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Acute Upper Respiratory Infection

A common cold can knock you out. Learn how to get relief.
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Written by
Sam Kelly, MD.
Medically reviewed by
Pulmonary & Critical Care Fellow, Brigham and Women's Hospital
Last updated March 22, 2022

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Care Plan

1

First steps to consider

  • Most upper respiratory infections, like colds and sore throats, can be treated at home.
  • You can treat symptoms by drinking lots of fluids, rest, and taking OTC medications like decongestants and acetaminophen (Tylenol).
2

When you may need a provider

  • Symptoms are really bad or not going away after 7–10 days.
  • You have a fever for more than 3 days that does not improve when taking fever-reducing medication (like Tylenol).

Acute URI quiz

Take a quiz to find out if you have acute URI.

Take acute URI quiz

What is an acute upper respiratory infection?

An acute upper respiratory infection (URI) is any infection of the nose or throat, which are part of the body’s upper respiratory system. Acute means an illness that comes on quickly.

Upper respiratory infections are mild infections and are often called the “common cold.” There are hundreds of viruses that can cause a cold. That’s why colds are very common—most adults get at least one cold every year. Colds generally last no more than a few weeks and go away on their own.

A sneeze releases thousands of droplets that travel through the air.

Most common symptoms

Your nose and throat may feel itchy or like it has a tickle. You’ll be congested (stuffed up) and probably have a runny nose. Mucus may even drip into your throat (post-nasal drip) and cause a cough. If you’re feeling really lousy—you have significant muscle aches, high fever (above 102F), non-stop coughing, or difficulty breathing—get in touch with your doctor.

Pro Tip

Symptoms I listen for when diagnosing this illness: Runny nose. Stuffy nose. Sore throat. Fever. Feeling tired or lousy. My child, spouse, coworker was sick with the same symptoms. Has been less than a week of symptoms. Sometimes has diarrhea or nausea. —Dr. Bina Choi

Main symptoms

Other possible symptoms

  • Pain or difficulty swallowing
  • Pain or difficulty speaking (hoarse voice)

Dr. Rx

It’s a common misconception that antibiotics can treat URI. They do not. Almost all patients with a URI get better on their own. Drink a lot of warm fluids and get plenty of sleep! —Dr. Choi

Swelling of the nose and throat and mucus causes congestion.

Treatment

There is no cure or vaccine. Focus on relieving symptoms until you feel better.

There are ways to reduce the duration or severity of symptoms. Start them as soon as you sense a cold coming on. You can

  • Moisturize airways with nasal irrigation (like saline spray or a neti pot).
  • Set up a humidifier in your bedroom to relieve congestion.
  • Honey or lozenges to soothe your throat.
  • Pain relievers like acetaminophen (Tylenol) for headache or fever.
  • Avoid irritants such as smoke and heavy air pollution—they can make your symptoms worse and slow the healing process.
  • Drink warm liquids like tea and soup.

Do see your doctor if you have a cold that causes you significant discomfort, lasts more than a week, worsens after a week, or there are other symptoms besides your nose and throat area.

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Next steps

Relieve your symptoms as best as you can. Try home remedies like tea or over-the-counter medications such as lozenges to soothe your throat. Take acetaminophen for a fever. If you’re not getting better after a few days or symptoms are interfering with your daily routine, contact your doctor. Also call your doctor or go to urgent care for any of the following:

  • Fever over 100.4
  • Fever comes back after having gone away
  • Coughing phlegm with blood
  • Swallowing is so painful that you can’t eat or drink
  • Wheezing

If you have difficulty breathing—call 911.

Causes

Almost all upper respiratory infections are caused by viruses. There are hundreds of different viruses that can infect the upper airway and cause a cold. The most common ones are rhinovirus, adenovirus, coronavirus, parainfluenza, and respiratory syncytial virus.

Bacteria can also cause an infection in the upper airway, but causes more severe symptoms than the classic “common cold.” Strep throat (Group A streptococcus bacteria) is the best known bacterial upper respiratory infection.

Whether viral or bacterial, these infections spread easily from person to person, typically by transmission through the air from a sneeze or cough, or by touching shared surfaces, like doorknobs.

Children and colds

Children catch more colds. That’s partly because they probably haven’t encountered the viruses before and haven’t built up any immunity. They also may be in childcare where viruses can spread easily. Some respiratory infections (not the common cold) can lead to more serious issues. If your child is having difficulty breathing (even if they seem to have a cold), take them to a doctor immediately.

Infants and toddlers can have trouble breathing when they have a cold. Antibiotics don’t help, but other treatments can be life-saving in very serious cases. If your child has a hard time breathing or drools a lot more than usual, get medical care immediately. Some other reasons to see a pediatrician.

  • Fever of 100.4F in newborns up to 12 weeks.
  • Fever keeps getting higher or fever for more than two days in a child of any age.
  • Symptoms that worsen or don’t improve.
  • Bad headache or cough.
  • Wheezing.
  • Ear pain.
  • Extreme fussiness.
  • Unusual drowsiness (sleepiness).
  • Lack of appetite.

Never give medicine to a young child without first checking with your doctor. Over-the-counter cold remedies can be very dangerous. Or even deadly. Never give aspirin to a child unless your doctor specifically says you should. Aspirin can cause Reye’s syndrome in children. It’s a rare but very serious condition.

Risk factors

Your immune system fights off infections, including ones that cause colds. When your immune system is weakened, you’re more likely to get sick.

  • Uncontrolled diabetes, HIV, and drug and alcohol abuse interfere with the body’s ability to fight off illness.
  • Smokers are much more likely to get an upper respiratory infection and lower respiratory infections like bronchitis and pneumonia. Symptoms may be more serious in smokers with these infections.
  • Risk is higher during the fall and winter months when the weather is colder.

Acute URI quiz

Take a quiz to find out if you have acute URI.

Take acute URI quiz

Prevention

Pro Tip

Get your flu shot annually. Some people don’t like getting the flu shot because it makes them feel worse for a short period of time, but this is better than actually getting the flu. Even young people can get very sick from the flu. —Dr. Choi

Upper respiratory infections are hard to avoid because there are so many types of common viruses in our world. There are a few things you can try to minimize your risk of infection.

  • Wash your hands. Clean your hands thoroughly (for at least 20 seconds) and often with soap and water. Especially after leaving the restroom, blowing your nose, or sneezing or coughing into your hands. Try to cough into your elbow, not your hands. When you can’t find soap and water, use an alcohol-based hand sanitizer.
  • Disinfect your things. Clean kitchen, bathroom, and office countertops with disinfectant, especially when someone around you has a cold.
  • Avoid close contact with people you know are sick. And don’t share food or drink.
  • Sleeve your sneeze. Whenever possible, sneeze or cough into a tissue. When that’s not possible, sneeze or cough into your elbow or sleeve of a shirt. This is better than into your hands.
  • Do not share things that go in your mouth. Glasses, utensils, straws, toothbrushes should not be used by other family members or friends.
  • Stop smoking and vaping. This can prevent respiratory infections.
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Pulmonary & Critical Care Fellow, Brigham and Women's Hospital
Dr. Choi is a board-certified Internist and current Pulmonary and Critical Care fellow at Brigham and Women’s Hospital. She completed her residency at Columbia University NewYork-Presbyterian Hospital, received her MD with a scholarly concentration in Health Services and Policy Research from Stanford School of Medicine, and received her BS from MIT. Her academic interests include clinical epidemio...
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