Stages of the Common Cold (2024)

The common cold lasts between seven and 10 days for most people. How long it lasts depends largely on your age, general health, and the type of cold virus you get.

Older adults with chronic health conditions often take longer to get over a cold than younger people with no health concerns. The same applies to very young children who have immature immune systems. In such cases, it can take 14 days or more to fully recover.

When infection occurs, a cold goes through four characteristic stages: incubation, early symptoms, peak symptoms, and recovery. As there is no cure for the common cold, treatment is focused on rest, fluids, and symptom relief.

This article looks at how colds develop and resolve, and the different factors that influence their duration. It also explains what to expect at each stage of infection.

Pattern of Infection of the Common Cold

A cold is a type of upper respiratory tract infection (URTI) that can be caused by hundreds of different respiratory viruses, including:

• Rhinoviruses
• Respiratory syncytial virus (RSV)
• Parainfluenza viruses
• Adenoviruses
• Coronaviruses
• Human metapneumovirus (hMPV)

By far, the most common cause is rhinovirus, accounting for between half and two-thirds of all colds. All of these viruses follow a characteristic pattern from the time of infection to the time that the immune system brings the infection under control.

How Cold Symptoms Develop

Cold viruses are typically spread by respiratory droplets that are ejected into the air by coughing or sneezing. Once the virus enters the body through tissues in the nose or mouth, it begins to rapidly multiply and trigger an immune response in the form of inflammation.

Inflammation is the body's natural response to infection. It involves the release of immune chemicals that cause the dilation (widening) of blood vessels, allowing defensive white blood cells closer access to the site of infection. The dilation also causes fluids to leak into the surrounding tissues, leading to swelling and hypersensitivity.

These are the responses that cause cold symptoms. In the end, the symptoms are due to the body's response to the virus rather than any damage done by the virus itself.

Symptoms typically start with a runny nose and sore throat, progressing to coughing, sneezing, and congestion as the virus invades nearby tissues. The expanding inflammation can soon trigger systemic (whole-body) symptoms like fatigue, body aches, and loss of appetite.

As the immune system gains control over the virus—usually within seven to 10 days—the inflammation will ease and so, too, will the symptoms.

Stages of the Common Cold

The typical cold usually goes through four stages during its life cycle. It starts when you get the virus and ends when you fully recover.

Stage 1: Incubation

Stage 1 typically causes no symptoms. The incubation period is the time between when you are infected and when you get the first symptoms. With most cold viruses—but rhinovirus in particular—the incubation period is quite short.

The appearance of cold symptoms varies based in part on which virus you have been exposed to. Rhinoviruses can produce symptoms from 12 to 72 hours after infection but commonly do so in 24 to 48 hours. Some other cold viruses take longer (for example, up to five-and-a-half days for adenoviruses).

Stage 2: Early Symptoms

Stage 2 of a common cold lasts approximately one to three days from the first appearance of symptoms. It usually starts with a scratchy sensation in the back of the throat, progressing to a sore throat. You may also have a runny nose and feel more tired than usual. Sneezing and congestion are also common.

As soon as symptoms appear, you are contagious. This means that you can spread the virus to others unless you take precautionary measures like staying home, covering coughs and sneezes, and washing your hands frequently.

Stage 3: Peak Symptoms

Stage 3 usually lasts from day four to day seven. At this stage, the immune defenses have fully kicked in, including your frontline innate immunity (which attacks all foreign invaders) and your secondary adaptive immunity (which specifically targets the type of virus you have).

The symptoms of stage 3 may include body aches, coughing, hoarseness, constant sneezing or runny nose, and severe congestion with postnasal drip, You may develop a fever, but this is more common in children than adults. A fever is also rare with rhinovirus infections.

Rest is key to getting over colds faster. Over-the-counter (OTC) medications like Tylenol (acetaminophen) can help control fever, but contact a healthcare professional if you have a fever higher than 105 degrees F or one that lasts longer than 48 to 72 hours. To avoid dehydration caused by fever, drink plenty of fluids.

OTC decongestants or cough suppressants can help ease cold symptoms in adults, but research suggests that they are not as beneficial for children. Speak with your child's pediatrician before using any cold & flu medication.

Stage 4: Recovery

Stage 4 of cold lasts from day seven of your illness until your symptoms fully resolve. You may feel ready to return to normal activity by this time, but some symptoms may persist for as long as two weeks.

Some people may develop a nagging cough, called a postinfectious cough, that can persist for up eight weeks. It is mostly due to lingering inflammation that causes postnasal drip. It is more common with influenza (flu) and COVID-19 but can also occur with severe colds.

People with postinfectious cough are not usually contagious as long as their other symptoms have cleared.

If you develop a lingering cough, speak with your healthcare provider to ensure that you haven't developed complications like pneumonia.

Factors Influencing the Duration of Colds

The same factors that influence the risk of getting a cold can also influence how long a cold lasts. This includes a person's immune status, which is affected by age and certain chronic health conditions.

Underlying lung and respiratory disease can not only increase a person's risk of complications from the cold but can make it harder to fight infection when the airways are already damaged.

Among the things that make it harder to get over colds are:

• Being 65 and older
• Being under five years of age
• Poor nutrition
• Cigarette smoking
• General poor health
• Having asthma or chronic obstructive pulmonary disease (COPD)
• Having a compromised immune system, such as caused by HIV or chemotherapy
  

Summary

The common cold lasts from seven to 10 days and goes through four characteristic stages. The incubation stage lasts one to several days, followed by the appearance of early symptoms (days one to three). The third stage involves peak symptoms (days four to seven), followed by the recovery stage which can sometimes persist with lingering symptoms for 14 days or more.