Home / Blog / RSV, FLU, AND COVID… OH MY!


By: Dr. Stefanie Aronow, Chief Medical Officer

It’s almost time to apply for the BEST. SUMMER. EVER! But first, we must get through another winter’s cough and cold season. Let’s stay as healthy as possible while we dream of another summer at “The Greatest Place On Earth!”! 

​Your child has a stuffy nose, cough, and fever. Is it the FLU? COVID? Or are they symptoms of respiratory syncytial virus (RSV)? 

Let’s look at four common childhood illnesses caused by viruses — respiratory syncytial virus (RSV)fluCOVID, and the common cold. All of them share some similar symptoms, and you can have more than one virus at a time. 

Here are some clues to help tell them apart:

  • RSV symptoms are more severe in babies and older adults. They may include fever, cough, fatigue, stuffy nose, shortness of breath, sneezing, fast/short breaths, flaring nostrils, wheezing and grunting, poor feeding/no appetite. You may also notice their head bobbing or chest caving between and under their ribs with each breath. Symptoms are usually the worst on days 3 through 5 and last about 7 to 14 days.
  • Flu symptoms may include fever, chills, headache, body aches, dry cough, fatigue, stuffy nose and sore throat. Some children may throw up and have diarrhea. Symptoms show up about 1 to 4 days after exposure to a sick person.
  • COVID symptoms may include fever, cough, fatigue, muscle or body aches, congestion, shortness of breath, sore throat, headache, sneezing, vomiting/diarrhea, or loss of taste/smell. Symptoms show up 2 to 14 days after infection.
  • Cold symptoms may include fever, cough, fatigue, stuffy nose, sore throat, sneezing, and slightly swollen glands. Colds are upper respiratory infections that can be caused by many viruses. Healthy children get about 6 to 10 colds a year. 

Call your pediatrician if your child has any of the following symptoms:

  • Rapid breathing, flaring nostrils, wheezing and grunting
  • Chest caving in with each breath
  • Shortness of breath/difficulty breathing
  • Vomiting for more than 24 hours
  • Bloody diarrhea
  • Very ill or drowsy
  • Poor feeding
  • Dehydration
  • Fever above 104 °F in any child; fever above 100.4 °F in a child under 2 months old; fever above 103 °F for more than 24 hours.

How to avoid getting sick when these viruses are spreading:

Immunizations are an effective tool to prevent serious illness from numerous preventable diseases. Staying up-to-date on routine immunizations also helps others—including people at high risk if they get infected.

  • Flu vaccines are recommended for everyone 6 months and older each year. Get your child vaccinated as soon as the vaccine is available to protect them throughout the flu season, which can last until the end of May.
  • The updated COVID vaccine is recommended for everyone 6 months and older
  • Nirsevimab is an RSV immunization recommended for babies younger than 8 months of age in their first RSV season and some children ages 8 to 19 months who are entering their second RSV season and are at high risk of getting very sick from RSV.
  • RSVpreF is a vaccine for pregnant people to protect their infants from RSV.

Remind your child about other ways to avoid illness. Children should learn to cover their mouths and noses with a tissue (or in their elbow) when they cough or sneeze (and then immediately put the tissue in the trash). They can wear a mask in public to avoid the spread of germs to and from others. Everyone should be encouraged to wash their hands with soap and water or use an alcohol-based hand sanitizer.

Remember, If your child is sick and you have any questions or concerns about their symptoms, don’t hesitate to call your pediatrician. Additionally, it is important for all children to stay up-to-date on immunizations, sports physical examinations, and routine care.