What is an Upper Respiratory Infection?

The upper respiratory infection (or URI infection) is one of the most common reasons people visit the doctor every year. Most of us will get one each year, most frequently occurring in the fall and winter. The upper respiratory tract infection is a fact of life for many of us in the colder months, and it is also the most common illness resulting in missed days of work and school.[1]

What is an upper respiratory infection? An upper respiratory infection is a contagious infection of the upper respiratory tract, which refers to the nose, paranasal sinuses, pharynx, larynx, trachea and bronchi. While most upper respiratory infection cases are mild and go away on their own without treatment beyond rest, extra fluids and chicken soup, some URI infection cases are severe enough to be life-threatening and require hospitalization.1

Causes of Upper Respiratory Tract Infection

Most of the time, people contract a viral upper respiratory infection, which is what makes an upper respiratory infection contagious. In fact, the vast majority of URIs are caused by viruses, although bacteria are responsible for a small percentage of cases.[2] There are over 200 different viruses that can cause the symptoms of a URI infection, the most common being the rhinoviruses, which are responsible for the common cold. Other common viruses include coronavirus, parainfluenza virus, adenovirus, enterovirus and respiratory syncytial virus.[3]

Types of URIs

The common cold is the most widespread type of viral upper respiratory infection. Other types of URI infection are named for the area of the upper respiratory tract that is most involved in the infection and include:

• Sinusitis – inflammation of the sinuses
• Laryngitis – inflammation of the larynx (voice box)
• Pharyngitis – inflammation of the pharynx (back of throat)
• Epiglottis – inflammation of the epiglottis, the upper part of the trachea.
• Bronchitis – inflammation of the bronchi (air tubes in the lungs)

Symptoms of Upper Respiratory Infection

Upper respiratory infection symptoms can vary, depending on which part of the respiratory tract is most involved in the infection. As such, your symptoms will differ based on where the infection has taken hold in your respiratory system. However, the most common symptoms of a URI include:[4]

• Nasal congestion
• Runny nose
• Increased mucus
• Sore, scratchy throat
• Cough
• Sneezing

Other possible upper respiratory infection symptoms include fever, general malaise, headache and body aches. Most symptoms go away on their own within 7 to 10 days with extra rest and hydration, and it is important to stay home and recover to minimize the chance of spreading your viral upper respiratory infection. However, if your upper respiratory tract infection symptoms persist beyond that time, or your URI infection symptoms worsen, it is important to seek medical attention as soon as possible.[5]

How Upper Respiratory Infections Spread

URIs can spread in several different ways, through both direct and indirect contact, depending on whether it is a viral upper respiratory infection or a bacterial URI infection. Typically, what makes your upper respiratory infection contagious is the fact that your symptoms spread your virus. For example, when you cough or sneeze, tiny droplets of fluid containing the virus are propelled into the air. If someone nearby inhales them, they too may become infected.[6] As such, if you have an upper respiratory infection that causes you to cough, sneeze or blow your nose frequently, make sure you cover your sneezes and coughs and wash your hands regularly with warm water and soap. 

Upper respiratory infections can also be spread through indirect contact. For example, if you have a URI and touch your nose, eyes or mouth and then you touch an object like a doorknob, the virus may be transmitted to someone else who touches that same doorknob and then touches their own nose, mouth or eyes.5 This is why it is essential that you wash your hands every time you blow your nose or cover a sneeze or cough. You will not only help keep others from catching your virus, but you will also protect yourself from picking up a different virus.

Upper Respiratory Infection Diagnosis

Most upper respiratory infections are self-diagnosed and managed at home. If a patient goes to the doctor with an uncomplicated URI infection, a diagnosis can be made by reviewing a patients’ medical history, assessing their symptoms and performing a physical exam. Most upper respiratory infections are acute URIs, meaning they are short-lived. However, if your URI infection symptoms last longer than 7 to 10 days, or if your symptoms worsen after that time, your doctor may administer tests to see if your acute URI has progressed to something else. Tests that are used to address more complicated cases of upper respiratory infection include:

• • Throat swab – used for diagnosing group A beta-hemolytic strep, the most common cause of strep throat
  • Lateral neck X-rays – used to rule out epiglottis in patients who are having difficulty breathing
  • Chest X-ray – used if a doctor suspects pneumonia
  • CT – used to diagnose sinusitis

Upper Respiratory Infection Treatment

What is an upper respiratory infection treatment and when is it necessary? Because most URIs are caused by viruses, are self-limiting and managed at home by the patient themselves, treatment for uncomplicated cases in an otherwise healthy patient is based on relief of symptoms. If you are uncomfortable and need to treat your acute URI symptoms, you can try the following:[7]

• Acetaminophen – may provide relief of fever, sore throat, body aches and facial pain.
• Decongestants – may provide symptom relief for stuffy nose and sneezing.
• Antihistamines – may reduce stuffy nose, sneezing and nasal secretions.
• Saline nasal drops – may provide relief from congestion and thick secretions.
• Guaifenesin – a mucolytic; may help thin thick secretions, making them easier to expel (cough up).

