As the clocks prepare to fall back and temperatures begin to drop, many people are experiencing a lingering runny nose, persistent cough, frequent sneezing and even fatigue.
While most assume it’s just a cold or the flu and turn to home remedies or over-the-counter medications, the cause may actually be something else, such as allergies or even a flare-up of asthma.
According to Dr. Lior Seluk of Sheba Medical Center, the main challenge is that many people struggle to distinguish between a cold, the flu, allergies and asthma.
The wrong treatment can be ineffective, and in some cases, even harmful. Antibiotics, for example, won’t help allergy sufferers, nasal sprays don’t resolve chronic respiratory conditions and flu medications won’t prevent asthma attacks. That’s why accurate diagnosis and understanding the differences between these conditions is essential.
Understanding the differences
The common cold is a relatively mild viral illness that usually lasts five to 10 days. It’s characterized by a runny or congested nose, dry or phlegmy cough and sometimes a low-grade fever. Later stages may include thick yellow or green mucus.
The flu, by contrast, is a much more acute viral illness. Symptoms include high fever, severe muscle aches, general weakness and sometimes headaches. It can last up to two weeks and may lead to complications, especially in vulnerable populations such as the elderly or those with heart or lung conditions.
Allergies, in contrast, are not caused by a virus but rather by an overreaction of the immune system to environmental triggers like pollen, dust mites, pet dander or mold. Classic signs include a clear, watery runny nose, repeated sneezing, eye irritation, tearing and sometimes a dry cough. Allergies do not cause fever or muscle pain. Symptoms can come and go, lasting for hours or days, and may persist as long as exposure to the allergen continues.
For asthma patients, allergic reactions that affect the lower respiratory tract can trigger an asthma flare-up. This includes shortness of breath, chest tightness, wheezing and a persistent cough.
Allergy - not just a spring problem
Many people associate allergies with springtime, when the air is filled with pollen, but winter can be just as problematic. During the colder months, people spend more time indoors, often in poorly ventilated spaces, creating an ideal environment for allergens.
Dust mites, for example, thrive in bedding, carpets and upholstery. Mold is commonly found in damp indoor areas, particularly bathrooms and poorly insulated homes.
Heating and air conditioning systems dry out the air and can irritate the nasal and throat linings.
Smoking indoors adds another layer of pollutants and can significantly worsen symptoms for those with allergies or asthma. It also increases the risk of asthma developing in children.
Even cold air itself can act as a trigger for airway constriction in asthma patients, explaining why many experience flare-ups during the winter months.
When conditions become more severe
For people with allergies or asthma, contracting a cold or the flu can complicate matters significantly. While most asthma patients have fully functional immune systems and aren’t more susceptible to viruses, infections can provoke more severe symptoms in them.
Their airways are already hypersensitive, so when a virus enters the system, the immune response can be overly intense, often leading to acute asthma exacerbation.
That’s why preventive treatment is critical. Relying solely on symptom relief is not enough. Consistent use of preventative medications helps minimize the risk of serious complications.
Treatment depends on the diagnosis
Colds require only supportive care, i.e., rest, plenty of fluids, saline nasal sprays for congestion, and over-the-counter medications for throat pain or cough. Antibiotics are ineffective since colds are caused by viruses.
Flu treatment is similar, although in certain high-risk cases, such as people with weakened immune systems or chronic lung conditions, antiviral medications may be prescribed. The most effective way to reduce complications and mortality from the flu is the seasonal flu vaccine, which is especially recommended for people with chronic lung disease.
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Flu vaccine, especially recommended for people with chronic lung disease
(Photo: shutterstock)
How are allergies and asthma treated?
Allergies are typically managed with antihistamines and steroid nasal sprays. Just as important are preventive steps like proper home ventilation, frequent washing of bedding and towels to reduce dust mites, and limiting exposure to mold.
Asthma, however, requires a more comprehensive approach. Most patients are treated with inhalers that combine inhaled corticosteroids and bronchodilators. During severe attacks, systemic steroids, either oral or intravenous, may be necessary.
However, long-term use of systemic steroids carries risks such as diabetes, high blood pressure, osteoporosis and cataracts.
A breakthrough in asthma treatment
In recent years, a new class of biologic drugs has transformed treatment for severe and allergic asthma. These therapies target specific immune system pathways responsible for inflammation and airway constriction. By blocking certain proteins, they reduce inflammation, decrease the frequency of asthma attacks and improve lung function and quality of life.
These medications are administered via subcutaneous injection every few weeks. In some cases, they allow patients to reduce or even discontinue long-term steroid use. Unlike biologic treatments used for other conditions, these asthma medications do not suppress the immune system.
How to prepare for winter:
Medical check-up: Get a lung function test and visit your doctor to ensure asthma is well-managed.
Inhaler readiness: Make sure your inhaler is working and that you know how to use it properly.
Vaccinations: Get a flu shot and any other vaccines your doctor recommends.
Home cleaning: Remove dust, mold and allergens; clean air conditioners and carpets.
Humidity control: Use a humidifier or place a bowl of water near the heater.
Daily ventilation: Open a window for at least an hour each day to reduce indoor pollutants.
No smoking: Avoid smoking at home, in the car or around children.
Hygiene: Wash hands frequently to prevent infection.
Stay hydrated: Drink plenty of fluids to keep airways moist.
See a doctor: Consult a physician for any changes in breathing, coughing or wheezing.
Not every runny nose or cough in winter is necessarily a cold or the flu. Allergies and asthma persist through the colder months—and may even worsen.
Accurately identifying the source of symptoms is key to effective treatment and avoiding complications. The more awareness grows, the better patients can benefit from proper diagnosis, personalized care and significant relief from day-to-day discomfort.
While asthma flare-ups are more common in winter and spring, following a few key guidelines can greatly reduce the risk, improve symptom control and help maintain a full and active lifestyle even during the colder season.
The author is a senior clinician at the Pulmonary Institute and leader of the Airway Diseases Clinic at Sheba Medical Center.