Cough, red eyes and runny nose… Blame it on Covid-19, the flu or pollen allergies?

The weather is almost fine, the temperatures are mild and like every year, spring has taken the pollen out of its bag, which tickles the nostrils of allergy sufferers. Currently, around fifty departments are on red alert for birch pollen, which is very allergenic. At the same time, the figures for coronavirus contaminations remain very high, and the seasonal flu epidemic, which is usually over at this time of year, is playing out after a late start.

Two viruses and respiratory allergies that occur at the same time, and which can trigger similar symptoms. Runny nose, scratchy throat and watery eyes can enter the clinical picture every time, but each pathology has its specificities.

Viruses and allergies in simultaneous circulation

This spring of 2022 is full of good reasons to blow your nose. “The good weather and the mildness this week will favor the dispersal of pollen, especially that of birch. Consequently, the risk of allergy will be high over a large part of northern France”, notes the National Aerobiological Surveillance Network (RNSA).

And as spring allergies start, the Covid-19 pandemic continues under the effect of Omicron’s highly contagious BA.2 subvariant, with “more than 135,000 new cases diagnosed on average per day”, underlines Health public France in its latest epidemiological bulletin.

At the same time, the seasonal flu epidemic, late this year, is still not over. If it is “stable in seven regions, and decreasing in Brittany, it is increasing in five regions (Centre-Val-de-Loire, Ile-de-France, New-Aquitaine, Occitanie and Pays-de-la-Loire )”, continues Public Health France.

Common symptoms, but different triggers

The figures show it, one month after the end of the compulsory wearing of the mask in closed public places (with the exception of public transport), viral contamination and allergic manifestations. But “if certain symptoms are common, the triggering situations are different, explains to 20 minutes Dr. Sophie Silcret-Grieu, allergist. The symptoms of birch pollen allergy are those of all respiratory allergies (birch or grass pollen, dust or even cat hair). The best known is rhinitis, which manifests as sneezing, a stuffy nose with a clear, itchy discharge, itchy back of the throat, and even the ears, she describes. This is very often associated with conjunctivitis, particularly for tree pollens which, in addition to being allergenic, are irritating: we have red, watery and itchy eyes. All this gives rhinoconjunctivitis, or hay fever. And if the symptoms worsen, it can cause a cough, and even asthma if you have a predisposition. This can then take the form of a fit of dry cough, or even a real asthma attack with great difficulty breathing and wheezing.

Runny nose, red eyes and cough: symptoms that can also be experienced in the event of Covid-19 or seasonal flu. However, “the symptoms of allergy are characteristic in that they occur every year at the same time, in March and April, and are of variable intensity depending on the climate: the nicer and drier the weather, the more the symptoms are severe, because the trees then release more pollen, continues the allergist. Allergic patients recognize the associated signs well.”

The coronavirus and the seasonal flu, on the other hand, present “suggestive symptoms: fever, aches, great fatigue, headaches, cough; which suggest that we are facing a respiratory virus, adds Dr. Silcret-Grieu. Obviously, in the event of loss of taste and smell, the diagnosis will lean towards the side of the coronavirus. Ditto if you have Covid cases in your entourage. In any case, a screening test will shed light on the contracted virus. On the other hand, the particularity at the moment is that you can have it all: being allergic to birches and contracting Covid-19 or the flu”.

Masks and ventilation required

So, to guard against pollen allergies like viruses, a few reflexes can work in all cases. If wearing the mask indoors has proven itself against Covid-19 and the flu, “wearing it outside somewhat limits the passage of pollen directly into the nose, adds the allergist. Many patients say it helps limit nasal symptoms. Washing the nose with sea water also protects”. A gesture that helps to dislodge pollen, but also mucus and bacteria. In addition, “rinsing your face with water and brushing your hair when you get home helps not to put pollen in the bed” and interfere with sleep, prescribed Dr. Silcret-Grieu.

For allergy sufferers, “in an acute situation, it is recommended to take antihistamines, advises the allergist. And if the symptoms come back every year, you have to consult, to take stock and, if necessary, set up desensitization”. Finally, “if no cross protection exists between these pathologies, they have in common to generate inflammation of the respiratory tract and covid too, recalls Dr Silcret-Grieu. As we know, patients who have had Covid-19 can have destabilized respiratory function, and asthmatics and allergy sufferers can, after contracting the coronavirus, observe an increase in their asthma for a few weeks.

So, to breathe air less loaded with pollen and microbes, ventilation is essential. But if it is recommended to ventilate closed spaces regularly to protect against Covid-19 and the flu, in the face of pollen, it is better to open the windows “early in the morning or late in the evening”, recommends the RNSA, at times the day when there is the least pollen in the air.

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