systematic Reviews 2013 (7): CD008800. July 2013. doi:10.1002/14651858.CD008800.pub2. PMID 23818046. 
  60. ↑ "Over-the-counter (OTC) medications for acute cough in children and adults in community settings". The Cochrane Database of Systematic Reviews 11 (11): CD001831. November 2014. doi:10.1002/14651858.CD001831.pub5. PMID 25420096. 
  61. ↑ 61.0 61.1 "Use of over-the-counter cough and cold medications in children". Canadian Family Physician 55 (11): 1081–3. November 2009. PMID 19910592. PMC 2776795. http://www.cfp.ca/content/55/11/1081.full.pdf. 
  62. ↑ "Safety and efficacy of over-the-counter cough and cold medicines for use in children". Expert Opinion on Drug Safety 9 (2): 233–42. March 2010. doi:10.1517/14740330903496410. PMID 20001764. 
  63. ↑ Eccles p. 246
  64. ↑ "Corticosteroids for the common cold". The Cochrane Database of Systematic Reviews 2016 (10): CD008116. October 2015. doi:10.1002/14651858.cd008116.pub3. PMID 26461493. PMC 8734596. https://pure.bond.edu.au/ws/files/32879677/Corticosteroids_for_the_common_cold.pdf. Retrieved 12 December 2019. 
  65. ↑ 65.0 65.1 65.2 "Nasal decongestants in monotherapy for the common cold". The Cochrane Database of Systematic Reviews 2016 (10): CD009612. October 2016. doi:10.1002/14651858.CD009612.pub2. PMID 27748955. 
  66. ↑ "Antihistamines for the common cold". The Cochrane Database of Systematic Reviews 2015 (11): CD009345. November 2015. doi:10.1002/14651858.CD009345.pub2. PMID 26615034. PMC 9468790. https://biblio.ugent.be/publication/7237869. Retrieved 12 December 2019. 
  67. ↑ "Nasal decongestants for the common cold". The Cochrane Database of Systematic Reviews (1): CD001953. January 2007. doi:10.1002/14651858.CD001953.pub3. PMID 17253470. 
  68. ↑ De Sutter, An Im; Eriksson, Lars; van Driel, Mieke L. (21 January 2022). "Oral antihistamine-decongestant-analgesic combinations for the common cold". The Cochrane Database of Systematic Reviews 1 (1): CD004976. doi:10.1002/14651858.CD004976.pub4. ISSN 1469-493X. PMID 35060618. 
  69. ↑ "Intranasal ipratropium bromide for the common cold". The Cochrane Database of Systematic Reviews 2013 (6): CD008231. June 2013. doi:10.1002/14651858.CD008231.pub3. PMID 23784858. 
  70. ↑ "Treatment of the Common Cold". American Family Physician 100 (5): 281–289. September 2019. PMID 31478634. 
  71. ↑ "Advising patients to increase fluid intake for treating acute respiratory infections". The Cochrane Database of Systematic Reviews 2011 (2): CD004419. February 2011. doi:10.1002/14651858.CD004419.pub3. PMID 21328268. 
  72. ↑ "Heated, humidified air for the common cold". The Cochrane Database of Systematic Reviews 2017 (8): CD001728. August 2017. doi:10.1002/14651858.CD001728.pub6. PMID 28849871. 
  73. ↑ "Vapor rub, petrolatum, and no treatment for children with nocturnal cough and cold symptoms". Pediatrics 126 (6): 1092–9. December 2010. doi:10.1542/peds.2010-1601. PMID 21059712. 
  74. ↑ 74.0 74.1 "Is it OK to exercise if I have a cold?". 9 February 2017. http://www.mayoclinic.org/healthy-lifestyle/fitness/expert-answers/exercise/faq-20058494. 
  75. ↑ 75.0 75.1 "Clearing the Air on Exercise and the Common Cold". http://www.acsm.org/about-acsm/media-room/acsm-in-the-news/2011/08/01/clearing-the-air-on-exercise-and-the-common-cold. 
  76. ↑ "Hot drinks ease cold and flu". National Health Service. 10 December 2008. https://www.nhs.uk/news/food-and-diet/hot-drinks-ease-cold-and-flu/. 
  77. ↑ 77.0 77.1 "Antibiotics for the common cold and acute purulent rhinitis". The Cochrane Database of Systematic Reviews 2013 (6): CD000247. June 2013. doi:10.1002/14651858.CD000247.pub3. PMID 23733381. 
  78. ↑ Eccles p. 238
  79. ↑ Eccles p. 234
  80. ↑ 80.0 80.1 Eccles p. 218
  81. ↑ 81.0 81.1 "Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds-Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds". Evidence-Based Complementary and Alternative Medicine 2018: 5813095. 2018. doi:10.1155/2018/5813095. PMID 29853961. "Considering zinc, the supplementation may shorten the duration of colds by approximately 33%. CC patients may be instructed to try zinc within 24 hours of onset of symptoms.". 
