Acute Viral Rhinosinusitis (Common Cold)?

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At the height of cold season, individuals are searching for remedies to prevent and treat the common cold.  Most individuals are familiar with the clinical findings associated with a common cold, which may include nasal congestion, cough, sore throat, rhinorrhea, headache, and malaise.  Acute viral rhinosinusitis is caused most commonly by rhinovirus or adenovirus.  The presence of various serologic types these viruses prevents the development of immunity, allowing individuals to remain susceptible to the virus.  This has also made vaccination difficult, as a single target cannot be identified.

Continued susceptibility to these viruses had led the public to seek over-the-counter remedies to prevent and treat the common cold.  School-aged children catch around 3-6 colds per year. Data reveals that at least 50% of parents administer vitamin C or zinc containing products to children with colds in attempts to shorten their duration. Data also reveals that about 50% of parents believe in common folklore myths such as going outdoors with wet hair may cause colds. 

However, there are no evidence-based therapies for treatment or prevent of acute viral rhinosinusitis.  Antiviral agents have not been developed for these viruses.  Antibiotics are not useful, despite frequent patient misconceptions. Zinc for treatment of acute viral rhinosinusitis has been very controversial and there is not currently enough evidence to widely support its use.  The data is also not supportive of vitamin C for treatment or prevention of acute viral rhinosinusitis.

The best way to prevent acute viral rhinosinusitis is careful handwashing.  If an individual contracts acute viral rhinosinusitis, the case is usually self-limited, and typically lasts 4-10 days.  Complications are rare, but may occur in those with pre-existing lung disease such as cystic fibrosis, asthma, or chronic obstructive lung disease.  Individuals that are profoundly deconditioned, malnourished, or those with very depressed immune systems are also at greater risk for complications.

The treatment of acute viral rhinosinusitis is largely supportive.  Patients that are high risk for complications should seek medical attention.  Most patients are managed symptomatically with nasal sprays, NSAIDs, and oral decongestants. 

Current Medical Diagnosis & Treatment 2019: Chapter 8: Ear, Nose, & Throat Disorders

University of Michigan: C.S. Mott Children’s Hospital: National Poll on Children’s Health

Julie Grishaw, ACNP

Senior Editor, McGraw-Hill Education