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What Is the Difference
between a Cold and the Flu?

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 22 in the March 1-2, 2003 issue of
The Mississauga News under the feature: Health & Wellness, Doctor's Corner.
Dr Peter W Kujtan portrait

Generally, influenza can be more severe and sudden. There are two distinct families of influenza viruses which invade humans. Influenza A attacks quite suddenly, while influenza B strains produce milder disease. You might wake up feeling sore and achy all over with no appetite, and go on to develop a high fever with chills and rigors. Colds on the other other hand, tend to progress slower, over a period of a few days, and only last a few days. Sore throats are common with both. Colds are due to rhinoviruses and produce running noses, cough and stuffy sinuses. Influenza severity may not allow you to even get out of bed easily. During the 1918 influenza A epidemic, stories abound about the severity of strain. Young healthy people would wake up afflicted. The disease would progress so quickly to weaken and dehydrate the body and affect the lungs, filling them with that at times people succumbed in the same day. Influenza A is the reason we advocate "flu shots" every year. The shots confer immunity against numerous strains. Influenza can last well beyond a week. In both diseases, long term immunity results after surviving an infectiion. But the viruses can mutate into a new strain capable of re-infecting the population. There are at least 42 different influenza strains active in North America at last check. This means that you could get influenza and colds repeatedly.

At the first sign of either illness, it is a good idea to begin drinking water to replenish the fluid lost to fever. Many of the symptoms are produced by our own bodies to defend the attack. Fever can decrease viral replication. Muscle aches can be the first sign that our immune system has been activated. Lymph nodes swell and produce antibody defenders by the millions. Taking acetominophen or Tylenol to help the aches is also a good idea. A warm beverage with a citrus flavouring is helpful in keeping sinus passages open. Antibiotics have no role in the early stages of both illnesses. They are used to treat secondary infections and strep throats, which may have many clinical symptoms in common. There may be a role for zinc lozenges and vitamin C once symptons appear, but they do not prevent the illnesses. Echinacea taken by mouth has no effect, but injected echinacea may be of some help.

Your doctor will take a history and examine you to try and determine which affliction you have. Rapid testing for influenza is not easily available in Ontario. Blood tests are the most reliable method of diagnosing this illness. Often times, you may have a throat swab drawn to ensure that a bacterial cause for symptons is not present. There are two medications on the market which can be used to lessen the severity and duration of influenza (Tamiflu and Relenza). Both are by prescription, and need to be started as soon as symptoms appear to be effective. There is no use in getting a flu shot once you have symptoms. To acquire immunity through a shot takes about 7-14 days. In some instances, such as nursing homes, another medication called amantadine is used to minimize spread.

In general, when influenza hits, stay rested, stay hydrated. Treat the symptoms vigorously and avoid contact sports. It has the potential to worsen all over medical conditions. These illnesses are spread by air and can travel fair distances. A flu shot is your best protection, but only protects against a few different strains. Therefore you can still suffer influenza despite a shot. There is some evidence appearing that people who get yearly shots may carry some immunity forward from previous shots. If the historical patterns of influenza are observed, we are almost overdue for the appearance of yet another virulent strain. Despite this, North America will still accumulate thousands of deaths attributable to influenza!


Related resources:

Google Flu Shot Locator. Find out where to get vaccinations against H1N1 and seasonal influenza in the United States.
H1N1 Flu (Swine Flu) Shot Clinics in Canada. Find Clinics for H1N1 Flu Shots by Canadian Province, by Susan Munroe, About.com.
616.2 Cold (Disease), (Common cold), Influenza, (Flu).
Is It a Cold or the Flu? Cold and Flu symptom check from ABC News.

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