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Is It Covid, Flu, Or RSV- Differences, Symptoms, And Diagnosis

With the ongoing COVID-19 pandemic, it can be challenging to know whether you have the flu, a respiratory syncytial virus (RSV) infection, or COVID-19.

The symptoms of these viruses can be similar, making it even more challenging to know what level of care you may require.

Let's discuss some key differences, symptoms to watch out for, and treatment options.

COVID-19

COVID-19 is caused by the SARS-CoV-2 virus and is a respiratory illness that can range from mild to severe.

Common symptoms of COVID-19 include fever, cough, shortness of breath, and loss of taste or smell. Other symptoms may include fatigue, body aches, headache, sore throat, congestion, or runny nose.

This virus typically has an average incubation period of five days from exposure. However, newer variants can become symptomatic in three days.

The flu

The flu, or influenza, is a viral respiratory illness caused by the influenza virus.

Common flu symptoms include fever, cough, sore throat, body aches, headache, and fatigue. Other symptoms may include runny or stuffy nose, chills, and muscle or body aches. Signs of the flu usually begin quickly, often one day after exposure.

The flu can lead to complications such as pneumonia, which can be life-threatening, especially for older adults, young children, and those with weakened immune systems.

RSV

Respiratory syncytial virus (RSV) is a highly contagious virus common in young children but can also affect adults, especially older adults and those with weakened immune systems.

RSV is a leading cause of lower respiratory tract infections, such as bronchiolitis and pneumonia.

Common symptoms of RSV often present, like the common cold, and include cough, runny nose, and low-grade fever. In severe cases, RSV can cause wheezing, rapid breathing, and difficulty breathing. Symptoms of RSV generally present four to six days after exposure.

Diagnosis

Since many symptoms of COVID-19, the flu, and RSV are similar, the most accurate diagnosis requires laboratory testing.

Most clinics, 24 hour urgent care centers, and hospitals have combination tests for all three viruses. A laboratory test can be done by collecting a sample of your saliva, throat swab, or nasal swab.

Treatment options

There is no cure for COVID-19, but treatment is available to help relieve symptoms and prevent complications. Treatment for COVID-19 may include rest, hydration, and medications to relieve symptoms. In severe cases, hospitalization may be necessary. A vaccine is also available for COVID-19, which can help prevent infection or reduce symptoms.

A vaccine is also available for the flu, which can help prevent infection. The flu can be treated with antiviral medications, which can help to reduce the severity and duration of symptoms. Antiviral medications can also reduce the risk of complications from the flu, such as pneumonia. In severe cases, hospitalization may be necessary.

RSV is typically treated with supportive care, such as rest, hydration, and over-the-counter medications to relieve symptoms. In severe cases, hospitalization may be necessary. Currently, there is no vaccine available for RSV.

Bottom line

A 24-hour urgent care center can be valuable for diagnosing COVID-19, the flu, or RSV. These centers can provide rapid and accurate testing for these respiratory illnesses, helping to quickly determine the cause of symptoms.

By utilizing a 24-hour urgent care center, individuals can receive prompt and effective care for their respiratory illness, helping to minimize the risk of complications and speed up recovery.

Common services provided by urgent care centers include in-person & virtual care for cold and flu symptoms, allergic reactions, physical examinations, and more.

Sources

https://www.Cdc.Gov/flu/symptoms/flu-vs-covid19.Htm

https://www.Cdc.Gov/rsv/about/symptoms.Html

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Should I Be Worried About The Respiratory Syncytial Virus (RSV)?

"We're not necessarily seeing RSV cause more severe disease this year than what we've typically seen, and it still is only a small percent of infected children that are requiring hospitalization," says Kristin Moffitt, M.D., an infectious disease expert at Boston Children's Hospital in Massachusetts. "But when so many children are infected at once, it leads to larger numbers of hospitalizations."

With that said, infants in particular may be experiencing more severe complications, notes Dr. Keren. "We're seeing a lot more infants admitted with severe bronchiolitis due to RSV," he says.

It's worth noting that even children who must be admitted to a hospital for treatment typically recover without further complications and are discharged within three to four days. Infants at higher risk for more severe disease may require longer hospital stays and medical interventions, such as intubation.

"The overwhelming majority of children with an RSV infection do very well and can be managed at home with fever medicine and attention to hydration," notes Dr. Moffitt.

What's Different About RSV This Year?

The early arrival of common respiratory viruses like RSV is "anything but typical," says Dr. Keren. In years prior, he notes that hospitals generally would see RSV infections rise in the fall and winter months, but this year the disease arrived early in April.

