Hi everyone welcome to MomDocs the special edition we're talking about everything COVID-19 and your
kid today it's getting into cold flu RSV croup season you name it it's here and so we want to
talk today about caring for your kid and also how to differentiate between all of these crazy
symptoms so today we have Dr. Kristen Bruno she is a Washington University pediatrician at Purely
Pediatrics at our children's specialty care center and we're going to talk right now about
about COVID versus all of these other childhood illnesses so Dr Bruno thanks for taking some time
with us today thanks for having me so let's start with the flu because the flu comes around every
year and one thing that we're hearing a lot about is that flu and COVID can look kind of similar so
if I’m a parent how do I tell the difference and so that's really tough right now because they do
look very similar and they're probably in their classic forms they're the two that are going to
look the closest if we look at all of the classic COVID symptoms all of the classic flu symptoms
they're going to be the two that most that look the most similar again in their classic forms
we don't see necessarily all COVID symptoms in kids we don't see all of flu symptoms in kids so
if we take the two with all the symptoms each one has the big differences between them loss of taste
and smell is really not a feature of flu but it is a very popular common feature of COVID I won't
say that I see that a lot in children when you're talking about with adults loss of taste and smell
is pretty common in kids we may younger kids may have loss of taste in smell in COVID
but if they're not able to let us know say it's a pre-verbal kiddo who just loses their appetite
are they losing their appetite because the food doesn't taste as good to them or is it just kind
of an appetite suppression with a virus so there may be more loss of taste and smell
in the younger kids but definitely for adults and that's not something you're going to see with flu
there's a lot of GI symptoms in children with COVID in flu it kind of depends on
whether you're A or B as to whether you'll have some GI symptoms with it but flu
is it's a sudden onset pretty much all the time it comes on like that hits you like a truck and
you have fever you have body aches you have cough you have sore throat
again no loss of taste or smell there can be some vomiting with it some shortness of breath but lots
of upper respiratory symptoms with flu and then just this fatigue and body aches with flu is what
you see and it's a very sudden onset and doesn’t build up gradually like a cold where you start oh
I have a little runny nose and three days later I have a little cough with the flu it's I’m well I’m
sick especially if you haven't had your flu shot full-blown flu is I’m well boom I’m sick and the
symptoms present you know within about one to four days after exposure for flu for COVID symptoms can
come on anywhere from two to fourteen days after exposure so that's quite a bit different it can
be sudden or gradual and some kids with COVID and in adults with COVID the symptoms can be very very
mild that kid might only have a sore throat might only be tired i've had kids just have a headache
adults that only lost their sense of taste and smell and that was the only symptom they had
but when you have the most common COVID symptoms which are going to be your your fever cough the
body aches the loss of taste and smell some of those are going to kind of overlap with what
we think of most commonly as flu but again symptom onset two to 14 days after exposure so kind of a
broad time frame the most common time is going to be about five days after exposure so that's quite
a bit different than flu the other differences are the contagious when you're contagious so with
flu you're contagious about a day before symptoms most contagious especially for kids in the first
three to four days that's when you're coughing and runny nose and all that kind of stuff and then
maybe maximum about seven days and then you're not contagious anymore you go back to school
with COVID symptomatic you can become you're contagious about 48 hours before you start
having symptoms and then up to 10 days so that's why that isolation period when you're
sick with COVID is 10 days long because you can still spread this virus for up to 10 days
so it's really it's kind of a long time how they spread are very very similar so our hope is that
maybe because they're both spread by droplets and anything coming from your mouth and your nose so
sneezing coughing snot that's all going to spread these viruses flu and COVID but everybody's masked
right now hopefully and everybody's washing their hands really well so it may be that
we don't see flu as bad this year that would be wonderful it always seems to hit us really hard
right after Christmas right after Hanukkah right around the new year so we'll have to see what it
looks like this year but hopefully masks will decrease that we do think that COVID spreads
a little bit more easily than flu from person to person so there there is that to consider yes flu
is contagious but we think flu in certain groups spreads even a little bit faster complications
for COVID versus the flu they both can have some similar complications some problems with the heart
pneonias you know bloodstream infections so there are complications similar to both of them
there are a couple that are unique to COVID that's the multi ... multi-system inflammatory syndrome
so the MIS-C that's unique to COVID in children we don't see that with flu and then they're in
adults or spend some blood clots associated with covalent associated with flu healthy kids however
have a much higher risk rate of complications with the flu kind of that random oh I was a healthy kid
