Cold or Flu Symptoms and Concerns About Anthrax

What are the symptoms of a cold?

If you have a cold, you can have any or all of these symptoms: increased nasal discharge (a runny nose), difficulty breathing through the nose, sneezing, a scratchy throat, and cough. The ability to taste and to smell may be affected, hoarseness may develop, and the voice often develops a nasal quality. Adults may experience a slight fever, while infants and young children may develop a higher temperature. The symptoms of the average cold last about one week. However, in roughly one out of every four cases, the illness lasts up to two weeks. In general, cold symptoms-especially the cough, tend to be worse in smokers.

What are the symptoms of the flu or influenza?

Flu symptoms are often more severe than cold symptoms. If you have the flu, you can have any or all of these symptoms: fever, muscle aches, headache, lack of energy, dry cough, sore throat, and possibly a runny nose. These symptoms usually last for several days for most people; however, they can last for as long as two weeks. People with lung disease or weakened immunity and the elderly are prone to severe and possibly fatal complications from the flu.

What are the symptoms of the inhalation form of anthrax?

Anthrax infection is a rare infection in the absence of a known exposure. Initial symptoms of the inhalation (breathing) form of anthrax are mild and not specific and may include fever, malaise, mild cough, or chest pain. Increased nasal discharge (a runny nose) is not usually seen in the inhalation form of anthrax. After several days, the symptoms may progress to severe breathing difficulties and shock.

How do I know that my cold or flu symptoms are not caused by the inhalation form of anthrax?

Many illnesses begin with symptoms commonly referred to as "flu-like" symptoms. These include fever, lack of energy, and muscle aches. The inhalation form of anthrax would quickly be distinguished from a cold or flu by the rapid development of severe symptoms that would require hospitalization.

If I have cold or flu symptoms, when should I call my doctor?

If you have a cold, you will get better, with or without medication, within a few weeks. However, the cold viruses can affect the lining of the upper respiratory system in a way that leads to other infections, such as sinusitis, ear infections or bronchitis. The most serious complication of influenza is pneumonia, which is an infection of the lungs. Pneumonia can be caused by the influenza virus itself, or by bacteria that are able to enter the lungs because natural defenses have been weakened by the flu. Patients with cold or flu symptoms should consult a physician for any of the following symptoms, which may indicate more severe illness:

High fever

Severe headache

Shortness of breath


Chest pain

Extreme weakness or dizziness

Sinus pain or a toothache develops

Ear pain develops

A cough gets worse, rather than better, as other cold or flu symptoms improve

Should I get an influenza immunization (flu shot) so that if I get flu-like symptoms I will know I don't have influenza?

Adults, including those in high-risk groups and those who are healthy, are encouraged to get a flu shot in order to avoid or lessen the effects of influenza. People should not get a flu shot in order to avoid confusion of flu symptoms with those of anthrax, for the following reasons:

Symptoms like fever, body aches, and headaches are common to many different infections besides influenza and anthrax. Since the majority of such illnesses are not caused by influenza (or anthrax), an influenza vaccination will not prevent many such cases of illness.

Influenza vaccine is not 100% protective and a small number of people who have been vaccinated will still develop influenza.

Influenza vaccine supplies available during the early part of the flu season should be targeted preferentially to health care workers, people with certain chronic medical conditions and the elderly who are at high risk for developing serious complications from influenza. Increasing influenza vaccine coverage of these groups could lead to a decrease in hospitalization and deaths.

Patients with "flu-like" symptoms should also be aware that:

There is no screening test available for the detection of anthrax disease in persons with few or no symptoms

Nasal swabs have been used for research purposes only. Nasal swabs are not used to diagnose anthrax infection in a person.