RSV and Flu: What’s the Difference and When Should I Seek Care? Posted on October 20, 2022 By: Juan C. Salazar, MD, MPH, FAAP Peak respiratory season is here. While COVID-19 is still top of mind for many parents, the flu and respiratory syncytial virus (RSV) have returned earlier than expected this year. RSV is spreading rapidly through New England and is already affecting our children. Influenza is expected to peak sometime in November and December. What is RSV? How is it different from the flu? When should I call my pediatrician or seek emergency care? Connecticut Children’s pediatric experts have the answers you need to get through this season. But first—flu shot check! Is your child up to date on their vaccines? What is RSV and how serious can it get? RSV is a virus that causes just one of many respiratory illnesses in infants, kids and even adults. For most of us, it’s not new and your child has likely already had it before turning 2. But RSV can be very serious for: Infants a year or younger Children younger than 2 Kids who are immunocompromised or who have existing lung disease, like asthma RSV is also the most common cause for pneumonia and bronchiolitis (a fancy term for a bad cold—and different from bronchitis!) in very young kids. >Related: Are Your Child’s Symptoms from RSV or Something Else? What to Know About this Common Illness How is RSV different than the flu? RSV and the flu are two different viruses, but often have very similar symptoms. Sometimes, the symptoms are no more severe than that of a common cold. Other times, they can be life threatening. Common symptoms of RSV: Fever, but not always Loss of appetite Cough, often with wheeze. The cough can sound startling. Runny nose Common symptoms of the flu: Body aches Chills Cough Fatigue Fever Headache Sore throat Stuffy nose Diarrhea and vomiting—sometimes The kicker? It’s possible to have both the flu and RSV at the same time. An in-office test can confirm. > Related: How Can I Tell if My Child Has the Flu or COVID-19? Antibiotics can treat both RSV and the flu, right? No. Antibiotics do not work against viral infections. But if your child develops an ear infection from the congestion caused by the virus, your doctor may prescribe them to treat the newly formed infection. Sometimes, if appropriate and depending on how old your child is, your doctor may prescribe an antiviral like Tamiflu to lessen the severity of flu symptoms. When should I call 911 or go to the emergency room? Look for these signs: Trouble breathing or fast breathing. Look for ribs pulling with each breath. Change in color in face—usually bluish skin and lips Fever of 100.4 or higher in infants younger than 3 months- call pediatrician on-call first Fever of 105 or higher, regardless of age- call pediatrician on-call first Fever of 102 or higher, lasting more than two days. This is to rule out any bacterial infections like meningitis. Not alert when awake Dehydration (no urine for 8 or more hours, mouth is dry and no tears are forming)- call pediatrician on-call first In a true emergency, always call 911. Trust your parental instinct. >Related: Fevers: To Worry, or Not to Worry My child’s cough is never ending and gives me anxiety. Should I go to the ER for constant cough alone? Usually not. Most of the time, while scary to hear, cough is our friend. It’s pushing out all the bad stuff and works to help your child ultimately get better. The challenge is, sometimes cough can be accompanied by wheezing or breathing difficulties—and it may get a lot worse at night. If your child is having trouble breathing, definitely call 911. But for a cough alone, rest, a cold-mist humidifier, nebulizer if your doctor says so, elevating the mattress, and encouraging lots of fluids can all make a difference. Ask your pediatrician about FDA-approved medications that could help before you try administering anything on your own. Stay away from the homeopathic stuff as it hasn’t been studied in depth. As a general rule, if your child’s cough hasn’t improved after two full weeks, give your pediatrician a call for a wellness check. There are so many factors—oftentimes unexplained—that can cause the “100-day” cough. Want more articles like this from pediatric experts you trust? Sign up for our newsletter. Subscribe How can I prevent my child from getting either the flu or RSV? Protection is always the best prevention! There is an FDA-approved influenza vaccine that comes out each year. Now is the time to make sure your child gets their flu shot at their pediatrician’s office. If you have an infant 6 months or older, and this is their first time, they’ll need two doses about a month apart. Your pediatrician will explain. Unfortunately, there is no RSV vaccine for the general public at this time. So, think back to all the strategies you pulled out of your toolbox during the many waves of COVID-19: wash hands, mask up when necessary and wipe down surfaces.