If you are wondering whether it is flu, it probably is not. Antivirals help a narrow group, within a narrow window.
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Flu is a viral infection of the airways. It is not a bad cold — it is a different illness with a different tempo.
The clearest distinguishing feature is how it starts. A cold builds over a day or two and you carry on. Flu arrives over a few hours and stops you: sudden fever, aching muscles, exhaustion so complete that people describe being unable to get off the sofa. If you are well enough to wonder whether it might be flu, it usually is not.
Most healthy adults recover in a week to ten days without any treatment, though the tiredness and cough often linger for two to three weeks.
Two practical points. Antiviral medication exists but only helps specific at-risk groups, and only if started within 48 hours of symptoms beginning — so the window is short and most people are outside it and outside the criteria. And the flu vaccine cannot give you flu: the injected vaccine contains no live virus and is incapable of causing the illness, whatever the feeling of being slightly off for a day afterwards suggests.
Children often also have tummy pain, vomiting and diarrhoea, which adults with flu usually do not — and ear pain is common.
Fever three to five days, feeling ill for about a week, and a cough and tiredness that can persist two to three weeks. Improving then suddenly worsening is the pattern that suggests a secondary bacterial infection and warrants reassessment.
These are broadly the same groups eligible for free NHS vaccination, and the overlap is not a coincidence.
Sudden onset, fever, muscle aches and exhaustion during flu season is enough to make the diagnosis. Testing is not needed for most people and does not change what happens.
A chest X-ray and blood tests if pneumonia is suspected — which is the main complication and the reason for reassessing anyone who worsens after initially improving.
Flu assesses well by video, because the diagnosis is clinical and the important judgement is whether you are in an at-risk group and whether anything has complicated it.
Prescribe antibiotics for flu. It is viral, and they do nothing. Where a secondary bacterial infection has genuinely developed that is a different assessment and a different answer.
We also will not prescribe antivirals outside the criteria, or beyond the window where they no longer help.
Call 999 or go to A&E if you or your child have:
Seek same-day assessment if:
The injected flu vaccine contains no live virus. It is not capable of giving you flu. Feeling slightly off for a day is your immune system responding, which is the vaccine working rather than failing.
It is free on the NHS for: everyone 65 and over, pregnant women, people with long-term health conditions, carers, health and care workers, and children in the eligible age groups — who receive a nasal spray rather than an injection.
Effectiveness varies year to year depending on how well the vaccine matches circulating strains, and it is honestly reported as such. Even in a poorly matched year it reduces the severity of illness and the chance of hospital admission.
Antibiotics. Flu is viral. Vitamin C in high doses does not prevent or shorten it. Echinacea has weak and inconsistent evidence.
Catch it, bin it, kill it — tissues, handwashing, and staying home while infectious. Particularly important if you live with or visit anyone in a high-risk group.
If you are eligible for a free flu vaccine, have it — do not pay for one. Eligibility is broader than most people realise and includes anyone with asthma, diabetes, heart disease and several other common conditions.
Pharmacies also offer flu vaccination, free if you are eligible and inexpensive if you are not.
This page follows NICE Clinical Knowledge Summaries on influenza, NICE TA158 and TA168 on antiviral treatment, and the UKHSA Green Book on influenza vaccination.
Effectiveness varies by season according to the match between vaccine and circulating strains. UKHSA publishes annual effectiveness estimates. Even in seasons with imperfect match, vaccination reduces severity and hospital admission, which is the principal aim in older and at-risk groups.
Reviewed against NICE CKS, TA158, TA168 and the UKHSA Green Book current at the date shown above.
Speed and severity. Flu arrives over hours with fever, aching and exhaustion that stops you functioning.
A cold builds gradually, centres on the nose, and you keep going. If you are able to wonder about it, it is probably a cold.
No — it is not biologically possible. The injected vaccine contains no live virus.
Feeling off for a day is your immune response, which is the vaccine doing its job.
Only if you are in an at-risk group and within 48 hours of symptoms starting.
They shorten the illness by about a day — real, but modest, and not worth pursuing outside those criteria.
No. Flu is viral and antibiotics do nothing for it.
They are for a secondary bacterial infection, which is suspected when you improve and then get worse again.
From about a day before symptoms until around five days after they start. Longer in children and anyone immunosuppressed.
That is normal. Post-viral fatigue and a lingering cough commonly persist two to three weeks.
Get checked if it goes beyond that, or if you have breathlessness or chest pain.
No — and this matters. Most cold and flu remedies already contain paracetamol.
Combining them causes accidental overdose, which is a real and entirely preventable cause of liver damage. Check every label.
They cannot reliably be told apart on symptoms. A test will distinguish them if it matters — for example if you are in a high-risk group or live with someone who is.
Tell a doctor about the travel, urgently. Malaria can look exactly like flu and can be fatal within days.
Any fever within a year of travel to a malaria area needs assessing on that basis first, not assumed to be flu.
August 30, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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