The common cold: transmission, accompanying symptoms, and treatment

The common cold is the most common upper respiratory disease.

It is usually caused by an infection with the onset of inflammation in the mucous membrane of the nasal cavity.

It is an acute viral disease that causes inflammation of the nasal mucosa, mainly characterised by swelling, increased nasal discharge and nasal congestion.

This results in typical symptoms.

Teh cold can also be associated with sinusitis and sometimes penetrate into the paraasal sinuses.

Inflammation can be both acute and chronic. The chronic form occurs in the case of insufficiently treated acute cold in the past.

However, sometimes a cold can occur due to an allergic reaction, butthere are also other causes.

FAQ: 

What is a cold and why is there a chronic form?

Is teh common cold contagious, so I can get infected from another?

How can I cure it and get rid of it quickly? Will home remeedies help?

As a result of inflammation, the mucosa swells, which significantly reduces the nasal passage and causes nasal congestion. Other symptoms are increased nasal discharge, including in children, and cough.

The incubation period of a cold is relatively short and lasts from 12 hours up to 3 days. The infectious form is also relatively contagious. Contagion is exacerbated by the fact that it is transmitted by airborne respiratory droplets, i.e. by coughing, sneezing, and hand-to-hand contact. The disease usually lasts 7-10 days.

What are the nose and the nasal cavity?

The external nose is pyramidal in shape. It consists of nasal bones extending from the facial part of the skull, i.e. the root of the nose. They are attached to the nasal cartilage. These parts are the ones that we can see. More importantly, however, is the cavity, which performs several important functions.

The nasal cavity is divided into two halves (they are not the same) by the nasal septum. However, it is also divided horizontally by the nasal conchae into the superior, middle and inferior passage. The nose opens into the nasopharynx.

The nasal cavity is adjacent to the paranasal sinuses, i.e. the maxillary sinus, the frontal sinus, the ethmoid sinus, and the sphenoid sinus. In the upper part of the nose, there is an important area that ensures the perception of odour, i.e. the olfactory region.

The distribution of the nasal cavity and the nasal mucosa provide important functions:

• the bloodflow of the nasal mucosa heats the inhaled air to body temperature
• the mucus that forms there captures impurities and microorganisms form the air
• dirt is also trapped on the cilia
• the nasal cavity represents the first barrier against infection from the external environment
• water evaporates from the mucus, which humidifies the dry air
• odorous substances stimulate the olfactory cells
• acting as a voice resonator, the nasal cavity is involved in voice production 

After the birth, the baby, i.e. a newborn, can only breathe through the nose. It puts a lot of effort into breathing through the mouth, as the oral cavity is small and is filled with the tongue. The quality of breathing through the mouth improves only after all the teeth have fully emerged.

The causes of teh common cold are diverse. It can be infectious or non-infectious. Allergic rhinitis is a form of non-infectious rhinitis. This common disease affects the upper respiratory tract.

Allergic rhinitis

The most common form is infectious rhinitis. It is mostly acute, but there is also a chronic one, which can also be the result of insufficient treatment. Rhinitis is also known as coryza, and viral rhinitis is also knows as the common cold.

Viruses are the most common cause of infectious rhinitis, which is why antibiotics are ineffective as they only affect bacteria.

This form of rhinitis is caused by a virus, especially by the rhinovirus, the coronavirus, and the adenovirus. Rhinitis is often a side symptom of flu or other inflammation of the airways. Rhinitis also occurs in diseases such as measles, scarlet fever or infectious mononucleosis.

Rhinovirus is the main cause of young children and coronavirus in adults. These viruses are transmitted by droplet infection. This means that they are transmitted by droplets, for example, when sneezing or coughing, but also by contaminated objects, by hands or by kissing.

Children getting sick 5-6 times a year is not uncommon.

Thus, the most common form of rhinitis is an acute infectious disease caused by viruses, such as:

• rhinovirus
• reovirus
• adenovirus
• coronavirus
• enterovirus
• influenza virus

In total, there are more than 70 different types of viruses that can cause inflammation. However, there are also cases when rhinitis is caused by an allergic reaction. In those cases, there is an even greater susceptibility to long-term persistence.

Non-infectious rhinitis

Allergic rhinitis is caused by the penetration of an allergen into the sensitive mucosa. In this case, into the nasal cavity. An allergic reaction is an exaggerated response of the organism to otherwise harmless substances. Hay fever is also an example of allergic rhinitis.

Allergic rhinitis can be seasonal, as in the case of hay fever, but can also occur throughout the year.

Other forms of non-infectious rhinitis are:

• idiopathic, hyperactive, vasomotor rhinitis in the predominance of the parasympathetic nervous system
• NARES, non-allergic rhinitis with eosinophilia syndrome (NARES), where the cause is not an allergen, but are substances in the secretion, such as in an allergy
• hormonal rhinitis, most commonly with hypothyroidism
• drug-induced rhinitis, after taking an aspirin, or in case of nasal spray overuse
• emotion-induced rhinitis
• atrophic rhinitis, due to mucosal damage
• food-induced (gustatory) rhinitis in the absence of an allergic reaction
• irritant-induced (occupational) rhinitis, such as certain chemicals

If rhinitis persists, it can also be caused by polyps. Allergic forms can be triggered by pollen, dust, mites, but also hair and many other particles that irritate the mucous membranes. This in turn forms an increased secretion.

