Colds are highly contagious viral infections of the nose and throat and many of us know the misery they bring—congestion, runny nose, sneezing, sore throat, coughing, mild fever, and headache. But as miserable as they are, most colds are minor illnesses, and they usually go away within 14 days, with or without treatment.
Infants and young children get more colds than adults—typically six to 10 per year—and are more likely to run a fever and to suffer cold-related complications that require doctor visits. Children, along with the elderly, smokers, and individuals with serious health problems such as asthma, heart disease, cancer, or chronic obstructive pulmonary disease (COPD), tend to suffer longer when they get colds.
When Is It More Than a Cold?
If your cold lasts much longer than two weeks or keeps coming back, allergies, sinusitis, or some other secondary infection may be the culprit.
"Fever is an important sign," says Dr. Norman Edelman, chief medical officer for the American Lung Association®. "Colds typically aren't associated with high-grade fever." Adults with a fever of 102º F (39º C) or higher and children with a fever of 103º F (39.5º C) and higher, should see a doctor, Dr. Edelman advises.
If your infant is younger than 3 months old and has a fever of 100º F (37.8º C) or above, go to the doctor immediately, says pediatrician Dr. Carlos Lerner, medical director for children's health at the Mattel Children's Hospital at University of California, Los Angeles. When in doubt, Dr. Lerner advises parents to give their doctor a call: "It's worth getting some advice over the phone."
Serious Complications of the Common Cold
Colds can wear down your body's natural defenses, leaving you vulnerable to health issues ranging from ear and sinus infections to strep throat, bronchitis, and pneumonia. Headaches, fever, and sinus pain could point to a sinus infection that requires treatment.
"Certainly if you've had a cold or sinus infection and now you've got a worsening headache and a fever, that needs to be seen," says Dr. David Ross, an emergency physician at Penrose Hospital in Colorado Springs, Colorado.
If you have symptoms such as stabbing pains in the chest, a cough that brings up colored sputum, fever, or shortness of breath, you should see your doctor. If symptoms came on fast, you should seek immediate medical care, Dr. Ross says.
Respiratory syncytial virus, or RSV, is a common respiratory virus that shares symptoms with the common cold but can cause severe symptoms in certain infants, young children, and older adults. While most people recover from RSV infection in one to two weeks, the virus is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in U.S. for children under 12 months of age. Signs of breathing difficulties in infants include flaring nostrils, breathing faster than usual, straining muscles in the neck, or bluish discoloration around the lips and on fingers. "If you see those things, bring them to the emergency room right away," says Dr. Ross.
Checklists of Cold Symptoms to Watch For
Of course, most colds will never require an emergency room visit, but if the signs and symptoms are looking questionable, it's worth a trip. The American Academy of Family Physicians summarizes the red flags to look for:
In children:
- High (above 103º F, or above 100º F for infants under 3 months) fever, or a fever that lasts for more than 3 days
- Symptoms that last for more than 10 days
- Trouble breathing, fast breathing, or wheezing
- Bluish skin color
- Earache or drainage from the ear
- Changes in mental state (such as not waking up, irritability, or seizures)
- Flulike symptoms that improve, but return with a fever and a worse cough
- Worsening of chronic medical condition (such as diabetes or heart disease)
- A high, prolonged fever (above 102º F)
- Symptoms that last for more than 10 days or get worse instead of better
- Trouble breathing or shortness of breath
- Pain or pressure in the chest
- Fainting or feeling like you are about to faint
- Confusion or disorientation
- Severe or persistent vomiting
- Severe pain in your face or forehead
- Hoarseness, sore throat, or a cough that won't go away after 10 days
