Hay Fever vs. Cold

Hay fever, or allergic rhinitis, is another term for allergies. Hay fever usually refers to outdoor allergies, such as to pollen or mold. Hay fever is often seasonal. The symptoms of hay fever are caused by an allergic reaction of the immune system to foreign material in the air you breathe.

The common cold is an upper respiratory infection caused by a virus that usually affects the nose but may also affect the throat, sinuses, Eustachian tubes, trachea, larynx, and bronchial tubes - but not the lungs. The common cold produces mild symptoms usually lasting a duration of only five to 10 days, although some symptoms may last for up to three weeks. In contrast, the "flu" (influenza), caused by a different class of virus, can cause severe symptoms but initially may mimic a cold.

• Symptoms of hay fever include sneezing, runny or stuffy nose, postnasal drip, sensation of plugged ear(s), watery or bloodshot eyes, itching (of nose, soft palate, ear canal, eyes, and/or skin), fatigue, and trouble sleeping.
• Symptoms of the common cold include sore throat, runny nose or postnasal drip, sneezing, nasal and sinus congestion with or without sinus pressure, headache, cough, fever, watery eyes or redness and/or itchy eyes, and mildly swollen lymph nodes near the neck and ears.
• The cause of hay fever is an allergic reaction when allergens enter your body by inhalation, by swallowing, or through your skin. The most common allergens in hay fever are pollens and molds.
• Viruses cause colds. Most cold-causing viruses are very contagious and are transmitted from person to person.
• The treatment for hay fever includes avoiding known or suspected allergens. Treatments for symptoms of hay fever include medications such as antihistamines, decongestants, steroid nasal sprays, leukotriene inhibitors, cromolyn sodium, and immunotherapy (allergy shots).
• There is no single antiviral medication that can treat or cure the common cold. Antibiotics are not effective in treating colds because they kill bacteria, not viruses. There are home remedies and treatments to relieve symptoms of the common cold including drinking plenty of fluids, taking over-the-counter (OTC) pain relievers and fever reducers, cough suppressants and expectorants, lozenges and throat sprays, decongestants, and antihistamines.

• Most likely you or someone you know has allergies. The telltale itchy, puffy, watery eyes and red, stuffy nose signal changes in the seasons in homes and workplaces across the country. What these people suffer from is allergic rhinitis, or hay fever.
• The medical name for this condition refers to stuffy and itchy nose ("rhin-"), the most common symptom.
• Hay fever is an allergic reaction. It is your immune system's response to foreign material in the air you breathe.
• Hay fever usually refers to allergies to outdoor, airborne materials such as pollens and molds.
• Hay fever is found equally in both men and women.
• Usually hay fever is seasonal, but it can last all year long if the allergen stays throughout the year.
• Spring and fall are the main hay fever seasons.

A common cold is defined as an upper respiratory infection caused by a virus that usually affects the nose but may also affect the throat, sinuses, Eustachian tubes, trachea, larynx, and bronchial tubes -- but not the lungs. Statistically, the cold is the most commonly occurring illness in the entire world. The common cold is a self-limiting illness caused by any one of more than 250 viruses. However, the most common causes of colds are rhinoviruses. Colds may also be termed coryza, nasopharyngitis, rhinopharyngitis, and sniffles. Everyone is susceptible to colds.

The common cold produces mild symptoms (see below) usually lasting only five to 10 days, although some symptoms may last for up to three weeks. In contrast, the "flu" (influenza), which is caused by a different class of virus, can cause severe symptoms but initially may mimic a cold.

