Winter is fast approaching and ’tis the season for colds and flu. In addition to the usual viruses, we have three specific viruses upon us this year. First we have Influenza, which in New England the flu season is in full swing. Covid-19 (and variants) is still present and we must be vigilant to observe for symptoms that have changed with differing variants and age of patient. Thirdly, for many reasons, we are seeing an up-tic in cases of Respiratory Syncytial Virus, commonly referred to as RSV.

Cold & Flu Season: Recognizing Symptoms

The important issue for families, especially with children under the age of 1 year, is to determine when to seek medical attention. Of course, any parent who feels their child is ill should contact their pediatrician for guidance. As a guide here are a few guidelines to help differentiate between the aforementioned viruses.


Flu season in the United States runs from October to May. Influenza may seem like a common cold, but there can be important differences. Generally this is a seasonal virus that affects people only 1 time a year; the common cold may occur several times a year. Flu symptoms begin rapidly and spread easily. The first symptom is often a high fever. Children tend to run much higher fevers than adults, 102-106 is not unusual. Other common symptoms include: body aches, chills, dizziness, headache, decreased energy, nausea and vomiting. The symptoms usually last from 4-7 days.
There are rapid flu tests that most doctors can perform in their office, but staying at home, resting and drinking plenty of fluids is perfectly fine. The key to staying out of the hospital is to stay hydrated. If a child is in diapers, monitoring numbers of wet diapers is important as appetite will likely be decreased. Small but frequent sips is effective in maintaining hydration. There is a vaccine for influenza available for children over 6 months of age.


There have been numerous symptoms associated with COVID and the emerging variants. Many of the symptoms we see with the flu are the same in COVID; this can be confusing during the flu season. Fever, sore throat, nausea, vomiting, diarrhea are all seen in both Influenza and COVID. Loss of taste and smell seems to be unique to COVID, though children especially young children, may not be able to express this complaint. In general, while symptoms may be similar they tend to be less dramatic that with the Flu. Treatment is also similar in that hydration is the key. Small frequent sips of water, diluted juice, popsicles all can keep a small child hydrated without having to go to the ER for IV fluids.


Most Respiratory Syncytial Virus (RSV) cases go undetected and symptoms mimic the common cold; it is most dangerous to infants. Historically we have seen RSV begin around November and last through March. This year, however, we have seen an early start with cases as early as Spring 2022. Due to everyone masking during COVID-19 and other non-pharmacological interventions such as social distancing and families opting to limit daycare attendance, we saw a dramatic decrease in cases of RSV during 2020-2021.
This virus mainly involves the respiratory system. Congestion, runny nose, dry cough, low grade fever, sneezing, sore throat, and headache are all common symptoms. Wheezing is perhaps the one symptom that is most important to manage. Often when a doctor hears wheezing they prescribe inhalers such as Albuterol, but in the case of RSV, it is not always helpful. Close observation and frequent trips to your Pediatrician is common to monitor respiratory effort, lung sounds, and hydration. This virus is most risky for preterm infants with complications such as 29 weeks gestation or less, chronic lung disease of prematurity, certain congenital heart diseases, or other lung or neurological conditions that make clearing their airways difficult.
With all of this information, the best way to keep your baby, children, and self healthy is to get rest, wash hands, and keep infants away from large crowds or people with known contagious illnesses. Maintain a healthy diet, stay hydrated and stay home if you or your child isn’t feeling well. You might think, “This is just a fever,” but it is usually the first sign that the immune system is detecting an illness brewing. Stay well this Winter and flu season!

About The Author

Susan M Stuart, DO, MS, MSHPE, FAAP is a Pediatrician in Rhode Island. She has 25 years of Board Certified Experience in General Pediatrics. Dr. Stuart’s specific interests are ADHD and Childhood obesity.