“With fever it's the real flu I would say”: laypersons' perception of common cold and influenza and their differences : a qualitative study in Austria, Belgium and Croatia

Background:There is little research on laypersons’perceptions regarding common cold and influenza, theirsymptomatic distinction and considerations of risk. This study investigates understanding of pathogenesisacross three European countries and provides a knowledge base from which adequate prevention recommendationsand treatment advice can be derived. Methods:This is a qualitative research study. Semi-structured face-to-face interviews were conducted with 85participants from three European countries (Austrian= 31, Belgiumn= 30, Croatian= 24) about their experiences,perceptions and risk considerations regarding the common cold and influenza. We performed a qualitative thematiccontent analysis. Results:Three main themes were identified: common cold as harmless with individualistic symptoms; influenza asmainly distinguishable by fever, confinement to bed and severity of symptoms, but description about onset andduration are diverse; and views on pathogenesis contain references to disease causing agents and circumstances.Overall we found that risk perception is based largely on personal experience and risk is assumed moderate for bothdiseases. Conclusions:Study participants possessed a fairly good understanding of symptoms, differences and pathogenesis ofcommon cold and influenza; but explanations integrated misconceptions, such as misinterpretation of fever, diseasecontinuums, diverse onset ideas etc. Perceptions were largely based on lived experiences and interventionsfor prevention and treatment should be led by health care workers and focus on these issues. Basic consultations,awareness raising activities and other knowledge disseminations strategies should include aspects ofcommunicableness and the self-limiting nature of both diseases. An informed understanding of bothinfectious diseases is crucial and may also increase influenza vaccination coverage in the three respectivecountries effectively