  82. ↑ 82.0 82.1 "Zinc Acetate Lozenges May Improve the Recovery Rate of Common Cold Patients: An Individual Patient Data Meta-Analysis". Open Forum Infectious Diseases 4 (2): ofx059. 2017. doi:10.1093/ofid/ofx059. PMID 28480298. "The 3-fold increase in the rate of recovery from the common cold is a clinically important effect. The optimal formulation of zinc lozenges and an ideal frequency of their administration should be examined. Given the evidence of efficacy, common cold patients may be instructed to try zinc acetate lozenges within 24 hours of onset of symptoms.". 
  83. ↑ "Zinc acetate lozenges for treating the common cold: an individual patient data meta-analysis". British Journal of Clinical Pharmacology 82 (5): 1393–1398. November 2016. doi:10.1111/bcp.13057. PMID 27378206. 
  84. ↑ "Loss of Sense of Smell with Intranasal Cold Remedies Containing Zinc". 2009. https://www.fda.gov/Drugs/DrugSafety/DrugSafetyPodcasts/ucm167282.htm. 
  85. ↑ "Chinese medicinal herbs for the common cold". The Cochrane Database of Systematic Reviews (1): CD004782. January 2007. doi:10.1002/14651858.CD004782.pub2. PMID 17253524. 
  86. ↑ "Saline nasal irrigation for acute upper respiratory tract infections". The Cochrane Database of Systematic Reviews 2015 (4): CD006821. April 2015. doi:10.1002/14651858.CD006821.pub3. PMID 25892369. PMC 9475221. http://espace.library.uq.edu.au/view/UQ:363301/UQ363301_OA.pdf. Retrieved 30 December 2018. 
  87. ↑ "Echinacea for preventing and treating the common cold". The Cochrane Database of Systematic Reviews 2 (2): CD000530. February 2014. doi:10.1002/14651858.CD000530.pub3. PMID 24554461. 
  88. ↑ "Garlic for the common cold". The Cochrane Database of Systematic Reviews 11 (11): CD006206. November 2014. doi:10.1002/14651858.CD006206.pub4. PMID 25386977. 
  89. ↑ "The effects of vitamin D on acute viral respiratory infections: A rapid review". Advances in Integrative Medicine 7 (4): 192–202. December 2020. doi:10.1016/j.aimed.2020.07.011. PMID 32837896. 
  90. ↑ "Duration of symptoms of respiratory tract infections in children: systematic review". BMJ 347: f7027. December 2013. doi:10.1136/bmj.f7027. PMID 24335668. 
  91. ↑ Eccles p. 76
  92. ↑ 92.0 92.1 Eccles p. 90
  93. ↑ "'You'll Catch Your Death!' An Old Wives' Tale? Well..". The New York Times. 4 March 2003. https://www.nytimes.com/2003/03/04/science/you-ll-catch-your-death-an-old-wives-tale-well.html. 
  94. ↑ Eccles p. 79
  95. ↑ 95.0 95.1 "Common cold – Background information". National Institute for Health and Clinical Excellence. http://www.cks.nhs.uk/common_cold/background_information/prevalence. 
  96. ↑ 96.0 96.1 Eccles p. 80
  97. ↑ 97.0 97.1 "Exposure to cold and respiratory tract infections". The International Journal of Tuberculosis and Lung Disease 11 (9): 938–43. September 2007. PMID 17705968. 
  98. ↑ Eccles p. 157
  99. ↑ "The Cost of the Common Cold and Influenza". vads. http://vads.bath.ac.uk/flarge.php?uid=33443&sos=0. 
  100. ↑ Eccles p. 6
  101. ↑ "Cold". Cold. http://www.etymonline.com/index.php?term=cold. Retrieved 12 January 2008. 
  102. ↑ Eccles p. 20
  103. ↑ "Interferons and their clinical value". Reviews of Infectious Diseases 9 (2): 243–9. 1987. doi:10.1093/clinids/9.2.243. PMID 2438740. 
  104. ↑ "Prophylaxis and treatment of rhinovirus colds with zinc gluconate lozenges". The Journal of Antimicrobial Chemotherapy 20 (6): 893–901. December 1987. doi:10.1093/jac/20.6.893. PMID 3440773. 
  105. ↑ 105.0 105.1 Eccles p. 226
  106. ↑ "Genetic map of cold virus a step toward cure, scientists say". CNN. 12 February 2009. http://www.cnn.com/2009/HEALTH/02/12/cold.genome/. 
  107. ↑ 107.0 107.1 107.2 "The economic burden of non-influenza-related viral respiratory tract infection in the United States". Archives of Internal Medicine 163 (4): 487–94. February 2003. doi:10.1001/archinte.163.4.487. PMID 12588210. 
  108. ↑ "The common cold". Primary Care 23 (4): 657–75. December 1996. doi:10.1016/S0095-4543(05)70355-9. PMID 8890137. 

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