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June 13, 2024

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RSV, Covid or flu?

RSV or COVID-19? How Can You Tell the Difference?

Or is it the flu? With RSV on the rise in Middle Tennessee, doctors are concerned for families.

RSV is on the rise in Middle Tennessee, just in time for flu season. So, does your child’s runny nose indicate Respiratory Syncytial Virus (RSV), Covid or the flu? Parents spend a great deal of time trying to figure out their child’s symptoms. But the similarities between RSV, Covid-19 and the flu can leave them flummoxed.

All three illnesses affect the nose, throat and lungs. RSV in children causes cough, runny nose and sometimes a fever. Symptoms usually last seven to 10 days, but some kids develop a cough that takes up to six weeks to clear up. The virus can be dangerous for a baby — and especially so for infants — so doctors say to be on the look out for labored breathing and a sort of “caving in” appearance in the chest.

The only way to tell the difference between RSV, Covid-19 or the flu is through testing. As a first course of action, call your pediatrician. While most kids can recover from these illnesses at home, you do need to know what you’re dealing with.

“It is always best to call your pediatrician for direction,” says Joseph Gigante, M.D., professor of pediatrics at Monroe Carell Jr. Children’s Hospital at Vanderbilt. “Many people immediately want to bring their child to the emergency room, but that is not always the best plan. A pediatrician should be the first point of reference because they know the child and can better advise parents on next steps,” he adds.

Be aware of the different symptoms:

RSV Symptoms in children include:

  • Mild cold symptoms like congestion, runny nose, fever, cough and sore throat. Very young infants may be irritable, fatigued and have breathing difficulties. Normally these symptoms will clear up on their own in a few days.
  • A barking or wheezing cough can be one of the first signs of a more serious illness. In these instances, the virus has spread to the lower respiratory tract, causing inflammation of the small airways entering the lungs. This can lead to pneumonia or bronchiolitis.
  • Infants with severe RSV will have short, shallow and rapid breathing. This can be identified by “caving-in” of the chest in between the ribs and under the ribs (chest wall retractions), “spreading-out” of the nostrils with every breath (nasal flaring), and abnormally fast breathing. In addition, their mouth, lips and fingernails may turn a bluish color due to lack of oxygen.
  • When to Call a Doctor: You should call your doctor if you or your child is having trouble breathing, has poor appetite or decreased activity level, cold symptoms that become severe, or a shallow cough that continues throughout the day and night.

Symptoms of COVID-19 in symptomatic children include:

  • Fever
  • Cough
  • Trouble breathing
  • Symptoms of a cold
  • Chills
  • Muscle pain
  • Headache
  • Loss of taste or smell
  • Nausea or vomiting
  • Diarrhea
  • Some children may have symptoms caused by multisystem inflammatory symptom in children (MIS-C). Doctors are still trying to learn how these symptoms are related to coronavirus: Symptoms of this can include fever, stomach pain, vomiting and diarrhea, neck pain, a rash, red eyes, feeling very tired, red and cracked lips, swollen hands or feet and swollen lymph nodes.
  • When to Call a Doctor: You should call your doctor if your child has a fever, cough, trouble breathing, sore throat, belly pain, vomiting, diarrhea, rash, dizziness, or just doesn’t feel well. If your child has been near someone with coronavirus or been in an area where lots of people have it, tell the doctor. Talk about whether your child needs a test for coronavirus.
  • Call 911 if your child is struggling to breathe, is too out of breath to talk or walk, or turns blue or has fainted.

Symptoms of the flu in children include:

  • Fever or feeling feverish/having chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue (tiredness)
  • Sore throat
  • Runny or stuffy nose
  • Muscle pain or body aches
  • Headache
  • When to Call a Doctor: Your child should be taken for medical care if he has a fever that does not respond to fluids, rest and fever-reducing medications, has fast or troubled breathing, a bluish discoloration of the skin, severe lethargy, irritability.


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About the Author

Susan Swindell Day

Susan Day is the editor in chief for this award-winning publication and all-things Nashville Parent digital creative. She's also an Equity actress, screenwriter and a mom of four amazing kids.