Do you have the flu or something worse? Here's how to tell

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One of the most common winter-health questions is this: How do you tell the difference between a cold and the flu?

With both, you may have a sore throat, cough and runny nose, but symptoms are typically far worse with the flu. Influenza starts suddenly, with other possible signs including intense muscle aches, nausea, vomiting, headache and fever.

But how do you know if it’s the flu or something even worse?

That’s a question Michael Curry gets several times a day at this time of year in his work as an emergency physician at B.C.’s Delta Hospital.

And it’s a question that seems to be on many peoples’ mind since last week, when 20-year-old Alani “Joie” Murrieta died just two days after being diagnosed with the flu — her seemingly-innocent symptoms developed into pneumonia.

“The big way you tell the difference between the flu running its regular course vs. something more severe is when you’re having problems with breathing — shortness of breath or being unable to breathe,” says Curry, who’s also a clinical associate professor of emergency medicine at the University of British Columbia. “If you can’t breathe or you feel like you’ve run a marathon and all you’re doing is lying in bed, go to emergency or urgent care or a walk-in clinic.”

ALSO SEE: How the flu can turn deadly

Trouble breathing could point to pneumonia or sepsis, a potentially life-threatening complication of an infection.

“The flu sets you up for secondary infections,” Curry cautions. “The flu can make you more predisposed to other things that make you sick.”

Another red flag? An altered level of consciousness.

“If you’re really confused, you can’t think straight, you can’t remember you name, it could be a sign of an infection or that something else has gotten more serious,” Curry says, noting this applies to the elderly in particular. “If your 75-year-old mother is coughing and sputtering and saying she’s got a fever, she’s achy and cold, it could be the flu, but if she’s out of it or doesn’t seem to be relating properly to world around her, it could be sepsis, a UTI [urinary-tract infection], or pneumonia caused by the flu virus or another virus or bacteria.”

If you do come down with the flu, Curry reminds that symptoms will last longer than those of a cold. While most people get over a cold within a week, the average length of time it takes from the onset of flu symptoms to when you’re feeling better is 10.5 days—with “average” being the key word.

“A lot of people will take longer to recover—two or even three weeks,” he says. “With respiratory infections including the flu, you’re really sick—you can’t go to work or school, you’re bed-ridden—for three to five days.”

ALSO SEE: What’s the difference between a cold and the flu?

The cough that comes with the flu virus could last even longer, especially in dry, cold parts of the country.

When it comes to fever, keep in mind that the World Health Organization defines it as 38.0 degrees Celsius or higher. That said, the degree of the fever doesn’t matter, whether it’s 38.7 or 39.4.

“It’s a yes or no question,” Curry says. “Once you have a fever, the question is why you have the fever.”

Stay well-hydrated, and remember that a fever is the body’s natural defence mechanism. If you’re not overly uncomfortable, it’s OK to ride it out; if, on the other hand, you’re experiencing chills or rigour (shivering or shaking), or you’re sweating or highly uncomfortable, it’s okay to treat a fever with ibuprofen (such as Advil) or acetaminophen (such as Tylenol).

While anti-viral medications are available, they’re only effective is they’re started right away when symptoms appear, and Curry says they don’t appear to shorten recovery time significantly. If someone with the flu takes anti-virals, they’re likely to get better in 10 days rather than 10.5.  

“If you don’t take them, you’re probably not missing out on too much,” Curry says.

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