Is it the flu, RSV, a cold, allergies or Covid?

Now that Covid is officially here to stay—It’s completely understandable if every cough, sneeze, sniffle or sore throat in your kiddo has you speed-dialing your pediatrician. And you should definitely pick up that phone or schedule a virtual visit if you have concerns like a recent Covid exposure, or if something just doesn’t feel right about the symptoms your child is showing. With Covid cases ticking up across the country, plus flu and RSV cases also on the rise, it’s hard to know exactly what you’re battling. Plus, seasonal allergies and common colds are still circulating, too.

But with overlapping symptoms among those various viruses, how can you tell what you’re dealing with? It’s helpful to know that the disease caused by the novel coronavirus, SARS-CoV-2, has a few distinguishing symptoms that are not shared by flu, RSV, allergies or the common cold.

Here’s how symptoms of Covid, and specifically, the latest variants, differ from the symptoms of flu, colds, RSV and seasonal allergies—but remember, you should always take a Covid test (we like the Lucira by Pfizer combined Covid & Flu test) or call your healthcare provider to confirm, because Covid symptoms can vary widely—and in some cases, may not be present at all.

The most common symptoms of Covid in kids

Covid still tends to be seen as a mild disease in young children, but the rise of the now-dominant JN.1 variant has resulted in an increase in the number of Covid cases, The Washington Post reports. Studies show that the latest monovalent Covid vaccines do provide protection against the newest strains.

Symptoms may include:

• Congestion or runny nose
• Headache
• Sore throat
• Coughing
• Fever
• Nausea
• Diarrhea
• Shortness of breath
• Difficulty breathing

Headache, sore throat, runny nose and fever are the most common symptoms that present in kids with Covid. Shortness of breath tends to be more commonly seen in adults.

Unfortunately for parents everywhere, these are also highly common symptoms of colds and flu.

It’s also important to be on the lookout for a rare yet serious condition known as multi-system inflammatory syndrome in children (MIS-C), which may be related to Covid exposure.

The most common symptoms of flu in kids

Symptoms of influenza (flu) tend to come on suddenly rather than gradually, and usually include fever (100.4 degrees or higher). Flu symptoms may cause your child to feel worse than they might feel with a common cold. Body aches are common.

Symptoms may include:

• Congestion
• Runny nose
• Cough
• Headache
• Muscle aches and pains
• General malaise
• Fever
• Sometimes nausea and vomiting
• Low appetite

Your child’s pediatrician or your local walk-in clinic can test your child for flu using a nasal swab. The primary treatment is rest and extra liquids, but some may need antiviral medications to relieve symptoms. 

The most common symptoms of the common cold in kids 

Common cold symptoms may be similar to those of the flu, but are generally milder.

Symptoms may include:

• Cough
• Congestion
• Runny nose
• Sore throat
• Possible low-grade fever

There’s no specific treatment for colds—they’re viruses that just need to run their course. Your child will likely still have good energy and a good appetite.

The most common symptoms of RSV in kids

RSV, or respiratory syncytial virus, is a separate condition that can cause cold-like symptoms in older children, but may cause a more severe lung disease in infants called bronchiolitis.

Symptoms may include:

• Clear, runny nose
• Decreased appetite
• Coughing
• Wheezing
• Sneezing

Shortness of breath, wheezing and fast heart rate are all symptoms of a more severe second stage of RSV. Contact your doctor or seek emergency medical treatment if your child has difficulty breathing.

The most common symptoms of seasonal allergies in kids

It’s not always easy to tell if your child has a cold or an allergy, but if there’s no fever and symptoms last one week or longer, it’s probably related to an allergy.

Symptoms may include:

• Sneezing
• Throat irritation or soreness 
• Nasal congestion or runny nose
• Watery or red eyes
• Possible fluid buildup in the ears

If you’re worried about your child’s symptoms, remember, your safest move is to call your healthcare provider for a diagnosis or test.

Best bets for illness prevention

If there’s one small silver lining about this long list of ailments with overlapping symptoms, it’s that the preventative measures we can take to protect our families are straightforward, powerful multi-taskers:

Practice cold-and-flu-season hygiene. Habitual hand-washing, along with frequent cleaning and disinfection of high-touch areas, will go a long way toward protecting your family from infectious diseases including Covid, RSV, influenza and the common cold.

Stay home if you’re sick. Stopping the spread starts with reducing exposure to those around you and in your community. If you have any symptoms, stay home until you can take a Covid or flu test.

Make sure your family is vaccinated. Vaccinating all those who are eligible is the top recommendation from public health experts for preventing the spread of Covid, flu and RSV. Covid and flu vaccines are authorized for use in kids aged 6 months and up. The RSV shot may be given to babies aged 8 months or younger, or the maternal RSV vaccine may be offered to women during pregnancy.

Consider wearing a mask. Even if you are vaccinated, wearing a mask in public areas can mean you’re less likely to transmit the virus to another person in your household. Ensure you’re using a KF94 or a KN95, which can effectively filter out more viral particles. Masks may also help protect your family’s respiratory health when it comes to common colds and the flu, and also if you live in an area where the air quality has been affected.

A version of this article was originally published on September 18, 2020. It has been updated.