RSV v. COVID v. Flu: Here’s what you need to know

(NEXSTAR) — Hospitals across the country have reported an increase in children being hospitalized for respiratory syncytial virus, commonly known as RSV. Amid what is expected to be a serious flu season, and with COVID-19 still infecting thousands every week, some are warning we could have a challenging few months ahead.

“We’ve already seen above what we expect for October of any given year in terms of RSV locally and across the country,” Diego Hijano, an infectious disease specialist at St. Jude Children’s Research Hospital, told The Hill. In the last week, nearly 7,000 RSV tests were positive, far more than the 30 or so reported at the same time last year, according to the Centers for Disease Control and Prevention.

dr Julie Holland, vice president of primary pediatric care at the Chicagoland Children’s Health Alliance, told Nexstar’s WGN there are concerns that patients could get all three viruses at the same time.

So how can you tell these viruses apart?

First, it’s important to note the most serious symptom: difficulty breathing. If your child has trouble breathing, see a doctor right away. Signs may include seeing your child’s ribs as they breathe, their lips turning pale or blue, or the area under your child’s Adam’s apple collapsing.

Who is most at risk?

Anyone can get these viruses, but infants are among the most at risk, as are older adults and people with compromised immune systems.

In the case of RSV, a young child’s smaller airways make them more vulnerable.

“Their airways are narrower, so inflammation and extra mucus make it difficult to breathe,” explained Dr. East Tennessee Children’s Hospital’s Joe Childs to Nexstar’s WATE. “Especially in the first months of life it can be very nasty.”

Their younger immune systems can also make them more susceptible to the flu. Holland says when it comes to flu and RSV, “the younger you are, the sicker you get.”

While young children can get COVID, according to Harvard Medical School, many who contract it have been found to have no symptoms. When they do have symptoms, they tend to be milder. However, children are at risk of developing a serious complication known as childhood multisystem inflammatory syndrome, or MIS-C, after being exposed to or having had the virus that causes COVID. MIS-C can cause problems with the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs, according to the CDC.

What are the symptoms?

All three viruses have similar symptoms in young children, Michael Meyer, medical director of Wisconsin’s pediatric intensive care unit, wrote in a blog post Monday.

“These include a stuffy or runny nose, cough, headache and low-grade fever,” writes Meyer. “Their appetites may also be reduced, and for infants who are breastfed, that may mean fewer wet diapers.”

These symptoms are similar to those listed by the CDC for COVID and by Johns Hopkins Medicine for the flu. The flu includes additional symptoms such as high fever, body aches, nausea, vomiting and diarrhea.

In younger children, RSV, an upper respiratory tract infection, can also cause wheezing and shortness of breath, Holland said. But she added that you can’t tell what virus someone has just by observing their symptoms. Instead, you need a diagnosis from a doctor.

How are the viruses diagnosed?

A COVID diagnosis requires a nasal swab test, using either a PCR test or an antigen test. Testing for RSV, although not usually required according to the American Lung Association, is usually done with a mouth swab or blood test. If your doctor suspects your child has the flu, testing may include swabs from the nose or throat.

How to protect your child

Although it can be difficult to tell the viruses apart, the protective measures for your child are all the same.

Meyer recommends washing your hands frequently and making sure everyone who comes into contact with your child has washed their hands. If your child or other people in your household are unwell, they should stay at home. If you don’t feel well, you shouldn’t come to your house. He also recommends keeping surfaces clean, as viruses can live on hard surfaces.

There is no vaccine for RSV, but vaccines are available for COVID and the flu.

The flu shot is recommended for most children from 6 months, according to John Hopkins.

Two COVID vaccines – Pfizer-BioNTech and Moderna – have been approved for children as young as 6 months. A third vaccine, Novavax, has been approved for children aged 12 and older.

During RSV season, an injection of an antibody-based drug is sometimes prescribed to protect premature and other very vulnerable babies. Infants born to mothers who had RSV during pregnancy may also have some immunity.

Whether your child has RSV, the flu, or COVID, if you’re concerned your child has a serious breathing problem, “don’t hesitate” to go to an emergency room or call 911, Dr. Russell Migita from Seattle Children’s Hospital.

For less serious medical problems, Migita said, call your regular health care provider for advice, use telemedicine, or go to emergency care.

The Associated Press contributed to this report.