question: When your sick with a cold why do symptoms like sneezing and runny nose seem to stop when you're sleeping but start again as soon as you wake up?
comment: Being deeply asleep is a vulnerable time for your airway. It's best for the body not to pump pints of mucus into the throat and mouth as you auto breathe in deep sleep. It makes sense for the body to shut these mechanisms off as you sleep to protect your breathing.
passages: Health care providers distinguish bacterial and viral sinusitis by watchful waiting. If a person has had sinusitis for fewer than 10 days without the symptoms becoming worse, then the infection is presumed to be viral. When symptoms last more than 10 days or get worse in that time, then the infection is considered bacterial sinusitis. Pain in the teeth and bad breath are also more indicative of bacterial disease.
   Infection occurs when the virus enters the body through the mouth or nose. Whether illness results or not depends on the immunity in the victim vs. the number of individual virus particles (i.e. the amount of virus) entering the body.
  
  Section::::Clinical signs.
   Viral infections such as canine parainfluenza or canine coronavirus are only spread for roughly one week following recovery; however, respiratory infections involving "B. bronchiseptica" can be transmissible for several weeks longer. While there was early evidence to suggest that "B. bronchiseptica" could be shed for many months post-infection, a more recent report places detectable nasal and pharyngeal levels of "B. bronchiseptica" in 45.6% of all clinically healthy dogs. This has potentially expanded the vector from currently or recently infected dogs to half the dog population as carriers. To put the relative levels of shedding bacteria into perspective, a study analyzing the shedding kinetics of "B. bronchiseptica" presents the highest levels of bacterial shedding one week post-exposure, with an order of magnitude decrease in shedding observed every week. This projection places negligible levels of shedding to be expected six weeks post-exposure (or approximately five weeks post-onset of symptoms). Dogs which had been administered intranasal vaccine four weeks prior to virulent "B. bronchiseptica" challenge displayed little to no bacterial shedding within three weeks of exposure to the virulent strain.
   Symptomatic infections are "apparent" and "clinical", whereas an infection that is active but does not produce noticeable symptoms may be called "inapparent," "silent," "subclinical", or occult. An infection that is inactive or dormant is called a "latent infection". An example of a latent bacterial infection is latent tuberculosis. Some viral infections can also be latent, examples of latent viral infections are any of those from the "Herpesviridae" family.
   A number of various diseases may present with symptoms similar to those caused by a clinical West Nile virus infection. Those causing neuroinvasive disease symptoms include the enterovirus infection and bacterial meningitis. Accounting for differential diagnoses is a crucial step in the definitive diagnosis of WNV infection. Consideration of a differential diagnosis is required when a patient presents with unexplained febrile illness, extreme headache, encephalitis or meningitis. Diagnostic and serologic laboratory testing using polymerase chain reaction (PCR) testing and viral culture of CSF to identify the specific pathogen causing the symptoms, is the only currently available means of differentiating between causes of encephalitis and meningitis.
   The latent stage is the asymptomatic stage, which includes two phases. The two phases of the asymptomatic stage include early (within one year of exposure and infection) and late(after one year of exposure and infection). In this stage, the bacteria can remain inactive for three to thirty years, and it may not progress to the tertiary stage of syphilis, which is the final stage. This stage is highly dangerous because the symptoms altogether disappear and remain hidden for a prolonged period of time. The diagnosis of this stage is positive serology. Because the bacteria remains inactive, the late latent syphilis does not spread and is noninfectious.
   A cold usually begins with fatigue, a feeling of being chilled, sneezing, and a headache, followed in a couple of days by a runny nose and cough. Symptoms may begin within sixteen hours of exposure and typically peak two to four days after onset. They usually resolve in seven to ten days, but some can last for up to three weeks. The average duration of cough is eighteen days and in some cases people develop a post-viral cough which can linger after the infection is gone. In children, the cough lasts for more than ten days in 35–40% of cases and continues for more than 25 days in 10%.
   While the general prognosis is favorable, current studies indicate that West Nile Fever can often be more severe than previously recognized, with studies of various recent outbreaks indicating that it may take as long as 60 to 90 days to recover. Patients with milder WNF are just as likely as those with more severe manifestations of neuroinvasive disease to experience multiple somatic complaints such as tremor, and dysfunction in motor skills and executive functions for over a year. People with milder symptoms are just as likely as people with more severe symptoms to experience adverse outcomes. Recovery is marked by a long convalescence with fatigue. One study found that neuroinvasive WNV infection was associated with an increased risk for subsequent kidney disease.
   Most types of eosinophilic pneumonia have similar signs and symptoms. Prominent and nearly universal signs and symptoms include cough, fever, difficulty breathing, and night sweats. Acute eosinophilic pneumonia typically follows a rapid course. Fever and cough may develop only one or two weeks before breathing difficulties progress to the point of respiratory failure requiring mechanical ventilation. Chronic eosinophilic pneumonia usually follows a slower course. Symptoms accumulate over several months and include fever, cough, difficulty breathing, wheezing, and weight loss. Individuals with chronic eosinophilic pneumonia are often misdiagnosed with asthma before the correct diagnosis is made.
   In contrast, during wake periods differentiated effector cells, such as cytotoxic natural killer cells and CTLs (cytotoxic T lymphocytes), peak in order to elicit an effective response against any intruding pathogens. As well during awake active times, anti-inflammatory molecules, such as cortisol and catecholamines, peak. There are two theories as to why the pro-inflammatory state is reserved for sleep time. First, inflammation would cause serious cognitive and physical impairments if it were to occur during wake times. Second, inflammation may occur during sleep times due to the presence of melatonin. Inflammation causes a great deal of oxidative stress and the presence of melatonin during sleep times could actively counteract free radical production during this time.
   The second phase of the disease, the neurological phase, begins when the parasite invades the central nervous system by passing through the blood–brain barrier. Disruption of the sleep cycle is a leading symptom of this stage and is the one that gave the disease the name 'sleeping sickness.' Infected individuals experience a disorganized and fragmented 24-hour rhythm of the sleep-wake cycle, resulting in daytime sleep episodes and nighttime periods of wakefulness.
   The mechanisms for infection, proliferation, and persistence of a virus in cells of the host are crucial for its survival. For example, some diseases such as measles employ a strategy whereby it must spread to a series of hosts. In these forms of viral infection, the illness is often treated by the body's own immune response, and therefore the virus is required to disperse to new hosts before it is destroyed by immunological resistance or host death. In contrast, some infectious agents such as the Feline leukemia virus, are able to withstand immune responses and are capable of achieving long-term residence within an individual host, whilst also retaining the ability to spread into successive hosts.
   Section::::Physiological regulation.:Sleep and rest.
  