Dr. Keren also notes that hospitals are seeing a greater volume of RSV cases this year. "During the pandemic, there were a few cohorts of infants born who, due to social distancing and masking, probably didn't get exposed to these respiratory viruses, including RSV," explains Dr. Keren. "They were not able to build up an immune defense, leaving them vulnerable to more severe disease because they don't have that prior experience seeing that virus."

A Convergence of COVID-19, Influenza and RSV: Is This a Real Threat?

As we move further into the fall and approach the winter season, there are growing concerns about a possible convergence of COVID-19, influenza and RSV infections overwhelming hospitals. In regard to these viruses, Dr. Moffitt says it's difficult to predict what might happen next.

"For example, RSV cases may plateau early this year given how much transmission is ongoing right now, because with each RSV infection, people build up immunity to subsequent RSV infections," she says. "There are a lot of dynamics at play here that include population-level immunity to these viruses." So while Dr. Moffitt says it's possible that these three viruses will peak simultaneously, it's "not at all a given."

"What we're seeing right now is probably—I hope—the peak of the RSV epidemic curve," adds Dr. Keren. "There's a sense that maybe the number of cases we had this month is the same as the number last month, which would be a good sign…And so we're hoping that RSV will blow through and be on the decline at the time that flu is peaking."


RSV Is A Serious Health Threat, But The Public Knows Little About It

As the Centers for Disease Control and Prevention (CDC) determines whether to approve a vaccine against RSV for adults 60 and older, a new survey from the Annenberg Public Policy Center finds that the American public is ill-informed about the virus, unfamiliar with its most common symptoms, and more hesitant to recommend the vaccine to pregnant people than to older adults.

Worldwide, RSV is the leading cause of lower respiratory tract infections in babies. Though its symptoms are typically mild, the highly contagious RSV, or respiratory syncytial virus, can cause serious illness, hospitalization, and even death among infants and the elderly. By the age of 2, nearly all children get sick from RSV, which was one of three illnesses—with the flu and COVID-19—contributing to last winter's "tripledemic" that overwhelmed some health care facilities. The CDC estimates that 58,000 to 80,000 children under age 5 are hospitalized annually because of it.

After decades of research, scientists have developed vaccines against RSV. In May, the Food and Drug Administration (FDA) approved two RSV vaccines for older adults, and this summer is likely to approve a maternal RSV vaccine for pregnant people to pass antibodies on to fetuses to prevent RSV in infants from birth up to at least six months of age.

The survey of more than 1,600 adults finds that less than half of Americans (49%) were likely to recommend the vaccine against RSV, if approved by the FDA, to a pregnant friend or family member. By contrast, most Americans (63%) would recommend a vaccine against RSV to a friend or family member aged 65 or older. (When the survey was fielded, the FDA had already approved the vaccine for adults 60 and older, although the shots were not yet available.)

"Those who recall the stress that the tripledemic placed on the nation's hospitals last fall will understand why older individuals and those who are pregnant should discuss the advisability of RSV vaccination with their health care providers," said Kathleen Hall Jamieson, director of the Annenberg Public Policy Center (APPC) of the University of Pennsylvania and director of the study.

APPC's Annenberg Science and Public Health Knowledge survey

The survey data come from the 11th wave of a nationally representative panel of 1,601 U.S. Adults, first empaneled in April 2021, conducted for the Annenberg Public Policy Center by SSRS, an independent market research company. This wave of the Annenberg Science and Public Health Knowledge (ASAPH) survey was fielded May 31-June 6, 2023, and has a margin of sampling error (MOE) of ± 3.3 percentage points at the 95% confidence level.

Data from earlier waves on COVID-19, society's "return to normal," vaccination, monkeypox, the seasonal flu, health misinformation, and related topics can be found here.

Underestimating the prevalence of RSV—but awareness of potential severity

A quarter of the public (27%) expresses worry about contracting or having a family member contract RSV, less than the one-third (33%) who were worried in our January survey, which was conducted during the tripledemic. The decrease in concern is not surprising given that RSV circulates during the fall and winter, and there was media coverage of the surge of cases last winter that, combined with flu and COVID-19 cases, filled some hospitals.

The prevalence of this common illness is vastly underestimated by the public. Only 22% in the current survey say they know children who have had RSV—and among these respondents, over half say they have known just one child or two children who have had it. Asked how many children contract RSV before the age of two, 2% of respondents say, "virtually all." According to the CDC, "Almost all children will have had an RSV infection by their second birthday."

