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Common Cold - General Common Cold Information

General Common Cold Information

Common cold is the most common disease

Common cold infections are so widespread that there can be very few humans who escape infection each year and most will suffer multiple infections. It has been estimated that adults suffer 2 to 5 colds per year, and infants and pre-school children have an average of 4 to 8 colds per year.

As we get older we get fewer colds

As we get older our immune system learns how to deal with more and more viruses as we generate antibodies each time we get a cold.

Can a cold kill you

Yes! Babies and the very elderly can develop chest infections which can be fatal. You are also at risk if you are taking any medication which depresses your immune system.

Viruses travel in style

Similar viruses are found in both the southern and northern hemispheres and in temperate and tropical climates and this is because cold viruses are as mobile as their host and readily jump from one continent to another by jumbo jet.

A golden age for common cold viruses

The densely populated cities of the modern world provide ideal breeding grounds for common cold viruses. Modern transport systems whisk viruses around from city to city.

Infection usually occurs at home

Young children represent the main reservoir of common cold viruses and infection usually occurs at home or in the nursery or school. Adults with regular contact with children are most exposed to infection.

Common cold viruses are not very contagious

Despite the fact that very few of us escape from at least a couple of common cold infections each year, common cold viruses are not very contagious. Under laboratory conditions when healthy volunteers are kept with others who are suffering from common cold infections it has proven remarkably difficult to spread infection from one person to another.

Kissing is OK

Close personal contact is necessary for the virus to spread and the home and school are the places where spread most often occurs. The common cold viruses are not spread by contact such as kissing but appear to be spread by large particles expelled at close range by coughs and sneezes, and by contaminated fingers which pass the virus to the nose and eye. Your fingers can easily become contaminated with viruses by touching dooor handles etc. in public places. You may then touch your nose or eye and infect yourself. Tears from the eye drain via a duct into the nasal cavity and when we touch our eyes with contaminated fingers we pass viruses into the nose!

How to avoid catching a cold

Become a hermit. If you are in contact with other people you are likely to get a cold as the viruses are so common.

Hand washing may help

Since cold viruses can be passed from person to person by hand contact or by touching contaminated surfaces such as door handles you can help prevent infection by washing your hands. Home studies have shown that hand washing can reduce the spread of common colds within the family.

When am I most infective

The incubation period for a common cold is usually around two days before symptoms start. You are most infective when you have the early symptoms of sneezing, runny nose and cough. The viruses replicate in the cells lining the nose and they are coughed or sneezed out in droplets of mucus. We can also spread the virus on our fingers when we contaminate them with secretions from the nose. In order for you to spread the infection you need to have close and prolonged contact with other people and to cough or sneeze on them or pass on secretions from your nose via your hands. Colds viruses are not very contagious.

The colds season

Colds occur all year round but there is an increased incidence during autumn and winter months.

Can a chill cause a cold

There is no evidence that chilling the body causes an increased susceptibility to infection or an increase in the severity of symptoms. Cooling the skin and nose may cause sneezing and this maybe why we link a chill and colds.

Why more colds when its cold

  • We spend more time indoors in poorly ventilated homes and offices in winter and this may facilitate spread of infection.
  • There is less sunlight in winter and ultraviolet light is known to kill viruses.
  • The air we breathe is colder in winter and this may cool the nose and allow the virus to replicate at a higher rate.
  • We may be more stressed during the winter period and this could suppress our immune response and predispose to infection.
  • Christmas is a good time for colds. Lots of stress; lots of visitors; lots of parties.
  • The start of school and college terms often coincides with an increased incidence of common cold infections and there is a decline in the incidence of infections during the summer vacations and half term periods.

Common Cold Viruses

Which viruses cause colds

The symptoms of the common cold syndrome are caused by over two hundred different viruses but Rhinoviruses (nose viruses) account for approximately 30-40% of adult colds. Other viruses, such as coronavirus, respiratory syncytial virus, adenovirus, parainfluenza virus and influenza virus also cause the common cold syndrome. There is no way of identifying the nature of the virus infection from the symptoms as these are very similar across the whole range of viruses.

What is a virus anyway

Viruses differ from bacteria in that they do not have a cellular structure and they are much smaller. Some scientists say viruses are not 'alive' because they need to replicate inside a cell such as those lining our nose. The rhinovirus is icosahedral in shape i.e. is a twenty sided structure with a protein shell surrounding a strand of genetic code.

