An upper respiratory infection (URI) affects the nose, throat, or sinuses. The common cold is the most common URI. Other common types include pharyngitis, sinusitis, and laryngitis.
Most upper respiratory infections are viral (caused by viruses) infections that affect the nose, sinuses, throat, and larynx (voice box).
The most common types of URIs include:
- Common cold: Over 200 viruses can cause the common cold, though it’s often caused by rhinovirus (a virus that most commonly causes colds).
- Influenza (flu): The flu is caused by the influenza virus and affects the upper and lower respiratory tract.
- Laryngitis: This type of URI causes inflammation of the larynx (voice box) that can lead to hoarseness or loss of voice.
- Pharyngitis: Inflammation of the pharynx (throat) or sore throat is called pharyngitis. It is caused by a viral infection, like the common cold.
- Sinusitis: A sinus infection occurs when fluid builds up in the sinuses, which are air-filled cavities in the forehead, nasal cavity, cheeks, and around the eyes. Sinusitis can be acute (less than four weeks), subacute (four to 12 weeks), or chronic (more than 12 weeks).
- Tonsillitis: Inflammation of the tonsils—two pads of tissue located at the back of the throat. Tonsillitis is more common in children and is usually caused by a viral infection or bacterial infection like strep throat.
Symptoms of an upper respiratory infection usually begin 1-5 days after exposure, but can start as early as 10-12 hours after exposure.
Most people experience mild to moderate discomfort for one week to 10 days, but you may have symptoms for up to three weeks.
Common URI symptoms include:
Most URIs resolve on their own. Reach out to a healthcare provider if your symptoms persist for more than ten days, worsen, or you develop new symptoms such as:
- A change in the color of the mucus you cough up
- Chest pain
- High fever (over 102 degrees Fahrenheit)
- Shortness of breath
- Worsening cough
Viruses cause about 85% of upper respiratory infections, particularly rhinoviruses, coronaviruses, and respiratory syncytial virus (RSV). Bacteria can cause some URIs, but this is less common.
Viruses spread through respiratory droplets when an infected person talks, coughs, or sneezes. Respiratory droplets are tiny water droplets released from the mouth and nose.
When exposed to these droplets, the virus can enter the mucus membranes in your mouth, nose, and eyes, causing you to become sick.
You can also contract a virus by touching a surface contaminated with a virus and then touching your mouth, nose, or eyes.
Risk Factors
Most people have many upper respiratory infections throughout their lifetime. However, certain risk factors can make you more vulnerable to developing a URI.
Young children and older adults are more susceptible to URIs. Other risk factors include:
- A weakened immune system—for example, if you have HIV or cancer, take immunosuppressant medications, or have received an organ transplant
- Abnormalities in your upper airways due to facial trauma, upper airway trauma, or nasal polyps (soft, noncancerous bumps lining your nose or sinuses)
- Close contact with a person who has a URI
- Contact with large groups of children or close contact with large groups of people in closed settings (for example, airplane travel)
- Exposure to air pollution
- Smoking and second-hand smoke exposure
A healthcare provider will review your symptoms and medical history and perform a physical examination.
They will examine your ears, nose, and throat to look for signs of inflammation and infection, and listen to your lungs with a stethoscope while you breathe.
Diagnostic tests are usually unnecessary because the diagnosis can be based on symptoms and physical exam findings.
Depending on your symptoms, a healthcare provider may order tests to rule out other conditions and confirm the diagnosis.
Testing might include:
- Nasal swabs or aspirates: These are often used for infants and young children, as they can be easier than a throat culture. For a nasal aspirate, the healthcare provider squirts saline solution into the nose and then removes the sample with suction.
- Respiratory pathogens panel: This is a sample of nasal secretions taken with a swab to identify the virus or bacteria causing the infection.
- Throat culture: This is a swab of the back of the throat to check for bacterial infections, such as strep A.
In special cases, such as for immunocompromised people, the following tests may be done:
- Blood tests: These help determine if the infection is bacterial or viral.
- Chest X-ray: This provides images of the chest cavity to rule out pneumonia or other respiratory conditions.
- Computerized tomography (CT) scan: This is a series of computerized X-rays that can take multiple images of your sinuses and other parts of the body. If you have severe symptoms or trouble breathing, it can indicate nasal polyps or other abnormalities in the nasal cavity.
Treatment for URIs focuses on symptom relief, and most people recover at home within 1-2 weeks.
At-Home Treatments
At-home treatments for upper respiratory infections include:
- Rest: Getting plenty of rest helps your body recover faster.
- Fluids: Drinking plenty of fluids, such as water and herbal tea, can help relieve congestion and prevent dehydration.
- Saltwater: Gargling with saltwater can help relieve a sore throat.
- Steam: Taking a hot shower or using a humidifier can help relieve congestion and coughing.
Medications
Some over-the-counter (OTC) medications may help relieve URI symptoms, including:
- Cough suppressants: Cough suppressants containing dextromethorphan may help reduce coughing. Brands that contain dextromethorphan include Mucinex, Robitussin, and Nyquil.
- Decongestants: Decongestants like Sudafed (pseudoephedrine) may help relieve nasal congestion.
- Nasal saline drops or sprays: Nasal saline drops or sprays may help relieve nasal congestion and dryness. You can also use a neti pot to rinse your nasal passages and clear mucus. A neti pot is a small device that resembles a teapot. You add a saline solution (a mixture of salt and warm water), then tilt your head and pour the solution into one nostril until it flows out of the other nostril.
- Pain relievers: Analgesics (pain relievers), such as Tylenol (acetaminophen) and Advil (ibuprofen), may help reduce fever and relieve body aches and sore throat.
- Throat lozenges: Lozenges that contain benzocaine can help soothe a sore throat.
If you take prescription medications, talk to your healthcare provider before taking OTC medicines. They can advise you on potential interactions.
Antibiotics
Most URIs are viral. Therefore, antibiotics, which kill bacteria, won’t be effective in helping to clear the infection.
Antibiotics are prescribed only for bacterial URIs or if a secondary bacterial infection, like sinusitis, develops during or after the initial viral infection.
Preventing a URI is not always possible, but taking certain steps can lower your chances of getting sick.
Here are some prevention strategies:
- Avoid close, prolonged contact with people who are sick.
- Do not touch your face, nose, or mouth—especially when in public spaces or if you have not washed your hands after being around others.
- Eat a balanced, nutritious diet and exercise regularly to boost your immune system.
- Wash your hands frequently with soap and water, especially after being in public spaces or around someone who’s sick.
If you have a URI, you can help others stay healthy by being mindful of not spreading germs:
- Cover your nose and mouth with a tissue when you sneeze and cough.
- Sneeze and cough into your elbow.
- Stay home from work or school.
- Wipe down countertops, doorknobs, and children’s toys when someone in your home has a URI.
- Wear a facial covering when around other people.
It’s important to treat URIs as needed to avoid possible complications. Young children and older adults might be more susceptible to complications,
Possible complications or URIs, especially influenza, include:
- Bronchitis: Swelling and inflammation of your bronchial tubes, the main airways of your lungs
- Pneumonia: An infection in one or both lungs that may cause them to fill with mucus
- Sinusitis: A condition that causes the lining of your sinuses to become inflamed or swollen
URIs can also cause more severe symptoms of conditions that make breathing difficult, like asthma and chronic obstructive pulmonary disease (COPD).
