Upper Respiratory Tract Infections
What Are Upper Respiratory Tract Infections?
Most winter illnesses are infections—meaning microbial diseases. In winter, cold weather, increased air pollution, crowded and enclosed environments, and continuous exposure to colds especially among children lead to the rise of infections. During this season, children often experience an increase in upper respiratory tract infections such as the common cold, throat infections, sinusitis, and laryngitis, as well as lower respiratory tract infections like bronchitis and pneumonia.
These viruses spread rapidly in cold weather because they can survive on inanimate surfaces for up to 48–72 hours. Transmission occurs through direct contact or droplets. When a person sneezes, coughs, or even just breathes, viral particles are suspended in the air in droplets. Each virus has different particle sizes. Those with smaller particles can more easily reach the lower respiratory tract.
While a 5-year-old child may only experience a mild upper respiratory infection, a newborn can develop bronchitis or pneumonia due to their underdeveloped immune systems. People with immunity issues or allergies are also at higher risk for both upper and lower respiratory tract infections. In allergic children, airways narrow and become blocked more easily, which promotes rapid bacterial and viral colonization.
Understanding these illnesses, using antibiotics properly, avoiding unnecessary medication, and learning how to measure and reduce fever can help both the child and family get through this period more comfortably.
You can view our Respiratory Pathogen PCR Test Panel at our laboratory to identify the microorganism causing the disease.
Most Common Upper Respiratory Tract Infections:
- Rhinitis (Common Cold):
Also known as a cold, rhinitis affects the upper respiratory tract, particularly the nose. Children in school may experience it 3–5 times a year, which is considered normal. It is caused by viruses and spreads through droplets released by sneezing or coughing. These droplets contaminate the environment, hands, and objects, allowing the virus to spread through contact.
- Influenza (Flu):
Caused by the influenza virus, the flu spreads through droplets and is transmitted by coughing and sneezing. Symptoms vary depending on the virus type. In some cases, the illness is more severe and the child feels more ill.
- Otitis Media (Middle Ear Infection):
Nasal congestion caused by upper respiratory infections often affects the ear, leading to infections in the middle ear, pain, and fever. It is the third most common illness after colds and flu in childhood. Two-thirds of children under age 3 experience at least one ear infection. It's a major cause of school absenteeism and can lead to hearing loss if untreated.
- Sinusitis:
This is the inflammation of air-filled spaces in bones around the nose. About 6–13% of children under three experience sinusitis. It usually follows a respiratory infection when inflamed tissues block drainage pathways. Nasal congestion, discharge, swollen tonsils, and pharyngitis can prevent proper sinus ventilation and result in infection.
- Pharyngitis:
One of the most common winter illnesses. Mostly viral, but it can also be bacterial. It occurs when the body can't overcome a cold due to low immunity.
- Acute Pharyngitis (Tonsillitis):
Spread via droplets, it starts with coughing, nasal discharge, fever, and fatigue. If untreated, it can lead to ear infections or, if caused by streptococcal bacteria, rheumatic fever.
- Laryngitis:
Also known as croup or diphtheria in children, it’s the inflammation of the larynx in the throat.
- Bronchiolitis:
This infection affects the small airways, mostly seen in children between 6 months and 2 years old.
- Bronchitis:
Commonly occurs when viruses causing upper respiratory infections settle in the main bronchial tubes. A simple upper respiratory infection can sometimes progress to bronchitis within a few days.
- Pneumonia (Pneumonitis):
Defined as inflammation of the air sacs in the lungs filling with fluid. It’s more common in children with heart conditions, past lung illnesses, or premature birth. Caused by viruses or bacteria, pneumonia results in serious breathing difficulties and visibly ill appearance. If bacterial, antibiotics are required.
Important Considerations for Children with Respiratory Infections
- Children should drink plenty of fluids such as fresh fruit juices and herbal teas, and take warm baths to feel better. They shouldn’t be forced to eat if they have no appetite.
- Ventilate and keep indoor environments cool. Taking the child outdoors helps the recovery process.
- Sick children should not attend school. Schools and families must be vigilant about this.