Hay Fever

The usual symptoms of hay fever include the following:

• Sneezing
• Runny nose (clear, thin discharge)
• Congested ("stuffy") nose
• Postnasal drip
• Sensation of plugged ear(s)
• Watery, bloodshot eyes
• Itching of nose, soft palate, ear canal, eyes, and/or skin
• Fatigue
• Trouble sleeping

Call your health care provider if you experience any of the following:

• Symptoms that do not improve with self-treatment
• Fever that does not subside
• Nasal secretions that are colored, thickened, or bloody
• Sore throat that gets worse
• Earache or ear discharge

Go to the hospital emergency department if you experience any of the following in conjunction with an allergic reaction:

• Very high fever
• Difficulty breathing
• Uncontrolled bleeding
• Discharge from the ear or severe earache

Cold

The most common complaints associated with a cold usually are mild. Cold stages are not well defined and have many names depending on which author you read. For example, stages of a cold can be the incubation period, the early symptomatic period (sore throat or scratchy throat), then quickly followed by several other symptoms listed below, followed by symptom reduction and recovery with symptoms stopping. Not all clinicians agree about cold stages and consider a cold a minor disease that runs its course quickly without formal "stages." The following symptoms usually occur with a cold:

• Sore throat or throat irritation
• Runny nose (increased mucus production) or postnasal drip
• Sneezing
• Nasal and sinus blockage (thick mucus and debris) or congestion with or without sinus pressure
• Headache
• Cough
• Mild fever
• Watery eyes or redness and/or itchiness of eyes
• Some individuals may have mildly swollen lymph nodes near the neck and ears

Hay Fever

Hay fever, like all allergic reactions, is caused by allergens, foreign "invaders" that enter your body by inhalation, by swallowing, or through your skin.

• In hay fever, the allergens are airborne substances that enter your airways (mouth, nose, throat, and lungs) via your breathing and the linings of your eyes and sometimes ears via direct contact.
• Most of the time it is difficult to identify a specific allergen.
• Once these allergens come in contact with your airway, the white blood cells of your immune system produce antibodies to the offending substance. This overreaction to a harmless substance is often called a hypersensitivity reaction.
  • The antibody, called immunoglobulin E, or IgE, is stored on special cells called mast cells.
  • When the antibody comes in contact with the corresponding antigen, they promote release of chemicals and hormones called "mediators." Histamine is an example of a mediator.
  • It is the effects of these mediators on organs and other cells that cause the symptoms of the allergic reaction, in this case hay fever.
• The most common allergens in hay fever are pollens.
  • Pollen is small particles released by plants.
  • It is moved around by wind to other plants of the same species, which it fertilizes so that the plant can bloom again.
  • Pollens from certain types of trees, grasses, and weeds (such as ragweed) are most likely to cause reactions. Pollens from other types of plants are less allergenic.
  • The time of year when a particular species of plant releases pollen, or "pollinates," depends on the local climate and what it normal for that species.
    • Some species pollinate in the spring and others in the late summer and early fall.
    • Generally, the farther north a plant is, the later in the season it pollinates.
  • Variations in temperature and rainfall from year to year affect how much pollen is in the air in any given season.
• The other common allergens in hay fever are molds.
  • Molds are a type of fungus that has no stems, roots, or leaves.
  • Mold spores float through the air like pollen until they find a hospitable environment to grow.
  • Unlike pollen, however, molds do not have a season. They are present throughout the year in most of the United States.
  • Molds grow both outdoors and indoors.
    • Outdoors, they thrive in soil, vegetation, and rotting wood.
    • Indoors, molds (usually called mildew) live in places where air does not circulate freely, such as attics and basements, moist places such as bathrooms, and places where foods are stored, prepared, or discarded.
• The amounts of pollen and molds in the air are measured daily in many areas around the United States and reported by the National Allergy Bureau.
  • The pollen and mold counts at which people develop allergic symptoms vary quite a lot by individual.
  • Pollen and mold counts are not very helpful in predicting how a specific person will react.
• Risk factors for hay fever
  • Family members with hay fever
  • Repeated exposure to the allergen
  • Other allergic conditions such as eczema or asthma
  • Nasal polyps (small noncancerous growths in the lining of the nose)
• The allergens that cause symptoms in an individual as he or she ages. Symptoms decrease in some allergy sufferers, but not all, as they grow older.
• Bodily changes of pregnancy may make hay fever worse.

