My Kid Is Sick: Is It RSV, Flu, COVID-19, or a Cold?

Parent checking temperature of sick child with words of virus symptoms around them

Verywell / Photo Illustration by Michela Buttignol / Getty Images

Key Takeaways

  • Both RSV and the flu have arrived unseasonably early, and are causing increased hospitalizations for children.
  • COVID-19 numbers are starting to rise again, as people gather for the holidays.
  • Many of the symptoms of RSV, the flu, and COVID overlap; the best way to know what your child has is to have them tested.

If it feels like your child has been sick constantly this fall, you are far from alone. This has been a particularly challenging season for respiratory viruses. The director of the Centers for Disease Control and Prevention (CDC) Rochelle Walensky stressed in a call with journalists on December 5th, the U.S. is facing a “tripledemic” of viruses.

RSV and flu levels are higher than they are in most typical years, Dr. Walensky said, and hospitals continue to be overburdened with patients. Of course, COVID-19 continues to loom in the background, with cases beginning to rise again as the holiday season ramps up and people gather indoors with family and friends, according to Dr. Walensky.

As a parent, it can be difficult to know what virus your child has brought home, especially as so many respiratory viruses are circulating at once, and many share similar symptoms. While you can’t know for sure what your child has without getting tested, there are some symptoms that set these viruses apart from one another.

The RSV Surge

This year’s RSV season has come early and is particularly intense, says Muzna Atif, M.D. FAAP, a pediatric hospitalist, and the medical director at Pomona Valley Hospital Medical Center. “Viral bronchiolitis from RSV usually peaks yearly in December to January, making this early surge in cases unusual with a large number of cases needing medical attention,” says Dr. Atif.

According to the CDC, RSV cases began to surge in the summer and early fall this year. RSV cases appear to have peaked or at least leveled out in most parts of the U.S., but it is still causing significant problems.

RSV hits young children under 6 months particularly hard, and emergency departments have been full of young patients for weeks now. In her December 5th call to reporters, Dr. Walensky said RSV hospitalizations continue to be higher than they typically are this time of year.

RSV Symptoms

For many of us, RSV presents like a typical cold, with a sore throat, congestion, and coughing. But young children can have a much tougher time with RSV and can develop serious breathing issues. Babies and toddlers can develop a condition from an RSV infection called bronchiolitis, says Zachary Hoy, MD, a pediatric infectious disease specialist at Pediatrix Nashville Pediatric Infectious Disease.

“The most affected pediatric patients are those younger than 6 months,” Dr. Hoy says. “Bronchiolitis from RSV can cause trouble breathing where patients need oxygen support, IV fluids or close monitoring in the hospital.”

Although RSV often resembles common colds, there are some distinguishing characteristics, says Dr. Hoy. “One of the hallmarks of RSV is the significant amount of mucus it produces,” he says. “The extra mucus can cause stopped up noses and sometimes younger infant patients need bulb suctioning to help clear their noses.”

Another way to tell the difference between RSV from something like the flu is the way the symptoms come on, says Dr. Atif. RSV symptoms usually have a gradual onset, as opposed to the flu, which has a shorter exposure period and is usually associated with rapidly progressing symptoms like fever and body aches, she describes.

COVID-19 Cases Are Rising

Early in the fall, we got a bit of a respite from COVID, with cases leveling off around the country. Unfortunately, cases appear to be rising again. “Since the start of the holiday season, COVID cases are again starting to rise slowly,” says Dr. Atif.

According to the CDC, for the week ending November 29, 2022, hospitalizations (which usually spike after cases rise) have increased almost 17%. With at-home testing, it can be difficult to get a true picture of caseloads, but COVID wastewater readings are currently rising all over the country.

COVID-19 Symptoms

COVID symptoms include sore throat, headaches, fever, chills, fatigue, nausea, and diarrhea. Symptoms can vary significantly from one child to another “Sometimes symptoms may be very mild to asymptomatic, especially in vaccinated children,” she describes.

In other words, it can be tough to distinguish COVID symptoms from symptoms of other common viruses like the flu or even the common cold. As such, the best way to know if you have COVID or something else is to test for it, Dr. Atif says.

In terms of distinguishing characteristics of COVID vs. other respiratory viruses, the loss of taste and smell that often comes with a COVID infection is a telltale sign, says Dr. Atif. But not all kids experience this, so again, it’s best to visit your healthcare provider and/or get your child tested for COVID.

