Is it a Cold or the Flu?

You wake up in the middle of the night with a scratchy, sore throat, runny nose, fever, and cough. Is it a cold or, or is it the flu? Both the common cold and flu are respiratory illnesses, and they often have similar symptoms. It can be hard to tell them apart. Your doctor can run a flu test by swabbing the inside of your nose or back of your throat, which is about the only way to know for certain.

But there are a few general rules of thumb that you can use to tell the difference between a cold and the flu. That’s important because most of the time, flu is a more serious illness than the common cold. Knowing whether you have the flu or a cold can give you a better idea of what to expect, how to treat it, and what possible problems to watch for.

The Common Cold

The common cold is just that – common. Most adults will have 2 to 3 colds in any given year, and children often have more. More than 100 different viruses can cause the common cold, although rhinoviruses are the most frequent culprits.

Symptoms of the common cold include a sore throat, which usually lessens in 2-3 days, runny nose, watery eyes, coughing, sneezing, headaches and body aches. Most adults and older children won’t develop a fever, although young children may develop a low-grade fever. Symptoms usually subside within 7 to 10 days.

For most people, a cold is just a week or so of misery. But a cold can be serious in people with compromised immune systems or other conditions such as asthma, cancer, or heart failure. See your doctor if you are concerned or have questions.

The Flu

The flu (influenza) is caused by an influenza virus. The exact nature of the virus varies from year to year, which is why experts recommend getting a flu shot every year.

People who have the flu tend to be much sicker than those who have a cold. When the flu strikes, even the healthiest adults may find themselves hardly able to get out of bed for up to two weeks. Flu symptoms usually include fever, extreme tiredness, body aches, and a dry cough. Even though the common cold may produce many of the same symptoms, they tend to be worse if it’s a flu infection.

For older people, young children, and people with other chronic conditions such as asthma, diabetes, or chronic heart failure, the flu can be deadly. The number of people who die each year from the flu varies widely, partly due to

Treatment

There is no cure for the common cold or the flu. Most healthy adults and children will feel better in 7 to 10 days if they get plenty of rest and drink lots of fluids. And don’t worry if you can’t remember whether it’s “starve a cold, feed a fever” or the other way around. Eat if you’re hungry, but if you’re not, don’t force it. If you’re uncomfortable, you can take over-the-counter medications such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) to control fever and reduce achiness. Be aware, though, that many over-the-counter “cold and flu” formulas also contain acetaminophen. Be sure to take only the recommended dose.

Need to Know

Do not give aspirin (salicylic acid) or medications containing aspirin for a cold or flu. Aspirin can lead to Reye’s Syndrome, a sudden onset of liver and brain damage. Although doctors do not know exactly what causes Reye’s Syndrome, they do know it is often linked to aspirin use during that unknown cause. Reye’s Syndrome is considered a two-phase illness. It almost always occurs about 2-3 days after the onset of a viral infection, such as a cold or the flu. Children ages 4-12 are most at risk, although Cases that occur with the flu are usually in children ages 10 – 14.

If your doctor diagnoses flu, she may prescribe an anti-viral medication such as Tamiflu® (oseltamivir) or Relenza® (zanamivir). Tamiflu® comes in pill or liquid form, and Relenza® is a powder that is inhaled. People with breathing problems like asthma or COPD should not take Relenza®.

Don’t pressure your doctor to give you antibiotics. Because colds and flu are caused by viruses, antibiotics will not help you to recover faster or lessen the symptoms. However, if your doctor suspects a secondary bacterial infection, she may prescribe an antibiotic.

When to Call a Doctor

Call a doctor if you or your child experience any of the following:   

  • Difficulty breathing
  • Especially severe or unusual symptoms
  • A temperature higher than 100.4
  • Symptoms that last more than 10 days

Need to Know

Any child less than three months old who has a fever should be seen by a doctor.

Prevention

Cold and flu viruses are spread through the air and close personal contact, as well as by touching surfaces that someone who has a cold virus on their hands has touched. If someone in your household has a cold, try to keep them separated from others.

Avoid getting colds and flu by taking the following steps:

  • Get a flu vaccine. The flu vaccine is safe, widely available, and it works.
  • Wash hands frequently and well. That means using warm soapy water and scrubbing for at least 20 seconds (one round of “Happy Birthday”), then rinsing and drying thoroughly.
  • Do not share water bottles, glasses, utensils, or anything else that touches your mouth with others
  • Disinfect surfaces in rooms where someone who might have had a cold has been, including doorknobs, handles, computer keyboards/mice, and grocery store carts.
  • Avoid touching your eyes, nose, or mouth with unwashed hands.
  • Support your immune system. You don’t need fancy supplements. Eat a healthy diet rich in fruits and vegetables, get plenty of exercise, and control stress. Get outside for at least an hour every day. Laugh.

Stopping the Spread

If you’re the one sick with a cold or flu:

  • Stay home. You can pass the virus to others simply by touching a doorknob, or being in the same room and coughing. That will not earn you the office Worker of the Year award.
  • Use tissues to blow your nose. Throw them out immediately after using them, and wash your hands.
  • Cough into your sleeve – not your hands.
  • Disinfect any surfaces you touch.
  • Wash linens, including comforters, quilts, and bedspreads, after you’ve begun to feel better.
  • Get a new toothbrush after you’re feeling better.

Cold or Flu Cheat Sheet

Still feeling confused? Check out your symptoms on our Cold or Flu Cheat Sheet, adapted from the National Institute of Allergies and Infectious Diseases.

Symptoms

Cold

Flu

Fever

  • Probably not.
  • Yes. A fever of 100°F to 102°F or higher is common; young children tend to run higher fevers. Fever generally lasts 3 to 4 days

Headache

  • Rare
  • Yes. The flu often causes headache, which can be severe.

Achiness and pain

  • A little.
  • Most of the time. Often severe

Fatigue, Weakness

  • Sometimes
  • Most of the time. Can last 2 to 3 weeks

Extreme Exhaustion

  • No.
  • Most of the time. Generally occurs when you’re first getting sick.

Stuffy Nose

  • Yes
  • Maybe.

Sneezing

  • Yes.
  • Maybe.

Sore Throat

  • Yes.
  • Maybe.

Chest Discomfort, Cough

  • Usually a mild to moderate, hacking cough
  • Yes. Cough and chest discomfort can become severe

Treatment

  • Supportive care (rest, liquids)
  • Antihistamines
  • Decongestant
  • Fever and pain control medication (Ibuprofen, Acetaminophen)
  • Supportive care (rest, liquids)
  • Antiviral medicines— see your doctor
  • Fever and pain control medication (Ibuprofen, Acetaminophen)

Prevention

  • Wash your hands often and thorouhly with soap and warm water
  • Avoid close contact with anyone with cold or flu symptoms
  • Disinfect surfaces
  • Annual vaccination
  • Wash your hands often with soap and water
  • Avoid close contact with anyone with cold or flu symptoms
  • Disinfect surfaces

Complications

  • Sinus infection
  • Middle ear infection
  • Asthma
  • Bronchitis, pneumonia
  • Chronic conditions such as diabetes, heart failure, asthma can worsen
  • Can be life threatening
  • Complications more likely in the elderly, those with chronic conditions, young children, and pregnant women

Additional Resources

Centers for Disease Control and Prevention. Influenza. http://www.cdc.gov/flu/index.htm

Centers for Disease Control and Prevention. Common Cold and Runny Nose. http://www.cdc.gov/getsmart/antibiotic-use/uri/colds.html

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