Upper respiratory tract infections involve the mucosa of the nasal cavity, sinuses, nasopharynx, oropharynx and larynx.


  • Incidence: 30000.00 cases per 100,000 person-years
  • Peak incidence: 1-5 years
  • Sex ratio: 1:1
Condition Relative
Viral upper respiratory tract infections1
Acute bronchitis0.15
Acute sinusitis0.08
Allergic rhinitis0.07
Acute tonsillitis0.02
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+


Many viruses can cause infection at this site, the most common of which are rhinoviruses (50-80%) and corona viruses. Other viruses include adenoviruses, influenza, parainfluenza, respiratory syncytial virus and enteroviruses. Terms which are often used to describe URTIs include 'cold' which is a non-specific term used by the general public usually to describe an illness with the main symptom of nasal discharge and sneezing, and 'coryzal symptoms' which is usually used by medical professionals and encompasses a wider range of symptoms as detailed below.

Clinical features



  • Examination of throat, ears and cervical lymph nodes
  • Respiratory examination to exclude pneumonia, significant wheeze etc
  • Assess hydration status, especially in young children and the elderly
  • Basic observations (heart rate, blood pressure, respiratory rate, temperature, oxygen saturations) - if significantly abnormal may need to consider other causes e.g. sepsis

Useful criteria for assessment
  • Children under 5 - NICE fever traffic light system
  • FeverPAIN score - used to assess likelihood of Strep infection in adult with sore throat and guide decision making re antibiotic usage


  • Generally not needed in healthy adults
  • May be required in less straightforward cases where more serious infections may present with similar symptoms e.g. baby/infant with fever, immunocompromised adult
  • Viral throat swabs may be needed in certain cases e.g. adult with suspected influenza being admitted to hospital for infection control purposes


  • Supportive management only is usually sufficient
  • Admission for supportive care may be required in frail or elderly patients with low physiological reserve or multiple comorbidities
  • An uncomplicated cold in a healthy adult usually resolves in 7-10 days but may last up to 3 weeks
  • Provide reassurance that condition is self-limiting and recovery will not be aided by antibiotics
  • Advise paracetamol, fluids, rest and over the counter remedies if appropriate


  • Sinusitis
  • Otitis media
  • Secondary bacterial infection e.g. pneumonia
  • Exacerbations of pre-existing respiratory conditions such as asthma, or COPD
  • Viral wheeze, bronchiolitis and croup in infants and young children