Nov 23, 2020, 11:17:50 AM CST Mar 29, 2023, 9:13:39 AM CDT

Flu, RSV and COVID-19: How to keep children healthy

Learn the similarities and differences between these respiratory viruses and ways to prevent illness

Mother taking child's temperature Mother taking child's temperature

This fall and winter season is a little different than recent years. Kids are back to school in person, working and playing together in larger groups and mask-wearing is less frequent. These are some of the reasons doctors are seeing an increase in viral infections.

Between COVID‑19, the flu and a surge in respiratory syncytial virus (RSV), parents are concerned.

In addition, the symptoms of many respiratory illnesses are similar, leaving parents wondering what to look for and how to tell the difference. Testing is the best way to find out if your child has one of these illnesses. Learn more about these illnesses and the best ways to keep your child healthy during a difficult cold and flu season.

How are RSV, COVID and the flu different?

RSV and the flu usually follow a seasonal pattern – beginning in the fall and early winter and continuing throughout early spring. However, this season RSV is spreading earlier. All three illnesses are contagious respiratory illnesses, but different viruses cause them:

  • RSV is caused by respiratory syncytial virus
  • Flu is caused by influenza virus
  • COVID‑19 is caused by SARS-CoV-2

It's important for parents to remember RSV is common. Almost all children will get RSV by their second birthday. Most children who get RSV recover quickly, while others may need medical attention.

What are the symptoms of RSV, COVID and the flu?

Symptoms of RSV, flu and COVID‑19 can vary, ranging from mild or no symptoms (asymptomatic) to severe illness. According to the Centers for Disease Control and Prevention (CDC), common symptoms of these viruses can include:

  • Fever or feeling feverish/chills
  • Cough
  • Shortness of breath or difficulty breathing (wheezing in RSV)
  • Fatigue (tiredness)
  • Sore throat
  • Runny or stuffy nose
  • Muscle pain or body aches
  • Headache
  • Possible vomiting and diarrhea, which may be more common in children than adults

RSV symptoms can also include wheezing, and a symptom that may differ between RSV, the flu and COVID‑19 is that more people with COVID‑19 experience a change in or loss of taste or smell.

Preeti Sharma, M.D., a pediatric pulmonologist at Children's Health℠ and Associate Professor at UT Southwestern, also reminds parents to watch for a common tell-tale sign of flu. "One thing to remember about influenza is that it often comes on very quickly," she says. "So, you might be feeling great and then suddenly experience fever, body aches and chills. Children infected with RSV usually show symptoms within 4 to 6 days after getting infected, and the symptoms can appear in stages and not all at the same time.

All three illnesses share similar signs and symptoms, making it hard to diagnose based on symptoms alone. It is also possible to have any combination of the three at the same time. If you are concerned about your child's symptoms, contact your health care provider for guidance. Testing may be needed to determine which virus your child has.

"It's important to keep track of symptoms in yourself and your child," Dr. Sharma says. "If your child isn't feeling well, talk to your health care provider and let their guidance move you towards a plan."

How do RSV, COVID and the flu spread?

These viruses circulate from person to person and it's possible to spread these illnesses before experiencing symptoms. However, people with COVID‑19 may remain contagious for a longer period than those with the flu or RSV.

RSV spreads in similar ways to the flu and COVID-19 and is very contagious. Jeffrey Kahn, M.D., Director of Infectious Disease at Children's Health and Professor at UT Southwestern, urges individuals to take precautions to not only protect themselves, but also their family members, against the spread of these viruses.

Dr. Kahn urges parents to be vigilant when it comes to good health practices, such as hand washing, sneezing in a tissue or upper shirt sleeve, staying home when not feeling well, mask-wearing and social distancing when possible. In the case of flu and COVID‑19, vaccination protects individuals and their household members. And for some premature babies and young children with certain heart and lung conditions, there is a medicine that can help protect against RSV.

How to prevent RSV, COVID and the flu?

The best way to prevent flu and COVID‑19 is to get vaccinated. Getting your flu shot during the 2022-2023 season is more important than ever. The flu vaccine does not prevent COVID‑19, but it will reduce the burden of flu cases and conserve medical resources for those who become infected with COVID‑19.

"Preventing that which we can prevent is key," Dr. Sharma says. "Getting a flu shot for yourself and your children will prevent a lot of the serious complications related to flu."

Everyone who is eligible should also get the COVID‑19 vaccine. The COVID‑19 vaccine is authorized for children ages 6 months and older. Getting vaccinated is a safe and effective way to prevent COVID‑19 illness. In addition, everyone who is eligible should also get a booster shot.

Flu vaccines and COVID‑19 vaccines can be given at the same time per CDC guidelines. You can visit to find a COVID‑19 vaccine near you.

You can also reduce your child's risk of contracting RSV or other common viral illnesses by:

  • Washing hands often
  • Covering coughs and sneezes
  • Covering the mouth and nose with a face mask when around others to prevent spread
  • Cleaning and disinfecting frequently touched surfaces
  • Monitoring your health by being alert for symptoms
  • Avoiding touching the face with unwashed hands
  • Avoiding close contact with others who are sick and staying home if your child doesn't feel well

What to do if your child becomes sick

If your child is sick, talk to their pediatrician about their symptoms and how they are feeling. If your child is older than 6 months, you can help reduce symptoms and discomfort by managing a fever or pain with over-the-counter fever and pain relievers. If your child is uncomfortable, try these home remedies to help relieve their symptoms:

  • Drink lots of water to prevent dehydration
  • Use a cool mist humidifier
  • Use nasal saline with gentle suctioning to help with breathing
  • Take a warm bath or shower to loosen mucus
  • Get as much rest as possible
  • Give a teaspoon of honey if your child is over the age of 1

Who is at the highest risk for severe illness from RSV, COVID and the flu?

RSV can cause severe illness and complications in the following:

  • Premature infants
  • Infants, especially those 6 months and younger
  • Children younger than 2 years old with chronic lung disease or congenital (present from birth) heart disease
  • Children with weakened immune systems
  • Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions

Flu and COVID-19 can cause severe illness and complications in the following:

  • Older adults
  • People with certain underlying medical conditions (including infants and children)
  • Pregnant people

The greatest risk of transmission of COVID‑19 is among people who are not vaccinated.

#Flu and #COVID19 share similar symptoms, and it can be hard to diagnose based on symptoms alone. Learn ways to keep your family healthy from @Childrens.

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