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Cold and flu

This information was published by Bupa's Health Content Team and has been reviewed by appropriate medical or clinical professionals. To the best of their knowledge the information is current and based on reputable sources of medical evidence, however Bupa (Asia) Limited makes no representation or warranty as to the completeness or accuracy of the Content.

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The runny nose, sore throat or bunged up feeling of a cold is caused by one of many viruses that infect the upper part of the breathing system (upper respiratory tract). Although a cold can make you feel miserable, in most people they are self limiting. This means the body fights off the infection and cure comes without the need for specific medical treatment.

Influenza - or flu - causes similar symptoms to a cold but tends to be a more severe illness. Although it is also self-limiting in most people, flu can be dangerous for people who are frail or have a weakened immune system.

Generally, there are two peaks for influenza occurrence in Hong Kong - one in February and the other in July, but this can be influenced by imported cases of flu from other countries. In the UK and North America, for example, most flu cases occur between December to March.

The viruses responsible for colds are spread from person to person as droplets in the air from sneezing or coughing, or from touching infected surfaces then transmitting the viruses from the hands to the mouth. Handshakes or touching a door handle are possible routes for transmission of cold viruses.

Infected people can spread the viruses from two days before the illness and up to four days after the symptoms start. Colds can occur all year round but are more common in the winter months. On average, adults catch two to three colds each year. School age children can have up to twelve or more colds in a year.


Colds - the virus multiplies in the soft, warm surfaces found in the nose, throat, sinuses, the windpipe (trachea) and the breathing tubes (the bronchi). The main symptoms are blocked or runny nose, sneezing, sore throat and cough. There may also be a fever, aching muscles and fatigue. The symptoms usually last for a week

Flu - These are the same as colds but the muscle aching is usually more severe and the fatigue may last for a few weeks after the illness has cleared up

To most healthy adults, flu can be just like a nasty cold. However, young children, the elderly and people with certain chronic medical conditions are susceptible to potentially serious complications. These are mostly related to a secondary bacterial infection of the lungs (pneumonia) or of the ears, nose and throat. In children under about six years old, fits - known as febrile convulsions - can occur as a result of the high body temperature. People living in residential or nursing homes, and people with the following conditions are at risk:

  • Asthma
  • Chronic chest problems such as chronic bronchitis and emphysema
  • Diabetes
  • Heart disease
  • Kidney diseases and kidney failure
  • People with reduced immunity, such as people with HIV or people who have had their spleen removed

There is no cure for colds or flu. Antibiotics, which do work to kill bacteria, do not work on viruses. However, home treatment can help to relieve the symptoms and ensure a speedy recovery.


Drink plenty of fluids to prevent dehydration

For adults, paracetamol, aspirin or ibuprofen can help to relieve fever and pain. Always follow the instructions carefully and take care not stay within the safe daily doses. It is easy to accidentally exceed these by using more than one product (tablets, capsules, a hot lemon drink…) containing the same active ingredient such as paracetamol

For children under 12 years old aspirin can be dangerous (in rare cases, it can cause Reyes syndrome). It should also be avoided in older children and adolescents. Childrens formulations of paracetamol (eg Calpol) and ibuprofen (Nurofen Junior) are available


Avoid tobacco smoke

Decongestants such as pseudo-ephedrine may clear congestion. Ask your pharmacist for advice on products that contain a decongestant

Steam inhalations with menthol or eucalyptus, or herbal products such as camomile, may help. Take care with the hot water

Eating a balanced diet with plenty of fruit and vegetables is sensible. Vitamin C is often claimed to help, but there is no firm evidence for this

Rest. Avoid strenuous exercise, as this can increase the chance of catching a secondary bacterial infection. Contrary to the advertising claims for some cold and flu medicines, if you are unwell with a heavy cold and, especially, flu, carrying on as normal is not advisable


Antiviral medicines

For people in general good health, who are not elderly, no specific medical treatment - apart from the home care suggested above - is required for flu. For vulnerable groups, where it is important to prevent complications or spread, prescription only medicines may be required.

There are several anti-viral treatments, taken as tablets or as an inhaler (similar to the ones used for asthma). They have been shown to reduce the duration of flu but only by around one day, and then only if treatment is started within two days of the onset of the illness. GPs are not currently routinely prescribing antiviral medicines for flu.

Antibiotics may be given to treat any bacterial infections such as a chest infection, ear infection or sinusitis.

  • Isolation of people with colds and flu to prevent it spreading to other people, if practical
  • Regular hand washing and immediate disposal of tissues
  • Aim for a healthy lifestyle a balanced diet, rich in fruit and vegetables, and regular (preferably daily) physical activity
  • Do not smoke - smokers are more likely to catch a cold

Having a flu jab each year significantly reduces the chance of catching the illnesses. It is recommended for people at risk from the complications of flu and for everyone over 65.

When to call the doctor

If the following symptoms develop with a cold, you should consult a doctor promptly:

  • Severe vomiting or diarrhoea
  • Earache
  • Difficulty breathing
  • Skin rash
  • Uncontrollable cough
  • Cough with green sputum - phlegm
  • Extreme lethargy or drowsiness

Pharmacists can give advice on over-the-counter cold and flu remedies.

Common Questions

1. Why isn't there a cure for the common cold?

There isn't a cure for the common cold because it's difficult to produce a vaccine or medicine that protects against all the different types of cold virus.

Colds are very common and most people will have at least one cold every year. This is because there are at least 200 different viruses that can cause a cold. The rhinovirus is the most common and there are more than 100 different types of this virus. So, even if your body develops immunity to one type of virus, a different one can give you another cold. This is why scientists haven't yet been able to develop a vaccine or medicines to prevent a cold.

2. Is being stressed linked to catching a cold?

Yes. You're more likely to get a cold if you're under stress.

There is a link between stress and how likely you are to get an infection. Research suggests that if you're under stress in your day-to-day life then you're more likely to develop an infection than someone who isn't stressed. This means that you’re more likely to catch a cold and develop symptoms if you're stressed.

Doctors don't yet know exactly why stress may make you more likely to develop infections, but it's thought that it affects how well your immune system works to fight off infection.

3. How long will I be infectious for?

You're at your most infectious during the first two or three days of a cold, when you are sneezing and have a cough and a runny nose. Although your symptoms will go within a week or two, you can remain infectious for several weeks.

When you catch the cold virus from someone, it usually takes about two days for you develop symptoms. You will be most infectious at the start of a cold when you have symptoms such as a runny nose, cough and sneezing. This is because you can pass the virus on by coughing and sneezing as well as by direct contact, for example when you blow your nose the virus will be on your hands.

Your symptoms are likely to be at their worst during the first two or three days of a cold and then you should gradually start to feel better. Most adults and older children usually have symptoms for about a week, in younger children symptoms can last for up to two weeks. However, you can remain infectious for several weeks.

Further Information
  • Common cold. Clinical Knowledge Summaries., published May 2007.
  • Common cold centre. Cardiff University., accessed 1 September 2010
  • Common cold medications. Cardiff University., accessed 2 September 2010
  • Arroll B, Kenealy T. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database of Systematic Reviews. 2005, Issue 3. doi: 10.1002/14651858.CD000247.pub2.
  • Aspirin. Joint Formulary Committee, British National Formulary. 55th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2010
  • Common cold. Clinical Evidence., published June 2008.
  • Clinical evidence issue 5, June 2001 pages 490-496
  • Clinical evidence issue 5, June 2001 page 1046

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