The big sick: How to tell if it’s cold, sinus infection or flu

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It’s the trifecta of the winter season – sniffles, sneezes and sore throats.

Colds, sinus infections and the flu all can share these common symptoms, but understanding the differences can help you and your physician determine the course of care and get you back to feeling better as soon as possible.

According to the Centers for Disease Control and Prevention (CDC), Americans have an average of two to three colds a year. Children often have more. And, more than 29 million Americans have sinus infections (also called sinusitis) or sinus-related problems each year.

When it comes to the flu, the CDC estimates that influenza virus has resulted in between nine million to 45 million illnesses, between 140,000 and 810,000 hospitalizations and between 12,000 and 61,000 deaths annually since 2010.

So, which is which?

There are some differences among all of these conditions that can help you determine which one you have.

The main difference between the symptoms of a cold and sinus infection is how long they linger. Colds are caused by viral infections, and sufferers typically have nasal congestion and a runny nose for three to seven days. After that, most people begin to feel better.

A sinus infection will hang around for seven days or more. It also can be seen with a “double worsening,” where the patient worsens with the start of the viral cold, starts to feel better as the viral symptoms start to resolve, and then worsens again as the bacterial infection starts to take hold.

The main difference between cold and flu symptoms is that flu more commonly includes fever; the fever can be 100 degrees Fahrenheit or higher and last for 3 to 5 days. The extreme fatigue associated with flu can persist for weeks.

Cold and flu are caused by different viruses, and, in general, the symptoms of flu are worse. Also, there are less likely to be serious complications from cold, such as pneumonia.

Runny nose or nasal congestion is more common with cold than flu.

Both viral and bacterial infections can cause common sinus symptoms, including: nasal obstruction, discolored nasal discharge, facial pain and pressure, and a reduced sense of smell.

Contrary to popular belief, the color of your nasal discharge does not differentiate a virus from a bacterial infection.  Both of these infections can cause your nasal mucus to become more discolored giving a greenish or yellow color to your nasal mucus.

Within the first week of any of these symptoms, you should seek supportive care such as getting additional rest, drinking lots of fluids and using over-the-counter or home remedies for symptom management.

Antibiotics are not an effective treatment for the cold or flu. However, if your symptoms linger longer than seven to 10 days or if you have a high fever, your doctor may order an influenza test. Depending on the results the doctor may prescribe antibiotics if it is determined to be a sinus infection, or an antiviral medication in the case of flu.

Preventing illness this winter

Short of never leaving your home, exposure to various cold and flu viruses may be unavoidable. There are things you can do to help reduce the risk of getting sick this winter. The best way to protect against the flu is by having an annual vaccination, as this helps the body to build up the immune system so that it can fight off the virus more quickly. Everyone six months and older should get a flu vaccine every year before flu activity begins in their community.

The flu vaccine also is recommended during pregnancy as it has been proven safe. If flu occurs during pregnancy, it can have serious complications for the unborn child and the mother.

Handwashing is a key to illness prevention. Try to avoid close contact with sick people. Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub. If you’ve been in public places, avoid touching your eyes, nose and mouth, and wash your hands as soon as possible.

While sick, limit contact with others as much as possible to keep from infecting them. If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. Your fever should be gone for 24 hours without the use of a fever-reducing medicine.

Cover your nose and mouth with a tissue when you cough or sneeze. After using a tissue, throw it in the trash and wash your hands. And be sure to clean and disinfect surfaces and objects that may be contaminated with germs like flu.

If you are concerned with your symptoms or if they worsen, visit your primary care doctor or an urgent care to rule out more serious illness.


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