Flu symptoms

The 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 can have very similar symptoms as the flu, there are some significant differences between the two which can be potentially harmful for your little ones. With our patients always in mind, we wanted to help address some recent concerns with this post.

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 the age two.

RSV, which stands for Respiratory Syncytial Virus, is a virus that causes infections in the lungs and respiratory tract. According to a recent report by the CDC, an estimated 57,000 children younger than five years old are hospitalized due to RSV infection.

Throughout this post, we will share with you seven things that every parent should know about RSV vs. the Flu, along with great preventative 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.

Here is a diagram of a few other symptoms that can help you differentiate these two illnesses:

RSV and Flu Seasonality

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

RSV and Flu Risk Factors

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

While the risk factors for RSV/ Flu can vary from patient to patient here are a few other facts to keep in mind that can increase your child’s risk of contracting these illnesses.

With RSV, risk factors increase for children with the following:

  • Infants younger than six 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 Downs syndrome
  • Immunocompromised patients (e.g., immunodeficiency, leukemia, or lung transplant)
  • Patients of any age group with significant asthma

INFLUENZA, risk factors can increase in children with the following:

  • Children under the age of 5 years, but especially less than two-years of age *
  • 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 [mental retardation], moderate to severe developmental delay, 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 mellitus)
  • Weakened immune system (e.g. HIV infection, Cancer or treatment with long term 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 areas (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 are important vectors for the spread of both diseases.

Patients with Influenza can be contagious before the onset of symptoms and for several days after. More extended periods of shedding can occur in immunocompromised hosts and young children, especially those with primary infection, due to the relative lack of immunity.

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

RSV Symptoms

After supportive care and monitoring of your child by a medical professional, a child may be admitted to the hospital for the following symptoms:

  • Toxic appearance, poor feeding, lethargy, or dehydration
  • Moderate to severe respiratory distress, manifested by one or more of the following signs: nasal flaring; intercostal, subcostal, or suprasternal retractions; respiratory rate 70 breaths per minute; dyspnea; or cyanosis
  • Apnea
  • Parents who are unable to care for them at home

Although 12 weeks is a risk factor for severe or complicated disease, your child being at a young age in and of itself, is not an indication for hospitalization.

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

  • Has a cold and is less than six months of age.
  • Has any breathing problems (wheezing or coughing, fast breathing, blue or gray skin color)
  • Has a cold and is at high risk for RSV (mentioned – under risk factors)
  • Seems very sick or has trouble eating, drinking, or sleeping.

Influenza Symptoms

The rate of influenza hospitalization is higher in children less than five years than children 5 through 17 years old.

Although the influenza virus infection is associated with increased rates of hospitalization in children with high-risk medical conditions, the majority of children hospitalized for influenza 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

For Both Influenza and RSV

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 nares may help to relieve partial upper airway obstruction in infants and young children with respiratory distress or feeding difficulties.


Hypertonic saline inhalation

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


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 and treatment instituted.

RSV vs Flu Recovery and Re-infection:


Patients with uncomplicated influenza 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 influenza infection may be infected with a different influenza type or subtype later in the season.

Otitis media — 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 symptom

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.

Here at Pediatrix Urgent Care, we offer Flu and RSV testing with same day results at all our 13 locations throughout Florida. 

Dr. Ayodeji Otegbeye

About the Author:

Dr. Ayodeji Otegbeye, better known as “Dr. O” is the President and Founder of Central Florida Pediatrics Intensive Care Specialists and Night Lite Pediatrics Urgent Care. Dr. O was the Medical Director of Children’s Medical Services in the Central Florida Region (Orange, Seminole, Osceola and Brevard Counties) from 2004 – 2019; and the Medical Director of Leesburg Regional Hospital Pediatric Hospitalist Program.


Disclaimer: These articles are not intended to be used for diagnosis or treatment. It is aimed at presenting a perspective only and is not a substitute for a prescription. Anyone experiencing a medical condition should consult their doctor.