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As the Northern Hemisphere heads into winter, whether a fever and cough mean the flu or Covid-19 is a nerve-racking guessing game. There is, however, a silent killer that causes similar symptoms and could be lurking in your home.

Carbon monoxide is a colorless, odorless gas that's produced when a fossil fuel — coal, crude oil or natural gas — is burned by furnaces, portable heaters, vehicles, stoves, grills, gas ranges or fireplaces.

Breathing in too much of it can poison you, leading to symptoms including headache, upset stomach, dizziness, weakness, vomiting, chest pain and confusion, according to the US Centers for Disease Control and Prevention — mimicking the symptoms of the flu or Covid-19.

Inhaling high concentrations can make you pass out or kill you, especially if you are sleeping, drunk or belong to a group that's at high-risk for serious illness and death from different diseases and exposures. Carbon monoxide can also poison your pets.

'Influenza and (Covid-19) hijack the cells, mostly in lungs, where they reproduce and that's where the main damage is often done' and where symptoms stem from, said Dr. Jeremy Brown, an emergency care physician and author of 'Influenza: The Hundred-Year Hunt to Cure the Deadliest Disease in History.'

Carbon monoxide, on the other hand, poisons people by hooking onto hemoglobin, the protein in red blood cells that carries oxygen from the lungs to the body.

'The carbon monoxide comes along and kicks the oxygen off the hemoglobin,' Brown said. 'What you start to have are signs of a lack of oxygen.'

Over 20,000 Americans annually visit the emergency room for carbon monoxide exposure, over 4,000 are hospitalized and over 400 die. Since many are now at home almost 24/7, it's certainly possible that emergency doctors will 'see more carbon monoxide exposure than usual' — especially if we have a harsh winter and rely more on heating, Brown said.

Inadvertent poisoning 'can be stopped by practicing safe behaviors,' said Scott A. Damon, health communication lead at the CDC's Asthma & Community Health Branch.

Read on to learn the common causes of exposure, how you can prevent it, how to know what's causing your symptoms and the potential treatments.

Preventing exposure and poisoning

Carbon monoxide exposure is the byproduct of incomplete combustion, Brown said — when the oil in appliances or vehicles is heated but doesn't burn completely. Blocked ventilation systems and running portable generators in confined spaces or on boats without proper ventilation can also lead to buildup.

Additionally, 'these are the months when people may warm up a vehicle inside an attached garage, which is extremely dangerous' even with the garage open, Damon said. That's because the fumes can seep into your house.

The most important way to be able to tell whether symptoms are from carbon monoxide exposure is to install a carbon monoxide detector, Brown said. Since carbon monoxide sinks, having one in your basement is critical, but the potential for exposure on every floor means you should also have detectors installed in the main living areas and in or near bedrooms so you can be woken up by an alarm while sleeping.

Install and test battery-operated detectors and check and replace batteries twice a year when you change your clock, the CDC recommends. And consider buying a detector with a digital readout that also shows the level of concentration in the home.

'Check the manufacturer's instructions on when to replace the detector itself,' Damon said.

Your smoke detector should indicate whether it can also detect carbon monoxide. Levels higher than one to 70 parts per million can cause symptoms.

What's the source of your symptoms?

If you or your family are experiencing even mild symptoms and carbon monoxide poisoning is possible, your best bet is to get everyone to a safe environment and get checked out by a medical professional, Brown said, especially if you belong to a high-risk group.

But could it be the flu? Having received an influenza shot doesn't guarantee that you don't have the flu since flu vaccines, even when they match the viruses circulating, reduce the risk of illness by 40% to 60%.

A process of elimination will allow emergency care doctors to figure out if you have Covid-19, the flu or carbon monoxide poisoning, Brown said.

'One of the ways in which carbon monoxide differs from (Covid-19) and from influenza is that if you step outside and get some fresh air, your symptoms will slowly dissipate' over the next several hours if your exposure was minimal, Brown said. If someone feels better outside but symptoms creep up at home, that could be a sign of poisoning.

If it's possible that you've been exposed in your home, a doctor can administer a blood test to measure your carbon monoxide level, Brown added.

Potential treatments

If a doctor suspects poisoning, Brown said, you'll receive an oxygen mask that would deliver about five times more oxygen to your body than is available in the atmosphere. The doctor would then keep an eye on you for up to several hours and check your carbon monoxide level until you can be discharged — 'with the instructions not to return to the place where they were exposed and to make sure that no one else is in that place either,' Brown said.

A qualified service technician should check your appliances before you reuse them.

For those with severe poisoning, symptoms can worsen into shortness of breath, comatose state or muscle rigidity, Brown said. That person would be admitted to the hospital for prolonged oxygen therapy.

Patients even worse off would be put in a dive chamber, a highly pressurized vessel or room where they would receive up to 'about three times the amount of pressure that is on the surface as we walk around,' Brown said. 'That will force the oxygen into the tissues and displace the carbon monoxide poisoning.'

Recovery and staying safe

How long recovery takes is a sliding scale depending on the levels of exposure and sickness, Brown said. If people can get to the hospital fast enough, carbon monoxide can be rapidly removed from the body. Complete recovery can happen if the body isn't damaged from the lack of oxygen.

