- The Washington Times - Tuesday, July 24, 2007

t takes Dr. Harvey Schwartz a week to figure out if his sneezing fits, watery eyes and runny nose are caused by a cold or an allergy even though he knows the symptoms for both.

“If my symptoms come on during the season, I know it’s allergies,” says Dr. Schwartz, an allergist and immunologist at Inova Mount Vernon Hospital who is allergic to ragweed and has other low-grade allergies. “If I get symptoms off season, I can’t tell.”

Seasonal allergic rhinitis, or seasonal allergies, can cause a sneezing spell or attack of three to five or more sneezes at a time, while colds can cause minor sneezing of one to two sneezes at a time, metro-area physicians say. Allergies and colds both can cause a runny or stuffy nose and headaches, they say.

Symptoms that differ include watery eyes and itchy throat, eyes and ears for allergies and low-grade fever and body aches for colds, the physicians say.

“The general thing is, most allergies follow a repetitive pattern. Viruses are more sporadic,” says Dr. Andrew Shorr, pulmonologist at Washington Hospital Center in Northwest.

Allergies can occur year-round or are seasonal, peaking in the spring and summer, when pollen from various plants becomes airborne, Dr. Shorr says.

Colds can occur any time of the year and peak in late fall and early spring, says Dr. Alkis Togias, section chief, asthma and inflammation, at the National Institute of Allergy and Infectious Diseases in Bethesda.

“Sometimes it’s easy to confuse because early spring is a time for allergies, particularly tree allergies,” Dr. Togias says.

The average adult gets three to four colds per year, while children get seven to eight a year, Dr. Togias says. Thirty percent of the population has seasonal and perennial allergies, he says.

Seasonal allergies tend to last a short time, usually three to six weeks, and are caused by seasonal allergens such as tree pollen in March and April, grass pollen in May and ragweed in September, Dr. Schwartz says.

Perennial allergies are caused by indoor allergens, such as dust mites, which are small insects that live in dust, along with molds, cockroaches, and pet dander and saliva, says Dr. Surender Veswani, an allergist at Howard County General Hospital in Columbia, Md.

Symptoms from perennial allergies, such as sinus pressure and congestion, can persist year-round, Dr. Veswani says. Alternatively, symptoms from colds usually last from three to 10 days, he says.

Allergy symptoms are more prolonged and severe than cold symptoms, says Dr. Mary Bollinger, associate professor of pediatrics at the University of Maryland School of Medicine in Baltimore.

“You often can see symptoms occurring soon after a trigger,” Dr. Bollinger says. “A cold can come on gradually, but you have similar symptoms.”

For instance, allergies and colds can cause nasal discharge, but the color of the discharge can differ. The discharge in allergies is clear, watery and thin, Dr. Bollinger says. Thick, colored discharge that usually is yellow or green indicates a cold, she says.

“The first few days both can have a clear discharge, so it’s difficult to tell,” Dr. Schwartz says.

However, nasal symptoms occurring several times throughout the year point to allergies, Dr. Schwartz says. Nasal and other symptoms that occur at the same time each year also suggest allergies, he says.

The cause of colds and allergies differ; one is an infection and the other a reaction.

Cold symptoms are caused by a viral infection of the upper airways, Dr. Shorr says.

Colds are transmitted from person to person through sneezing and coughing when viruses are released out of the nose and mouth in small droplets of liquid, Dr. Togias says. A person who breathes in the droplets can catch the cold when viruses sit in the lining of the nose and respiratory tract and multiply, he says. As the viruses multiply, the body produces cells to make chemicals that attack the virus that also cause the cold symptoms, he says.

Alternatively, allergies are caused by a protein that comes from the allergens, Dr. Togias says. The protein becomes airborne and once breathed in is deposited in the respiratory tract, he says.

“In order to cause allergy, a person has to have special sensitivity to it. That special sensitivity is an immune-system reaction,” Dr. Togias says. “Our immune system recognizes the proteins as an enemy or an intruder and attacks them. … It’s the wrong type of response or reaction.”

Over-the-counter and prescription antihistamines that work against sneezing, itching and runny nose, and decongestants and prescription nasal sprays that work against congestion can provide relief to cold and allergy sufferers, Dr. Shorr says.

Acetaminophen, such as Tylenol, treats cold, flu and allergy symptoms and reduces fever, Dr. Togias says.

Antibiotics, however, should not be given for colds because colds are viral, not bacterial, Dr. Shorr says.

“In the vast majority of cases, especially with colds, symptoms will get better over time,” he says.

If medications prove ineffective, allergies can be treated with immunotherapy, or allergy shots, to enable the body to build up immunity and accept the allergens the immune system attacks, Dr. Togias says. Doses are increased slowly over a three- to five-year period to achieve the desensitization, he says.

Colds can be avoided by careful hand washing after coming in contact with cold germs and by sneezing into a handkerchief or tissue to avoid spreading the germs, then washing the hands, Dr. Schwartz says.

Avoiding allergic symptoms takes avoiding the known allergen, such as staying indoors when a particular pollen is present for seasonal allergies and using air-conditioning to filter out the pollens, Dr. Schwartz says.

Keeping the house on the cool, dry side also helps prevent dust mites, which prefer high temperatures and humidity, Dr. Togias says.

For dust allergies, avoiding carpeting and upholstered furniture, which can allow dust to build up, and using impermeable covers on mattresses and pillows also helps, Dr. Schwartz says.

“There’s many ways of treating allergy. You always recommend those methods of avoidance to begin with, knowing that they won’t be 100 percent successful,” Dr. Togias says.

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