View source for Medicine:Common cold

{{short description|Common viral infection of the upper respiratory tract}}
{{Pp-semi|small=yes}}
{{Infobox medical condition (new)
| name          = Common cold
| image         = Rhinovirus isosurface.png
| alt           = 
| caption       = A representation of the molecular surface of one variant of human rhinovirus
| image_size    = 220
| field         = [[Medicine:Infectious disease (medical specialty)|Infectious disease]]
| synonyms      = Cold, acute viral nasopharyngitis, nasopharyngitis, viral rhinitis, rhinopharyngitis, acute coryza, head cold,<ref>{{cite book |title=Textbook of Oral Medicine |year=2008 |publisher=Jaypee Brothers Publishers |isbn=978-81-8061-562-7 |page=336 |url=https://books.google.com/books?id=8_jWY8wOGEsC&pg=PA336 |vauthors=Pramod JR |url-status=live |archive-url=https://web.archive.org/web/20160529132044/https://books.google.com/books?id=8_jWY8wOGEsC&pg=PA336 |archive-date=29 May 2016}}</ref> upper respiratory tract infection (URTI)<ref name=korean>{{cite journal |vauthors=Lee H, Kang B, Hong M, Lee HL, Choi JY, Lee JA |title=Eunkyosan for the common cold: A PRISMA-compliment systematic review of randomised, controlled trials |journal=Medicine |volume=99 |issue=31 |pages=e21415 |date=July 2020 |pmid=32756141 |pmc=7402720 |doi=10.1097/MD.0000000000021415}}</ref>
| symptoms      = Cough, sore throat, runny nose, [[Medicine:Fever|fever]]<ref name=CDC2015/><ref name=Eccles2005/>
| complications = Usually none, but occasionally [[Medicine:Otitis media|otitis media]], [[Medicine:Sinusitis|sinusitis]], [[Medicine:Pneumonia|pneumonia]] and [[Medicine:Sepsis|sepsis]] can occur<ref name=Ben2014>{{cite book |vauthors=Bennett JE, Dolin R, Blaser MJ |title=Principles and Practice of Infectious Diseases |date=2014 |publisher=Elsevier Health Sciences |isbn=978-1-4557-4801-3 |page=750 |url=https://books.google.com/books?id=BseNCgAAQBAJ&pg=PA750 |language=en |url-status=live |archive-url=https://web.archive.org/web/20170908184148/https://books.google.com/books?id=BseNCgAAQBAJ&pg=PA750 |archive-date=8 September 2017}}</ref>
| onset         = ~2 days from exposure<ref name=CMAJ2014/>
| duration      = 1–3 weeks<ref name=CDC2015/><ref name=Heik2003/>
| causes        = [[Biology:Virus|Viral]] (usually rhinovirus)<ref name=CE11/>
| risks         = 
| diagnosis     = Based on symptoms
| differential  = [[Medicine:Allergic rhinitis|Allergic rhinitis]], [[Medicine:Bronchitis|bronchitis]], [[Medicine:Bronchiolitis|bronchiolitis]],<ref>{{cite web |title=Bronchiolitis: Symptoms and Causes |url=https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565 |website=Mayo Clinic |access-date=3 May 2022 |archive-date=3 May 2022 |archive-url=https://web.archive.org/web/20220503002225/https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565 |url-status=live }}</ref> pertussis, [[Medicine:Sinusitis|sinusitis]]<ref name=Ben2014/>
| prevention    = Hand washing, cough etiquette, [[Medicine:Social distancing|social distancing]], [[Biology:Vitamin C|vitamin C]]<ref name=CDC2015/><ref name=E209/>
| treatment     = [[Medicine:Symptomatic treatment|Symptomatic therapy]],<ref name=CDC2015/> [[Chemistry:Zinc|zinc]]<ref name=NIH2016Zinc/>
| medication    = NSAIDs<ref name=Kim2015/>
| frequency     = 2–3 per year (adults)<br /> 6–8 per year (children)<ref name=AFP07/>
| deaths        = 
}}

The '''common cold''' or the '''cold''' is a [[Biology:Virus|viral]] [[Medicine:Infectious disease|infectious disease]] of the upper respiratory tract that primarily affects the respiratory mucosa of the [[Medicine:Human nose|nose]], [[Medicine:Throat|throat]], [[Medicine:Paranasal sinuses|sinuses]], and [[Medicine:Larynx|larynx]].<ref name=CMAJ2014/><ref name=CE11>{{cite journal |vauthors=Arroll B |title=Common cold |journal=BMJ Clinical Evidence |volume=2011 |issue=3 |page=1510 |date=March 2011 |pmid=21406124 |pmc=3275147 |quote=Common colds are defined as upper respiratory tract infections that affect the predominantly nasal part of the respiratory mucosa}}</ref> Signs and symptoms may appear fewer than two days after exposure to the virus.<ref name=CMAJ2014>{{cite journal |vauthors=Allan GM, Arroll B |title=Prevention and treatment of the common cold: making sense of the evidence |journal=CMAJ |volume=186 |issue=3 |pages=190–9 |date=February 2014 |pmid=24468694 |pmc=3928210 |doi=10.1503/cmaj.121442}}</ref> These may include coughing, sore throat, runny nose, [[Biology:Sneeze|sneezing]], [[Medicine:Headache|headache]], and [[Medicine:Fever|fever]].<ref name=CDC2015/><ref name=Eccles2005>{{cite journal |vauthors=Eccles R |title=Understanding the symptoms of the common cold and influenza |journal=The Lancet. Infectious Diseases |volume=5 |issue=11 |pages=718–25 |date=November 2005 |pmid=16253889 |pmc=7185637 |doi=10.1016/S1473-3099(05)70270-X}}</ref> People usually recover in seven to ten days,<ref name=CDC2015/> but some symptoms may last up to three weeks.<ref name=Heik2003>{{cite journal |vauthors=Heikkinen T, Järvinen A |title=The common cold |journal=Lancet |volume=361 |issue=9351 |pages=51–9 |date=January 2003 |pmid=12517470 |pmc=7112468 |doi=10.1016/S0140-6736(03)12162-9}}</ref> Occasionally, those with other health problems may develop [[Medicine:Pneumonia|pneumonia]].<ref name=CDC2015/>

<!-- Cause, diagnosis, and pathophysiology -->
Well over 200 virus strains are implicated in causing the common cold, with rhinoviruses, [[Biology:Coronavirus|coronavirus]]es, [[Biology:Adenoviridae|adenoviruses]] and [[Biology:Enterovirus|enterovirus]]es being the most common.<ref>{{cite web |url=https://www.cdc.gov/getsmart/community/for-patients/common-illnesses/colds.html |title=Common Cold |publisher=Centers for Disease Control and Prevention |access-date=27 January 2021 |url-status=live |archive-url=https://web.archive.org/web/20160201101449/http://www.cdc.gov/getsmart/community/for-patients/common-illnesses/colds.html |archive-date=1 February 2016}}</ref> 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.<ref name=CDC2015/> Risk factors include going to child care facilities, [[Medicine:Sleep deprivation|not sleeping well]], and [[Medicine:Psychological stress|psychological stress]].<ref name=CMAJ2014/> The symptoms are mostly due to the body's [[Biology:Immune response|immune response]] to the infection rather than to [[Biology:Tissue|tissue destruction]] by the viruses themselves.<ref name=E112>Eccles p. 112</ref> The symptoms of [[Medicine:Influenza|influenza]] are similar to those of a cold, although usually more severe and less likely to include a runny nose.<ref name=CMAJ2014/><ref>{{cite web |title=Cold Versus Flu |date=11 August 2016 |url=https://www.cdc.gov/flu/about/qa/coldflu.htm |access-date=5 January 2017 |url-status=dead |archive-url=https://web.archive.org/web/20170106173600/https://www.cdc.gov/flu/about/qa/coldflu.htm |archive-date=6 January 2017}}</ref>

