Coughing, sneezing, runny nose: Is it a cold or allergy?

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Spring is in the air, and for some, that means nothing but sneezing and coughing.

The season that ushers in flowers and sunshine can be a “dreadful time” for allergy sufferers, says Dr. Lawrence Schwartz, who is affiliated with Shore Memorial Hospital and Cape Regional and AtlantiCare Medical Centers.

“This year the pollen count rose earlier than normal,” says Schwartz, who specializes in allergy and immunology. Though the winter didn’t seem so mild, there were enough warm days in February for the trees to start their allergy magic.

“Juniper and maples, they’re bringing on the symptoms,” Schwartz says. “The warm days broke early; though they may have disappeared, they left their mark. It’s been cold, but not so cold that we had a lot of frost.

“Once we have those warm days, it allows the trees to start pollinating earlier. A mild winter means an earlier allergy season. The allergic start feeling the symptoms after the trees are pollinated.”

With the amount of rain the region has experienced lately, this season looks to be especially brutal.

“Weather plays a direct role in the severity and length of the allergy season,” says Schwartz.

Those with seasonal allergies, asthma and recurrent sinusitis are feeling the effects of tree pollen, which is typically present from the end of February through mid-May. Grass pollen is predominant from early May through early July.

“Grass peaks about mid-May,” says Schwartz.  “Oak trees start in mid-May, and you’ll know because you’ll see green dust everywhere.”

By mid-July, most grass pollen is gone, but when the grass is cut, residual pollen may be released into the air. Wind also spreads allergens around, increasing symptoms. Rain can reduce the pollen count by washing it from the air, providing symptom relief. Conversely, heavy rain in late fall or winter can cause grass to grow faster, producing even more pollen.

There are differences between “spring colds” and “seasonal allergies,” says Schwartz.

“Allergies are the result of a hypersensitive and overactive immune system, usually due to genetic tendency, which mistakes harmless substances like mold or pollen as serious threats and reacts out of proportion,” he says. “Allergy symptoms can last for days or months depending on the length of time you are exposed to the allergen, and may occur any time of year, but most commonly during spring or fall.”

Colds mostly occur during the winter and are caused by hundreds of different viruses.

“After a couple of weeks your immune system fights the virus off and symptoms go away,” he says. “Seasonal allergies don’t go away so easily. Although there are some differences, cold and allergy symptoms are very similar.”

Those symptoms include a stuffy nose, post-nasal drip, cough, headache, runny nose and sneezing. Fevers may be present with a cold, but not an allergy.

“I think the most important difference is that colds don’t last longer than 14 days. If you still have symptoms after two weeks, these may be allergy symptoms,” Schwartz says.

Diagnosing allergies is an important first step. Using prick/scratch allergy tests – which are performed without the use of a needle – a physician can determine if the patient has an allergy by placing a small amount of the suspected allergen just under the skin surface to look for a reaction.

“Several suspected allergens can be tested for at once, and results are usually obtained within about 15 minutes. Most areas of redness resolve by the time your visit is over, and these tests are very well tolerated by kids and nervous adults,” says Schwartz.

After the test determines the allergy, Schwartz recommends three different treatment modalities: avoidance, medications such as antihistamines and prescription nasal sprays, and allergen immunotherapy, known as allergy shots.

“Allergy shots can be used to treat many allergens, and are quite effective,” he says.  “Allergy shots are a way of desensitizing, almost like not being allergic. There are so few options; allergy shots are one of our mainstays, though we try other things first.”

Immunotherapy is used for pollen, dust, pet dander and mold allergies and insect venom stings.

“By gradually increasing the doses of the injected allergen, a patient develops resistance to it,” he says. “As a patient develops this tolerance, they will have decreased or in most cases no symptoms upon re-exposure to that allergen.  In effect, the immune system becomes less sensitive to those allergic substances, reducing their symptoms for long-lasting benefits.”

Meanwhile, Schwartz predicts a long season ahead.

“The worst is yet to come,” he says.

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