How to distinguish colds from more serious respiratory infections?

Have you been attacked by headaches, muscle aches, fever, scratchy throat, dry cough, breathing difficulties, stuffy nose or other symptoms?
No need to panic right away, it might just be a common cold!

Why are we more afraid of respiratory infections today than before?

Perhaps a silly question at a time when we are facing the global pandemic of COVID-19.

Yet we must not forget that there are many other diseases in the world.

Some are trivial, some are a greater threat than the coronavirus.

The current situation:

• people are scared at the slightest snot
• over-monitoring and disregarding other diseases that have existed so far.
• forgetting that the other diseases still exist.
• they are afraid to cough in public, despite wearing a nose mask
• they feel guilty when they sneeze in a shop
• if they have a fever, they get nasty looks from others and are shunned
• they forget that excessive stress can also kill

Also read the articles in the magazine:
What is the disease course of coronavirus COVID-19? Plus typical and less common symptoms

Not every cold means COVID-19

As winter approaches, the number of viral illnesses rises, just like every year before.

The most critical time for developing colds, flu, and other infections is from October to the end of March.

The cold, cloudy weather and lack of sunshine cause lower production of vitamin D and therefore a weakening of immunity.

Simply put, this is the period when people are more susceptible to getting sick. This can be confusing for many lay people at the moment, as not every temperature automatically means coronavirus.

Interesting:
Coronavirus is a virus that we have known about for a very long time.
The common cold (rhinitis acuta) is often caused by coronavirus.
However, in late 2002 and early 2003, a new type of this virus emerged that reached people from civets.
This did not only cause inflammation of the nasal mucosa, but also invaded the lower respiratory tract and caused SARS acute respiratory failure syndrome.
The turn of 2019-2020 brought us its new mutation SARS-Cov-2 in the form of COVID-19 disease.

The most common viruses occurring in winter:

• hRV - human rhinovirus
• adenovirus (rhinovirus)
• coronavirus (rhinitis, pneumonia)
• orthomyxovirus - influenza virus (influenza A, B, C)
• RSV - respiratory syncytial virus (rhinitis, bronchitis)
• hMPV - human metapneumovirus (rhinitis, bronchitis)
• hBoV - human boca virus

Read also articles in the magazine:
New coronavirus: Do you know the symptoms, similarities or differences with flu?
Coronavirus vs. flu: Which threatens us more?

Colds (sniffles), what are they and what causes them?

Rhinitis acuta (acute rhinitis) is mainly known by the popular name of the common cold. It is a predominantly viral disease of the upper respiratory tract.
It is a sudden inflammation of the nasal mucosa caused by more than 200 different respiratory viruses.
Rhinoviruses predominate (50-60%), followed by coronaviruses (25%), and less frequently by adenoviruses, influenzae A and B viruses.
Occasionally, it can also be caused by bacterial agents.

The common cold occurs sporadically throughout the year, but is one of the most common viral diseases of the world of seasonal nature. In the colder seasons its incidence is enormous.

It occurs mainly in winter, when the cold environment accelerates the drying of the nasal mucosa, making it easier for viruses to attach and establish themselves.
In addition, heated and unventilated homes accelerate the spread of infection among relatives.

Table with the basic division of rhinitis

Infectiousness and transmission

The cold has a relatively short and mild course. However, this is what allows the ill person to move freely without much difficulty.

Uncontrolled movement (schools, kindergartens, shops, leisure centres) allows the virus to spread rapidly and to come into contact with susceptible persons without problems.

Transmission from person to person occurs by droplet infection, i.e. infected droplets dispersed in the air after a sick person has sneezed or coughed, or by direct contact.

Once a susceptible person is infected, the virus establishes itself in the cells of the respiratory mucosa, attacking, drying, peeling and damaging the mucous membranes, most commonly the nasal mucosa.

Pyogenic microbes like to settle on such sensitive mucous membranes, which subsequently cause local blood circulation, swelling and trigger a watery discharge - snot.

The incubation period of a cold is usually 2 to 3 days before the first symptoms appear.
It does not last long. It begins to subside in about the same time (1 to 4 days).

How does a cold manifest itself?