Viruses are really small

The rhinovirus is around 20 nanometres in diameter. To put that in perspective you could line up fifty thousand rhinoviruses end to end across one millimetre. Another way of thinking about the size of the virus is that a typical human cell in the nose would be around 20 micrometres in diameter and therefore around a thousand times bigger than the virus. It is difficult to imagine such a small virus causing the misery and symptoms of the common cold.

How the virus gets up your nose

When the virus enters the nose it is probably accompanied by hundreds of similar viruses all stuck together in a tiny blob of mucus which has been picked up from an infected person. A critical stage in infection is the attachment of the virus to nasal cells lining the nose.

The virus uses a docking mechanism

The mechanism used by the rhinovirus to attach to the nasal cells has been studied in some detail. The rhinoviruses have many depressions on their protein shell called 'canyons' and these fit on to a surface protein receptor on the nasal cell just like a docking port. The cell protein receptor is called an ICAM receptor (Inter Cellular Adhesion Molecule). Once attached to the cell the virus enters the cell and uncoats to release its strand of genetic code.

Colds and computer code

The genetic code of the colds virus is in the form of RNA (Ribo Nucleic Acid) and this is rather like a bit of computer code which is inserted into the cell machinery and which instructs the cell to construct new viruses. The strand of RNA contains around seven thousand nucleotides and is in the form of a long string which is tightly coiled inside the viral shell. The normal operation of the cell is switched off by the viral RNA and the cell produces thousands of copies of the virus. The viruses are released into the nose when the cell disrupts. These viruses soon infect adjacent nasal epithelial cells or are expelled from the nose in drops of mucus to start a new cycle of infection in another human nose.

Infection does not always mean a cold

Most viral infections in man produce no disease at all, they are 'subclinical' (i.e. no symptoms), despite extensive viral replication . The concept that the majority of viral infections pass unnoticed without any signs of disease is known as the 'iceberg concept of infection' as the classical and severe disease cases only represent the tip of the iceberg of infection. .

Colds are like an iceberg

The 'iceberg' concept of viral infection describes the general consensus by virologists that most infections in the community do not cause symptoms and pass without notice. At the very bottom of the iceberg we have the vast majority of encounters with common cold viruses in which the virus does not infect the nose or causes only minor symptoms such as short lived throat irritation and a couple of sneezes which are not recognised as a cold.

A stinking cold

The infections that we recognise as colds with severe symptoms are the minority and represent the tip of the iceberg of infection.

Factors which influence the immune response, such as stress may be important in determining whether we develop cold symptoms or not.

Get stressed and get a cold

There is much evidence which indicates that the stress of every day life can influence the susceptibility to infection . Experimental studies in which common cold viruses have been administered into the nose of healthy volunteers have shown that there is a link between recent history of psychological stress and susceptibility to infection. Stress appears to be associated with the suppression of general resistance to infection which leaves the person susceptible to infection. It is still not clear how psychological stress affects the immune system but the most likely link appears to be the increase in the release of corticosteroid hormones associated with stress as corticosteroid hormones are known to decrease resistance to infection.

The increased stress of modern city life may be one of the factors predisposing to the very high incidence of common cold infections in our crowded cities.

Common Cold Symptoms

Symptoms flare out from a pinpoint of infection

Common cold infections do not cause any visible damage to the lining of the nose. Sites of infection may occur as tiny pin points scattered over the lining of the nose and throat. The pinpoint of infection is represented as the tip of the flare and this triggers a cascade of events in the lining of the nose starting with the immune response and sometimes expanding to generate chemical mediators and symptoms.

Killer cells and antibodies

Viral infection triggers the immune response by the activation of white cells which act as killer cells or produce specific antibodies. It is the killer cells which overcomes the infection rather than the production of antibodies.

Antibodies do not cure your cold

Antibody production starts two weeks or so after the infection and reaches a maximum after three to four weeks. The antibodies help to prevent repeat infections by the same virus but do not protect against other viruses. Since there are over two hundred different types of cold virus, over the period of a lifetime one could have a couple of infections each year with each infection involving a new virus.

