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COLD AND FLU

Well-known Symptoms

The common cold presents with the well-known symptoms outlined below.

Congestion

Nasal congestion is the most unpleasant and inconvenient symptom of the common cold. Excess mucus, particularly if thick and purulent, suggests infection. In allergic rhinitis the mucus will probably be clear and watery; although this may also be the case, at least initially, in a patient with the common cold.

Runny Nose

This is a symptom of both the common cold and allergic rhinitis. It often accompanies nasal congestion.

Sneezing

Sneezing may occur in the common cold and also in allergic rhinitis. In allergic rhinitis, sneezing is likely to be in bouts or fits of repetitive sneezing and accompanied by itching of the nose. This characteristic helps distinguish an allergy from a viral infection.

Onset and Duration

The common cold normally lasts for a few days and not longer than 2 weeks. Any longer than this and one should consider allergic rhinitis as the cause. Allergic rhinitis is common throughout the year as it can be due to a number of different allergens such as pollen, house dust, feathers or animal dander.

Accompanying Symptoms

Nasal symptoms are often accompanied by shivering, sweating, headaches, sore throat and sometimes earache, the latter especially in children.

Conjunctivitis

Red eyes may be a sign of a common viral infection such as a cold, but is more likely to accompany allergic rhinitis.

Myalgia

Aching muscles and joints accompany a viral respiratory infection, commonly known as flu or influenza.

Cough

The common cold often spreads to the lower respiratory tract, and a cough may then result.

Sinusitis

Tender sinuses, headache, dizziness or a feeling of fullness in the head, together with thick mucus, may be a sign of sinusitis

Management

Traditional advice to sufferers of the common cold is to take some aspirin or paracetamol, keep warm, and drink plenty of fluids. This is generally sound advice in that the best approach is to provide symptomatic relief. There are also many products marketed for symptom relief. Note: Aspirin should not be given to children under 16 years of age.

Fluid Intake and Steam Inhalations

A high fluid intake maintains adequate hydration of the body to counteract excessive fluid loss caused by fever. Steam inhalations provide local hydration to the air passages and might also work by diluting the secretions of mucus, making them easier to expel. These remedies are based on folklore and anecdotes but are harmless and might help together with pharmacy remedies.

Decongestants, Nasal Sprays and Drops

Oral decongestants are effective in reducing inflammation of the lining of the nose which results having a blocked nose. These remedies are known to elevate blood pressure and therefore should be avoided in patients suffering from hypertension and in patients with ischemic heart disease. Patients with hyperthyroidism (overactive thyroid) should also not take these over the counter products. In some patients unable to use oral decongestants, antihistamines might provide some relief.

Nasal decongestants provide rapid, effective relief from nasal congestion, and claim to have duration of approximately 8 hours. These have relatively few side effects as they tend to work locally. The main issue with these products is a phenomenon known as rebound congestion, where the decongestive effect is followed by congestion caused by the product itself. This is easily avoided by reducing usage to no more than 7 days.

Vitamin C and Zinc

The benefits of Vit C are controversial, studies suggest that doses of about 3g per day are necessary to prevent the onset of the cold and that even up to 1or 2g per hour are required to suppress the symptoms when they appear. Zinc lozenges have been shown to have a beneficial effect, but it is unclear if tablets containing zinc are of any help in combating the common cold.

Other

  • The benefits of Garlic, Echinacea and Vit E are unknown, but there is little evidence of their effectiveness.
  • When to see your GP
  • Thick mucus for several days
  • Sinus or ear pain that does not resolve after 7 days
  • Difficulty in breathing
  • Wheezing, especially in young children
  • Malaise in teenagers and young adults for more than 7 days
  • Severe symptoms that do not improve within 7 days