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URTI symptoms are one of the most common reasons people feel suddenly “run down”, a scratchy throat, a blocked nose, a nagging cough, and that heavy, tired feeling that makes work and daily life harder. A URTI (upper respiratory tract infection) usually affects the nose, sinuses, throat, and voice box, and in most cases it’s viral and settles with time and supportive care.
This guide keeps it simple and practical: how URTI symptoms usually start, the most common symptom patterns, and a realistic timeline so you know what’s normal vs when it’s time to get help. If you want a deeper “what URTI is” explainer, you can also refer to your existing URTI overview here
Quick answer
Early URTI symptoms often begin with a scratchy throat, sneezing, a runny/stuffy nose, and mild fatigue. Symptoms typically peak in the first few days and improve over 7–14 days, though a mild cough can linger longer. Get medical advice sooner if you have breathing difficulty, chest pain, persistent high fever, severe worsening, or symptoms lasting beyond ~2 weeks without improvement.
Early URTI signs (first 24 to 48 hours)
Most URTIs don’t start with everything at once. The first day or two often feels like a “something is coming” phase, mild but noticeable changes that can be easy to dismiss until they build.
What many people notice first:
- A scratchy throat or “tickle” that makes you clear your throat often
- Sneezing or watery nasal discharge
- Mild tiredness or brain fog
- A sense of being “off” (especially later in the day)
Then, over the next 24 to 48 hours, the illness usually shifts from irritation to inflammation, which is when congestion and cough become more obvious. The reason the first couple of days matter is that URTIs tend to be more contagious early, especially when sneezing and runny noses are active.
A quick reality-check: If your illness starts very suddenly with high fever, strong body aches, or extreme fatigue, that pattern can fit flu/COVID more than a typical cold-style URTI and testing/advice is often the smarter move than guessing.
If symptoms start suddenly with high fever, chest tightness, or you’re in a higher-risk group, it can be helpful to speak to a clinician early to avoid delays.
URTI Symptom Patterns
Instead of listing the same symptoms repeatedly, it’s more useful to identify the pattern you’re in because it helps you:
- Understand what might show up next,
- Choose supportive care that actually matches your problem, and
- Recognize when the pattern is becoming “not typical.”
1) Nose-dominant URTI (classic cold pattern)
This is the most familiar URTI style: it centres around runny or blocked nose, sneezing, and post-nasal drip. The cough (if it appears) is often from mucus dripping down the throat rather than deep chest involvement.
What it feels like: blocked sinuses, constant tissues, irritated throat from drip, worse at night.
2) Throat-dominant URTI
Here, the main issue is throat inflammation. You may feel soreness, dryness, or pain when swallowing, sometimes with mild swollen glands. The nose may be fine at first, then symptoms can shift later.
What it feels like: raw throat, swallowing discomfort, talking feels tiring.
3) Sinus-dominant URTI
This pattern brings facial pressure, headache (often worse when bending forward), and thicker nasal discharge. It can still be viral early on because sinus pressure alone doesn’t automatically mean “bacterial sinus infection.”
What it feels like: heavy face, pressure around cheeks/forehead, congested head.
4) Voice and irritation pattern (larynx/post-nasal drip)
Some URTIs inflame the voice box or irritate the throat enough that hoarseness becomes the star symptom. Cough can be triggered by talking, dry air, or post-nasal drip.
What it feels like: raspy voice, voice loss, tickly cough that flares with speaking.
5) Wheeze-prone pattern (asthma/allergy overlap)
If you have asthma (or tend to wheeze with colds), URTI symptoms can trigger chest tightness or wheeze even if the infection is “upper.” That doesn’t always mean the infection has gone to your lungs but it does mean you should monitor breathing more closely.
If you feel better and then suddenly worse again, it’s worth getting assessed so you can rule out complications and get the right doctor guidance.
How long do URTI symptoms last?
A typical URTI improves within 7–14 days, but the more helpful question is: “Is the trend improving?” Most uncomplicated viral URTIs follow a predictable rhythm.