<!-- Prevention and treatment -->
There is no [[Biology:Vaccine|vaccine]] for the common cold.<ref name=CDC2015/> The primary methods of prevention are hand washing; not touching the eyes, nose or mouth with unwashed hands; and [[Medicine:Social distancing|staying away from sick people]].<ref name=CDC2015/> Some evidence supports the use of [[Medicine:Surgical mask|face masks]].<ref name=E209>Eccles p. 209</ref> There is also no [[Medicine:Cure|cure]], but the symptoms can be treated.<ref name=CDC2015/> [[Chemistry:Zinc|Zinc]] may reduce the duration and severity of symptoms if started shortly after the onset of symptoms.<ref name=NIH2016Zinc>{{cite web |title=Zinc – Fact Sheet for Health Professionals |url=https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional |publisher=Office of Dietary Supplements, US National Institutes of Health |date=10 July 2019 |access-date=27 December 2019 |quote=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]. |archive-date=25 March 2021 |archive-url=https://web.archive.org/web/20210325180015/https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/ |url-status=live }}</ref> [[Chemistry:Nonsteroidal anti-inflammatory drug|Nonsteroidal anti-inflammatory drug]]s (NSAIDs) such as [[Chemistry:Ibuprofen|ibuprofen]] may help with pain.<ref name=Kim2015>{{cite journal |vauthors=Kim SY, Chang YJ, Cho HM, Hwang YW, Moon YS |title=Non-steroidal anti-inflammatory drugs for the common cold |journal=The Cochrane Database of Systematic Reviews |volume=2015 |issue=9 |pages=CD006362 |date=September 2015 |pmid=26387658 |doi=10.1002/14651858.CD006362.pub4|pmc=10040208 }}</ref> [[Chemistry:Antibiotic|Antibiotic]]s, however, should not be used, as all colds are caused by viruses,<ref>{{cite journal |vauthors=Harris AM, Hicks LA, Qaseem A |title=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 |journal=Annals of Internal Medicine |volume=164 |issue=6 |pages=425–34 |date=March 2016 |pmid=26785402 |doi=10.7326/M15-1840 |doi-access=|s2cid=746771 }}</ref> and there is no good evidence that [[Medicine:Cough medicine|cough medicine]]s are effective.<ref name=CMAJ2014/><ref name=Mal2017>{{cite journal |vauthors=Malesker MA, Callahan-Lyon P, Ireland B, Irwin RS |title=Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold: CHEST Expert Panel Report |journal=Chest |volume=152 |issue=5 |pages=1021–1037 |date=November 2017 |pmid=28837801 |pmc=6026258 |doi=10.1016/j.chest.2017.08.009 |quote=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.}}</ref>

<!-- Epidemiology and history -->
The common cold is the most frequent infectious disease in humans.<ref name=E1>Eccles p. 1</ref> Under normal circumstances, the average adult gets two to three colds a year, while the average child may get six to eight.<ref name=CE11/><ref name=AFP07>{{cite journal |vauthors=Simasek M, Blandino DA |title=Treatment of the common cold |journal=American Family Physician |volume=75 |issue=4 |pages=515–20 |date=February 2007 |pmid=17323712 |url=http://www.aafp.org/afp/20070215/515.html |url-status=live |df=dmy-all |archive-url=https://web.archive.org/web/20070926230125/http://www.aafp.org/afp/20070215/515.html |archive-date=26 September 2007}}</ref> Infections occur more commonly during the winter.<ref name=CDC2015>{{cite web |title=Common Colds: Protect Yourself and Others |url=https://www.cdc.gov/features/rhinoviruses/ |website=CDC |access-date=4 February 2016 |date=6 October 2015 |url-status=live |archive-url=https://web.archive.org/web/20160205062000/http://www.cdc.gov/features/rhinoviruses/ |archive-date=5 February 2016}}</ref> These infections have existed throughout human history.<ref name="Eccles p. 3">{{cite book |vauthors=Eccles R, Weber O |title=Common cold |year=2009 |url=https://books.google.com/books?id=rRIdiGE42IEC&pg=PA3 |publisher=Birkhäuser |location=Basel |isbn=978-3-7643-9894-1 |page=3 |url-status=live |archive-url=https://web.archive.org/web/20160508020931/https://books.google.com/books?id=rRIdiGE42IEC&pg=PA3 |archive-date=8 May 2016}}</ref>

==Signs and symptoms==
[[File:A lady suffering from the Common Cold.png|thumb|upright=1|Woman with symptoms of the common cold]]

The typical symptoms of a cold include cough, runny nose, [[Biology:Sneeze|sneezing]], nasal congestion, and a sore throat, sometimes accompanied by [[Medicine:Myalgia|muscle ache]], fatigue, [[Medicine:Headache|headache]], and loss of appetite.<ref name=E24>Eccles p. 24</ref> A sore throat is present in about 40% of cases, a cough in about 50%,<ref name=CE11/> and muscle ache likewise in about 50%.<ref name=Eccles2005/> In adults, a [[Medicine:Fever|fever]] is generally not present but it is common in infants and young children.<ref name=Eccles2005/> The cough is usually mild compared to that accompanying [[Medicine:Influenza|influenza]].<ref name=Eccles2005/> While a cough and a fever indicate a higher likelihood of influenza in adults, a great deal of similarity exists between these two conditions.<ref>Eccles p. 26</ref> A number of the viruses that cause the common cold may also result in [[Medicine:Asymptomatic|asymptomatic infections]].<ref>Eccles p. 129</ref><ref>Eccles p. 50</ref>

The color of the [[Biology:Mucus|mucus]] or nasal secretion may vary from clear to yellow to green and does not indicate the class of agent causing the infection.<ref>Eccles p. 30</ref>

