Parents ask us every day the difference between the flu (influenza), RSV (respiratory syncytial virus), or COVID (coronavirus disease 2019). While no method is fool proof, here are some typical differences among these viruses:

The flu, caused by influenza virus, comes on suddenly and makes you feel as if you’ve been hit by a truck.

Flu almost always causes fever of 101°F or higher and some respiratory symptoms such as runny nose, cough, or sore throat (many times, all three). In addition to the usual respiratory symptoms, the flu causes

body aches, headaches, and often the sensation of your eyes burning. Fever can last 5-7 days. Children, more often than adults, can vomit and have diarrhea along with their respiratory symptoms, but contrary to popular belief, there is no such thing as “stomach flu.” All symptoms come on at once; there is nothing gradual about coming down with the flu.

COVID can cause the same symptoms. Since home COVID tests are readily available, you can answer the question of “Flu or COVID?” at home.

Colds, even really yucky ones from RSV, come on more gradually.

RSV, a common cause of the common cold, is notorious for causing very thick mucus. The mucous is why some babies and young children have more severe coughing and breathing difficulties with this particular cold virus. Our immune systems are not good at mounting a lasting immunity to RSV so kids and adults tend to get this virus again and again. The first time someone is hit with RSV is usually their worst episode.

Symptoms usually start out with a sore throat or mild runny nose. Gradually, the nose runs more and a cough starts. Sometimes RSV can cause fevers for a couple of days and some hoarseness. Children are often tired from interrupted sleep because of cough or nasal congestion. This tiredness leads to extra crankiness. To further complicate things, Covid can cause identical symptoms.

Usually kids still feel well enough to play and attend school with colds like RSV.

The average length of a cold is 7-10 days although sometimes it takes two weeks or more for all coughing and nasal congestion to resolve.

Wondering about the color of mucus?

The mucus from a cold can be thick, thin, clear, yellow, green, or white, and can change from one to the other, all in the same cold. The color of mucus in the first few days does NOT tell you if your child needs an antibiotic and will not help you differentiate between a cold and the flu.

So, is it the flu, RSV, or COVID?

• Flu = sudden and miserable
• Colds, including RSV = gradual and annoying
• COVID = either

If your child has several days of runny nose and cough, but is drinking well, playing well, sleeping well and does not have a fever, the illness is unlikely to “turn into the flu.” A home test can help tease out COVID from a cold or the flu.

And yes, a kid can have multiple respiratory viruses at the same time. Let’s hope that does not happen this winter.

Julie Kardos, MD and Naline Lai, MD

©2022 Two Peds in a Pod®

 

Oh my aching back…

Right now, with schools closed, kids of all ages are doing schoolwork at home.  Technology has allowed continuation of learning and even face-to-face check in with teachers.  But it also poses some challenges. School classrooms are designed for children; our kitchen tables are not.  How to sit at the computer? Just as we require ergonomic workstations for our jobs; we need to consider proper fit and alignment for our children as they learn virtually. The following are basic ergonomics for kids doing schoolwork from home that can prevent muscle aches and fatigue.

Where to place the computer screen:

Place the computer screen directly in front of your child with the eyes level with a spot about 2-3” below the top of the screen.  In addition, place the keyboard so that the upper arms and shoulders are relaxed. The forearms should be parallel to the floor and the elbow bent less than 90 degrees.  The chair should have back support and allow the thighs to be supported parallel with the floor. Knees should also be bent to 90 degrees or a bit less with feet supported. This can be a challenge for our elementary school kids who are trying to work at home.  The Canadian Safety Council suggests: “choose a chair that places the child at the proper height in relation to the equipment. If that means a higher chair, provide a footrest to support the feet and a pillow to support the back.”

How can you adjust the chair?

Chairs with adjustable seat and footrest heights are great for this.  If you don’t have an adjustable chair, you may need to create a footrest out of a box, block or storage crate.  Also, since many children are using laptops, it is difficult to position both the screen and keyboard appropriately; it may be best to attach a separate monitor at the right height once the keyboard is set for proper arm and body position.