Of course, in case of chronic or recurrent rhinitis, it is advisable to have it checked by an ENT specialist.

The difference between infectious and non-infectious rhinitis is not so significant. However, some difficulties may indicate a preliminary cause. The main manifestations are difficulty breathing through the nose and increased mucus secretion. The breathing problem is not just a consequence of accumulated mucus.

Swelling of the mucosa will cause difficulty breathing through the nose and also a change in voice, as the resonance of the cavity changes. As a result, the typical nasal voice or speech is called hyponasal or denasalised voice. Increased secretion of mucus will also cause excessive discharge.

The increased discharge can be thin and watery, but also coloured and purulent (pus). This is already a sign of an infection. Swelling and increased nasal discharge will also cause olfactory dysfunction (loss of smell)which can be partial or total. Symptoms of rhinitis include itching of the nose and sneezing.

Due to the closeness of the route between the ear and the nasal cavity, i.e. the Eustachian tube, there may be some pressure or earache, as well as a sensation of ear blockage and hearing loss. Otitis media (inflammation of the middle ear) is a common complication of colds and flu in young children, including babies.

Similarly, there are also some ocular symptoms. Due to proximity the eyes are often watery, red, swollen and irritated. Mucus is can be transferred through the nasopharynx to the throat and to the lower parts of the airways. This is the cause of post-nasal drip in newborns or infants, but also in older children and, of course, in adults.

Cough is a symptom of post-nasal drip. This way, the infection spreads to other parts of the respiratory system. In turn, this may cause a sore throat, an itchy or a scratchy throat. The mucous membrane of the throat is red and swollen as a result of inflammation.

TIP: Useful information in an article on sore throat and treatment options.

Symptoms of rhinitis

• swelling of the mucous membrane
• increased nasal discharge, excessive secretion of mucus, watery, purulent discharge
• nasal voice, hypo- or denasalisation
• itchy or burning senstation in the nose
• sneezing
• olfactory (smell) dysfunction
• change of voice, i.e. nasal voice, rhinophonia

Accompanying symptoms of rhinitis:

• cough
• sore throat, exacerbated by swallowing
• hoarseness
• watery eyes and other eye problems, as well as swelling of the eyelids, photophobia
• hearing impairment, sensation of ear blockage, inflammation of the middle ear
• earache
• headache
• sensation of pressure in the facial area and in the sinuses
• weakness, fatigue, malaise
• increased body temperature, fever
• chills
• loss of appetite
• pain in the muscles and joints or in the whole body if viral inflammation is present

The diagnosis of the disease takes place in the general practitioner's office for children or adults. Based on the anamnesis, the doctor will determine whether the disease is infectious or non-infectious. The throat, the ears, the nose, and the nasal discharge are visually inspected.

Of course, if the cause of the rhinitis is not an acute infection, additional tests are added. The general practitioner will propose an ENT or immunological examination. A blood test may be helpful. CRP values can be determined by a doctor in an outpatient clinic.

Based on an allergological test, the immunologist confirms or refutes the allergic cause. The ENT doctor can diagnose the cause of vasomotor rhinitis as well as polyps by using rhinoscopy.

Of course, testing is recommended if the symptoms persist for more than 10 days or recur if they are seasonal.

In the case of an allergic reaction, rhinitis develops in response to the presence of an allergen. Most often for the seasonal occurrence of pollen. As is the case with hay fever. Allergens include, for example, pollen, dust, mold, mites, pet hair.

Chronic rhinitis has the same symptoms, i.e. a stuffy nose, swelling of the mucous membranes, and nasal discharge. The discharge is rather watery, clear, and contains no pus. Watery eyes or sneezing may also be associated, but does not have to, as it is rather rare.

Allergic rhinitis is more likely to occur with asthma, atopic eczema and other allergies, especially in the case of a positive family history.

How infectious rhinitis works

However, in most cases, rhinitis is caused by na infection. In case of an airborne infection, symptoms appear after the incubation period. Incubation can take from 12 hours to 3 days.

Among the first are symptoms are breathing problems due to swelling, nasal congestion, rhinophonia/hypernasal speech, olfactory dysfunction, increased mucus production with mucus that may be watery at the onset. Over time, it becomes denser and stains due to the presence of pus, which may be greenish, yellowish, or brownish with traces of blood.

Frequent nose blowing and mucosal irritation may cause nosebleeds accompanied by frequent sneezing, itching or burning sensation in the nose. Coughing occurs due to post-nasal drip. Possible complications are a sore throat, which is painful, or difficulty swallowing. The voice is hoarse.

Watery eyes, swelling of the eyelids are common. The condition is complicated by an infection of the middle ear, especially in young children, which can be painful. There is pressure in the ear, a sensation of ear blockage, or hearing loss. A runny nose is often the cause of headaches and sinusitis.

At the onset, there may be general symptoms, such as weakness, fatigue, or anorexia, but also pain in the whole body, muscles and joints. This is especially true for the flu. Elevated body temperature to fever may occur as well. Typically, when the body temperature rises, the patient has chills.

The disease usually lasts from a week to up to 10 days, but the stuffy and congested nose are rather unpleasant. In children, there is a decrease in appetite. However, it is very important to treat rhinitis thoroughly, as various complications may occur, whether the aforementioned infection of the middle ear, sinusitis,but also the infection may pass to the lower part of the respiratory system.