Cold vs. Flu: How Are They Different?

You might ask yourself, “Do I have a cold or the flu?” when you wake up with a sore throat, runny nose, and cough. While a cold and the flu can have similar symptoms, there are some important differences to know.

Here, we’ll go over those differences, talk about treatments for the cold and flu, and give you some tips to help you avoid getting either one.

What’s the difference between a cold and the flu?

The common cold and the flu both cause respiratory infections. But there are some key differences to know.

They’re caused by different viruses

The seasonal flu is caused by two main viruses: influenza A and influenza B. 

The common cold, on the other hand, can be caused by over 200 different types of viruses. Some of these include viruses you may have heard of, like: 

• RSV (​​respiratory syncytial virus) 

• Coronavirus (which is related to, but different from, the virus that causes COVID-19) 

Other viruses that cause the common cold are less well known, including: 

• Rhinovirus

• Adenovirus

• Enterovirus

• Parainfluenza virus

Flu symptoms may be more severe than the common cold

The flu and the common cold can cause similar symptoms, but the flu is generally more severe. Every year, up to 52,000 people in the U.S. die from the flu. And up to 710,000 are hospitalized because of it. It’s very rare for people to be hospitalized or to die from the common cold.

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The good news is that, even though the flu is more severe, it’s less common than the cold. Most adults get 2 to 4 colds per year, on average. By contrast, your chance of getting the flu is only about 8% each year.

Flu vs. cold symptom severity, duration, and onset

The chart below lists some other differences between the common cold and the flu, including how severe symptoms are, how fast they start, and how long they last.

Common cold vs. flu symptoms: How can you tell which one you have?

Both a cold and the flu can cause symptoms of a respiratory infection, including: 

• A cough

• Runny nose

• Sore throat

• Sneezing

Because cold and flu symptoms are similar, it can be hard — and sometimes impossible — to tell them apart. But some symptoms are more common with one versus the other. 

Here’s what to look out for with cold or flu symptoms.

Common flu symptoms

In general, flu symptoms come on faster and are more severe than cold symptoms. Common flu symptoms include:

• Fever

• Chills

• Muscle aches

• Headache

• Sore throat

• Runny or stuffy nose and sneezing

• Cough and/or chest congestion

• Fatigue and weakness

Young children sometimes get an upset stomach with vomiting and diarrhea when they have the flu.

Common cold symptoms

Cold symptoms can vary, but in most cases they’re mild.

Common cold symptoms include:

• Runny or stuffy nose and sneezing

• Cough

• Postnasal drip

• Sore throat

• Pink or irritated eyes

• Low-grade fever in some cases

COVID virus vs. flu vs. cold symptoms

Another respiratory virus that can cause similar symptoms is COVID. It can be very difficult to tell the difference between COVID, the flu, and the common cold. It’s also possible to have both COVID and the flu at the same time.

COVID symptoms include:

• Fever and/or chills

• Cough

• Sore throat

• Headache

• Body aches

• Runny or stuffy nose and sneezing

• Fatigue

• Loss of taste or smell

• Difficulty breathing 

• Nausea, vomiting, and/or diarrhea

Can you be tested for the flu and colds?

Yes. There are tests available for the flu, COVID, and many of the viruses that cause the common cold.

You can now get several flu and COVID tests over the counter (OTC) without a prescription. These include at-home rapid antigen tests and combination COVID/flu tests. You can also be tested in a clinic, where healthcare professionals typically swab your nose or throat. Rapid flu tests done in clinics can give results in as little as 15 minutes. Lab-based tests take longer but are more accurate.

Most people don’t get tested for common cold viruses. But some new, multiplex respiratory virus tests can screen for several different infections all at once. This type of testing can be expensive, but they help healthcare professionals make more informed decisions about treatment. 

Are treatments for a cold and the flu the same?

While some treatments for a cold and the flu are similar, there’s an important difference: specific antiviral medications can help treat the flu, but no such medications exist for the common cold. 

Prescription flu medications

There are four FDA-approved prescription medications for the flu:

• Oseltamivir phosphate (Tamiflu)

• Zanamivir (Relenza)

• Peramivir (Rapivab)

• Baloxavir marboxil (Xofluza)

Most people who get the flu have mild symptoms and may not need medications. Antiviral medications may be helpful for people with more severe disease or those in high-risk groups, including:

• Adults older than age 65

• Children under age 5

• People with lung disease

• Pregnant women

• People with weakened immune systems

For those who do get flu treatment, it’s important to start any medications early for them to be effective — ideally within 2 days of symptom onset. If started early, these medications have been shown to decrease symptoms, shorten the course of illness, and prevent some serious flu-related complications, like being hospitalized.

Other than antiviral medications, cold and flu symptoms are treated similarly. If you have either illness, you should stay home, get plenty of rest, and stay hydrated with lots of fluids. 

OTC cold and flu medications

Fever and other symptoms, like cough and congestion, can be treated with OTC medications that don’t require a prescription.

Some common examples of OTC medications that can help lower fever include: 

• Acetaminophen (Tylenol)

• Ibuprofen (Advil)

There are also combination medications that can help with fever and other flu symptoms, like cough and congestion: 

• DayQuil (acetaminophen / dextromethorphan / phenylephrine)

• Theraflu

Your primary care provider can help determine what’s best for you. 

When should you get medical attention for the cold or flu?

Most people who catch a cold or the flu don’t need medical attention. Some people have a higher risk of getting very sick from the flu. This includes people with chronic medical conditions or weakened immune systems, as well as pregnant people, young children, and adults age 65 and older. 

If you’re at risk for serious infection, be sure to contact a healthcare professional as soon as possible, even if your symptoms are mild. 

When the flu becomes severe, it can look very different than what you might expect. Serious complications of the flu include: 

• Brain infections, like encephalitis or meningitis

• Heart infections, like myocarditis or pericarditis

• Lung infections, like pneumonia

• Nervous system diseases, like Guillain-Barré syndrome

• Multi-organ system diseases, like sepsis 

Anyone who develops any of the following warning signs should also get medical care right away:

• Shortness of breath or difficulty breathing

• Chest pain 

• Abdominal pain

• Confusion

• Lightheadedness or dizziness

• Excessive sleepiness

• Seizures

• Blue discoloration of their lips or face

The flu can look different in children than it does in adults. For more details on warning signs to look out for in children, read our article on flu symptoms in kids.

How can you prevent getting a cold or flu?

Like with any virus, prevention is the best strategy to avoid getting colds and the flu.

Here are some basic steps you can take:

• Clean your hands often. Wash your hands with soap and water for at least 20 seconds, or use hand sanitizer. Viruses that cause the common cold and flu can live on your fingers. Keeping them clean is one of the best ways to avoid getting sick.

• Stay away from people who’re sick. The common cold and the flu are contagious. Avoiding people who have symptoms will help keep you from getting sick.

• Don’t touch your face. Avoid touching your nose, eyes, and mouth with unwashed hands. The viruses that make people sick often enter your body from these places.

• Cover your sneeze. Cover your mouth and nose when you cough or sneeze with the flu or a cold. This helps prevent viruses from spreading through droplets in the air. 

In addition to these steps, the best way to prevent the flu is to get the flu vaccine each year. The flu vaccine has been shown to keep people from getting the flu and also to help prevent flu-related hospitalizations.

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Farzon A. Nahvi, MD

Farzon Nahvi, MD, is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works at Concord Hospital in Concord, New Hampshire, and teaches at the Geisel School of Medicine at Dartmouth.

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