Acute Upper Respiratory Infection (Cold)
During the flu season, the majority of respiratory illnesses are caused by organisms other than the flu (rhinoviruses, coronaviruses, parainfluenza, etc.). While the common cold and influenza share many clinical features, acute cold symptoms typically appear gradually over one to two days, whereas influenza symptoms (high fever, severe muscle aches, dry cough, severe headache) are typically more severe and abrupt in onset, often developing within hours.
Acute Upper Respiratory Infection (Cold) Symptoms
Symptoms in otherwise healthy individuals include:
• Sore throat and sneezing occur early in the course of the infection and usually resolve in 3 - 6 days.
• Low grade fever (less than 100 degrees Fahrenheit) and muscle aches commonly accompany these initial symptoms and usually resolve within a week.
• Nasal congestion, sinus pressure, ear pressure are common symptoms and usually persist through the first week of illness. About 30% of patients still have these symptoms at 2 weeks, although they should be improving after 7 - 10 days.
• Nasal or post-nasal drainage is usually clear and watery the first few days, but often becomes thick and discolored (green to yellow) after several days. Discolored secretions do not automatically imply that a bacterial infection is present; most improve after 5-7 days.
• Cough occurs in the majority of colds and is usually more productive than seen with the flu. Sputum varies from clear to yellow-green and usually resolves within 2-3 weeks, although a lingering dry cough can persist 4 weeks in up to 25% of infections.
Treatment of Acute Upper Respiratory Infections
How do I keep from spreading the infection?
• Stay Home: Students (employees) with acute infectious symptoms should stay home to avoid spreading the infection to patients and colleagues.
• Infectious Time Period: Cold sufferers are most contagious during the first 3-4 days of their illness, so it is important to limit contact with others during these times.
• Transmission: A large quantity of virus is present in nasal secretions and can survive on the hands and environmental surfaces up to several hours. To avoid spreading the virus it is important to:
• Cover your nose and mouth with your sleeve or disposable tissue when you cough or sneeze - throw the tissue away after you use it. Avoid handkerchiefs which harbor virus and may re-inoculate the hands with virus after use.
• Wash your hands often with soap and water, especially after you cough or sneeze. If you are not near water, use an alcohol-based hand cleaner.
When should I seek medical attention for my cold?
1. Bacterial sinusitis and middle ear infections are infrequent complications (less than 2%) of colds and should be considered when there is:
• No improvement of symptoms after 10 days.
• Worsening symptoms after 5-7 days(Temperature is greater than or equal to 100 degrees Fahrenheit, focal sinus pressure or earache unrelieved with regular decongestant use, persistently discolored nasal drainage or sputum).
• Rapidly worsening symptoms: Temp (greater than or equal to 100 degrees Fahrenheit) associated with focal pain over a sinus or earache that doesn't improve with regular use of decongestants.
2. Cough is associated with up to 80% of viral upper respiratory infections. Sputum varies from clear to yellow-green and usually resolves within 2-3 weeks, although a lingering dry cough can persist 4 weeks in up to 25% of infections. Antibiotics are mainly reserved for infections complicated by pneumonia or when pertussis is suspected. A cough should be evaluated if:
• Temperature is greater than or equal to 100 degrees Fahrenheit
• Cough that shows no improvement after 14 days.
• Shortness of Breath / Wheezing
3. Sore Throat (Pharyngitis) is a frequent early cold symptom, typically worse on arising and usually resolves within a week. Sore throat is most likely viral in origin if accompanied by runny nose, post-nasal drainage, nasal congestion, or cough. It should be evaluated if associated with:
• Temperature greater than or equal to 100 degrees Fahrenheit
• Pus/exudate coating tonsils
• Sore throat pain that persists or worsens after a week
How to Obtain Medical Evaluation of Symptoms
Students experiencing acute respiratory symptoms that are abrupt and unusually severe should call Student Health at (415) 476-1281 to speak to a healthcare provider to see if further evaluation is warranted. These symptoms include:
• fever (greater than 100 - 101 degrees Fahrenheit), ),
• severe muscle aches,
• severe generalized headache,
• worsening sinus pain after 5-7 days that is not responding to decongestants.
• If medical evaluation is necessary, CALL STUDENT HEALTH FIRST. This is to avoid transmitting infection to others in the waiting area and save yourself the time if you are better off at home resting.
• When seeking medical attention for your illness, you can optimize your evaluation by providing the following information:
1. Onset of Illness: date/time your symptoms began.
2. Progression of Illness where the symptoms gradual in onset (one to two days) vs abrupt (go from feeling normal to severely ill in several hours).
3. Symptoms: Make note of the presence, severity, and quality of the following:
• Fever: the degree of measured temperature is helpful in distinguishing influenza from other acute respiratory infections. Colds raise body temperature around 1 - 1.5 degrees above normal, whereas the majority of healthy adults diagnosed with the flu have a temperature greater than 100 degrees Fahrenheit. Everyone should own a thermometer to better evaluate and monitor their illness.
• Cough: dry vs productive, presence of wheezing, shortness of breath - unable to catch your breath or complete a sentence.
• Headache: generalized pain vs focal pressure over one side of the face.
• Muscle Aches
• Sore Throat: constant pain vs transient morning scratchy/raw feeling.
• Nasal Congestion
• Nasal/Post-Nasal Drainage
4. Medications: Prescription and OTC medications currently taking.
5. Chronic Medical Conditions
6. Drug Allergies