Decoding the Symptoms: Common Colds vs. Allergies

It’s that time of the year again. Pollen levels around the country are rapidly increasing at the same time that some of my patients are catching cold viruses at the tail-end of winter. How can you tell if your runny nose and watery eyes are a result of allergies or a cold virus? Sometimes it's difficult to decode the symptoms, but I have some quick tips for telling the difference between the two. I also have some treatment options that will help you make it through spring without having to buy extra tissues!

What causes respiratory allergies?

If you have allergies, you are not alone. Nearly 50 million other Americans have them, too. In fact, allergies are the fifth leading chronic, or long-term, disease in the United States, and the third most common chronic disease among children under 18-years-old.

Allergic reactions are caused by an over-reactive immune system. Sometimes the body mistakes a harmless substance (like pollen or dust) for a dangerous invader. This results in a release of chemicals from immune cells, which can cause sneezing, itchy, runny nose or eyes, rashes or hives, inflamed eyes, skin, or lungs. In severe allergic reactions, whole body reactions may require immediate medical attention. 

What causes the common cold?

The common cold is caused by viruses (mainly rhinoviruses) that get into the cells lining the nose, pharynx, and bronchi. The body’s immune system reacts to these viruses in that it opens up blood vessels and increases mucus secretion. This leads to the common cold symptoms including stuffy nose, sore throat, and cough.

Types of allergies

There are six main types of allergies

1. Indoor/Outdoor Allergies (allergic rhinitis or “hay fever”): Most commonly triggered by tree, grass, and weed pollen; mold spores; dust mites and cockroach allergens; and cat, dog, and rodent dander.
2. Eye Allergies (allergic conjunctivitis): Most commonly caused by the same things that trigger indoor/outdoor allergies, but symptoms are specific to the eyes.
3. Skin Allergies (atopic or contact dermatitis): Most commonly triggered by plants such as poison ivy, oak, and sumac. However, skin contact with cockroach and dust mite allergens, certain foods, or latex may also trigger symptoms of skin allergies. Symptoms of skin allergies include eczema or hives.
4. Latex Allergies: Latex is most commonly found in hospital gloves and certain paints. Latex can react with sensitive skin or can be inhaled and cause breathing problems.
5. Food and Drug Allergies: The majority of food allergies are caused by eight types of foods: milk, soy, eggs, wheat, peanuts, tree nuts, fish, and shellfish. Penicillin is the most common drug allergy, though there are many other drugs that may cause allergic reactions.
6. Insect Allergies: Most commonly caused by bee and wasp stings, venomous ant bites, and cockroach and dust mites.

Colds and allergies: What’s the difference?

Many of my patients are not sure how to tell the difference between a common cold and allergies. It’s easy to get confused, since colds and allergies share some (but not all) of the same symptoms. Here’s how you can tell if your symptoms are related to a cold virus or allergies:

• Duration: Colds don’t usually last longer than 5 to 7 days, but allergies can last as long as you’re exposed to the thing you’re allergic to, the allergen.
• Onset of Symptoms: Cold viruses take about three days (from the time of infection) to cause symptoms. The sneezing, watery eyes, etc., from an allergy can happen as soon as you are in contact with the allergen.
• Allergy Symptom Characteristic: Allergies never cause a fever or body aches. The following symptoms are more common in allergy sufferers (though can sometimes be associated with colds, too): itchy, watery eyes; clear mucus that doesn’t turn yellow; and symptoms that are triggered when seasons change.
• Cold Symptom Characteristics: The following symptoms are more common in cold virus infections (though they can sometimes be associated with allergies, too): cough; sore throat; thick, yellow mucus; and winter-time onset. Unlike allergies, the common cold is often accompanied by fever and body aches.

The American Academy of Pediatrics issued a new policy statement Monday, advising that toddlers remain in rear-facing car seats until they are at least 2 years old — and preferably longer. This is because, as Madonna Behen reports in The Times, “children under 2 are 75 percent less likely to suffer severe or fatal injuries in a crash if they are facing the rear.”

Click link below to see an 8 minute video about these new guidelines:

3/8/11: PRINCIPALS OF APPROPRIATE USE OF ANTIBIOTICS FOR UPPER RESPIRATORY TRACT INFECTIONS

Approximately three quarters of all prescriptions of antibiotics for children are given for 5 conditions: ear infections, cough illness/bronchitis, common cold and sore throat. These antibiotics are prescribed even though many of these illnesses are caused by viruses and are unresponsive to these medications. Children treated with these antibiotics are at increased risk of becoming carriers of resistent bacteria, therefore developing illnesses from a type of bacteria resistent to antibiotics.

Below are some guidelines that can help you understand when your child needs antibiotics:

• Ear Infections: observation with out use of antibiotics in a child with uncomplicated ear infection is an option. About 70% of children resolve their infections spontaneusly within the first 48-72 hours. Pain management during this time is advisable. When antibiotics are used, a simple antibiotic is the first choice such as Amoxacillin for 5 to 7 days in children 6 years and older. Younger children need a longer course of 10 days.
• Sinus Infections: The diagnosis of sinus infection requieres the presence of nasal or postnasal discharge of any quality (from clear to green) without improvement for 10 to 14 days, with or without daytime cough (cough maybe worse at night time). Findings on x-rays of sinuses correlate poorly with this disease and should not be used. Initial treatment is also with a simple antibiotics such as Amoxacillin.
• Cough Illness/Bronchitis: nonspecific cough illness/bronchitis in children, regardless of duration, does not warrant use of antibiotics
• Sore Throat: most cases of sore throat are viral in origen. Antibiotic therapy should not be given to children in the abscense of identified Strept infection with a throat culture test.
• The Common Cold: antibiotics should not be given for the common cold. A thick, opaque or green nasal discharge commonly accompanies the common cold and is not an indication for treatment with antibiotics.

3/1/11: Fever and Antipyretic (Tylenol or Motrin) use in Children

The new AAP report summarizes the recommendations related to the use of antipyretics in children. The report highlights the need to educate parents about fever and "fever phobia". Fever is a way for the body to fight the infection and it is not known to endanger the child. The primary goal of treating the fever is to keep the child comfortable. Parents should focus on the general well being of their children while they have a febrile illness. The degree of the fever does not correlate with the severity of the illness and there is no need to awaken a child to give antipyretics.