But among the people who say they know children who have had RSV, its potential severity is clear. Among these respondents, over half (54%) say the illness was somewhat or very serious. "Most children with cold-like symptoms are not tested for RSV, but when a child becomes severely ill, it's more likely that child will undergo diagnostic testing," Jamieson said. While RSV can cause severe illnesses such as bronchiolitis and pneumonia, the CDC says it usually causes mild, cold-like symptoms—like runny nose, coughing, sneezing, fever, wheezing, and decreased appetite—and is often mistaken for cold or flu.

This does not mean, however, that some do not experience serious illness. Among 100 babies under the age of six months who get RSV, 1 to 2 may require hospitalization, the CDC says. Although RSV-associated deaths are "uncommon" in the United States, they nonetheless do occur at an estimated rate of 100 to 500 per year for children under five, according to the CDC. Worldwide deaths of children under 5 years old attributable to RSV exceed 100,000 annually.

Far fewer people say they know older adults who have had RSV. Only 6% of those surveyed say they know someone age 65 or older who has had RSV. Among this group of respondents, most (71%) say they know one or two people who have had it and most (72%) say the infection was somewhat or very serious. The CDC reports that among adults 65 and older, there are 60,000 to 160,000 hospitalizations per year from RSV, and 6,000 to 10,000 deaths.

Great uncertainty about RSV

Only small segments of the American public correctly answer questions about RSV. Most people say they are not sure. The survey found that:

  • Symptoms: Less than 1 in 5 people (18%) know it's more accurate to say that RSV usually produces mild, cold-like symptoms than serious difficulties in breathing (38%). And 44% say they are not sure.
  • Persistence: Less than 1 in 5 people (17%) know it's more accurate to say that RSV is able to survive for many hours on hard surfaces such as table or crib rails than to say RSV can't survive for many hours on these hard surfaces (9%). Most people (75%) say they are not sure.
  • Recurrence: Less than 4 in 10 people (38%) know it's more accurate to say that once a person contracts RSV, they can get it again. Only 2% incorrectly believe it's more accurate to say that you can't get RSV again, but 60% say they are not sure.
  • Spreading the virus: Just over 4 in 10 people (42%) know it's more accurate to say it is possible to have and spread RSV before showing symptoms than to say it is not possible (3%). But over half of those surveyed (54%) are not sure.
  • Vaccine for older adults: Just 13% knew at the time the survey was fielded about the existence of an FDA-approved vaccine against RSV for older adults, while 18% said there was not an FDA-approved vaccine. Nearly 7 in 10 people (69%) said they were not sure. (The FDA approved one RSV vaccine for adults 60 and older on May 3, 2023, and the second one on May 31, the beginning of the survey period. A CDC committee of experts known as ACIP is meeting today on whether the CDC should recommend those vaccines and, if so, for what ages.)
  • Vaccine for pregnant people: Just 1 in 5 people (20%) knew when the survey was fielded that there was not an FDA-approved vaccine against RSV for those who are pregnant to benefit their newborns, while 7% thought there was one. Nearly three-quarters of those surveyed (73%) were not sure. "However," Jamieson noted, "since an FDA advisory panel had recommended approval at that point, we would expect a high level of uncertainty about whether or not an FDA-approved vaccine existed."
  • Vaccine for infants and children: About 1 in 5 people (19%) know there is currently not an FDA-approved vaccine against RSV for infants and children in the United States, while 11% say incorrectly that there is one and 70% are not sure.
  • Fewer than half recognize the symptoms of RSV

    Fewer than half of those surveyed recognized some of the most common symptoms of RSV (respondents were asked to select all that applied):

  • Wheezing: 46% know this is a symptom
  • Runny nose: 38% know this is a symptom
  • Pauses in breathing: 33% know this is a symptom
  • Decreased activity: 32% know this is a symptom
  • Decreased appetite: 29% know this is a symptom
  • Very few people incorrectly selected non-respiratory symptoms as associated with RSV:

  • Jaundiced skin: 5% incorrectly say this is a symptom of RSV
  • Spontaneous bruising: 2% incorrectly say this is a symptom of RSV
  • Bleeding gums: 2% incorrectly say this is a symptom of RSV.
  • More information: For more information, see these Q&As on the RSV maternal vaccine and RSV vaccines for older adults from FactCheck.Org, a project of APPC.

    Citation: RSV is a serious health threat, but the public knows little about it (2023, June 21) retrieved 27 June 2023 from https://medicalxpress.Com/news/2023-06-rsv-health-threat.Html

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