I have just had one cold can I get another straight away

Yes. The antibodies you generate against colds viruses are very specific and since there are around two hundred known types of colds virus you could easily encounter two different types one after the other.

What triggers the symptoms

The natural disinfectants produced by the white cells can cause damage to the cells lining the nose and this triggers the symptoms. Oxidising agents produced by white cells in response to viral infection may activate enzymatic pathways that lead to the generation of chemical mediators in a cascade of reactions that eventually result in symptoms.

Chemical mediators cause symptoms!

Common cold symptoms are caused by the effects of a complex soup of chemical mediators on blood vessels, glands and nervous tissue. Mediators such as bradykinin, prostaglandins, tachykinins, histamine and cytokines are formed as components of the inflammatory and immune responses to infection.

Bradykinin is important

Out of the complex soup of chemical mediators responsible for the symptoms of common cold the peptide bradykinin has been proposed to play a dominant role.

Bradykinin can be detected in nasal washings taken from patients with common cold infections and intranasal administration of bradykinin in healthy volunteers causes, nasal congestion, nasal irritation, throat irritation and stimulation of nasal secretion .

A bradykinin antagonist to block cold symptoms

There is much interest in developing a medication which would act as a bradykinin antagonist as this would be a rational approach to treating common cold symptoms in the same way as antihistamines can be used to treat the symptoms of hay fever. If such a development is to take place it is likely to come from research into medications for the treatment of rheumatoid arthritis since bradykinin is also implicated in causing the pain and swelling associated with joint inflammation.

Symptoms start two days after infection

The time to onset of common cold symptoms can only be studied in persons who are infected experimentally with a common cold virus and in these volunteers symptoms typically start one to two days after infection.

Symptoms may last two weeks

Symptoms in patients presenting with common cold usually last for around seven days although some cold symptoms may persist for up to 14 days in one quarter of patients .

The frst signs of a cold

A dry scratchy sore throat is often the first sign of a common cold and this may be due to the virus first infecting the back of the nose .

Sneezing and a clear watery nasal fluid are also early signs of infection.

Is it a cold or flu

Headache, fever and muscle aches and pains are commonly associated with influenza and bacterial infections but they are also associated with common cold viruses.

You cannot distinguish between a cold and flu!

You cannot separate a cold and flu just from the symptoms.

In general influenza has a sudden onset and is associated with fever and muscle aches and pains but a severe common cold can also cause these symptoms.

Fever is common in children

Fever associated with common cold is uncommon in the adult but quite common in infants and children.

How does the nose get blocked

A blocked and stuffy nose is one of the most bothersome symptoms of common cold.

Nasal congestion is caused by the swelling of large veins lining the nasal passages. The degree of swelling of the nasal veins is controlled by nerves which release a chemical called norepinephrine or noradrenaline. Topical and oral nasal decongestants mimic the action of norepinephrine.

Cough

Cough is usually a later symptom of colds and it is caused by inflammation and infection of the larynx, trachea and lower airways. The dry non productive cough is related to inflammation of the upper airway and the productive chesty cough to inflammation of the lower airways.

References

  1. Sperber S J (1994) The common cold. Infections in Medicine 11: 235-242.
  2. Kaslow R A, Evans A S, Eidemiologic concepts and methods, in Viral Infections of Humans. Epidemiology and Control, A.S. Evans and R.A. Kaslow, Editors. 1997, plenum Medical Book Company: New York. p. 26.
  3. Tyrrell D A, Cohen S, Schlarb J E (1993) Signs and symptoms in common colds. Epidemiology and Infection 111: 143-156.
  4. peterhans E, Reactive oxygen, antioxidants, and autotoxicity in viral diseases, in Oxidative stress, cell activation and viral infection, p. pasquier, et al., Editors. 1994, Birkhauser Verlag: Basel. p. 203-215.
  5. proud D, Reynolds C J, Lacapra S, Kagey-Sobotka A, Lichenstein L M, Naclerio R M (1988) Nasal provocation with bradykinin induces symptoms of rhinitis and a sore throat. American Review of Respiratory Disease 173: 613-616.
  6. Cohen S (1995) psychological Stress and Susceptibility to Upper Respiratory- Infections. American Journal Of Respiratory and Critical Care Medicine 152: S 53-S 58.
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