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Vol. 53, No. 10, October 2007, pp.1735 - 1736
Copyright © 2007 by The College of Family Physicians of Canada
ARI Series |
Common cold
Graham Worrall, MBBS MSc MRCGP FCFPProfessor of Family Medicine at Memorial University of Newfoundland in St John’s
Correspondence to: Dr Graham Worrall, Dr William H. Newhook Memorial Health Centre, Whitbourne, NL A0B 3K0; telephone 709 759-2300; fax 709 759-2387; e-mail gworrall{at}mun.ca
The only way to treat the common cold is with contempt.
Sir William Osler
The common cold is the most common condition FPs have to deal with. Although most people do not visit the doctor when they have a cold, the workload generated by those who do is considerable.
- Adults get 4 to 6 colds per year.
- Children get 6 to 8 colds per year.
- Colds are the cause of 40% of all time off work.
- Colds are the cause of 30% of all time off school.
- Colds can be caused by more than 200 types of viruses; however, the rhinovirus and coronavirus are the most common causes.
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Clinical course and diagnosis |
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Symptoms caused by colds typically last for 1 to 2 weeks, and most patients will feel better after the first week. Tests are of no use in diagnosing the common cold.
Only a tiny proportion of common cold cases do not resolve spontaneously. Complications, which are rare, can occur in infants, the very old, and immunocompromised and chronically ill people.
Symptoms and signs of the common cold include the following:
- rhinorrhea,
- nasal obstruction,
- throat irritation or laryngitis,
- cough but normal chest examination, and
- fever.
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Treatment |
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Despite many media claims, there is really no evidence that any medication produces more than minimal relief of symptoms or duration of illness.
- Cough suppressants. Antitussives relieve cough in adults. Over-the-counter cough syrups relieve symptoms in schoolchildren; however, there is no evidence that over-the-counter medication is effective in preschool children.
- Antihistamines. There is no evidence of benefit from treatment with antihistamines.
- Decongestants. Decongestants relieve cold symptoms.
- Antipyretics and nonsteroidal anti-inflammatory drugs. These drugs can relieve fever and headache, but do not affect the cold’s clinical course.
- Echinacea. There is no evidence of Echinacea being effective in treating colds.
- Vitamin C. Vitamin C can reduce the duration of a cold by less than half a day.
- Zinc. Zinc can reduce the duration of a cold slightly, but there is no consistent evidence of benefit.
- Comfort measures. Steam inhalation relieves cold symptoms, but there is no good evidence for other comfort measures.
- Antibiotics. There is no evidence of effectiveness in treating a cold with antibiotics.
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Prevention |
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Results of a Canadian trial suggested that taking ginseng polysaccharides daily all winter would prevent 1 cold (and would probably cost more than $100). Although the results of this study have received much hype in the media, ginseng (marketed as COLD-fX) is probably no more effective at preventing colds than hand washing after contact with a cold sufferer. It is also worth remembering that the studies that advocate frequent hand washing and avoidance of contact with cold sufferers were done using weak methods.
Vitamin C has no preventive effect for most people; however, it can benefit athletes or heavy labourers slightly.
- Hand washing. Hand washing is effective in preventing the spread of colds.
- Echinacea. Echinacea has a possible small preventive effect.
- Vitamin C. Vitamin C has no preventive effect.
- Ginseng. Ginseng can have a small preventive effect.
- Vaccines. There are no effective vaccines to prevent colds.
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Footnotes |
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Competing interests
None declared
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References |
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TOPClinical course and diagnosisTreatmentPreventionFootnotesReferences |
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Arroll B, Kenealy T. Antibiotics for the common cold. Cochrane Database Syst Rev 2002;(3):CD000247.
Bean RB. Sir William Osler—aphorisms from his bedside teachings and writings. Springfield, IL: Charles C. Thomas Ltd; 1968.
Douglas RM, Chalker EB, Treacy B. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev 2000;(2):CD000980.
Nguyen A, Slavik V. COLD-fX. Can Fam Physician 2007;53:481-2.
Predy GN, Goel V, Lovlin R, Donner A, Stitt L, Basu TK. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ 2005;173(9):1043-8.
Schroeder K, Fahey T. Over-the-counter medications for acute cough in children and adults in ambulatory settings. Cochrane Database Syst Rev 2001;(3):CD001831.
Taverner D, Bickford L, Draper M. Nasal decongestants for the common cold. Cochrane Database Syst Rev 2000;(2):CD001953.
Worrall G. The common cold. In: Worrall G. There’s a lot of it about: acute respiratory infection in primary care. Abingdon, Engl: Radcliffe Publishing Ltd; 2006. p. 15-23.
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