Cold Symptoms and Complications

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Couple suffering from cold in bed

By Ben Hayes, MD, PhD, FAAD

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:

  • sinusitis
  • 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
  • bronchiolitis
  • pneumonia
  • croup

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.

PREVENTION

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.

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Anaphylaxis: Always an Emergency

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anaAbout 30 of every 100,000 people experience food-induced anaphylaxis.  An anaphylactic reaction should always be considered a medical emergency. Symptoms generally appear as soon as someone who is hypersensitive swallows a food allergen. The symptoms may not appear until up to four hours after exposure. How swiftly an anaphylactic reaction begins and how severe it becomes depends on:

  • the sensitivity of an individual to the allergen.
  • the amount of allergen swallowed.
  • how many different food allergens were consumed.
  • food preparation.
  • precipitating medical conditions.

An anaphylactic reaction may begin with tingling, itching, or a metallic taste in the mouth. Even the mildest symptoms can become severe within a short time. Anaphylactic reactions can go on for hours. They may include:

  • wheezing and other breathing problems.
  • swelling of the mouth and throat.
  • cramps and nausea.
  • rapid pulse and sudden drop in blood pressure.
  • hives and flushing.
  • itching of the palms of the hands and the soles of the feet.
  • loss of consciousness.

Anaphylaxis can be a biphasic reaction: New, more severe symptoms sometimes appear as long as two to six hours after the initial wave of symptoms has receded. These recurring symptoms often involve the respiratory system and can be deadly.

Peanuts and tree nuts are the foods most likely to cause severe food-allergic reactions. The other most common causes of anaphylaxis attributed to food allergies are:

  • shellfish
  • fish
  • milk
  • eggs

People who have asthma and food allergies are thought to have a greater than average risk of developing a food-allergic anaphylactic reaction. Having experienced one or more severe allergic reactions also increases the likelihood that an individual will have an anaphylactic reaction in the future.

The risk of fatal anaphylactic reaction is greatest among adolescents who have asthma and allergies to peanuts and tree nuts but disregard early food allergy symptoms and do not have ready access to epinephrine. Used to halt the progress of an anaphylactic reaction and reverse its symptoms, this drug is self-administered by injection. Epinephrine is often prescribed for individuals with a history of severe allergic reaction

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Dust Mites and Allergies

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mite-67638_640By Rajinder S. Hullon, M.D., J.D.

Distantly related to spiders, dust mites are tiny organisms that cannot be seen with the naked eye. They feed on dust containing human skin flakes and primarily live in places that tend to collect dust:  such as carpets  and upholstered furniture —  and even sheets, pillows, blankets, and mattresses. As many as 90% of people who have allergic asthma are allergic to dust mites. Some people are allergic to live dust mites as well as the decayed bodies of dust mites and their fecal material, often found in household dust.

Symptoms of dust mite allergy typically include: repeated and prolonged sneezing, an itchy, stuffed-up nose, a watery nose, and watery eyes. The eyes, throat, mouth, and even the ears may itch.

Reducing household dust and humid environments, where dust mites thrive, can alleviate or eliminate allergic symptoms.

It can be nearly impossible to eliminate dust mites entirely, but here are some ways to decrease dust allergens in your home:

  • Keep humidity as low as possible, preferably less than 50%. Eliminating any water leaks or sources of moisture around the house, particularly in the basement, will also help make your home more inhospitable to mold.
  • Use air-conditioning properly. Air-conditioning can effectively lower the humidity level; filters should be changed and cleaned on a regular basis.
  • Replace surfaces where dust mites can proliferate, such as carpeting as well as upholstered furniture  that has smooth surfaces. In particular, avoid using wall-to-wall carpeting.
  • Remove stacks of paper, blankets, and similar dust catchers. Store blankets in sealed plastic bins or bags in a closet or a room apart from living areas.
  • Use dust-mite impermeable covers for pillows, mattresses, and bed covers.
  • Wash bedding in water hotter than 130˚F at least once a week. This kills mites.
  • Vacuum and dust often, especially in bedrooms.

DO AIR FILTERS HELP?

Because most dust mites are concentrated in surface dust, not airborne dust, air cleaners and filters are not very effective in reducing these allergens. Ion and ozone generators can remove dust particles from the air, but not from surfaces, where dust mites are most apt to be found. Ozone generators, which produce ozone at levels 10 times above what the U.S. Code of Federal Regulations specifies as safe, should be avoided.

DOES VACUUMING CARPETS HELP REDUCE DUST?

Vacuum cleaners stir up dust, so wearing a dust mask when vacuuming can reduce allergen exposure. Newer Higher Efficiency Particle Arresting (HEPA) vacuums may not actually reduce the number of dust mite allergens, but the vacuum cleaners can reduce the amount of small-particle dust that vacuuming generates. This, in turn, reduces the amount of inhaled dust containing dust mites and their droppings.

GETTING MEDICAL HELP FOR DUST MITE ALLERGIES

An allergist-immunologist will ask about your:

  • medical history.
  • eating habits.
  • home and work environments.
  • pets.

A blood test may be ordered to confirm dust mite allergy diagnosed on the basis of a scratch test. The doctor performs this test by painting a small patch of diluted dust mite allergen onto the patient’s back or forearm and then uses a needle to scratch the skin beneath the allergen. Swelling or redness that develops within 15 to 30 minutes indicates that the patient’s immune system has responded to the allergen.

Allergy shots and prescription medicines may provide relief for patients with persistent symptoms.

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