• A cold is a disease affecting the upper respiratory tract, i.e. the nasal mucosa - rhinitis.
• Often it passes to the mucous membrane of the nasopharynx, then it is called rhinopharyngitis.

As a result of the inflammatory reaction, the affected mucous membrane is excessively engorged, red, swollen and locally swollen.
Swelling reduces nasal patency.
This results in hoarseness, difficulty breathing through the nose and forced breathing through the mouth.

Increased nasal secretion is typical.
Secret is watery at the beginning. Later it is cloudy, mucoid.

Patients experience an irritating 'itchy nose'.

Symptoms of the common cold in its various stages:

1. Prodromal stage - malaise, general weakness, fatigue, insomnia at night, fever, headache, appetite, dryness of mucous membranes, itching in the nose and eyes
2. Catarrhal stage - swelling of the nasal mucosa, watery nasal discharge, stuffy nose, transient loss of smell, humming, watery ears, tearing
3. Final stage - gradual retreat of the problem, relaxation of the airways, return of the sense of smell

Swelling of the nasal mucosa to increased secretion from the nose can cause severe breathing problems to suffocation in newborns and infants.

Read also the magazine article:
Mucus plugging in children: why does it cause vomiting and how is it treated?

Which illnesses are most often confused with the common cold?

The common cold can very easily be confused with any other respiratory infection of a seasonal nature and with almost any respiratory infection affecting the upper respiratory tract.

When these circumstances combine, it is almost impossible to tell some diseases apart without laboratory diagnosis.

There are many seasonal diseases, so only the most common and serious are listed.

Nasopharyngitis (inflammation of the nasopharynx)

Nasopharyngitis is a primary viral disease, which usually coexists with another bacterial infection.
It is caused by viruses that also cause rhinitis, but also by paramyxoviruses, picornaviruses, or even herpesviruses.
The causative agents of nasopharyngitis are really wide ranging.

Nasopharyngitis (inflammation of the nasopharynx) is seasonal, with a peak in winter.
It manifests itself very similarly to the common cold, with slight variations. It affects all ages.
The course of the disease can be mild to life-threatening, depending on the causative agent.

The incubation period of nasopharyngitis ranges from 1 to 3 days.
The illness lasts on average 7 to 10 days, but may be longer depending on the type of concurrent bacterial infection.

Symptoms of nasopharyngitis:

• the disease begins with redness and swelling of the throat, i.e. "sore throat"
• associated with sore throat and difficulty swallowing
• symptoms of rhinitis (runny nose, stuffed nose, hoarseness, cough, conjunctivitis, watery eyes...)
• temperature rises, the patient is weak, lethargic, sleepy
• enlarged and painful lymph nodes can be felt in the neck

Acute tonsillitis

Acute tonsillitis is a disease more commonly known as tonsillitis.
It is caused mainly by bacterial agents. Bacterial occurrence is observed mainly in summer.

In winter, we can encounter tonsillitis of viral origin, which is not so common.

The incubation period of nasopharyngitis ranges from 1 to 3 days.
The disease lasts on average 7 to 10 days, depending on the type of causative agent.

Symptoms of tonsillitis:

• Redness, swollen and swollen tonsils and soft palate
• presence of pus on the tonsils (whitish dots, plaque)
• pain and scratching in the throat
• difficulty swallowing, painful swallowing
• whitish coating on the tongue
• taste in the mouth, bad breath
• watery secretion in the nose, later mucous to purulent
• chills, shivering, excessive sweating, high fever
• malaise, fatigue, daytime drowsiness, nighttime insomnia, dehydration, dizziness
• headache, neck, muscle, joint, back pain
• appetite, nausea, abdominal pain, vomiting

Influenza

After the common cold, influenza is the second most common viral infection with a seasonal pattern.
It occurs year after year, in small epidemics as winter approaches.
It is caused by several types of influenza viruses.

The most commonly encountered is influenza A virus, which is characterised by high infectivity, relatively rapid community spread and a more severe course.
Smaller epidemics with a milder course are usually caused by influenza B virus.

The incubation period of influenza ranges from 1 to 3 days.
The illness lasts 3 days (influenza B virus), up to 7 days (influenza A virus).