Days 1–3: onset and peak
This is when symptoms often ramp up quickly. Your body’s immune response is switching on, so fatigue can feel surprisingly strong even if symptoms look “mild” on paper. Expect a mix of irritation + congestion, and possibly a mild fever.
Days 4–7: congestion and cough phase
For many people, this is the messy middle: congestion is heavier, post-nasal drip is active, and cough is more likely. Even if your throat feels better, you may cough more because mucus and airway sensitivity linger.
Days 8–14: recovery and leftovers
Most people feel clearly better overall, but some symptoms can hang around commonly a mild cough or leftover congestion. What matters is that you’re steadily improving week-to-week, not stuck or worsening.
The “double-worsening” sign
If you start improving and then suddenly worsen again (especially with new fever, stronger facial pain, or feeling significantly unwell), that’s often the point to consider medical review; it can suggest a complication or a different infection pattern.
When Can Telehealth Help?
Most URTIs settle on their own, so you don’t need a consult for every sniffle. Telehealth becomes useful when you’re uncertain, worsening, or you need clear guidance for work/school without waiting days to “see how it goes.”
A telehealth review can help if:
- You’re not sure whether it’s a typical URTI vs flu/COVID/strep
- Symptoms are severe, not improving, or you have double-worsening
- You have asthma and URTI symptoms are triggering wheeze/chest tightness
- You’re in a higher-risk group (pregnancy, chronic conditions, weakened immunity)
- You need advice on whether to rest longer and when it’s safe to return to work/school
If a clinician assesses you and feels it’s appropriate, they can also provide a medical certificate for work or study. In some cases, prescriptions may be discussed only if clinically appropriate. If you’re asking about a certificate for earlier dates, that’s handled carefully and depends on the clinical history and clinician discretion.
If you need time to rest away from work or study, you can also ask during the consultation whether a medical certificate is appropriate.
FAQs
1) How long is a URTI contagious?
URTIs are usually most contagious in the early days, especially when sneezing/runny nose are active. Risk generally reduces as symptoms improve, but it’s still wise to use hygiene measures until you’re clearly better.
2) Why does my cough last longer than my runny nose?
A cough often lingers because the airway remains sensitive and post-nasal drip can keep irritating the throat even after congestion improves. The key is that it should be gradually improving, not worsening.
3) Do I need antibiotics for URTI symptoms?
Usually no, because most URTIs are viral. Antibiotics are only used when a clinician suspects or confirms a bacterial infection (for example, certain cases of strep throat or complications).
4) When should I worry about a sore throat?
Get checked sooner if the sore throat is severe, lasts more than a few days without improvement, you can’t swallow fluids, you have high fever, or one side of the throat feels much worse.
5) Can URTI trigger asthma or wheezing?
Yes. URTIs can trigger wheeze or chest tightness in people with asthma or reactive airways. If breathing symptoms are increasing, seek advice early.
6) What if I feel better and then worse again?
That “double-worsening” pattern can suggest a complication or a different infection pattern. If you improve and then suddenly worsen (especially with fever or significant sinus pain), it’s a good reason to get assessed.
7) Can I go to work/school with URTI symptoms?
If symptoms are improving and you feel well enough, you may return but you should still reduce spread (mask if needed, hand hygiene, don’t share utensils). If you have fever or feel significantly unwell, rest is usually the better choice.
8) Can I get a medical certificate for URTI?
If a clinician assesses that your URTI symptoms made you unfit for work or study, a medical certificate may be provided where appropriate often via telehealth.
Conclusion
URTI symptoms usually start with mild irritation (scratchy throat, sneezing, runny nose) and then move into congestion/cough before gradually improving over 7 to 14 days. The most useful way to judge recovery is the trend: you should feel stable or gradually better as days pass. If you’re worsening, not improving by two weeks, or you develop red flags like breathing difficulty, chest pain, persistent high fever, or dehydration, don’t wait to seek medical advice. When you’re unsure what you have or you need guidance for work/school, a short review can help you choose the safest next step.
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