The online search for flu-like symptoms has logarithmically increased since the coronavirus outbreak.

One of the most asked questions I receive when wearing my Food Safety Dietitian hat, or apron, as the case may be, is: “How do I know if I have the flu or food poisoning? “ Food poisoning is also known as a foodborne illness or FBI. It is confusing! Several of the symptoms of a cold, the flu or a bout of food poisoning do overlap. Now, the coronavirus is added to that list. Here are some hints to tell the difference.

**Questions people ask when I wear Mom’s apron: “How do I know if I have food poisoning?”**

What’s that cough? Is it a cold? The flu?

(Want the Verbal Version? Check Out Secret Life of Dietitians Podcast: Cough, Cold or Coronavirus Episode)

I was a few bites into a late dinner, a plate of deconstructed kebab leftovers (reheated to 165 °F) from a satisfactory mid-eastern Detroit eatery (satisfactory because it did not quite live up to its YELP rave reviews) from a road trip earlier that week, when my dinner was halted by a coughing spell. Ok, more like a throat tickle, an irritant most likely generated by an overly generous dollop of hot sauce. As I gulped water, a cough coughed this year raises more concern than one coughed in 2019. I reached for my phone to research the symptoms of Coronavirus.

It didn’t take long to find them. There was an email message from Ohio State University (my other job) medical leaders in my inbox. That information, coupled with a brief internet search revealed that lower respiratory tract symptoms such as cough and shortness of breath and difficulty breathing, coupled with fever and close contact with a carrier are the primary differentiators from other forms of virus like the flu.

**What is meant by “Close Contact with a Carrier?”**

· A history of travel from Wuhan, China

· Being within 6 feet of a person with Coronavirus

On New Year’s Eve I was in an international throng of thousands huddled within 6 inches of each other, raising a glass while being splashed by the Bellagio fountains, and photographing the rainbow of flashing lights on the Paris Casino Eiffel Tower across the strip. At the time, joyfully celebrating side by side in an international crowd welcoming 2020, was inspirational.

Later that week, my family along with 2 other extended families, shared an enclosed pod on the LINQ Casino’s High Roller Ferris Wheel, the largest observation wheel in the world. Our interactions consisted of gestures volunteering to take pictures of each other’s groups but didn’t extend to discussions of countries of origin. At that time, we were all pleased to be able to help each other out in capturing the moment.

Hmmm. Should I be worried?

My cough, clearly in the vicinity of my throat, which would be upper respiratory, was calmed by the fact that I was now 21+ days post Nevada and had no fever. The incubation period for coronavirus from exposure to onset of symptoms is about 2 weeks.

Could it be an FBI?

But I know from my food safety training that throat tingling is a symptom of scromboid poisoning a toxin responsible for one kind of FBI. Quick mental dietary recall: No, no seafood eaten recently. So no coronavirus, no FBI, and since I’ve had my flu vaccination, fingers crossed, no flu. Since I’d done the research, I decided to compile and compare the symptoms for colds and flu, the coronavirus and FBIs. I checked the expert sites and created a chart that lists them side by side.

symptoms of coronavirus flu food poisoning keepsafe food food safety dietitian

Download the Symptom Chart

Overlapping Symptoms: Colds, Flu, Coronavirus and Foodborne Illnesses

It’s no wonder that there’s confusion. Headache and all over symptoms like body and muscle aches, fever and chills, weakness and fatigue are common to all four. Runny, stuffy nose, sneezing, congestion, cough, sore throat are common with cold, flu and coronavirus. But, if in addition to these, if you have a fever, difficulty breathing and visited WuHan China, or been in contact with a person infected with coronavirus in the last 2 weeks, seek medical care immediately Otherwise, if your symptoms are primarily above the neck, you probably have a cold or the flu.

If you’re feeling poorly down below … an FBI may be the Cause

Abdominal cramps and pain, vomiting and diarrhea are more likely the result of an FBI, which are infamous for causing gastrointestinal distress. The vomiting may be more severe, the diarrhea bloody or watery. And, it could have been something you ate days or weeks ago, because that’s how long some germs linger before creating a disturbance.

Treatment In all cases: treat the symptoms, especially to prevent dehydration. Seek medical care if symptoms are severe and/or last more than 72 hours, if you have difficulty breathing or shortness of breath, if symptoms get better and then get worse. Check out the incidence numbers: the CDC estimates that the flu has led to up to 25,000 deaths this season and FBIs identified as the cause of death in over 3,000 people. Compare that to the rare case of death by cold, and so far zero deaths from coronavirus in the US… so far.

Consider: You could have both flu and an FBI at the same time. A weakened immune system caused by one illness makes you more susceptible to contacting others. Flu for example my lead to pneumonia.

Practice Common Sense Prevention

Wash your hands or use alcohol hand rub after coughing or sneezing
Cover your mouth and nose when you sneeze or cough
Avoid close contact with people who are sick. If you’re the sick one, stay away from others
Practice Food Safety: Find the essential tools in KeepSafe Food’s Personal Food Safety Kit which includes hand sanitizer, with the recommend alcohol content greater than 60%. It comes attached to carabiner, so you can attach it to your purse, backpack or belt, everywhere you go

Before you ask:

To those of you who challenge me on health and food safety practices (that’s a good thing): Yes, I transported my leftovers and temperature sensitive groceries in a cooler for the 3 hour drive from Detroit to Columbus. Part of the purpose of the road trip was to fill the pantry with authentic ingredients from Dearborn, Michigan’s Warren Avenue’s web of shops. One of my best childhood friends was Lebanese. Renee’s mom traveled with her church group from our home in NE Ohio to Michigan, to buy supplies. My favorite were Mrs. B.’s meat pies. I know now that these are called sfeehas or fatayer. These were on the menu when Mrs. B. helped me prepare the foods for my cultural foods class at Youngstown State University. I’ve never attempted to make them since, but here’s a recipe from Little Spice Jar that looks equally delicious.

Where did I dine?

I won’t name the “mediocre” restaurant frequented on this trip. But, next time I’m grocery shopping in Michigan I will return to Cedarland Restaurant because every meal I’ve had there has been delicious. Typically I won’t mention a restaurant without first checking out its food safety inspection results. Michigan only posts reports prior to 2015. I’ve emailed them for a current report and reserve the right to alter this recommendation based on what I learn.

We welcome your suggested updates and comments. Send them here: maryangela@keepsafefood.com

Cough, Cold...Coronavirus, Flu or Food Poisoning?