1. What are respiratory infections?

Acute respiratory infections are among the most common illnesses of all – many adults have several a year. They are mostly caused by viruses and affect the upper airways (nose, throat, larynx) and/or the lower airways (bronchi, lungs).^¹

The four most important viral respiratory infections are: the common cold, flu (influenza), COVID-19 and RSV. All are transmitted mainly by droplets or aerosols and occur more often in the autumn and winter months.^¹

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2. Common cold

Colds can be triggered by a wide variety of pathogens – often rhinoviruses, alongside seasonal coronaviruses (not SARS-CoV-2), adenoviruses and parainfluenza viruses. They are usually mild and typically clear up on their own within about a week.^⁵

Typical symptoms

• Runny nose (running or blocked nose) – often the first symptom, frequently starting with tickling or sneezing
• Sore throat – scratchiness, difficulty swallowing (often in the first few days)
• Cough – usually dry at first, later often productive; can occasionally last several weeks
• Mild fever or raised temperature (rarely very high in adults)
• Mild headache and general malaise
• Usually a gradual onset over 1–2 days

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3. Flu (influenza)

True flu is caused by influenza viruses and often runs a markedly more severe course than a cold. Depending on the severity of the wave, the RKI estimates between close to zero (mild season) and well over 20,000 additional deaths (very severe seasons such as 2017/18).^¹ Older and chronically ill people are usually especially at risk.

Typical symptoms

• Often a sudden onset – from relatively healthy to severely ill within a few hours
• Often high fever, chills
• Marked feeling of illness – many describe it as “like being run over”
• Severe headache and body aches
• Dry, painful cough
• Marked fatigue and exhaustion – can occasionally last for weeks
• Runny nose – usually less prominent in flu than in a cold

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4. COVID-19

COVID-19 is caused by the virus SARS-CoV-2. After the pandemic, SARS-CoV-2 has become one of the seasonally circulating respiratory viruses. Thanks to the now widespread immunity (vaccinations and past infections), most infections today run a rather mild course.^³

Common symptoms (current variants)

• Sore throat, runny nose, cough – often cold-like
• Fever, headache, joint pain
• Fatigue, exhaustion
• Shortness of breath – mainly in more severe courses
• Loss of taste or smell – rarer with current variants than at the start of the pandemic, but still occurs

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5. RSV (respiratory syncytial virus)

RSV is often underestimated but is considered one of the most common causes of hospital admissions in infants and can also lead to severe courses in seniors (e.g. pneumonia, worsening of existing COPD or heart failure).^⁶

Typical symptoms

• In adults: often cold-like (runny nose, cough, mild fever)
• In infants: feeding weakness, rapid breathing, nasal flaring, wheezing, occasionally pauses in breathing
• In seniors: often shortness of breath and worsening of existing lung or heart conditions

In detail: RSV article.

6. Symptom comparison: cold vs. flu vs. COVID-19

Scroll table right

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7. When to see a doctor? When 112?

To the GP or medical on-call service (116 117)

• High fever for more than about 3 days
• Symptoms worsen after an initial improvement (possible sign of a bacterial secondary infection)
• Cough with yellowish-green sputum that persists
• Earache – especially in children (possible middle-ear infection)
• You belong to a risk group (e.g. older age, chronic underlying conditions, immunosuppression)
• In infants: feeding weakness, rapid breathing, fever in the first six months of life

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8. Treatment and home remedies

Most respiratory infections clear up on their own. Treatment usually aims to relieve the symptoms.

General measures

• Physical rest – with fever, ideally bed rest. No sport until the symptoms have fully cleared (among other reasons because of the risk of myocarditis)
• Drink enough – e.g. water, tea, broth. With fever the fluid requirement usually rises
• Humidify the air – dry heating air can further irritate the mucous membranes
• Stay at home with symptoms and avoid contact with risk groups where possible

Medicines to relieve symptoms

Fever and pain

Paracetamol or ibuprofen can be used for fever, headache and body aches. Important: in children and adolescents under 16, acetylsalicylic acid (ASA) is usually not recommended because of the rare but dangerous Reye’s syndrome. More: medication before or after eating.

Runny nose

Saline solution (e.g. as a nasal spray or nasal rinse) is usually well tolerated. Decongestant nasal sprays (e.g. with xylometazoline) should only be used for a limited time to avoid a rebound effect (rhinitis medicamentosa).

Sore throat

Lozenges, warm or cool drinks, gargling with salt water or sage tea can help.

Cough

Inhalations with saline solution moisten the mucous membranes. Herbal expectorants (e.g. with thyme or ivy) are often used. Honey can be used as a home remedy for children from one year – for infants under one year, honey is off-limits because of the botulism risk.

Antiviral therapy (only for flu and COVID-19)

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9. Protective measures and vaccinations

General protective measures

• Regular hand-washing with soap – usually the single most important measure
• Cough or sneeze into the crook of your elbow (not into your hand)
• Keep your distance from ill people
• Stay at home with symptoms – avoid daycare/school/work
• Indoors during heavy virus circulation, wearing a mask can be sensible – especially for risk groups
• Ventilate regularly (e.g. burst ventilation)

Flu vaccination (influenza)

The STIKO recommends an annual flu vaccination – usually in autumn (about October–November). Recommended, among others, for:^²

• Everyone aged 60 and over – from the 2025/26 season the STIKO recommends either a high-dose or an MF59-adjuvanted vaccine^²
• People with chronic underlying conditions (e.g. airways, heart, kidney, diabetes)
• Medical and nursing staff and people with a lot of public contact
• Residents of care facilities

COVID-19 vaccination

The STIKO recommends an annual booster in autumn, mainly for:^³

• People aged 60 and over
• People with relevant underlying conditions (e.g. lung, heart, kidney, diabetes, immunosuppression)
• Medical and nursing staff

For healthy adults under 60, the STIKO generally considers the basic immunity sufficient.^³

RSV vaccination/prophylaxis

• Nirsevimab (Beyfortus) – recommended by the STIKO for all infants in their first RSV season as passive immunisation^⁶
• RSV vaccination for older people – as a standard vaccination from a certain age and as an indication-based vaccination with relevant pre-existing conditions^⁶

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10. How brite helps you with respiratory infections

brite supports you from the first symptom to full recovery.

• Health record – document symptoms day by day. Make the fever course, cough duration, improvement or worsening traceable. Track your course
• Medication reminder – painkillers, nasal drops, oseltamivir or Paxlovid: brite reminds you on time. Set a reminder
• Interaction check – review cold medicines with your regular medication or Paxlovid with other drugs. Check now
• Digital medication plan – all medicines clearly laid out for GP, pharmacy and emergency department. To the medication plan

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