Common Cold vs. Strep vs. Flu

Dr. Sanders: Today I want to talk about the common cold versus strep versus flu. So let’s talk about flu and the common cold first. The common cold is runny nose, sometimes watery eyes, sore throat, and that’s about it. Kind of the common head cold. Influenza is going to be similar symptoms but just profound. So you’ll have a fever often, you’ll get really sick, you’ll feel a lot of fatigue. A common cold can sometimes make you have some body aches and those things, it’s a nonspecific finding. So just think of influenza as a common cold really, really on steroids, so just really, really severe.

Now, let’s talk about the common hold, which will give you a sore throat, inflamed tonsils, a redness in the back of your throat, lots of mucus and coughing and all of that versus strep. Strep is one that you don’t want to miss, you got to treat that, you can get rheumatic fever, you can have heart valve, you can have kidney disease, you can have joint disease from non-treated strep, so we want to definitely detect that. It’s offered for free as part of my membership in Voyage Direct Primary Care. A rapid strep test, we can do that any time we want to.

So, what’s the difference? Well, strep is going to cause sore throat, fever, sometimes a tummy ache and a headache. But the thing that’s real kicker for strep is going to be the they don’t have the mucus, they don’t have the cough, they don’t have the nasal congestion or all of that other stuff. Does it mean that you can’t get a cold on top of a strep, no it doesn’t mean that. And in fact, I’ve almost gotten fooled on that before. As a whole, if you have a cough and you have lots of mucus and you have a sore throat, chances are it’s not strep. If you have a sore throat and a fever and a tummy ache and no cough, no mucus, chances are it’s strep and you have to get tested. 

So just to help you kind of parse through that a little bit, Dr. Sanders with Voyage Direct primary care.

Additional Information on Strep Infections In the USA

According to the CDC, the United States sees 14,000–25,000 cases of invasive group A strep disease each year, and 1,500–2,300 deaths from it. The CDC also estimates that the country has several million cases of mild group A strep infections, and 11,000–13,000 cases of severe group A strep infections, with 1,100–1,600 deaths. 

Key Points

  • Preliminary 2023 data indicate the number of severe infections caused by group A Streptococcus (group A strep) reached a 20-year high.
  • Currently, less severe infections are also at high levels throughout the country, as is typically seen from December through April.
    • (https://www.cdc.gov/groupastrep/current-activity.html)

Prevention Tips

Now that we’ve talked about the differences between the common cold, the flu, and strep, let’s touch on a few more important points. One thing people often ask is, “How can I prevent these illnesses?” Well, good hygiene is key. Wash your hands frequently, avoid touching your face, and try to stay away from people who are sick. For the flu, getting an annual flu vaccine is highly recommended, as it can significantly reduce your chances of getting sick.

When to See a Doctor for Flu, Strep, “Colds”?

Another question that comes up is, “When should I see a doctor?” For a common cold, you usually don’t need to see a doctor unless your symptoms are severe or prolonged. Rest, fluids, and over-the-counter medications can help manage symptoms. However, if you have a high fever, difficulty breathing, or symptoms that are getting worse instead of better, it’s a good idea to seek medical advice.

For the flu, because it can lead to more serious complications, it’s wise to see a doctor if you have significant symptoms like a high fever, severe body aches, or fatigue that doesn’t improve after a few days. Antiviral medications can sometimes be prescribed to lessen the severity and duration of the flu if caught early.

As for strep throat, if you suspect you have it based on the symptoms we discussed—sore throat, fever, tummy ache, no cough or mucus—it’s important to get a rapid strep test. If it’s positive, antibiotics are necessary to prevent those serious complications like rheumatic fever or kidney issues.

Treatment Options

Lastly, let’s talk a bit about treatment. For a common cold, focus on symptomatic relief. Hydrate well, use saline nasal sprays, throat lozenges, and rest as much as you can. For the flu, rest and hydration are also critical, and your doctor may prescribe antivirals if needed. For strep, antibiotics are the cornerstone of treatment, and it’s crucial to complete the full course even if you start feeling better quickly to ensure the infection is fully eradicated and to prevent complications.

Overall Health

Remember, keeping yourself healthy also means taking care of your overall well-being. Eat a balanced diet, get regular exercise, and ensure you’re getting enough sleep. These steps can help boost your immune system and keep these illnesses at bay.


So, to recap, good hygiene, knowing when to seek medical advice, and following the appropriate treatments are key in managing and preventing these common illnesses. Stay healthy, and don’t hesitate to reach out if you have any concerns or need further information. Dr. Sanders and Voyage Direct Clinics, Direct Primary Care pioneers, wishing you well!