What to Expect with an Upper Respiratory Infection
More than 90 percent of upper respiratory infections are caused by viruses. These infections create different symptoms at each stage. Most colds and flus go away in about a week, although some symptoms (like coughing) can take two or three weeks to go away completely.
Helen (Eleni) Xenos, a One Medical doctor in Chicago, describes the typical progression of the common cold:
Day 1: Fatigue, headache, sore or scratchy throat.
Day 2: Sore throat worsens, low fever, mild nasal congestion.
Day 3: Congestion worsens, sinus and ear pressure become very uncomfortable. It may be difficult to sleep.
Day 4: Mucus may turn yellow or green (this is normal). Sore throat improves, but coughing begins.
Days 5-7: Energy and congestion improve.
1 week+: Cough usually tapers off after a week, but can take up to 3 weeks to fully resolve.
If your symptoms are much worse than these, such as coughing so hard you throw up, or coughing up bloody mucus, or if you have a fever over 102°F, you might have something more serious going on, like pertussis (whooping cough) or pneumonia.
If a cold drags on, it can turn into a sinus infection that causes pain around the eyes, nose and/or sinus headaches. Chest colds (bronchitis) cause chest congestion and a hacking cough that drag on for a few weeks.
The flu comes with similar symptoms but features a prominent fever, chills, headache, and body aches that usually last several days.
What Helps You Feel Better
Treating the symptoms and supporting your immune system is the best first course of action to get you feeling better faster. Everyone’s experience of a cold is slightly different from the next person’s, and there are so many options in the cold and flu aisle at the drugstore. How do you know which symptom remedies are right for you?
The key is to find what works best for you personally, for your symptoms, whether it’s over-the-counter cold and flu remedies or soothing herbal tea. If, for example, you experience bad sinus pressure when you have an upper respiratory infection, a decongestant like pseudoephedrine or a nasal sinus rinse might be good to have on hand. If it’s coughing that usually makes your life miserable during a head or chest cold, you could try inhaling hot steam from the sink or shower a few times a day to help break things up.
Your immune system’s job is to eradicate viral and bacterial infections from your body. It’s very effective as long as you provide it with the proper support. The best way to do that is to rest. Being stressed out or not getting enough sleep releases hormones that suppress your immune system.
In addition, taking one to two grams a day of vitamin C during cold season may lessen the severity and duration of your colds, although it won’t prevent you from catching them in the first place. Taking zinc lozenges during a cold also supports your immune system, but you have to start within 24 hours of symptom onset for them to work. Take one lozenge or melt-away every two hours on a full stomach to avoid nausea.
Why Antibiotics Won’t Help — and Might Hurt
Almost all URIs are caused by viruses, and at present we don’t have medications that work against them. (One notable exception: There are antiviral medications for the flu. If you start them in the first 24 to 48 hours of symptoms, it might reduce the duration of your illness by about a day.)
As for the small percentage of upper respiratory infections caused by bacteria, most go away on their own — and often just as quickly — even if you don’t take antibiotics. So if there’s a chance antibiotics can help, what’s the harm?
There are many reasons to be conscientious about taking antibiotics (such as breeding resistant superbugs, or making your health care cost more), but there’s another that’s of immediate concern: diarrhea. Antibiotics can wreak havoc in your intestines and upset the normal balance of bacteria — including the bacteria that help you digest food, which can lead to abdominal pain, bloating, gas, and alternating diarrhea and constipation. And taking multiple courses of antibiotics puts you at risk of potentially long-lasting effects on your gut.
Like everything health-related, the decision about whether to take antibiotics for a bacterial infection comes down to weighing the risks and benefits. Your provider will be happy to discuss the decision with you in detail.
Keeping Your Infection to Yourself
Colds and flus are contagious from the time you get them (even before you have symptoms) until around three to five days after your symptoms start. They’re usually not contagious after a week, even if you’re still coughing or congested.
The best way to avoid passing on a URI (or catching one in the first place) is to wash your hands frequently and cover your mouth with your arm when you cough or sneeze. It’s also best to take at least a couple of days off work or school while you’re most contagious.
When to Call Your Provider
Occasionally, viral infections can set the stage for more complicated bacterial infections. If you experience any of the following, call your health care provider:
High fever (over 102°F)
Shortness of breath or wheezing
Coughing up bloody mucus
Coughing so hard that you throw up
Feeling worse after 5 to 7 days of symptoms, especially if you have worsening headache, congestion, or sinus pain
If you don’t start to feel better after 10 days of symptoms
Remedies for Cold and Flu Symptoms
Cough and Chest Congestion
Antihistamine/decongestant combo (e.g., brompheniramine/pseudoephedrine)
Cough suppressant: Dextromethorphan (Delsym)
Expectorant (mucus thinner): Guaifenesin (Mucinex, Robitussin)
Gentle hot tea (chamomile, licorice root, peppermint, thyme) with or without honey or lemon juice; Traditional Medicinals “Throat Coat” or “Breathe Easy” teas.
Honey (1 tablespoon of raw honey 1 to 3 times daily). Note: honey is not safe for infants under 12 months.
Steam inhalation: Boil 1 inch of water in a pot, remove from the stove, add 5 drops of eucalyptus oil if desired, and inhale slowly for a few minutes twice daily with a towel over your head.