07-02-2025
Flu, COVID, strep or norovirus? Here's what's spreading this cold and flu season in Austin
Coughing, sneezing, body aches, puffy eyes ... all of these symptoms are spreading around Central Texas, but coming from a few different sources.
We asked local doctors what they are seeing in their clinics and urgent care.
"Flu A, Flu A, Flu A," said Dr. Charu Sawhney, an internal medicine physician at Harbor Health in Round Rock.
The Texas Respiratory Virus Surveillance Report backs that up. The positivity rates reached 41.61% of flu tests, with 95.44% coming back with Flu A, not Flu B. (Flu B is more common in children and doesn't mutate as quickly as Flu A.)
Already in Travis County, two adults have died from flu this season. Peak flu season tends to be in February, but already in January, the levels of flu were higher than the four previous years.
"To me, this feels like a pre-pandemic flu season," Sawhney said.
People are coming in sicker and this flu is also lasting longer, with symptoms lingering seven to 14 days, Sawhney said. For people who are vaccinated for flu, their symptoms, if they have any at all, are only lasting a few days, she said.
The reported flu numbers also might be lower than what is actually occurring because there are now over-the-counter tests for flu. If those tests come back positive, you should feel pretty confident that it is flu, said Dr. Tera Brooks, associate chief of family medicine at Austin Regional Clinic. She uses those tests when doing a telehealth visit.
If the at-home home test is negative or if the test in the doctor's office is negative, you might need to retest in a few days if the symptoms continue. Sometimes, it's just too early to show up on those tests, Brooks said.
Clinics also are seeing people come in with both flu and strep, especially among children. Strep does require a visit to the clinic for a diagnosis and then antibiotics to treat the illness.
Cases of COVID-19 have been steady and not seeing the spike that is happening with flu. Typically doctors use a combined flu and COVID-19 test because the symptoms are similar. It is possible to have both.
Brooks also has seen some norovirus and other stomach viruses. Those typically start in schools and then spread to the adults in the family.
And she's seen mycoplasma pneumonia, also known as walking pneumonia, which is a bacterial infection.
Allergies also have been a problem with mold in January and a few bouts of cedar fever at the beginning of December and some isolated days in January and February as the mountain juniper trees spread their pollen. Those allergies are often weather dependent, such as how much wind and how much rain.
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Many of these ailments have similar symptoms. Without doing a test or seeing a doctor, it can be hard to know which one you have. Here are the typical symptoms for each illness:
High fever of 102 degrees or higher
Body aches
Sore throat
Runny or stuffy nose
Cough
Chest congestion
Headache
Muscle aches
Feeling very tired
Sweating and chills
Nausea
Diarrhea
Stomach pain
Stomach issues are more common in children than adults
Diagnosis: Flu test either with the new over-the-counter test or in the doctor's office
Treatments: Antivirals for people who are older than 65 or have a chronic illness, symptom management
Fever or chills
Shortness of breath
Sore throat
Runny or stuffy nose
Cough
Headache
Loss of taste or smell
Muscle aches or body aches
Fatigue
Nausea or vomiting
Diarrhea
Nausea
Stomach pain
Stomach issues are more common in children than adults
Diagnosis: COVID-19 test, either the over-the-counter one or in the doctor's office
Treatments: Antivirals, especially for people who are older than 65 or have a chronic illness, symptom management
Painful sore throat
Painful swallowing
Red and swollen tonsils
Red spots on the roof of the mouth
Tender, swollen lymph nodes
Fever
Headache
Body aches
Nausea or vomiting
Diagnosis: Needs a test in a doctor's office
Treatment: Needs antibiotics
Diarrhea
Nausea
Vomiting
Low-grade fever
Abdominal bloating
Diagnosis: Usually based on symptoms, though there are stool sample tests
Treatment: Replenish fluids until it passes. Try small sips of water or mixing electrolytes (Gatorade) into water.
Difficulty catching breath
Chest pain
Productive cough
Fever
Sore throat
Diagnosis: Based on symptoms, then a chest X-ray
Treatments: Antibiotics, hospitalization if it doesn't get better
Cedar fever is coming. Prepare now for our worst allergy season.
Facial pain or sinus pressure
Very rarely a fever unless there is a sinus infection
Sneezing
Runny or itchy eyes
Congestion/runny nose
Itchy throat
Cough from nasal drainage
Headache
Rash or hives
Diagnosis: Rule out everything else. Allergy testing can be done when not feeling the symptoms.
Treatments: Antihistamines and other mostly over-the-counter medications, nasal irrigation.
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For all of these illnesses except allergies, you should:
Isolate the person into their own room if you can.
Stay home until symptoms have passed, and you are fever free for 24 hours without the use of any fever-reducing medications.
Wash hands frequently, but especially before eating.
Wipe down surfaces.
With flu, strep, COVID-19 or any respiratory infection, you should wear a mask around the person and have the infected person wear a mask.
This article originally appeared on Austin American-Statesman: Is it Flu, COVID or norovirus? Know what's spreading in Central Texas
