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Diagnosing Flu – Questions and Answers

February 24, 2023

How do I know if I have the flu?

Your respiratory illness might be influenza (flu) if you have fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and/or fatigue. Some people may have vomiting and diarrhea, though this is more common in children. People may be sick with flu and have respiratory symptoms without a fever. Flu viruses usually cause the most illness during the colder months of the year. However, flu can also occur outside of the typical flu season. In addition, other viruses can also cause respiratory illness similar to flu. So, it is impossible to tell for sure if you have flu based on symptoms alone. If your doctor needs to know for sure whether you are sick with flu, there are laboratory tests that can be done.

What kinds of flu tests are there?

A number of tests are available to detect flu viruses in respiratory specimens. The most common are called “rapid influenza diagnostic tests (RIDTs).” RIDTs work by detecting the parts of the virus (antigens) that stimulate an immune response. These tests can provide results within approximately 10-15 minutes but may not be as accurate as other flu tests. Therefore, you could still have flu, even though your rapid test result is negative. Other flu tests called “rapid molecular assays” detect genetic material of the flu virus. Rapid molecular assays produce results in 15-20 minutes and are more accurate than RIDTs.

In addition to RIDTs and rapid molecular assays, there are several more accurate flu tests available that must be performed in specialized laboratories, such as hospital and public health laboratories. These tests include reverse transcription polymerase chain reaction (RT-PCR), viral culture, and immunofluorescence assays. All of these tests require that a health care provider swipe the inside of your nose or the back of your throat with a swab and then send the swab for testing. Results may take one to several hours.

How well can rapid tests detect flu?

During a flu outbreak, a positive rapid flu test is likely to indicate flu virus infection. However, rapid tests vary in their ability to detect flu viruses, depending on the type of rapid test used, and on the type of flu viruses circulating. Also, rapid tests appear to be better at detecting flu in children than in adults. This variation in ability to detect viruses can result in some people who are infected with flu having a negative rapid test result. This situation is called a false negative test result. Despite a negative rapid test result, your health care provider may diagnose you with flu based on your symptoms and their clinical judgment.

Will my health care provider test me for flu if I have flu-like symptoms?

While your doctor may test you for flu, not everyone who goes to the doctor with flu-like symptoms will be tested. After evaluating you, your doctor may choose to diagnose you with flu without the need for testing based on your symptoms and his or her own clinical judgement.

Please visit diagnosing flu for more information.

Difference Between Flu and COVID-19

Influenza (Flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a coronavirus named SARS-CoV-2, and flu is caused by infection with influenza viruses. You cannot tell the difference between flu and COVID-19 by symptoms alone because some of the symptoms are the same. Some PCR tests can differentiate between flu and COVID-19 at the same time. If one of these tests is not available, many testing locations provide flu and COVID-19 tests separately. Talk to a healthcare provider about getting tested for both flu and COVID-19 if you have symptoms.

Can I have flu and COVID-19 at the same time?

Yes. It is possible to have flu as well as other respiratory illnesses including COVID-19 at the same time. Health experts are still studying how common this can be.

Is there a test that can detect both flu and COVID-19?

Yes. There is a test that will check for seasonal flu type A and B viruses and SARS-CoV-2, the virus that causes COVID-19. This test is being used by U.S. public health laboratories for surveillance purposes. Testing for these viruses at the same time will give public health officials important information about how flu and COVID-19 are spreading and what prevention steps should be taken. The test will also help public health laboratories save time and testing materials, and possibly to return test results faster.

The Food and Drug Administration (FDA) has given CDC an Emergency Use Authorization for this new test. Initial test kits were sent to public health laboratories in early August 2020. CDC will continue to manufacture and distribute these kits.

More information for laboratories is available.

To learn more, please visit https://www.cdc.gov/flu/symptoms/testing.htm.