Upper Respiratory Infection (URI or Common Cold)

An upper respiratory infection (URI), also known as the common cold, is one of the most common illnesses, leading to more doctor visits and absences from school and work than any other illness every year. It is estimated that during a one-year period, people in the United States will suffer 1 billion colds.

Caused by a virus that inflames the membranes in the lining of the nose and throat, colds can be the result of more than 200 different viruses. However, among all of the cold viruses, the rhinoviruses and the coronaviruses cause the majority of colds.

Cold Symptoms

Flu Symptoms

Low or no feverHigh fever
Sometimes a headacheCommonly a headache
Stuffy, runny noseSometimes a stuffy nose
SneezingSometimes sneezing
Mild, hacking coughCough, may progress
Slight aches and painsOften severe aches and pains
Mild fatigueFatigue, may persist
Sore throatSometimes a sore throat
Normal energy levelExhaustion

Most children will develop at least six to eight colds a year. This number increases for children who attend daycare. Colds do not happen as much after the age of 6. Adolescents get colds about two to four times a year.

Children are most likely to have colds during fall and winter, starting in late August or early September until March or April. The increased incidence of colds during the cold season may be attributed to the fact that more children are indoors and close to each other. In addition, many cold viruses thrive in low humidity, making the nasal passages drier and more vulnerable to infection.

There are many different types of viruses that cause the common cold. In fact, over 200 different varieties of viruses can cause the symptoms of a cold. The most common virus is called the rhinovirus. Other viruses include the coronavirus, parainfluenza virus, adenovirus, enterovirus, and respiratory syncytial virus.

After the virus enters your child's body, it causes a reaction -- the body's immune system begins to react to the foreign virus. This, in turn, causes:

  • An increase in mucus production (a runny nose)
  • Swelling of the lining of the nose (making it hard to breath and congestion)
  • Sneezing (from the irritation in the nose)
  • Cough (from the increased mucus dripping down the throat)

To catch a cold, your child must come in contact with one of the viruses that cause a cold, from someone else who is infected. The cold virus can be transmitted in various ways.

Virus in the Air

If a person with a cold sneezes or coughs, small amounts of the virus can go into the air. Then, if your child breathes in that air, the virus will adhere to your child's nasal membrane.

Direct Contact With an Infected Person

This means that your child directly touched a person that was infected. A cold is easy for children to spread, because they touch their nose, mouth, and eyes often and then touch other people or objects and can spread the virus. It is important to know that viruses can be spread through objects, such as toys, that have been previously touched by someone with a cold. 

Vitamin C and the Common Cold

  • Many people believe taking large amounts of vitamin C will either prevent the common cold or reduce its symptoms.
  • However, to date, studies have not indicated that high amounts of vitamin C affect the onset and symptoms of the common cold.
  • In addition, taking large quantities of vitamin C over a long period of time may, in fact, be harmful, causing diarrhea and distorting urine and blood test results.

The symptoms of a cold start from one to three days after your child has been in contact with the cold virus. Usually, the symptoms last about one week, but this varies in each child, and may last even up to two weeks. The following are the most common symptoms of a cold. However, each child may experience symptoms differently.

Cold Symptoms in Infants

  • Unable to sleep
  • Fussiness
  • Congestion in the nose
  • Sometimes vomiting and diarrhea
  • Fever

Cold Symptoms in Older Children

  • Stuffy, runny nose
  • Scratchy, tickly throat
  • Watery eyes
  • Sneezing
  • Mild hacking cough
  • Congestion
  • Sore throat
  • Achy muscles and bones
  • Headaches
  • Low grade fever
  • Chills
  • Watery discharge from the nose that thickens and turns yellow or green
  • Mild fatigue

Symptoms of the common cold may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

A cold and the flu (influenza) are two different illnesses. A cold is relatively harmless and usually clears up by itself after a period of time, although sometimes it may lead to a secondary infection, such as an ear infection.

The flu can also be harmless but may progress to a more complicated illness, such as pneumonia and even death. What may seem like a cold, could, in fact, be the flu. Be aware of these differences.

Children suffer more colds each year than adults, due to their immature immune systems and to the close physical contact with other children at school or daycare. In fact, the average child will have between six to eight colds a year, while the average adult will get two to four colds a year. However, the average number of colds for children and adults will vary.  

