Adult man sitting on the sofa and holding a paper tissue while sneezing
Diseases & Conditions

Cold or Flu? How to Tell Them Apart

By on 01/23/2019
Angela Nicholas, MD

Angela Nicholas, MD

You’re sneezing and you don’t feel great and you think you’ve got a fever. Is it influenza — the dreaded flu — or just a cold?

It’s not always easy to tell one from the other, says Angela M. Nicholas, MD, a family physician and medical director of Einstein Physicians Montgomery. Some of the symptoms can be similar. But, she says, the flu comes on fast, and it’s much worse.

Typical symptoms of both colds and flu include sneezing, a stuffy head, sore throat and cough.

“But how hard they hit and how long they last usually can help you sort out which one you have,” Dr. Nicholas says. “Typically, with a cold, it’s a couple of days of starting to get symptoms. Sometimes you get a little bit of a low-grade fever, around 100.

“Typically, you can do some of your normal activities. And after about three to five days of over-the-counter medicine, usually you’re starting to feel better.”

The flu doesn’t let you off so easy.

“Flu typically hits you like a train,” Dr. Nicholas says. “It is abrupt onset. There is usually a fever, and it’s usually 101, sometimes higher. You get severe aches, headache, feeling seriously unwell.

“You can’t drag yourself out of bed to go to work. In some cases, you can barely get yourself dressed to even go to the doctor because you feel so unwell.”

Influenza also lasts longer, she says. “With a cold, usually five to seven days are the worst of it. Influenza can last seven to 10 days.”

If those flu symptoms sound like what you’re feeling, get to the doctor right away. Antiviral medicines can reduce the amount of time you feel sick, Dr. Nicholas says, but they need to be given within two days after your symptoms start.

And if you’re feeling fine, the best thing you can do is go to your doctor’s office and get a flu shot, Dr. Nicholas says. “It’s not too late to get a flu shot because influenza can last into the late spring months.”

You can also get the shots at many pharmacies and walk-in clinics.

Of course, no vaccine is perfect. Flu shots don’t always prevent the flu because the vaccine may not perfectly match the strains of flu that are circulating in a particular year, Dr. Nicholas says. But the shots do reduce the odds that you’ll get the flu. And your symptoms may be milder if you do get sick, the U.S. Centers for Disease Control and Prevention says.

“You know, I think there are a lot of people that choose not to get flu shots because they, quote, don’t ever get the flu,” Dr. Nicolas says. “And unfortunately, their number will be up at some point for most people, and they regret it. They’ll come in the next year and say, ‘Oh, I don’t want to get that again.’”

Some people also have heard that flu shots cause flu, but this is not true, Dr. Nicholas says. “If you get the flu shot and you feel a little bit tired or achy for a couple of days, that’s your immune system recognizing a foreign body and creating the antibodies necessary to fight the flu off the next time it sees that virus. That’s a good thing. That means that the flu shot is able to do its job.”

Getting a flu shot protects more than just you, Dr. Nicholas notes. It also helps to keep the virus from spreading in your community and your family. And that helps to protect babies under age 6 months, people with compromised immune systems, people getting chemotherapy for cancer, and others who are not able to get flu shots.

By the way, if you checked your symptoms and what you’ve got sounds like just a cold, let’s hope you get well quickly.

But if you’re not feeling better after a week to 10 days, you probably should call your doctor, Dr. Nicholas says.

Both colds and flu are caused by viruses. But if they linger, they sometimes open the door to something called a bacterial superinfection. In that case, you may need antibiotics, Dr. Nicholas says. “So, if you’ve had these symptoms for 10 days, you really do need to let us know about it.”

Do you need a flu shot? Or do you think you have the flu? Make an appointment with an Einstein doctor.

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Perspectives highlights the expertise and services provided by the physicians, specialists, nurses and other healthcare providers at Einstein Healthcare Network. Through this blog, we share information about new treatments and technologies, top-tier clinical teams and the day-to-day interactions that reinforce our commitment to delivering quality care with compassion. Here, you will also find practical advice for championing your health and wellness. The Einstein Healthcare Network "Terms of Use" apply to all content on this blog.