Cold Symptoms Breakdown- what you need to know

It is that time of the year when everyone has cold symptoms, sore throats, coughs, fevers, and/or body aches.  So when do you worry?  When do you make an appointment with your doctor?  When do you wait at Urgent Care for hours?  When do you go to Minute Clinic – this one is easy, never!!

Disclaimer: This post is for kids/adults older then 3months old.

General Facts - colds are caused by viruses.  Symptoms appear and generally get worse, DAY 3-5 are the WORST.  80% of colds resolve by day 14.  10% of people have a runny nose a bit longer.

Fever – Most colds and viral illnesses start with a fever.  This is usually the first sign of illnesses in younger kids.

  1. #1 rule – leave the fever alone.  Stop checking it all the time.  Treat the child, not the thermometer.  If the child is playing, sitting quietly, drinking fluids don’t treat the fever.  However, if the child is a mess, laying on the floor, not drinking, screaming, treat the child.
  2. #2 rule – let the fever hang out for 3-4 days (in those not severely ill) before seeking medical attention so other symptoms develop and it becomes a bit more obvious what’s really going on.
  3. #3 rule – fever may arrive without any other symptoms for the first few days and that is ok, as long as the child is not deathly ill and drinking fluids
  4. #4 rule – with colds, generally, after 2 days of fever snot, boogers, cough and sore throat may appear and now we all know its a cold.  The fever goes away 3-5 days and the person is left with cold symptoms
  5. #5 rule – fever does not mean antibiotics are needed.  Fever is the body’s response at fighting an infection, and 80% of the time is due to a viral illness (this is where we are all thankful for children’s immunizations)
  6. When to worry:
    • Lethargic child who refuses to drink fluids
    • Fever lasting more then 5 days
    • Urine output less then 3x a day
    • Sick appearing child

Get more info here  on Fevers: Fever – what is a parent to do?

Sore Throat – Most colds and viral illnesses have a sore throat component.  This is usually the first sign of an illness in older kids, teens, and adults.

  1. Sore Throat does not mean Strep.  1 in 179 doctor visits for sore throat is actually strep according to a survey done in 2006-2007.  That means 0.56% of people with a sore throat have Strep.
  2. Now, if everyone in the household has Strep, strep may be the reason for Sore Throat in the next person.  If the person has had numerous strep throat infections in the past several months, this may mean strep this time as well.
  3. Strep Throat Symptoms – Sore Throat, Fever (generally), Headache, Abdominal Pain, +/- Vomiting, Swollen lymph nodes around the neck, Giant red swollen pus filled tonsils!
  4. Cold symptoms/Viral Illnesses – Sore Throat, +/- Fever, Headache, Achy, Abdominal Pain (occ.), congestion, boogers, cough, snot, fatigue.
  5. Strep Throat does not have cold, congestion, cough symptoms with it.  If sore throat appears for 1-2 days and then runny nose, cough, develop, then this is a cold.
  6. When to worry:
    • Sore Throat with Strep symptoms as mentioned above
    • Sore Throat that is getting worse for more then 5-7days
    • Drooling, refusing to drink liquids, lethargic
    • Sever sore throat with high fever and no other symptoms

Boogers/Snot – are present with a cold and do not mean a sinus infection.

  1. Boogers seem to appear clear at the beginning of a cold and all parents are ok with this.
  2. Boogers turn a bit yellow and thicker as the cold progresses.  This is when parents get nervous.  Yellow snot means the body starts absorbing fluid out of snot.
  3. Boogers can be green and really gross (now everyone is running to the doctor convinced of a bacterial infection).  Green Snot alone has nothing to do with anything.  This means that the body absorbed tons of fluid out of snot, the boogers are getting thicker, and the cold is progressing along its natural course.  Green boogers do not mean sinus infection.
  4. Snot happens!  Kids in day care and preschool have snot all year long, it seems.  Remember that in the first 2 years of day care, kids will have 12 COLDS per YEAR.  Each cold last 10-14 days.  This means snot all the time for the first 2 years of schooling.  This is not an immune system deficiency.  Many times, as one cold is getting better, they get  another cold, and the process waxes and wanes all winter long.  Awesome!
  5. When to worry:
    • boggers lasting more then 14 days, a headache becoming regular, tooth pain, low grade temp, fatigue, feeling run down.  At 14 days, symptoms should get better, if they are getting worse, see your doctor.

Cough – is a common symptom with colds

  1. If you or your child have asthma, use Albuterol for the Cough.  Do not use Delsym or Robitussin, use Albuterol.  Most people are afraid of albuterol.  But if you were prescribed it before, then its safe and please use it.  The worst thing that happens, it doesn’t work.  Also, if you were prescribed a spacer to use with Albuterol, please use that as well.  Otherwise, the Albuterol puffs go into your stomach and not your lungs.
  2. Coughs can be occasional during the day from post nasal drip irritating your throat.  They can be all night long (a parent favorite) from boogers draining down the back of the throat.  Coughs can be dry or juicy.  Coughs are annoying!
  3. Most coughs are benign and resolve by themselves 7-10 days.
  4. When to worry:
    • Dry Barking coughs with Inspiratory Stridor – this is Croup.  Inspiratory Stridor means a weird breathing noise as the child is trying to breathe.  Croup happens in young children, esp in the middle of the night.
    • Dry constant cough that gets worse with running/playing/talking.
    • Increasing cough in those with a diagnosis of Asthma or in those without a diagnosis of Asthma, but have been prescribed Albuterol in the past
    • Cough lasting more then 14 days
    • Cough for days and then associated with a high fever
    • Wheezing
    • Retractions – when you can see the child’s ribs with each breath
    • Rapid breathing, color changes, worsening fever with cough, appearing ill and very lethargic

Congestion and Sinus Pressure – are very common symptoms of colds

  1. Sinus pressure and headache in the first 1-5 days of a cold are normal due to the swelling of the nasal passages.  If the nasal passages are swollen, then pressure builds in the sinuses, causing headaches and pressure.  This does not mean sinus infection.  This does not mean antibiotics are needed.
  2. Congestion gets worse at night when laying down.
  3. When to worry:
    • congestion lasting more then 10-14 days, worsening headaches lasting longer then 10-14 days
    • by day 7 symptoms would have reached the worst, then slowly symptoms should get better. If symptoms are getting worse and worse after day 7, its time to see your doctor

Ear Pain – can happen in the setting of cold symptoms

  1. Ear pain in older children at the beginning of a cold, without a fever, is generally from the congestion in the sinus cavities as mentioned above.
  2. Ear Infections in healthy children older then 24months are generally not treated with antibiotics.  80% of ear infections in this population resolved without antibiotics.  Please give pain relievers such as ibuprofen and acetaminophen to relieve pain.  If symptoms are still present 48hrs later, visit your doctor.
  3. When do we treat Ear Infections:
    • in children less then 18-24months
    • in ill appearing children
    • in children with a long history of ear infections

Next Post Will Address Symptom Relief for all the above

In the mean time … Check out the following posts on Immune Health

Building Your Immune System – nutrition

Building Your Immune System – supplements
Building Your Immune System – sleep
In Good Health, Ana-Maria Temple, MD

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