Avoid back and neck pain:

If children are using an iPad or reading a textbook, an angled book holder may help with proper positioning to avoid back and neck pain.  We have cookbook holders for a reason!

If your child is doing lots of writing or drawing:

An angled writing surface will help with fatigue and proper support.  There are quite a few child sized desks available with a surface that raises to an angle. If you child is a wiggler; consider a ball chair with an appropriate height table that allows for that 90-90-90 ankle, knee, hip alignment, or consider using a standing desk. In each case, the keyboard, mouse and screen still need to be adjusted for alignment as above.

The most important thing you can do is make sure your kids take a break and MOVE every 30 minutes according to both the Cornell University Ergonomics Web and Canada Safety Council.  Active breaks are necessary not just for the body, but for the eyes as well.  The best ergonomics for kids doing schoolwork at home cannot substitute for these breaks. 

Here are some ideas for quick movement breaks to keep the aches and pains away:

1. Stand and stretch arms up overhead.  Grasp hands interlocking fingers, flip palms up to the ceiling and stretch.
2. Bring arms behind your back at hip height, grasp hands or hand to wrist and try to pull shoulder blades down and together.
3. Stand with hands against a wall, place one leg back with knee straight and foot flat on the floor.  Keeping your body straight like a board, lean into the wall and stretch the back of the calf.
4. If you have a yoga ball, lie back over the ball with feet flat on the floor,  raise your arms out to the sides like a “T” and take some deep breaths.
5. Go outside in the yard and play!
6. No yard? Raining?  Have a dance party or play “Simon Says.”

Stay home.  Stay safe… and keep moving.

Deborah Stack, PT DPT PCS
©2020 Two Peds in a Pod®

We thank Dr. Stack for contributing to twopedsinapod.org— Drs. Lai and Kardos

Dr. Stack is a board certified specialist in pediatric physical therapy and the owner of the Pediatric Therapy Center of Bucks County, LLC in Doylestown, PA. In addition to treating children ages 0-21 for conditions such as torticollis, coordination,  neurologic and orthopedic disorders, she also instructs physical therapists across the country in pediatric development and postural control and is a Certified Theratogs fitter.

Every spring I find bunched up tissues wedged everywhere- in the cup-holders of the car, in couch crevices, and in the bottom of back packs. Yes, beautiful flowering spring is here in the United States along with lots of pollen to tickle everyone’s noses. But this year, along with the pollen, the coronavirus disease, aka COVID-19, has swept in. 

So how can you tell when your children’s noses become congested and they start coughing, if your child has spring allergies or coronavirus disease? While there is an overlap in symptoms between allergies and viruses, there are a few distinguishing features:

Allergies Itch

Itchy nose, itchy eyes, itchy throat. If your child is doing a lot of facial rubbing or throat clearing, you can fairly accurately blame allergies. If needed, treat these annoying itches with allergy medicine such as cetirizine (brand name Zyrtec), loratadine (brand name claritin), or fexofenadine (Brand name Allegra). You can also read our prior post about spring allergies. Allergy medicine does not improve these symptoms if your child has a virus. 

Fever: Viruses can cause fever. Allergies do not.

If your child has a fever along with their runny or stuffy nose, coughing, sore throat, and watery eyes, think VIRUS. Also, think “contagious.” In contrast, allergies do not trigger fevers. So if your child has sudden onset of respiratory symptoms WITH FEVER, you can’t blame it on allergies. 

Age 

If your child is younger than a year, it is unlikely that they will show signs of spring allergies because they have never been exposed to spring pollen. A person needs to be sensitized to something before they can be allergic to it. If it is only your child’s first spring,  they  will not show signs of allergies. Usually, cold symptoms in a child this young means that your child does, in fact, have a cold virus. 

While we do have medications to treat allergies, respiratory viruses, including the one caused by covid-19, have to run their course.

The following are helpful websites to keep up with emerging information about the novel coronavirus disease, or COVID-19: 

Centers for Disease Control (www.cdc.gov)
Your state’s Health Department (You can click here for the PA Health Department)
World Health Organization (https://www.who.int/) 

Julie Kardos, MD and Naline Lai, MD
©2020 Two Peds in a Pod®