Occupational Health Clinic
January 3, 2020

​We speak with Dr. Ana Nobis, physician at Vanderbilt Occupational Health Clinic, about what symptoms distiguish a cold from the flu and recommendations for when to seek care and treatment.

Begin Transcript

Welcome to this edition of the Vanderbilt Health and Wellness wellcast.  I'm Shaina Farfel with Occupational Health.

Shaina Farfel:  Today, we are speaking with Dr. Ana Nobis, physician at the Vanderbilt Occupational Health Clinic.  Hi, Dr. Nobis.  Thanks so much for being with us today.

Dr. Ana Nobis:  Thank you, Shaina, for having me.  It's an honor.

Shaina Farfel:  Yeah, we're happy to have you.  So, we're in the middle of another winter season, which means colds, coughs, congestion galore.  I know personally my family has been hit pretty hard by illness this year.  So, I wanted to talk to you about recognizing the differences between a cold and something like the flu.  Let's jump right in.  What causes a common cold versus the flu?

Ana Nobis:  Well, so, first of all, I have a little news for you.  I think, Shaina, that I am actually getting one of these two illnesses right now.

Shaina Farfel:  Oh my goodness.

Dr. Ana Nobis:  As we speak, it is developing.

Shaina Farfel:  Well, appropriate for today's conversation.

Dr. Ana Nobis:  Yes, so, I am going to put on a mask.

Shaina Farfel:  I appreciate the thought.  That's always appreciated.

Dr. Ana Nobis:  Thank you.  Basically, what causes a common cold versus influenza ... first of all, both of these are respiratory illnesses.  They affect the nose and throat and lungs, and are caused by viruses, but different viruses.  So, the common cold, what makes it so common is that there are over 100 different viruses that can cause the common cold.  The most common of these is rhinovirus, whereas, with influenza, which is also called the flu.  It's called by influenza virus types A, B, and C, with A and B being the ones responsible for the seasonal outbreaks.  So, yes, they are both caused by viruses but different ones.

Shaina Farfel:  A lot of times I know that these two things can be sort of difficult to distinguish.  So, how do I know kind of based on symptoms ... how do we tell the difference?

Dr. Ana Nobis:  Yeah, that's a very good question.  So, it can be difficult even for an experienced clinician to distinguish between these two, as you said, but there are some factors that can clue us in.  So, a common cold, the prominent features can be like cough, congestion, runny nose, sore throat, and kind of can develop slowly, whereas, the flu will hit you pretty suddenly.  You feel like you've been hit by a Mac truck, basically.  You'll have fever, fatigue, body aches, and then, obviously, there are tests that we can do to help us distinguish.  So, something called the "flu swab" is a little nasal test, and that can help us to figure out if you do, in fact, have the flu.

Shaina Farfel:  I know sometimes these things can sort of resolve on their own, but when do we know when to seek professional care, and also, what is the best place to be seen?

Dr. Ana Nobis:  Okay.  So, you should definitely be seen if you, for example, have a cough, even if it is a simple cough, that is disrupting your sleep.  So, you could come see us if you are having a cough, or if you feel achy, if you have a fever, or even if you think you have a fever, also if you feel that you've been exposed to somebody with flu or with a really bad cold and you are starting to develop some symptoms.  With the flu, even if you don't have any symptoms, but you know you've been exposed, you are welcomed to come see us, and you may want to, especially if you are immunocompromised.  People who are at risk for complications from the flu are the very young, the elderly, pregnant women, and again, people who are immunosuppressed.  So, for those individuals, it is especially important to be evaluated, and you can always come to our friendly Occupational Health Clinic on the 6th Floor, Medical Arts Building, or to a number of the Vanderbilt Walk-In Clinics.

Shaina Farfel:  Do I just have to suffer through these illnesses, or are there any treatments available?

Dr. Ana Nobis:  Yes, great question.  So, no, you do not have to suffer in silence.  So, for the flu, as I mentioned, there is a medication that can help actually prevent it, okay, if you've had a known exposure, and that's a discussion that you and the provider would have.  So, it is not an automatic decision, but we do have a medication that can help treat the flu, and you know, won't make things go away right away, but it should lessen the duration of the symptoms and help make them a little less severe.  In terms of the common cold, if someone had a medication to treat the common cold, they would be a gazillionaire, but unfortunately, we have to kind of manage the symptoms.  So, for cough, for example, we may tell you to stay really hydrated, take big spoonfuls of honey to help kind of coat the throat and sooth the throat, use a humidifier, we may talk about a decongestant or a cough medication, but unfortunately, there is no magic pill that will cure a cold.

Shaina Farfel:  Here is a question that I've always wanted to know the answer to.  People talk about, and use the phrase, "stomach flu."  Is that the same thing as the flu that we're talking about today?

Dr. Ana Nobis:  No.  They are very different.  So, when people say "stomach flu," they are usually referring to something more formally known as a viral gastroenteritis, which presents with symptoms of nausea, vomiting, diarrhea, things like that.  So, that is not influenza or the flu, okay?  "Stomach flu" or viral gastroenteritis is caused by viruses, but again, very different virus.

Shaina Farfel:  I always wanted to know the answer to that one.  And what are steps that individuals can take to help prevent getting colds or the flu?  What can they do to not get these?

Dr. Ana Nobis:  Okay, yeah.  First of all, covering your cough or sneeze with your sleeve, with your elbow, okay, and not coughing into your hand, which, when I was growing up, not that long ago, we were told to cover our cough with our hand.  I don't know who figured it out, but they should get a prize for pointing out the obvious that none of us recognized.  But anyway, so, that is one way, practicing good hand hygiene, so if you do cough into your hand or sneeze into your hand, washing your hand.  And just washing your hands regularly can really help protect you and others, and of course, in terms of the flu, getting the flu vaccine.  So, everyone over the age of six months should get a flu vaccine with very rare exceptions.  Okay, there are exceptions.  But the flu vaccine can actually decrease your chance of having to go to the doctor or a provider for the flu by 40-60%.  So, it really can help, and I'd like to emphasize that you cannot get the flu, the disease, the illness, from the vaccine.  So, any flu vaccine given by needle is killed.  It's a killed virus, and so, it's inactivated.  It cannot cause the actual disease.  It just stimulates your immune system to prepare for battle if it were to encounter the actual virus.

Shaina Farfel:  Right.  That's good to know because that's a common misconception I've heard around ...

Dr. Ana Nobis:  Yeah.

Shaina Farfel:  Well, wonderful.  Dr. Nobis, thank you so much for your time today.  I think this information will be really helpful for folks when differentiating between like just a pesky cold and something maybe more serious like influenza, and I hope you feel better, too.  Thanks for masking up.

Dr. Ana Nobis:  Yes.  Thank you.  Thank you.  Make sure to wash your hands.

Shaina Farfel:  Yeah, will do.  Thank you so much.  Have a wonderful day.

Thanks for listening.  If you have a story suggestion, please email it to us at health.wellness@vanderbilt.edu or you can use the "Contact Us" page on our website at www.vumc.org/health-wellness.