Aspirin and the Risk of Reye Syndrome in Children

  • Do not give aspirin to a child who has fever without first contacting the child's physician. Aspirin, when given as treatment for viral illnesses in children, has been associated with Reye syndrome, a potentially serious or deadly disorder in children.
  • Pediatricians and other healthcare providers recommend that aspirin (or any medication that contains aspirin) not be used to treat any viral illnesses (such as colds, the flu and chickenpox) in children.

Most common colds are diagnosed based on reported symptoms. However, cold symptoms may be similar to certain bacterial infections, allergies, and other medical conditions. Always consult your child's physician for a diagnosis.

It is important to remember that there is no cure for the common cold and that antibiotics will not help treat a common cold. Medications are used to help relieve the symptoms, but will not make the cold go away any faster. Therefore, treatment is based on helping the symptoms and supportive care. Specific treatment will be determined by your child's physician based on:

  • Your child's age, overall health, and medical history
  • Extent of the disease
  • Your child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

Increased Fluid Intake

Increasing fluid intake will help keep the lining of the nose and throat moist and help to prevent dehydration.

Avoid Secondhand Smoke

Keep your child away from passive (secondhand) smoke, as this will increase the irritation in the nose and throat.

To help relieve the congestion and obstruction in the nose for younger children, consider the following:

  • Saline nose drops may be used.
  • Use a bulb syringe to help remove the mucus.
  • Place a cool mist humidifier in the room.
  • Analgesics, such as acetaminophen, are sometimes helpful in decreasing the discomfort of colds. Consult your child's physician before giving any medication to your child.
  • There are other medications for congestion, cough, or runny noses. Discuss your options with your child's physician.

Children suffer more colds, due to their body’s inability to fight off viruses to which they have not been exposed. Taking proper preventive measures can reduce the risk of your child developing a cold. Preventive measures may include the following:

  • Keep your child away from a person with a cold
  • Encourage your child to wash his / her hands frequently and not to touch his / her mouth, eyes, or nose until their hands are washed
  • Make sure toys and play areas are properly cleaned, especially if multiple children are playing together
  • Ear infections
  • Sinus infections
  • Pneumonia
  • Throat infections

Contrary to popular belief, cold weather or getting chilled does not cause a cold, according to the National Institute of Allergy and Infectious Diseases (NIAID). However, more colds do occur during the cold season (early fall to late winter), which is probably due to various factors, including:

  • Schools are in session, increasing the risk for exposure to the virus
  • People stay more indoors and are in closer proximity to each other
  • Low humidity, causing dry nasal passages which are more susceptible to cold viruses

Antibiotic overuse in children has become a common problem, aggravated by parental pressure for the medication, according to the American Academy of Pediatrics (AAP).

In 1980, 4.2 million prescriptions were written for amoxicillin, an oral antibiotic to treat ear infections.

In 1992, the number of prescriptions had grown to 12.3 million (194 percent increase). Use of another antibiotic to treat ear infections, cephalosporins, increased from 876,000 prescriptions in 1980 to 6.8 million in 1992 (a 687 percent increase).

Overuse of antibiotics is leading to strains of diseases that are becoming resistant to the medication, making it harder to treat patients. Too often, antibiotics have been prescribed for conditions such as colds, fluid in the middle ear, or bronchitis, which do not respond to antibiotics, according to the Centers for Disease Control and Prevention (CDC).

Antibiotics are only effective in treating bacterial infections.

The key to preventing overuse of antibiotics is education of the parents and physicians in the appropriate use of antibiotics, according to the American Academy of Pediatrics.

Some tips to remember when taking antibiotics, according to the American Medical Association (AMA), include:

  • Take the antibiotics as prescribed
  • Finish the full course of antibiotics, as prescribed
  • Do not save or reuse antibiotics

The rhinoviruses and the coronaviruses are the most common causes of a cold. According to the National Institute of Allergy and Infectious Diseases (NIAID), the rhinoviruses cause about one-third of all colds (30 to 35 percent), while the most common causes of adult colds are the coronaviruses. However, the cause of 30 to 50 percent of colds remains unidentified.


There are more than 110 different rhinoviruses that cause most colds in early fall, spring, and summer. Named after the Greek word "rhin" for "nose," rhinoviruses thrive in the human nasal mucosa.


More than 30 different strains of the coronavirus exist, with three or four types affecting humans. The virus is most active in the winter and early spring.

Last Updated 06/2012