Flu Cases Continue to Rise

In her recent call to reporters, Dr. Walensky said the U.S. is seeing the highest number of flu cases in a decade, especially for this time of year. So far, the U.S. has recorded over 8.7 million flu cases and 78,000 hospitalizations. Tragically, 4,500 people have died this season so far.

Flu Symptoms

The recent surge is attributed to the influenza A variant, says Dr. Atif. “Children are coming for medical attention and some are being hospitalized with symptoms like high-grade fever, body aches, weakness, poor appetite, sore throat, and croup-like symptoms,” she describes.

Most of the very sick children are unvaccinated, Dr. Atif says, and are being admitted to pediatric hospitals with severe respiratory distress, requiring large amounts of oxygen and sometimes ventilation. The highest rates of hospitalization for flu this season have been among children under 4 years old.

Telling the difference between the flu and other common respiratory viruses can be difficult at times. Again, the rapid onset of symptoms is one of the flu’s defining characteristics. “As opposed to other viral infections like COVID, symptoms onset is rapid usually within a day or two of exposure to a sick contact, and more severe in presentation,” Dr. Atif explains.

Symptom Check: Is it RSV, Flu, Or COVID?

 RSV Flu  COVID-19 
Sore Throat Sometimes Common Common
Congestion Common Sometimes Sometimes 
Nausea/Diahrrea  Rare Sometimes  Sometimes 
Taste/Smell Loss Rare  Rare  Sometimes 
Rapid Onset Gradual  Rapid  Sometimes 
Difficulty Breathing  Sometimes  Uncommon  Sometimes 
Fever Sometimes  Common  Common 
Cough  Common  Common  Common 
Sources: CDC, AAP

Is It Just a Cold?

Of course, COVID, flu, and RSV aren’t the only viruses currently making the rounds. The common cold is still here, and many kids are catching that too. How to tell the difference between it and others?

“The common cold is generally self-limited and associated with much milder symptoms, most of the time easily managed at home and not requiring medical attention,” Dr. Atif describes.

But again, there is often overlap between cold symptoms and COVID and RSV symptoms, Dr. Hoy reminds. “The main way to tell if it is a common cold virus is by getting your child tested,” he says. “Because RSV, COVID and influenza can all cause cough, malaise, intermittent fever and other respiratory symptoms, it is difficult to predict which one based on symptoms alone.”

What This Means For You

When faced with such a tough season of illness, it’s easy to feel powerless. But there are things you can do to reduce the chances of your child catching these viruses—or at least, reduce the risk of them getting seriously ill. Practicing hand washing, ventilating indoor spaces, and wearing a mask during surges of illness, can help tremendously.

Both flu and COVID vaccines/boosters can reduce the chances of infections, and most importantly reduce the chances that your child will get severely ill if infected. The CDC recommends every child 6 months and up get a COVID vaccine (or booster) and an annual flu vaccine.

13 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Transcript: CDC media telebriefing- update on respiratory disease circulation.

  2. Centers for Disease Control and Prevention. RSV National Trends.

  3. American Academy of Pediatrics. RSV: When It's More Than Just a Cold.

  4. Centers for Disease Control and Prevention. COVID data tracker.

  5. Centers for Disease Control and Prevention. National wastewater surveillance system (NWSS).

  6. Centers for Disease Control and Prevention. Symptoms of COVID-19.

  7. Centers for Disease Control and Prevention. Weekly U.S. Influenza Surveillance Report.

  8. Centers for Disease Control and Prevention. Weekly U.S. Influenza Surveillance Report.

  9. American Academy of Pediatrics. The Flu: What Parents Need to Know.

  10. American Academy of Pediatrics. The Flu: What Parents Need to Know.

  11. American Academy of Pediatrics. Children and Colds.

  12. Centers for Disease Control and Prevention. How to protect yourself and others.

  13. Centers for Disease Control and Prevention. Frequently Asked Influenza (Flu) Questions: 2022-2023 Season.

By Wendy Wisner
Wendy Wisner is a lactation consultant and writer covering maternal/child health, parenting, general health and wellness, and mental health. She has worked with breastfeeding parents for over a decade, and is a mom to two boys.