Roman Tuma, M.D.
UPMC Infectious Disease

During cold and flu season, it can be challenging to differentiate illnesses like the common cold, flu, COVID-19, respiratory syncytial virus (RSV), and norovirus. Each show distinct symptoms, modes of transmission, and treatment approaches. Knowing what you’re dealing with can help you make informed decisions about care and prevention.

The Common Cold
Symptoms: Runny or stuffy nose, sore throat, sneezing, mild cough, mild fatigue, possible low-grade fever.

Transmission: Colds spread through respiratory droplets when an infected person coughs, sneezes, or talks. Touching contaminated surfaces and then your face can also transmit the virus.

Key Differentiator: Cold symptoms are generally milder than the flu and don’t come on as suddenly. If you’re mostly dealing with nasal congestion and a scratchy throat, it’s likely a cold.

Influenza (Flu)
Symptoms: The flu often strikes suddenly and may include a high fever, severe fatigue, body aches, headache, dry cough, sore throat, and chills.

Transmission: The flu spreads similarly to the cold, through respiratory droplets and surface contact. However, it tends to spread more aggressively.

Key Differentiator: The flu’s main characteristic is the rapid onset of symptoms, especially fever, fatigue, and body aches. You’ll likely feel much worse than you would with a cold.

COVID-19
Symptoms: Fever or chills, cough (often dry), shortness of breath/difficulty breathing, fatigue, body aches, sore throat, headache, congestion or runny nose, and the unique symptom of loss of taste or smell.

Transmission: COVID-19 spreads primarily through respiratory droplets but can also linger in the air in poorly ventilated spaces. Surface transmission is less common.

Key Differentiator: Loss of taste or smell is the main identifier of COVID-19, though not always present. COVID-19 symptoms can also escalate to severe respiratory distress in some cases.

Respiratory Syncytial Virus (RSV)
Symptoms: RSV symptoms overlap with both colds and the flu but may include a runny nose, wheezing or difficulty breathing, persistent cough, fever (low to moderate), and decreased appetite.

Transmission: RSV spreads through respiratory droplets and surfaces. It’s particularly concerning for infants, older adults, and those with weakened immune systems.

Key Differentiator: RSV often involves more significant breathing issues than the cold or flu. In young children, watch for signs like flaring nostrils, rapid breathing, or a bluish tint around the lips.

Norovirus
Symptoms: Norovirus is a gastrointestinal virus, not a respiratory one, with symptoms including nausea, vomiting, diarrhea, stomach cramping, and sometimes a low-grade fever.

Transmission: Norovirus spreads through contaminated food, water, surfaces, or direct contact with an infected person. It’s highly contagious and can cause outbreaks in schools, cruise ships, and nursing homes.

Key Differentiator: Norovirus primarily affects the stomach and intestines, not the respiratory system. If your symptoms are mainly digestive, norovirus is the likely culprit.

Prevention Tips and When to Seek Medical Attention
Washing your hands regularly with soap and water can reduce your risk of infection. Annual vaccinations and immunizations for high-risk groups can prevent severe illness. Disinfecting surfaces, especially frequently touched areas, can help get rid of lingering viruses as they can live on surfaces for hours.

While usually symptoms of these common illnesses can be monitored and cared for at home, certain symptoms warrant fast medical attention. If you are having trouble breathing or wheezing, a persistent high fever, severe dehydration from vomiting or diarrhea, confusion, chest pain, or symptoms lasting more than 10 days, it’s important to reach out to your primary care provider, and in some cases, head to the nearest emergency department.

Roman Tuma, M.D., is with UPMC Infectious Disease and sees patients at UPMC Williamsport, 700 High St., Williamsport. To schedule an appointment with Dr. Tuma, call 570-321-2181. For more information, visit UPMC.com/NorthCentralPa.