A Cold, The Flu, The Stomach Flu: Keeping them Straight

I see A LOT of confusion about this. Just this morning, I had to seriously restrain myself when I read the following on Reddit: “you couldn’t have known it was gastroenteritis and not the stomach flu”. And the other day, during a class observation I was doing for my TESOL, the teacher was doing a presentation on colds and flus and was insisting on nausea and diarrhea as the main symptoms of the flu (and disregarded suggestions of “muscle aches and pains” and “fatigue”).

So for the sake of clearing up misinformation, here’s the run down on the three VERY DIFFERENT yet so often confused ailments. I”ll add some links too, in case you want to read more or, as a good critical reader, you want to make sure I’m not writing out of my ass.

The Common Cold

You know you have it when: You had a sore throat for a day or more, which slowly turned into a running nose, which eventually turned into the Niagara falls gushing from your nostrils. You might have a mild cough, a low grade fever and some light headaches, but you’ll feel better in a week, maybe two.

You caught it because: You were exposed to a cold virus. Perhaps you were a bit more tired than usual, perhaps not, but you definitely met a virus.

You can treat it by: Letting your body do its thing. There’s nothing you can do to make it go away. Lots of rest and water will help you fight it faster and feel less shitty. If the symptoms are getting in the way of your life, you can take some cough and cold meds from your pharmacy but make sure you read the instructions and follow them carefully! A lot of medical incidents are caused by misused cold meds. Have a chat with your pharmacist if you need help.

You should see a doctor if: You’re still having heavy symptoms after 10 days. Or your symptoms are way more intense than expected for a cold (think fever, thick gooey mucus, chest pain, severe fatigue, severe sore throat that doesn’t go away after a few days). Also, if you didn’t have a sore throat, your runny nose is persistent but the intensity changes with the time of day, maybe you don’t have a cold, maybe you have allergies.

Clearing up myths:

You won’t get a cold for sleeping with wet hair or going outside without a hat. (Though going outside without a hat in intense sun or cold might cause you other problems.) We get more colds at times of the year where we’re indoors and in close contact a lot, which is fall to spring for temperate climates and rainy season for tropical climates.

There’s no miracle cure for the common cold, or you’d know about it. Antibiotics can’t help you since you’re being attacked by a virus. The highly-publicized herbal products might have a slight effect if you take them every day for months and month before you get sick (like, your symptoms might last a few hours less) but up to you whether you think one less cold over X years or colds that last 2 hours less are worth the 100s of $$$ and risks of adverse reactions. Better time management, lots of water and good sleep is cheaper, safer, more effective and you’ll feel better all around.

Where can I read more about the Common Cold?
Mayo Clinic – The Common Cold
Canadian Centre for Occupational Health and Safety – Common Cold
CDC – Common Colds: Protect Yourself and Others

The Flu

You know you have it when: You’re inhaling fire, you feel like you were just put through the blender and you’re completely exhausted even though you’ve done little but sleep the past few days. You might also feel hot or cold (or both at the same!) if you have a nasty fever.

You caught it because: You were exposed to the influenza (“flu”) virus. You probably didn’t get your flu shot, or you were exposed to different a strain than the ones you were vaccinated against.

You can treat it by: Getting a lot of rest. If you see a doctor and are diagnosed early enough and/or are considered “high risk” (very young, very old, has a breathing condition, has a suppressed immune system, or other) you might be given antivirals.

You should see a doctor if: You are “high risk” (see above), you’re having a lot of trouble breathing, your chest really hurts, you’re confused or suddenly dizzy, you’re throwing up a lot for a long time or you were starting to get better when your symptoms returned with a vengeance. If you’re concerned about a child, refer to this list by the CDC.

Clearing up myths:

GI symptoms (in scientific terms, puking and liquid poop) are not typical of the flu. They occur in certain strains or populations, but the flu is primarily a respiratory (breathing) infection.

Antibiotics won’t do anything for the flu, because they don’t work on viruses. You might get antivirals from your doctor, they’re not the same thing.

The flu is serious. In 1918, the Spanish flu killed about 50 million (MILLION) people worldwide and 675 000 in the US. In 1956-1957, another flu killed 69 800 people in the US. The CDC estimates that between 1967 and 2007, between 3000 and 49 000 people in the US die from the flu each year (the numbers vary a lot depending on how aggressive the strain is that year) and an average of 200 000 people are hospitalized, with the number going up each year. The very old, the very young and the already sick tend to be the most affected, but there have been years where there were the strains were particularly fatal to young, healthy adults. While you don’t have to running to the doctor if you catch it (in fact, we’d rather you don’t spread your germs around a clinic if you don’t have to), do take the disease seriously. If you take a turn for the worse, seek medical attention. And get your flu shot before you get sick.

