Is it cedar fever or the flu? How Texans can tell the difference

Texas winters herald the bane of many allergy sufferers: cedar fever.

From December to February, acres of mountain cedar—also known as Ashe juniper—in the Hill Country and parts of Dallas-Fort Worth hit their pollination season. Male trees turn a golden brown, producing cones bearing copious amounts of pollen. Swift winds carry the pollen to female trees—and to sensitive eyes and noses.

In Texas, around 20% of residents experience cedar pollen allergies. Ashe junipers and springtime pollinators put Dallas in the top 20 of allergy capitals in the United States, according to a 2025 report by the Asthma and Allergy Foundation of America.

With the seasonal overlap, symptoms of cedar fever can resemble a cold or the flu. If you’re new to Texas or haven’t experienced allergies before, here’s how to tell if your case of the sniffles is benign or contagious.

What is cedar fever?

While the term “cedar fever” implies you may run a high temperature if you catch a whiff of pollen, it actually refers to a constellation of symptoms that mark a severe allergic reaction to Ashe juniper.

When the body encounters cedar pollen, the immune system releases a cascade of inflammatory chemicals. For many people, the problem isn’t just the pollen—it’s the sheer volume of it. A single Ashe juniper cone produces roughly 400,000 pollen grains, and each tree creates up to 500 billion grains per season.

In Texas, the trees cover approximately 8.6 million acres, predominantly in central Texas. Ashe junipers are also native to parts of Missouri, Oklahoma and New Mexico.

Peak pollen release is in mid-January. Ashe junipers are often described as appearing “on fire” because of the intense plumes of pollen wafting off them, according to Texas A&M.

How to tell if you have cedar fever

Symptoms of cedar fever include sneezing, a runny or stuffy nose and watery or itchy eyes. Some people may feel slightly warmer than usual because inflammation can raise body temperature a bit, according to Baylor Scott & White.

An indication that you’re dealing with cedar fever rather than a viral illness can come from the symptoms themselves. If they improve when you limit time outdoors or flare up on windy days when there’s more pollen in the air, that points more toward allergies.

Mucus can offer another hint, but it’s not a perfect test. Both cedar fever and many viral infections can cause clear, runny mucus. If mucus becomes colored, it can signal other illnesses, such as the flu, according to WebMD.

Additionally, feeling warm with cedar fever typically doesn’t cause true fever—generally above 100 degrees Fahrenheit—or body aches that often come with viral infections.

To confirm a pollen allergy, clinicians typically use a skin test by placing small drops of allergen on the skin and lightly scratching the surface. There is also a blood test that looks for antibodies linked to cedar pollen allergy.

How do you treat cedar fever?

Over-the-counter treatments such as allergy medications and antihistamines can help ease cedar fever symptoms. Nonsedating antihistamines like those found in Zyrtec or Allegra can help control itching and sneezing during the day. Sedating options like Benadryl may be more useful at bedtime, Dr. Edward Brooks, an allergist at The University of Texas Health Science Center at San Antonio, told the Texas Standard in 2023.

To nip cedar fever at the source, immunotherapy is the more effective option. It works by exposing your immune system to small, controlled amounts of cedar pollen proteins over time, helping your body build tolerance to them and respond less dramatically.

Immunotherapy helps about 70% to 80% of people who try it, but timing matters: It generally needs to start well before cedar season to be most useful. For cedar pollen immunotherapy—whether traditional allergy shots or drops placed under the tongue—allergists often recommend starting six to 12 months ahead of the season.

Depending on the type of immunotherapy, insurance coverage may vary. A course of allergy shots, for instance, can cost anywhere from $1,000 to several thousand dollars a year without insurance, according to GoodRx.

A newer approach called ExACT Immunoplasty has been marketed as a faster alternative. The approach involves a series of three shots given over roughly 60 days, with the allergen injected directly into a lymph node rather than into the arm using imaging guidance, as NBC5 reported in 2021. In a trial for ExACT Immunoplasty, the long-term success rate was 87%, according to the report.

How can you prevent cedar fever?

Aside from investing in immunotherapy, limiting your environmental exposure is the best way to keep cedar fever at bay. Tips from Baylor Scott & White include:

• Checking daily pollen counts and limiting outdoor activities when counts are high.
• Keeping windows closed during peak cedar season.
• Using air purifiers with HEPA filters in your home.
• Showering and changing clothes after spending time outdoors.
• Washing your bedding regularly in hot water.
• Avoiding drying your laundry on a clothesline outside during cedar season.

2026 The Dallas Morning News. Distributed by Tribune Content Agency, LLC.