Flu or a cold? The difference
In everyday language flu is often used for every viral respiratory infection. Medically, influenza means infection by influenza A or B viruses. It differs from a common cold by sudden onset, high fever, marked muscle and limb pain and severe fatigue.
Colds develop over several days and focus on nose and throat. Influenza usually strikes within hours, often with chills and a profound sense of illness. While a cold tends to resolve within a week, influenza can leave exhaustion behind for two to three weeks.
The distinction is not academic: in at-risk patients – seniors over sixty-five, pregnant women, patients with COPD, diabetes, heart failure or immunosuppression – a confirmed influenza diagnosis may justify antiviral treatment and closer monitoring.
Diagnostics during the Berlin house call
The RAB specialist starts with a full history and physical examination: auscultation, oropharyngeal inspection, otoscopy, lymph node and abdominal palpation, pulse oximetry and vital signs. Oxygen saturation below 94 percent or a respiratory rate above 24 per minute are warning signs that may lead to hospital admission.
An influenza rapid test – a PCR-comparable test or high-grade antigen test – returns a result within fifteen minutes. A positive result for A or B allows individualised therapy. We also test for SARS-CoV-2 and RSV when needed, since mixed presentations are common in Berlin winters.
Rapid CRP testing helps to estimate bacterial superinfection. If pneumonia is suspected, lung ultrasound can be performed on request, or rapid imaging can be arranged through the Berlin radiology network.
Treatment options: symptomatic and antiviral
For uncomplicated cases symptomatic therapy comes first: bed rest, adequate fluids, paracetamol or ibuprofen for fever and pain control, cough and mucolytic preparations when helpful. Antibiotics are not indicated in pure influenza and have no antiviral effect.
Antiviral therapy with oseltamivir (Tamiflu) is useful when symptoms have been present for less than forty-eight hours and the patient belongs to a risk group or shows a severe course. The standard dose is 75 mg twice daily for five days. Common side effects such as nausea must be weighed against expected benefit.
For bacterial superinfection – for example post-influenza pneumonia – resistance-guided antibiotic therapy is needed. The RAB specialist prescribes according to current Berlin recommendations and coordinates follow-up with the Reiche private practice.
Sick notes, isolation, return to daily life
After examination and any positive rapid test we issue a sick certificate. Influenza patients are typically unfit for work seven to ten days, longer in severe cases. The certificate is issued as a private attest, accepted by all Berlin employers.
During the first five to seven days an influenza patient sheds highly infectious virus. We recommend home isolation, avoidance of contact with seniors or pregnant relatives, careful hand hygiene and a mask when close contact is unavoidable.
Returning to daily life should be gradual: absence of fever, sufficient physical resilience and resolution of cough are the key markers. If exhaustion persists beyond two weeks we screen for post-viral fatigue or myocarditis.
Prevention and seasonal advice
The most effective prevention remains the annual influenza vaccination. In Berlin it is offered by family doctors, company doctors and pharmacies, and is free of charge for risk groups. The ideal window is October or November, before the season begins.
Hand washing, ventilation, distance and, where helpful, a mask in busy Berlin metros reduce transmission. Within the family separate towels, frequent ventilation and – if possible – a dedicated bedroom for the sick member help.
On request, RAB patients can be offered a vaccination appointment at the Reiche private practice or referred to a suitable Berlin family doctor. We believe in integrated care: house calls in acute illness, preventive advice in between.