Sneezing, scratchy throat, runny nose – everyone knows the first signs of a cold, probably the most common illness known. Although the common cold is usually mild, with symptoms lasting one to two weeks, it is a leading cause of doctor visits and of school and job absenteeism.
The Problem
In the course of a year, individuals in the United States suffer 1 billion colds, according to some estimates.
Colds are most prevalent among children, and seem to be related to youngsters_ relative lack of resistance to infection and to contacts with other children in day-care centers and schools. Children have about six to ten colds a year. In families with children in school, the number of colds per child can be as high as 12 a year. Adults average about two to four colds a year, although the range varies widely. Women, especially those aged 20 to 30 years, have more colds than men, possibly because of their closer contact with children. On average, individuals older than 60 have fewer than one cold a year.
The Causes
The Viruses. More than 200 different viruses are known to cause the symptoms of the common cold. Some, such as the rhinoviruses, seldom produce serious illnesses. Others, such as parainfluenza and respiratory syncytial virus, produce mild infections in adults but can precipitate severe lower respiratory infections in young children.
Rhinoviruses (from the Greek rhin, meaning „nose“) cause an estimated 30 to 35 percent of all adult colds, and are most active in early fall, spring and summer. More than 110 distinct rhinovirus types have been identified. These agents grow best at temperatures of 33 degrees Celsius [about 91 degrees Fahrenheit (F)], the temperature of the human nasal mucosa.
Coronaviruses are believed to cause a large percentage of all adult colds. They induce colds primarily in the winter and early spring. Of the more than 30 isolated strains, three or four infect humans. The importance of coronaviruses as causative agents is hard to assess because, unlike rhinoviruses, they are difficult to grow in the laboratory.
Approximately 10 to 15 percent of adult colds are caused by viruses also responsible for other, more severe illnesses: adenoviruses, coxsackieviruses, echoviruses, orthomyxoviruses (including influenza A and B viruses), paramyxoviruses (including several parainfluenza viruses), respiratory syncytial virus and enteroviruses.
The causes of 30 to 50 percent of adult colds, presumed to be viral, remain unidentified. The same viruses that produce colds in adults appear to cause colds in children. The relative importance of various viruses in pediatric colds, however, is unclear because of the difficulty in isolating the precise cause of symptoms in studies of children with colds.
Does cold weather cause a cold? Although many people are convinced that a cold results from exposure to cold weather, or from getting chilled or overheated, NIAID grantees have found that these conditions have little or no effect on the development or severity of a cold. Nor is susceptibility apparently related to factors such as exercise, diet, or enlarged tonsils or adenoids. On the other hand, research suggests that psychological stress, allergic disorders affecting the nasal passages or pharynx (throat), and menstrual cycles may have an impact on a person_s susceptibility to colds.
The Cold Season
In the United States, most colds occur during the fall and winter. Beginning in late August or early September, the incidence of colds increases slowly for a few weeks and remains high until March or April, when it declines. The seasonal variation may relate to the opening of schools and to cold weather, which prompt people to spend more time indoors and increase the chances that viruses will spread from person to person.
Seasonal changes in relative humidity also may affect the prevalence of colds. The most common cold-causing viruses survive better when humidity is low—the colder months of the year. Cold weather also may make the nasal passages_ lining drier and more vulnerable to viral infection.
Cold Symptoms
Symptoms of the common cold usually begin two to three days after infection and often include nasal discharge, obstruction of nasal breathing, swelling of the sinus membranes, sneezing, sore throat, cough, and headache. Fever is usually slight but can climb to 102o F in infants and young children. Cold symptoms can last from two to 14 days, but two-thirds of people recover in a week. If symptoms occur often or last much longer than two weeks, they may be the result of an allergy rather than a cold.
Colds occasionally can lead to secondary bacterial infections of the middle ear or sinuses, requiring treatment with antibiotics. High fever, significantly swollen glands, severe facial pain in the sinuses, and a cough that produces mucus, may indicate a complication or more serious illness requiring a doctor_s attention.
How Cold Viruses Cause Disease
Viruses cause infection by overcoming the body_s complex defense system. The body_s first line of defense is mucus, produced by the membranes in the nose and throat. Mucus traps the material we inhale: pollen, dust, bacteria and viruses. When a virus penetrates the mucus and enters a cell, it commandeers the protein-making machinery to manufacture new viruses which, in turn, attack surrounding cells.
Cold symptoms: the body fights back. Cold symptoms are probably the result of the body_s immune response
to the viral invasion. Virus-infected cells in the nose send out signals that recruit specialized white blood cells to the site of the infection. In turn, these cells emit a range of immune system chemicals such as kinins. These chemicals probably lead to the symptoms of the common cold by causing swelling and inflammation of the nasal membranes, leakage of proteins and fluid from capillaries and lymph vessels, and the increased production of mucus.
Kinins and other chemicals released by immune system cells in the nasal membranes are the subject of intensive research. Researchers are examining whether drugs to block them, or the receptors on cells to which they bind, might benefit people with colds.