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It's More Than "Just The Flu"

What Are the Symptoms?

The symptoms of flu are generally much worse than just a bad cold. The symptoms of influenza A and B viruses are similar. Influenza A is generally more severe, however, and five times as many people with it require hospitalization compared to those with influenza B.  Most patients present with a classic flu-like syndrome: sudden onset of fever, chills, fatigue, headache, muscle aches, weakness, fatigue, sore throat, dry cough, and decreased appetite.  Early in the course of illness, patients appear flushed, and the skin is hot and moist.  Fainting may occur in severe cases. Among the elderly, fever is common, although it may not rise as high as it does in children and young adults. Fever usually rises rapidly on the first day along with the other symptoms. The most troublesome initial symptoms are often head and muscle aches, which are often related to the severity of the fever.  Joint pains, but not frank arthritis, are also common. Visual symptoms may also develop in one of five patients: looking sideways may cause pain in the eyes, bright lights may be disturbing (called "photophobia"), and eyes may appear red and watery or even start to burn. Respiratory symptoms (i.e., dry cough and a clear runny nose) are usually present at the beginning of the flu, but are overshadowed by the other, systemic symptoms.  Nasal congestion, hoarseness, and a dry or sore throat may also occur.

Small, tender cervical lymph nodes develop in about one in 4 patients.

On the second and third days of illness, the fever begins to decrease, along with the systemic symptoms. However, as symptoms and signs decline, respiratory complaints and findings, especially cough, increase. The cough, which is nonproductive, may be accompanied by chest discomfort or burning. Scattered wheezes or localized crackles are heard in one of five patients. Nasal obstruction and discharge can occur with throat pain and redness. These symptoms and signs usually persist for 3 to 4 days after the fever subsides, although full recovery can take 2 weeks or more.

Numerous complications, especially pneumonia and severe bronchitis, can occur in elderly patients with influenza. The rate of complications is low in patients under 50 years old but increases progressively with age and is high in those 70 years old and over.   The pneumonia may be a consequence of a primary influenza viral infection or secondary bacterial infection.  Primary influenza pneumonia most often affects persons with cardiovascular disease.  Other chronic illnesses may increase risk as well. Healthy adults of any age may develop this deadly syndrome, although it occurs infrequently.

Gastrointestinal symptoms, such as nausea, vomiting, and diarrhea, are rare in adults with the flu. What some people call "stomach flu" is actually the result of another virus.

How Can You Tell if it's a Cold or the Flu?


Symptoms of the Flu

Symptoms of a Cold




Fever high (over 101 F); lasts 3-4 days rare
Cough nonproductive; can become severe hacking
Headache prominent rare
Muscle aches characteristic; can be severe slight
Fatigue/weakness early and prominent very mild
Extreme exhaustion
Can last 2-3 weeks rare
Chest discomfort Common mild to moderate
Stuffy nose sometimes very common
Sneezing sometimes very common
Sore throat sometimes very common


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 There are 40--90 million cases of influenza reported in the U.S. each year. It is expected that there will be 110,000 Americans hospitalized with flu complications this year. 

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