Viruses enter the upper respiratory tract mucosa via inhalation of aerosols or infected droplets or direct contact with contaminated secretions. After cell entry, viral replication and shedding occur for several days to weeks. Clinical symptoms are a result of epithelial cell damage, inflammation, vasodilation, edema from increased vascular permeability, increased mucus production, and impaired mucociliary clearance from neutrophil migration, cytokine release, and cytotoxic immune responses.42,45

Tracheobronchial inflammation and irritation induce cough via afferent nerve impulse

transmission to the medulla. Antibody production halts viral replication and inflammation as symptoms wane.

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