A Cold or The Flu? How to Tell the Difference

Cold vs. Flu: Does It Matter?

Cold vs. flu viruses, a microscopic view.

The common cold and the flu (influenza) are both types of upper respiratory infections. Many people think they are treated the same way but this is not the case.

Flu symptoms are usually much worse than common cold symptoms, and the flu can lead to serious complications including pneumonia, bacterial infections, and even death. There are some antiviral flu treatments available that can help you feel better and reduce the time you are sick, but they work best when taken within the first 48 hours of the illness. There are special tests available to determine whether you have the flu so your doctor can prescribe the right treatment for you.

Cold and Flu Symptoms: Fast or Slow?

A woman suffering from the symptoms of the flu.

One way to determine if you have a common cold versus the flu is that flu symptoms are usually much more severe. The flu hits you fast and hard and affects your entire body. Symptoms such as fever, body aches, extreme fatigue, and dry cough are more intense with the flu. Flu symptoms may start to improve in 2 to 5 days, but you may feel run down for a week or more.

Common cold symptoms are more minor and often begin with a sore throat, and include a runny or stuffy nose. Most symptoms tend to be above the neck. Cold symptoms come on gradually and usually last about a week.

Is Fever a Cold or Flu Symptom?

A woman sick in bed with a fever caused by the flu.

Fever is less likely to accompany a common cold. If there is a fever, it is usually mild. Children may be more likely to have a fever as a common cold symptom.

On the other hand, with the flu, most people will experience a fever of 100-102 degrees or higher, especially in children. However, not everyone will develop fever as a flu symptom.

Is Long-Lasting Fatigue a Cold or Flu Symptom?

A fatigued woman suffering the symptoms of a cold or flu.

When you have a cold, you may feel tired and achy, but the symptoms are usually mild and will resolve within a few days.


How Long Does Flu Fatigue Last?

With the flu, symptoms like body ache, fatigue, and weakness are more severe and can last up to a week or two. The elderly and people with chronic illness may have symptoms of fatigue linger even longer.

Is a Headache a Cold or Flu Symptom?

A man with a headache suffering from cold and flu symptoms.

Headache can be a symptom of both a cold and the flu. However, headaches only occasionally occur as cold symptoms but are a common symptom of the flu. And like most symptoms, headaches that accompany the flu tend to be more severe.

Is a Cough a Cold or Flu Symptom?

A young woman suffers from a cough, a symptom of a cold and the flu.

Both the common cold and the flu are types of upper respiratory infections and both cause coughing. With the common cold, the cough symptom may be productive at first but then turn dry and hacking. Cough is a common symptom of the flu. A cough with the flu tends to be dry and can be severe.

A complication of the flu is pneumonia, which can make people very sick, sometimes requiring hospitalization. If your cough doesn't go away, you cough up yellow-green or bloody mucus (phlegm), you develop a fever over 102 degrees with chills, have shortness of breath or difficulty breathing, call your doctor.

The elderly, young children, people with chronic illness, people with compromised immune systems, and pregnant women are at highest risk of flu complications.

Are Earaches a Cold or Flu Symptom?

A woman is in pain suffering from an earache, a symptom of a cold and the flu.

Another symptom that can occur in both a cold and the flu is earaches. Both illnesses can cause inflammation of the eardrum and the Eustachian tube that connects the throat and middle ear. The pain may be dull, sharp, or burning but if the earache is related to the cold or flu it will go away on its own.

In some cases, a secondary infection will occur in the ear. It may feel similar to the pain when you had the cold or flu, but often this pain comes on more suddenly and is much more sharp and intense. See your doctor if the earache outlasts your illness to get treatment for an ear infection.

Is a Sore Throat a Cold or Flu Symptom?

A woman suffering from a sore throat, a symptom of a cold and the flu.

One of the first signs of a cold is a sore throat. This usually lasts a couple of days and then progresses to a runny and stuffy nose. You may also have a sore throat if you have the flu, but if you have the flu you will have other symptoms that come on at the same time that affect your whole body including fever, body aches, and fatigue.

Is a Stuffy Nose a Cold or Flu Symptom?

A man sick in bed with a stuffy nose has a cold.

A runny or stuffy nose is typically a symptom of a cold. If you have a runny or stuffy nose and don't feel like you've been hit by a ton of bricks you probably have a cold. Occasionally people with the flu will have nasal congestion too, but it would also be accompanied by flu symptoms of fever, body aches, and fatigue.