In some cases, severe exposure could mean delayed and long-term cognitive effects up to a month after the incident.

Protection comes 'down to making sure that whatever heating system you have — if it involves gas or heating oil — is properly maintained, that the flues are all clean and that you have a carbon monoxide detector,' Brown said. 'That is the basic, most important way to make sure that you remain safe over the winter.'

© Smith Collection/Gado/Getty Images Installing a carbon monoxide detector is the best way to prevent poisoning in your home.

The McLennan County Sheriff's Office says an undercover investigation has led to 45 arrests of people related to some form of prostitution and human trafficking.

This is the third sting the McLennan County Sheriff's Office has conducted since November and it is the largest one yet.

This operation went beyond Central Texas, but officials said the majority of those arrested are local.

64 charges are being brought against those arrested. 44 of them face sex-related crimes and one of them who had a warrant for unpaid child support was arrested after he drove a prostitute to a hotel.

Detectives posed as underage prostitutes, adult prostitutes and clients after tracking online postings for prostitutes nationwide.

Some of the prostitutes and pimps crossed state lines to meet with those detectives.

Law enforcement arrested four pimps in the particular undercover operation. According to the McLennan County Sheriff's Office, 25 women working in 13 states, including Texas no longer have to answer to their pimps.

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“We're simply not going to tolerate this kind of behavior in the county. These pimps become very brutal with the girls they are working. It's a very sad situation, especially when you have young girls that get involved in this prostitution,” said McLennan County Sheriff Parnell McNamara.

The McLennan County Sheriff's Office is prepared to continue doing operations of this magnitude in the future.

'It is bigger than what we've done. If we are going to target prostitution, I think we need to do it in the biggest scale we can. If we have someone here in Waco with one prostitute, we've arrested them. We can have someone that has 12 prostitutes that's running all over the country, we'll take those guys too,” said McLennan County Sheriff's Office Detective Joseph Scaramucci.

According to Scaramucci, Emmanuel Bailey faces federal charges for trying to prostitute women across state lines.

Loren Morris, of San Antonio, who allegedly has up 15 prostitutes working for her, could also face federal charges.

Elijah Muhammad, who was arrested in a previous sting conducted by the McLennan County Sheriff's Office, was also caught this time for allegedly trying to hire a prostitute.

As a result of the investigation, authorities seized $6,500 in cash and approximately 30 grams of illegal drugs.

Members of UnBound, an organization that fights human trafficking helped some of the victims of this sting with services, including immediate needs, volunteer legal services, counseling and connection to an after care home.

UnBound National Director Susan Peters said the undercover operations conducted by the McLennan County Sheriff's Office are making a positive impact on the community.

'We're so excited about what the law enforcement is doing and the Sheriff's Office leading out to address this issue because it's jeopardizing the safety of our kids,” said Peters.

According to Peters, a coalition has been formed to fight human trafficking in the community. She said the group believes with their efforts Central Texas will be a hostile environment for human trafficking.

Here is the full list of those arrested:

Racquel Jackson -- Prostitution

Tiffany Harr -- Prostitution

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Manuel Perez -- Prostitution/Prostitution under 18

David Mojica -- Prostitution

Ricky Guerin -- Prostitution/Prostitution under 18, possession of a controlled substance

Ernest Daniels -- Prostitution

Ronnie Kelley -- Prostitution

David McDaniel -- Prostitution/Prostitution under 18, possession of a controlled substance

Rebecca Rios -- Prostitution, possession of a controlled substance

Meagan Jones -- Prostitution

Juan Ruiz -- Prostitution

Lacey Smith -- Prostitution

Lance Turner -- Prostitution

Edwin Cortez -- Prostitution

Kennedy Bivins -- Prostitution, failure to identify, aggravated promotion of prostitution, money laundering

Emmanuel Bailey

Senica Stanley -- Prostitution, prostitution of a minor

Craig Robinson -- Prostitution, possession of a controlled substance

Jeremy Watson -- Human Trafficking

Anthony Brown -- Prostitution

Kevin Brand -- Prostitution

Courtney Morris -- Prostitution

Ashley Salazar -- Prostitution

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Taylor Brown -- Engaging in organized crime

Cameron Blain -- Engaging in organized crime, possession of a controlled substance

Katelynn Donnell -- Engaging in organized crime

Richard Soloman -- Prostitution

Nicholas Lane -- Prostitution

Elijah Muhhamad -- Prostitution

Lisa Braasch -- Prostitution, possession of a controlled substance

Chimere Henderson -- Prostitution

Kayla Kopp -- Prostitution

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Eric Kopp -- Promotion of prostitution

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Loren Morris -- Aggravated promotion of prostitution, engaging in organized criminal activity, resisting arrest

Crystal Sanchez -- Prostitution

Keith Richards -- Warrant, child support

Shed Cousins -- Prostitution, evading arrest

Leonard Blevins -- Prostitution, possession of a controlled substance

Rene Torres -- Prostitution, tampering with a government document

Samuel Smith -- Delivery of a controlled substance

Zachary Sowers -- Prostitution

Jeremy Cox -- Prostitution, delivery of controlled substance

Eduardo Gutierrez -- Prostitution

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Jose Lugo -- Prostitution