Cold, flu, allergic rhinitis or sinusitis: how to tell the difference


Suffering from respiratory issues but not sure why? Here's a handy guide to understand the difference between common conditions that affect the health of your airways.

Respiratory problems are a symptom of all kinds of medical conditions, such as the common cold, influenza, allergic rhinitis and sinusitis, so it's no wonder that these conditions are sometimes confused. Here are some ways to help tell the difference:

The common cold - annoying but short-lived

  • What is it? Colds are upper airway infections caused by viruses that are passed from person to person through direct contact with infected secretions or by inhaling infected droplets.
  • Symptoms: Symptoms usually begin 2-3 days after infection and include a runny nose or a congested nose, sneezing, a sore throat, a cough, and headaches.
  • How to diagnose it: Colds are short-lived and not too serious, you generally just have to 'wait it out' - most people recover in a week or two.
  • How to treat it: There's no "cure" to make a cold disappear, but you can take over-the-counter meds to relieve symptoms. Sometimes a cold can lead to a secondary bacterial infection in your sinuses or middle ear. Only at this point, if your doctor prescribes it, would you take antibiotics. You should also visit your GP if you develop a high fever, have significantly swollen glands and severe facial pain in the sinuses.

Sinusitis - the nose knows

  • What is it? Sinusitis is the inflammation (swelling) of the lining of paranasal sinuses.
  • Symptoms: classic symptoms of acute sinusitis are nasal congestion, a greenish nasal discharge, facial or dental pain, eye pain, headache, and a night-time cough. Some patients also complain of fever, malaise (feeling ill), bad breath, and a sore throat.
  • How to diagnose it: Sinusitis usually develops after catching a cold which doesn't improve, or worsens after 5 to 7 days. Chronic sinusitis can be difficult to diagnose. It presents the symptoms above in a milder form, but usually persists for longer than 8 weeks. It is most common in patients with allergies.
  • How to treat it: There are a variety of ways to try treat this condition, from drinking plenty of fluids and getting a lot of rest to steaming, using a humidifier, and over the counter medications as prescribed by your GP. Sometimes antibiotics are necessary to treat the infection in your sinuses.

The flu - fever and whole body symptoms

  • What is it? Influenza is a viral infection characterised by fever, fatigue, a flushed face, body aches and head pain - for some, even dizziness or vomiting. The fever usually lasts for a day or 2, up to 5.
  • Symptoms: 'Whole body' symptoms usually lessen after day 2 to 4, and respiratory symptoms increase. The flu virus can affect the respiratory tract to produce symptoms such as a sore throat, bronchitis, and pneumonia. The most pronounced respiratory symptom here is usually a dry, hacking cough.
  • How to diagnose it: Doctors rarely use lab tests to identify the flu. They generally determine it based on the symptoms and whether the flu is epidemic in the community at the time. Nose and throat swabs can be used to test for the Influenza virus, but should be done at your doctor's discretion.
  • How to treat it: Most of the symptoms resolve in one to two weeks, and can be alleviated with symptom relief medications. It is usual for the cough, tiredness and 'low mood' to last for weeks after the rest of the illness is over. Of course, it's best to avoid catching the flu in the first place. Here are some FAQs doctors commonly get, and guidelines to help you avoid the flu this year. Get your flu vaccine at your nearest GP or pharmacy today!

Allergic rhinitis - less common but more risky

  • What is it? An allergy is an immune system reaction to a typically harmless substance.
  • Symptoms: These can include sneezing, watery eyes, itchy eyes and nose or cold symptoms that last more than 10 days without a fever; repeated ear and sinus infections; loss of smell or taste; frequent throat clearing, hoarseness, coughing, or wheezing; dark circles under the eyes caused by increased blood flow near the sinuses and a crease above the tip of the nose from constant upward nose-wiping.
  • How to diagnose it: You can do skin tests where a drop of a suspected allergen is pricked on the surface of the skin of your back or forearm. The spot will turn red and swell if you are allergic to it. An allergist might also use a blood test to diagnose allergies.
  • How to treat it: Consult an allergist or ask your GP for a referral. Treatment mostly involves identifying and then avoiding the triggering substance.

"Remember that good nutrition, regular physical activity and enough good quality sleep when you are healthy does wonders in building up a strong immune system - which will keep you in good stead when the winter season and all its common illnesses roll round," says Dr Noluthando Nematswerani, Head of the Centre for Clinical Excellence at Discovery Health.

"Don't underestimate the effect of maintaining a healthy lifestyle - and if you get ill, take the time to recover completely before you return to work and daily routines."

The Discovery Health Medical Scheme is an independent non-profit entity governed by the Medical Schemes Act, and regulated by the Council for Medical Schemes. It is administered by a separate company, Discovery Health (Pty) Ltd, an authorised financial services provider.

1 Get Expert Advice On Children's Lung Conditions n.d. [online] Accessed: 24 May 2018

2 Nicklouse children's hospital. Is it a cold, flu, allergic rhinitis, or sinusitis? N.d. [online] Accessed: 24 May 2018

Free doctor advice is just a click away

Do you have a niggling medical concern that you're not sure warrants a trip to the doctor, but you wish you could consult one anyway? With Discovery DrConnect, you can access to trustworthy, high quality medical information. Through the Discovery app and website, you now have access to:

  • Ask a doctor: a growing library of over 5 billion doctor-created answers to medical questions - or you can get a personalised answer from a doctor, at no additional cost to you.
  • Health goals: Doctor-created tips and checklists to help you meet your health goals and manage your chronic conditions.
  • Your doctors: Virtual follow-up consultations with participating doctors who you have seen in the last 12 months, using voice, video or text, paid from your applicable day-to-day benefits.

If you are already a Discovery Health Medical Scheme member, you can access this functionality here or download the Discovery DrConnect app now.


Related articles


4 flu myths you shouldn't fall for this season

Being mindful entails seeking trusted sources and facts behind common assumptions and practices. This is especially important when it comes to medical issues. Read on to see if you have all your flu facts straight.


A fierce flu season is expected: immunising early is the best defence

One of the best ways to be mindful of your own and others' health this March is to protect against, and prevent the spread of, the frighteningly contagious influenza virus. Here's why getting immunised early offers you the best defence.


You and the flu: what your GP wants you to know

Every autumn and winter, the trickle of flu patients becomes a flood in doctor's waiting rooms around the country. Here are some FAQs doctors commonly get, and guidelines to help you avoid and manage the flu this year.

Log in

Please click here to login into Discovery Digital Id

Please click here to login into Discovery Digital Id