It's October and leaves are starting to turn, there's a nip to the air some mornings and, all of a sudden, a scratchy feeling in your throat. And then there's the sneezing, the coughing or maybe a minor headache. Are you getting sick with a cold — or even the flu — or is it just allergies?
Fall allergy season, and cold and flu season overlap in early autumn, a triple threat to your sinus passages, but proper prevention and treatment will vary depending on what is causing that congestion. Fortunately, there are some guidelines for determining just what you're dealing with: The Times caught up with Dr. Hava Ladinsky, an allergy/immunologist with the Maryland Asthma and Allergy Center in Westminster, and Dr. Wendy Miller, a primary care physician with the Carroll Health Group in Eldersburg, to discuss the fall allergy/cold/flu season and what people need to know to keep themselves healthy.
Q: There's often a lot of focus on allergies in the spring and early summer when there is a lot of plant pollen in the air. What causes fall allergies? What's the normal duration of the fall allergy season? The fall allergy season typically runs from August to mid-October/November and peaks mid-September. Ragweed pollen is one of the top triggers for fall allergy symptoms. Other weed pollens also bloom this time of year. Another big trigger is mold, which grows well among rotting leaves. Raking leaves and mowing the lawn can both increase mold and pollen in the air. Some children will note increased allergy symptoms when they return to school due to dust mite allergies.
Q: What about symptoms? Is there anything unique about fall allergies or do they present for most people just like spring allergies? Like spring allergies, fall allergies may present with sneezing, stuffy or runny nose, and post-nasal drip. Some people also complain of itchy, red, watery, and swollen eyes. Worsening nasal symptoms may lead to coughing and trigger asthma symptoms. In some patients, ragweed allergies may also trigger oral allergy syndrome (OAS), where the body's immune system becomes confused and triggers an allergic response. The proteins in some fruits and vegetables are similar to the proteins in certain pollens. When a person ingests raw fruit or vegetables, OAS may lead to an itchy mouth and throat or swollen lips, tongue, or throat. Very rarely does OAS lead to severe, life-threatening allergic reactions. People with ragweed allergy may be symptomatic when they eat melons, banana, cucumber, and zucchini. Cooking the fruit or vegetable often reduces or alleviates OAS symptoms. Birch trees are another important trigger of OAS, however, they bloom in the spring and are associated with different fruits and vegetables.
Q: Is there any connection between whether or not you suffer from allergies in the spring and dealing with fall allergies. Not everyone suffers from both spring and fall allergies. However, it is not unusual for patients who suffer from spring allergies to also suffer from fall allergies. Allergies, including seasonal and food allergies, may occur at any age. Adult onset allergies typically begin in a person's 20s or 30s but may develop even later. It is not clear what causes a person to react to allergens in their environment they had previously tolerated. However, family history plays an important role in allergies. A change in environmental exposures may trigger a person's predisposition to allergies and allergic reactions. Or a person may be exposed to a large enough quantity of allergen that they reach a threshold that triggers a reaction.
Q: What are the recommended treatments for fall allergies? Is there a spectrum of care based on how severe a person's allergies are? In addition to medical management of fall allergies, patients may also introduce environmental precautions to reduce allergy symptoms. This includes keeping the windows closed and running the air conditioning. It is also important to regularly change or clean the filters. Staying inside from 10 a.m. to 4 p.m., when pollen counts are highest, may reduce symptoms. Consider changing clothes and showering after spending time outside. Some patients benefit from wearing filter masks when mowing the lawn and raking leaves.
Q: Cold and flu season is also almost upon us. Are there any rules of thumb you could pass on for determining whether or not symptoms are a cold or just allergies? Is that even an important distinction to make? This distinction is important, as the treatment is different for allergies and viral illnesses. Fall allergy symptoms typically occur all at once with clear, thin, watery nasal discharge and no fever. Symptoms continue as long as the person is exposed to the allergen. A cold begins one to three days after exposure to a virus and symptoms typically occur sequentially. Viral illness symptoms include watery or thick, yellow mucus drainage, body aches, and low grade fevers. Symptoms typically last seven to 10 days.
Dr. Miller: Cold and Flu Q: What is cold and flu season? An annually recurring time period when we see outbreaks of the cold and flu. The season is typically during the cold half of the year, in this area, beginning in October.
Q: What's the difference between the cold and the flu? They are both viral infections right? Yes, the common cold and flu are caused by a virus that is spread by airborne droplets or contact. Flu is caused by the influenza virus and the common cold is caused by one of many viruses, most likely the rhinovirus.
Q: Sometimes people are not sure if the beginnings of cold-like symptoms are a cold or just allergies. What about the common cold and the flu — how do you distinguish one from the other? Unfortunately both can cause coughing, sore throat, runny nose, sneezing, body aches and a fever lasting seven to 15 days. The only way to be sure is to get a flu test.
Q: What about treatments? We all know there is no cure for the common cold, but there are all kinds of supplements and fizzy drinks and folk cures that claim to boost your immune system and shorten the length of a cold. Do any of these, such as extra vitamin C or Zinc, actually help? Is boosting your immune response even something you want to do when it comes to cold? True, there is no cure for the cold. Treatments are aimed at relieving the symptoms. Boosting your immune system is only helpful if you have a weakened immune system to begin with.
Q: What about the flu? It's a more serious infection. What should people do to avoid it, and what happens if they fail to avoid it? How can they mitigate the severity and length of their illness? Flu can be a more serious infection. Often with high fever and sudden onset of extreme fatigue. Flu can lead to pneumonia and even death. An annual flu shot is indicated above age 6 months. Hand washing is the best protection, avoid contact with people that have symptoms and get tested for the flu if you develop symptoms. Those that test positive can be treated with antiviral medication. This medication needs to be started within 48 to 72 hours of onset of symptoms.
Q: Some people get their flu shot religiously, others swear it's not worth it. Can you address some of the myths about the flu shot and give a clear case as to who should get it, when and why? Each year the flu virus changes and the flu shot is redesigned each year. The shot contains inactivated virus antigens, not the live virus itself, and it cannot give you the flu. Very few people have mild side effects from the shot. The risk of getting the flu outweighs the risk of side effects from the vaccine. This is especially true for the elderly —over 65 years old — and those with other chronic illness. Getting the flu shot in early October is the best protection.
*Read the original article on at CarrolCountyTimes.com.