Allergies, Flu, Runny Nose, Cough, Strep Throat & Covid-19 In Children

kid coughing

Pediatrician’s explanation on Allergies, Strep Throat, Common Cold, Flu, Covid-19, their symptoms and what to expect

There are different reasons a child might get sick. Change in weather might cause allergies that lead to sore throat & dry cough. The start of school might expose children to one another’s coughs, sneezes, and respiratory droplets resulting in infections like colds or strep throat. This year, there’s an additional overhanging fear that sore throat & dry cough may be related to a COVID-19 infection. 

Reviewing the symptoms of different conditions can help distinguish between the different ailments and how to manage them. 

Seasonal Allergies

Little girl is blowing her nose

Symptoms of Seasonal Allergies

Seasonal Allergies tend to flare in the spring and fall with changes in weather, pollen, and mold patterns. A few things can help one identify Seasonal Allergies Symptoms.

Absence of Fever

Allergies are not accompanied by fever. They are not contagious or infectious. They are simply a body’s over-reactive response to something in its environment, like pollen, mold, dust, pet dander, etc. 

Post-Nasal Drip

Thin clear mucus is produced by the nose as a way to wash out allergens that are perceived by the body to be intruding foreign agents. This mucus will often drip down the back of the throat when one lies flat. The body will also sneeze & produce tears to try and expel these intruders. 

Presence of Itching

In addition to runny nose and sneezing, people with allergies will experience some kind of itchings like an itchy nose, itchy watery eyes, itchy ears, or itchy scratchy throat. 

Sore Throat & Cough

Post-Nasal Drip leads to an itchy, scratchy, sore throat that is worse when lying down (when falling asleep or waking in the morning.) Often, the body will begin to cough in an attempt to relieve the irritation of the throat. 


People with allergies sometimes have asthma or reactive airways as well. Thus, when allergies flare, coughing, shortness of breath, and wheezing can also be present. Wheezing is the body’s way of trying to remove the foreign agent from the airway.

Absence of Body Aches & Fatigue

Because there is no infection, allergy symptoms affecting the whole body like body aches & fatigue usually don’t accompany allergy flares. Mild fatigue may sometimes creep into the picture for some people, but isn’t commonly seen with everyone experiencing allergy symptoms.

Predictable Pattern

Allergies are driven by certain triggers that a person may be susceptible to. Thus, people will find their allergies flare at the same time every year making the allergies symptoms predictable. 

Duration: How long do Allergies last

Allergies may persist for days, weeks, or months until:

1) The trigger has been removed (i.e: pet is gone or weather becomes too hot or too cold for pollen/mold to thrive).

or until

2) Medical management (i.e: antihistamine, nasal steroid, decongestant) has reduced the body’s response to the trigger. 

Common CoLD (Runny or Stuffy Nose)

Common Cold

There are a number of virus families that can cause the common cold. It’s important to remember that we can treat cold symptoms, but we have to wait for our bodies to recover from a cold. There is no cure nor prescription that can make a cold go away any sooner. 

Symptoms of Common cold (Runny Nose)

Sore Throat, Runny/Stuffy Nose, Cough

Common Cold Symptoms will appear in this order. The sore throat is the first symptom as the virus invades the back of the nose & throat. Runny nose & sneezing is the body’s response to try and flush out the foreign invader. With a viral infection like a cold, the mucus will often turn yellow/green and become thicker than it does with allergies. This is due to the inflammatory response of the body as it fights infection. Again, cough is the body’s response to try and clear that irritation caused by mucus along the back of the throat. The sore throat & cough with a cold will persist day & night unlike that with allergies which occurs more at night and in the morning when lying flat. 


Children will often present a low-grade fever when they have a cold (< 101 degrees Fahrenheit). Adults may have a cold without a fever. 

Fatigue/Body Aches

Because a cold is an infection affecting the entire body, it may be accompanied by mild body aches and fatigue. Once the fever goes away, the fatigue & body aches resolve. 

Duration: How long does a Common Cold Last

The fever at the onset of a cold usually lasts no longer than 48 to 72 hours. The runny nose/congestion may persist for a few days and the cough will be the last thing to disappear, usually 7-10 days later. Symptoms lasting longer than this may indicate a cause other than a cold and should be evaluated by a doctor. 

Common cold is Contagious

All infections are contagious. Colds spread by droplets of mucus or saliva (i.e: sneezing, coughing, sharing food or drinks). Within 24 hours after the resolution of the fever, one is a lot less likely to be contagious. Please take all precautions to ensure we limit the spread of this infection.

