The transition between winter and spring is often the peak season for upper respiratory tract diseases. As the temperature drops, respiratory diseases are on the rise among the population. Family members, friends or colleagues around us often hear that they go to the hospital to be diagnosed with influenza, mycoplasma pneumoniae and respiratory syncytial virus infection. Many medical terms confuse us. Modern medicine is more inclined to accurate diagnosis. Although the pathogens of respiratory diseases are different, the transmission routes are similar, and the symptoms of onset are also very similar, such as fever, cough, asthma, fatigue, headache, etc. If you catch a cold, what kind of pathogen is infected? Is it serious? How should you deal with upper respiratory tract diseases? This is the most common confusion when people are sick.
1. What are the pathogens of the upper respiratory tract?
Upper respiratory tract infection usually refers to infections including the nasal cavity, pharynx or larynx. The trachea, bronchi and lungs are collectively referred to as the lower respiratory tract, which is not the scope of upper respiratory tract infection. The pathogens of upper respiratory tract infection are caused by 70%~80% of viruses, such as influenza A virus, influenza B virus, respiratory syncytial virus, adenovirus, coxsackie virus, parainfluenza virus, metapneumovirus, human rhinovirus, etc., and 20%~30% of bacteria, such as Streptococcus pneumoniae and Haemophilus influenzae, etc. In addition, there are other pathogens such as mycoplasma, chlamydia, fungi, etc., which account for a smaller proportion. In January 2025, the Chinese Center for Disease Control and Prevention released authoritative monitoring data. Regardless of the south or the north, outpatient emergency influenza virus ranks first (mainly influenza A HINI), and in hospitalized severe respiratory tract infection cases, influenza still ranks first.
When we have a cold, if the symptoms do not improve significantly after taking medicine at home within 2 days, we should go to the hospital in time to clarify the type of infectious pathogens and use targeted medications.
2. Is the upper respiratory tract disease serious?
Taking influenza as an example, in 2022, The Lancet published an article that the number of people diagnosed with influenza or influenza-related symptoms in the United States was 9.3-41 million, of which 140,000-710,000 people needed hospitalization (accounting for about 1.5-1.7%), and 12,000-52,000 people died. Generally speaking, some severe influenza patients need to be hospitalized, and there is even a certain probability that influenza will develop into critical illness. Given the limitations of previous influenza virus testing and the relatively low proportion of patients tested, the data on influenza incidence and severity vary greatly. The highest hospitalization rate is for people over 65 years old and under 5 years old. Therefore, the elderly, children, and patients with chronic diseases should especially take good protection to avoid becoming seriously ill or inducing the aggravation of the original disease.
Complications of upper respiratory tract diseases are divided into respiratory diseases and non-respiratory diseases. The mechanism of occurrence is mainly direct damage by the virus or secondary damage to the inflammatory response caused by the virus.
In terms of respiratory diseases, in children, asthma, bronchiolitis, tracheitis, otitis media and even pneumonia may occur; in adults, if combined with lower respiratory tract diseases and develop into pneumonia, it can further lead to respiratory failure, acute respiratory distress syndrome, septic shock and multiple organ failure, requiring hospitalization in the respiratory department or even ICU for monitoring and treatment.
Non-respiratory complications, myocarditis, pericarditis or aggravation of existing chronic cardiovascular diseases, such as viral myocarditis, may occur in all age groups. Some patients may develop neurological diseases such as encephalitis, and children may have convulsions or epileptic seizures due to high fever.
When upper respiratory tract diseases occur, you should seek medical attention in time, but the overall proportion of hospitalization is not high. However, if the symptoms persist, especially if symptoms of multiple body systems occur, hospitalization is often required to avoid delaying the disease.
3. How should you deal with upper respiratory tract diseases?
If you have cold symptoms, first of all, it is recommended to go to the hospital for etiology examination to clarify the type of infection, whether it is virus, bacteria or mycoplasma, etc., to clarify the cause and then treat it in a targeted manner; secondly, it is recommended to check blood routine, chest X-ray, etc. in the outpatient or emergency department to determine the type and severity of the disease, and even need to complete CT to confirm the diagnosis; thirdly, if you have shortness of breath, which means that the oxygen saturation decreases, it may be a severe case and you need to be hospitalized.
Vaccination has been proven to be effective, especially for children, the elderly and patients with chronic respiratory diseases; good personal hygiene habits, keep the living and working environment clean and ventilated, and wear masks in crowded places. Traditional Chinese medicine is also a good way to prevent and treat. It is formulated according to the cold and heat differentiation and the patient's physical condition. During the recovery period of upper respiratory tract infection, some late symptoms such as cough, sore throat and fatigue can often be treated with good results through the conditioning of traditional Chinese medicine.