Cold Symptoms

It Is Important To Distinguish Cold From Flu When You Have Asthma

Asthma inhaler.

It is important to identify asthma cold symptoms when you are sick during flu season. The main reason that you want to differentiate cold and flu is treatment. If you have flu and asthma, treatment with an antiviral drug may be indicated. Flu treatment may not only shorten the duration that you experience symptoms but may also prevent you from experiencing flu complications.

While a cold may require increased use of your rescue inhaler due to wheezing, chest tightness, cough or shortness of breath, there is really only symptomatic treatment for a cold available.

Your asthma action plan may have you adjust your asthma meds based on symptoms or peak flows, but this is not really a cold treatment.

Symptoms of the common cold generally arise from your body’s immune response to the viral infection. While most flu patients experience symptoms for less than five days, symptoms may last three to ten days with a common cold. You are also more likely to experience a prolonged course of symptoms from the common cold with 1 in 4 patients still experiencing symptoms at two weeks. However, symptoms of the common cold are generally milder and more of an annoyance. Patients may not feel well, but rarely describe the incapacitating exhaustion and level of severity that flu patients describe.

While symptoms can vary from one patient to the next, you are likely to experience at least some of the following:

1. Sore Throat

Sore throat is a common complaint in patients with a common cold, often one of the first.

Patients will often describe their throat as scratchy and this will usually resolve fairly quickly.

2. Runny Nose, Sneezing, And Nasal Congestion

Many patients describe nasal symptoms very early on in their illness and nasal complaints will be the predominate complaint after several days. Many patients seek care for colds thinking it is the flu or a bacterial infection when symptoms persist or have not responded to home treatment.

While bothersome, symptoms are generally less severe than what patients describe with the flu. Your runny nose may be clear or it might be green or yellow. While patients often think the purulence means they need antibiotics, this is generally not the case.

3. Cough

While not present initially, cough comes on later and may become the predominant symptom by day four or five. When cough presents itself as the predominant symptom, the sore throat and nasal symptoms will often be resolved. If cough is a predominant symptom, your asthma action plan may have you increase your rescue or controller inhaler.

4. Fever

While fever is common in patients with flu, it is much less so with a common cold. Fever is more likely to occur in kids with flu compared to adults with a common cold. If it does occur in an adult, it is usually lower and not as likely to cause symptoms.

5. Muscle Aches

If you have a cold you are much less likely to feel “achy all over” as patients with flu symptoms often do.

6. Headaches

Headaches occur with both cold and flu illnesses.

In my experience, headaches tend to be much less severe in patients with the common cold compared to flu.

Do I Need To Go To The Emergency Room For Certain Symptoms?

Generally, you do not need to go to the emergency room for a cold. However, you may need to go to the emergency department if you experience any of the following symptoms that are not typical of a cold, but may indicate a more serious illness:

  • Shortness of breath or difficulty breathing does not improve after initially following your asthma action plan.
  • Bluish or pale lips indicating significant hypoxia.
  • Chest or abdominal pain.
  • Confusion, severe dizziness or are not thinking correctly.
  • Trouble speaking.
  • Vomiting that is continuous.
  • Seizures.


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Turner RB. Epidemiology, pathogenesis, and treatment of the common cold. Ann Allergy Asthma Immunol. 1997;78(6):531.

Tyrrell DA, Cohen S, Schlarb JE. Signs and symptoms in common colds. Epidemiol Infect. 1993;111(1):143.

Kirkpatrick GL. The common cold. Prim Care. 1996;23(4):657.

Heikkinen T, Järvinen A. The common cold. Lancet. 2003;361(9351):51.

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