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Difference Between a Cold and a Flu
February 2000

Q. How can I tell if I have a cold or the flu? Is there any decent treatment for the flu?

A. The common cold is usually caused by a rhinovirus, which typically causes a runny and stuffy nose, sore throat and sometimes cough. A cold is self-limited (gets better on its own) and rarely causes serious complications. Plenty of oral fluids, rest, and Tylenol as needed can be helpful.

The flu, or influenza A or B, is a virus that causes more severe symptoms and sometimes deadly complications. Typical flu outbreaks usually occur in the late fall or early winter. Symptoms usually include fever, chills, headache, muscle or joint aches, sore throat, cough and fatigue. The symptoms can last from about 3 to 10 days. Most younger patients can weather the illness fairly well and it too is usually self limited. However, one who has a weaker immune system, and/or the elderly, can suffer quite a bit.

The most common complication is pneumonia, which is a lung infection. This may be caused by the flu virus itself or by a secondary bacterial infection such as strep. Antibiotics should be used when pneumonia is present. Several thousand deaths in the US each year are due to the flu.

Fortunately, there are now 2 new medications that are FDA approved for treatment of flu: Relenza (an inhaler) or Tamiflu (a pill). Both have been shown to decrease the severity and length of flu symptoms. They reportedly have few side effects, mostly similar to placebo. On average, the medication will decrease the length of illness by one day. This is far from a panacea, but when one is able to return to work, or take care of their kids, even one day earlier, it may be a significant benefit. Both treatments must be started within 48-hours of the onset of illness, otherwise it doesn't help. Of course drinking plenty of fluids, rest, Tylenol and cough medications as needed also may be helpful.

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