Cold and Flu

• Cold and Flu


  Common Cold
• Common Cold


  • Mixture of upper respiratory tract infections
  • Can be transferred via direct contact or droplets
  • Self-limiting, patients able to recover without medicine
  • Symptomatic relief often required
  • Potentially occurring 312 times per year
• Transmission of common cold virus

  1. Comes into contact with hands

  2. Touches nose, mouth and eyes

  3. Transferred by droplets that shed from nose and coat surfaces

  4. Viable on surfaces for several hours

  5. Uninfected person touches contaminated surface

  6. Sneezing and coughing can also transmit
• Epidemiology of common cold
• Aetiology (cause) of common cold

  • More than 200 subtypes of viruses can cause symptoms
  • Virus invades nasal and bronchial epithelia and attaches to specific receptors
  • Causes damage to ciliated cells
  • Leads to release of inflammatory mediators and inflammation in the nose
• Pathophysiology of common cold

  1. Vasodilation and increase in fluid or immune cells in the nose

  2. Permeability of capillary cell walls increases, resulting in oedema and nasal congestion

  3. Fluid may drip down the back of the throat, spreading the virus
• Symptoms of common cold

  • Sore throat, sneezing, profuse nasal discharge and congestion
  • Cough and UACS, headache, mild to moderate fever, general malaise
  • Symptoms can last up to two weeks, most disappear after a week
  • Influenced by causative agent, patient age and underlying conditions
• Symptoms of common cold

  • Rhinorrhoea — runny nose
  • Clear water fluid
  • Thicker mucus
  • Sneezing
  • Irritation and congestion of nasal passages
  • Nasal congestion
  • Vasodilation of blood vessels
  • Swelling of nasal lining
  • Narrowed nasal passages
  • Blockage
  • Coughing
  • Irritated pharynx
  • Dry and tickly
  • Irritated bronchi — post-nasal drip
  • Headache
  • Inflammation and congestion of nasal passages and sinuses
  • Shivering
  • Sore throat
  • Sweating
  • Earache
• Differential diagnosis between cold and flu

  • Onset of symptoms - flu has more abrupt onset
  • Nature of symptoms - flu has more marked myalgia, chills, fever and malaise
  • Symptom severity - flu symptoms are more severe
• Conditions to eliminate in differential diagnosis

  • Rhinitis
  • Acute rhinosinusitis (sinusitis)
  • Acute otitis media (middle ear infection)
• When to refer for common cold
• Management of common cold

  1. TLC

  2. Steam inhalations

  3. Analgesics

  4. Oral decongestants

  5. Topical decongestants

  6. Throat lozenges

  7. Vitamin C, zinc supplements

  8. Antihistamines

  9. Inhalations (menthol, eucalyptus, vapour rubs)
• Influenza


  • Viral infection that causes upper and lower respiratory and systemic symptoms
  • Transmitted via droplet inhalation or direct contact with infected nasal secretions
• Aetiology (cause) of influenza

  Caused by RNA viruses, types A and B are most virulent
• Symptoms of influenza


  • Sudden onset, shivering, chills, malaise, marked aching of limbs, insomnia, fatigue, non-productive cough, loss of appetite
  • More debilitating than common cold
• Management of influenza