The common cold (also known as nasopharyngitis, rhinopharyngitis, acute coryza,[

1] head cold, or simply a cold) is a viral infectious disease of the upper respi
ratory tract which primarily affects the nose.
Symptoms include coughing, sore throat, runny nose, sneezing, and fever which us
ually resolve in seven to ten days, with some symptoms lasting up to three weeks
. Well over 200 virus strains are implicated in the cause of the common cold; th
e rhinoviruses are the most common.
Upper respiratory tract infections are loosely divided by the areas they affect,
with the common cold primarily affecting the nose, the throat (pharyngitis), an
d the sinuses (sinusitis), occasionally involving either or both eyes via conjun
ctivitis. Symptoms are mostly due to the body's immune response to the infection
rather than to tissue destruction by the viruses themselves. The primary method
of prevention is by hand washing with some evidence to support the effectivenes
s of wearing face masks. The common cold may occasionally lead to pneumonia, eit
her viral pneumonia or secondary bacterial pneumonia.
No cure for the common cold exists, but the symptoms can be treated. It is the m
ost frequent infectious disease in humans with the average adult getting two to
three colds a year and the average child getting between six and twelve. These i
nfections have been with humanity since antiquity
Signs and symptoms
The typical symptoms of a cold include a cough, a runny nose, nasal congestion a
nd a sore throat, sometimes accompanied by muscle ache, fatigue, headache, and l
oss of appetite.[3] A sore throat is present in about 40% of the cases and a cou
gh in about 50%,[4] while muscle ache occurs in about half.[5] In adults, a feve
r is generally not present but it is common in infants and young children.[5] Th
e cough is usually mild compared to that accompanying influenza.[5] While a coug
h and a fever indicate a higher likelihood of influenza in adults, a great deal
of similarity exists between these two conditions.[6] A number of the viruses th
at cause the common cold may also result in asymptomatic infections.[7][8] The c
olor of the sputum or nasal secretion may vary from clear to yellow to green and
does not indicate the class of agent causing the infection.[9]
Progression
A cold usually begins with fatigue, a feeling of being chilled, sneezing and a h
eadache, followed in a couple of days by a runny nose and cough.[3] Symptoms may
begin within 16 hours of exposure[10] and typically peak two to four days after
onset.[5][11] They usually resolve in seven to ten days but some can last for u
p to three weeks.[12] The average duration of cough is 18 days[13] and in some c
ases people develop a post-viral cough which can linger after the infection is g
one.[14] In children, the cough lasts for more than ten days in 35 40% of the case
s and continues for more than 25 days in 10%.[15]
Cause
Virology
Coronaviruses are a group of viruses known for causing the common cold. They hav
e a halo, or crown-like (corona) appearance when viewed under an electron micros
cope.
The common cold is a viral infection of the upper respiratory tract. The most co
mmonly implicated virus is a rhinovirus (30 80%), a type of picornavirus with 99 k
nown serotypes.[16][17] Others include: human coronavirus (~15%),[18][19] influe
nza viruses (10-15%),[20] adenoviruses (5%),[20] human parainfluenza viruses, hu
man respiratory syncytial virus, enteroviruses other than rhinoviruses, and meta
pneumovirus.[21] Frequently more than one virus is present.[22] In total over 20
0 different viral types are associated with colds

Transmission
The common cold virus is typically transmitted via airborne droplets (aerosols),
direct contact with infected nasal secretions, or fomites (contaminated objects
).[4][23] Which of these routes is of primary importance has not been determined
; however, hand-to-hand and hand-to-surface-to-hand contact seems of more import
ance than transmission via aerosols.[24] The viruses may survive for prolonged p
eriods in the environment (over 18 hours for rhinoviruses) and can be picked up
by people's hands and subsequently carried to their eyes or nose where infection
occurs.[23] Transmission is common in daycare and at school due to the proximit
y of many children with little immunity and frequently poor hygiene.[25] These i
nfections are then brought home to other members of the family.[25] There is no
evidence that recirculated air during commercial flight is a method of transmiss
ion.[23] However, people sitting in close proximity appear at greater risk.[24]
Rhinovirus-caused colds are most infectious during the first three days of sympt
oms; they are much less infectious afterwards.[26]
Weather
The traditional folk theory is that a cold can be "caught" by prolonged exposure
to cold weather such as rain or winter conditions, which is how the disease got
its name.[27] Some of the viruses that cause the common colds are seasonal, occ
urring more frequently during cold or wet weather.[28] The reason for the season
ality has not been conclusively determined.[29] This may occur due to cold induc
ed changes in the respiratory system,[30] decreased immune response,[31] and low
humidity increasing viral transmission rates, perhaps due to dry air allowing s
mall viral droplets to disperse farther and stay in the air longer.[32] It may b
e due to social factors, such as people spending more time indoors, near an infe
cted person,[30] and specifically children at school.[25][29] There is some cont
roversy over the role of low body temperature as a risk factor for the common co
ld; the majority of the evidence suggests that it may result in greater suscepti
bility to infection.[31]
Other
Herd immunity, generated from previous exposure to cold viruses, plays an import
ant role in limiting viral spread, as seen with younger populations that have gr
eater rates of respiratory infections.[33] Poor immune function is also a risk f
actor for disease.[33][34] Insufficient sleep and malnutrition have been associa
ted with a greater risk of developing infection following rhinovirus exposure; t
his is believed to be due to their effects on immune function.[35][36] Breast fe
eding decreases the risk of acute otitis media and lower respiratory tract infec
tions among other diseases[37] and it is recommended that breast feeding be cont
inued when an infant has a cold.[38] In the developed world breast feeding may n
ot however be protective against the common cold in and of itself
Pathophysiology
The common cold is a disease of the upper respiratory tract.
The symptoms of the common cold are believed to be primarily related to the immu
ne response to the virus.[40] The mechanism of this immune response is virus spe
cific. For example, the rhinovirus is typically acquired by direct contact; it b
inds to human ICAM-1 receptors through unknown mechanisms to trigger the release
of inflammatory mediators.[40] These inflammatory mediators then produce the sy
mptoms.[40] It does not generally cause damage to the nasal epithelium.[5] The r
espiratory syncytial virus (RSV) on the other hand is contracted by both direct
contact and airborne droplets. It then replicates in the nose and throat before
frequently spreading to the lower respiratory tract.[41] RSV does cause epitheli
um damage.[41] Human parainfluenza virus typically results in inflammation of th
e nose, throat, and bronchi.[42] In young children when it affects the trachea i
t may produce the symptoms of croup due to the small size of their airway.[42]
Diagnosis

The distinction between different viral upper respiratory tract infections is lo

osely based on the location of symptoms with the common cold affecting primarily
the nose, pharyngitis the throat, and bronchitis the lungs.[4] However there ca
n be significant overlap and multiple areas can be affected.[4] The common cold
is frequently defined as nasal inflammation with varying amount of throat inflam
mation.[43] Self-diagnosis is frequent.[5] Isolation of the actual viral agent i
nvolved is rarely performed,[43] and it is generally not possible to identify th
e virus type through symptoms.[5]
Prevention
The only possibly useful ways to reduce the spread of cold viruses are physical
measures[44] such as hand washing and face masks; in the healthcare environment,
gowns and disposable gloves are also used.[44] Isolation, e.g. quarantine, is n
ot possible as the disease is so widespread and symptoms are non-specific. Vacci
nation has proved difficult as there are so many viruses involved and they mutat
e rapidly.[44] Creation of a broadly effective vaccine is thus highly improbable