I am a physician (an anesthesiologist) and I have continued to try to (silly me) find a really good description of the difference between Flu and Cold.

This has really been nagging me, not only for my kids, but for me as well.

I did see the excellent article that you have on the site regarding not using antibiotics for colds. I couldn't agree more! Do you feel antibiotics are overused for ear infections too, which after all may frequently be caused by colds?

Thank you.

I am so glad you asked this question. Cold and flu have become an inseparable pair, like salt and pepper or New Year's and weight loss. Walking down the "cold and flu" aisle of any drugstore, you will find stacks of bright boxes with bold claims of help for those suffering from a cold or the flu. Since the two illnesses share some similar symptoms, and both come during "cold and flu season," the two often run together in people's minds. We have a vague idea that they are different, but if pressed, have a hard time saying exactly how. The significant distinctions between these two common conditions elude most of us, but the question is rarely raised.

The symptoms we get during a viral illness are often the body's attempt to get rid of the virus and to minimize damage. Sneezing ejects the virus from the nose, cough from the lungs and throat, vomiting from the stomach, and diarrhea from the intestines. Fever makes it difficult for the virus to reproduce. The topic of viral illnesses will always remain somewhat confusing, since the body has a relatively small number of symptoms with which to respond to an ever-changing, wide variety of viruses. While colds and flus may overlap, the differences between them are important.

The common cold is centered in the nose.

Over 200 different types of viruses can cause a cold. Rhinoviruses, which means "nose viruses", are the most common cause. Respiratory syncitial viruses (RSV) and a host of others can produce colds. Of note, influenza viruses occasionally cause illnesses with symptoms of the common cold.

The three most frequent symptoms of a cold are nasal stuffiness, sneezing, and runny nose. Throat irritation is often involved (but not with a red throat). Adults and older children with colds generally have minimal or no fever. Infants and toddlers often run a fever in the 100 to 102 degree range.

Depending on which virus is the culprit, the virus might also produce a headache, cough, postnasal drip, burning eyes, muscle aches, or a decreased appetite, but in a cold, the most prominent symptoms are in the nose. (By the way, forcing a child to eat with a decreased appetite due to a cold is both unnecessary and unhelpful, but do encourage drinking plenty).

If anything, using the term "common" with cold is an understatement. Colds are the most prevalent infectious disease. Children average 3 to 8 colds per year (younger children and boys are on the higher end of the range). Colds occur mostly in the winter (even in areas with mild winters). In areas where there is no winter, colds are most common in the rainy season. Parents get about half as many colds as their children do. Moms tend to get at least one more cold per year than dads.

When someone has a cold, the nasal secretions are teeming with cold viruses. Coughing, drooling, and talking are all unlikely ways to pass a cold. But sneezing, nose-blowing, and nose-wiping are the means by which the virus spreads. You can catch a cold by inhaling the virus if you are sitting close to a sneeze, or by touching your nose, eyes, or mouth after you have touched something contaminated by infected nasal secretions.

Once you have "caught" a cold, the symptoms begin in 1 to 5 days.