Strep Throat

Boy with sore throat sick

Though viruses are the most likely cause of a sore throat, sometimes a bacterial infection of the throat and tonsils can occur called strep throat. Up to 30% of children with a sore throat have strep throat. It is most common in kids between the ages of 5 and 15 years. 

Symptoms of strep Throat

Sore Throat

The sore throat with a strep throat infection comes on all of a sudden. It is much more intense than the sore throat one would have with allergies or a common cold. With strep throat infection one may also have red swollen tonsils, little red spots on the roof of the mouth, as well as white streaks of pus on the tonsils. 

Pain with Swallowing

It is very painful to swallow with strep throat, sometimes even difficult to swallow one’s own saliva. It is crucial to make sure children can stay hydrated (often with soothing cold fluids from the fridge or freezer) until antibiotics have a chance to start fighting the bacteria to improve pain from the infection. 


Strep throat is usually accompanied by a fever higher than 101 degrees Fahrenheit. It tends to resolve quickly within 24 to 48 hours of starting antibiotics.

Whole Body Symptoms

Response to infection can lead many children to have body aches & fatigue much more intense than with the common cold. Children may have stomach aches, headaches, loss of appetite, nausea, vomiting, enlargement of lymph nodes in the neck, and rash with strep throat. 

Cough without Runny Nose

Occasionally, some children will have a dry cough when they have strep throat due to the irritation in the back of the throat. There is not any accompanying runny nose or nasal congestion with strep throat as there is with viral infections.


Strep throat can be diagnosed either by an in-office throat swab or throat culture sent to the laboratory. 

Treatment with Antibiotics

Strep throat requires antibiotics to expedite the resolution of symptoms, prevent the spread of infection, and reduce the risk for long-term consequences. Fever, sore throat, loss of appetite, and fatigue begin to resolve within 24 to 48 hours of taking antibiotics. It is important to complete the entire 10-day course of antibiotics to prevent complications like rheumatic fever.

Strep Throat is Contagious

Just like colds, strep throat spreads by droplets of mucus or saliva (i.e: sneezing, coughing, sharing food or drinks). One should stay away from others until 24 hours into the course of antibiotics and 24 hours free of fever.


Allergies, Flu, Runny Nose, Cough, Strep Throat & Covid-19

One may think of the flu as a really bad cold. Like a cold, the flu is caused by a virus. While a cold should completely resolve in 7 to 10 days, the more intense symptoms of the flu might be just beginning to get better in that time. The risk of complications requiring hospitalization is much higher with the flu than with a cold. 

Symptoms of Influenza

Fever, Body Aches, Chills, Fatigue

Within 24 to 48 hours of exposure to the flu virus, people often feel like they’ve been “hit by a ton of bricks.” The flu comes on very abruptly and symptoms affect the entire body. While a cold presents with mild or no fever, the flu usually presents with high fevers. 

Stuffy Nose/Congestion

Thick yellow-green mucus is common with viral upper respiratory infections as the body responds to inflammation, but might not be the predominant symptom with the flu when compared to how the whole body is feeling. 

Sore Throat

Sore throat may be present but is not always present with the flu. 

Shortness of Breath/Chest Discomfort and Cough

Chest pain & discomfort may occur with the flu as a result of whole-body muscle aches, cough, and inflammation in the body. Sometimes this may be more pronounced in people who have underlying Asthma. One should be prompt to see a doctor if the chest pain is getting worse. There is a concern that pneumonia might develop as a complication of the flu. 


Vomiting & diarrhea may come along with the flu more so in children than adults. 

Diagnosis & Anti-Viral Treatment

The flu can be diagnosed by a nasal swab at one’s doctor’s office. If diagnosed within the first 48 to 72 hours of infection, one might be able to reduce the duration and severity of flu symptoms with Anti-Viral medication. After this time, however, the Anti-Viral is not as effective since the flu virus has already spread throughout the cells of the body.

Flu Can Be Prevented

Every year, the Flu Vaccine prevents millions of people from getting the flu, being hospitalized due to complications, and dying from the flu. It has been shown to reduce the risk of catching the flu by 40-60% in some seasons! 

Duration: How long does the flu last:

The flu can take from a few days to a couple of weeks to completely resolve. If flu symptoms first appear to get better, but then begin to get worse again, one should seek medical attention to make sure secondary infections like pneumonia, sinusitis, or ear infections have not set in. 

Flu is Contagious

We know that viral respiratory infections like colds & the flu spread by respiratory droplets. The flu and its potential complications are most dangerous in children & the elderly.



