Is It a Cold or the Flu? How to Tell the Differenceby James Hubbard, MD, MPH

One reason colds and the flu spread during winter is the same reason they’ll spread during a disaster: There are lots of crowds. Respiratory infections don’t care whether you’re in an emergency shelter after a flood or a crowded mall the week before Christmas; they’re just thrilled about the opportunity to multiply.

As such, it’s a good idea to be able to differentiate a common cold from the full-blown flu. Why? Because usually with a cold, you get over it no matter what you do. The flu can be different, and the complications can be deadly.

Cold Vs. Flu: What It Feels Like
2 Ways to Catch Them

You can catch a cold or the flu in two ways:

1. Through the air: Both cold and flu viruses are airborne. They float in the air after someone who has the virus coughs or sneezes, and you breathe it in. Your nose hairs and mucous lining catch many of the viruses, allowing antibodies to kick in and destroy them, but some sneak through. You’ve still got antibodies in your blood to fight them off, but the more you’re exposed, the more likely you are to get the illness.

2. Through touch. Another common way of getting sick is by touching a common object, such as a doorknob, after someone has sneezed into their hand and touched it. You then inadvertently touch near your mouth or nose (all of us do it many times a day without noticing), and the virus is introduced.

With a common cold, you feel bad and maybe have the sniffles, sneezing, and mild muscle aches and fever. No matter what you do, it runs its course in a few days without serious complications.

I often tell patients that if they wonder whether they have the full-blown flu, they probably don’t. Because the flu hits you like a ton of bricks. You often ache so badly you feel like someone has beaten you with a club. Your fever can easily climb to 102, 103, or more for several days to a week. Often, nothing tastes good, and all you feel like doing is staying in the bed.

And rightly so. Many people die each year from the flu, and those who don’t rest and take care of themselves are more likely to have complications, such as pneumonia. Babies; elderly people; and people with chronic diseases, heart problems, or diabetes can be hit especially hard.

Prevention How-Tos

Click here for my previous post on study-proven cold preventions and treatments.

If the flu is going around, stay out of crowds as much as you can. (Colds are always going around.)

For colds or the flu, wash your hands frequently, and consider carrying disinfecting wipes or waterless hand sanitizer. If you’re in a crowd and can’t get away from the sick folks (like in a disaster relief center), and especially if the flu is going around, consider wearing an N95 mask. (You can search on to see samples.) This does a much better job of screening out tiny viruses than a regular surgical mask or a scarf.

A healthy diet and plenty of rest helps prevent viruses too.

Wondering about the flu shot? See my previous posts on that here:

Note: The link is an affiliate link.

Treatments for Colds and the Flu

Colds: As I noted, colds run their course. For the mild fever and aching, some acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve) can help. A decongestant can relieve a stuffy nose. Dextromethorphan or guaifenesin can help the cough; honey (though not for babies) is just as good or better. For a rundown on natural remedies proven to work on the cold, click here.

Flu: With the flu, rest is essential to help your body fight it off. Drinking a lot of fluids is important also. Why fluids? With the flu, nothing tastes good. Combine that with your misery index, and you tend not to eat or drink much. Now eating is good—it gives your body energy to fight off the virus—but drinking fluids is a must. Otherwise, you’ll quickly get dehydrated. And none of your organs perform efficiently when you are. Being hydrated also helps keep your airways from drying out and thins the mucus so you can get it out if needed.

If you can’t drink fluids, have concerns, or have one of the risk factors noted in the previous section, see a doctor. Pneumonia and other illnesses are going around at the same time as the flu. And there are prescription medicines that can decrease flu symptoms and shorten the course by a day or two, but you have to start one within 48 hours of onset.

You definitely need to get to a doctor if you:

  • Are not urinating and not drinking fluids
  • Are confused or so lethargic you can’t wake up, say, to go to the bathroom
  • Have shortness of breath
  • Have severe headaches or a stiff neck
  • Have new symptoms, such as sore throat, or an earache, or if you seem to be getting better and suddenly start getting worse (you may have a secondary infection that requires antibiotics)

If you absolutely can’t get expert help, you’ll need to rest, drink fluids, and try to eat. And watch out for these four common secondary infections. (The list above includes some clues to these and other complications.)

  1. Pneumonia
  2. Meningitis
  3. Ear infection
  4. Strep throat


What about you? Do you agree with the difference in symptoms of a cold vs. the flu? Have you ever had complications from the flu? How were they treated?

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