Cold symptoms generally emerge between one and three days after a cold virus enters the body and resolve in a week, with or without medication. One cold in four lasts up to 14 days; this most often occurs in children, the elderly, and people who are in poor health. Smokers often have more severe, extended cold symptoms than nonsmokers.
Fewer than five percent of colds lead to such complications as bronchitis, middle ear infection, or sinusitis accompanied by a prolonged cough. But between five and 15 percent of children who have colds develop acute ear infection when bacteria or viruses infiltrate the space behind the eardrum. A cold can produce wheezing, even in children who do not have asthma. Symptoms of asthma, bronchitis, and emphysema can be exacerbated for many weeks. Symptoms that persist for more than two weeks or that recur might be more allergy than infection-related.
Post-infectious cough, which usually produces phlegm, may disrupt sleep and persist for weeks or months following a cold. This complication has been associated with asthma-like symptoms and can be treated with asthma medications prescribed by a physician. Medical attention is indicated if symptoms progress to:
- ear pain
- high fever
- a cough that worsens as other symptoms abate
- a flare-up of asthma or of another chronic lung problem
- significantly swollen glands
- strep throat
Babies can have between five to seven colds during their first two years of life. This enhanced susceptibility results both from immature immune systems and from exposure to older children who are often careless abut washing their hands or covering coughs and sneezes. Nasal congestion and runny nose are the most common symptoms of colds in babies. Treatment consists of breathing moist air and drinking plenty of fluids. Medical attention is recommended at the first sign of a cold in infants less than three months of age because of a heightened risk for pneumonia, coup, and other complications.
Physician evaluation is also necessary if a baby of any age:
- has an uncomplicated cold, the symptoms of which last for more than seven days.
- does not wet a diaper properly.
- refuses to nurse or accept fluids.
- coughs up blood-tinged sputum or coughs hard enough to cause vomiting or changes in skin color.
- has trouble breathing.
- has bluish-tinted lips or mouth.
- has a temperature higher than 102°F for one day
- has a temperature higher than 101°F for more than three days.
- shows signs of having ear pain.
- has reddened eyes or yellow-eye discharge.
- has a cough or thick green nasal discharge for more than a week.
- has any other symptoms that concern parents and/or caregivers.
Common sense plays an important part in preventing the common cold. Absolute avoidance of cold viruses is virtually impossible to achieve, but experts advise keeping a healthy distance from anyone who is ill. The actions the human body takes to clear infection are the same actions that spread the infection to others. Sneezing, for example, is a response to irritation of the nose and mouth. Sneezing as well as a runny nose is the body’s attempt to expel cold viruses before they can invade the nasal passages more deeply. Unfortunately, a sneeze sends infectious particles hurtling through the air at a speed of more than 100 miles an hour.
Simply being in the company of someone who has a cold can contaminate the hands of another person. Touching one’s eyes, nose, or mouth can transfer the infection. It is imperative to wash hands thoroughly after touching someone who has a cold or something that has been touched by someone who has a cold. Playthings touched by a child who has a cold should be washed before being put away. Cleaning surfaces with antiviral disinfectant may help prevent the spread of infection, and increasing interior humidity can reduce susceptibility.
By Ben Hayes, MD, PhD, FAAD