Colds and flu

Updated 11 July 2014

Cold or flu?

Both are common in winter and caused by viruses. We often confuse the one with the other. But there is a huge difference between a cold and influenza: influenza may kill you.

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Both are common in winter, both are caused by viruses and we often confuse the one with the other. But there is a huge difference between a cold and influenza: influenza may kill you.

With influenza, you need to take greater care in order to prevent complications such as irreversible damage to your heart muscle.

Unfortunately, it isn't always easy to distinguish between the two. Interestingly, influenza C is not even believed to cause 'flu, but rather something milder like a cold.

Nonetheless, here is a general guide to differences between influenza and a cold (note, however, that symptoms are variable from person to person – and that there could be plenty of overlap between, for example, the cough you may have with a cold, 'flu, pneumonia or bronchitis):

  Cold Influenza
Cause 50% of colds are caused by one of more than 100 rhinoviruses. The rest are caused by five other groups of viruses. One of the strains of two types of influenza viruses (A or B), with A responsible for major 'flu epidemics.
Fever Rare in adults; if it does occur, it is usually not higher than 38,5 degrees Celsius. A high fever (often reaching 39 to 40 degrees Celsius) with chills, lasting two to three days. The fever is highest in children and least marked in the elderly.
Sneezing, nasal congestion Lots of it. In some cases.
Sore throat Usually begins with or is accompanied by a sore throat. In some cases.
Cough In some cases. A dry cough is usual.
Sweating Unusual. Common and related to the fever.
Muscle aches Unusual. Can be severe. The "I've-been-run-over-by-a-bus" feeling.
Malaise Sometimes, but only mild. Can be severe.
Fatigue Mild. Can be severe and may last three to four weeks. In the acute phase, you may feel as though you want to sleep al day.
Headache Sometimes. Often severe.
Complications Seldom leads to serious secondary bacterial infections in adults, but can worsen existing chronic bronchitis. Colds can progress to pneumonia or croup in young infants. Influenza often leads to serious secondary bacterial infections such as pneumonia or bronchitis in high-risk groups including infants, the elderly and immune-compromised people.
Onset Slow onset of illness over days. Symptoms can occur abruptly. It is sometimes possible to pinpoint the exact hour that the symptoms began.
Duration Symptoms usually clear within two to four days. Generally a cold should be completely over in four to 10 days. Symptoms may last four to seven days; cough and fatigue may linger for two to three weeks.
Contagious A person can spread the virus one to three days before first symptoms, and then for as long as the symptoms last. A person can spread the virus almost immediately after they themselves become infected, and for as long as the viral symptoms last.

Take action:
As the 'flu is a viral infection, it will not respond to any antibiotic. Antibiotics are only effective in treating secondary bacterial infections sometimes associated with influenza.

But there are steps you can take to speed up your recovery:

  • Stay in bed for a few days to rest.
  • Ask your pharmacist about over-the-counter drugs to relieve some of the symptoms. Aspirin, paracetamol or ibuprofen may help to relieve fever, muscle aches and headache, while decongestants may help to treat nasal congestion. Suppressive cough mixtures may help clear up the dry cough, typical of 'flu. Pregnant mothers should be cautious about taking drugs and children should not receive aspirin.
  • Increase your intake of vitamin A to 10 000 IUs a day and vitamin C to 1000-2000mg a day. Vitamin C may reduce the severity and duration of symptoms.
  • Try aromatherapy oils like lavender, grapefruit, rosemary and tea tree oil in your bath or as a massage oil.
  • Try zinc lozenges to soothe a sore throat and zinc nasal spray for a runny nose. Make tea with fresh or dried sage leaves simmered in boiling water, with a teaspoon of honey. You can also gargle with sage tea.
  • Chicken soup may soothe a sore throat, clear clogged passageways, and hydrate a thirsty body.
  • Consult your doctor if the 'flu is severe, if you show any signs of a secondary infection (e.g. difficulty breathing or earache), if you are in the high-risk group, or your fever persists longer than three days. New anti-influenza treatment is expensive, but may reduce the severity and duration of your 'flu.

Watch out for 'flu in children
A toddler younger than two years is particularly vulnerable to highly infectious diseases like 'flu. In fact, all children younger than 12 years are susceptible to the 'flu virus. A temperature raised or lowered any degree from normal in a baby under three months, above 38 degrees Celsius in a child of three to six months, and a temperature above 39 degrees Celsius in an older child would be reason to get medical advice.

In the older child, four to six hours of home treatment with paracetamol or mefenamic acid (Ponstan) can be tried in the first instance. If there is no response, seek medical advice.

Tip: Do not exercise if you have 'flu! It may lead to inflammation of the heart muscle. You should generally not exercise for at least seven days after recovering from the 'flu, after which you can gradually return to exercise.

Updated May 2011

Read more about preventing flu
 

 

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Ask the Expert

Flu expert

Dr Heidi van Deventer completed her MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 2004 at the University of Stellenbosch.
She has additional training in ACLS (Advanced Cardiac Life Support) and PALS (Paediatric Advanced Life Support) as well as biostatistics and epidemiology.

Dr Van Deventer is currently working as a researcher at the Desmond Tutu Tuberculosis Centre at the University of Stellenbosch.

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