Cold

Viruses cause colds. Most cold-causing viruses are very contagious and are transmitted from person to person. Some facts about common colds are as follows:

• Although colds have been with humans likely for eons, the first common cold virus was identified in 1956 in England, so the history of the cause of colds is relatively recent.
• Of the viruses that cause a cold, the most commonly occurring subtype is a group that lives in the nasal passages known as the "rhinovirus." Other less common cold viruses include coronavirus, adenovirus, and respiratory syncytial virus (RSV).
• Cold viruses may spread through the air and can be transmitted from airborne droplets expelled when someone with a cold coughs or sneezes. Close association with an infected person with a cold is the major risk factor.
• The primary means of spreading a cold is through hand-to-face or -mouth contact or from objects that have been touched by someone with a cold, or by touching items where droplets produced by coughs or sneezes have recently landed and then touching the face or mouth.
  • The typical transmission occurs when a cold sufferer rubs his or her nose and then, shortly thereafter, touches or shakes hands with someone who, in turn, touches his or her own nose, mouth, or eyes.
  • Virus transmission also often occurs via frequently shared or touched objects such as doorknobs and other hard surfaces, handrails, grocery carts, telephones, and computer keyboards.

Hay Fever

Avoid known or suspected allergens.

Hay fever symptoms lend themselves to home treatment.

• Gargle with warm salt water, 1-2 tablespoons of table salt in 8 ounces of warm water, to soothe a mildly sore throat.
• Take nonprescription antihistamines such as diphenhydramine (Benadryl) to relieve symptoms of sneezing, runny nose, and itchy throat and eyes. Caution - these medications may make you too drowsy to drive a car or operate machinery safely.
• For stuffy nose, a combination of an antihistamine and a decongestant such as pseudoephedrine (Sudafed, Actifed) may work better.

Steroid Nasal Sprays

Examples of these include beclomethasone (Beconase), triamcinolone (Nasacort), and fluticasone (Flonase).

• These are not the steroids taken by some people to increase athletic performance.
• Sprays take a few days to work, but when they reach an effective level, they do a very good job of decreasing symptoms without causing drowsiness.
• They must be used daily if they are to work properly.

Antihistamines

• Nonprescription antihistamines (diphenhydramine [Benadryl], clemastine [Tavist], hydroxyzine [Atarax]) are the most commonly used drugs. Loratadine (Claritin), cetirizine (Zyrtec) and fexofenadine (Allegra) are long-acting, nonsedating antihistamines available without a prescription.
• These antihistamines are inexpensive and readily available. The effects do not last long.
• They may make you too drowsy to drive a car or operate machinery safely. You may start using them at bedtime. Drowsiness often lessens with continued, regular dosage.
• Many hay fever sufferers choose to take longer acting prescription antihistamines, such as fexofenadine (Allegra), loratadine (Claritin), and desloratadine (Clarinex).

These drugs are more expensive, but they have to be taken only once or twice a day. The biggest advantage of these drugs is that they cause only mild sleepiness, if any at all.

Leukotriene inhibitors

• Montelukast (Singulair) is a leukotriene inhibitor approved by the US Food and Drug Administration for treatment of hay fever.
• It is available with a prescription and comes in tablet, chewable tablet, or granule forms. The granules may be sprinkled directly on the tongue or mixed with cold or room temperature soft food like applesauce or pudding.
• Leukotrienes are powerful chemical substances that promote the inflammatory response seen during exposure to allergens. By keeping these chemicals from producing swelling, leukotriene inhibitors reduce inflammation.
• Leukotriene inhibitors are particularly effective when used with an antihistamine.
• Cromolyn sodium
• Available in aerosol (Nasalcrom) and in eyedrops (Crolom), cromolyn sodium makes your mucous membranes less sensitive to allergens.
• It gives better relief if you take it as a preventive measure, even when you do not have symptoms.

Decongestants

• Decongestants are available in oral versions (such as pseudoephedrine [Sudafed]), eyedrops, or sprays (such as phenylephrine [Sinex])
• Eyedrops are effective for relieving annoying eye itch.
• Nasal sprays are very useful, especially in relieving nasal congestion. However, they can cause a rebound effect and inflammation called rhinitis medicamentosa if overused.
• Oral decongestants can cause high blood pressure, rapid heartbeat, and nervousness.
• Use all decongestants according to package instructions—usually no more than 3 days.

