Cold, flu or something else? How to tell the difference

Almost everyone gets a blocked nose, a sore throat or a cough a few times a year. Most of the time it clears on its own. The difficulty is knowing when it is an ordinary cold, when it is flu, and when something else is going on.

How a cold usually behaves

A common cold tends to start gradually. You may notice a scratchy throat first, then a runny or blocked nose, sneezing and a mild cough. You can feel tired, but most people keep going with daily activities. Symptoms usually peak after two to three days and ease within a week, although a cough can hang on longer.

How flu usually behaves

Influenza tends to arrive suddenly and hit harder. People often describe fever, body aches, headache and deep exhaustion that makes work or school difficult. A cough and sore throat are common too. The worst of it usually passes within a week, but tiredness can last longer.

When it may be an allergy

Allergic rhinitis causes sneezing, an itchy nose and eyes, and clear nasal discharge, without fever. It often follows a pattern: worse after dust, pollen, smoke or contact with animals, or worse at certain times of year. If your “cold” lasts for weeks and keeps returning in the same situations, allergy is worth discussing with a clinician.

What helps at home

• Rest and drink enough fluids, especially if you have a fever.
• Warm drinks, steam from a hot shower, and honey in warm water can soothe a sore throat and cough. Honey should not be given to babies under one year.
• Saline drops or a saltwater gargle can ease a blocked nose or sore throat.
• Paracetamol can help with fever and aches when taken at the correct dose for your weight and age.

Why antibiotics usually will not help

Colds and flu are caused by viruses, and antibiotics work only against bacteria. Taking antibiotics when they are not needed will not speed up recovery, and it contributes to antibiotic resistance, which makes infections harder to treat later. A clinician will advise if your symptoms suggest a bacterial infection that needs treatment.

When to seek medical help

• Difficulty breathing, chest pain or rapid breathing
• A fever that stays high or lasts more than three days
• Symptoms that improve and then suddenly get worse
• Confusion, severe headache or a stiff neck
• Any illness in a baby under three months, or in someone with a long-term condition such as asthma, diabetes or heart disease
• Coughing up blood, or a cough lasting more than two to three weeks

A persistent cough in Kenya should always be assessed, since tuberculosis remains a cause worth ruling out.

Reducing your chances of catching one

Hand washing with soap, covering coughs and sneezes, staying home when unwell and keeping rooms ventilated all reduce spread. If you are offered a seasonal flu vaccine and you have a long-term condition or are pregnant, ask your clinician whether it is right for you.

If you are not sure what you are dealing with, a short online consultation can help you decide whether home care is enough or whether you need to be examined in person.