Viral rhinitis or simply referred to as the common cold is the most
frequent viral infection affecting the general population. The term common cold is often used when referring to an upper respiratory infection that is self limited and caused primarily by a virus. The term “cold” refers to an afebrile, infectious, acute inflammation of the mucous membranes of the nasal cavity characterized by nasal congestion, rhinorrhea, incessant sneezing, sore throat and general body malaise.
More broadly, viral rhinitis or the common cold refers to an acute upper respiratory infection is caused by a specific causative microorganism which is viral in nature . The causative agent is influenza (the flu). Colds are highly contagious because the virus is shed for about two days before the signs and symptoms appear and during the first part of the symptomatic stage of the disease. The incidence of viral rhinitis follows a specific pattern during the year, specifically three time periods (start of September, late January and towards the end of April) account for the epidemics in North America alone.
Pathophysiology of the common cold
A common cold is believed to be caused by as many as two hundred different strands of viruses. Rhinoviruses implicated in the common cold include corona viruses, adenovirus, influenza virus and parainfluenza virus. Because of the diversity, development and constant mutation, developing an accurate vaccine are near impossible. Immunity after recovery is variable and is highly dependent on a lot of factors, including a person’s natural host resistance and the specific virus that caused the viral infection. Despite popular belief, cold temperatures and exposure to cold rainy weather do not increase the incidence or severity of the common cold. The onset of the symptoms as well as the severity of its effects is highly dependent on a person’s age, preexisting medical condition and current immunity status.
Clinical manifestations of the common cold
Signs and symptoms of viral rhinitis include; nasal congestion, rhinorrhea and nasal discharge, sneezing, tearing watery eyes, scratchy or sore throat, general malaise, low-grade fever, chills and often headache and muscle aches. In some people, the virus exacerbates herpes simplex, commonly called a cold sore. The symptoms of viral rhinitis may last 1 to 2 weeks. If there is a significant high grade fever or more severe systemic respiratory symptoms, it is no longer considered viral rhinitis but one of the other acute upper respiratory infections. Allergic conditions can affect the nose, which mimics the symptoms of a common cold.
Medical management of the common cold
Management consists of symptomatic therapy. Some
measures include providing adequate fluid intake, encouraging rest, preventing chilling, and using expectorants as needed. Warm salt-
water gargles soothe the soreness of the throat and non-steroidal anti-inflammatory agents (NSAIDS), such as aspirin or ibuprofen can significantly help in relieving aches, pains and fever in adults. Antihistamines are used to relieve sneezing episodes, rhinorrhea and nasal congestion. Topical (nasal) decongestant agents may help in alleviating nasal congestion, however if such agents are overused they often create a rebound congestion that can be worse than the original symptoms of a common cold.
Most patients normally treat viral rhinitis with the use of over-the-counter (OTC) medications that produce moderate clinical benefits. OTC medications generally can provide symptomatic relief along with other measures to improve well-being throughout the duration of the common cold.