Be sure to tell your health care provider if you are pregnant, plan to become pregnant, or become pregnant while taking these medications.

Immunotherapy (allergy shots) is an alternative if medical therapy is not helpful. Allergy shots do not always help, but they can improve symptoms in many people. They are best given by an allergist.

• Immunotherapy consists of a series of injections over several months. The shots contain very small amounts of the antigen causing the hay fever reaction. The idea is to minimize your reaction to the allergen by slowly decreasing your sensitivity to it in a controlled setting, which is usually the allergist's office.
• Allergy shots do not always work, but in general hay fever responds well to this treatment.
• Severe adverse effects are uncommon.

Your immune system changes over time. Sometimes your body naturally lowers its immune reaction to allergens.

• If a cold occurs during pregnancy, women should check with their OB/GYN doctors before they attempt self-care at home that involves any over-the-counter (OTC) medications.
• To date, no specific cure has been found for the group of viruses that cause the common cold. Antibiotics kill bacteria, not viruses, and are of no use in treating a cold.
• It seems unlikely a single antiviral medication will be discovered in the near future that can target the over 200 different cold viruses. That is true in part because the viruses genetically change (mutate) each season just enough to prevent the development of a specific treatment for that virus.
• The good news is that people can take several steps to alleviate the symptoms once they have contracted a virus:
• Congestion: Drink plenty of fluids to help break up congestion and help keep mucus from becoming too thick. Drinking water will prevent dehydration and keep the throat moist. Some clinicians recommend people with colds drink at least eight to 10 (8-ounce) cups of water daily.
  • Fluids might include water, sports drinks, herbal teas, fruit drinks, ginger ale, and soups.
  • Cola, coffee, and other drinks with caffeine often work to increase urine output when the goal is to increase fluids in the body system; consequently, such fluids may be counterproductive.
  • Inhaled steam (from a safe distance so scalding of skin or mucus membranes is avoided) may ease congestion and drippy nose. Suggestions on how to do this safely:
    • Put a pot or teakettle on a trivet on a table and drape a towel over the head and around the steam.
    • A humidifier can increase humidity in a room and is useful to use during the winter when heating dries out the air and a person's mucus membranes.
    • Moisture from a hot shower with the door closed, a saline nasal spray, or sitting close to a room humidifier may be as useful as any of the above
  • Fever and pain: Medications such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve) or other anti-inflammatory medications often help decrease fever, reduce sore throat pain, and relieve body aches.
    • High fever usually is not associated with the common cold and may be indicative of "the flu" -- a more severe illness caused by an influenza virus. Report to your doctor any temperature greater than 102 F/38.8 C.
    • Never give a child aspirin or medications containing aspirin. In children younger than 12 years, aspirin has been associated with Reye's syndrome, a potentially fatal liver disorder.
  • Cough: The cough is a reflex that occurs when the airway passages are irritated. Cough preparations are usually divided into two main categories:
    • Suppressants: These act by blocking your cough reflex. As a general rule, use a suppressant for a dry, hacking cough. The agent usually found in over-the-counter cough suppressants is dextromethorphan (Benylin, Pertussin CS or DM, Robitussin Maximum Strength, Vicks 44 Cough Relief).
    • Expectorants: A cough associated with excessive mucus production, or phlegm, warrants use of an expectorant. Guaifenesin (Mucinex, Organidin) is the most common active ingredient in over-the-counter expectorants (such as Anti-Tuss, Fenesin, Robitussin, Sinumist-SR, Mucinex). It is also used for nasal decongestion (see below).
  • Sore throat
    • Lozenges and topical sprays can provide relief from sore throat pain. In particular, lozenges containing zinc may relieve many cold symptoms better than other types of throat lozenges. The benefits of zinc are not proven, however, and it can cause stomach upset. It also has been linked to loss of the sense of smell. Lozenges are not recommended for young children as they can be a choking hazard.
    • A warm saltwater gargle can relieve a scratchy throat.
  • Nasal congestion and itching: Nasal decongestants help relieve clogged nasal and sinus passages caused by excessive and thickened mucus secretion. There are several general types of decongestants and other medications available; some medications may combine some of these drugs:
    • Oral medications come in either pill or liquid form and act by shrinking engorged blood vessels in the nasal and sinus passages. They work well because the medication is distributed in the bloodstream. Oral decongestants often are associated with stimulant side effects such as increased heart rate, increased blood pressure, and insomnia. A commonly used over-the-counter oral decongestant is pseudoephedrine (Actifed, Sudafed, Triaminic), but people with certain health conditions such as Parkinson's disease, high blood pressure, or prostate disease should avoid its use.
    • Nasal spray decongestants act similarly to oral decongestants but have the advantage of acting only in the area applied, usually without the stimulant side effects. The most common active ingredient in nasal sprays is oxymetazoline (Afrin, Dristan nasal spray, Neo-Synephrine, Vicks Sinex).
    • A side effect of excessive use of nasal decongestants is dependency (rhinitis medicamentosa). Additionally, a "rebound" effect may occur in which nasal symptoms recur after a person abruptly stops the medication. Use nasal decongestants no longer than the package instructions indicate -- usually three days.
    • An expectorant, guaifenesin, is used to thin out bronchial secretions, including mucus. This allows the patient to more easily clear their airways that may become blocked with secretions and mucus thus making blowing the nose more effective in clearing secretions. It also functions as a cough suppressant.
    • Antihistamines such as diphenhydramine (Benadryl) can help relieve itching.

