Prevention and Treatment

Since such a large number of immunologically different viruses cause colds, vaccines are impractical. Rhinoviruses, like all other viruses, are not affected by antibiotics and other antibacterial medications. Prevention of the spread of rhinoviruses includes handwashing, even in plain water, which readily removes rhinoviruses, and keeping hands away from the face. In addition, one should avoid crowds and crowded places such as commercial airplanes when respiratory diseases are prevalent, and especially avoid people with colds during the first couple of days of their symptoms. Except for the estimated 10% of colds caused by bacteria where an antibiotic might be helpful, only the antiviral medication pleconaril shortens the duration of symptoms. In experimental rhinovirus infections, aspirin and acetaminophen, commonly present in cold remedies, both somewhat prolonged symptoms, antibody production, and duration of virus excretion.

Table 23.5 summarizes some facts about the common cold.

Table 23.5 The Common Cold

Symptoms

Scratchy throat, nasal discharge, malaise, headache, cough

Incubation period

1 to 2 days

Causative agent

Mainly rhinoviruses—more than 100 types; many other viruses, some bacteria

Pathogenesis

Viruses attach to respiratory epithelium, starting infection that spreads to adjacent cells; ciliary action ceases and cells slough; mucus secretion increases, and inflammatory reaction occurs; infection stopped by interferon release and antibody production

Epidemiology

Inhalation of infected droplets; transfer of infectious mucus to nose or eye by contaminated fingers; children initiate many outbreaks in families because of lack of care with nasal secretions

Prevention and treatment

Handwashing; avoiding people with colds and touching face. No generally accepted treatment except for control of symptoms although the antiviral pleconaril shows promise

Adenoviral Pharyngitis

Adenoviruses are widespread and can cause epidemics of upper respiratory illness throughout the year. Although they typically produce sore throat and enlarged lymph nodes with or without conjunctivitis, they can sometimes also cause pneumonia or diarrhea. They are representative of the many viruses that cause upper respiratory symptoms with fever.

23.4 Viral Infections of the Upper Respiratory System 575

Table 23.6 Adenoviral Pharyngitis

Symptoms Fever, very sore throat, severe cough, swollen lymph nodes of neck, pus on tonsils and throat, and conjunctivitis; less frequently, pneumonia

Incubation period 5 to 10 days

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