Folks to our north may laugh and shake their heads when North Texans dust off our heavy coats once temperatures drop below 60 degrees, but despite mild winters, we still experience an uptick in illnesses as the year comes to a close. As winter arrives, it’s a fact of life that the sniffles, sneezes and shakes are likely to affect more folks around the Metroplex.

Here are some of the most common cold weather culprits, as well as tips on how to spot them and then send them packing:

Common cold: The U.S. Food & Drug Administration points to the increased proximity of other people during colder months as the main reason why we all tend to get sick during the winter. The common cold (most commonly caused by rhinoviruses) is characterized by a stuffy or runny nose, sneezing, coughing, a scratchy throat and watery eyes. While no vaccine exists, the cold is usually spread through contact with infected mucus, rendering limited contact with infected people important, as well as diligent hygiene practices (hand washing, covering sneezes and coughs, etc.).

Colds usually last seven to 10 days and are the leading cause of missed school and work, as adults experience an average of two to three colds per year with even more for kids. There is no cure for the common cold, but a combination of rest, increased fluids and over-the-counter medications can ease symptoms until it passes.

Mark Till, M.D., emergency medicine physician on the medical staff at Texas Health Dallas, says to watch for a change in symptoms to signal that it’s more than a cold.
“Colds make us all miserable but if there’s a change in the pattern of your symptoms, you may be dealing with something else,” he explains. “Usually pain with coughing is still just a cold because your muscles are getting overworked. Now if you’re having a fever, are short of breath or start coughing up new stuff, go see the doctor to make sure it’s not pneumonia.”

Influenza (flu): Flu season typically runs from October to March, but this year we experienced an earlier kickoff to flu season, making annual vaccinations for everyone over six months of age crucial in fighting off this common winter illness. The flu virus is spread by airborne droplets when an infected person sneezes, coughs or talks. The flu may also be spread when a person touches a surface or an object that has the virus on it.

The flu comes on quickly and lingers around longer than colds, bringing with it the following long list of miserable symptoms: fever, body aches, fatigue, headache, chills, cough, runny or stuffy nose, sneezing and watery eyes. Younger children may also experience nausea and vomiting.

With flu season now in full swing (as it peaks between November and January), there are five things to remember about the flu:

“Obviously anybody working in healthcare, anyone who takes care of older people or small children, and anybody who is any way susceptible needs to get the flu vaccine with the four components,” he said. “Second, if you’re sick, stay home from work and don’t spread it to everybody else. Next, practice good hygiene and wash your hands often, as that’s mostly how the flu spreads. Fourth, get plenty of sleep and eat well…and stay home!

“Finally, if you have the flu you need to call your doctor as soon as you suspect it, because Tamiflu won’t help unless you get it within the first two days. Sometimes it’s hard to tell, but watch for fever and body aches.”

COVID-19: As we know by now, COVID is not a seasonal illness, however, infection rates can tick up during the busy holiday and winter season where we are traveling more, congregating with more groups of people, and spending more time indoors. The virus is most commonly spread by airborne respiratory droplets, but can also be spread through contaminated surfaces or skin-to-skin contact.

Symptoms may appear 2-14 days after exposure to the virus. While symptoms vary from person to person, the most common include:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

The flu and COVID-19 can look eerily similar, although spread by different viruses. Since a definite diagnosis cannot be made based on symptoms alone, your physician may recommend getting test for COVID and the flu at the same time that way you can be diagnosed and treated earlier and more efficiently.

If you test positive for COVID, new isolation guidelines recommend that you stay home for at least five days and isolate from others in your home since you are the most infectious during these first five days.

You should rest and stay hydrated. You can take over-the-counter medications to help treat the symptoms of COVID-19. If you are high-risk, you may want to discuss additional prescribed treatment options available to you with your physician. 

Most people will feel better within two weeks, however it’s important to look for any emergency warning signs for COVID-19, especially if you aren’t seeing an improvement in symptoms after a few days.

If someone is showing any of these signs, seek emergency medical care immediately:

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

You may end your isolation after day 5 and without a fever for at least 24 hours, however, you may not feel better around this time based on the severity of your symptoms.

Regardless of when you decide to end your isolation, it is recommended that you avoid being around high-risk people and wear a high-quality mask until at least day 11.

Vaccines for COVID-19 are still available, free, and are being updated regularly. Whether you’d like to start up the first shot in the series, or get covered with a booster, getting vaccinated is the best way to protect yourself from serious illness caused by COVID-19.

