Colds account for over 50% of all acute
illness, up to 50% of time lost from work in adults, and up to 80% of
time out of school in children. And while they seldom cause death,
except in the very young and very old or in persons seriously ill with
other diseases, these afflictions are surrounded by considerable
misunderstandings that can lead to unnecessary anxiety and poor
Basic to an understanding of any infectious disease is the fact that
there are two major kinds of germs in this world, bacteria and
viruses. In the case of colds, this distinction becomes critical
because most of these are caused by viruses. And since viruses are not
affected by antibodies, the obvious conclusion is that the vast
majority of colds should not be treated with antibiotics.
Generally, infections are named for their location followed by the
suffix "-itis." Thus an infection in the major breathing tubes to each
lung - the bronchi - becomes "bronchitis." Other examples are
laryngitis, pharyngitis and tonsillitis.
URI (upper respiratory infection):
This phrase is used for infections located in the upper part of the
breathing system, that is, above the lungs. This is what the term
"cold" generally refers to, the infamous collection of symptoms such
as runny nose, sore throat, weepy eyes, and so on. URIs may be caused
by many different groups of viruses. Some of these groups are
themselves very large. For instance, there are over 100 types of
rhinoviruses, the viruses most commonly associated with fall and
Generally these infections are distinguished from URIs by the
suddenness and severity of symptoms and the more generalized ill
feeling ("ache all over") and prostration (being "pooped out") that
usually accompanies the flu. Unlike URIs, flu often is accompanied by
fever greater than 101 degrees Fahrenheit. When flu occurs in large
epidemics, it usually is caused by influenza type A viruses.
Croup and bronchiolitis:
These common infections in young children are apt to produce
obstruction to air flow that results in considerable breathing
difficulty. Signs of such difficulty, such as stridor (a harsh, shrill
noise) or retraction (pulling in) of chest muscles during breathing,
signal the need for immediate medical attention.
As mentioned above, this term refers to infection in the major
breathing tubes leading to the lungs from the windpipe. This diagnosis
is often invoked when no evidence of infection in the lungs can be
found but chest findings such as deep cough and wheezing are present.
This word should be used only for infection in the lungs. The word "lungitis"
might be more logical, but the term pneumonia, stemming from the Greek
word for lung, has long been used. Such infections are more likely to
be treated with antibiotics. Viral pneumonias are common, however, and
may be difficult to distinguish from bacterial pneumonias.
TREATMENT IN GENERAL
It is important to distinguish between viral and bacterial infections
since viruses should not be treated with antibiotics. Sometimes this
distinction is not easy even after careful examination and many tests
(such as blood count, chest x-rays, microscopic examination and
cultures of sputum). And sometimes it is legitimate to treat with
antibiotics, even though the infecting organism is not certain. But as
a general rule, the doctor who takes time to examine you and then
indicates that antibiotics are not necessary is doing you a favor by
avoiding unnecessary expense and possibly severe reactions to
antibiotics. Instead of requesting antibiotics, you should be asking
if they are really necessary. Obviously, self-medication with
antibiotics is totally inappropriate. In addition to the danger
involved, antibiotics can confuse culture tests that might be needed.