Symptoms of Illness: Cold vs Flu
When people describe an illness as “the flu” in my office, it can mean many things. A bad cold, influenza, a gastrointestinal illness. To medical providers, “the flu” always refers to an infection with the Influenza virus. On the contrary, there are many different viruses that cause the common cold, including Adenoviruses, Parainflunenza, Human Metapneumoviruses, Rhinoviruses, and seasonal Coronaviruses (different from SARS-COV-2, the cause of COVID-19 infections).
Influenza and the common cold both cause illnesses that affect the respiratory system – the lungs and upper airways. In the United States, Influenza infection typically occurs from the Fall to the early Spring. Unfortunately, this is also the same time of year that we see an increased rate of infection from the many viruses that cause the common cold.
Symptoms
In general, infections from Influenza are much more severe than those of the common cold. Children and adults alike feel much more miserable with with the flu than they do with the common cold. While thes terms are frequently interchanged in everyday conversation, there are actually some significant differences in symptoms between the two.
| Common Cold | Influenza |
| Gradually worsens | Quickly worsens |
| Fevers are rare | Fever greater than 101F |
| Significant congestion and runny nose | Chills |
| Sneezing | Body aches, chest pain |
| Sore throat | Dry cough |
| Rarely causes serious complications | Congestion or runny nose |
| Fatigue | |
| May have serious complications |
If you are unsure if your child has the flu, if symptoms seem severe, or if you are worried about your child’s level of activity, be sure to make an appointment with your Pediatrician.
Diagnosis
The common cold is diagnosed clinically – meaning that your child’s Pediatrician will ask questions about the time course of illness and all relevant symptoms, and will do a physical exam before determining a diagnosis. Influenza can also be diagnosed clinically but there are lab tests (nasal swabs) that can confirm the diagnosis as well as determine which type of influenza is present (A or B).
Prevention
I say this every year, I will say it again now: The most important thing you can do to protect your child from the flu is to give them the flu vaccine every year. The flu vaccination is the best method of prevention of infection from the flu and potential associated complications. Receiving the flu vaccine has been shown to decrease visits to the doctor and emergency room, school absences, and hospitalization of both children and adults.
For more information about the flu vaccination, please see my previous post, Influenza, Winter’s Recurring Threat.
Unfortunately, since there are many different viruses that cause the common cold, there is no vaccination to prevent against colds. However, simple measures – hand washing, keeping children home when they are sick, and teaching them to cover coughs and sneezes and to avoid touching their faces – DO help prevent the spread of these viruses.
Treatments
Treatment of the common cold is largely symptom based:
- over-the-counter cough and cold medicines (age appropriate)
- nasal saline and sinus rinses
- fever-reducers
- pushing fluids and staying hydrated
Treatment of Influenza is also similarly symptom based, but can also include prescription antiviral medications if diagnosed within the first few days of illness. More careful monitoring for complications including pneumonia and sinus infections is also necessary with the flu.
Final thoughts
With each office visit from a sick child, there is opportunity to educate parents about illness – which illnesses we consider more severe, how high fever can be before we worry, and what symptoms are red flags of worsening illness. The distinction between the flu and a cold is one of these opportunities as well. With the continued presence of COVID-19 infections in our communities, Pediatricians are certainly seeing more kids in the office with respiratory illnesses than we would typically see. Parents, schools, and daycares are seeking reassurance regarding severity of illness more often than in years past. It is my hope that this article can help clear up a little of the confusion between these two very common respiratory illnesses in children.
This article was originally posted on Oct 23, 2021. It has been modified slightly.
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