Pneumococcal disease: Caused by the Streptococcus pneumoniae bacteria, pneumococcal disease is more common during the winter and early spring and causes pneumonia (lung infection), meningitis (infection of the covering around the brain and spinal cord) and bacteremia (infection of the bloodstream), as well as ear and sinus infections. These bacteria are passed through coughing, sneezing and close contact with an infected person.

Symptoms vary based on the location of the infection but may include fever, cough, shortness of breath, chest pain, stiff neck, joint pain, chills, ear pain, confusion and disorientation, sensitivity to light, sleeplessness and irritability. In the most serious cases, which most often involve high-risk groups including adults over age 65 and children under 2, pneumococcal disease can lead to hearing loss, brain damage and even death. Other factors that increase the risk of infection due to a weakened immune system include diabetes, heart and lung disease, HIV/AIDS, smoking and asthma.

Vaccines for children from birth to age 18 are recommended, as well as for those over age 65 and adults with elevated risk factors. Practice good hygiene and avoid close contact with infected people. If you suspect you are infected and especially if you have a fever, see your doctor as soon as possible.

Respiratory syncytial virus (RSV): Caused by a common respiratory virus, an RSV infection most often produces mild symptoms, similar to a cold. However, RSV can lead to bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children under one, as well as respiratory illness in older adults, and in the most severe cases, it can be fatal.

Symptoms may include a runny nose, sneezing, coughing, fever, wheezing and/or a decrease in appetite, but will often appear in stages and not all at once. Additionally, very young infants may only display irritability, decreased activity and difficulty breathing. People with RSV are contagious from three to eight days, but may spread the virus for up to four weeks via airborne droplets (coughing, sneezing, talking), very close contact (kissing a baby) or touching surfaces the virus is on. The virus can survive for shorter times on soft surfaces but may linger for several hours on hard surfaces (doorknobs, tables, crib rails).

Those with the highest level of risk include premature infants; young children with congenital heart disease, chronic lung disease or compromised immune systems; adults with compromised immune systems; and older adults with heart or lung disease. There is no vaccine for RSV, but a drug called palivizumab can prevent severe RSV illness in infants and high-risk children. Talk to your doctor if your child is at high risk for severe RSV.

“RSV is more of a problem in little babies and can be a bigger deal, but there aren’t any good treatments, unfortunately,” Till says. “If it seems like a cold, they have a snotty nose and a low-grade fever or one that comes down with Tylenol, it’s probably okay. If they aren’t feeding, are short of breath or they’re starting to get dehydrated, they should see a doctor.

“Most over-the-counter medications are a waste of time, especially for kids, but you can let them sleep propped upright and use a humidifier. They don’t need to go to the hospital unless there is a change in symptoms, or they aren’t eating or are short of breath.”

Strep throat: A sore throat may be caused by anything from bacteria and viruses to irritating allergens and postnasal drip, but one of the worst is brought on by group A Streptococcus bacteria, leading to an infection of the throat and tonsils. There is no vaccine for strep throat, so prevention is the best weapon, including frequent hand washing, and avoiding close personal contact and using shared drinking glasses and eating utensils.

Spread by airborne droplets from coughing or sneezing, as well as by touching an infected surface or direct contact with a sick person, strep throat is characterized by the following symptoms: a sore throat with pain when swallowing, fever, red and swollen tonsils, white patches or streaks of pus, small red spots on the roof of the mouth and swollen lymph nodes. Additional symptoms may include headache, stomach pain, nausea, vomiting and a rash, known as scarlet fever.

If you suspect you have, or your child has, strep throat, your doctor can perform a quick swab test and then prescribe antibiotics if the results are positive. Antibiotics help reduce symptoms and lessen your sick time, as well as preventing the spread of infection and potentially serious complications. Don’t return to work, school or daycare until the fever is gone and after 24 hours of being on antibiotics.

“The way you can tell a sore throat from strep is if you have a combination of fever, pus pockets on your tonsils and swollen lymph nodes, it’s probably strep,” Till explains. “Also, if there’s a bulging in the back of the throat or if the uvula is pushed off to one side, go see a doctor.
Around 90 percent of sore throats are just a virus, but if it’s strep, you can take an antibiotic.

“It might be tempting to live in a bubble all winter, but you can’t realistically avoid viruses anyway because they are just everywhere. Obviously, avoid sick people, but your body isn’t meant to be sterile. Your immune system needs to be working.”

Remember – when it comes to your health, it's always best to play it safe. You can visit our website any time to schedule a Virtual Visit or in-office appointment with a Texas Health Physicians Group primary care doctor or find a Texas Health Breeze Urgent Care facility near you.