Upper respiratory tract infections

The common cold and most upper respiratory infections are caused by infection with germs (viral infections). They usually get better in a week or two. This information gives some tips on what to do and what symptoms to look out for which may indicate a more serious illness.

What is an upper respiratory tract infection and a cold?

A cold is an infection of the nose and upper airways caused by a germ (virus). They are extremely common. An adult can expect 2-4 colds a year and a child can expect about 5-6 colds a year. Very young children in nursery school may get as many as 12 colds a year. Many different viruses can cause a cold. This is why colds come back and immunisation against colds is not possible.

Infections of the throat, or the main air, or the airways going into the lungs are also common. These infections are sometimes called laryngitis, tracheitis, or bronchitis. Doctors often just use the term upper respiratory tract infection (URTI) to include any, or all, of these infections. Most URTIs are due to a viral infection.

What are the symptoms of an upper respiratory tract infection?

The common symptoms of a cold are a blocked nose, a runny nose and sneezing. At first, there is a clear discharge from the nose. This often becomes thick and yellow/green after 2-3 days. It may be difficult to sleep due to a blocked nose. You may feel generally unwell and tired and you may develop a cough or a mildly high temperature.

In other URTIs, cough is usually the main symptom. Other symptoms include fever, headache, aches and pains.

Symptoms are typically at their worst after 2-3 days and then gradually clear. However, the cough may carry on after the infection has gone. This is because swelling (inflammation) in the airways, caused by the infection, can take a while to settle. It may take 2-3 weeks, after other symptoms have gone, for a cough to clear completely.

What is the treatment for an URTI?

A main aim of treatment for an URTI is to ease symptoms whilst your immune system clears the infection. One or more of the following may be helpful:

■ Taking paracetamol or ibuprofen to reduce a high temperature and to ease any aches, pains and headaches. Follow the instructions given with the medicines and if you are not sure discuss it with your pharmacist or doctor.

■ Having plenty to drink especially if you have a fever, to prevent mild lack of fluid in the body.

■ If you smoke, you should try to stop for good. URTIs and serious lung diseases tend to last longer in smokers.

■ Steam inhalation. There is not very much evidence that this helps; however, some people find it useful. It is very important to be careful to avoid burns and scalds, particularly with children.

■ Vapour rubs. These can be bought in pharmacies. Some people find they help with a stuffy nose. Rub the vapour on to the chest and/or back of the person with the cold, but avoid the area under the nose.

■ Sucking sore throat lozenges or boiled sweets may help ease a sore throat.

■ Warm drinks with honey and lemon may help to ease a sore throat.

■ Salt (saline) nose drops. These are nose drops made of a salty solution, which may help clear a blocked nose. They are sometimes helpful for babies who are having difficulty breathing through a blocked nose as they feed. They can be bought from a pharmacy.

What about cold and cough remedies?

You can buy many other cold and cough remedies at pharmacies. These are suitable for adults and older children only. These remedies do not help fight the infection but they may be useful for certain symptoms. For example, a decongestant nasal spray may help to clear a blocked nose.

Remember that cold and cough remedies often contain several ingredients. Be careful about taking more than one remedy in case you get too much of one ingredient.

Some cold and cough remedies may make you drowsy. This may be welcome at bedtime if you have difficulty sleeping because of your cold. However, do not drive if you are drowsy.

If you use a decongestant nasal spray, do not use it for more than a few days. It can have an immediate effect to clear a blocked nose. However, the effect does not last very long. If you use a decongestant nasal spray for more than 5-7 days, you may feel that your nose is becoming more blocked. This is called a rebound effect.

What about antibiotic medicines?

Antibiotics are not usually advised if you are normally in good health. Your immune system can usually clear the infection. Antibiotics do not kill germs which are viruses. Even if a different type of germ (called a bacterium) is the cause, antibiotics usually do little to speed up recovery from a URTI.

Antibiotics may be prescribed if you become more unwell, or if you already have an underlying (chronic) lung disease. They may also be prescribed if a complication develops, such as pneumonia - but this is unlikely to occur if you are otherwise healthy. Your Dr will advise if you require antibiotics and will give you a prescription to obtain them from the pharmacy.

What symptoms should I look out for?

Most URTIs do not cause complications. A URTI may trigger coughing, wheezing and shortness of breath especially in people with asthma or other lung disease. Sometimes the infection travels to the lung tissue, sinuses, or ears. Germs (bacteria) may thrive in the mucus so some people with colds may go on to develop a bacterial infection of the lung tissue, ears or sinuses. Therefore, see a doctor if symptoms do not start to ease within two weeks, or if you suspect that a complication is developing. In particular, symptoms to look out for that may mean more than just a URTI include:

■ If high temperature (fever), wheezing or headaches become worse or severe.

■ If you develop fast breathing, shortness of breath or chest pains.

■ If you cough up blood or if your phlegm (sputum) becomes dark or rusty-coloured.

■ If you become drowsy or confused.

■ If a cough persists for longer than 3-4 weeks.

■ If you have returning URTIs

Can upper respiratory tract infections be prevented?

Prevention is difficult. Many germs (viruses) can cause an URTI. Also, many viruses that cause URTIs are in the air, which you cannot avoid. However, the following are suggestions that may reduce the risk of catching a URTI or of passing one on, if you have one:

■ If you have a URTI do not get too close to others - for example, kissing, hugging, etc.

■ If you have a URTI, wash your hands often with soap and water. Many viruses are passed on by touch, especially from hands that are contaminated with a virus.

■ Avoid sharing towels, flannels, etc, if you have a URTI, or with anyone who has a URTI.

■ For children, discourage the sharing of toys belonging to a child with a URTI. If your child has a URTI, consider washing toys with soapy water after use.

Basically, common sense and good hygiene may prevent the passing on of some viruses that cause URTIs.

Exercise may help too

An interesting research study showed that people who exercise regularly are less likely to get URTIs. The researchers thought this may be because exercise boosted the immune system and this may help us fight infections.