Allergies, the Common Cold, or Strep Throat? Determining What Your Symptoms Mean

By Jennifer Cunningham, MD, Valley Health Shenandoah Memorial Hospital Family Medicine | Mt. Jackson

It is often challenging to distinguish between allergies, viral upper respiratory symptoms (common cold), and strep throat.

So what’s the difference?

Allergies typically are worse in the spring and fall, but there are those who have year-round allergies. Allergies often will results in sinus congestion; sneezing; a clear runny nose; and itchy, watery eyes. Most often those who suffer from allergies will have symptoms at the same time each year. While there can be a sore throat, it is rarely severe. Most people describe the sore throat as “scratchy.”

The common cold involves a lot of congestion, runny nose and cough. It can also involve a sore throat. There is rarely fever or body aches. Most often, individuals don’t feel as bad as they would with other types of infections. It is important to note that colds are caused by a virus. Viruses are not killed by antibiotics. Patients are frequently insistent that an antibiotic has helped them, but what actually heals them is the dose of time that is often equivalent to the length of time they were on antibiotics. This means they would have improved without the antibiotics.

Strep throat follows an entirely different course. Unlike the other processes that I described, strep throat is not accompanied by other upper respiratory symptoms. Typically, the only symptom is a very sore throat. Patients most often have a fairly high fever. Adults get sicker than children. If strep is not treated by antibiotics, there is the potential for it to damage the heart valves.

It is important to recognize that COVID is the great imitator and can present as any of the above. I have often seen patients that think their symptoms are from allergies only to return a positive COVID test.

When to see the doctor, nurse practitioner or PA?

A person should seek care if they have a fever with sore throat or a fever with body aches and headaches. Being unable to handle oral secretions or drooling is also an indication that an individual needs urgent care. Shortness of breath or increased work in breathing will need to be seen. If there is decreased alertness, a decrease in wet diapers, concentrated urine, or other signs of dehydration, an individual needs to visit their provider. We are always happy to see those who don’t feel well and don’t know what to do.