PARENTS CONNECTION
Ask the Pediatrician

Cold or Flu? How Do You Know?
Sometimes it’s hard to tell the difference between the cold and the flu. And with germ season in full swing, it’s important to understand the symptoms of each so you can choose the best treatment for your child.

Dr. Anne Marie Chavez, a pediatrician with Texas Children’s Pediatric Associates, offers the following advice for determining what’s really going on:

What’s the best way to know if your child has the flu or just a cold?
A cold typically has a gradual onset, beginning in the nose with nasal stuffiness, sneezing and runny nose. It may progress to include other symptoms like headache, sore throat, cough, postnasal drip, swollen lymph nodes, burning eyes, muscle aches or decreased appetite.

Within 1 to 3 days, nasal secretions may thicken and become yellow or green. During this period, children's eardrums can become congested and an ear infection can occur. Often, a low-grade fever will accompany a cold, but not always. A cold usually runs its course in about 7 days, but some symptoms may linger for another week or so.

Anne Marie Chavez, M.D. Dr. Anne Marie Chavez is a pediatrician with Texas Children's Pediatric Associates - Pearland. She is also a member of the American Academy of Pediatrics.

The flu begins abruptly with a high fever, flushed face, body aches and marked lack of energy. Other symptoms may include headache, sore throat, dizziness or vomiting. Fever usually lasts 2 to 3 days, but can endure for 5 days.

The virus typically settles somewhere in the respiratory tract, producing symptoms like a dry, hacking cough, nasal congestion and sneezing.

Flu symptoms should subside within 7 to 10 days. It is not uncommon to develop bacterial infections on top of the flu, such as ear infections, strep throat or pneumonia. Signs of a bacterial infection include a return of fever after the initial fever has resolved, increased effort to breathe, persistent or worsening sore throat or ear pain. These symptoms require evaluation by a physician.

What’s the difference in treatment for a cold versus the flu?
Treatments for cold and flu are similar. Fever should be treated by giving acetaminophen or ibuprofen, fluids should be pushed and rest encouraged. Never give a child aspirin. Aspirin use during childhood has been linked to Reye syndrome, a serious condition which can damage the liver and brain, especially when used to treat fever or viral illnesses.

For nasal congestion, use saline mists or drops 3 to 4 times per day and make sure the nose is blown or suctioned often. A humidifier at night can also help. A teaspoon of honey can help alleviate the cough (only for children over 12 months of age).

Antiviral drugs may be prescribed for the flu, particularly to children under 2 years of age, or those with chronic medical conditions such as asthma or diabetes. If a bacterial infection develops, antibiotics will be prescribed.

When should I take my child to the doctor if I suspect a cold or flu?
If your child is over 4 years of age, does not have a chronic medical condition and symptoms are mild, it is best to stay home.

Children 4 years and younger and those with chronic medical conditions should be evaluated by a physician. Getting your child to the doctor within 48 hours of symptom onset may make her a candidate for antiviral drugs, which keep flu viruses from reproducing in the body and can reduce the duration of the flu.

Note: Currently, the CDC only recommends anti-viral medications for those considered high-risk, including children younger than 2 and children with chronic medical conditions or severe disease. The CDC also recommends that your child stay home from school or daycare until he has been fever-free without ibuprofen or acetaminophen for at least 24 hours.

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