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Is it a cold, or is it the flu? Eight ways to tell the difference
September 15, 2009

The cold and flu season is fast approaching, and we hear more every day about the dangers of H1N1. When the first symptoms begin to appear, however, many people aren’t sure which illness they have.


According to Paul Karazija, M.D., Wellmark Blue Cross and Blue Shield vice president and chief medical officer, there are eight easy ways to tell the difference between colds and the flu.


Symptom Cold H1N1/Seasonal Flu


Fever is rare with a cold.

Fever is common with the flu in up to 80% of all flu cases. A temperature of 100°F or higher for 3 to 4 days is associated with the flu.


Body aches and pains are rarely associated with a cold.

Severe aches and pains are common with the flu.


Chills are uncommon with a cold.

Chills are common with influenza.


Tiredness is mild with a cold.

Tiredness is moderate to severe with the flu.


A headache is uncommon with a cold.

A headache is common with the flu (present in 80% of flu cases).

Sudden Symptoms

Cold symptoms tend to develop over a few days.

The flu has a rapid onset within 3-6 hours. The flu hits hard and includes sudden symptoms like high fever, aches and pains.


Sneezing is commonly present with a cold.

Sneezing is uncommon with the flu.


A productive (mucus- producing) cough is often present with a cold.

A non-productive (non-mucus producing) cough is usually present with the flu (sometimes referred to as dry cough).


The differences between seasonal flu and H1N1 are more subtle, and most people will not be able to tell which kind of flu they have. Karazija notes that four main symptoms associated with H1N1 are a fever above 100.4 degrees, a sore throat, muscle aches and more pronounced respiratory symptoms. “If you’ve been ill for several days, and don’t seem to be getting better,” Karazija says, “then don’t be afraid to visit a doctor to find out which type of flu you have.”


Visit for more information on Wellmark’s health and wellness services. Members should also review their Wellmark Blue Cross and Blue Shield Coverage Manual to determine coverage for doctor’s visits and other services under their health plan.

Contact Wellmark Media Relations

Traci McBee
Phone: 515-376-4338


Teresa Roof
Phone: 515-376-5869


1331 Grand Avenue
Des Moines, IA 50309-2901

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