Additional home-care measures that help relieve symptoms include:7

• Drinking at least 8 eight-ounce glasses of water, juice or non-caffeinated beverages (unless your doctor tells you otherwise) to help thin mucus and replace fluid loss.
• Breathing warm, moist air by turning on the shower, closing the bathroom door, sitting down and inhaling the steam to help moisten mucus membranes and loosen secretions.
• Reducing airway irritants (smoking, secondhand smoke, indoor and outdoor air pollution, cold, dry air) that provoke coughing.
• Sleeping with head and shoulders slightly elevated to help promote sinus and nasal drainage.
• Using warm facial packs (warm, folded washcloth or warm water bottle) applied directly to the face and cheeks may provide comfort, relieve congestion and promote drainage (in cases of rhinosinusitis).

It is important to note that antibiotics are ineffective against a viral upper respiratory infection and are reserved for URIs that are bacterial in nature. These can include any upper respiratory tract infection caused by:7

• Group A streptococcal pharyngitis
• Bacterial sinusitis
• Epiglottis
• Pertussis
• Diphtheria

When Should You See a Doctor for a URI Infection?

Most upper respiratory infections will improve on their own with adequate rest and hydration. However, if your acute URI becomes more severe, you may need to see your doctor. Here are the signs that you should seek a doctor’s care:

• An upper respiratory tract infection that returns after getting better
• Blue-tinged lips
• Difficulty breathing
• Difficulty swallowing
• Fever lasting longer than 3 days
• Symptoms lasting longer than 2 weeks
• Worsening symptoms after 10 days

Lowering Your Risk of Upper Respiratory Infection

What is an upper respiratory infection’s impact on high-risk populations? People with COPD or other chronic (ongoing) health conditions are at risk for respiratory infections that may further impair their lungs. The following tips may help you prevent a URI before it happens:7

• Ask potential visitors with cold or flu symptoms to wait to visit until they are feeling better.
• Wash hands frequently with soap and warm water whenever possible, especially before eating or after arriving home from a public place. If a sink is unavailable, use a hand sanitizer instead.
• Do not smoke (and avoid secondhand smoke) as this may exacerbate (worsen) symptoms.
• Get plenty of sleep and rest to promote healing.
• Sneeze or cough into a tissue, then discard promptly and wash your hands.
• Avoid touching your eyes, nose and mouth as these are the most common places that viruses and bacteria can enter your body.
• Talk to your doctor about getting an annual flu shot and pneumonia vaccine if you have not had one.

Upper respiratory infections are common and many people get several each year. Although treatment is directed toward managing symptoms while the body’s own immune system fights the infection, the best way to manage URIs is through prevention. For more information about preventing an upper respiratory infection, talk to your primary health care provider.

Frequently Asked Questions: Upper Respiratory Infections

What happens if you get an upper respiratory infection when you have chronic lung disease?

If you have a chronic lung disease and develop an upper respiratory tract infection, you are more likely to experience a flare-up in your symptoms. Depending on the state of your health, and your particular disease, this could be dangerous. If you do develop a URI infection, make sure you rest as much as possible to avoid complications. If you use oxygen therapy, you will need to take additional measures to ensure that you protect yourself from reinfection. Change your tubing and nasal cannula (or mask) once a week while you are sick, and immediately after getting better, as a virus or bacteria can live inside the tubing. Talk to your doctor about other measures you should take. 

How can I prevent an upper respiratory infection?

Upper respiratory tract infections are quite common, so it is unlikely that you will be able to prevent yourself from ever contracting one. However, the best way to avoid getting a URI infection is to wash your hands frequently, avoid contact with people you know are sick and avoid touching your eyes, nose and mouth, particularly in public. If you are sick, make sure you stay home and recover to avoid spreading your illness to others. 

How long does an upper respiratory infection last?

In most cases, a viral upper respiratory infection will last between 3 days and 2 weeks. If your symptoms last beyond 2 weeks, it is likely that you have more than just an upper respiratory infection. If that is the case, see your doctor to make sure you do not need medical treatment. 

Sources

[1] Roger Zoorob, MD, MPH, et. al. “Antibiotic Use in Acute Upper Respiratory Infections.” Am Fam Physician. 2012 Nov 1;86(9):817-822.

[2] Sherif B. Mossad. Upper Respiratory Infections. Cleveland Clinic. Accessed 3/23/2017.

[3] Johns Hopkins Medicine. Upper Respiratory Infection (URI or Common Cold). Accessed 3/23/2017.

[4] Mary T. Caserta, MD. Overview of Viral Respiratory Tract Infections in Children. Merck Manual. Accessed 3/23/2017.

[5] American Rhinologic Society. Upper Respiratory Infections. Revised 2/17/2015.

[6] National Health Services UK. Respiratory Tract Infections. Last reviewed 4/14/2015.

[7] Anne Meneghetti, MD. Respiratory Tract Infections. Medscape. Updated 2/17/2017.

https://www.medicalnewstoday.com/articles/323886.php

https://www.healthline.com/health/acute-upper-respiratory-infection