Common Cold

Liliana Rios, M.D. – PGY-1 July 24 - 2008

CASE: Mr. Sniffle, 35 y.o. male ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

QUIZ What is the most likely diagnosis? a. influenza b. acute bacterial sinusitis c. the common cold d. pneumonia e. asthma

Definition: the common cold benign self-limited syndrome caused by members of several families of viruses Mild upper respiratory viral illness

Symptoms: the common cold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Symptoms: the common cold* Day 1 * Epidemiol Infect 1993 Aug;111(1):143-56

Symptoms: the common cold* Day 2 to 3 * Epidemiol Infect 1993 Aug;111(1):143-56

Symptoms: the common cold* Day 4 to 5 * Epidemiol Infect 1993 Aug;111(1):143-56 ,[object Object]

QUIZ: the common cold What is the most common culprit? a. rotavirus b. coronavirus c. rhinovirus d. echovirus e. influenza virus

Virology *4,5 * 4 Lancet 2003 Jan 4;361(9351):51-9. * 5 Lancet Infect Dis. 2005 Nov;5(11):718-25.

Seasonal Patterns Fall, late spring : Rhinovirus Parainfluenza Winter, spring: RSV, coronavirus Summer: Enterovirus (year) Adenovirus: Outbreaks in Military facilities daycare centers, hospital

Facts: the common cold ,[object Object],[object Object],[object Object],[object Object],[object Object],*Ann Allergy Asthma Immunol 1997 Jun;78(6):531-9;

Diferential diagnosis: the common cold ,[object Object],[object Object],[object Object],[object Object]

But how do I know it’s just a cold? Mod-Severe Mild Chest discomfort/ cough Common Common Sore throat Sometimes Common Sneezing Common Common Nasal congestion Usual Unusual Extreme fatigue May last 3 wks Mild Malaise Severe Mild Myalgia Usual Rare Headache 39-40 o Rare Fever INFLUENZA COLD

Facts: Influenza ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Facts: Influenza Vaccine All of the mentionated before Plus Health care workers Pregnant women in second or third trimestrer

But how do I know it’s just a cold? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

But how do I know it’s just a cold? ,[object Object],[object Object],[object Object],[object Object]

[object Object],Airway reactivity *1 Vs Acute asthma attacks exacerbations Up to 40% of viral upper resp infection *2 *1 Am J Respir Crit Care Med 1995 May;151(5):1666-73; discussion 1673-4. *2 Chest 1997 Sep;112(3):591-6.

Complications Sinusitis: Acute bacterial sinusitis develops in 0.5 to 2.5 percent of adult patients after viral *1 Lower respiratory tract disease : RSV, elderly (CHF) and immunocompromised Acute otitis media: Eustachian tube dysfunction; *1 J Allergy Clin Immunol 1998 Sep;102(3):403-8.

QUIZ: the common cold ,[object Object],[object Object],[object Object]

QUIZ: the common cold ,[object Object],[object Object],[object Object],* Prim Care 1996 Dec;23(4):657-75

FACTS: transmission* ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*Epidemiol Rev 1988;10:243-58.

FACTS: the common cold ,[object Object],[object Object],*1 Am J Epidemiol 1989 Feb;129(2):319-40. *2 Prim Care 1996 Dec;23(4):657-75.

FACTS: the common cold ,[object Object],[object Object],* Arch Intern Med. 2003 Feb 24;163(4):487-94. ,[object Object],[object Object],[object Object],[object Object]

QUIZ: the common cold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment: the common cold ,[object Object],[object Object],*1 Cochrane Database Syst Rev. 2005 Jul 20;(3):CD000247.

Treatment: what might work ,[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment: what might work ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*1 Cochrane Database Syst Rev 2004;(3):CD001953 *2 Cochrane Database Syst Rev 2004;(3):CD001953 *3 Arch Fam Med. 1998 Jan-Feb;7(1):39-43.

Treatment: what WON’T work ,[object Object],[object Object],[object Object],*1 Chest. 2006 Jan;129(1 Suppl):72S-74S *2 Chest. 2006 Jan;129(1 Suppl):72S-74S

Treatment: what WON’T work ,[object Object],[object Object],[object Object],[object Object],[object Object],*1 J Gen Intern Med 1996 Apr;11(4):240-4.

Treatment: the common cold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*1 Cochrane Database Syst Rev. 2007 Jul 18;(3):CD000980. *2 Am J Med. 2006 Nov;119(11):937-42.

Treatment: the common cold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*1 Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000530. *2 Laryngoscope. 2006 Feb;116(2):217-20.

Case Conclusion: Mr. Sniffle ,[object Object],[object Object],[object Object],[object Object]

Common Cold

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