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Health & Exercise Forum

Not Feeling Well? Is it the Cold or Flu? Part I of III

Nov 4, 2009

Guest Columnist: Janet M. Caputo, PT, OCS

Medical Reviewer: Gregory Cali, D.O.

It is that time of year when people wake up coughing and sneezing and hope that the symptoms are only a mild seasonal allergy. Unfortunately, it is also cold and flu season and it is important to know the difference. In the last month alone, our office was hit with several seasonal illnesses that lead to days off from work for Gretchen, Amy, and Chris. Did they have a cold or flu?

When you wake up sneezing and coughing with muscle aches and fever, how do you know if you have just a cold or if you have the flu? Generally, a cold is a milder respiratory illness than the flu. While cold symptoms can make you feel bad for a few days, flu symptoms can make you feel quite ill for a few days to a week. The flu can result in serious health problems, such as pneumonia, which require hospitalization.

A cold usually begins with a sore throat which resolves in a day or two. By the fourth or fifth day, you may experience nasal congestion, a runny nose and a cough. Fever is uncommon in adults but a slight fever is possible. Children are more likely to encounter a fever with their cold. The watery nasal secretions that occur during the first few days eventually become thicker and darker. Dark mucus is natural and does not necessarily mean that you have developed a sinus infection!

Your cold can be caused by several hundred different viruses and will usually last about a week. During the first three days of your cold, you are contagious. To prevent spreading your cold to others, staying home and getting some rest is recommended.

“Cold symptoms” can be mistaken for allergic rhinitis (hayfever) or a sinus infection. If your cold symptoms develop slowly and improve after one week, then a cold is the most likely cause. However, if after one week your symptoms have not improved, you may be suffering from an allergy or sinusitis. The best advice is to consult your family doctor for the correct diagnosis and appropriate treatment.

FLU symptoms differ from those of the common cold because they usually are more severe and develop suddenly. Flu symptoms include sore throat, fever, headache, muscle aches and soreness, nasal congestion, and cough. The flu is caused by a variety of inFLUenza viruses.

Most flu symptoms gradually improve after two to five days but it’s not unusual to feel run down for a week or more. A common complication of the flu is pneumonia, particularly in the young, elderly, or people with lung or heart problems. Shortness of breath frequently accompanies pneumonia. A fever that has been absent for a day or two and then returns is another common sign of pneumonia.

The symptoms of the common cold and the flu are so similar that you may have difficulty distinguishing between the two! Typically, the common cold is not accompanied by a fever above 101 °F. Body and muscle aches are additional symptoms that are frequently associated with the flu. Use this quick chart to decide whether your symptoms are a cold or the flu:



Sudden onset of illness

Slow onset of illness

High fever

Low or no fever

Extreme fatigue

Mild fatigue

Dry cough

Severe cough with runny or stuffy nose

Achy head

No headache

Achy muscles

No achy muscles


No chills

If you have flu or cold symptoms, notifying your family doctor is recommended especially if you have any one of the following serious symptoms:

  • Difficulty breathing or chest pain: May be signs of asthma or a more life-threatening condition (e.g. pneumonia or a heart problem).
  • Persistent fever: Could be a sign of another bacterial infection requiring intervention.
  • Severe headache: Can indicate meningitis, an inflammation of the lining of the brain.
  • Vomiting: Frequent vomiting places you in serious risk of dehydration. Dehydration reduces the amount of blood that your body is able to get to your organs.
  • Painful swallowing: Your typical sore throat causes mild discomfort. Severe pain could indicate strep throat which requires prompt medical intervention.
  • Persistent coughing: A cough continuing for more than two or three weeks could signify bronchitis. Postnasal drip, sinusitis, or asthma can also cause persistent cough. A medical doctor can determine the correct treatment for these conditions.
  • Persistent congestion or headaches: Blockage of sinus passages from a cold can cause sinus infection. Pain around the eyes and face with thick nasal discharge after a week may indicate a sinus infection requiring an antibiotic.

Please join us next week when we will discuss cold and flu prevention, including vaccination.

Janet M. Caputo, PT, OCS – guest columnist is an associate and clinic director at Mackarey Physical Therapy where she specializes in outpatient orthopedic and neurologic rehab. She is presently working on her doctorate in physical therapy from the University of Scranton.

Visit your doctor regularly and listen to your body.

Keep moving, eat healthy foods, exercise regularly, and live long and well!

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Part II of III on Cold and Flu