Feeling itchy? Cedar fever is here. Know what to do, how to tell allergies from COVID-19

Nicole Villalpando
Austin American-Statesman
High winds associated with colder temperatures have wreaked havoc on cedar fever sufferers.

Cedar fever is here. By the end of December, the Austin area was seeing very high counts of Ashe juniper pollen in the air. 

Here's what to know about the season and how to deal with what you might be feeling. 

What is cedar fever?

Cedar fever is an allergy to a pollen. It's not really cedar-related and doesn’t typically come with a fever. It’s triggered when the male Ashe juniper trees get excited to spread their pollen to the female Ashe juniper trees. They let the wind spread their pollen to all their female Ashe juniper friends far and wide. (How do you tell a male Ashe juniper from a female? The female has berries on the branches. The male will be coated with yellowish brown pollen.)

Anyone who has been exposed to this Ashe juniper pollen over time might start feeling its effects.

What makes cedar fever so difficult compared with other allergies is the amount of allergens in the air. Cedar pollen counts can be in the 10,000 to 12,000 range on a bad day. A bad oak day would be 800, meaning 800 pollen grains landing in a defined area compared with 12,000 pollen grains for cedar. Austin has seen 20,000-plus cedar counts this year. 

More:Enjoy balmy New Year's Eve before we kick off 2022 with subfreezing temperatures this weekend

How to tell the difference between Texas cedar fever and COVID symptoms

"There's definitely some overlap," said Dr. Haley Overstreet of Aspire Allergy & Sinus. She has treated patients who thought it was just their allergies, including cedar fever last season, and it turned out to be COVID-19. 

Both allergies and COVID-19 can have nasal congestion, runny nose, lack of smell and taste, and sore throat. Sneezing has been a challenge, Overstreet said, because initially everyone thought sneezing wouldn't be part of COVID-19, but she has tested patients with severe sneezing and they have been positive for COVID-19. 

What COVID-19 typically doesn't have is itchiness. Itchy eyes, itchy throat and itchy nose are more likely to be allergies than a virus, but sometimes a scratchy throat can be a COVID-19 sign, especially in the omicron variant.

Track your symptoms with what's currently in the air. 

Cedar fever will soon return to Central Texas when the male Ashe juniper trees become full with pollen and try to spread it to the female Ashe juniper trees.

Some symptoms that typically are not allergies but could be a virus include nausea and diarrhea. High fever also is not allergies, Overstreet said. 

If you're not sure, take a COVID-19 test, especially right now because of the the number of cases of the omicron variant in the community.

More:'Hitting kids hard:' What to know about children and the omicron COVID-19 variant

Getting your allergies under control is important during times when a lot of virus is circulating in the community (be it COVID-19, common colds or RSV). 

Allergies can increase your risk for other illnesses, Dr. Gaurang Shah, emergency medical director at St. David’s Medical Center, said during the last cedar fever season. “Because you have more mucus, you’re more likely to catch and hold onto viral particles, which increases the risk of developing an infection,” he said.

Nasal Spray

How to lessen your cedar fever symptoms 

Start taking allergy medications, if you haven't already. Choose either a nasal spray, such as Flonase, or an antihistamine, such as Claritin or Zyrtec. These can take about two weeks before they have the maximum effect. Once you start taking these medications, don't stop until at least the end of January or after the daily pollen charts no longer list cedar or juniper.

Choose the medication that works for you. They can come with side effects such as being sedating or drying out the nose and mouth too much. Sometimes you might have to try a medication for a few weeks before you know if it is working, Overstreet said. Check with your doctor if you don't know what to try or are concerned about side effects or interactions with other medications.

Plan around the pollen. Watch the allergy counts and plan outdoor activities for days when the pollen counts are lower. Dry windy days are worse than wet ones.

For subscribers:'A huge advance': Dell Children's performs first fetal surgery on Austin mom expecting twins

Rinse and repeat. Do a daily nasal rinse using distilled water in a neti pot or a squeeze bottle. This helps flush the pollen from the nose.

Dress the part. Wear long sleeves, long pants and hats to keep pollen off the skin and out of the eyes when working or playing outside. Then remove those clothes and hat when you come inside and put on fresh clothes.

Shower after an outdoor activity and at night. This helps keep pollen in your hair and on your skin off your pillow when you sleep. 

Wear a mask outside. It's great for keeping out viruses as well as pollen. 

Keep pollen outside. Keep windows and doors closed during cedar fever season.

Change air filters in your home if they haven't been changed recently.

How long does it take to get cedar fever?

Some people will never get it. Some people might get it the first year they move to Central Texas. Most people, though, need to go through a few seasons before they become allergic to the juniper pollen. It takes some exposure to produce the reaction.

Allergists typically don't see babies with cedar fever, but will see kids 18 months to 2 years with their first bad cedar fever season. It tends to be worse in kids that have eczema or asthma, Overstreet said.

"If you feel like it's impacting your life in any way, whether it be work, leisure or productivity, then it's worth getting treated," Overstreet said. Treatments start with testing to make sure cedar is the allergen that's bothering you.