Does Your Child Have COVID-19 or the Flu?

Is your little one coughing? Complaining of a sore throat? Is your child’s temperature running high?

Is it COVID-19 or the flu? Both illnesses are caused by viruses that infect the respiratory tract. Also, both the SARS-CoV-2, the virus that causes COVID-19, and the influenza virus are contagious and spread easily from person to person.

Here’s what to look for when trying to decide if your child has the flu or COVID-19:

Similar Symptoms?

Both illnesses have similar symptoms, which can make it difficult to tell them apart. Dr. Stephanie Stovall, medical director of quality and safety at Lee Health, says researchers are still learning how early symptoms of COVID-19 differ from flu symptoms in children.

“Adding to the challenge is that symptoms sometimes can overlap when COVID-19 and flu are circulating in a community at the same time,” Dr. Stovall says. “That’s why children need to be vaccinated against the flu, which decreases their chance of getting the flu. It also helps decrease the complications if they do get sick.”

Dr. Stovall adds that children can develop a fever from many other causes, however. Parents shouldn’t automatically assume their child has COVID-19.

When Do Symptoms Start Showing?

Children who have COVID-19 or the flu may not have any symptoms (asymptomatic), but they can still spread the viruses. Both infections can also cause mild-to-severe symptoms.

Flu symptoms show up about 1 to 4 days after infection (exposure to a sick person). COVID-19 symptoms appear about 2 to 14 days after infection, but often can start within 4-5 days after exposure to a sick person.

The Rundown

When it comes to symptoms, these viruses are remarkably alike. As mentioned above, both run the spectrum from no symptoms at all to a severe illness that can require hospitalization.

The flu and COVID-19 share these common symptoms:

• Fever and chills
• Trouble breathing
• Cough
• Fatigue
• Sore throat
• Runny nose
• Congestion
• Muscle and body aches
• Headache
• Vomiting
• Diarrhea

Symptoms more likely with COVID-19

• Loss of taste or smell

The Flu: The Importance of Vaccination

Most children with the flu gradually get better by staying home, drinking plenty of liquids, and resting. For some, their doctor might prescribe them an antiviral prescription to reduce their symptoms and help them heal faster.

However, some children may become ill enough to require treatment in the hospital.

“Your pediatrician or family doctor can check if your child has the flu by doing a test that looks for the flu virus,” Dr. Stovall says. “Again, that’s why a flu vaccination is so important. Unlike with COVID-19, which doesn’t have a vaccine yet, a flu vaccine can help protect your child from severe influenza. The vaccine may completely prevent influenza infection in some people, but it is most protective against severe disease. Children under age 5 are at higher risk of influenza complications than older children.”

COVID-19

Most children with COVID-19 have mild symptoms or have no symptoms at all, says Dr. Stovall, but some recent evidence suggests that young babies (under 1 year) may have more symptoms than older children.

“The symptoms of COVID-19 are similar in children and adults,” she says. “COVID-19 can look different in different people, but for many, having COVID-19 can feel much like the flu. A child can get a fever, cough, or have a hard time taking deep breaths. Typically, most children develop a milder form of the disease. Severe COVID-19 is rare for children and most recover within one to two weeks.”

Dr. Stovall adds that, in some rare cases, COVID-19 has been associated with multisystem inflammatory syndrome in children (MIS-C), a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.

“Most children recover with careful observation and treatment,” Dr. Stovall notes. “We don’t know yet what causes MIS-C or why some children get with MIS-C and others don’t. We also don’t know if children with certain health conditions are more likely to get MIS-C. Most children who were diagnosed with this condition have gotten better with medical care, though, and go home without significant symptoms.”

She says because MIS-C is so new, symptoms are still being documented and they may vary from child to child. “The main thing to watch for is a persistent fever lasting more than 24 hours and usually present for several days, your child appearing fatigued and ill, or loss of appetite or not drinking enough fluids,” Dr. Stovall says. “Symptoms can get worse quickly, so seek timely medical attention if you see anything concerning.”

How Does COVID-19 Spread?

People within 6 feet of each other can spread either virus through droplets of saliva or mucous released from one person’s mouth or nose to another’s. COVID can be spread by tiny aerosols that can be caused by forceful breathing, but influenza typically requires larger droplets for passing from one person to another.

Unfortunately, children can spread influenza or COVID before they show any symptoms.

Also, touching a surface contaminated with either virus – such as shaking someone’s hand – then touching your face, can spread it. Although COVID-19 appears easier to spread this way than the flu.

What Can Parents Do?

Common steps that help prevent the spread of germs also work well against the flu and COVID-19.

• Wash hands well and often. Wash for at least 20 seconds with soap and water or use hand sanitizer with at least 60% alcohol.
• Avoid people who appear sick.
• Clean surfaces that get touched a lot (such as doorknobs, counters, phones, etc.).

During the coronavirus pandemic, everyone in your family also should:

• Avoid large crowds and busy places.
• Stay at least 6 feet from people they don't live with.
• Wear a mask when in public (all adults and kids over 2 years old).
• Try not to touch their eyes, nose, or mouth.

Takeaway Message

Parents should call their doctor when a child has a fever, cough, sore throat, vomiting, diarrhea, or any type of trouble breathing, eating, or sleeping, Dr. Stovall says. “Your doctor may want to your symptomatic child for flu or COVID-19 depending on their symptoms, timing of disease, and contacts.”

Dr. Stovall adds: Until a COVID-19 vaccine is available, wear masks, wash hands, and practice social distancing.

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What about adults? COVID-19 and flu symptoms can often cross for them, too. Read more about these symptoms and what adults can do in our latest blog post.