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Am Fam Physician. 2003;67(4):793-794

How can I tell if I have a cold or the flu?

Colds and the flu (also called influenza) have many of the same symptoms. A cold is generally mild, while the flu tends to be more severe.

A cold often starts with feeling tired, sneezing, coughing, and having a runny nose. You may not have a fever, or you may run a low fever (just one or two degrees higher than usual). You also may have muscle aches, a scratchy or sore throat, watery eyes, and a headache.

The flu starts suddenly and hits hard. You'll probably feel weak and tired, and have a fever, dry cough, runny nose, chills, muscle aches, severe headache, eye pain, and a sore throat. It usually takes longer to get over the flu than it takes to get over a cold.

What causes colds and the flu?

Viruses. More than 100 different viruses can cause colds. There are not as many viruses that cause the flu. That's why there is a shot to help prevent the flu but not a shot for colds.

What about medicine?

No medicine can cure a cold or the flu. Antibiotics don't work against viruses. Some medicines can help relieve some of your cold or flu symptoms. Check with your doctor before giving any medicine to children. Many cold and flu products are available without a prescription. See the box below for a guide to common ingredients in cold and flu products.

Some prescription medicines can help flu symptoms. These medicines may help reduce the severity of symptoms if you start taking them soon after you begin to get sick. These medicines come as pills or as an inhaler. The inhaled type may cause problems for some people with asthma or COPD (chronic obstructive pulmonary disease).

What is in over-the-counter cold and flu medicines?

These ingredients are found in many cold and flu medicines. Read labels carefully. If you have questions, talk to your doctor or pharmacist.

  • Analgesics relieve aches and pains and reduce fever. Examples: acetaminophen, aspirin, ibuprofen, ketoprofen, and naproxen. Warning: Children and teenagers should not be given aspirin.

  • Antitussives tell your brain to stop coughing. Example: dextromethorphan. Don't take an antitussive if you are coughing up mucus.

  • Expectorants help thin mucus so it can be coughed up more easily. Example: guaifenesin.

  • Oral decongestants shrink the passages in the nose and reduce congestion. Example: pseudoephedrine.

Should I call my doctor?

In most cases, you don't need to see your doctor when you have a cold or the flu (see box to the right). However, call your doctor if you have any of the following:

  • A cold that lasts for more than 10 days.

  • Earache or drainage from your ear.

  • Severe pain in your face or forehead.

  • Temperature higher than 102°F.

  • Shortness of breath.

  • Hoarseness, sore throat, or a cough that won't go away.

  • Wheezing.

Ways to treat your cold and flu symptoms

  • Stay home and rest, especially while you have a fever.

  • Stop smoking and avoid secondhand smoke.

  • Drink plenty of fluids like water, fruit juices, and clear soups.

  • Don't drink alcohol.

  • Gargle with warm salt water a few times a day to relieve a sore throat. Throat sprays or lozenges also may help relieve the pain.

  • Use salt water (saline) nose drops to help loosen mucus and moisten the tender skin in your nose.

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