What to look for if your child has a respiratory virus or the flu

As temperatures begin to drop, a handful of respiratory viruses are spreading at unusually high levels in the United States and landing children in hospital, and doctors are urging parents to be aware of symptoms that signal serious illness.

Pediatric cases of influenza and RSV, or respiratory syncytial virus, are on the rise. Covid cases are decreasing among children, but the coronavirus is also circulating at high levels.

Most children should recover from Covid, RSV or flu infections on their own, especially with rest and plenty of fluids, said Dr Paul Offit, a pediatrician and vaccine expert at the hospital. for children of Philadelphia. But some, including very young children and those with underlying lung problems, may need extra care.

Here are the signs and symptoms to look out for if your child has a respiratory virus.

Does my child have RSV, Covid or the flu?

Since every virus typically starts with an upper respiratory infection, it can be difficult, if not impossible, for parents to know which virus they’re dealing with early on, said Dr. Kristin Moffitt, an infectious disease specialist at the Boston Children’s Hospital. Even for doctors, the only way to determine which virus is causing an infection is to use a test.

Early symptoms of Covid, RSV and the flu may look similar for many children, including:

  • Congestion
  • Cough
  • Runny nose
  • Muscle aches
  • Fever
  • Headache

A sore throat, Moffitt said, could be a sign of Covid, as doctors have noticed that infections with omicron subvariants often start with a sore throat.

At-home Covid tests can help parents determine if Covid is the cause of their child’s illness, although negative results from rapid tests don’t always mean a person is clear.

Children can also be tested for RSV or the flu at the doctor’s office, usually with what’s called a multiplex test, Moffitt said.

It’s also possible, she said, for a child to be infected with more than one virus at the same time, known as a co-infection.

Why are respiratory viruses dangerous for very young children?

It all comes down to anatomy: babies and toddlers have much smaller airways than older children and teens. That means when they get sick with respiratory viruses, their airways can quickly fill with mucus, leading to breathing problems, said Dr. Deanna Behrens, a pediatric critical care physician at Advocate Children’s Hospital in Chicago.

Children with underlying health conditions, such as chronic lung disease or heart problems, may also be at higher risk of serious illness from respiratory viruses, said Mayo pediatrician Dr Nusheen Ameenuddin. Clinic in Rochester, Minnesota.

Moffitt said if parents aren’t sure if their children need more help recovering from infections, they should call their pediatrician.

“Paediatricians’ offices are very responsive right now to try to ease the pressure that urgent care and pediatric emergency departments are feeling,” she said. They “often open disease windows and things like that so they can assess children who aren’t improving and whose parents are concerned but don’t quite meet the criteria for an ER assessment.”

When should a child go to the emergency room?

Symptoms that warrant an immediate trip to the emergency room include a child’s refusal to eat, difficulty urinating or abnormal breathing, Behrens said.

It’s especially important, she says, for “infants and maybe even toddlers who can’t tell parents what’s wrong with them.”

Abnormal breathing can manifest as rapid breathing, heavy wheezing or difficulty breathing in air, Behrens said.

Breathing problems can also show up when the lips turn blue or the muscles between the ribs pull inward with each breath, said Ameenuddin, of the Mayo Clinic.

If left untreated, severe cases of Covid, RSV or the flu can turn into pneumonia, an infection of the lungs, said Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital.

RSV, Hotez said, is also known to cause bronchiolitis, inflammation of the small airways in the lungs. Both conditions can be fatal, especially in children with underlying health conditions.

Is there a treatment for RSV?

A child who is sick with Covid can be given steroids or the antiviral drug remdesivir, Moffitt said. Likewise, a handful of antivirals might be given for the flu, including Tamiflu.

However, there is no treatment for RSV, so a child who is infected with the virus and is sick enough to go to hospital usually only receives supportive care, which may include oxygen, Moffitt said.

There is also no vaccine for RSV, Hotez said. A handful are in development, one of them from Pfizer.

And some children with underlying health conditions may be eligible for monoclonal antibody injections to prevent severe RSV.

Hotez also urged parents to get their children vaccinated against Covid and the flu.

“There are three viruses going around,” he said, “and if you can eliminate one or two of them by getting your child vaccinated, that makes it a lot easier.”

Ameenuddin said parents can protect their children too young to be vaccinated by creating a “cocoon” in which everyone around the children is vaccinated, reducing the risk of transmission and serious illness.

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