===Progression===
[[File:Cold symptoms cdc.jpg|Cold symptoms over time|thumb]]
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.<ref name=E24/> Symptoms may begin within sixteen hours of exposure<ref>{{cite book |veditors=Helms RA |title=Textbook of therapeutics: drug and disease management |year=2006 |publisher=Lippincott Williams & Wilkins |location=Philadelphia, Pa. [u.a.] |isbn=978-0-7817-5734-8 |page=1882 |url=https://books.google.com/books?id=aVmRWrknaWgC&pg=PA1882 |edition=8. |url-status=live |archive-url=https://web.archive.org/web/20160430175008/https://books.google.com/books?id=aVmRWrknaWgC&pg=PA1882 |archive-date=30 April 2016}}</ref> and typically peak two to four days after onset.<ref name=Eccles2005/><ref>{{cite book |vauthors=Turner RB, Hayden FG |veditors=Rübsamen-Waigmann H |display-editors=etal |title=Viral Infections and Treatment |chapter=Rhinovirus |year=2003 |publisher=CRC Press |location=New York |isbn=978-0-8247-4247-8 |page=111 |chapter-url=https://books.google.com/books?id=AltZnmbIhbwC&pg=PA111 |url-status=live |archive-url=https://web.archive.org/web/20160504193824/https://books.google.com/books?id=AltZnmbIhbwC&pg=PA111 |archive-date=4 May 2016}}</ref> They usually resolve in seven to ten days, but some can last for up to three weeks.<ref name=Heik2003/> The average duration of cough is eighteen days<ref name="pmid23319500">{{cite journal |vauthors=Ebell MH, Lundgren J, Youngpairoj S |title=How long does a cough last? Comparing patients' expectations with data from a systematic review of the literature |journal=Annals of Family Medicine |volume=11 |issue=1 |pages=5–13 |year=2013 |pmid=23319500 |pmc=3596033 |doi=10.1370/afm.1430}}</ref> and in some cases people develop a post-viral cough which can linger after the infection is gone.<ref name="pmid21198555">{{cite journal |vauthors=Dicpinigaitis PV |title=Cough: an unmet clinical need |journal=British Journal of Pharmacology |volume=163 |issue=1 |pages=116–24 |date=May 2011 |pmid=21198555 |pmc=3085873 |doi=10.1111/j.1476-5381.2010.01198.x}}</ref> In children, the cough lasts for more than ten days in 35–40% of cases and continues for more than 25 days in 10%.<ref>{{cite journal |vauthors=Goldsobel AB, Chipps BE |title=Cough in the pediatric population |journal=The Journal of Pediatrics |volume=156 |issue=3 |pages=352–8 |date=March 2010 |pmid=20176183 |doi=10.1016/j.jpeds.2009.12.004}}</ref>

==Causes==
===Viruses===
[[File:Coronaviruses 004 lores.jpg|thumb|upright=1|[[Biology:Coronavirus|Coronavirus]]es 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 [[Medicine:Respiratory tract|respiratory tract]] which can be caused by many different viruses. The most commonly implicated is a rhinovirus (30–80%), a type of [[Biology:Picornavirus|picornavirus]] with 99 known [[Biology:Serotype|serotype]]s.<ref>{{cite journal |vauthors=Palmenberg AC, Spiro D, Kuzmickas R, Wang S, Djikeng A, Rathe JA, Fraser-Liggett CM, Liggett SB |display-authors=6 |title=Sequencing and analyses of all known human rhinovirus genomes reveal structure and evolution |journal=Science |volume=324 |issue=5923 |pages=55–9 |date=April 2009 |pmid=19213880 |pmc=3923423 |doi=10.1126/science.1165557 |bibcode=2009Sci...324...55P}}</ref> Other commonly implicated viruses include adenoviruses, [[Biology:Enterovirus|enterovirus]]es, parainfluenza and [[Biology:Respiratory syncytial virus|RSV]].<ref name=ebm>{{cite book |chapter=Common Cold: Cause |vauthors=Janicki-Deverts D, Crittenden CN|title=Encyclopedia of Behavioral Medicine |page=504 |publisher=Springer |doi=10.1007/978-3-030-39903-0_795 |veditors=Gellman MD |year=2020 |edition=2nd|isbn=978-3-030-39901-6 |s2cid=242944824 }}</ref> Frequently more than one virus is present.<ref>Eccles p. 107</ref> In total, more than 200 viral types are associated with colds.<ref name=Eccles2005 /> The viral cause of some common colds (20-30%) is unknown.<ref name=ebm/> 

===Transmission===
The common cold virus is typically transmitted via airborne droplets (aerosols), direct contact with infected nasal secretions, or fomites (contaminated objects).<ref name=CE11/><ref name=Cold197>{{cite book |vauthors=Eccles R, Weber O |title=Common cold |year=2009 |publisher=Birkhäuser |location=Basel |isbn=978-3-7643-9894-1 |page=197 |url=https://books.google.com/books?id=rRIdiGE42IEC&pg=PA197 |edition=Online-Ausg. |url-status=live |archive-url=https://web.archive.org/web/20160502212944/https://books.google.com/books?id=rRIdiGE42IEC&pg=PA197 |archive-date=2 May 2016}}</ref> Which of these routes is of primary importance has not been determined.<ref name=E211>Eccles pp. 211, 215</ref> 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.<ref name=Cold197/> 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.<ref name=Allen1973>{{cite journal |vauthors=Allen TR, Bradburne AF, Stott EJ, Goodwin CS, Tyrrell DA |title=An outbreak of common colds at an Antarctic base after seventeen weeks of complete isolation |journal=The Journal of Hygiene |volume=71 |issue=4 |pages=657–67 |date=December 1973 |pmid=4520509 |pmc=2130424 |doi=10.1017/s0022172400022920 |}}</ref>

Transmission is common in daycare and at school due to the proximity of many children with little immunity and frequently poor hygiene.<ref name=Text2007/> These infections are then brought home to other members of the family.<ref name=Text2007>{{cite book |vauthors=Papadopoulos NG, Xatzipsaltis M, Johnston SL |veditors=Zuckerman AJ |display-editors=etal |title=Principles and Practice of Clinical Virology |chapter-url=https://books.google.com/books?id=4il2mF7JG1sC&pg=PR3 |year=2009 |publisher=John Wiley & Sons |isbn=978-0-470-74139-9 |page=496 |chapter=Rhinoviruses |edition=6th |url-status=live |archive-url=https://web.archive.org/web/20160603221154/https://books.google.com/books?id=OgbcUWpUCXsC&pg=PA496 |archive-date=3 June 2016}}</ref> There is no evidence that recirculated air during commercial flight is a method of transmission.<ref name=Cold197/> People sitting close to each other appear to be at greater risk of infection.<ref name=E211/>

Rhinovirus-caused colds are most infectious during the first three days of symptoms; they are much less infectious afterwards.<ref name="contagiousness">{{cite journal |vauthors=Gwaltney JM Jr, Halstead SB |title=Contagiousness of the common cold |department=Questions and answers |journal=Journal of the American Medical Association |date=16 July 1997 |volume=278 |issue=3 |pages=256–57 |doi=10.1001/jama.1997.03550030096050}}</ref>

