Cold vs. flu – do you have a cold or is it the flu?

We’re are on the leading edge of flu and cold season and, to dispel a common myth: the change in weather and cold weather will not make you sick!  Bacteria, viruses and a few other things (we call them all pathogens) will make you sick.

Cooler weather tends to cause runny noses. When we put a bunch of runny noses together in a classroom and they share pens, pencils, doorknobs, tables (you get the idea) they share the bad germs, including influenza (the flu) and the common cold.  Influenza and the common cold share similar symptoms, but they usually play out quite differently.

In simple terms: a cold will make you feel crummy, the flu will make you feel like you have been hit by a truck.

What causes these illnesses?

Colds are caused by many different viruses (over 200), but the most common is the rhinovirus.  With so many viruses causing colds, the common cold is … common… NOT curable.  Influenza is caused by the Influenza A or B virus and is a completely different beast.  Why does it even matter which one you have?

Who tends to get sick?

The population at highest risk for catching a cold are kids under 6 years old. However, it is not uncommon for a healthy adult to have 3 colds in a year!

If you have a weakened immune system, smoke or you spend time in crowded spaces such as a school, daycare, or airport, you are more likely to get sick.  

How is a cold spread?

You can get a cold by inhaling droplets in the air form a sick person who coughs, sneezes or talks near you.  Influenza is contracted in a similar manner.  You can also pick up these viruses from objects such as phones, keyboards and doorknobs and infect yourself by touching your nose, mouth or eyes.

What symptoms  will I have and how can I tell the difference between the flu and a cold?


With a cold you may have a low-grade fever that can last several days.  Patients with influenza usually develop a fever over 100.4F and often as high as 104F. Fevers are often accompanied by sweating and shaking chills, called rigors, that can be so severe they cause your teeth to chatter and make your muscles sore.  Fevers can be treated with tylenol and NSAIDs (medications like ibuprofen) unless you have been told not to take these), but will continue to occur until the virus is cleared from your body.


You can have a cough with a cold, but, as influenza can effect your lungs, a cough with the flu is usually deeper and more harsh.


These are common in either illness, but tend to be more common, more severe and more persistent with influenza.  

Aching muscles

The medical term for this is myalgias which occurs frequently in the back, arms and legs with influenza.  Colds rarely cause significant myalgia.  This is often the worst symptom for flu patients!  Deep, dry hacking coughs when your entire body has severe myalgia might the definition of misery.

Fatigue and weakness

While it is common to feel run down with a cold, influenza can cause severe fatigue and weakness.  Feeling run down from a cold will usually improve over several days, but the recovery is usually slower when recovering from the flu.

Nasal congestion and sore throat

These symptoms are common in colds and the flu, but as with the other symptoms, they can be more severe and last longer when caused by the influenza virus.

How long will I be sick?

The average cold, from start to feeling better will last 3-10 days.  During most of this time you may not feel great, but you’ll improve pretty quickly.  Influenza, on the other hand, will typically last 2-3 weeks.

What medications can I use?

There is no antiviral medication to treat the common cold.  Antivirals can be used to treat influenza.  If you are at risk for complications of the flu you should seek care as soon as possible after your symptoms start. Antivirals can lessen symptoms by 1-2 days and prevent complications., but need to be started early.  Antibiotics will not fix a cold or the flu!

Who is at risk for complications of the flu?

  • Children under the age of
  • Pregnant women
  • people over the age of 65 years older
  • people with underlying medical problems such as COPD, asthma, diabetes mellitus and heart disease or those who are immunocompromised.

What are the complications?

The common cold typically runs its course and gets better, but some complications can occur, including ear infections, bronchitis, bronchiolitis, and croup and these may require further treatment.

Influenza has a lot of complications and the younger or older you are and the more medical problems you have, the higher you risk fro complications. These complications are similar to those problems arising from the common cold and pneumonia which may be from the influenza virus itself or a secondary bacterial infection, inflammation of the heart, brain, or muscle, sepsis which is an extreme inflammatory response to the infection.  As well, if you have chronic medical problems, they may be made worse by severe infection, especially lung and heart problems.

When should I go to an urgent care near me, or an emergency room?

If you have any chronic medical problems or your immune system does not work you should be seen soon after your symptoms start as you may need early treatment for the flu.

You should be seen immediately if you have difficulty breathing or you are breathing fast, can’t drink enough fluids to stay hydrated, feel dizzy, don’t wake up easily or are acting normally when awake, you develop a rash, your flu-like symptoms start to improve and then you have worsening fever and cough.  Additionally, children who are not making wet diapers, tears when they cry or  can’t eat and those under 12 weeks with a rectal temperature over 100.4 should be seen immediately.

At ER Specialists Urgency Center one of our board-certified ER doctors will determine if you need IV fluids, IV pain medications, or radiologic studies to evaluate for complications and treat your symptoms.  If you require admission we will arrange that as well.

How can I avoid a cold or the flu?

Get a flu shot!  Specialists use huge data sets to try and predict which flu strains will predominate for the upcoming season and they build a vaccine based on theses predictions.

As a doctor-mom, how do I help my family avoid cold and the flu?

  • We get flu shots as soon as we can each year!  
  • WE DO NOT share water bottles, straws, utensils or anything else that touches saliva.
  • We cover our coughs and sneezes (even toddlers can learn to do this) EVERY. SINGLE. TIME.
  • Handrails and doorknobs get a quick swipe with a cleaner as frequently as possible (read: when I occasionally think about it).
  • The minute we feel a cold coming on we reach for the NeilMed Sinus Rinse and use it frequently, drink plenty of fluids and try to rest.

I am not a germ-phobe (I promise you would believe me if you saw my house), but by trying to follow these simple measures we stay remarkably healthy and stay well below the national average of three colds a year in healthy adults!

Best wishes for good health!  We’re here when you need us!