Austin deals with a predictable rotation of respiratory illnesses and allergens throughout the year, with the heaviest overlap hitting between November and March. During that stretch, flu, RSV, COVID-19, strep throat, and cedar fever all circulate at the same time, making it hard to tell what you’re actually dealing with. Here’s a breakdown of the most common culprits and how to tell them apart.
Cedar Fever: Austin’s Signature Misery
If you’re new to Austin or Central Texas, cedar fever is likely the first thing locals will blame for your symptoms. It’s not actually a fever. It’s an allergic reaction to pollen from Ashe juniper trees, which blanket the Hill Country and release massive amounts of pollen starting in November. Symptoms peak from December through February, though some people feel the effects into March.
Cedar fever causes intense sneezing, nasal congestion, itchy and watery eyes, sore throat, and fatigue. Some people do run a low-grade fever from the inflammatory response, which is where the name comes from. Central Texas has some of the highest Ashe juniper concentrations anywhere, making Austin one of the worst places in the country for this particular allergen. If your symptoms are mainly above the neck (eyes, nose, throat) and you don’t have body aches or a true high fever, cedar pollen is a strong possibility. Over-the-counter antihistamines and nasal corticosteroid sprays are the standard approach. Keeping windows closed and showering after time outdoors helps reduce exposure.
Flu Season Peaks in Winter
Influenza follows a reliable pattern in Austin and across the U.S. Flu viruses circulate during fall and winter, with activity most often peaking between December and February. Over a 40-year tracking period, the CDC found that flu season peaked in February more than any other month (17 out of 40 seasons), followed by December, January, and March. That means if you’re reading this during the colder months, flu is almost certainly circulating in Austin.
Flu hits harder and faster than a cold. You’ll typically notice sudden onset of fever, chills, body aches, headache, and exhaustion, often before respiratory symptoms like cough and congestion set in. That combination of high fever plus full-body misery is the clearest way to distinguish flu from allergies or a mild cold. If you’re within the first 48 hours of symptoms, antiviral treatment can shorten the illness. A yearly flu vaccine remains the most effective prevention.
RSV and Young Children
Respiratory syncytial virus is the leading cause of hospitalization among infants in the United States, with babies under two months old facing the highest risk. RSV circulates on a similar timeline to flu, peaking during the winter months. In adults and older children, RSV usually looks like a bad cold. In infants, it can cause wheezing, difficulty breathing, and poor feeding.
The good news for Austin parents: newer prevention tools are making a measurable difference. During the 2024-25 season, RSV hospitalization rates among infants under eight months dropped significantly compared to pre-pandemic baselines. The largest reduction was among the youngest babies (under two months), with hospitalization rates falling by roughly 45 to 52 percent. One thing to watch: RSV hospitalization rates actually rose among children aged eight months to five years during the same period, so older toddlers and preschoolers aren’t necessarily in the clear.
COVID-19 Still Circulates Year-Round
COVID-19 no longer follows a single seasonal peak the way flu does. Austin sees waves at various points throughout the year, with winter surges still common. Current variants tend to cause symptoms that overlap heavily with flu and colds: sore throat, congestion, cough, fatigue, fever, and body aches. Loss of taste and smell, once a hallmark symptom, is less common with recent variants but still occurs.
If you’re trying to figure out whether you have COVID, flu, or allergies, a rapid home test is the fastest way to narrow it down. COVID and flu can feel nearly identical, and coinfections (catching both at once) do happen. Testing matters most for people at higher risk of complications, since antiviral treatment for COVID works best when started within the first five days of symptoms.
Strep Throat and Other Bacterial Infections
Group A streptococcus, the bacteria behind strep throat, circulates in Austin alongside everything else during the cooler months. Travis County reported 78 cases of invasive Group A strep in 2018 and 56 in 2019, though milder strep throat infections are far more common and aren’t tracked with the same surveillance. Strep throat causes a sudden, severe sore throat, pain when swallowing, fever, and swollen lymph nodes in the neck. One useful clue: strep rarely causes cough or runny nose. If your sore throat comes with congestion and sneezing, allergies or a virus are more likely. A rapid strep test at a clinic takes minutes and determines whether you need antibiotics.
Stomach Bugs: Norovirus and Others
Norovirus peaks during the winter months and spreads efficiently in schools, daycare centers, and restaurants. If what’s “going around” involves vomiting, diarrhea, and stomach cramps that come on suddenly, norovirus is the most common cause. It’s extremely contagious and moves fast through households. Most people recover in one to three days without treatment, but dehydration is the main risk, especially for young children and older adults. Careful handwashing with soap and water (not just hand sanitizer, which doesn’t kill norovirus well) is the best prevention.
Mosquito-Borne Illness in Warmer Months
Austin Public Health has confirmed that West Nile virus is active in Austin-Travis County. Mosquito-borne illness becomes a concern as temperatures rise, typically from late spring through fall. Most people infected with West Nile never develop symptoms, but about one in five gets a fever, headache, body aches, and sometimes a rash. Reducing standing water around your home and using insect repellent during dawn and dusk hours are the primary ways to lower your risk.
How to Tell What You Have
With so many illnesses overlapping, a few patterns help sort things out. Itchy, watery eyes with sneezing and no fever point toward cedar pollen or other allergies. Sudden high fever with body aches suggests flu or COVID, and a home test can distinguish between them. A sore throat without cough or congestion is classic for strep. Vomiting and diarrhea with little to no respiratory symptoms suggest norovirus. And in infants, any wheezing or labored breathing during winter months warrants prompt evaluation for RSV.
Keep in mind that Austin’s unique geography, sitting right at the edge of the Hill Country’s juniper forests, means many people deal with overlapping allergies and infections at the same time. It’s entirely possible to have cedar fever and a cold simultaneously, which makes symptoms feel worse and harder to pin down.