Cold

Related Terms
 Common Cold
 Coryza
 Head Cold
 Nasopharyngitis
 Rhinitis
 Upper Respiratory Tract Infection
 URI

Differential Diagnoses
 Allergic rhinitis
 Influenza
 Sinus infection

Specialists
 Family Physician

Comorbid Conditions
 Asthma
 Autoimmune disease
 Chronic lung disease
 Chronic respiratory conditions

Factors Influencing Duration

Severity of symptoms will determine the length of disability in a previously healthy
person. If symptoms are mild, there may be no loss of time from work. If the symptoms
are severe, or complications occur, disability may be longer.

Medical Codes
 ICD-9-CM: 460, 472.0

Definition
The common cold is an acute and self-limited illness caused by any of more than 250
viruses that invade the mucous cells of the nose and disrupt their normal functioning.
Once infected with one of the 250 strains, the immune system develops antibodies to it, so
any subsequent colds are the result of one of the other 249 strains. The most common
subtype of virus that causes a cold is a group that is found in the nasal passages,
rhinoviruses. Less common cold viruses include coronavirus, adenovirus, and respiratory
syncytial virus (RSV).

The illness is characterized by a runny nose (rhinorrhea), nasal congestion, sneezing, mild
fatigue, mild fever, and sore throat, with or without a cough. Symptoms of this illness are
confined to the upper respiratory tract and do not involve the lungs.

Contrary to popular belief, most cold viruses do not spread through the air and are seldom
transmitted from airborne particles expelled when someone with a cold coughs or sneezes.
Researchers have also shown that exposure to cold temperatures has little or no effect on
the development of a cold, nor do factors such as diet, exercise, or enlarged tonsils. The
vast majority of cold viruses are transmitted through hand contact with an infected person.
After exposure to a cold-causing virus, symptoms usually appear within 48 to 72 hours.

Colds generally last from 5 to 7 days, with about 25% having symptoms that continue for
up to 2 weeks.

Risk: Factors that increase an individual's susceptibility to colds include psychological

stress, allergic disorders (affecting the nose or throat), and menstrual cycles. Women (age
20 to 30) have more colds than men.

Incidence and Prevalence: Normal healthy adults may average 2 to 4 colds per year,
although the range varies greatly. In a single year in the US, individuals suffer an
estimated 1 billion colds. Colds are the most frequent cause of absenteeism from work.

Source: Medical Disability Advisor

Diagnosis
History: Common symptoms include dry, sore, or scratchy throat; runny or stuffy nose;
cough; sneezing; sinus blockage; headache; and body aches.

Physical exam: Mild fever (99° F to 101° F [37.2° C to 38.3° C]) may be present.
Examination may reveal reddening of the throat or nose with swelling of these mucosal
tissues. Lymph nodes in the neck may be enlarged and tender.

Tests: Diagnosis is based on clinical signs and symptoms; no laboratory tests or x-rays
are necessary for diagnosis.

Source: Medical Disability Advisor

Treatment
The infected individual should be isolated as much as possible to avoid contaminating
others. Without treatment, cold symptoms should disappear in about 7 to 10 days.
Because no cure for the common cold exists, only symptomatic treatment is available: bed
rest, increased fluid intake, inhaling steam (through a humidifier or a hot shower) to ease
congestion; gargling with warm salt water (to relieve inflammation, discomfort, and
swelling of the throat), saline gel (for irritated nasal tissue), and analgesics (for headache
and fever).

Nonprescription cold preparations (decongestants and cough suppressants) may relieve

some cold symptoms, but will not cure or even shorten the duration of the illness.

Since antibiotics do not kill viruses, these drugs should not be used to treat routine colds.
Antibiotics should be reserved for treating any bacterial complications of colds (sinusitis
or ear infections).

Source: Medical Disability Advisor

ACOEM

ACOEM's Practice Guidelines, the gold standard in effective medical treatment of

occupational injuries and illnesses, are provided in this section to complement the
disability duration guidelines.*
 
 
* The relationship between the MDGuidelines (MDA) content and ACOEM's guidelines is approximate and does not always link
identical diagnoses. The user should consult the diagnostic codes in both guidelines, as well as the clinical descriptions, before
assuming an equivalence.

Source: ACOEM Practice Guidelines

Prognosis
The prognosis for the common cold is excellent. Individuals can expect symptoms to
disappear in approximately 7 to 10 days and a complete recovery to pre-illness health. In
individuals with chronic respiratory conditions, the decreased immunity caused by the
cold may put these individuals at greater risk for developing secondary bacterial
infections, such as sinusitis, bronchitis, or pneumonia. In these cases, a protracted
recovery period may be expected.

Source: Medical Disability Advisor

Complications
The great majority of common colds run their course without complication. The most
common complications of colds are secondary bacterial infections (sinusitis and ear
infection). Individuals with pre-existing respiratory conditions (asthma or chronic lung
disease) are more susceptible to secondary bacterial infections such as bronchitis or
pneumonia.

Source: Medical Disability Advisor

Return to Work (Restrictions / Accommodations)

A day of bed rest may be necessary for a particularly bad cold. Usually, individuals may
continue to work despite cold symptoms. Individuals with colds should be encouraged to
take precautions not to infect other workers, including staying as isolated from others as
possible, using tissues and discarding them properly after use, and washing hands
frequently. As with other respiratory illnesses, exposure to inhaled irritants such a dust,
gases, smoke, and cold air should be minimized or avoided.

Source: Medical Disability Advisor

Failure to Recover
If an individual fails to recover within the expected maximum duration period, the reader
may wish to consider the following questions to better understand the specifics of an
individual's medical case.
Regarding diagnosis:

 Does individual have a runny nose? Congestion? Sneezing? Sore throat? Cough?
 Does individual have a mild fever or fatigue? Enlarged lymph nodes?
 Are the lungs involved?
 Does individual have additional symptoms? Have they lasted more than 2 weeks?

Regarding treatment:

 Was individual isolated as much as possible to prevent spread?

 Is individual following a proper treatment regimen (rest, increased fluids,
analgesics)?
 Is individual a smoker?

Regarding prognosis:

 Can individual's employer accommodate any necessary restrictions?

 Does individual have any conditions that may affect ability to recover?
 Have any complications developed such as a secondary bacterial infection, and
are these receiving appropriate treatment?