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allergies or COVID?

Ask the Pediatrician: Is it allergies or COVID? Tips for hay fever season

Not everything is COVID. There also are lots of allergens out there.

Spring is here (we made it, team!) and for us that means sunny days, windy days, rain and of course, beautiful flowers and pollen.

Let’s talk about allergic rhinitis, otherwise known as hay fever. These days, every sneeze and cough makes us wonder if we have COVID. But remember, not everything is COVID. Read on for tips on telling the difference — and on coping with this not-so-welcome side effect of spring.

About one in five people in the United States, or 50 million people, have allergies. Hay fever is incredibly common and for many it flares up in the spring. Hay fever also runs in families. If one parent has allergic rhinitis, there’s a 25% chance that their children will have allergies. If both parents have allergies there’s about a 65% chance their child will have allergies.

What are allergies?

Allergies are the result of an overactive immune system. Typically the immune system protects the body against disease by destroying foreign invaders such as viruses and bacteria. For people with a tendency toward allergies, the immune system overreacts against harmless invaders such as pollen and animal dander.

Substances that trigger allergies are called allergens. Depending on which part of the body is affected, you can develop allergic rhinitis (hay fever), asthma (lungs) or eczema (skin).

While allergies can develop at any age, they typically show up during childhood. There is often a strong family history, but the child will not always be allergic to the same allergens as the parents. People with hay fever are also more likely to have eczema and asthma.

Allergy symptoms

Allergic rhinitis often presents with red itchy eyes, runny nose, sneezing, nasal congestion and a post-nasal drip. Allergies can also bring a dry, hacking cough, wheezing, or dry, itchy red skin.

With COVID on our minds, it is no wonder that every sneeze makes us pause. Some allergy symptoms can easily be confused with a respiratory infection.

Allergies or COVID? Or common cold? How to tell

There are definitely many overlapping symptoms between allergies and a viral infection. Here are a few rules of thumb to help you tell the difference:

  • Allergies often have itching of eyes and nose, spasmodic sneezing and clear, watery nasal discharge.
  • Fever is never a part of an allergy and almost always suggests an infection.
  • Viral infections tend to last about a week, whereas allergies can go on for weeks to months.

If you think your child might have COVID, get a test to confirm and follow the current public health guidelines.

You don’t want your kids to avoid being outdoors, so talk to a doctor about treating symptoms of seasonal allergies.

What to do if you suspect your child has allergic rhinitis

This is definitely something to talk to your primary care provider about. In addition to being uncomfortable, allergic rhinitis can affect a child’s ability to get a good night of sleep. (We all know how important sleep is to feeling well, feeling happy and engaging in learning. More on that here.)

There are a number of ways to treat allergies, so talking with your provider is the best way to find something that works well. Your provider will also consider approaches if your child has asthma or other conditions that can be aggravated by allergies.

With allergies it’s often best to see what works with the least intervention, and there are a few simple measures you can take.

First, try to avoid the allergen, so no cats if it’s kitty-triggered and, unfortunately, hold back on rolling in the grass during pollen season if that’s the trigger. To help get ahead of symptoms, try out using a pollen forecast or app to see what’s blooming when your kid starts sneezing.

You can also have your child wash their hands, change clothes, or shower after encountering an allergen. If avoidance isn’t enough to stop the sneezing, you can discuss other options with your provider from saline rinses to short-acting medications that treat symptoms to daily medicines.

Although allergies often are mostly uncomfortable rather than a serious health issue, suffering from allergies can take the fling out of our spring and even make kids want to avoid the outdoors and exercise. Finding ways to stop or reduce symptoms handles more than just the red eyes and runny nose, it can help sleep, activity levels and overall enjoying this time of year.


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About the Author

Susanna Block

Dr. Susanna Block, MD, MPH, is a pediatrician with Kaiser Permanente in Seattle and lives with her family in Queen Anne.