The common cold: easing it, waiting it out and knowing when to see a doctor

Runny nose, scratchy throat, one sneeze after another: the common cold is the most frequent infection there is. It clears up on its own, with no specific treatment, but it can last longer than people expect. Here is how to ease it, what is best avoided, and the signs that mean you should see a doctor.

What is a common cold?

The common cold, which doctors call nasopharyngitis, is an infection of the nose and the back of the throat. It is caused by a virus: more than a hundred different ones can trigger it. That is why we catch several colds every year.

The virus spreads through droplets and, above all, through hands. A young child can easily have six to eight colds a year, sometimes more in daycare. This is normal: their immune system is learning.

How long does a common cold last?

A cold almost always follows the same course:

• first, the throat feels scratchy, you sneeze and the nose runs clear;
• then the nose gets blocked and the mucus thickens, sometimes turning yellow or green;
• a mild fever is possible, especially in children, for two to three days;
• everything improves within seven to ten days.

The cough, however, often lingers for two to three weeks. It often comes from mucus dripping from the back of the nose into the throat. On its own, it does not mean the infection is getting worse. In the same way, green mucus does not mean there is a bacterial infection.

Common cold, flu or COVID?

All three are caused by viruses, but they show up differently:

• the common cold comes on gradually; the nose is the main problem, and fever is absent or mild;
• flu starts suddenly, with a high fever, aching muscles and an exhaustion that keeps you in bed;
• COVID can look like either one; only a test can tell them apart.

In people at higher risk, flu or COVID may justify antiviral treatment, which needs to start early.

What helps with a common cold

The common cold gets better on its own. The aim is to make those few days more comfortable:

• rinsing the nose with saline, several times a day: this is the most useful step, especially for a baby, who cannot blow their nose yet;
• drinking regularly, to thin the mucus; for a baby, smaller and more frequent bottles;
• paracetamol (acetaminophen) for a fever that is hard to bear or for pain, at a dose adjusted to the child's weight;
• rest, in a well-aired room that is not too warm;
• a little honey can soothe a cough, but never before the age of one.

What is pointless or best avoided

Some treatments are often asked for even though they do not help, or they carry risks:

• antibiotics: they work on bacteria, NOT on viruses. They do not shorten a cold, and they encourage bacteria to become resistant;
• decongestants that narrow the blood vessels in the nose, as sprays or tablets: they carry a risk of rare but serious side effects on the heart and the nervous system. They should not be used in children, and in adults only after medical advice;
• cough syrups, which are of little use and should be avoided in babies without medical advice.

An antibiotic still has a role when a bacterial complication sets in: that is for the doctor to judge.

When should you see a doctor?

A simple cold does not need a consultation. On the other hand, see a doctor if any of these signs appear:

• a fever that lasts more than three days, or that comes back after settling;
• difficulty breathing, or fast or wheezy breathing;
• ear pain, which suggests an ear infection;
• pain in the face, often on one side, that gets worse when you lean forward: it suggests sinusitis;
• a baby who takes less than half of their usual feeds, or has fewer wet nappies;
• symptoms that last more than ten days, or that get worse after improving.

In a baby under three months, any fever of 38 °C or above calls for medical advice without delay. The same applies to pregnant women, older people and anyone with a weakened immune system, as soon as the cold seems out of the ordinary.

When should you call 101?

Call 101 (Magen David Adom) if any of these signs is present:

• severe difficulty breathing: the skin pulling in between the ribs, flaring of the nostrils, a child too breathless to drink;
• bluish lips or face, or a greyish complexion;
• a child who is unusually drowsy or hard to wake;
• red or purple spots on the skin that do not fade when pressed, together with a fever.

Stopping a cold from spreading

A cold is most contagious in the first few days. A few simple habits limit its spread:

• wash your hands often, with soap and water;
• use disposable tissues, throw them away straight after use, and cough into your elbow;
• avoid kissing a baby when you have a cold, and wear a mask around people at higher risk.

The common cold and video consultation

The common cold lends itself well to a remote consultation: the diagnosis rests on the symptoms, how long they have lasted and how they are changing. Careful questioning and the video image make it possible to reassure you, to watch a child's breathing and to suspect an early ear infection or sinusitis.

On the other hand, a baby who is struggling to breathe, a high fever that persists or ear pain in a young child calls for an examination: a home visit is then offered.

Seeing Dr Nathalie Gozlan

Dr Nathalie Gozlan, a general practitioner, sees adults and children for a cold that drags on, leads to complications or causes concern — as a home visit in the Sharon region (Netanya, Kfar Saba, Raanana, Kadima-Tzoran, as well as the moshavim and kibbutzim of the area), or by video consultation anywhere in Israel, in English, Hebrew and French.

A baby who is struggling to breathe cannot be assessed remotely: call 101.

Frequently asked questions