===Other===
[[Medicine:Herd immunity|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.<ref name=E78/> Poor immune function is a risk factor for disease.<ref name=E78/><ref>Eccles p. 166</ref> [[Medicine:Sleep deprivation|Insufficient sleep]] and [[Medicine:Malnutrition|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.<ref>{{cite journal |vauthors=Cohen S, Doyle WJ, Alper CM, Janicki-Deverts D, Turner RB |title=Sleep habits and susceptibility to the common cold |journal=Archives of Internal Medicine |volume=169 |issue=1 |pages=62–7 |date=January 2009 |pmid=19139325 |pmc=2629403 |doi=10.1001/archinternmed.2008.505}}</ref><ref>Eccles pp. 160–65</ref> Breast feeding decreases the risk of acute otitis media and lower respiratory tract infections among other diseases,<ref>{{cite journal |vauthors=McNiel ME, Labbok MH, Abrahams SW |title=What are the risks associated with formula feeding? A re-analysis and review |journal=Breastfeeding Review |volume=18 |issue=2 |pages=25–32 |date=July 2010 |pmid=20879657}}</ref> and it is recommended that breast feeding be continued when an infant has a cold.<ref>{{cite book |vauthors=Lawrence RA, Lawrence RM |title=Breastfeeding: A guide for the medical profession |publisher=Mosby/Elsevier |location=Maryland Heights, Mo. |isbn=978-1-4377-3590-1 |page=478 |url=https://books.google.com/books?id=c4BnozBW3EMC&pg=PA478 |edition=7th |year=2010 |url-status=live |archive-url=https://web.archive.org/web/20160617002059/https://books.google.com/books?id=c4BnozBW3EMC&pg=PA478 |archive-date=17 June 2016}}</ref> In the developed world breast feeding may not be protective against the common cold in and of itself.<ref name="NelsonWilliams2007">{{citation |vauthors=Nelson KE, Williams CM |title=Infectious Disease Epidemiology: Theory and Practice |url=https://books.google.com/books?id=o_j-G4zJ4cQC&pg=PA724 |year=2007 |publisher=Jones & Bartlett Learning |isbn=978-0-7637-2879-3 |pages=724– |edition=2nd |url-status=live |archive-url=https://web.archive.org/web/20160520134003/https://books.google.com/books?id=o_j-G4zJ4cQC&pg=PA724 |archive-date=20 May 2016}}</ref>

==Pathophysiology==
[[File:Illu conducting passages.svg|thumb|upright|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.<ref name=E112/> The mechanism of this immune response is virus-specific. For example, the rhinovirus is typically acquired by direct contact; it binds to humans via [[Biology:ICAM-1|ICAM-1 receptors]] and the [[Biology:Cadherin related family member 3|CDHR3 receptor]] through unknown mechanisms to trigger the release of inflammatory mediators.<ref name=E112/> These inflammatory mediators then produce the symptoms.<ref name=E112/> It does not generally cause damage to the nasal [[Biology:Epithelium|epithelium]].<ref name=Eccles2005/> The respiratory syncytial virus ([[Medicine:Human 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.<ref name=E116>Eccles p. 116</ref> RSV does cause epithelium damage.<ref name=E116/> Human parainfluenza virus typically results in inflammation of the nose, throat, and bronchi.<ref name=E122>Eccles p. 122</ref> In young children, when it affects the trachea, it may produce the symptoms of [[Medicine:Croup|croup]], due to the small size of their airways.<ref name=E122/>

==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).<ref name=CE11/> There can be significant overlap, and more than one area can be affected.<ref name=CE11/> Self-diagnosis is frequent.<ref name=Eccles2005/> Isolation of the viral agent involved is rarely performed,<ref name=E51>Eccles pp. 51–52</ref> and it is generally not possible to identify the virus type through symptoms.<ref name=Eccles2005/>

==Prevention==
The only useful ways to reduce the spread of cold viruses are physical measures<ref name=E209/> such as using correct hand washing technique and face masks; in the healthcare environment, gowns and disposable gloves are also used.<ref name=E209/> Isolation or [[Medicine:Quarantine|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.<ref>{{Cite web |last=CDC |date=11 February 2019 |title=Common Colds |url=http://www.cdc.gov/features/rhinoviruses/index.html |access-date=18 September 2020 |website=Centers for Disease Control and Prevention |language=en-us |archive-date=27 September 2020 |archive-url=https://web.archive.org/web/20200927120520/https://www.cdc.gov/features/rhinoviruses/index.html |url-status=live }}</ref> [[Biology:Vaccination|Vaccination]] has proven difficult as there are many viruses involved and they [[Biology:Viral evolution|mutate]] rapidly.<ref name=E209/><ref>{{Cite journal |last1=Montesinos-Guevara |first1=Camila |last2=Buitrago-Garcia |first2=Diana |last3=Felix |first3=Maria L. |last4=Guerra |first4=Claudia V. |last5=Hidalgo |first5=Ricardo |last6=Martinez-Zapata |first6=Maria José |last7=Simancas-Racines |first7=Daniel |date=14 December 2022 |title=Vaccines for the common cold |journal=The Cochrane Database of Systematic Reviews |volume=2022 |issue=12 |pages=CD002190 |doi=10.1002/14651858.CD002190.pub6 |issn=1469-493X |pmc=9749450 |pmid=36515550}}</ref> Creation of a broadly effective vaccine is, therefore, highly improbable.<ref>{{cite journal |vauthors=Lawrence DM |title=Gene studies shed light on rhinovirus diversity |journal=Lancet Infect Dis |volume=9 |issue=5 |page=278 |year=2009 |doi=10.1016/S1473-3099(09)70123-9}}</ref>

Regular hand washing appears to be effective in reducing the transmission of cold viruses, especially among children.<ref name=":0">{{Cite journal |last1=Jefferson |first1=Tom |last2=Dooley |first2=Liz |last3=Ferroni |first3=Eliana |last4=Al-Ansary |first4=Lubna A. |last5=van Driel |first5=Mieke L. |last6=Bawazeer |first6=Ghada A. |last7=Jones |first7=Mark A. |last8=Hoffmann |first8=Tammy C. |last9=Clark |first9=Justin |last10=Beller |first10=Elaine M. |last11=Glasziou |first11=Paul P. |last12=Conly |first12=John M. |date=30 January 2023 |title=Physical interventions to interrupt or reduce the spread of respiratory viruses |journal=The Cochrane Database of Systematic Reviews |volume=1 |issue=1 |pages=CD006207 |doi=10.1002/14651858.CD006207.pub6 |issn=1469-493X |pmc=9885521 |pmid=36715243}}</ref> Whether the addition of [[Biology:Antiviral drug|antivirals]] or antibacterials to normal hand washing provides greater benefit is unknown.<ref name=":0" /> Wearing face masks when around people who are infected may be beneficial; however, there is insufficient evidence for maintaining a greater [[Medicine:Social distancing|social distance]].<ref name=":0" />

It is unclear whether [[Chemistry:Zinc#Biological role|zinc]] supplements affect the likelihood of contracting a cold.<ref name=Cochrane2013>{{cite journal |vauthors=Singh M, Das RR |title=Zinc for the common cold |journal=The Cochrane Database of Systematic Reviews |issue=6 |pages=CD001364 |date=June 2013 |pmid=23775705 |doi=10.1002/14651858.CD001364.pub4 |veditors=Singh M}}{{Retracted|intentional=yes}}</ref> Routine [[Biology:Vitamin C|vitamin C]] supplements do not reduce the risk or severity of the common cold, though they may reduce its duration.<ref name="Hem2013"/>

==Management==
[[File:Pneumonia strikes like a man eating shark.jpg|upright|thumb|Poster from 1937 encouraging citizens to "consult your physician" for treatment of the common cold]]

