When a child starts feeling sick, it’s often a challenge for parents to figure out what it is that their kid has—and how serious it is. Is it a cold or the flu? Or maybe allergies, or some other virus?
And now we have COVID-19, too.
The short answer is that it’s not always going to be clear what infection your child has. COVID-19, other respiratory viruses, and the flu have many symptoms in common. As the months progress, lessons learned about COVID-19 may help parents figure out what to do when their kids feel sick during the pandemic.
What are the biggest differences between COVID-19 and the flu?
Most children who have the flu experience rapid onset of symptoms and start to feel sick with a fever, cough, and runny nose for several days.
In contrast, children with COVID-19 may not have any symptoms or may have a fever for a short period of time, congestion, a cough and loss of taste and smell.
Common COVID-19 Symptoms in Children
COVID-19 is a new respiratory virus and we’re still learning about it. People with COVID-19 have reported a range of symptoms, and not everyone infected with the virus will have all these symptoms. Some people with COVID-19 become severely ill, others have mild symptoms, and still others show no symptoms at all—but may still transmit the virus without getting sick themselves. Symptoms tend to appear from 2-14 days after exposure to the virus.
What are the most common symptoms of COVID-19?
Symptoms of COVID-19 can include:
- Brief episodes of fever
- Shortness of breath
- Abdominal pain
- New loss of taste or smell
- Sore throat
- Nausea or vomiting
- Muscle or body aches
The loss of taste or smell seems to be unique to COVID-19; most other illnesses don’t have this symptom. But it’s important to know that plenty of people with COVID-19 never experience loss of taste or smell, so just because your child shares that he can taste and smell doesn’t mean he doesn’t have COVID-19.
What should I do if my child has symptoms that could be either COVID-19 or the flu?
Because any symptom could mean that your child could be infectious with any virus, you should keep your kids at home if they are experiencing any of these symptoms.
“If your child has a temperature or fever, keep them at home,” says Andi Shane, MD, MPH, MSc, System Medical Director, Infectious Diseases at Children’s “Have them remain at home for 24 hours to see if symptoms progress.”
If your child develops a fever or cough, use our COVID-19 Pediatric Assessment Tool, designed to help parents answer two questions:
- What should I do if my child has a fever and/or a cough?
- What should I do if my child has been around someone with COVID-19, but my child has no symptoms?
What about MIS-C?
Multisystem inflammatory syndrome in children (MIS-C) is a recently described condition, found to rarely develop in some children 3-4 weeks after having recognized COVID-19, or having been exposed to someone with COVID-19.
You should contact your child’s doctor or an urgent care clinic right away if your child is showing the following symptoms, which could suggest MIS-C:
- Abdominal pain
- Neck pain
- Bloodshot eyes
- Feeling extra tired
Be aware that not all children will have all the same symptoms.
Common Flu Symptoms in Kids and Teens
The seasonal flu (influenza) can cause mild to severe illness, and it can even cause serious complications that lead to death in children. Flu usually comes on very suddenly; your child may feel perfectly fine one day and be very sick the next, unlike COVID-19, which tends to start gradually.
What are the most common symptoms of the flu?
A child with the flu will typically experience:
- Runny nose
- Loss of appetite
- Sore throat
The best news about flu is that flu shots that can protect you and your children from having severe infections, and in some cases from infection altogether.
Since some flu symptoms are similar to symptoms of COVID-19, preventing a flu infection by getting your annual flu shot could reduce confusion or concerns about possible COVID-19 infection in your family. Remember, it’s never too late to get a flu shot.
“It is very, very important for parents to make sure that they and their children receive their flu vaccines as soon as possible,” says Dr. Shane. “It’s something parents can actively do to protect children and themselves.”
Comparing Symptoms of Other Common Respiratory Illnesses in Kids
COVID-19 and flu aren’t the only common respiratory illnesses parents should be on the lookout for. It’s important to know the differences between respiratory syncytial virus (RSV), allergies and the common cold.
What are the symptoms of RSV in kids?
RSV is a viral illness that causes people to have trouble breathing. It mostly affects the very young and is extremely common: Almost all children will have an RSV infection by their second birthday. A child’s first RSV infection is usually the most severe and children who are born prematurely, with breathing or heart problems, are more likely to have complications from an RSV infection.
Symptoms of RSV infection usually include:
- Runny nose
- Decrease in appetite
These symptoms usually appear in stages and not all at once. Kids infected with RSV usually show symptoms within 4 to 6 days after getting infected. In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties.
What are the most common symptoms of allergies in kids?
- Runny nose
- Itchy, watery eyes
Allergies occur when the body produces an abnormal immune response to something. They can be seasonal, or can happen when a child comes into contact with an allergen, like something they ate or environmental factors like pollen or dust. Allergies are more likely to occur at certain times of the year (fall and spring) and are more likely to affect older children.
What are the symptoms of the common cold?
Symptoms of a cold usually peak within 2 to 3 days and can include:
- Sore throat
- Runny or stuffy nose
- Watery eyes
While it may be incredibly hard to tell which of these illnesses your child has, the bottom line during these pandemic times is that if your child is exhibiting any symptoms at all, you should keep him at home. It’s important to try to keep anyone with symptoms physically separate from those who do not have symptoms, encouraging everyone to wash their hands. Those with symptoms should maintain a safe distance, of at least six feet, from people without symptoms at all times. And as your family continues to battle any illness, people with and without symptoms over the age of 2 years should wear masks when they cannot be physically distant from each other in the home.