The Confusion Between Colds, Flus, or Bacterial Infections. What's the Difference?

Gillian May

Image by skeeze from Pixabay

Colds, flus, and bacterial infections have plagued us for as long as we can remember. And now, with the rise of more dangerous strains like Covid19 has made all of us more paranoid about getting sick. More confusing is that there are many types of infections going around at the same time as Covid19. There's seasonal flus, regular colds, and secondary bacterial infections.

We search the internet, go to our doctors, read up on the latest cures and remedies, but we still don’t have a firm grip on some basic education around colds, flu and infections. Mainly, we don’t understand what separates a cold from the flu, and we still don’t understand the difference between a bacterial and viral infection.

Many people run to the doctor hoping to get antibiotics for a viral infection, and they don’t need them. With the rise of Covid19, more people know to get tested for it. But what about testing for seasonal flu?

Lastly, many people are still not sure about how to properly treat colds and flu at home or when they should consult a doctor or go to the ER.

As a former nurse who provided a lot of health education, I hope to provide some easy to follow tips about colds, flu, and infections and how to look after yourself and your family. I’ll use some common questions people have as a way to guide the discussion.

What is the difference between a colds, the flu, and Covid19?

All three of these conditions are caused by viruses, but the strain of virus is different. Colds and Covid19 are corona viruses whereas the flu is an influenza virus. All three are viral infections and cause very similar symptoms. Cold viruses are usually less severe as they've been around for a long time and our immune systems know how to handle them. Influenza is a more severe viral infection. However Covid19 is the most severe because, as we know, it's new and so our bodies immune system struggles to fight it.

Here are some common symptoms for both colds, flu, and Covid 19:

  • Cough
  • Congestion
  • Fever with chills
  • Muscle aches and pains
  • Decreased appetite
  • Headache
  • Runny nose

The main difference between a cold and the flu is that the fever is often higher and lasts longer for the flu. Also, symptoms such as headache and muscle pain are often much worse for the flu. However the Covid19 virus has more severe symptoms as well as some new symptoms we haven't seen before with other viruses. These symptoms are:

  • Loss of taste and smell
  • Vascular complications
  • Respiratory arrest
  • Cardiac complications
  • Blue toes (Covid toe)
  • Diarrhea and vomiting

Covid19 is the most severe but in general, cold viruses are less severe than influenza. A person with a healthy immune system and no other health conditions may only have mild symptoms from a cold. However, someone with a compromised immune system due to cancer, autoimmune issues, or certain medications may have worse symptoms. Also, heavy smokers and people with asthma, reactive airways, and chronic lung conditions can have severe symptoms from a cold. Unfortunately, even healthy people can become severely ill with the influenza or Covid19. Although it may depend on the amount of virus that the person picks up when exposed. This is called the viral load.

How do I know if it’s a bacterial or viral infection?

Colds, flu, and Covid19 are caused only by viruses. The strains and names are different, but the behavior and trajectory are quite similar.

Let’s repeat that: Colds and flu are ONLY caused by viruses.

The thing that gets confusing is when a viral infection creates circumstances where bacteria can grow. This is called a secondary bacterial infection. The reason people get paranoid, and rightfully so, (especially with children and older people) is because a secondary bacterial infection can be severe.

Let me explain how this works. The main symptoms of a virus are congestion, cough, and runny nose. This happens because the virus causes inflammation of the whole respiratory system. Sometimes the inflammation stays in the nasal area, and sometimes it travels down into the lungs. Either way, the inflammation causes swelling, mucus, and liquid production.

Within this swollen and mucus-filled area lies a high potential for bacteria to multiply and have a party. This is particularly dangerous for people with immune system issues. Sometimes even healthy people can get a secondary infection if they are really run-down or the congestion is so severe that there’s reduced air-flow in the respiratory tract. Some bacteria love places with limited air flow and lots of mucus to live in.

What are the indicators of a secondary bacterial infection?

This is the million dollar question because so many people are confused about whether to see a doctor or stay home and rest. The best advice is to check with a doctor if you have any doubts.

However, there are signs and indicators that you can learn about to help you make a decision. Bacterial infections will create new symptoms or make existing symptoms much worse. So, if a bacterial infection has set in, you’ll notice a sharp rise in symptoms such as fever, pain, discharge, congestion, and shortness of breath. These symptoms will get much worse, and it will happen quickly. Also, an increase of pain in areas that previously were normal is indicative of secondary bacterial infection. Anyone suspecting a new infection should see a doctor asap.

Here are more signs to look out for to decide if you ought to see a doctor.

Appearance — This may be gross, but it’s also beneficial to understand. If you can stomach it, try having a look at the discharge from both the sinus and lungs.

You can do this by blowing your nose in a kleenex or coughing up phlegm and spitting into the sink. In either case, if the discharge has a dark green and very thick appearance, that’s a clue that an infection might be present. Also, check for blood as this may also accompany a bacterial infection in the sinus area or can indicate pneumonia in the lungs.

Pneumonia can happen with or without bacterial infection and is usually the worst outcome of colds or flu. Remember that colds and viruses both create a yellowish and slightly thickened nasal fluid, but this doesn’t indicate a bacterial infection.

Smell and taste — Secondary bacterial infections in the sinus or lungs will have a bad taste and smell. It’s pretty noticeable and quite different than the regular metallic smell and taste of a cold or virus. People each have a different experience of the smell and taste of bacterial infection, so it’s good to become familiar with it. Some people say it has a sickeningly sweet or putrid taste, and others say it tastes rotten.

