Do I have a cold or the flu?

Hi Alice,

I've been wicked sick all week with a really bad runny nose, face pain, cough and now my right ear is hurting. I can't think!! And I am trying to study for exams!!!

My mom told me I have the flu and should go to a doctor to get medicine to treat it. But I think it's just a wicked bad cold. Can you tell me the difference?

Faucet Nose

Dear Faucet Nose,

Having either a cold or the flu may not be an ideal situation. But how do you know which is which? People often wonder if they've got the "common cold," something more serious such as influenza ("the flu"), or even pneumonia. Here are a few characteristic clues that may help you tell the difference between a severe cold and the flu:

  • Onset: A cold usually comes on gradually, over a few days, while the flu hits you like a truck. You may wake up one morning feeling awful, while yesterday, you were fine.
  • Fever: In adolescents and adults, a cold rarely causes a fever. When it comes to the flu, it frequently causes high fever (100.4°F to 104°F) usually on the higher end for young children. The fever typically lasts for three to four days.
  • Cough: Both a cold and the flu may cause a cough — for colds it's usually mild to moderate but for flu, it might become more severe and lead to chest discomfort.
  • Other symptoms: A cold usually affects just the upper respiratory system: runny or stuffy nose, sore throat, sinuses, and ears. The flu gets your whole body involved: you may have cold-like symptoms but also feel really achy and weak. These symptoms may last for two to three weeks.

Even though this information may be a place to start, it might be difficult to tell the difference based on only symptoms. If you think you may have the flu and your symptoms are less than 48 hours old, you might want to contact a health care provider. If you’re diagnosed with the flu, you’ll be able to get started on treatment (if necessary) as soon as possible. However, if you find you’re having trouble breathing, or feel short of breath with normal activity (whether with a cold or the flu), it’s best to seek out more immediate medical care.

The flu may be treated with bed rest and plenty of fluids. In certain cases you might use over-the-counter (OTC) pain relievers or you might be prescribed antiviral medication. For a cold, bed rest and warm fluids might also help, but it's possible to treat the symptoms with OTC medications such as antihistamines, decongestants, and non-steroidal anti-inflammatory drugs (NSAIDs). It’s good to note that antibiotics don't help with either colds or the flu specifically — but they may be used if you acquire a bacterial infection at the same time or aquire one that's caused by the flu or cold. To find out more, check out the Centers for Disease Control and Prevention (CDC) flu page

Of course, an ounce of prevention is worth a pound of cure. Here are a few tips to help reduce your cold and flu risk:

  • Wash your hands frequently.
  • Keep your hands away from your face (especially your nose and mouth).
  • Get a seasonal flu shot.
  • Cover your mouth and nose when sneezing and coughing using a tissue or sleeve (not your hands).
  • Use antibacterial wipes on public equipment like computer keyboards and phones.
  • Open restroom doors with a paper towel to keep your hands clean.
  • Stay home if you aren't feeling well.

Feel better soon!

Last updated Sep 12, 2019
Originally published Mar 03, 2005

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