Where can I read more about Influenza?
Mayo Clinic – Influenza (flu)
Canadian Centre for Occupational Health and Safety – Flu versus a pandemic flu (Also has a good comparison chart for Flu VS Stomach Flu VS Colds)
CDC – Flu Symptoms & Severity
CDC – The Flu: What To Do If You Get Sick
CDC – Key Facts about Influenza (Flu) & Flu Vaccine
CDC – People at High Risk of Developing Flu–Related Complications
flu.gov – Pandemic Flu History
CDC- Disease Burden of Influenza
CDC – Seasonal Influenza-Associated Hospitalizations in the United States
CDC – Estimating Seasonal Influenza-Associated Deaths in the United States: CDC Study Confirms Variability of Flu

The “Stomach Flu”

I hate the nickname “stomach flu”. It’s terribly misleading.

The “stomach flu” is the colloquial term for gastroenteritis, an inflammation of the stomach (“gastritis”) and the intestines (“enteritis”). Stomach flu, gastroenteritis… THEY ARE THE SAME THING (though, after research, it seems that stomach flu generally refers to the viral form of gastroenteritis, only it’s kinda hard to identify the offending germ without lab work). When I was a kid in Quebec, we called these unpleasant afflictions “gastros”, which, in my opinion, is a more accurate nickname.


Now back to our regular format.

You know you have it when: You feel kinda queesy, think it might be something you ate, then the next thing you know, you’ve got liquid rushing out of one or both ends.

You caught it because: You were exposed to a virus (usually a norovirus or a rotavirus), a bacteria or a parasite. You could have caught it from something you ate or from another person. Gastroenteritis can have non-infectious causes as well, but they’re less interesting common.

You can treat it by: Drinking lots of fluids to prevent dehydration. Mild cases resolve on their own as long as you keep replacing the water you’re expelling. In a more serious case, you might want to upgrade to electrolyte formulations (Pedialyte, for example) in addition to water, especially if you go long enough without eating. In persistent cases, an antiviral, an antibiotic or anti-parasite medication, depending on the offending germ, might be needed. Listen to your body, get as much rest as it requests and eat what it will tolerate (mainly bland stuff like crackers, bread and bananas. Save the coffee, the steak and the spicy exotic stuff for a few days after your recovery.)

You should see a doctor if: You’re really dehydrated. The warning signs are usually lightheadedness and dark urine. You should also see a doctor if the throwing up is particularly severe or doesn’t stop on its own after 2 days. Same goes for the diarrhea, if it’s bloody or continuous or sticks around for too long (give it maybe 5-7 days), you’ll want medical help. Severe stomach pain or a high fever (Mayo Clinic suggests 101F/38.3C) or a change in mental state (aka confusion or saying weird things or fainting) also warrant a doctor’s visit. If you’re concerned about a child, please read here.

Clearing up myths:

The main point is, as you probably know by now, the “stomach flu” has nothing to do with the flu.

Another myth is that your gastro is caused by the last thing you ate, or the last restaurant you went to. In reality, it can take anywhere from a couple of hours to a couple of weeks for the little critters in your food to knock you on your back. So, unless a lot of people who haven’t had other contact with each other get sick from eating at the same place around the same time, it’s almost impossible to know where you picked up your germs.

Where can I read more about Gastroentritis?
Mayo Clinic – Gastroenteritis: First aid (Best page I’ve found.)
Mayo Clinic – Viral gastroenteritis (stomach flu)
NHS Choices – Gastroenteritis in adults (This looks like the UK Government Health Website. I’m not too familiar with it, but from a quick overview it seems legitimate.)
CDC – Foodborne Germs and Illnesses
CDC – Diagnosis and Management of Foodborne Illnesses (This one is intended for physicians and is very technical, but if, like me, you’re a microbiology enthusiast, there are lovely tables describing the different causes of foodbourne illnesses, their incubation period, their typical clinical presentation and more.)

Hopefully that clears up some of the confusion around these three super common illnesses and will lead you to pass on the information to others. If you have questions, know of other myths that need clarifying or have found wrong information here, feel free to let me know.

Also, be a responsible citizen and get your flu shot.

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