Infections from a bacteria that commonly causes “walking pneumonia” have been on the rise this year, according to information from the US Centers for Disease Control and Prevention, which cited an especially high rise in infections in young children.
Walking pneumonia, which is generally a milder lung infection than “just” pneumonia, can cause symptoms including cough, sore throat and low-grade fever. This means it may overlap with symptoms of COVID (which continues to circulate), flu (which typically starts peaking in December) and other respiratory viruses, such as RSV.
As the weather cools down and people gather closely for the holidays, a perfect storm is created for viruses and infections to spread. The general guidance on what to do if you’re sick likely doesn’t matter much based on what caused it (stay home if you’re feeling unwell and be especially mindful to limit any contact with people who may have a higher risk of severe illness or hospitalization), but finding out what you have is important to get appropriate treatment, such as antiviral medication for a virus, or antibiotics for pneumonia. (Antibiotics do not treat viruses because they work by killing bacteria.)
Here’s what to know about flu and COVID symptoms, as well as some clues to look for regarding whether you’re sick with a virus rather than allergies (or vice versa). If you’d like to learn more, here’s our guide to which vaccines adults 50 and older should consider and information on how to order more free COVID tests, so you can be fully stocked up for winter.
Is it walking pneumonia or a virus?
Walking pneumonia gets its name because it typically is less severe than pneumonia, pneumonia. Meaning, that people may continue “walking” around, assuming they have a cold with a bad cough, for example.
Walking pneumonia, or any type of pneumonia, is contagious. According to information from the Cleveland Clinic, walking pneumonia typically results in a low-grade fever and a “dry” cough, i.e. one that doesn’t produce phlegm. Other symptoms like a low fever and chills overlap with symptoms of COVID and flu, so the only way to know if you have walking pneumonia is to go to your doctor or urgent care for testing and treatment.
If you have a cough that won’t go away or one that’s getting progressively worse, seek health care. If you have an underlying health condition (a heart or lung condition, for example), that can make a bout of pneumonia or a virus-like COVID especially dangerous, make sure to reach out to your doctor as soon as possible so you can get the necessary testing and start the right treatment.
It’s also possible to get pneumonia after you’ve had a virus like the flu, for example. So again: If you have symptoms that are uncomfortable or aren’t getting better, seek medical care.
Flu vs. COVID symptoms; is there a difference?
It may be too soon to tell how severe the flu will be this year, since most flu activity typically peaks between December and February, according to the US Centers for Disease Control and Prevention.
Is there a real difference between COVID and flu symptoms? Not really, according to Dr. Amesh Adalja, an expert in infectious diseases and a senior scholar with the Johns Hopkins Center for Health Security, who spoke with CNET via email in late 2023.
“There is no real way to distinguish COVID-19 from influenza based on clinical symptoms because they overlap so much,” he said. Common COVID and flu symptoms include sore throat, fever, fatigue, muscle aches, cough and more. The big COVID symptom, loss of taste and smell, has become much less common than during the peak of the pandemic.
There may be a slight difference in how soon your symptoms show up after getting infected with the flu vs. COVID, according to the CDC. Flu symptoms may appear one to four days post-infection, vs. two to five post-COVID infection, and some people may take up to two weeks to show COVID symptoms, according to the CDC. Because the average window to develop symptoms is similar for both viruses, you likely won’t be able to tell based on this criteria either.
Both COVID and the flu cause the most severe illness and lead to complications in the same populations: adults in their 60s and up and younger people with certain medical conditions. If you’re planning on spending time with someone at high risk of any virus, it’s especially important that you err on the side of caution and wait until you’re no longer sick to see them face-to-face.
If you are at higher risk, you should speak with your doctor about getting a real diagnosis for the appropriate treatment. Flu has a different treatment than COVID-19, but antivirals for either should be started immediately.
What about RSV?
RSV is a common virus that causes only mild symptoms in most adults, such as a runny nose, decreased appetite and fever. In older adults and young babies, it can cause severe symptoms or other conditions, like pneumonia or trouble breathing.
Vaccines for RSV are now available to older adults and to pregnant people, to protect newborns once they’re born. Some infants may also receive a monoclonal antibody as protection against RSV.
