CLEVELAND -- When you meet with misery, it can be hard to know: is it the flu or a cold? And the questions built from there.
If you have a high fever and cough, coupled with loss of appetite and dehydration, think influenza.
"People are going to have sweats. People are going to have shivers. Those are all normal symptoms," said Dr. Ethan Leonard, associate chief medical officer for University Hospitals Rainbow Babies & Children's Hospital.
"We really want to look for kids who are showing us they have a more significant amount of illness."
Your next concern: high or low? Your risk level determines your next step.
"Most children get over the flu with no need to see a physician," said Dr. Leonard. But if a child is younger than 3 months old, or has asthma or another lung disease, diabetes or other conditions that weaken the immune system, or the patient is elderly, you should see a doctor soon.
These groups could qualify for antiviral intervention. Otherwise wait it out with Tylenol and rest -- 72 to 96 hours.
Now are you feeling better or worse?
"We would expect around day three or four most people are starting to feel a little bit better," he said. If not, you could be experiencing a complication.
"Could be an ear infection in a younger child, or could you actually get a bacterial pneumonia on top of a viral illness? The answer is yes," said Leonard.
These require a doctor's care -- but is it time for the emergency room?
If you're feeling faint or can't keep food down, having trouble breathing or seem confused, extremely irritable, get to the ER.
"We're all a little bit irritable when we're achey and have a fever," said Dr. Leonard. "But if you have a child who is irritable and truly not able to be consoled...that's a patient that we would want seen."
While local hospitals are seeing severe flu cases rise, they see one similarity -- nearly everyone admitted did not get vaccinated against influenza.