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Pediatrician Answers Questions About Colds and Flu

How to tell the difference between colds and the flu, and what to do about each.




Dr. John Lukeman, M.D., is a pediatrician with Warren Clinic South Memorial.

Runny noses, coughs and fevers are all symptoms that families are familiar with, but sometimes knowing what the symptoms mean and what to do about them is confusing. To make matters worse, the Centers for Disease Control and Prevention reports that this flu season is especially severe. We asked Dr. John Lukeman, M.D., a pediatrician with Warren Clinic South Memorial, to answer some questions about colds and the flu.

Q: How do you tell the difference between a cold and the flu?

Dr. Lukeman: A cold and the flu can in fact look similar. Both are infections caused by viruses.  Although the flu has different strains, patients with the flu will typically have rapid onset of more severe symptoms, which may include multiple body systems.  If a child is having high fevers >101˚, respiratory symptoms, and GI symptoms such as vomiting or diarrhea, it would be a good idea to obtain a rapid flu test. 

Q: What are the symptoms of each? (are they similar?) Do you always get a fever with the flu?

Dr. Lukeman: Viruses can affect patients in many different ways – cough, runny nose, vomiting, diarrhea, etc.  The flu will cause fever.  Therefore, physicians are less inclined to test for the flu in a patient without fever.  In a patient with without fever, symptoms are likely secondary to a viral infection causing a cold.

Q: When should parents call the doctor? (what are dangers of the flu)

Dr. Lukeman: Any time a child has fever, I am willing to see them in the office for evaluation. Although symptoms of the flu can self-resolve, some patients may worsen. One example of this is when a child has the flu but also develops a bacterial pneumonia on top of the flu. These children can become very ill, and require treatment. 

Q: How long does a cold last?

Dr. Lukeman: Most colds, or viral infections last 10-14 days.  Symptoms of cough and runny nose can last much longer.  However, the high fevers should not last more than about five days.  If a child has fever more than five days without an official diagnosis, they should be evaluated by a physician to verify they do not have another illness.

Q: How long typically does the flu last?

Dr. Lukeman: Viral infections (including the flu) tend to last 10-14 days.

Q: Can either a cold or flu be cured with medication?

Dr. Lukeman: Most viral infections have no cure. Antibiotics are used to fight bacterial infections. Unfortunately, most viruses just have to run their course. Tamiflu, a medication used to treat the flu, is one exception (and its use is still somewhat controversial).  Tamiflu is an expensive medication that can decrease the severity or length of flu minimally.  The key to Tamiflu is that it must be started within 48 hours of symptom onset, or it will likely not help alleviate symptoms. 

Q: What medications are recommended for a child’s cold? For the flu?

Dr. Lukeman: Other than Tamiflu for treating the flu, there is very little that specifically treats colds or flu.  Doctors typically recommend symptomatic therapy for treatment of specific symptoms a patient is experiencing.  If a patient is febrile or having body aches, try treating with appropriate pediatric dosages of ibuprofen or acetaminophen. If a patient is vomiting or has coughing that keeps them awake, contact your pediatrician’s office for guidance. For more specific symptoms, a patient may need to be seen to verify there is not another infection or problem requiring further medication.

Q: Can a cold be prevented by taking anything (vitamin C, or other?) Can a cold’s duration be shortened by taking anything over-the-counter?

Dr. Lukeman: Patients frequently ask about vitamins, minerals, and essential oils.  Everyone is looking for a magic solution to preventing and curing illness.  If it existed, it would be well known.  I recommend not forgetting the basics; a good diet full of fruits and vegetables, drinking lots of water and regular exercise to improve lymphatic flow, can all help maintain health.  A multivitamin that contains Vitamin C is typically helpful as well. 

Q: What about the idea that you can get a cold from being in the cold air or wind? Is that true?

Dr. Lukeman: A cold is caused by a virus.  Viruses are not necessarily spread through the cold air or wind.  However, if someone spends a great deal of time outside in cold and wet conditions, it can certainly hurt their immune system, making them more prone to catching a cold. 

Q: Can anything be done to shorten the duration of the flu?

Dr. Lukeman: If Tamilfu is started within 48 hours of symptom onset, it may shorten the duration of the flu by one to two days.

Q: What can be done, if anything to prevent a cold? To prevent the flu?

Dr. Lukeman: People can prevent catching all types of viral infections with frequent hand washing, healthy diet and regular exercise.  Additionally, the flu shot is recommended to patients 6 months and older. It must be noted, there are several misconceptions circulating about the flu shot.  The first is when people believe they got the flu directly from the flu shot; this is impossible as the flu shot is not a live vaccine.  The other major misconception is that the flu shot is a 100% guarantee against all strains of flu.  The flu shot is produced in an attempt to treat the most common strains of the flu.  Some years the vaccine does well, and other’s it doesn’t do as well.  Regardless, any protection against the flu is better than none, especially for patients who are very young, very old, immunocompromised or otherwise unable to protect themselves. 

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