Sinus infections are a complication of both colds and the flu. Symptoms of a sinus infection include a feeling of pain, pressure, or fullness in the face, around your cheekbones, the bridge of your nose, behind your eyes, and in your forehead. See your doctor to determine if you have a sinus infection and to get treatment.

Swab Test for the Flu Virus

A nurse performing a flu swab test on a young woman.

The only sure way to know if you have the flu is through a test done at the doctor's office within the first couple of days of the onset of symptoms. Rapid influenza diagnostic tests can give results in about 30 minutes. If you have the flu, your doctor may prescribe antiviral medications to help relieve symptoms and shorten the duration of your illness.

Should I Take Antibiotics for a Cold or the Flu?

A man reading the box of anti-viral flu medication.

As both the cold and flu are caused by viruses, antibiotics are useless to stop them. In some cases, however, a doctor may prescribe antiviral medications for the flu. If your doctor diagnoses you with the flu and decides antiviral medication will help you, you need to start taking the medications within 48 hours of the onset of your symptoms. Starting them later may still be helpful, especially in people who have a high risk of developing complications from the flu. Take all medications as directed.

The Best Over-the-Counter Medicine for a Cold or Flu

Over-the-counter cold and flu medicine.

There are many medications available over-the-counter (OTC) to help relieve symptoms of both colds and the flu.

Effective OTC Medicine for Cold and Flu

  • Decongestants
  • Cough suppressants
  • Antihistamines
  • Pain relievers (this includes acetaminophen [Tylenol], ibuprofen [Advil, Motrin], or naproxen [Aleve])

Before taking any OTC medications, read the ingredients as many are combination products and may contain the same ingredients.

Children under 18 should not be given aspirin; it has been linked to Reye syndrome, a rare but serious illness that affects the brain and liver.

Don't Get Sick This Flu Season, Wash Your Hands

A little girl washing her hands to stop cold and flu virus.

Hand washing is one of the best ways to prevent the spread of colds and the flu. Wash your hands frequently and thoroughly with regular soap and water, and scrub for at least 20 seconds. If you don't have soap, use an alcohol-based sanitizer that contains at least 60% alcohol. Apply at least a dime-sized amount of sanitizer and rub into hands until dry – do not wipe off. Avoid touching your eyes, nose, or mouth if your hands are unwashed.

During cold and flu season it is important to wash hands frequently, especially after you cough, sneeze, or blow your nose. Don't sneeze or cough into your hands. Get a tissue, or sneeze or cough into your upper shirtsleeve or elbow, covering your mouth and nose.

Get a Flu Shot

A pharmacy sign advertises flu shots to prevent the flu virus.

Get a flu shot. It's made from harmless versions of the flu virus, and it helps your body recognize and fight when you're exposed to the real thing. Despite what you may hear, the flu shot doesn't give you the flu.

It's especially important for children older than 6 months, pregnant women, adults older than 50, and people with long-term (chronic) illness or weak immune systems to receive a flu shot.

Healthy children 2 years and older and healthy adults under 50 who aren't pregnant can opt for the nasal mist vaccine.

Swine Flu (H1N1): Still a Threat?

A family wearing masks to protect against Swine flu.

Swine flu is a type of respiratory disease of pigs caused by the influenza A virus. It generally does not affect humans, except in rare instances like the recent swine flu pandemic (world-wide epidemic). The swine flu pandemic ended in 2010, though current vaccines still protect against swine flu and seasonal flu.

Swine flu symptoms are similar to seasonal flu symptoms and include cough, sore throat, fever, and body aches. Nausea, vomiting, and diarrhea are also symptoms of swine flu.

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REFERENCES:

  • American College of Asthma, Allergy and Immunology: "Sinus Infection"
  • CDC: "Flu Symptoms and Severity", "Cold Versus Flu", "Common Colds: Protect Yourself and Others", "What You Should Know About Flu Antiviral Drugs", "Diagnosing the Flu", "When to Use Hand Sanitizer", "Preventing Seasonal Flu with Vaccination", "Flu Treatment"
  • HealthyChildren.org: "Ear Infection Symptoms"
  • Flu.gov: "Symptoms of the Flu", "Flu: Treatment"
  • National Jewish Medical and Research Center: "Is It a Cold or the Flu?"
  • UpToDate: "Clinical Manifestations and Diagnosis of Influenza in Adults," "The Common Cold in Adults: Diagnosis and Clinical Features."
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