Quick tips to help check whether it’s allergies or a virus
“It’s very common that people who have allergies, they think they’re having a series of viral infections,” Dr. Geoff Rutledge, chief medical officer at HealthTap, told CNET during spring 2022. On the other end, some people have reported COVID-19 symptoms from newer versions of the virus that are typically linked to allergies, including pink eye. That can make it even trickier to know what you have.
Rutledge said some symptoms and clues are “very suggestive” that you’re experiencing a virus rather than seasonal allergies or vice versa.
If you have a fever, it’s not allergies
“Fever” is in the name, but hay fever does not actually cause a fever, according to the American College of Allergy, Asthma and Immunology. If you have a sinus infection or other bacterial infection, that may cause a fever and can be caused “sometimes secondarily” by allergies, according to Rutledge.
If you’re really itchy, it might be allergies
“Allergies typically cause itching of either the eyes, nose or top of the mouth, which is not usually common in viral infections,” Dr. Jennifer Bourgeois, pharmacy expert at SingleCare, told CNET in an email during spring 2022. It’s important to note that while it’s hard to pin symptoms down to specific variants of COVID-19, there have been some reports of conjunctivitis or pink eye connected with the COVID-19 virus. Viruses and bacteria can also cause pink eye, which in turn can cause itching around the eye.
According to the Cleveland Clinic, other symptoms of allergic rhinitis besides itching include congestion; sneezing; headaches and sinus pain; dark circles under the eyes; increased mucus; postnasal drip (mucus draining down the back of your throat); trouble breathing; and fatigue or generally feeling bad.
Take an at-home COVID test
This one’s pretty simple, but the best way to find out whether you have COVID-19 is by taking an at-home test, or a more accurate lab test at a doctor’s office. This might be especially important if you plan on being around a person who’s older or otherwise at higher risk of serious illness from COVID-19.
The FDA recently authorized a new at-home test for both COVID and flu, the first one outside of pandemic-era marketing rules, and it’s expected to be available around Thanksgiving time. Other at-home tests on the market, such as this one, can distinguish between COVID and flu and have emergency use authorization.
In September, the USPS started offering four free at-home COVID test kits to US households.
Take the antihistamine test
For people who experience seasonal allergies but aren’t entirely sure if that congested feeling is from the same cold your friend had or the familiar allergies that usually kick in this time of year, Rutledge suggested what he calls a “therapeutic trial” of taking an over-the-counter antihistamine to see if that clears up your symptoms.
“There are specific treatments that only work for allergies,” he said, and antihistamines are one of them. Histamine is what your body releases when you have an allergy and your immune system is activated. Antihistamines work by blocking the effects of histamine and helping many allergy symptoms. On that note, if you have sinus pain or sneezing and your symptoms improve after you take an antihistamine, it might be safe to say you have allergies.
Pollen is the culprit behind many people’s allergy symptoms.
COVID, flu and RSV treatments
Antiviral medications like Paxlovid may be prescribed for older adults and younger people who have a higher risk of getting severe illness from COVID-19. For Paxlovid to work, you need to start the medication within the first few days of your symptoms appearing.
Flu treatments are also available for people at higher risk. Like COVID, it’s important for people at risk to start antiviral medication for the flu as soon as possible.
What are some effective allergy treatments?
In terms of allergies, what kind of medication you need depends on which symptoms you have.
“Each medication is designed to treat specific symptoms, so it’s important to find the correct over-the-counter medicine in order to manage and relieve your symptoms,” Bourgeois said. For example, antihistamines like Claritin or Zyrtec are standard allergy medications, but you could also find relief from a decongestant.
In a pinch, fever-reducing medications like ibuprofen might also work for allergies because they have anti-inflammatory properties, Bourgeois said.
You might even try stopping allergy symptoms before they start with a steroid nasal spray, according to Bourgeois. They do the work before you’re exposed to the allergens in the air.
“It is best to begin the steroid nasal spray a couple of weeks before the allergy season that triggers your symptoms and continue throughout the duration of the season, as it’s typically not required to use the steroid nasal spray all year long,” she said.
If you choose to do a nasal rinse after symptoms and mucus set in, Bourgeois referred to the CDC’s guide for safely carrying it out with sterile material.
Many people will manage allergy symptoms with help from their primary doctor or the right medication, Rutledge said, and they won’t need further medical help. If you’re still not getting relief from your symptoms, and you’ve done some detective work into what’s causing your allergies, then you might be a good candidate for in-clinic allergy testing or a follow-up appointment with a specialist to get to the source, according to Rutledge.