  The immune system is affected by sleep and rest, and sleep deprivation is detrimental to immune function. Complex feedback loops involving cytokines, such as interleukin-1 and tumor necrosis factor-α produced in response to infection, appear to also play a role in the regulation of non-rapid eye movement (REM) sleep. Thus the immune response to infection may result in changes to the sleep cycle, including an increase in slow-wave sleep relative to REM sleep.
   When a virus causes a large portion of humanity to become uncontrollably violent, Deacon, his wife Sarah (Courtnee Draper), and his friend Boozer (Jim Pirri) attempt to flee for safety and escape the carnage. However, Sarah is stabbed and critically wounded, forcing Deacon to evacuate her on a National Emergency Response Organization (NERO) helicopter. Due to the helicopter being at capacity, Deacon stays behind with Boozer, intending to reunite with Sarah.
   Preliminary diagnosis is often based on the patient's clinical symptoms, places and dates of travel (if patient is from a nonendemic country or area), activities, and epidemiologic history of the location where infection occurred. A recent history of mosquito bites and an acute febrile illness associated with neurologic signs and symptoms should cause clinical suspicion of WNV.
   For example, whooping-cough occurs in spring, whereas measles produces two epidemics, one in winter and one in March. Influenza, the common cold, and other infections of the upper respiratory tract, such as sore throat, occur predominantly in the winter.
  
  There is another variation, both as regards the number of people affected and the number who die in successive epidemics: the severity of successive epidemics rises and falls over periods of five or ten years.
  
  Section::::Types.
  
  Section::::Types.:Common source outbreak.
   A large number of nucleocapsids are produced in the neurons and the glial cells. In these cells the viral genes that encode envelope proteins have restricted expression. As a result, infectious particles like the M protein are not produced, and the virus is able to survive persistently without evoking an immune response. Eventually the infection will lead to SSPE.
  