Treatments of the common cold primarily involve [[Medicine:Symptomatic treatment|medications and other therapies for symptomatic relief]].<ref name=AFP07/> Getting plenty of rest, drinking fluids to maintain hydration, and gargling with warm salt water are reasonable conservative measures.<ref name="NIAID2006">{{cite web |title=Common Cold |publisher=[[Organization:National Institute of Allergy and Infectious Diseases|National Institute of Allergy and Infectious Diseases]] |date=27 November 2006 |url=http://www3.niaid.nih.gov/healthscience/healthtopics/colds/ |access-date=11 June 2007 |archive-url=https://web.archive.org/web/20080906193939/http://www3.niaid.nih.gov/healthscience/healthtopics/colds/ |archive-date=6 September 2008}}</ref> Much of the benefit from symptomatic treatment is, however, attributed to the placebo effect.<ref>Eccles p. 261</ref> {{As of|2010|post=,}} no medications or herbal remedies had been conclusively demonstrated to shorten the duration of infection.<ref>{{cite web |title=Common Cold: Treatments and Drugs |publisher=Mayo Clinic |url=http://www.mayoclinic.com/health/common-cold/DS00056/DSECTION=treatments-and-drugs |access-date=9 January 2010 |url-status=live |archive-url=https://web.archive.org/web/20100212105512/http://www.mayoclinic.com/health/common-cold/DS00056/DSECTION%3Dtreatments-and-drugs |archive-date=12 February 2010}}</ref>

===Symptomatic===
[[File:Treatments for the Common Cold (37652567755).jpg|thumb|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 [[Chemistry:Antipyretic|medications for fevers]] such as [[Chemistry:Ibuprofen|ibuprofen]]<ref name="Kim2015" /> and [[Chemistry:Paracetamol|acetaminophen (paracetamol)]].<ref>{{cite journal |vauthors=Eccles R |title=Efficacy and safety of over-the-counter analgesics in the treatment of common cold and flu |journal=Journal of Clinical Pharmacy and Therapeutics |volume=31 |issue=4 |pages=309–19 |date=August 2006 |pmid=16882099 |doi=10.1111/j.1365-2710.2006.00754.x |s2cid=22793984 |doi-access=free}}</ref> However, it is not clear whether acetaminophen helps with symptoms.<ref>{{cite journal |vauthors=Li S, Yue J, Dong BR, Yang M, Lin X, Wu T |title=Acetaminophen (paracetamol) for the common cold in adults |journal=The Cochrane Database of Systematic Reviews |issue=7 |pages=CD008800 |date=July 2013 |volume=2013 |pmid=23818046 |pmc=7389565 |doi=10.1002/14651858.CD008800.pub2}}</ref> It is not known if over-the-counter [[Medicine:Cough medicine|cough medications]] are effective for treating an [[Medicine:Acute|acute]] cough.<ref>{{cite journal |vauthors=Smith SM, Schroeder K, Fahey T |title=Over-the-counter (OTC) medications for acute cough in children and adults in community settings |journal=The Cochrane Database of Systematic Reviews |volume=11 |issue=11 |pages=CD001831 |date=November 2014 |pmid=25420096 |pmc=7061814 |doi=10.1002/14651858.CD001831.pub5}}</ref> Cough medicines are not recommended for use in children due to a lack of evidence supporting effectiveness and the potential for harm.<ref name=CFP09>{{cite journal |vauthors=Shefrin AE, Goldman RD |title=Use of over-the-counter cough and cold medications in children |journal=Canadian Family Physician |volume=55 |issue=11 |pages=1081–3 |date=November 2009 |pmid=19910592 |pmc=2776795 |url=http://www.cfp.ca/content/55/11/1081.full.pdf |url-status=live |df=dmy-all |archive-url=https://web.archive.org/web/20150923202113/http://www.cfp.ca/content/55/11/1081.full.pdf |archive-date=23 September 2015}}</ref><ref>{{cite journal |vauthors=Vassilev ZP, Kabadi S, Villa R |title=Safety and efficacy of over-the-counter cough and cold medicines for use in children |journal=Expert Opinion on Drug Safety |volume=9 |issue=2 |pages=233–42 |date=March 2010 |pmid=20001764 |doi=10.1517/14740330903496410 |s2cid=12952868}}</ref> 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.<ref name=CFP09/> The misuse of [[Chemistry:Dextromethorphan|dextromethorphan]] (an over-the-counter cough medicine) has led to its ban in a number of countries.<ref>Eccles p. 246</ref> [[Biology:Corticosteroid|Intranasal corticosteroids]] have not been found to be useful.<ref>{{cite journal |vauthors=Hayward G, Thompson MJ, Perera R, Del Mar CB, Glasziou PP, Heneghan CJ |title=Corticosteroids for the common cold |journal=The Cochrane Database of Systematic Reviews |issue=10 |pages=CD008116 |date=October 2015 |volume=2016 |pmid=26461493 |doi=10.1002/14651858.cd008116.pub3 |pmc=8734596 |url=https://pure.bond.edu.au/ws/files/32879677/Corticosteroids_for_the_common_cold.pdf |access-date=12 December 2019 |archive-date=9 November 2020 |archive-url=https://web.archive.org/web/20201109194311/https://pure.bond.edu.au/ws/files/32879677/Corticosteroids_for_the_common_cold.pdf |url-status=live }}</ref>

In adults, short term use of nasal decongestants may have a small benefit.<ref name="Deckx2016" /> [[Chemistry:Antihistamine|Antihistamine]]s may improve symptoms in the first day or two; however, there is no longer-term benefit and they have adverse effects such as drowsiness.<ref>{{cite journal |vauthors=De Sutter AI, Saraswat A, van Driel ML |title=Antihistamines for the common cold |journal=The Cochrane Database of Systematic Reviews |volume=2015 |issue=11 |pages=CD009345 |date=November 2015 |pmid=26615034 |doi=10.1002/14651858.CD009345.pub2 |pmc=9468790 |url=https://biblio.ugent.be/publication/7237869 |hdl-access=free |hdl=1854/LU-7237869 |access-date=12 December 2019 |archive-date=5 May 2020 |archive-url=https://web.archive.org/web/20200505030304/https://biblio.ugent.be/publication/7237869 |url-status=live }}</ref> Other decongestants such as [[Chemistry:Pseudoephedrine|pseudoephedrine]] appear effective in adults.<ref>{{cite journal |vauthors=Taverner D, Latte J |title=Nasal decongestants for the common cold |journal=The Cochrane Database of Systematic Reviews |issue=1 |pages=CD001953 |date=January 2007 |pmid=17253470 |doi=10.1002/14651858.CD001953.pub3 |veditors=Latte GJ}}</ref><ref name=Deckx2016>{{cite journal |vauthors=Deckx L, De Sutter AI, Guo L, Mir NA, van Driel ML |title=Nasal decongestants in monotherapy for the common cold |journal=The Cochrane Database of Systematic Reviews |volume=2016 |pages=CD009612 |date=October 2016 |issue=10 |pmid=27748955 |pmc=6461189 |doi=10.1002/14651858.CD009612.pub2}}</ref> Combined oral analgesics, antihistaminics and decongestants are generally effective for older children and adults.<ref>{{Cite journal |last1=De Sutter |first1=An Im |last2=Eriksson |first2=Lars |last3=van Driel |first3=Mieke L. |date=21 January 2022 |title=Oral antihistamine-decongestant-analgesic combinations for the common cold |journal=The Cochrane Database of Systematic Reviews |volume=1 |issue=1 |pages=CD004976 |doi=10.1002/14651858.CD004976.pub4 |issn=1469-493X |pmc=8780136 |pmid=35060618}}</ref> Ipratropium nasal spray may reduce the symptoms of a runny nose but has little effect on stuffiness.<ref>{{cite journal |vauthors=AlBalawi ZH, Othman SS, Alfaleh K |title=Intranasal ipratropium bromide for the common cold |journal=The Cochrane Database of Systematic Reviews |issue=6 |pages=CD008231 |date=June 2013 |volume=2013 |pmid=23784858 |pmc=6492479 |doi=10.1002/14651858.CD008231.pub3}}</ref> Ipratropium may also help with cough in adults.<ref>{{cite journal |vauthors=DeGeorge KC, Ring DJ, Dalrymple SN |title=Treatment of the Common Cold |journal=American Family Physician |volume=100 |issue=5 |pages=281–289 |date=September 2019 |pmid=31478634}}</ref> The safety and effectiveness of nasal decongestant use in children is unclear.<ref name=Deckx2016 />

