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Could that sniffle or scratchy throat be the start of a cold or the flu? Here’s how to tell the difference between the two — and how to feel better, faster.
A little under the weather? It could be a common cold. Or it could be influenza, otherwise known as the flu. Both are caused by a virus, and both can spread like wildfire. Cold and flu season kicks into high gear during the winter, when more people head indoors.
Each year, millions of Americans catch the common cold — it’s the No. 1 reason for missing school or work. No wonder it’s called common: The average adult comes down with 2 to 3 colds a year.
You’re likely to catch the flu only a couple of times a decade. But if you get it, it can knock you off your feet. Millions of people get sick with the flu every year, according to the Centers for Disease Control and Prevention (CDC). And some of them end up in the hospital.
But a diagnosis can be tricky. “The symptoms for colds and flu can be almost exactly the same,” says Samuel Mathis, MD. He’s on the board at the American Academy of Family Physicians. “With the flu, though, you’ll probably feel a lot worse.”
Read on to learn about the symptoms and treatments for colds and flu — and how to tell the difference between the two.
The common cold is usually caused by a rhinovirus. “Rhino” means “nose,” and that’s where this tiny virus likes to hang out. It affects your upper respiratory system (nose, mouth and throat). There are more than 200 different viruses that cause colds, according to the Cleveland Clinic.
Colds can come on gradually. Symptoms of a common cold include:
Colds are super contagious. They spread through coughs and sneezes. You can catch a cold when you breathe in tiny drops of the cold virus launched into the air or when you touch droplets that have landed on surfaces.
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Like the common cold, the flu is a respiratory illness that affects your nose, throat and sometimes even your lungs. It’s caused by influenza viruses. That’s different from the rhinoviruses or other viruses that cause the common cold. And the flu hits you from out of nowhere.
“One of the key differences is that flu symptoms tend to be more intense and come on suddenly, in just a few hours,” says Dr. Mathis. You’re more likely to have a fever. And it should respond to fever-reducing medications like acetaminophen (Tylenol) or ibuprofen (Advil). “And with really severe flu, you might have breathing trouble or confusion,” says Dr. Mathis.
It can even be hard for your doctor to tell the difference. They may sometimes send you for a lab test to be sure. Per the CDC, the signs of the flu include:
You can get the flu at any age. But people over age 65 and those with conditions such as diabetes, heart disease or asthma have a higher risk of developing serious complications.
(Could your symptoms mean you have COVID-19 instead? Learn more here.)
Yes. For the flu, ask your doctor about the prescription medication Tamiflu (oseltamivir). It works by keeping the flu from multiplying in your body, according to the U.S. Food and Drug Administration (FDA). But you need to start taking it in the first couple of days after symptoms appear for it to be effective. It comes in pill or liquid form.
There’s no prescription medication that can treat a cold. But there are over-the-counter (OTC) remedies that can help ease the symptoms and make you feel better. Whether you’ve got a cold or the flu, try these:
Be sure to check with your doctor first to make sure it’s right for you. And don’t forget your pharmacist. They’re a great source of practical information.
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Don’t forget about the treatments your mom may have given you as a kid, says Kathryn Boling, MD. She’s a family physician with Mercy Personal Physicians at Lutherville in Maryland. Try some of these tried-and-true home remedies to ease your symptoms:
With a cold, most people feel better in 7 to 10 days. But sometimes a cold can turn into a big problem. For those with conditions such as asthma, a weakened immune system or lung issues, a cold can lead to a more serious illness, such as pneumonia.
When should you call your provider if you have a cold? If your symptoms last longer than 10 days or you have a fever for 3 days and it’s not responding to fever reducers, it could be more than the common cold.
The aches, pains and fevers of the flu start to feel better after about a week for most people. But the cough and fatigue can last for more than 2 weeks. This is especially true if you have a chronic lung condition such as asthma or chronic obstructive pulmonary disease (COPD).
“All viruses can cause inflammation that drags on for a while,” Dr. Boling says. “You might have a cough or feel really tired for a while.”
But keep your doctor in the loop if your illness gets worse or lasts longer than a week. Be on the lookout for signs of severe illness. “You don’t always need to go to the doctor for the flu,” says Dr. Mathis. But if you develop a fever over 103° F — or if your fever lasts longer than 3 days — go in and get checked.
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Getting your annual flu shot is the best way to protect yourself from getting sick. According to the CDC, flu vaccination prevents millions of illnesses and doctor visits each year. In 2019-20, the vaccine prevented 7.5 million flu cases, 105,000 hospitalizations and more than 6,000 deaths.
You can still get the flu even if you’ve had a flu shot, but your case will likely be milder. The flu shot is safe and effective for all adults and for kids 6 months and older. It’s the best way to protect yourself and the people you love.
Your flu vaccine does wear off over time, and the flu virus changes every year. That’s why you need to get a new shot each fall. Experts recommend getting a flu shot in September or October. You can get one at your doctor’s office, health clinic or local pharmacy.
(By the way, if you’re not caught up on your COVID vaccines/boosters, now is the time. You need both shots to protect yourself from illness. And it’s perfectly safe to get them at the same time.)
The best way to avoid colds and flu is to follow a healthy lifestyle. Experts say these habits are key:
Bottom line: Following healthy habits can keep you germ-free this fall.
Samuel Mathis, MD, family doctor in Galveston, Texas; board member for the American Academy of Family Physicians
Kathryn Boling, MD, family physician with Mercy Medical Center in Lutherville, Maryland
Flu stats: Centers for Disease Control and Prevention (2021). “Frequently Asked Questions about Estimated Flu Burden”
Rhinovirus: Cleveland Clinic (2020). “Common cold”
Decongestants and high blood pressure: American Heart Association (2017). “Understanding Over-the-Counter Medications and High Blood Pressure”
Flu symptoms: Centers for Disease Control and Prevention (2021). “Key Facts about Influenza.”
Tamiflu: U.S. Food and Drug Administration (2017). “Tamiflu: Consumer Questions and Answers.”
Activity guidelines: U.S. Department of Health and Human Services (n.d.). “Physical Activity Guidelines for Americans, 2nd edition”