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July 01, 2022

Where Every Family Matters

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

The CDC recently issued an alert about the rise of RSV cases in Tennessee and other Southern states. Now we're even MORE confused!

Respiratory Syncytial Virus (RSV) is making the rounds among kids although it's actually not in season. So a big thing for parents right now amid the local COVID-19 surge is, does my child have RSV or is this COVID-19? RSV affects the nose, throat and lungs. In most people, it 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. The only way to tell the difference of whether or not your child has COVID-19 or RSV is through testing — only, call your pediatrician first. Most kids can recover from either illness at home, although RSV can be dangerous for infants.

“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.

The Centers for Disease Control and Prevention has issued an alert about RSV cases rising in the south, so there's plenty you need to know. First, while nearly every child contracts RSV by the age of 2 in a "normal" year — resulting in 57,000 hospitalizations among children ages 5 and younger — this year is different. The volume of cases doctors are seeing locally are what they typically expect to see in December or January. Doctors are theorizing that due to pandemic precautions last winter, they didn't see the typical seasonal spike in RSV cases. And while COVID-19 can affect kids, it's the adults that make up most of the cases in the area so far. Furthermore, it's older adults and immunocompromised individuals who are also more likely to have serious symptoms from coronavirus. 

If there's good news here, it's that both RSV (learn more about it from the American Academy of Pediatrics) and COVID-19 are detectable through testing. With RSV, your child's pediatrician can use a swab to take a sample for your child's nose or throat.

Symptoms of RSV 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.



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About the Author

Susan Swindell Day

Susan Day is the editor in chief for this publication and the mom of four amazing kids.