Common cold

Introduction
• Common cold is acute, self limiting viral infectious disease of
the upper respiratory tract that primarily affects the nose,
sinuses, pharynx and larynx.
• Also called as acute infective rhinitis, acute coryza, acute rhino
pharyngitis, nasopharyngitis.
• Begins as a fatigue, headache, sneezing followed by runny
nose and cough in couple of days.
Epidemiology
•Most common infectious disease and affects people all over the
globe.
Adults - 2 to 5 infections per year
Children - 6 to 10 infections per year
 Epidemiological determinants
• Agent factors
– Rhinovirus
– Coronavirus
– Respiratory syncytial virus
– Influenza virus
– Para influenza virus
– Adenovirus
– Enterovirus
• Host factors
– Pediatric patients (infant, young children)
– Elderly person
– Immune-compromised
• Environmental factors
–Cases of common cold usually occur in winter and
autumn in temperate region.
Mode of transmission
–Hand to hand contact
–The disease is spread by droplet infection or fomites.
Incubation period
–1 to 2 days
Clinical features
It presents as acute mild and self limited catarrhal
syndrome with a median duration of about 1 week.
Rhinorrhea
Nasal congestion
Cough
Sore throat
Sneezing
Fever( especially in children)
Generalized malaise
Lymphadenopathy
Hoarseness
Headache
Throat discomfort
Decreased sense of smell
Complication may arise if the symptoms last beyond 10
days which is due to secondary bacterial infection. Bacterial
infection is accompanied by greenish or yellowish nasal
secretion and unilateral facial or tooth pain.

• Complications are
– Sinusitis
– Bronchitis
– Pneumonia
– Otitis media
Treatment
•Treatment is symptom based.
•Conservative measures like maintaining hydration, getting
rest are essential.
•Nasal decongestant
•NSAIDs (antipyretics and analgesic)
•Antihistamines ( improves cough)
•High dose Vitamin C (improves immunity)
•Antibiotics has no role in treatment of common cold
unless complicated.
Prevention
•Hand washing
•Use of face masks
•Avoid close contact
•No vaccination
Viral Meningitis

Nikhil Muni Shakya

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 What is meningitis?
• Meningitis is an infection of the pia-arachanoid and
the CSF fluid that surrounds the brain.
Viral Meningitis
• Benign and self limiting illness requiring no specific
therapy
• Also called aseptic, lymphocytic meningitis
• Most common type of meningitis
 Problem statement

• The incidence during non-epidemic conditions is rarely

known.
• Recent outbreaks
Romania in 1996 A.D.
Gaza in 1997 A.D.
Taiwan 1998 A.D.
 Agent (Viral)
• Enterovirus(85%)
coxsackie virus,
echoviruses
human enteroviruses 71
Coxsackie virus subgroups alone account for more than
60% of meningitis cases in children younger than age 3
months.
• Cytomegalo Virus, Herpes Simplex Virus
• EBV
• HIV , JEV( South east Asia, western pacific)
• VZV, West Nile Virus
• Adeno Virus
• Arbo Virus
• Lymphocytic Choriomeningitis Virus
 Host factor
• children
• Incidence drops with age
• Neonates at greatest risk
• Incidence during first year of life 20 times than in
adults.
• Immuno compromised
Environmental & Social Factors:
•In temperate climates, there is a substantial increase
in cases during the late summer and early autumn
reflecting the seasonal predominance of enterovirus
and arthropod-borne virus (arbovirus) infections
• Predisposed by factors like overcrowding, low socio-
economic status with poor standard of living
 Mode of transmission

• Viral meningitis can be spread through contact with

nose and throat secretions.

• Viral meningitis can also be transmitted by fecal

contamination when an infected person sheds or
excretes virus in his/her stool.
 Clinical features
In infants
Fever
Irritability, frequent crying
Poor eating
Sleepiness or trouble waking up from sleep
• In adults
Headache
Fever
Neck stiffness
Photophobia
associated clinical findings in enteroviral infections
may include pharyngitis, rash, and pericarditis.
 Investigation
• Diagnosis by lumbar puncture
• CSF = Elevated WBC with excess lymphocytes
Glucose level normal
Protein level normal or slightly elevated
Organisms are not seen on Gram's stain
• Polymerase Chain Reaction Amplification of Viral
Nucleic Acid:
 Treatment
• Meningitis outside the neonatal period is usually
benign
• Treatment for viral meningitis is usually supportive
(aimed at relieving symptoms).
• There are no specific medications to treat the
organisms that cause viral meningitis.
 Prevention
• Practice good hygiene
• Covering mouth before sneezing or coughing
• Disinfect utensils and fomites soiled by secretions
and excretions of patient
• Vaccination for viruses like: Chicken pox, Mumps ,JE
• Prevent mosquito exposure