Due to lack of studies, it is not known whether increased fluid intake improves symptoms or shortens respiratory illness.<ref>{{cite journal |vauthors=Guppy MP, Mickan SM, Del Mar CB, Thorning S, Rack A |title=Advising patients to increase fluid intake for treating acute respiratory infections |journal=The Cochrane Database of Systematic Reviews |issue=2 |pages=CD004419 |date=February 2011 |volume=2011 |pmid=21328268 |pmc=7197045 |doi=10.1002/14651858.CD004419.pub3 |veditors=Guppy MP}}</ref> As of 2017, heated and humidified air, such as via RhinoTherm, is of unclear benefit.<ref>{{cite journal |vauthors=Singh M, Singh M, Jaiswal N, Chauhan A |title=Heated, humidified air for the common cold |journal=The Cochrane Database of Systematic Reviews |volume=2017 |pages=CD001728 |date=August 2017 |issue=8 |pmid=28849871 |pmc=6483632 |doi=10.1002/14651858.CD001728.pub6}}</ref> One study has found chest vapor rub to provide some relief of nocturnal cough, congestion, and sleep difficulty.<ref name="pmid21059712">{{cite journal |vauthors=Paul IM, Beiler JS, King TS, Clapp ER, Vallati J, Berlin CM |title=Vapor rub, petrolatum, and no treatment for children with nocturnal cough and cold symptoms |journal=Pediatrics |volume=126 |issue=6 |pages=1092–9 |date=December 2010 |pmid=21059712 |pmc=3600823 |doi=10.1542/peds.2010-1601}}</ref>

Some advise to avoid physical exercise if there are symptoms such as fever, widespread [[Medicine:Myalgia|muscle aches]] or fatigue.<ref name=mayo>{{cite web |url=http://www.mayoclinic.org/healthy-lifestyle/fitness/expert-answers/exercise/faq-20058494 |title=Is it OK to exercise if I have a cold? |website=Mayo Clinic |vauthors=Laskowski ER |date=9 February 2017 |access-date=4 July 2017 |url-status=live |archive-url=https://web.archive.org/web/20170719092604/http://www.mayoclinic.org/healthy-lifestyle/fitness/expert-answers/exercise/faq-20058494 |archive-date=19 July 2017}}</ref><ref name=acsm>{{cite web |url=http://www.acsm.org/about-acsm/media-room/acsm-in-the-news/2011/08/01/clearing-the-air-on-exercise-and-the-common-cold |title=Clearing the Air on Exercise and the Common Cold |website=American College of Sports Medicine |access-date=4 July 2017 |archive-url=https://web.archive.org/web/20170722112319/http://acsm.org/about-acsm/media-room/acsm-in-the-news/2011/08/01/clearing-the-air-on-exercise-and-the-common-cold |archive-date=22 July 2017}}</ref> It is regarded as safe to perform moderate exercise if the symptoms are confined to the [[Medicine:Human head|head]], including runny nose, nasal congestion, sneezing, or a minor sore throat.<ref name=mayo/><ref name=acsm/> There is a popular belief that having a hot drink can help with cold symptoms, but evidence to support this is very limited.<ref>{{cite web |publisher=National Health Service |title=Hot drinks ease cold and flu |date=10 December 2008 |url=https://www.nhs.uk/news/food-and-diet/hot-drinks-ease-cold-and-flu/ |access-date=27 January 2021 |archive-url=https://web.archive.org/web/20201125101914/https://www.nhs.uk/news/food-and-diet/hot-drinks-ease-cold-and-flu/ |archive-date=25 November 2020}}</ref>

===Antibiotics and antivirals===
Antibiotics have no effect against viral infections, including the common cold.<ref name=CochraneAR2013>{{cite journal |vauthors=Kenealy T, Arroll B |title=Antibiotics for the common cold and acute purulent rhinitis |journal=The Cochrane Database of Systematic Reviews |volume=2013 |issue=6 |pages=CD000247 |date=June 2013 |pmid=23733381 |pmc=7044720 |doi=10.1002/14651858.CD000247.pub3}}</ref> Due to their side effects, antibiotics cause overall harm but are still frequently prescribed.<ref name=CochraneAR2013/><ref>Eccles p. 238</ref> 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.<ref>Eccles p. 234</ref> There are no effective [[Biology:Antiviral drug|antiviral drug]]s for the common cold even though some preliminary research has shown benefits.<ref name=AFP07/><ref name="EcclesPg_b">Eccles p. 218</ref>

===Zinc===
{{Main|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&nbsp;hours of the onset of symptoms.<ref name=NIH2016Zinc/><ref name=Cochrane2013/><ref name="Zinc CC 2018 SystRev">{{cite journal |vauthors=Rondanelli M, Miccono A, Lamburghini S, Avanzato I, Riva A, Allegrini P, Faliva MA, Peroni G, Nichetti M, Perna S |display-authors=6 |title=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 |journal=Evidence-Based Complementary and Alternative Medicine |volume=2018 |pages=5813095 |year=2018 |pmid=29853961 |pmc=5949172 |doi=10.1155/2018/5813095 |quote=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. |doi-access=free}}</ref><ref name=Hemila_2017a>{{cite journal |vauthors=Hemilä H, Fitzgerald JT, Petrus EJ, Prasad A |title=Zinc Acetate Lozenges May Improve the Recovery Rate of Common Cold Patients: An Individual Patient Data Meta-Analysis |journal=Open Forum Infectious Diseases |volume=4 |issue=2 |pages=ofx059 |year=2017 |pmid=28480298 |pmc=5410113 |doi=10.1093/ofid/ofx059 |quote=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.}}</ref><ref name=Hemila_2016>{{cite journal |vauthors=Hemilä H, Petrus EJ, Fitzgerald JT, Prasad A |title=Zinc acetate lozenges for treating the common cold: an individual patient data meta-analysis |journal=British Journal of Clinical Pharmacology |volume=82 |issue=5 |pages=1393–1398 |date=November 2016 |pmid=27378206 |pmc=5061795 |doi=10.1111/bcp.13057}}</ref> Some zinc remedies directly applied to the inside of the nose have led to the [[Medicine:Anosmia|loss of the sense of smell]].<ref name=NIH2016Zinc/><ref>{{cite web |url=https://www.fda.gov/Drugs/DrugSafety/DrugSafetyPodcasts/ucm167282.htm |title=Loss of Sense of Smell with Intranasal Cold Remedies Containing Zinc |website=[[Organization:Food and Drug Administration|Food and Drug Administration]] |year=2009 |archive-url=https://web.archive.org/web/20150604024153/https://www.fda.gov/Drugs/DrugSafety/DrugSafetyPodcasts/ucm167282.htm |archive-date=4 June 2015}}</ref> A 2017 review did not recommend the use of zinc for the common cold for various reasons;<ref name=Mal2017/> whereas a 2017 and 2018 review both recommended the use of zinc, but also advocated further research on the topic.<ref name="Zinc CC 2018 SystRev" /><ref name="Hemila_2017a" />

