HJAR Jan/Feb 2020

34 JAN / FEB 2020  I  HEALTHCARE JOURNAL OF ARKANSAS COLD OR SINUS INFECTION? EVALUATION for cold symptoms is one of the most common reasons for doctor’s vis- its in the United States, accounting for an estimated 17 billion healthcare dollars (and thereby contributing to rising healthcare costs). However, the vast majority of common colds are caused by self-limiting viruses and do not require medical evaluation or treat- ment. An often unnecessary time burden can be placed on both patients and physicians when people carve out time to come to the doctor’s office for a viral upper respiratory infection for which no testing and treatment is indicated. Your doctor will be more than happy to reassure you and offer you sug- gestions of over-the-counter symptomatic remedies, but individuals can also become empowered to use a bit more discernment when deciding whether or not to seek medi- cal attention for their cold symptoms. The term common cold refers to a viral up- per respiratory infection. Over 200 types of viruses have been identified as a cause of the common cold, and rhinovirus (rhino derived fromLatin for nose) is a group of viruses that are the most commonly associated with cold symptoms. These infections can be spread by hand contact (via direct contact with an infected person or with a surface contain- ing infected particles), small particle drop- lets in the air (e.g., from a person’s sneeze), and large particle droplets (which requires to see a doctor when they have symptoms of a common cold is that they want their doctor to rule out more serious infections, such as pneumonia. This will also be your doctor’s goal when you are in their office. However, if your symptoms are limited to the afore- mentioned common cold symptoms and have been occurring for less than 10 days, your doctor will not have much to offer you beyond recommendations for over-the- counter cold medications that can manage your symptoms (and importantly, do not treat the underlying infection or alter the natural course of the illness) and generic advice to rest and hydrate. If you come to the doctor with cold symp- toms during the late fall and winter, you may be tested for the flu, which is caused by the influenza A or B virus. A sign that you have the flu is if your cold-like symptoms are no- tably more intense than regular colds you’ve had in the past and are interfering with your ability to function normally. People with the flu often have an abrupt onset of fever and malaise in addition to respiratory symptoms such as sore throat and runny nose. If you test positive for the flu, you will likely be offered an antiviral medication (generally Tamiflu), which can shorten the duration of your symptoms by 1-3 days if it is started within the first 24-30 hours of symptom on- set. It is estimated that there is little to no closer contact with an infected person). Cold viruses can remain viable on surfaces for many hours. However, antibacterial home cleaning products have not shown to have an advantage over reducing transmission of the common cold. This is not too surprising, as antibacterial agents are ineffective against viruses. Aperson is most contagious to oth- ers on the third day after inoculation with the virus, which often coincides with the peak of their symptoms. However, low levels of viral shedding (and thus infectivity) can be pres- ent for up to two weeks. The time between contact with infectious material and the start of symptoms is generally 24-72 hours but can occur as early as 10 hours after exposure. Symptoms usually persist for 3-10 days, but can last as long as two weeks. The symptoms of a common cold in- clude runny nose, nasal congestion, sneez- ing, coughing, low-grade fever, sore throat, malaise (feeling weak and generally ill), head- ache, head and ear pain and pressure, and body aches. The first symptom is often a dry or scratchy throat. It is a common myth that yellow or green nasal discharge (mucus) is a sign of a bacterial infection. Colored nasal discharge is a normal phase of a viral upper respiratory infection, and should not alone prompt a doctor’s visit or prescription for antibiotics. The number one reason people may want “See a doctor if your cold symptoms fail to noticeably start improving within ten days of symptom onset, or if your symptoms improve, but then worsen again.”