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Is it a Cold or Flu? How to Tell and Get the Right Care

By Melissa Pandika | February 4, 2019 | Rally Health

It’s still the season — cold and flu season, that is. The drop in temperature during the fall and winter months typically brings a spike in cold and flu cases. And this year is no different. The flu has already sickened six to seven million Americans, around half of whom went to the doctor. But how do you know when it’s a cold or flu, and when to seek help?

For most healthy people, a cold or flu may make make you feel miserable for a week or two, but it usually clears up on its own, eventually. But for young children, seniors, and people with health conditions, the flu can pose serious health threats.  And even among the healthiest adults, it can sometimes lead to something more serious. That’s one reason getting the flu vaccine is so important. It’s the best way to protect not only yourself, but the most vulnerable in your community, from the flu. If you haven’t gotten one this year, it’s not too late!

We spoke to experts about how to tell whether you have the cold or flu, and whether you should rest and recover at home, or if a visit with your doctor is in order.

How to tell if it’s a cold?

Cold symptoms tend to develop gradually. “If it’s something slowly worsening over a couple of days, it’s most likely a cold,” says Sterling N. Ransone Jr., a practicing family physician in Virginia.

Cold symptoms often include:

  • Stuffy or runny nose.
  • Sneezing
  • Cough
  • Sore throat
  • Headache
  • Muscle pain and body ache

How to tell if it’s the flu?

You can’t definitively tell whether it’s a cold or flu without a lab test from your doctor, but you usually don’t need a test like that. There are signs and symptoms that will help you make an educated guess. A big difference between the common cold and the flu is that the flu tends to appear all of a sudden. “It’s abrupt, and it comes on in a day or two,” Ransome says. And the symptoms, are typically more severe. Either a cold or the flu can cause a stuffy nose, cough, or sore throat, but flu is more likely to bring muscle pain, chills, and extreme fatigue. And while a fever can occasionally result from a cold, it more commonly occurs with the flu, Ransone says. “Does the hair on the back of your arm hurt?” Ransone says. “If it does, that’s the flu.”

Flu symptoms often include:

  • Fever or chills
  • Runny or stuffy nose
  • Cough
  • Sore throat
  • Fatigue or tiredness
  • Headache
  • Muscle pain or body aches in the arms, legs and back.

How to feel better

There’s no cure for a cold or the flu. To feel better, you’ll need lots of rest and fluids. Symptoms typically subside on their own within a week or two. But there are some medications that can help make that time feel less crummy. If your symptoms are mild you might make do with over-the-counter drugs like acetaminophen (Tylenol) or ibuprofen (Advil), for pain and fever. But read the labels and don’t take multiple drugs with acetaminophen, which is often an ingredient in combination products like Excedrin and Theraflu. A decongestant or antihistamine can help ease a stuffy or runny nose (pregnant women and those with high blood pressure should avoid any that contain pseudoephedrine).

Aspirin is also an option for adults, but not for kids. Infants under 6 months should stick to infants’ acetaminophen (talk to your pediatrician about dosing). Older kids can be given children’s or infants’ acetaminophen or ibuprofen. Use a saline solution to help with kids’ stuffy noses.

When should you see a doctor?

If the options above don't provide enough relief, a virtual appointment may be a good idea, says Isabel Valdez, a physician assistant and instructor of general internal medicine at Baylor College of Medicine. Your doctor may be able to suggest an over-the-counter medication. Matthew Thompson, a professor of family medicine at the University of Washington School of Medicine and a family practitioner at the UW Northgate Neighborhood Clinic, recommends virtual appointments for cold symptoms in particular. In most cases, doctors simply end up reassuring patients that their respiratory symptoms aren’t signs of something worse.  

“We can usually make those judgments without even listening to your chest, but by a description of your symptoms and whether you’ve had problems in the past with chronic bronchitis,” Thompson says. “For many patients, we’re able to do this virtually.”

For the most part, “young, otherwise healthy people who have a mild case of the flu and may have been vaccinated already will fight it off just fine,” he says.

Valdez suggests scheduling an office visit if you have a fever above 101 degrees that rebounds a few hours after taking a fever reducer, accompanied by body aches, which point to the flu. “Try to get to a doctor within 24 to 48 hours” so you can take a flu test, Valdez says. If you test positive, your doctor can prescribe an antiviral medication that, when taken within 48 hours of the first appearance of your symptoms, can reduce the length of your illness, and potentially the risk some flu-related complications.

