Cold vs. Flu

Monday, November 24, 2014

What's causing your coughing and congestion? An NCH expert explains

With influenza season in full swing, you'll probably find yourself asking at least once this winter: Is it a cold or the flu? Here's how to tell the type of illness you might have, plus advice on when to seek medical attention.

How to Tell the Difference

The flu and the common cold are respiratory illnesses caused by viruses. Although they have similar symptoms, a few clues point to the flu.

"Fever is one big difference. The flu almost always causes fever that hovers around 101 degrees," says Heidi Chatham, MD, a family medicine physician at NCH Medical Group. Additionally, the flu usually comes on suddenly, while a cold often progresses from a sore throat to nasal symptoms, runny nose or congestion.

Although colds and the flu share some symptoms—cough, sore throat, congestion—flu symptoms are typically much worse and can include muscle aches, headache, chills and fatigue.

The flu can lead to serious complications, such as pneumonia, bacterial infection and hospitalization. Dr. Chatham says this is especially true for high-risk patients, including children younger than 5; adults older than 65; patients with health conditions such as asthma, diabetes and congestive heart failure; and pregnant women.

When to Call the Doctor

The flu can be treated within 72 hours of the first signs of sickness using antiviral drugs that lessen symptoms and duration. It's important to see a doctor if you have the following:

  • Persistent fever
  • Problems swallowing
  • Coughing and congestion
  • Persistent headaches
  • Trouble breathing due to coughing and congestion, especially when lying down
  • Difficulty keeping food down
  • Dehydration

Dr. Chatham acknowledges that it can be tricky to tell the difference between a cold and the flu. She encourages her patients to err on the side of caution. "It's never wrong to be evaluated," she says. "Even if it's 'just' a cold, we can prescribe inhalers and cough medicines to help."

When It's an Emergency

Some symptoms warrant immediate treatment, including:

  • Severe chest pain
  • Severe headache
  • Shortness of breath or difficulty getting enough air
  • Dizziness
  • Confusion
  • Persistent vomiting
  • Blue lips, especially in children

Seniors should be especially alert. During a regular flu season, about nine in 10 flu-related deaths occur in people 65 and older.

Expert Care

Heidi Chatham, MD

Family medicine physician at NCH Medical Group

  • Medical school: Central America Health Sciences University
  • Residency: Hinsdale Hospital
  • Board-certified: Family Medicine
  • Heidi Chatham


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