Does My Child Have the Flu, RSV or COVID?

Understanding Flu, RSV and COVID in Children

It’s important to understand common childhood illnesses so you can best protect your family, especially illnesses with more concerning symptoms, like breathing issues. Understanding these illnesses helps you make confident decisions when your child is sick. That’s why we asked Tina Scott-Mordhorst, MD, a pediatrician at Children’s Physicians – Plattsmouth, to weigh in with clear information.

Common Respiratory Viruses in Children

The respiratory tract is the part of the body that goes through the nose, down the mouth and throat, and into the lungs. Respiratory viruses are infections that impact the respiratory tract.

Common respiratory viruses in children include:

• COVID-19, a specific type of coronavirus

• Influenza, often called “the flu”

• Respiratory syncytial virus (RSV)

Because all these illnesses affect breathing, it can be hard to spot key differences or know how these conditions differ from the common cold.

“These viruses can be especially hard to differentiate,” says Dr. Scott-Mordhorst. “Both can range from a child showing no signs at all to having severe, life-threatening symptoms. As parents, you know your child best. If something seems off, it’s always best to err on the side of caution by seeing a doctor.”

Signs and Symptoms of Flu, RSV and COVID-19

You may already be familiar with these common symptoms. But it’s helpful to compare them side by side to determine whether your child’s symptoms fall squarely into one category over another.

The flu and COVID-19 both usually cause body aches and sore throats. However, one key difference is COVID-19 can lead to changes in your child’s senses of taste and smell.

RSV can resemble a cold, although infants younger than 6 months old may not show signs. If they do, their symptoms can look a little different, such as:

• Irritability or fussiness

• Low activity levels

• Difficulty breathing

“RSV can be really dangerous for infants in particular,” says Dr. Scott-Mordhorst. “Yet parents often mistake it for a cold or allergies. The one tell-tale sign? Wheezing. If your child is wheezing, it’s best to assume it could be RSV.”

Another important difference among these illnesses is the incubation period, which is how long it takes for your child to show symptoms after they’re exposed to the virus. Though incubation periods can vary, they are roughly:

• 1 to 3 days for a cold

• 1 to 4 days for the flu

• 2 to 14 days for COVID

• 4 to 6 days for RSV

While the common cold doesn’t generally lead to serious health problems, the flu, COVID-19 and RSV all can. It’s important to monitor your child closely when they’re sick and take any sickness seriously.

If you take your child to the pediatrician, they may test your child to confirm which illness they have. This information will guide the advice they give you for caring for your child at home. It also determines which medication, if any, may be used for treatment. Testing is the only real way to know which virus your child has, and which treatments will best manage their symptoms.

When to See a Doctor or Seek Emergency Care

If you have an infant 2 months old or younger who develops a fever, get medical care as soon as possible. “Their immune systems just aren’t as robust as those of kids and adults, or even older babies,” says Dr. Scott-Mordhorst.

Call 911 or take your child to the emergency room if they:

• Can’t seem to wake up

• Experience persistent pain

• Have a blue tint to their lips or face

• Have a fever of 100.4°F or higher (if younger than 3 months)

• Have a fever that rises above 104°F repeatedly (for a child of any age)

• Have trouble breathing

• Show signs of unexplained confusion

Your child may also need medical help if they become dehydrated and you can’t get them to drink more fluids. Signs of dehydration include feeling dizzy, being very thirsty or extra tired, dark urine or low urine output (too few wet diapers). If you’re not sure if you need to take your child to the emergency room or their pediatrician, read our guidance on where to go when your child is sick.

Home Remedies for Flu, RSV and COVID in Kids

When your child is sick, it’s best to keep them home unless they need to see a doctor. Most kids recover on their own, and common colds simply need to run their course.

No matter which illness your child has, here are general tips to best care for them:

• Control symptoms with over-the-counter medications (only if recommended by their provider and after carefully reading the product warnings and dosage)

• Ensure they get plenty of rest

• Give them extra fluids (especially babies who have RSV) to avoid dehydration

• Keep their nasal passages clear with saline drops or sprays (use a bulb syringe or nasal aspirator with infants)

• Monitor their temperature

• Elevate their head to help control coughing

• Use a cool-mist humidifier to loosen mucus and clear airways

Remember prevention is the goal, and there are vaccines to prevent the flu and COVID-19 for children 6 months and older. Speak with your pediatrician about recommendations for the RSV vaccine.

“Getting vaccinated is the one thing we can do to protect our families — and communities,” Dr. Scott-Mordhorst says. “These vaccines are safe, but if you have concerns or are worried, have a conversation with your doctor or your kids’ doctor to address those concerns.”

We’re Here to Support You When Your Child Is Sick

If you become concerned about severe or lasting symptoms, call your child’s primary care provider or send them a message through our Children’s Connect Health Portal.

Remember that flu vaccines are a great way to protect your family. For more information and to find a provider, visit our Children’s Physicians page and find a location near you.