Upper respiratory tract infections (URTI or URI)

(URI or URTI) Upper respiratory tract infections   are illnesses caused by an acute infection which involves the upper respiratory tract including:-

•  Nose
•  Sinuses
•  Pharynx
•  Larynx

Infection of the specific areas of the upper respiratory tract can be named specifically. Examples of these may include:-

rhinitis	inflammation of the nasal cavity
sinusitis	inflammation of the sinuses located around the nose
nasopharyngitis	inflammation of the nares, pharynx, hypopharynx, uvula, and tonsils
pharyngitis	inflammation of the pharynx, uvula, and tonsils
epiglottitis	inflammation of the upper portion of the larynx or the epiglottis
laryngitis	inflammation of the larynx
laryngotracheitis	inflammation of the larynx and the trachea
tracheitis	inflammation of the trachea

Upper respiratory infections are one of the most frequent causes for a doctor visit with varying symptoms ranging from runny nose, sore throat, cough, to breathing difficulty, and lethargy. In the United States, upper respiratory infections are the most common illness leading to missing school or work. Although upper respiratory infections can happen at any time, they are most common in the fall and winter months, from September until March. This may be explained because these are the usual school months when children and adolescents spend a lot of time in groups and inside closed doors. Furthermore, many viruses of upper respiratory infection thrive in the low humidity of the winter.

Signs and symptoms

Symptoms of URTIs commonly include :-

•  Cough
•  Scratchy or sore throat
•  Runny nose
•  Nasal congestion
•  Headache
•  Low grade fever
•  Facial pressure
•  Sneezing

Onset of symptoms usually begins 1–3 days after exposure. The illness usually lasts 7–10 days.

Causes

In one study, 250 patients with the cold were assessed over a period of time, and it was found that the most common virus is the rhinovirus. Other viruses include the virus, influenza virus, adenovirus, enterovirus, and respiratory syncytial virus. Up to 15% of acute pharyngitis cases may be caused by bacteria, most commonly Streptococcus pyogenes, a group A streptococcus in streptococcal pharyngitis ("strep throat"). Other bacterial causes are Streptococcus pneumoniae, Haemophilus influenzae, Corynebacterium diphtheriae, Bordetella pertussis, and Bacillus anthracis.

Treatment

Treatment depends on the underlying cause. There are currently no medications or herbal remedies that have been conclusively demonstrated to shorten the duration of the illness.Treatment comprises symptomatic support usually via analgesics for headache, sore throat and muscle aches.

Antibiotics

Judicious use of antibiotics can decrease adverse effects of antibiotics as well as decrease costs. Decreased antibiotic usage will also prevent drug resistant bacteria, which is a growing problem in the world. Health authorities have been strongly encouraging physicians to decrease the prescribing of antibiotics to treat common upper respiratory tract infections because antibiotic usage does not significantly reduce recovery time for these viral illnesses. Some have advocated a delayed antibiotic approach to treating URIs which seeks to reduce the consumption of antibiotics while attempting to maintain patient satisfaction. Most studies show no difference in improvement of symptoms between those treated with antibiotics right away and those with delayed prescriptions.Most studies also show no difference in patient satisfaction, patient complications, symptoms between delayed and no antibiotics. A strategy of "no antibiotics" results in even less antibiotic use than a strategy of "delayed antibiotics". However, in certain higher risk patients with underlying lung disease, such as chronic obstructive pulmonary disease (COPD), evidence does exist to support the treatment of bronchitis with antibiotics to shorten the course of the illness and decrease treatment failure.

Decongestants

According to a Cochrane review, single oral dose of nasal decongestant in the common cold is modestly effective for the short term relief of congestion in adults; however, "there is insufficient data on the use of decongestants in children." Therefore, decongestants are not recommended for use in children under 12 years of age with the common cold. Oral decongestants are also contraindicated in patients with hypertension, coronary artery disease, and history of bleeding strokes.

Alternative medicine

The use of vitamin C in the inhibition and treatment of upper respiratory infections has been suggested since the initial isolation of vitamin C in the 1930s. Some evidence exists to indicate that it could be justified in persons exposed to brief periods of severe physical exercise and/or cold environments.

The use of nasal irrigation has been shown to alleviate symptoms in some people.There are also saline nasal sprays which can be of benefit.