RSV vs Flu: 7 Things Every Parent Should Know

 

The influenza (flu) season may be slowing down in some areas, but here at Pediatrix Urgent Care, we’ve seen an increase in flu cases in the last few weeks. While RSV and flu can have very similar symptoms, there are some significant differences between the two.

So, let’s jump in!

Now, I am sure there are some of you reading this and thinking, what is RSV? While RSV is not an illness that we hear much about in the media, it is quite common for kids to be infected by this virus by age 2.

RSV, which stands for Respiratory Syncytial Virus, causes infections in the lungs and respiratory tract. According to the Centers for Disease Control and Prevention, an estimated 57,000 children younger than 5 years old are hospitalized due to RSV infection.

In this post, we will share seven things that every parent should know about RSV and the flu, including preventive measures to start right away.

RSV and Flu Symptoms

A significant difference between flu and RSV is the way symptoms begin. The flu usually starts with a high fever along with aches and pains.

RSV starts as a cold, sometimes with fever, that leads to coughing, fast breathing and wheezing.

RSV and Flu Seasonality

Both infections occur in the winter months. In the northern hemisphere, these usually occur from October to May, with a peak in January or February.

RSV and Flu Risk Factors

RSV is the most common cause of lower respiratory tract infection in children younger than one years old. RSV hospitalization rates were highest among children 6 months old and premature infants.

There is an increased risk of developing RSV for:

• Infants younger than 6 months of age, particularly those who are born during the first half of the RSV season, those attending daycare and those with older siblings (who may not show any RSV symptoms)
• Infants and children with underlying lung disease, such as chronic lung disease (bronchopulmonary dysplasia)
• Infants born before 35 weeks of pregnancy
• Infants and children with congenital heart disease
• Infants exposed to secondhand smoke
• Patients with Down syndrome
• Immunocompromised patients (e.g., immunodeficiency, leukemia or lung transplant)
• Patients of any age group with significant asthma

There is an increased risk of developing flu for:

• Children under the age of 5 years, but especially those under age 2*
• Kids with medical conditions including asthma
• Children with neurologic and neurodevelopmental conditions (including disorders of the brain, spinal cord and peripheral nerve and muscle such as cerebral palsy, epilepsy, stroke, intellectual disability, muscular dystrophy and spinal cord injury)
• Chronic lung disease (e.g., bronchpulmonary dysplasis, cystic fibrosis)
• Heart disease (e.g., congenital heart disease, congestive heart failure)
• Blood disorders (e.g., sickle cell disease)
• Endocrine and metabolic disorders (e.g., diabetes)
• Weakened immune system (e.g. HIV infection, cancer or long-term treatment with steroids)

We know that a trip to the doctor can be stressful experience for young patients, so reserve a spot or walk in to have your child seen by a pediatrician now.

RSV and Flu Transmission

Direct contact is the most common route of transmission of RSV and influenza. This includes contact with virus-containing secretions through sneezing, coughing and the touching of infected items (furniture, clothes, utensils).

RSV can survive for several hours on hands and infected areas.

Influenza can also spread by small particle aerosols that are released into the air during breathing. Children commonly spread both diseases.

Patients with influenza can be contagious before the onset of symptoms and for several days after. Immunocompromised people and young children can spread the virus for extended periods due to their irrelative lack of immunity.

When Should You Go the Hospital for RSV or Flu Symptoms?

RSV Symptoms

A child may be admitted to the hospital for the following symptoms:

• Toxic appearance, poor feeding, lethargy or dehydration
• Moderate to severe respiratory distress
• Apnea

Call your child’s doctor or come to Pediatrix Urgent Care if your baby:

• Has a cold and is less than 6 months old
• Has any breathing problems (wheezing or coughing, fast breathing, blue or gray skin color)
• Has a cold and is at high risk for RSV (see risk factors above)
• Seems very sick or has trouble eating, drinking or sleeping

Influenza Symptoms

The rate of hospitalization with the flu is higher in children under age 5.

Although the flu is associated with increased rates of hospitalization in children with high-risk medical conditions, the majority of children hospitalized with the flu are usually healthy.

Children with high-risk conditions and young children, particularly those who are 12 months of age, are at increased risk for respiratory failure and admission to the intensive care unit.

RSV and Flu Care

Supportive care includes maintenance of adequate hydration, relief of nasal congestion/obstruction, supplementary oxygen as needed and monitoring for disease progression.

Saline nose drops and mechanical aspiration of nasal passages may help to relieve partial upper airway obstruction in infants and young children with respiratory distress or feeding difficulties.

RSV CARE

Hypertonic saline inhalation

Ribavirin should be reserved for immunosuppressed patients with severe RSV infection.

INFLUENZA CARE

Neuraminidase inhibitors: Oseltamivir (Tamiflu), Zanamivir (Relenza), selective inhibitors of influenza cap-dependent endonuclease: Baloxavir (Xofluza)

If you identify the flu in the first 24 to 48 hours, your child may be able to take medication so that he or she will have a shorter duration of illness and misery. Rapid testing can be done at Pediatrix Urgent Care.

RSV vs Flu Recovery and Re-infection:

Patients with uncomplicated flu cases usually improve gradually over approximately one week (with or without antiviral therapy), but symptoms – especially cough – may persist, particularly in young children.

Weakness and fatigue may last for several weeks in older children and are sometimes referred to as “post-influenza asthenia.”

Children who recover from one episode of flu infection may be infected with a different influenza type or subtype later in the season.

Otitis media (middle ear infection) complicates the course of influenza in 10 to 50 percent of children. The typical time of onset for otitis media is three to four days after the start of influenza symptoms. However, RSV is more likely to cause sinus and ear involvement.

RSV RE-INFECTION

Individuals can be infected more than once in the same RSV season. However, subsequent infections are usually milder whether they occur in the same season or different year.

Pediatrix Urgent Care offers flu and RSV testing with same day results.