===Alternative medicine===
{{main|Unsolved:Alternative treatments used for the common cold}}
While there are many [[Medicine:Alternative medicine|alternative medicine]]s and [[Medicine:Traditional Chinese medicine|Chinese herbal medicines]] supposed to treat the common cold, there is insufficient [[Medicine:Evidence-based medicine|scientific evidence]] to support their use.<ref name=AFP07/><ref>{{cite journal |vauthors=Wu T, Zhang J, Qiu Y, Xie L, Liu GJ |title=Chinese medicinal herbs for the common cold |journal=The Cochrane Database of Systematic Reviews |issue=1 |pages=CD004782 |date=January 2007 |pmid=17253524 |doi=10.1002/14651858.CD004782.pub2}}</ref> As of 2015, there is weak evidence to support nasal irrigation with [[Medicine:Saline|saline]].<ref>{{cite journal |vauthors=King D, Mitchell B, Williams CP, Spurling GK |title=Saline nasal irrigation for acute upper respiratory tract infections |journal=The Cochrane Database of Systematic Reviews |volume=2015 |issue=4 |pages=CD006821 |date=April 2015 |pmid=25892369 |doi=10.1002/14651858.CD006821.pub3 |pmc=9475221 |url=http://espace.library.uq.edu.au/view/UQ:363301/UQ363301_OA.pdf |access-date=30 December 2018 |archive-date=5 May 2020 |archive-url=https://web.archive.org/web/20200505030257/https://espace.library.uq.edu.au/data/UQ_363301/UQ363301_OA.pdf?Expires=1588647864&Key-Pair-Id=APKAJKNBJ4MJBJNC6NLQ&Signature=JNzYRuMeJadbzbgCE~xCv8xoYpIcVafTFA-YDCLgXUQxrBDH84lVq2sENa6OkdMaBI1hD7EIAdcrNxl4Zpx1dfo05al3UFxXwQiYIxlAf1iiGf8DzCYk2pv7gvM-kgHXa46x2P~571ZZz6a5cFmlzMTm2xfmfHSwLv9zObHNiIPn~QauXGNGkKCLpQs4wA6CsAbY4utwc~wQiB-8VYuXj~WgsRK0ng3zOi5mk~wlAbMPqyzqyrrZx2SZERa6fJBXHvAhM5pzPYUXC6aSMNC82Usp7OEASHbkmQeu0WE8023xvwrQTzKDWu43cYXJ1VAsVEpBaL0ulZYYD1898nUZ6Q__ |url-status=live }}</ref> There is no firm evidence that [[Biology:Echinacea|Echinacea]] products or [[Biology:Garlic|garlic]] provide any meaningful benefit in treating or preventing colds.<ref>{{cite journal |vauthors=Karsch-Völk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, Linde K |title=Echinacea for preventing and treating the common cold |journal=The Cochrane Database of Systematic Reviews |volume=2 |issue=2 |pages=CD000530 |date=February 2014 |pmid=24554461 |pmc=4068831 |doi=10.1002/14651858.CD000530.pub3 |type=Systematic review}}</ref><ref>{{cite journal |vauthors=Lissiman E, Bhasale AL, Cohen M |title=Garlic for the common cold |journal=The Cochrane Database of Systematic Reviews |volume=11 |issue=11 |pages=CD006206 |date=November 2014 |pmid=25386977 |pmc=6465033 |doi=10.1002/14651858.CD006206.pub4 |veditors=Lissiman E}}</ref>

===Vitamins C and D===
{{Main|Chemistry:Vitamin C and the common cold}}
{{Main|Biology:Vitamin D and respiratory tract infections}}
[[Biology:Vitamin C|Vitamin C]] supplementation does not affect the incidence of the common cold, but may reduce its duration.<ref name=Hem2013>{{cite journal |vauthors=Hemilä H, Chalker E |title=Vitamin C for preventing and treating the common cold |journal=The Cochrane Database of Systematic Reviews |volume=1 |issue=1 |pages=CD000980 |date=January 2013 |pmid=23440782 |pmc=1160577 |doi=10.1002/14651858.CD000980.pub4}}</ref> There is no conclusive evidence that [[Chemistry:Vitamin D|vitamin D]] supplementation is efficacious in the prevention or treatment of respiratory tract infections.<ref>{{cite journal |vauthors=Bradley R, Schloss J, Brown D, Celis D, Finnell J, Hedo R, Honcharov V, Pantuso T, Peña H, Lauche R, Steel A |display-authors=6 |title=The effects of vitamin D on acute viral respiratory infections: A rapid review |journal=Advances in Integrative Medicine |volume=7 |issue=4 |pages=192–202 |date=December 2020 |pmid=32837896 |pmc=7397989 |doi=10.1016/j.aimed.2020.07.011}}</ref>

==Prognosis==
The common cold is generally mild and self-limiting with most symptoms generally improving in a week.<ref name=CE11/> In children, half of cases go away in 10&nbsp;days and 90% in 15&nbsp;days.<ref>{{cite journal |vauthors=Thompson M, Vodicka TA, Blair PS, Buckley DI, Heneghan C, Hay AD |title=Duration of symptoms of respiratory tract infections in children: systematic review |journal=BMJ |volume=347 |pages=f7027 |date=December 2013 |pmid=24335668 |pmc=3898587 |doi=10.1136/bmj.f7027}}</ref> Severe complications, if they occur, are usually in the very old, the very young, or those who are immunosuppressed.<ref name=E1/> Secondary bacterial infections may occur resulting in [[Medicine:Sinusitis|sinusitis]], [[Medicine:Pharyngitis|pharyngitis]], or an ear infection.<ref>Eccles p. 76</ref> It is estimated that sinusitis occurs in 8% and ear infection in 30% of cases.<ref name="EcclesPg_a">Eccles p. 90</ref>

==Epidemiology==
The common cold is the most common human disease<ref name=E1/> and affects people all over the globe.<ref name=Text2007/> Adults typically have two to three infections annually,<ref name=CE11/> and children may have six to ten colds a year (and up to twelve colds a year for school children).<ref name="AFP07"/> Rates of symptomatic infections increase in the elderly due to declining immunity.<ref name="E78">Eccles p. 78</ref>

