Are flu and cold the same thing?

No. A cold is caused by rhinovirus and has mild symptoms (runny nose, sneezing, low fever). The flu is caused by the influenza virus and causes high fever (above 38.5 C / 101.3 F), intense body aches, and severe fatigue. The flu can lead to serious complications, especially in young children.

Can I give honey to my child with flu or cold?

Honey can be used as a cough soother for children over 1 year of age. Never give honey to babies under 12 months due to botulism risk. A teaspoon of pure honey before bedtime can relieve nighttime cough.

Do antibiotics cure the flu?

No. Flu and cold are caused by viruses, and antibiotics only work against bacteria. Using antibiotics unnecessarily contributes to bacterial resistance. Antibiotics should only be prescribed by a pediatrician in case of secondary bacterial infection.

How long does flu last in children?

Flu lasts 7 to 10 days in most cases. Fever usually improves in 3-5 days, but cough and fatigue can persist for up to 2 weeks. If symptoms worsen after initial improvement, see your pediatrician.

Can a child with flu go to school?

No. The child should stay home while they have fever and for at least 24 hours after the fever resolves without antipyretic medication. This protects other children and allows proper recovery.

Does the flu vaccine protect against colds?

No. The flu vaccine protects against the influenza virus, not against cold viruses (rhinovirus). Even when vaccinated, a child can still catch colds normally. The vaccine prevents serious flu complications like pneumonia.

Flu vs Cold in Children: How to Tell the Difference and When to Worry

Your child has a runny nose, is coughing, and has no energy. Is it the flu or a cold? Although they may look similar, these are different diseases caused by distinct viruses — and knowing the difference helps you care better and recognize when it is time to see the pediatrician. For expat families in São Paulo, understanding how to manage respiratory illnesses and navigate Brazil's healthcare system during flu season is essential.

What Is a Cold?

The common cold is the most frequent respiratory infection in childhood. It is caused primarily by rhinovirus — there are over 200 variants, which explains why children seem to always have a cold.

Children can have 6 to 8 colds per year, and this number increases for children who attend daycare or school. This is completely normal and is part of the immune system's maturation process.

Typical Cold Symptoms

Runny nose (clear discharge)

Frequent sneezing

Mild sore throat

Dry or productive cough

Low fever (up to 38°C / 100.4°F) or none

Nasal congestion

Mild irritability

Duration: 5-7 days

Colds generally resolve on their own in 5 to 7 days. The nasal discharge may change color (from clear to yellowish) over the course of the illness — this is normal and does not mean it has become a bacterial infection. If nasal congestion persists for weeks, consider evaluating for allergic rhinitis.

What Is the Flu (Influenza)?

The flu is caused by the influenza virus (types A and B). Unlike the cold, the flu is a more intense illness that can lead to serious complications, especially in children under 5, babies, and children with chronic conditions like asthma.

Typical Flu Symptoms

High fever (38.5°C to 40°C / 101.3°F to 104°F)

Sudden onset of symptoms

Body and muscle aches

Severe fatigue ("child looks wiped out")

Headache

Chills

Intense dry cough

Duration: 7-10 days

Flu fever typically lasts 3 to 5 days, but the cough and fatigue can persist for up to 2 weeks. If symptoms worsen after an initial improvement, this is a warning sign of a possible secondary bacterial complication, such as pneumonia or ear infection.

Flu vs Cold: Comparison Table

Feature	Cold	Flu
Virus	Rhinovirus (200+ types)	Influenza A or B
Onset	Gradual (2-3 days)	Sudden (hours)
Fever	Low or absent	High (38.5-40°C / 101.3-104°F)
Body aches	Mild or absent	Intense
Fatigue	Mild	"Completely wiped out"
Runny nose	Main symptom	May occur, secondary
Cough	Mild to moderate	Intense, dry
Headache	Rare	Common
Duration	5-7 days	7-10 days
Complications	Rare	Pneumonia, ear infection, sinusitis
Vaccine available	No	Yes (annual)

The most practical tip: if the child starts playing normally when the fever goes down, it is probably a cold. If the child remains listless and without energy even without fever, it is more likely the flu.

What About COVID-19?

