UNIVERSITY STUDENT HEALTH SERVICES • Fact Sheet
UPPER RESPIRATORY INFECTIONS
INTRODUCTION
The majority of upper respiratory infections are due to colds caused by viruses. Over 200 different
viruses can cause colds, including the rhinovirus, coronavirus, adenovirus, and respiratory syncytial
virus (RSV). Treatment is aimed at symptom control while the virus runs its course.
Only a small percentage of upper respiratory infections are caused by bacteria, and fewer than 2% of
viral infections become bacterial. Therefore, treatment with an antibiotic is usually not necessary.
Most adults develop 2-3 upper respiratory infections each year. Symptoms can last up to 2 weeks
and vary in severity.
TREATMENT TIPS
Self-care measures
 Drink plenty of non-caffeinated fluids. This will help prevent dehydration from high fevers. Fluids will
also keep nasal and throat secretions thin.
 Get plenty of rest to increase your chances of fighting off a cold.
 Do not smoke and avoid secondhand smoke, which can worsen cold symptoms and delay recovery.
 Avoid alcohol and recreational drugs. They can lower your body’s ability to fight infections.
 Take care not to spread your cold!
o Colds are spread through respiratory droplets. Avoid coughing or sneezing near others. If you
do not have a tissue to cough or sneeze into, use your elbow or sleeve.
o Many people with colds carry the virus on their hands. Wash your hands frequently, especially
after coughing or sneezing. Avoid touching your eyes, nose, and mouth.
Medications
 Use your medication(s) properly. Read the labels, and follow the directions for safe use.
 Avoid using “combination” products. Treat your cold symptoms individually, and do not take products
that contain medications for symptoms that you do not have. Combination products may cause
unnecessary side effects and many contain caffeine, which can worsen dehydration.
 Pain relievers and fever reducers can help with symptoms. Over-the-counter products include
ibuprofen (Motrin or Advil), naproxen (Aleve), and acetaminophen (Tylenol). Do not use ibuprofen or
naproxen on an empty stomach if you have a history of stomach ulcers, or if you develop an upset
stomach after taking it. Consult your healthcare provider if you have a history of liver or kidney
disease.
 Antihistamine use is controversial. If a runny nose or postnasal drip is the main symptom,
antihistamines may help decrease secretions; however, they can cause excessive drying, resulting in
thick mucus. Some of these products cause drowsiness (ie. Benadryl) and should not be used if you
plan to drive, use alcohol, or operate machinery. Non-sedating antihistamines available over-thecounter include loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra).
 Cough suppressant medications (known as antitussives) are rarely needed during early illness.
Coughs associated with colds are commonly caused by nasal obstruction or postnasal drip, rather
than a chest infection.
 Zinc may decrease the severity and duration of colds, but study results have been inconsistent. Zinc
lozenges work best if begun within the first 24 hours of symptom onset. Avoid nasal preparations (ie.
Zicam Nasal Gel and Nasal Swabs) as their use has been associated with a permanent loss of smell.
A saline irrigation kit or Neti pot or may be used to rinse the nasal passages and relieve sinus symptoms.
 Use only distilled, sterile, or previously boiled water to make up the irrigation solution.
 DO NOT USE TAP WATER in the irrigation solution, as this can lead to deaths from brain infections.
 Be sure to clean the sinus rinse bottle or Neti pot after each use, and leave it open to air dry.
Vitamins and Herbal Remedies
 Vitamin C has not been found to improve cold symptoms. However, some studies have shown
efficacy in preventing colds. Some experts suggest taking vitamin C (200 to 500 mg daily) for
preventive purposes in patients planning high-intensity physical activity in extreme cold conditions.
 Echinacea has shown little benefit in the treatment or prevention of the common cold.
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Published by VCU Division of Student Affairs and Enrollment Services
University Student Health Services (Monroe Park Campus: 828-8828, MCV Campus: 828-9220)
Revised 2/15
Symptoms
How to care
for yourself
Seek medical attention
if you have…
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Nasal Congestion
and
Drainage
 Nasal or oral decongestants can help shrink stuffy
nasal passages.
 Do not use nasal decongestants (such as Afrin) for
more than 3 days because it will worsen your
congestion.
 Do not take an oral decongestant (such as Sudafed
or phenylephrine) if you have high blood pressure.
 Antihistamines (such as Zyrtec, Claritin, Allegra, or
Benadryl) may help decrease secretions.
 Saline (salt water) nose drops or sprays can help
loosen mucus and soothe irritated skin in the nose.
 Drink plenty of non-caffeinated fluids to thin and
loosen nasal congestion.
 Warm humidified air can decrease congestion.
Use a vaporizer or hot shower.
 Do not smoke, and avoid second-hand smoke.
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Discolored (yellow, green, or
brown) nasal drainage that lasts
longer than 7-10 days.
A headache that does not go
away.
Severe facial pain.
Fever over 101°F for more than
48 hours.
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Cough
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Do not suppress a wet cough (a cough that
produces phlegm).
Drink plenty of non-caffeinated fluids to thin and
loosen phlegm.
Expectorants (such as guaifenesin, Mucinex, or
plain Robitussin) may thin and loosen phlegm.
Cough suppressants can be used for a dry,
hacking cough that does not improve.
Sucking on cough drops or hard candy may quiet a
cough.
Do not smoke, and avoid second-hand smoke.
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A cough that lasts more than one
week.
A cough accompanied by
shortness of breath, wheezing, or
chest pain.
A cough with blood clots in the
phlegm.
A fever over 101°F for more than
48 hours.
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Sore Throat
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Symptoms are best treated with an oral pain
reliever (such as Advil, Tylenol, or Aleve).
Drink plenty of non-caffeinated fluids to keep your
throat moist.
Warm salt water gargles every 3-4 hours (1/4-1/2
tsp of salt in 8-12 oz of warm water) may help.
Lozenges, gargles, and sprays containing
antiseptics and topical anesthetics may decrease
pain.
Sucking on hard candy can help moisten and
soothe the throat.
Do not smoke, and avoid second-hand smoke.
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Rapid onset of throat pain
(overnight or within hours).
Severe throat pain or difficulty
swallowing.
White patches in the back of the
throat.
A muffled voice or difficulty
opening your mouth.
Neck glands that are very swollen
and tender.
A fever over 101°F for more than
48 hours.
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Fever

Body Aches
and
Fatigue
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Use a fever reducer (such as Advil or Tylenol) to
control symptoms.
Drink plenty of non-caffeinated fluids to prevent
dehydration.

A fever unresponsive to a fever
reducer.

 A fever accompanied by a rash,
stiff neck, or headache.
 A fever over 101°F for more than
48 hours.
 Persistent dizziness or the feeling
that you are about to faint.
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Get plenty of rest, and sleep 8-10 hours a night.
 Persistent fatigue for more than 7Drink plenty of non-caffeinated fluids.
10 days.
An oral pain reliever (such as Advil, Tylenol, or
Aleve) can decrease symptoms.
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 An oral pain reliever (such as Advil, Tylenol, or
 A fever over 101°F for more than
Earache
Aleve) can decrease symptoms.
48 hours.
 Ear drainage.