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Boy coughing from covid or flu or allergies

Flu? Allergies? COVID? A Doctor’s Tips on How to Tell the Difference

can you spot the difference?

With fall, flu season makes its grand arrival. And with COVID, the common cold and allergies on the mind as well, how do you tell the difference? Can you tell a difference?

We spoke to Dr. Mansi Lalwani, pediatrician at Baylor Scott & White Family Health Center – Mesquite, and she shares that there is some crossover in the way these illnesses may present. “Flu and COVID share some common symptoms such as: Fever or feeling feverish/chills, cough, shortness of breath or difficulty breathing, fatigue (tiredness), sore throat, runny or stuffy nose, muscle pain or body aches, headache [and] some people may have vomiting and diarrhea, though this is more common in children than adults,” Lalwani says.

“Colds and allergies typically differ in that they do not present with shortness of breath. However, if a cold turns into pneumonia or a lower respiratory tract infection, then it can present with shortness of breath.” Lalwani adds that individuals with asthma may experience shortness of breath if associated with allergies.

One of the hallmark symptoms of COVID—loss of taste and/or smell—is not usually seen in flu, the common cold or allergies. Lalwani also points out that it’s “possible that people with flu [or] COVID, especially based on their age and underlying co-morbidities, may be sicker than the ones with cold and allergies.”

One thing that really sets allergies apart from the others is the presence of itchiness, usually in the eyes, nose or throat. Plus, patients with allergies don’t usually have fevers. “They can have a cough and runny nose though,” she notes. “They may have past medical history [of] significant allergies, and also family history of allergies. They may have associated history of other allergic conditions such as eczema and asthma.”

But while there are differences, Lalwani urges parents to not make their own diagnosis, since there’s so much overlap.

That’s true even if you think you or your kiddo is dealing with allergies. Let’s be honest, allergies seem to be the one condition out of the four that can be most easily identified. Lalwani says this is due to “slightly more distinct symptoms, past medical history of allergies/eczema/asthma [and] family history of allergies.” Still, she says it’s best to schedule a visit with your pediatrician so they can determine the cause of your child’s symptoms, as well as the appropriate testing.

If your child’s symptoms warrant a test, you may be wondering if it’s best to test for flu or COVID. Lalwani says that decision doesn’t necessarily have to be yours. “If your child has fever, cough, runny nose, sore throat, I would consult with your pediatrician to decide which tests [should] be done,” she says. “Most likely both tests would be ordered given the closeness in the symptoms. Rapid antigen tests are available at many doctor’s offices for flu and COVID.”

If your doctor does recommend a COVID test for your child and you decline, you may be offered and advised of appropriate isolation and quarantine recommendations. “Their pediatrician also may appropriately advise follow up [and] give emergency room warnings.”

And now that many kids are back to in-person school or extracurricular activities, if your child has minor symptoms (the sniffles, for example), how do you know when to keep your child home? Lalwani says if your child has any symptoms—even if it’s just a minor sniffle or a tummy ache—“it’s safest to keep your child home, inform the school authorities and immediately schedule an appointment with your pediatrician.”

And what’s the protocol for returning to campus? That’s something you’ll need to ask your child’s school.  “A lot of the schools and team activities have their own rules regarding this,” Lalwani says. “What I am seeing is that parents are being asked to consult with their pediatrician, who can then write a letter stating an alternate diagnosis for their symptoms or getting them a COVID test.”

Image courtesy of iStock.