For cold or flu symptoms, seek emergency medical care immediately for trouble breathing, persistent chest or abdominal pressure, confusion or inability to wake, seizures, not urinating, or severe weakness. Contact a clinician promptly if you are at higher risk for serious flu or COVID-19, or if symptoms worsen after improving. Over-the-counter (OTC) medicines can ease symptoms temporarily, but they do not cure the illness—and they should never delay care for warning signs.
When should I go to the ER for flu or cold symptoms?
Seek emergency medical care immediately for severe warning signs. Do not wait to see whether an OTC medicine helps or try to manage these symptoms through a routine appointment. The Centers for Disease Control and Prevention (CDC) says its warning-sign lists are not exhaustive; get urgent help for any other severe or concerning symptom, too.
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Emergency warning signs in adults
- Difficulty breathing or shortness of breath.
- Persistent pain or pressure in the chest or abdomen.
- Persistent dizziness, confusion, or inability to wake or be aroused.
- Seizures.
- Not urinating.
- Severe muscle pain, severe weakness, or unsteadiness.
- Fever or cough that improves and then returns or worsens.
- A chronic medical condition that is getting worse.
These signs are listed in the CDC’s flu warning-sign guidance and respiratory-virus guidance.
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- Fast or difficult breathing, bluish lips or face, or ribs pulling in with each breath.
- Chest pain or severe muscle pain, such as refusing to walk.
- Dehydration: no urine for eight hours, a dry mouth, or no tears when crying.
- Not alert or interacting while awake, or having a seizure.
- Fever above 104°F that is not controlled by fever-reducing medicine.
- Any fever in an infant younger than 12 weeks.
- Symptoms that improve and then return or worsen, or a chronic condition that gets worse.
For any of these signs, seek emergency medical care immediately. The CDC’s flu warning-sign guidance provides the child-specific list.
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When should I contact a doctor promptly?
Call a healthcare provider promptly if you or the person you care for is at higher risk of serious flu or COVID-19 and develops respiratory symptoms, even if they seem mild. Early contact matters because antiviral treatments for flu and COVID-19 work best when started as soon as possible. For flu, the CDC says treatment benefit is greatest when antivirals begin within two days after illness starts; a clinician can advise whether treatment is appropriate.
Groups identified by the CDC as at higher risk for serious flu complications include adults 65 and older, pregnant people, children younger than five—especially those younger than two—and people with certain chronic conditions, such as asthma, diabetes, or heart disease. Tell the clinician about relevant health conditions and when symptoms began. See the CDC’s flu high-risk guidance and flu treatment guidance.
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Most people with flu have mild illness and do not need medical care or antiviral drugs, according to the CDC. But people at higher risk, people who are very sick, or anyone worried about their illness should contact a provider. Emergency warning signs call for emergency care, not a routine call.
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Contact a healthcare provider if a fever lasts more than four days, symptoms last more than ten days without improving, or symptoms such as fever or cough improve and then return or worsen. Also seek advice for trouble or fast breathing, dehydration, or a worsening chronic condition. These thresholds come from the CDC’s common-cold treatment guidance; seek care for any severe or concerning symptom even if it is not listed there.
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Colds often peak two to three days after infection and usually last less than a week, but the course alone cannot establish which virus is responsible. CDC guidance notes that more than 200 respiratory viruses can cause colds and that U.S. adults average two to three colds per year. Flu, COVID-19, and RSV can also cause cold-like symptoms. Consider testing when flu or COVID-19 is suspected, especially for someone at higher risk; the CDC’s common-cold overview explains the overlap.
Can I tell a cold from the flu by symptoms?
Symptoms can offer clues, but they cannot confirm the virus. Colds usually come on gradually, while flu often starts abruptly. Fever is rare with a cold and common with flu; aches tend to be slight with a cold and common, often severe, with flu. Flu may also cause chills, cough, sore throat, a runny or stuffy nose, headache, and fatigue; some people, especially children, may have vomiting or diarrhea. Because COVID-19 and RSV can look similar, symptoms alone are not a reliable diagnosis.
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Can I just take over-the-counter medicine?
For an uncomplicated illness without warning signs, OTC medicines may offer temporary relief of symptoms, but they will not cure the illness. Adults should use products only as directed and ask a healthcare provider or pharmacist about suitable pain relievers or fever reducers, especially if they take other prescription or OTC medicines. The CDC’s cold treatment guidance recommends checking about medicines and interactions rather than assuming a product is appropriate.
Medicine safety for children
- OTC cough and cold medicines are not recommended for children younger than six and can cause serious, sometimes life-threatening side effects.
- Ask a healthcare provider about the correct dose of fever medicine for a child and follow all directions.
- Do not give lozenges to children younger than four, or honey to infants younger than one year.
- Do not give aspirin or salicylate-containing products to children and teenagers age 18 or younger with flu or suspected flu because of the risk of Reye’s syndrome.
These age-specific precautions are described by the CDC in its cold treatment and flu treatment guidance.
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Comfort measures at home
For comfort while recovering, the CDC lists rest, fluids, a clean humidifier or cool-mist vaporizer, saline nasal spray or drops, age-appropriate throat lozenges or cough drops, and honey for adults and children at least one year old. These measures do not determine whether an illness is dangerous and should not delay medical care when symptoms call for it.
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