Many people may see their doctor because they think antibiotics can treat a cold. Antibiotics may kill bacteria but have no effect on viruses that usually cause colds.
Don't expect the doctor to prescribe an antibiotic for a cold, even if one is requested. Antibiotics may not prevent bacterial infections developing from a cold, such as sinusitis or ear infections, even if taken "just in case" and may lead to diarrhea or the development of more serious problems such as infection with Clostridium difficile or allow some organisms to become resistant to the antibiotics.

Alternative treatments claim to either prevent colds or reduce the severity and length of time of symptoms. Some of the major alternative treatments include zinc compounds, vitamin C, and Echinacea supplements. Although there are some publications on these compounds, many clinicians consider the results inconclusive. Others suggest if the compounds are not used to excess, they may be helpful. Studies in 2012 suggested zinc may reduce symptoms by about one to two days but may produce a metallic taste or cause hearing difficulties. Over-the-counter medications may help reduce symptoms (throat lozenges, menthol), and nasal irrigation or eye medications may help reduce nasal congestion and/or inflammation. Some doctors suggest that the side effects are not worth the one to two days of reduced or absent symptoms. Check with your physician before using these treatments.

Hay Fever

Common complications of hay fever include the following:

• Secondary infection: This is a bacterial infection that occurs in tissues such as the mucous membranes of the nose, throat, or sinuses or the ear that have already been irritated and inflamed by the allergic reaction. Ear infection (otitis) or sinus infection (sinusitis) are common secondary infections of hay fever.
• Rebound nasal congestion (rhinitis medicamentosa): This may result from using decongestant nasal sprays more than twice daily for 3 consecutive days.
• Nosebleeds
• Enlargement of lymph nodes in the nose and throat
• Decreased lung function
• Facial changes: Most of the facial changes are because of local inflammation and congestion. These are temporary and resolve with the treatment of the disease. These include facial swelling, redness around the nose, and allergic "shiners."
• The crease across the top of the nose caused by frequent nose wiping can persist in children with long-term hay fever.

Cold

The common cold usually will go away in usually about five to 10 days although some symptoms may last as long as three weeks in some individuals. Americans get over 1 billion colds per year and rarely report any complications.

In general, pregnant women and their fetus usually have no complications if the mother develops a cold. Pregnant females should consult their OB/GYN doctor before using any medical treatments.

Among the elderly and other groups of people with serious medical conditions, a cold may sometimes lead to a serious problem. Those people should see a doctor early during the course of a cold as a preventive measure.