  Section::::Diagnosis.
   Paroxysmal sneezing in morning, especially in morning while getting out of the bed. Excessive rhinorrhea - watering discharge from the nose when patient bends forward. Nasal obstruction - bilateral nasal stuffiness alternates from one site to other; this is more marked at night, when the dependent side of nose is often blocked. Postnasal drip.
  
  Section::::Presentation.:Complications.
  
  Nonallergic rhinitis cases may subsequently develop polyps, turbinate hypertrophy and sinusitis.
  
  Section::::Pathophysiology.
   Some viral hemorrhagic fevers, such as Ebola, Lassa fever, and Lábrea fever, may kill in as little as two to five days. Diseases that cause rapidly developing lung edema, such as some kinds of pneumonia, may kill in a few hours. It was said of the "black death" (pneumonic bubonic plague) that some of its victims would die in a matter of hours after the initial symptoms appeared. Other pathologic conditions that may be fulminating in character are acute respiratory distress syndrome, asthma, acute anaphylaxis, septic shock, and disseminated intravascular coagulation.
   The most frequent presenting symptoms are headache, drowsiness, confusion, seizures, hemiparesis or speech difficulties together with fever with a rapidly progressive course. Headache is characteristically worse at night and in the morning, as the intracranial pressure naturally increases when in the supine position. This elevation similarly stimulates the medullary vomiting center and area postrema, leading to morning vomiting. 
   The optimal pH for viral adsorption to "N. muscorum" is 7.6–8.1. The rate of adsorption is reduced with increasing age of the host cells. The viral latent period is 7 hours, which is similar to cyanophages of the LPP-1 group. The burst size is 100 plaque-forming units per cell.
   Section::::Signs and symptoms.
  
  Anaerobes have been found in infections throughout the human body. The frequency of the host or patient's recovery depends on the employment of proper methods of collection of specimen, their transportation to the microbiology laboratory and cultivation. The recovery of organisms depends on the site of infection and is related to the adjacent mucous membranes microbial ﬂora.
  
  Section::::Signs and symptoms.:Central nervous system.
   Viruses may reach the lung by a number of different routes. Respiratory syncytial virus is typically contracted when people touch contaminated objects and then they touch their eyes or nose. Other viral infections occur when contaminated airborne droplets are inhaled through the mouth or nose. Once in the upper airway, the viruses may make their way in the lungs, where they invade the cells lining the airways, alveoli, or lung parenchyma. Some viruses such as measles and herpes simplex may reach the lungs via the blood. The invasion of the lungs may lead to varying degrees of cell death. When the immune system responds to the infection, even more lung damage may occur. Primarily white blood cells, mainly mononuclear cells, generate the inflammation. As well as damaging the lungs, many viruses simultaneously affect other organs and thus disrupt other body functions. Viruses also make the body more susceptible to bacterial infections; in this way, bacterial pneumonia can occur at the same time as viral pneumonia.
   Section::::Diagnosis.
  
  The distinction between viral upper respiratory tract infections is loosely based on the location of symptoms with the common cold affecting primarily the nose, pharyngitis (the throat), and bronchitis (the lungs). There can be significant overlap and more than one area can be affected. The common cold is frequently defined as nasal inflammation with varying amount of throat inflammation. Self-diagnosis is frequent. Isolation of the viral agent involved is rarely performed, and it is generally not possible to identify the virus type through symptoms.
  
  Section::::Prevention.
   The virus first appears in bronchial lymph nodes and tonsils 2 days after exposure. The virus then enters the bloodstream on the second or third day. A first round of acute fever tends to begin around 3-8 days after infection, which is often accompanied by a low white blood cell count, especially of lymphocytes, as well as low platelet count. These signs may or may not be accompanied by anorexia, a runny nose, and discharge from the eye. This first round of fever typically recedes rapidly within 96 hours, and then a second round of fever begins around the 11th or 12th day and lasts at least a week. Gastrointestinal and respiratory problems tend to follow, which may become complicated with secondary bacterial infections. Inflammation of the brain and spinal cord, otherwise known as encephalomyelitis, either is associated with this, subsequently follows, or comes completely independent of these problems. A thickening of the footpads sometimes develops, and vesicular pustular lesions on the abdomen usually develop. Neurological signs typically are found in the animals with thickened footpads from the virus. About half of sufferers experience meningoencephalitis. Less than 50% of the adult dogs that contract the disease die from it. Among puppies, the death rate often reaches 80%.
  