- No smoking at home.
- Viral infections usually begin to improve within 3–5 days.
- If there is no improvement, consult a doctor.
Symptoms of Upper Respiratory Tract Infections
- Rhinitis (Common Cold):
Symptoms appear 12–36 hours after the virus enters the body. Runny or blocked nose, sneezing, burning throat, dry cough, headache, sore throat, fatigue, mild fever, eye redness, and watering are common.
- Influenza (Flu):
Compared to the common cold, symptoms are more severe: chills, high fever, muscle and joint pain, fatigue, and headaches (especially triggered by eye movement). Fever above 38.5°C can last 3–8 days. Chest pain, nausea, vomiting, and abdominal pain may also occur.
- Otitis Media (Ear Infection):
Swelling and fluid buildup caused by infection result in ear pain, discharge, fever, and hearing loss.
- Sinusitis:
Depending on the sinus affected, pain is felt near the eyes, nose, and under the eyes. Symptoms include localized headache, nasal tone change, fever, cough, and postnasal drip.
- Pharyngitis:
Dry cough, sore throat, burning sensation, mild fever. If symptoms last longer than 3 days, bacterial infection should be investigated.
- Acute Pharyngitis (Tonsillitis):
Symptoms may include:
- Fever (up to 39–40°C), chills
- Swollen, red tonsils
- Ear pain
- Sore throat
- Painful swallowing
- Fatigue and muscle/joint aches
- Swollen neck lymph nodes
- Headache
- Loss of appetite
- Bad breath
- Voice changes
Children may also experience:
- Nausea
- Vomiting
- Abdominal pain
- Laryngitis:
Sudden hoarse, barking cough, raspy voice, and deep vocal tone are typical.
- Bronchiolitis:
Fast, wheezy breathing, increased cough, nasal congestion. Fever may not always be present depending on the child's immune response.
- Bronchitis:
In older children, intense phlegm, wheezing, fast breathing, and coughing fits occur. Fever often stays below 38°C. Diagnosis is based on clinical symptoms and X-ray.
- Pneumonia (Pneumonitis):
Symptoms include cough, fever, chills, headache, fatigue, abdominal pain, and bloating. However, cough is more intense and productive, and fever tends to be higher and more persistent.
Treatment Methods for Upper Respiratory Tract Infections
- Rhinitis (Common Cold):
There’s no specific treatment. Symptomatic medications like over-the-counter syrups for pain and fever may be used. Nasal sprays or saline drops can help relieve congestion. Antibiotics are ineffective. The child should rest and drink fluids.
- Influenza (Flu):
Flu vaccine is recommended every year before flu season begins, preferably in October or November. If delayed, it can still be administered until March. First-timers should receive two doses a month apart; afterward, only one dose is needed annually. Children aged 6 months to 3 years receive a half dose, older children get a full dose. Not suitable for those with egg allergies.
- Otitis Media:
Antibiotics are effective. Complications like permanent hearing loss or infections in nearby organs can occur, such as mastoiditis (infection of air cells in the temporal bone).
- Sinusitis:
If symptoms last more than 3 days or worsen, antibiotics may be needed. Untreated sinusitis can lead to meningitis due to its proximity to the brain and skull structures.
- Pharyngitis and Acute Pharyngitis (Tonsillitis):
Treatment must be guided by a doctor using appropriate antibiotics if necessary.
- Laryngitis:
Cold mist therapy is helpful. Since it can cause difficulty breathing, a doctor’s consultation is essential. Corticosteroids may be used in moderate to severe cases. Antibiotics are rarely needed.
- Bronchiolitis:
Common in winter due to RSV. Typically improves within 4–5 days. Since small children are prone to bacterial co-infections, close monitoring is important.
- Bronchitis:
There’s no specific treatment. Usually resolves on its own. Expectorants and bronchodilators may help. Doctor follow-up is important. Antibiotics are considered only if there's suspicion of pneumonia.
- Pneumonia (Pneumonitis):
If respiratory failure is present, hospitalization is required. Otherwise, if the child’s condition is stable, outpatient monitoring is possible.