COVID-19 can have symptoms similar to the flu in children. Some points that help differentiate:

→Loss of smell/taste: More common in COVID than in flu or cold

→Gastrointestinal symptoms: Diarrhea and vomiting are more frequent in pediatric COVID

→Duration: Most children with COVID improve in 5-7 days

→When to test: When in doubt, especially if there was contact with a confirmed case or persistent fever

In practice, clinical differentiation is difficult. If you are in doubt, a rapid antigen test resolves it. Rapid tests are widely available at pharmacies (farmácias) throughout São Paulo. The most important thing is to watch for the warning signs below, regardless of which virus it is.

When to See the Pediatrician: Warning Signs

Most colds and flu improve at home. However, some signs indicate it is time to seek medical care:

See a Pediatrician If:

Fever above 39°C (102.2°F) for more than 48 hours

Any fever in a baby under 3 months (above 37.5°C / 99.5°F)

Difficulty breathing or rapid breathing

Refusal of fluids or won't nurse

Extreme fatigue (not reacting, not playing)

Symptoms worsen after initial improvement (may indicate secondary infection)

Intense ear pain (baby pulling on ear)

Persistent vomiting

If your child is under 3 months with any fever, go directly to the hospital — this requires urgent evaluation. For older children, your pediatrician can assess via telemedicine in many cases.

Worried about your child's respiratory symptoms?

Dr. Paula can assess your child in person or via telemedicine. Bilingual care in Itaim Bibi, São Paulo.

Talk to the Pediatrician

Home Treatment: What to Do (and What NOT to Do)

What to Do

Offer fluids frequently (water, breast milk, soups)

Nasal saline washing (multiple times a day)

Rest — respect the child's pace

Honey for cough (only for children over 1 year)

Antipyretic if fever above 38.5°C (paracetamol or ibuprofen)

Keep the child at home until 24 hours fever-free

Humidify the room if the air is very dry

What NOT to Do

Give antibiotics without prescription (flu and cold are viral!)

Give aspirin to children (risk of Reye's Syndrome)

Use decongestants in children under 6

Give honey to babies under 1 year (botulism risk)

Give cough suppressants without medical guidance

Force food — reduced appetite is normal during illness

Ignore warning signs thinking it's just a cold

Medication Note for Expat Families

In Brazil, paracetamol (acetaminophen/Tylenol) and ibuprofeno(ibuprofen/Advil) are widely available at pharmacies without a prescription. Brand names may differ from your home country. Common pediatric brands include Tylenol Bebê, Novalgina (dipyrone — widely used in Brazil but not available in many other countries), and Alivium. Your pediatrician can provide specific dosing guidance based on your child's weight. Understanding the cost of healthcare helps with planning.

Prevention: Flu Vaccine 2026 and Hygiene

There is no vaccine against the common cold (too many virus variants). But against the flu, the annual vaccination is the most effective prevention measure.

Flu Vaccine 2026 for Children in Brazil

→Who should get it: Children 6 months to 6 years (priority group through SUS — free of charge)

→When: SUS campaign runs March-April 2026. Private clinics offer it year-round.

→Doses: 1 dose for previously vaccinated children. 2 doses (30-day interval) for first-time vaccination.

→Efficacy: Reduces hospitalization risk by 50-70% and protects against severe complications.

For expat families, the flu vaccine is available free through SUS (public health clinics called UBS) for children in the priority group, or through private vaccination clinics at any time. Private clinics often offer quadrivalent vaccines, which cover one additional strain.

Other Prevention Measures

Handwashing

Wash with soap and water for 20 seconds, especially before eating and after blowing the nose

Respiratory etiquette

Teach children to cough and sneeze into their elbow, not their hands

Ventilation

Keep rooms well-ventilated, especially in daycare and school settings

Do not share items

Cups, utensils, and towels should be individual during flu season

Respiratory illnesses are most common during autumn and winter in São Paulo. For more tips on staying healthy during this period, read about bronchiolitis prevention and learn about the other common challenges parents face during the first year.

Allergic Rhinitis in Children

When nasal symptoms last for weeks, it may be allergy, not cold

Baby Bronchiolitis Guide

RSV prevention and when cold symptoms in babies need urgent care

Childhood Asthma Guide

Flu can trigger asthma attacks — know the signs

Brazil Vaccination Schedule

Complete immunization guide including flu vaccine