How To Tell The Difference Between A Cold And The Flu

Cold and flu season runs from November to March.  We see hundreds of patients each week who want to know if they have a cold or the flu, what symptoms to look for, and how the treatment differs between these two types of infections.

1)  Severity of symptoms

The symptoms of influenza are typically more severe than other viral upper respiratory infections (aka, common colds.)  While colds can cause mild congestion, sore throats and coughs, the symptoms of influenza are both severe and serious. Influenza causes secondary complications like pneumonia, dehydration, organ failure and pregnancy complications.  In the U.S., there are hundreds of thousands of hospital admissions and tens of thousands of deaths each year related to the flu.

2) Onset of symptoms

The symptoms of the common cold tend to develop gradually, reaching their peak after a day or two.  Influenza, on the other hand, comes on rapidly. Often patients know the minute they came down with the flu because the onset of their symptoms was so sudden.

3)  Fever

A fever is defined as a temperature 100.4 F or above.  In adults, colds rarely cause fevers, but influenza often causes significant fevers that may run as high as 104.0 F.  If you don’t have a true fever, the likelihood that you have the flu is very low.

4)  Gastrointestinal symptoms

The common cold causes upper respiratory symptoms, including nasal congestion, ear pressure, sore throat and cough.  The flu, on the other hand, affects more than the respiratory tract. In addition to causing significant headaches and body aches, influenza can also involve the GI tract, resulting in nausea, vomiting and diarrhea.  

5)  Prevention

Washing your hands, eating a nutritious diet and getting at least seven hours of sleep a night can help decrease your risk of contracting the common cold as well as influenza.  In addition, the flu shot is an effective way to prevent influenza. Flu shots keep millions of people from contracting the flu each year, prevent hospitalizations, lower the risk of flu-related complications, and save lives.

6)  Treatment options

Many patients are disappointed to hear that there’s no cure for the common cold, except giving your immune system the time it needs to fight the virus (which takes 7-10 days on average).  Treatment options for the common cold are called “supportive,” which means they don’t cure the virus, but they can alleviate the symptoms it causes. Decongestants like Sudafed can alleviate congestion.  Menthol lozenges can soothe sore throats and coughs. And honey can alleviate coughs as well. (Click here to learn about five over-the-counter medicines that aren’t effective).

On the other hand, there is a specific treatment for influenza called Tamiflu that resolves symptoms faster and helps to prevent influenza-related complications.  Tamiflu works best if its started within the first 48 hours of the illness, so if you think you have the flu, it’s wise to be seen as soon as possible.


At Golden Gate Urgent Care, we have six Bay Area locations, open seven days a week, to care for you.  Schedule an appointment online or simply walk in to get a flu shot, or receive the medical attention you need.

Sarah Thebarge MMSc, PA-C Sarah Thebarge earned her physician assistant degree at Yale School of Medicine, and then studied journalism at Columbia School of Journalism. She has been a physician assistant and a freelance journalist since 2004. In addition to caring for patients at Golden Gate Urgent Care, Sarah frequently volunteers her medical skills in the developing world. Her writing has appeared in Huffington Post, USA Today and National Geographic, and her blog was featured on She is the author of the memoir The Invisible Girls and the upcoming book WELL: Healing our Beautiful, Broken World from a Hospital in West Africa. She currently lives in the Mission District of San Francisco.

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