Patient Information

How can I tell the difference between a cold, the flu and pneumonia?

If it’s winter, it’s also the coughing, sneezing, scratchy throat and achy body season. And with the non-stop news about the H1N1 virus, it’s not surprising that people are more concerned than ever before about knowing the difference between colds, flu and pneumonia

In their early stages, these three illnesses have similar symptoms. Here are some ways to tell them apart. Remember, if you are in doubt about whether or not you should contact your physician about an illness, you probably should call.


On average, adults contract two or three colds each year and children as many as half a dozen. Coughing and sneezing often are thefirst outward signs of a cold, but by the time you notice these symptoms you will already have a cold and will be passing the virus to others. Other signs of a cold are sinus pain, a sore throat and mild body aches. You can “catch a cold” just by inhaling a virus that has been released into the air from an infected individual’s cough or sneeze. And when infected individuals cough or sneeze into their hands, they keep the virus out of the air, but can then deposit it on doorknobs, handrails or elevator buttons. The next person who touches the same spot, picks up the virus and can then become infected by touching his or her nose or eyes.

The best cold remedies are rest and lots of fluids. If you have any chronic medical condition or take any prescription medication, check with your physician before taking an over-thecounter cold medicine. Also contact your physician if your cold persists for more than a week, if your cough suddenly worsens or you develop a fever


The flu, which is also caused by a contact virus, strikes suddenly and with more intensity than a cold. A sudden, high fever (above 100.4º) accompanied by significant body aches indicates the flu. The flu can also cause headaches, extreme fatigue and a mild cough or mild sore throat.

If you haven’t gotten a flu vaccine, contact your health care provider or check with your local health department for free clinics. The H1N1 vaccine has been in short supply, but should be more plentiful in the near future. You will need that and the seasonal vaccine to give yourself the best chance of staying flu free this season. Flu season usually continues through early spring.

If you develop flu symptoms, rest and drink lots of liquids and take over-thecounter medications for fever and body aches. Stay home until you recover. You can continue to spread the flu virus for a full day after your symptoms disappear. Prescription antiviral medications may help you recover more quickly, but you will need to begin taking the medication soon after symptoms develop. Bacterial pneumonia, dehydration and a worsening of such chronic medical conditions as congestive heart failure or asthma are all potential complication from the flu.


A serious infection of the lungs that can be caused by either bacteria or a virus, pneumonia is particularly dangerous for people who have been weakened by other medical conditions. Early on, pneumonia may seem like a bad chest cold. But the combination of a fever, headache, fatigue and a strong “wet” or “dry” cough that makes breathing difficult, indicate pneumonia.

Contact a physician immediately if you suspect pneumonia. Your physician can diagnose pneumonia easily, but may order a chest x-ray to confirm the diagnosis and to determine whether it is bacterial or viral pneumonia. Prescription antibiotics are needed to combat bacterial pneumonia. Treatment for viral pneumonia consists of managing the symptoms and the use of anti-viral medications.

If you are older, experience frequent chest colds or have chronic medical conditions, ask your physician if you should receive the pneumonia vaccine.

Originally published in The University Doctor's MedicaLink- 12/09

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