If you are at high risk for flu complications and experience body aches, fever, or any other flu symptoms, call your doctor ASAP. Groups at high risk for flu-related complications include young children, seniors, pregnant women and new mothers, American Indians and Native Alaskans, nursing home residents, people who have a chronic health condition, such as asthma, severe obesity, neurological conditions, blood disorders, lung disease, heart disease, liver disorders, and people with a weakened immune response.

If your community is in the midst of a flu outbreak, you are not at high risk of complications and you think you might have the flu, Ransone encourages a virtual appointment instead of an office visit. “I would rather you stay home and get well, and not spread it to other people.”

An existing relationship with a primary care doctor can come in handy for these more worrisome symptoms. “The first thing I always tell folks to do is call my office,” Ransone says. Calling your primary care doctor allows him or her to determine whether you should seek urgent or emergency care. If so, he or she can alert the urgent care or ER staff of your visit, as well as your symptoms, ahead of time. As a result, “the visit is a lot more streamlined.”

The Centers for Disease Control and Prevention (CDC) recommends that you consider avoiding the emergency room unless you are very sick and have the emergency warning signs of flu sickness (see below). If you have a mild case of the flu, the CDC advises you stay at home until you've gone 24 hours without a fever. If you have flu symptoms and are at high risk of flu complications or have other concerns about your illness, call your health care provider for advice. An unnecessary trip to the emergency room could distract clinicians from severe cases — and compromise your own health in the process, says Sandra Fryhofer, who practices internal medicine in Atlanta. “Think about it. If it’s flu season, and you don’t have the flu, and you go to the ER and are around a bunch of sick people, you could leave with the flu.”

When should you seek emergency care?

Some symptoms warrant more serious attention. According to the CDC you should seek emergency care if you experience any of these symptoms.

Emergency symptoms in adults:

  • Difficulty breathing
  • Shortness of breath
  • Chest pain or tightness
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting
  • Flu-like symptoms improve, but come back with a fever and worsened cough

Emergency symptoms in infants and children:

  • Fast breathing or troubled breathing
  • Bluish skin color
  • Not able to keep down fluids
  • Trouble waking up or not interacting with others
  • Irritability, not wanting to be held
  • Flu-like symptoms improve, but come back with a fever and worsened cough
  • Fever with a rash

Additional emergency symptoms for infants include:

  • Inability to eat
  • Trouble breathing
  • Crying without tears
  • A significant decrease in wet diapers

What about stomach flu?

Contrary to the name, the stomach flu, which also picks up in winter, isn’t actually a flu. The flu — aka influenza — is caused by several different viruses that infect the respiratory system. Meanwhile, the stomach flu — aka gastroenteritis — which can be caused by viruses, bacteria or parasites, triggers inflammation of the intestinal lining.  Flu symptoms tend to primarily affect the upper airways, Valdez says, while the stomach flu “will probably just hit you from the gut down.”

If you have the stomach flu, you may experience:

  • Abdominal pain
  • Nausea
  • Vomiting
  • Diarrhea
  • Fever
  • Chills
  • Headache
  • Body Aches

Viral gastroenteritis typically lasts up to a week, Ransone says. He recommends an office visit if you’ve had loose stools for longer than that, which may indicate something else, like food poisoning. Also consult your doctor if you notice blood in your stool or vomit, says Teresa Everson, a family medicine doctor and associate professor at Oregon Health and Science University.

If you’re sipping teaspoons of water but vomiting much more than that, head to an urgent care facility or ER immediately, Valdez says. The same goes for passing more liquid through your stool than you’re drinking, notes Everson. You may be dehydrated and need to receive fluids through an IV.  

How to find a primary care doctor

In most cases of the cold or flu, if you need to consult a doctor, a virtual or office visit with your primary care doctor will suffice. Don’t have a primary care doctor? Take the time to find one now. A primary care doctor, especially one with whom you have a strong rapport, can help you stay healthy and quickly spot anything that may need treatment, and direct you to good specialty care, if needed.

For more on finding great primary care, check out our guide, How to Choose a Primary Care Provider.


Copyright © 2019 Rally Health, Inc. All rights reserved.

Melissa Pandika
Rally Health