During this pandemic, people with a fever, dry cough, shortness or breath & fatigue are fearful they may have a COVID-19 infection. This is even more stressful now with kids returning to school and being sent home for testing if they have certain symptoms like a sore throat or fever. These children are being isolated at home to do online learning until they are symptom-free if they have a negative test or until 10-14 days have passed without symptoms if they had a positive test.

SYMPTOMs of covid-19

Loss of Taste/Smell

This seems to be the most common & persistent symptom in even mildly symptomatic patients with COVID-19 infection. Studies have shown that anosmia (loss of smell) happens in as many as ⅔ of patients with COVID-19 infection. Anosmia resolves in the majority of patients once the infection is over. Though nasal congestion with a cold or allergies might cause anosmia due to nasal congestion, the anosmia seen with COVID-19 happens by the virus affecting cells at the top of the nose in the absence of congestion. 

Fever, Body Aches, Chills, Fatigue

SARS-CoV-2 is a more intense viral respiratory infection (just like the flu) when compared to viral infections like the common cold. This means the fevers are higher & the symptoms can be more severe. Unlike the flu, however, symptoms don’t present suddenly. Symptoms may be mild for the first few days and then become severe after about a week into a COVID-19 illness. With both the Flu and COVID-19, however, there may be some people with no symptoms at all. 

Nasal Congestion & Sore Throat

Nasal congestion & sore throat are rare symptoms with COVID-19 infections.

Shortness of Breath/Chest Discomfort and Cough

As with the flu, chest discomfort, shortness of breath & dry cough may occur with COVID-19 infections. We worry about pneumonia as the infection progresses, but also worry about the body’s response to infection leading to inflammation in the lungs. 


Vomiting & diarrhea may sometimes present as the initial or primary symptom in children with COVID-19 infections. 

Incubation Period

The common cold, flu, and strep throat will cause infection usually within 2-3 days of being in one’s body (sometimes even sooner). COVID-19, however, has an incubation period of 2-14 days and on average will begin to show it’s symptoms about 5-6 days after being present in one’s body. That means one may have the virus and spread it before even knowing they are carrying the virus.

Fewer Infections in Children

When the pandemic hit, schools & activities shut down instantaneously. Fearing that this infection might affect children & elderly more intensely like the flu, we sought to isolate our kids from neighbors, family & friends. Then we began to see that children weren’t being affected as badly as the elderly and this summer many children began interacting with others through activities and summer camps. 

Diagnosis & Treatment

Like the flu, COVID-19 can be diagnosed by a nasal swab. Treatment remains the management of symptoms at home under isolation from others unless one is sick enough to be hospitalized. In the hospital, there are a number of medications that are being used to try and alleviate the inflammation that is caused all over the body during a COVID-19 infection. 

According to the CDC, as of August 3rd, 2020, only 7.3% of all COVID-19 cases in the United States have been in children. Up to 16% of all pediatric cases of COVID-19 in the United States are asymptomatic. As we begin sending our kids to school, we will learn more about COVID-19 and how it affects our kids, but for now, it seems that it hasn’t been as intense an infection for children as is the flu. 

duration: How long does Covid-19 infection last

As we have seen thus far, COVID-19 infection may resolve within a couple of weeks if one’s body is strong enough to fight off the virus. Unfortunately, in other cases where one’s immune response may be a little weaker leading to hospitalization, the infection can last weeks to months. The recovery thereafter can last even longer. Through the progression of this virus in people, we see the levels of the inflammatory response in the body sometimes rise so high that it can cause a state of shock where one’s immune response starts attacking one’s own body’s cells. Young kids have presented to hospitals in a state of shock called Multi-System Inflammatory Syndrome in Children (MIS-C).

COVID-19 is Contagious

While we don’t have a vaccine to effectively prevent COVID-19 infection and we are still learning about the virus, it is crucial to remember the importance of handwashing, social distancing, and covering one’s mouth & nose to prevent transmission of the virus through respiratory droplets. We are still learning about how long the virus can “hang” in the air before dropping to the ground. Though SARS-CoV-2 technically doesn’t have airborne transmission, it’s “hang time” in these air clouds may be what leads to it causing “super-spread” in certain settings. 

In Conclusion

There is a likelihood your child will have a sore throat & cough in the next few months as fall arrives & turns into winter. Though it may be frightening to think this could be COVID-19, there are a number of other players that could be causing your child’s symptoms. Don’t hesitate to have your child evaluated by a doctor. They can go through the process with you of determining what the right source of the problem might be & get your child the treatment they need to feel better as quickly as possible.

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