Odds are that most people will get sick at least once or twice a year. The question that remains is whether they have a cold or the flu.
Both infections result from exposure to viruses, and both share some symptoms. It’s the severity and duration of those symptoms that largely separate the flu from the common cold.
“You can still function with a cold. With influenza, you truly don’t want to do anything. People with the flu talk about feeling like they’ve been run over by a truck,” says Dr. John Martin, a family medicine specialist with Southwest Regional Medical Center, in Waynesburg. “They look sick and feel sick.”
While cold symptoms usually develop gradually, the flu manifests more rapidly. Dr. Amy Crawford-Faucher, an assistant clinical professor of family medicine at the University of Pittsburgh Medical Center has witnessed this rapid onset firsthand. She was dining with her husband one night when the flu suddenly hit him.
“You could see the fever come on and the chills start over the course of 10 minutes,” she recalls. “If you get the flu, you can almost track the minute when you started feeling bad, and then you go downhill quickly. Think of the flu as a cold on steroids. The flu tends to come on much faster, and it tends to be more severe.”
Colds primarily affect the nose and throat, causing nasal and sinus congestion, sneezing and a mild cough. In some people, colds produce a slight fever and mild fatigue. Influenza targets the lungs, and its hallmarks are more intense: high fever, chills, headache and muscle aches, extreme fatigue and severe cough (see chart for an overview of cold and flu symptoms).
The symptoms of a cold and flu may differ somewhat, but for most people the ways to manage those symptoms are relatively the same. Over-the-counter medications such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin) and naproxen (Aleve) can reduce fever and ease headaches, muscle aches and sore throat. People over age 6 can take over-the-counter cold remedies and decongestants to control nasal symptoms, Crawford-Faucher says.
Other remedies aren’t so proven. For example, many people have turned to products containing zinc as a “natural” way to shorten their colds, but their efficacy and safety remain unclear, Crawford-Faucher says. A 2012 review of studiesfound that taking oral zinc preparations, compared to a placebo, shortened the common cold by a little more than a day-and-a-half overall and by slightly more than 2½ days among adults. However, zinc users were about 65 percent more likely to experience side effects such as nausea and an unpleasant taste, the researchers reported. Additionally, the U.S. Food and Drug Administration issued an advisory in 2009 that nasal zinc products may cause declines in the sense of smell.
Likewise, research into supplements containing echinacea or high-dose vitamin C has produced varying results, with some studies showing benefit and others none. For most people, these supplements appear to be safe to try, Crawford-Faucher says. “However, some of them can interact with other medications,” she adds, “so I always recommend that patients talk to their doctor about them to make sure there aren’t any drug-drug interactions.”
Several basic home remedies have been shown to offer a safe way to ease cold and flu symptoms. Warm liquids, such as hot tea with honey or chicken soup, can help loosen congestion and prevent dehydration, while saltwater gargles (one-quarter or one-half teaspoon of table salt dissolved in 8 ounces of warm water) can soothe sore throats. And, since cold viruses thrive in dry conditions, a humidifier can moisten the air, but it also can add mold or bacteria if not cleaned properly—humidifier users should change the water daily and clean the unit periodically.
Martin also recommends nasal irrigation, using a neti pot or saline nasal spray to flush the nasal passages and sinuses and provide relief from congestion.
“For colds and sinus infections, it makes sense that you’re basically washing out some of the secretions,” he says. “I’ve used them, and I know that if I use it for a cold, I seem to get some relief.”