===Weather===
A common misconception is that one can "catch a cold" merely through prolonged exposure to cold weather.<ref>{{cite news |vauthors=Zuger A |title='You'll Catch Your Death!' An Old Wives' Tale? Well.. |newspaper={{wipe|The New York Times}} |date=4 March 2003 |url=https://www.nytimes.com/2003/03/04/science/you-ll-catch-your-death-an-old-wives-tale-well.html |url-status=live |archive-url=https://web.archive.org/web/20170322034343/http://www.nytimes.com/2003/03/04/science/you-ll-catch-your-death-an-old-wives-tale-well.html |archive-date=22 March 2017}}</ref> 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.<ref>Eccles p. 79</ref> The reason for the seasonality has not been conclusively determined.<ref name=nhs>{{cite web |title=Common cold – Background information |url=http://www.cks.nhs.uk/common_cold/background_information/prevalence |publisher=National Institute for Health and Clinical Excellence |access-date=19 March 2013 |url-status=dead |archive-url=http://webarchive.nationalarchives.gov.uk/20121115105310/http%3A//www.cks.nhs.uk/common_cold/background_information/prevalence |archive-date=15 November 2012}}</ref> Possible explanations may include cold temperature-induced changes in the respiratory system,<ref name="EcclesPg" /> decreased immune response,<ref name="Mourtzoukou"/> 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.<ref>Eccles p. 157</ref>

The apparent seasonality may also be due to social factors, such as people spending more time indoors, near infected people,<ref name="EcclesPg">Eccles p. 80</ref> and specifically children at school.<ref name=Text2007/><ref name=nhs/> Although normal exposure to cold does not increase one's risk of infection, severe exposure leading to significant reduction of body temperature ([[Physics:Hypothermia|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.<ref name="Mourtzoukou">{{cite journal |vauthors=Mourtzoukou EG, Falagas ME |title=Exposure to cold and respiratory tract infections |journal=The International Journal of Tuberculosis and Lung Disease |volume=11 |issue=9 |pages=938–43 |date=September 2007 |pmid=17705968}}</ref>

==History==
[[File:The Cost Of The Common Cold & Influenza.jpg|upright|thumb|A British poster from [[Social:World War II|World War II]] describing the cost of the common cold<ref>{{cite web |title=The Cost of the Common Cold and Influenza |website=Imperial War Museum: Posters of Conflict |publisher=vads |url=http://vads.bath.ac.uk/flarge.php?uid=33443&sos=0 |url-status=dead |archive-url=https://web.archive.org/web/20110727091037/http://vads.bath.ac.uk/flarge.php?uid=33443&sos=0 |archive-date=27 July 2011}}</ref>]]

While the cause of the common cold was identified in the 1950s, the disease appears to have been with humanity since its early history.<ref name="Eccles p. 3"/><!-- Quote=[in reference to pre and early history] Despite our lack of specific knowledge, we can be relatively sure that colds existed at that time --> Its symptoms and treatment are described in the Egyptian Ebers papyrus, the oldest existing medical text, written before the 16th century BCE.<ref>Eccles p. 6</ref> The name "cold" came into use in the 16th century, due to the similarity between its symptoms and those of exposure to cold weather.<ref>{{cite dictionary |dictionary=Online Etymology Dictionary |url=http://www.etymonline.com/index.php?term=cold |title=Cold |access-date=12 January 2008 |url-status=live |archive-url=https://web.archive.org/web/20071024173928/http://www.etymonline.com/index.php?term=cold |archive-date=24 October 2007}}</ref>

In the United Kingdom, the [[Biology:Common Cold Unit|Common Cold Unit]] (CCU) was set up by the Medical Research Council in 1946 and it was where the rhinovirus was discovered in 1956.<ref>Eccles p. 20</ref> In the 1970s, the CCU demonstrated that treatment with [[Biology:Interferon|interferon]] during the incubation phase of rhinovirus infection protects somewhat against the disease,<ref name="pmid2438740">{{cite journal |vauthors=Tyrrell DA |title=Interferons and their clinical value |journal=Reviews of Infectious Diseases |volume=9 |issue=2 |pages=243–9 |year=1987 |pmid=2438740 |doi=10.1093/clinids/9.2.243}}</ref> but no practical treatment could be developed. The unit was closed in 1989, two years after it completed research of [[Chemistry:Zinc gluconate#Zinc gluconate and the common cold|zinc gluconate lozenges]] in the prevention and treatment of rhinovirus colds, the only successful treatment in the history of the unit.<ref>{{cite journal |vauthors=Al-Nakib W, Higgins PG, Barrow I, Batstone G, Tyrrell DA |title=Prophylaxis and treatment of rhinovirus colds with zinc gluconate lozenges |journal=The Journal of Antimicrobial Chemotherapy |volume=20 |issue=6 |pages=893–901 |date=December 1987 |pmid=3440773 |pmc=7110079 |doi=10.1093/jac/20.6.893}}</ref>

==Research directions==
[[Biology:Antiviral drug|Antivirals]] have been tested for effectiveness in the common cold; as of 2009, none had been both found effective and licensed for use.<ref name="EcclesPg_b" /> There are trials of the anti-viral drug [[Chemistry:Pleconaril|pleconaril]] which shows promise against [[Biology:Picornavirus|picornavirus]]es as well as trials of BTA-798.<ref name=E226>Eccles p. 226</ref> The oral form of pleconaril had safety issues and an aerosol form is being studied.<ref name=E226/> The [[Biology:Genome|genome]]s of all known human rhinovirus strains have been sequenced.<ref name="CTgov">{{cite news |url=http://www.cnn.com/2009/HEALTH/02/12/cold.genome/ |title=Genetic map of cold virus a step toward cure, scientists say |date=12 February 2009 |access-date=28 April 2009 |work=CNN |vauthors=Willingham V |url-status=live |archive-url=https://web.archive.org/web/20090426044933/http://www.cnn.com/2009/HEALTH/02/12/cold.genome/ |archive-date=26 April 2009}}</ref>

==Societal impact==
The economic impact of the common cold is not well understood in much of the world.<ref name="EcclesPg_a" /> 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.<ref name=Frend03>{{cite journal |vauthors=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=Archives of Internal Medicine |volume=163 |issue=4 |pages=487–94 |date=February 2003 |pmid=12588210 |doi=10.1001/archinte.163.4.487 |doi-access=|s2cid=10169748 }}</ref> More than one-third of people who saw a doctor received an antibiotic prescription, which has implications for antibiotic resistance.<ref name=Frend03/> 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.<ref name="NIAID2006"/><ref name=Frend03/> This accounts for 40% of time lost from work in the United States.<ref>{{cite journal |vauthors=Kirkpatrick GL |title=The common cold |journal=Primary Care |volume=23 |issue=4 |pages=657–75 |date=December 1996 |pmid=8890137 |pmc=7125839 |doi=10.1016/S0095-4543(05)70355-9}}</ref>

== References ==
'''Notes'''
{{Reflist}}

'''Bibliography'''
* {{cite book |veditors=Eccles R, Weber O |title=Common Cold |year=2009 |publisher=Springer Science & Business Media |isbn=978-3-7643-9912-2 |edition=Illustrated |url=https://books.google.com/books?id=rRIdiGE42IEC}}

== External links ==
* {{curlie|Health/Conditions_and_Diseases/Respiratory_Disorders/Common_Cold/}}

{{Medical condition classification and resources
|ICD10={{ICD10|J|00}}
|ICD9={{ICD9|460}}
|DiseasesDB=31088
|MedlinePlus=000678
|eMedicineSubj=
|eMedicineTopic=
|eMedicine_mult={{EMedicine2|med|2339}}
|MeshID=D003139
}}
{{Common Cold}}
{{Viral diseases}}
{{Respiratory pathology}}

[[Category:Inflammations]]

{{Sourceattribution|Common cold}}