I got the flu I didn't have my vaccine and I got really sick with the flu those random pediatric
vests we hear every from every year from the flu more common with the flu than with COVID
so there are all things being equal healthy kids more likely to get a complicated flu
case than a complicated COVID case not so true when you're the elderly the immunocompromised
underlying medical problems like heart lungs genetic those kind of things those are going to
put you pretty evenly at risk for complications from both flu and COVID thank you Dr. Bruno and
one thing that always comes around every year especially for the little littles is RSV RSV
it's the gift that keeps on giving right after Christmas that is yes it is always after Christmas
yep so what about that and I mean again though usually the ones that get it are the littles yes
they are the littles yeah so it's an RSV is it's a seasonal so just like our regular flu seasonal flu
usually starts hitting you know some our big push for our big hit with flu is always kind of early
January end of December at least around here RSV tends to be a little bit later for us now
the season for RSV really starts around October November goes all the way until March or April
which is kind of the same season for flu but typically here in St. Louis we really see RSV
hit us harder kind of later January and then we see January March with RSV but one of the
hallmarks of RSV is lots and lots of congestion so it is a little bit like the common cold when
you get a cold virus like rhinovirus which is what the other virus that everybody's seeing right now
when you get that snotty nose and and the cough because you're full of mucus RSV is another upper
respiratory virus so you're going to get lots and lots of mucus production so these kids are
full of snot nose is running they're congested in their nose they can't breathe through their nose
and it generally starts with lots of can with congestion runny nose and congestion and then a
little bit of cough and kind of progresses from there so it is a little bit more gradual onset
generally children with RSV aren't kind of just well and then sick like what happens with flu
with COVID they have a little bit of runny nose a little bit more a little bit more lots more
congestion and then somewhere by the time they're about three to five days into symptoms if they're
going to start having problems with their breathing that's really what it's going to be
lots of misery out there I’m afraid yeah the other thing with RSV I will say is that you know they
the contagious period it's sort of similar to what you see with flu so they're contagious about you
know somewhere three to eight days after exposure they're gonna get it they're gonna be contagious
but they can shed it especially in young infants for up to about a month so that's why we say oh
you can still have that cough for a little while after RSV it tends to linger for longer than flu
and comes traditional COVID does and it definitely affects our our youngest guys the most so the risk
factors for RSV are under six months of age and fence pre-term the elderly unfortunately it can
get hit hard with RSV too but most children by the time they're two years of age have been exposed to
RSV to some degree well that's good news so I know a lot of parents might be you know wanting to stay
out of the doctor's office as much as possible right now with the pandemic going on but on the
flip side they might just be worried about their kiddos so what would you tell parents when is it
quote unquote bad enough or when are their kids sick enough where you really want them to be seen
yeah and this this kind of depends on what the situation is that you are in because we do want
to test for COVID you know we want to know when your child has COVID because it it matters for
quarantine it matters to limit the spread so if your child is in school and has some has some
cold symptoms right the cold symptoms are mild runny nose congestion they're not getting better
at about 24-48 hours I would recommend that you that you call your pediatrician they're probably
going to do like a video visit if they're if they're in school which means they've got a risk
for exposure and they've got these symptoms that haven't been getting better in a couple of days
testing is definitely indicated for that if they have a high risk symptom like you know cough or
loss of taste or smell or shortness of breath that kind of stuff automatically going to recommend
getting tested so do you need to be seen in the office to be tested or do you go to the ER or do
you do a car visit with a zoom it kind of depends on the situation if your kid was really sick
so if they are having trouble breathing if they're wheezing if they're not eating or drinking we're
going to want to see that kiddo in person with ear pains even if I think the kiddo may have may
have COVID symptoms having COVID doesn't mean you can't have an ear infection too so we still are
going to need to see those ears and we're still going to need to listen to those lungs because you
can certainly have a pneonia and have COVID you can have strep and have COVID so having COVID in
itself doesn't mean okay we don't see you for the other things we still need to examine that stuff
so if your child needs to have an exam or we need to know for sure whether or not this is
COVID so we can direct them either home back to school at a certain time that kind of stuff then
you definitely want to call your doctor and see what's the best way to have your child assessed
thank you Dr. Bruno and that's going to wrap it up for today
I just want to let everyone know there are lots of resources on COVID but also
on RSV croup the flu on the MomDocs website childrensmd.org see you next time everyone