Flu symptoms:

• Influenza begins suddenly with chills signaling the onset of fever
• fevers tend to be high between 39 °C and 40 °C and are accompanied by sweating
• loss of fluid causes dryness of the mucous membranes, dehydration, dizziness
• the patient has a distinct feeling of illness, which he describes by saying: 'I feel sick', 'I feel sick', 'I feel like dying'
• muscle weakness, malaise and fatigue prevent the patient from getting out of bed
• associated headaches, typically behind the eyes, back, muscle, joint and body pain
• swelling of the mucous membranes of the nose and pharynx
• conjunctivitis accompanied by photophobia is typical
• later, a dry irritating cough is associated
• the persistent coughing and the effort involved cause chest (lung) pain

Interesting:
We generally think of influenza as a minor illness, but many epidemiologists would disagree with this incorrect statement.
Scientists and doctors have been concerned about the influenza virus and its gene mutations for years.
For example, the influenza A virus does not just cause the "common flu" but often life-threatening infections.
Evidence of its danger is the past epidemics of Spanish flu (H1N1), swine flu (H1N1) in 2009, and avian flu (H5N8) in 2016.

Acute laryngitis

Acute laryngitis is a predominantly childhood disease (6 months to 5 years) that affects adults without mercy.
It is an acute inflammation of the larynx. The most pronounced swelling is in the subglottic space (below the vocal cords).

The incidence of laryngitis is highest in autumn and winter, i.e. at the peak of other respiratory diseases.
The causative agent of the disease is parainfluenza virus (parainfluenza A and B) in more than half of the cases.
It can also be caused by influenza viruses, rhinoviruses, adenoviruses, coronaviruses, metapneumoviruses, RSV, or echoviruses.

The incubation period of laryngitis ranges from hours to days.
The illness lasts 7 to 14 days.

Symptoms of acute laryngitis:

• Laryngitis starts slowly, initially resembling a common upper respiratory tract illness (cold, flu).
• weakness, malaise, fatigue, loss of interest, crankiness, lack of appetite, crying, headache, sore throat
• chills, shivering, sweating and fever up to 38 °C
• the illness may occur without fever
• due to vocal cord involvement, the child may become hoarse or even lose his voice
• the child breathes heavily, with a whistling sound when breathing in
• a typical sign of laryngitis is a barking cough and worsening of the condition at night
• the condition is aggravated by the child's persistent crying

Interesting:
The danger of acute laryngitis lies in the swelling of the subglottic space, which is located in front of the entrance to the larynx.
The progression of the condition, but also the child's crying and exertion, increases the swelling, causing obturation of the upper airway.
Crying can also cause laryngospasm (contraction of the larynx) and obstruction of breathing.
Laryngospasm is the most common cause of death in a child with laryngitis, so it is necessary to calm the child who is ill in this way.

Acute bronchiolitis

Acute bronchiolitis is a difficult disease caused by obstruction of the bronchial tubes and bronchioles.
It is 85% caused by respiratory syncytial virus RSV, which also belongs to the group of viruses that cause seasonal illness.
Influenza virus, parainfluenza virus, adenoviruses and others can also be the causative agent.

RSV is not as well known as colds, flu or laryngitis, but we should know about it. It typically occurs in childhood.
It is thought that every child has had an RSV infection by the time they are 2 years old.
It is most common around the 5th month.

The incubation period of bronchiolitis ranges from 2 to 8 days.
The disease lasts 7 to 14 days.

Symptoms of acute bronchiolitis:

• The danger of bronchiolitis lies in the mild onset of the disease.
• at the beginning, it typically manifests itself with a non-serious rhinitis
• the child is weak, faint, tired, does not sleep at night, loses interest, does not like to eat, is sullen, tearful
• chills, shivering, sweating
• temperature rises from 37 °C to 40 °C
• headache, eye pain, body aches
• nasal discharge, full nose and hooting
• conjunctivitis causes redness, itching (rubbing the eyes), pain and tearing
• respiratory problems starting with a dry cough
• the cough worsens, the young patient starts to have difficulty breathing
• breathing becomes more labored, faster, breathing rate rises to 70-80 breaths per minute
• retraction of the jugular fossa and the space under the ribs during breathing, inspiratory position of the chest
• the child is not red, as is usual with fever, but distinctly pale
• blue on respiratory failure
• untreated condition causes death by suffocation