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Is it RSV or a cold? How to tell the difference

Winter brings with it far more than the potential for snow. Respiratory illnesses abound as we retreat indoors.

Jack Cleland, a pediatrician with Medical Group of the Carolinas – North Grove Pediatrics in Spartanburg, said the season will see dozens of cold and flu viruses come through the Upstate.

“The usual typical course of a cold peaks by day four or five,” he said.

In adults and children, a cough can still linger even after other symptoms have improved. Influenza — the flu — can be dangerous for any age. Cleland said RSV (respiratory syncytial virus) is not a major event for older children and adults, but can be very serious in babies.

“RSV is a really bad cold,” Cleland said. “The reason it gets kids in trouble is they make so much snot. They will basically drown in it, especially NICU babies. We all probably catch RSV. For us, it’s a bad cold. For babies, it sets them up for a tailspin.”

In most cases of respiratory viruses, a common cold will come and go without lasting effect. Sometimes, a secondary infection or other symptoms develop.

“Colds can set you up for serious infections,” Cleland said. “Pink eye, ear infections — particularly in smaller kids, croup. If you are predisposed to asthma, colds can trigger flare ups.”

Pneumonia and even diarrhea, which can lead to dehydration, can result from respiratory viruses.

Cleland said if a child gets a cold, parents should watch for fever, dehydration and breathing issues.

“If your child is 3 months or younger and has a fever of 100.4, I want to see them,” he said. “After 3 months, I’m OK with a fever. If it drags out for 24 – 48 hours, I want to see them at any age.”

While a lack of appetite might worry parents, Cleland said he is more concerned about how much children are drinking.

“Babies, you can’t make them drink,” he said. “Sometimes we hospitalize kids because they get dehydrated. If they are drinking enough to have three wet diapers a day, you’re doing OK.”

Breathing issues become especially concerning as they could signal asthma or croup. Croup, which causes swelling in the voice box, according to Cleland, leads to a high-pitched, barking cough. Asthma can develop at any time, even in a child that has not been diagnosed in the past.

“Most kids sound terrible when they are sick,” Cleland said. “I don’t want them looking bad. Kids with asthma are struggling to breathe. You see their neck retracting, their nose flaring, their bellies going in and out. You are watching to see if they are struggling to breathe.”

Cleland said parents should discuss the use of over-the-counter medications with their child’s pediatrician. He said the use of a vaporizer or humidifier, as well as nasal saline and suction, may help relieve cold symptoms. Though symptom relief may be needed, especially at night, Cleland said it is helpful to let the body’s reaction to a virus do exactly what it is supposed to do.

“Let them cough, let their nose run,” he said. “For them, it’s a good thing.”

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