Cold and Respiratory Infections

I have a sore throat!  Colds, Flu, COVID, or something else?

With more people back on campus and air quality poor, UHS is seeing lots of people with respiratory symptoms.  Based on our testing, most do NOT have COVID, however it can be hard to tell.  What to do?   

Here is our HOW-TO guide to quickly figure out what is going on, and when you need to come in for care:

The best thing to do when you have a respiratory virus is stay home to rest and avoid infecting others and treat your symptoms (see advice at the bottom of this page).  There is no diagnostic test for a “cold” or “upper respiratory infection” -- in other words, healthcare providers cannot tell you which virus you have with a very few exceptions, listed below, and there is no cure for most of them. But we do have lots of experience managing them and will share our advice below.

But first, here are the exceptions:

  • COVID-19: cold symptoms are virtually indistinguishable from COVID-19.  If you have not had a COVID test since your current symptoms began, get one ASAP.  COVID testing is available 7 days/weeK; schedule on eTangOne PCR test is enough: please save appointments for others if you have already had a negative result.

  • Influenza, or “the flu”: influenza usually circulates in Berkeley in mid-fall through early spring, and can be prevented with vaccination.  Flu causes sudden onset sore throat, nasal congestion, cough, fever, and sometimes stomach symptoms … much worse than  “a cold,” you go from feeling fine to feeling very ill the same day.  Testing and treatment are available, but are generally only recommended for people at higher risk of complications, like those with asthma and underlying lung disease.  Testing for influenza requires a clinician order, thus a phone or in-person appointment, which can be booked on eTang.

  • Strep throat: strep is caused by a bacteria, not a virus, and as such is treatable with antibiotics, which are recommended to prevent complications and to make you feel better more quickly.  You should get a strep test if you have a severe sore throat, with or without a fever, and nothing else…. Strep does NOT cause nasal congestion or cough.  Testing for strep can be self-booked on eTang.

  • Mononucleosis, or “mono”: famously known as the “kissing disease,” mono is caused by a virus that is best spread by sharing oral secretions (including sharing a water bottle), but can also pass between roommates, teammates, or others who may have close contact.  Symptoms include severe sore throat with swollen tonsils and fever (a lot like strep), but you can also have some regular cold symptoms and nausea/stomach pain.  We CAN test for mono but there is no treatment, testing is optional, and it requires a blood test.  We recommend testing if you have a fever/sore throat last more than 3 days with a negative strep test, particularly if you participate in contact sports, as mono can cause an enlarged spleen.  Testing for mono required a clinician order, thus a phone or in-person appointment, which can be booked on eTang.

  • Sexually transmitted infections (STIs):  yes, really.  You can get a bad sore throat from gonorrhea or chlamydia, and new HIV infection can give you a whole host of symptoms including sore throat, fever, and sometimes a rash.  It’s important to get testing for STIs if you have had unprotected sex with a new sexual partner within the last month, especially if you did not know them very well, especially for men and transfolk, based on epidemiological risk.  This can be ordered online at eTang.

How do I know I need to be seen in person right away?  Any severe symptoms should be taken seriously, but here is our top list:

Any severe symptoms should be taken seriously, but here is our top list: 

  • Fever >/= 103 F

  • A new rash

  • A worsening headache

  • New chest pain

  • Shortness of breath or wheezing

  • A worsening cough

  • Severe abdominal pain

  • Trouble touching your chin to your chest

  • Severe, one sided throat pain

  • Drooling while awake (inability to swallow saliva)

  • Unable to drink enough fluids to stay hydrated

  • Ear pain interfering with sleep

  • Eye pain or changes in vision

  • Toothache accompanying nasal congestion

  • Nausea/vomiting preventing you from staying hydrated

  • Fainting

None of the above?  You probably have “a cold” - which means a mild upper respiratory infection caused by one of many viruses that circulate every year in our community.  Because colds are caused by viruses, antibiotics (which work against bacteria) are ineffective. Over-the-counter medications may relieve some symptoms, but will not affect the course of the illness.

How to treat your symptoms:

  • STEAM, fluids, rest.  Hot and sour soup, hot lemon ginger or peppermint tea with honey!

  • Either acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help pain and fever, but only use them when you need to, and be sure to take with food. 

    • Don’t take them if you have allergies to any of the ingredients. Also, don’t take more than is written on the package directions

  • If you have severe nasal congestion, consider Pseudoephedrine 30-60mg every 6 hours to open up your nasal passages (warning: can cause insomnia and makes some people anxious/jittery). 

    •  Don’t take them if you have allergies to any of the ingredients. Also, don’t take more than is written on the package directions.

  • Avoid cold air, smoke, irritants, and allergens.

  • If you have asthma or have needed an inhaler in the past, make sure you have one on hand and use it! 

uhs.berkeley.edu/health-topics/colds-and-flu/cold-care

Remember, your symptoms are a sign that your body’s defenses are fighting the virus. Your body will ultimately heal itself, so be patient and be good to yourself.  

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