RSV vs. Flu vs. Pneumonia: Sorting out Your Child’s Fever and Cough

When symptoms call for a trip to the doctor

Sick child lying down with thermometer

It’s a dilemma that can baffle even the most seasoned parents: Your child’s miserable with a cough and fever. You don’t want to run to the doctor if a run-of-the-mill virus is the culprit and rest and fluids will do the trick. But you don’t want to delay and risk allowing a more serious condition take hold.

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How do you know when your child’s illness is something serious like the influenza virus (flu), respiratory syncytial virus (RSV) or pneumonia, for instance?

Fever and cough are common symptoms for all three — and for a host of less serious maladies too, says pediatrician Amy Sniderman, MD.

She walks us through common symptoms you should watch for and offers advice on when to check in with your child’s doctor.

Is it the flu?

Common signs of the flu include fever, cough, congestion, body aches and chills.

“Sometimes younger children will have vomiting or diarrhea, but typically it’s more of a respiratory condition,” Dr. Sniderman says.

Call the doctor right away if your child is not eating or drinking, not urinating, or is acting much more tired or irritable than usual, she advises.

It’s especially important to call the doctor when you suspect flu if your child has an underlying medical condition such as asthma or diabetes. Children who have these conditions are at higher risk of developing complications.

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Dr. Sniderman recommends getting a flu shot for any child older than 6 months to help head off serious illness.

“The best way to prevent getting the flu is by getting the flu vaccine,” she says. “Even if you get the flu after you get a flu shot, your symptoms won’t be as severe and you’ll be less likely to experience complications such as pneumonia.”

Is it RSV?

RSV is a contagious illness that infects the respiratory tract and can lead to more severe infections like pneumonia or bronchiolitis.

Symptoms of RSV include runny nose, cough, fever, and sometimes trouble breathing or respiratory distress, Dr. Sniderman says.

In older children, RSV can resemble a bad cold. In babies, however, it’s sometimes a serious illness — particularly for those with other medical conditions such as asthma, or those who were born prematurely.

Call the pediatrician right away if your child shows any of these signs:

  • High fever
  • Fever that lasts more than two days
  • Rapid or difficult breathing
  • Extreme irritability or tiredness
  • Decreased urination
  • Dehydration

“RSV tends to produce a lot of mucus, so you can help keep your child comfortable by encouraging him to blow his nose, or by using a nasal suctioning device to remove mucus from your young child’s nose,” Dr. Sniderman says.

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Is it pneumonia?

Symptoms of pneumonia in kids can include cough, fever, and fast or difficult breathing.

“With pneumonia, your child will act sicker than with a normal cold,” Dr. Sniderman says.

If you suspect your child has pneumonia, contact his or her doctor.

Usually doctors can diagnose pneumonia by examining the child, but sometimes a chest X-ray is necessary, she says.

When in doubt, call the doctor

Still worried and wondering? Because flu, RSV and pneumonia symptoms can overlap, diagnosis is tricky, Dr. Sniderman says. So don’t feel as though you need to diagnose your child on your own.

“If your child is feeling ill and you are worried about them, you should call their doctor,” she says. “That’s what we’re here for.”

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