Lingering symptoms — Sometimes, a mild bacterial infection can cause cold and flu symptoms that seem to linger on and on. There could be a slight growth of bacteria that the immune system is keeping at bay, but that keeps the symptoms hanging on longer than expected.

Image by Mojca JJ from Pixabay

Are there other symptoms not related to bacterial infections that I should see a doctor about?

People with reactive airways, asthma, or other lung conditions can often see a rise in serious breathing issues due to colds and flu. As I said above, you can develop pneumonia without a bacterial infection. Pneumonia simply means that an area of the lung has become consolidated with fluid and mucus. This can become very serious and requires immediate medical attention.

Whenever there is a sharp rise in shortness of breath, especially if accompanied by fever and extreme fatigue, you should always consult a doctor as this may indicate pneumonia, which can lead to respiratory emergencies.

With Covid19, we are seeing a lot of new alarming symptoms as well. These are symptoms that weren't previously part of the seasonal colds or influenza. You'll need to isolate, put on a mask and consult a doctor if you have new strange symptoms on top of regular cold and flu symptoms.

Also, due to Covid19, everyone with any symptoms menitoned above should get tested, stay home, and take precautions to ensure they don't infect others.

How can we treat colds and viruses properly at home?

Again, when in doubt, consult your doctor. Most viral infections in the absence of bacteria or severe shortness of breath can be treated at home. Viruses usually get better on their own with proper rest, fluids, and symptom management. There are tons of over the counter (OTC) medications that can ease symptoms such as Advil, Tylenol, and antihistamines.

Many OTC cold and flu remedies have a combination of these with the added bonus of decongestants and cough suppressants.

What you need to know about OTC medications is that they can be strong and can interact with other medicines or conditions. If you have other health problems or take medications that you’re not sure about, consult your doctor or pharmacist for advice on proper over the counter remedies. Also, scientists don't yet understand how Covid19 will interact with other medications, so it's best to check with your doctor before taking anything.

Even if you don’t take other medications and don’t have other health conditions, you need to be careful with OTC medications.

Do not mix one cold medication with another cold medicine. For example, don’t take Nyquil and then also take Tylenol. Nyquil already contains Tylenol, so adding more can put you at high risk of acute liver damage by accidental overdose.

Do not mix cold medication with alcohol and other street drugs. These can cause serious side effects that can be fatal when taken together.

Here are some fantastic home remedies that can ease symptoms and are safe to use.

Honey, lemon, ginger, and lemongrass tea.

Take a large jar and add cut up lemon, ginger, and lemongrass. Pour unpasteurized honey over the whole mixture until the jar is full. Leave on the counter for an hour and gently shake or turn the jar every 10 minutes or so. Put a few tablespoons of the mixture in a cup and pour hot water over it. Drink this as often as you need throughout the day or night.

This helps loosen mucus congestion, relaxes the airways, soothes pain, and has both antiviral and antibacterial effects. Not to mention that it keeps you hydrated and helps you rest, which is the best remedy.

Hot soup packed with nutrient-dense vegetables.

Everyone has their favorite soup for colds or flu; chicken noodle soup, minestrone, or clear broth. Hot soup is incredibly soothing for all cold and flu symptoms with the added bonus of keeping you hydrated. However, did you know that chicken soup made with lots of veggies can also lessen the impact and length of a cold or flu?

Studies have shown that it can inhibit the inflammatory response of colds and flu and helps boost the immune system. Also, adding lots of nutritious vegetables will help the body recover well.

Rest and decreased stress

This should be a no-brainer, but many people don’t realize the importance of prolonged rest as viruses can reactivate if you over-do it while still in recovery. Sometimes this is the cyclic nature of viruses, but often this “getting sick again” is because the virus reactivated after the person went back to work too soon or went out with friends and stayed up too late.

Also, continuing to work, exercise, or do high-impact activities before you’ve fully recovered can increase risks of developing a secondary bacterial infection. A cold or flu is a perfect excuse to stay home, have a movie binge, take hot baths, eat healthy food, read all the books you haven’t been able to read and just lavish yourself in soothing self-care.

I hope this clears up any confusions you’ve had about colds and flu as well as bacterial versus viral infections.

It’s helpful to know both the standard and dangerous symptoms of colds and flu and how to spot a secondary bacterial infection. This simple knowledge can help you learn how to take care of yourself and know when to seek help from your doctor.

Educating ourselves on ways to understand and treat these common illnesses can help empower our ability to look after ourselves and our family.

Here are some research references I used to inform this article:

Covid 19 - CDC

Cold Versus Flu — CDC
Bacterial vs. Viral Infections: How Do They Differ?
Prevention and Treatment of The Common Cold: Making Sense of the Evidence
Flu: Overview
Flu and Colds: In Depth
Flu: Signs of Bacterial Infection
Chicken soup inhibits neutrophil chemotaxis in vitro
What’s The Scoop on Bone Soup?
Effect of Honey, Dextromethorphan, and No Treatment on Nocturnal Cough and Sleep Quality for Coughing Children and Their Parents
Scientific basis for the therapeutic use of Cymbopogon citratus, stapf (Lemon grass)

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I'm a former nurse turned freelance writer. I have extensive experience in administration, frontline care, and education in mental health, public health, and geriatrics. However, after 20 years, I needed a change and always wanted to write. I have personal and family experience in mental health and addictions, so I'm passionate about advocacy and education in those areas. I'm also a traveler, photographer, and artist. I funnel all my various expertise into my writing and hope to provide valuable content that is entertaining and educational. Join my email list if you want to read more of my work - I also have a book on Alcoholic Liver Disease coming out in 2021.


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