Dear Doc,
How do I know if my child has a common cold or if it is a more serious illness such as the Flu?

Reader,
Yes, the cold really is very common... You have probably heard your doctor talk about your child having an “upper respiratory tract infection,” which is just a fancy medical term for the common cold. The upper respiratory tract includes the nose, throat, and voice box; in contrast to the lower respiratory tract which includes the windpipe and the lungs. Children and adults can get colds all year round but they are most common during the winter season. It is most usually caused by a virus; the most common virus is the rhinovirus. Other viruses include: coxsackie virus, parainfluenza, adenovirus, respiratory syncytial virus, influenza, human metapneumovirus, coronavirus, and there are a lot more. A cold is mostly diagnosed clinically by your health care provider. Laboratory work, nasal swabbing to identify what virus it is and chest x-rays are not necessary. Colds can present in a variety of symptoms which may or may not include all of the following:

a. Fever (anything > 100.4F is considered as fever)
b. Cough
c. Runny nose
d. Congestion
e. Sore throat
f. Pink eye/eye discharge
g. Hoarseness (voice)
h. Sneezing

Symptoms gradually improve in 7 to 14 days. Virus can be spread easily from person to person either by hand contact or inhalation of viral particles (from coughing and sneezing). That is why observing proper hygiene is really important to prevent the spread of such an infection. Make sure to tell your child to wash their hands regularly, and teach them to cover their mouth when coughing/sneezing.
Since common cold is cause by a virus, treatment with antibiotics is not necessary, unless of course your physician suspects a bacterial infection is also present. Unnecessary antibiotic intake may cause your child to develop resistance to the medication, which they may find helpful in fighting an infection in the future and so antibiotics shouldn’t be used unnecessarily. Supportive/symptomatic care is suggested – using saline drops, a bulb to suction the nose and a humidifier are some common recommendations to provide comfort. Encourage your child to increase their fluid intake as this may help thin out their secretions. Honey can be given in kids older than 1 year old (you should not give honey to a child who is younger than 1 year old) to help calm their cough. Antipyretics (acetaminophen or ibuprophen) can also be given for fever. Over the counter cough and cold medications (mucolytics, expectorants, antitussives, and decongestants) are not recommended, as there is not enough evidence regarding their safety in kids.

Although this illness typically resolves in about 10-14 days, some may have asthma exacerbation and others may develop ear infection, sinusitis, and lower respiratory tract infection (pneumonia). These will require medication most of the time. Your physician will be able to determine the need for treatment depending on their symptoms when they come for the office visit.

If your child attends daycare or school, and presents with the above symptoms, they most likely has a COMMON COLD, which can happen several times a year, and unfortunately, they will feel sick/yucky until the cold runs its course. If the illness lasts longer than 10-14 days or you have any concerns, you should schedule an appointment with your child’s health care provider.

Raissa Ong, MD, is a pediatrician at the Rochester General Medical Group Pediatric Office at Newark-Wayne Community Hospital. A native of the Philippines, she earned her Medical Doctorate from the University of Santo Tomas in Manila and completed her Pediatric residency training at Geisinger Medical Center in Danville, Pennsylvania. Dr. Ong has a special interest in newborn medicine and immunizations. This column is meant to be educational and not intended to be used to make individual treatment decisions. Prior to starting or stopping any treatment, please confer with your own health care provider. To send questions on children’s health, please email the practice manager at wendy.fisher@rochesterregional.org and write “Ask a Doc” in the subject line. The Pediatrics Practice is located at 1200 Driving Park Avenue, Newark. Call (315) 359-2660 to schedule an appointment.