Children’s Health: How to Tell the Difference Between a Common Cold and Something More Serious

According to the American Academy of Pediatrics (AAP), almost all children will have RSV, or respiratory syncytial virus, by the time they are 2. For most infants and children, RSV presents like a common cold with minor complications. But for some, respiratory syncytial virus causes potentially life-threatening symptoms. In this article, we take a closer look at how parents and caregivers can determine the difference between a minor case of RSV and one that warrants a trip to a medical professional.

RSV is a virus that causes respiratory illnesses of the nose, throat, and lungs. Respiratory syncytial viruses are more common from the late fall to early spring, but people can become ill year-round. Although the AAP observed fewer cases of RSV during the first year of the pandemic, largely due to strict social distancing guidelines and wearing masks, cases began to climb again last year. Similar to the common cold virus, RSV spreads from one person to another, entering the body through the nose or eyes. It usually spreads from direct person-to-person contact, unclean hands, and unclean objects and/or surfaces.

Certain children are at a greater risk for contracting respiratory syncytial virus, such as:

• Children who are 12-weeks-old or younger at the start of the RSV season in the late fall
• Babies with certain types of heart defects
• Children with weakened immune systems that result from illnesses or medical treatments
• Infants and children with chronic lung disease of prematurity, like bronchopulmonary dysplasia (BPD)
• Premature or low birth weight infants, particularly those who were born prior to 29 weeks’ gestation
• Other risk factors include exposure to secondhand smoke, having siblings, a mother’s smoking during pregnancy, a history of eczema and/or allergies, being around children in a childcare setting or living in crowded residential conditions, and not breastfeeding

Respiratory syncytial virus usually causes a cold, or an upper respiratory tract virus. Sometimes, the cold is followed by bronchiolitis, a lower respiratory tract infection that causes an inflammation of the small airways in the lung, or pneumonia, which affects the lung(s). According to the AAP, symptoms typically last 5-7 days, but more serious cases can cause bigger problems. In fact, RSV is the leading cause of bronchiolitis and pneumonia in children under the age of 1.

What are Some Key Differences Between a Cold, Bronchiolitis and Pneumonia?

It is important for parents and caregivers to know the differences between common cold symptoms and the signs of bronchiolitis and pneumonia in infants and young children. The AAP reports that common cold symptoms can include fever (100.4 temperature or higher), a wet or dry sounding cough, runny nose, congestion, sneezing, fussiness, and poor feeding. Symptoms of bronchiolitis, however, include cold symptoms in addition to fast breathing, flaring of the nostrils and the head bobbing with breathing, rhythmic grunting during breathing, belly breathing, tugging between the ribs and/or lower neck, and wheezing. Typical symptoms of pneumonia include some cold and bronchiolitis symptoms like fever, cough, chills, breathing quickly or breathing with grunting or wheezing sounds, and loss of appetite or poor feeding. Pneumonia is also often accompanied by other symptoms, such as chest pain, vomiting, belly pain, working too hard to breath, and being less active.

To see how hard your baby is breathing, the AAP recommends looking out for chest wall retractions. Chest wall retractions occur when a baby has to use the muscles between their ribs or in their neck to breath; they are a sign that your child is having to work harder than normal to take in air. If you notice that your child’s rib cage is “caving in” and forming an upside-down “V” shape under their neck, then they are working too hard to breath. If you notice chest wall retractions in your child, call your pediatrician right away. Other signs that warrant an immediate call to your child’s doctor include:

• Fast or short breaths
• Grunting noises
• Experiencing any symptoms of bronchiolitis or pneumonia
• Signs of dehydration (fewer than 1 wet diaper every 8 hours)
• Pauses or difficulty breathing
• Gray or blue color to tongue, lips, or skin
• Significant decrease in activity and/or alertness levels
• Symptoms that worsen or do not begin to improve after 7 days
• A fever of 100.4 or higher when they are younger than 3 months old
• A fever that rises above 104 degrees for a child of any age
• Poor sleep or fussiness, chest pain, ear tugging or ear drainage

Although respiratory syncytial virus can cause serious complications, only 1%-2% of children younger than 6 months require hospitalization for treatment. In rare instances, infants need oxygen to assist with breathing and/or an intravenous (IV) line to push fluids. In most cases, children are discharged from the hospital in 2 to 3 days; very seldom does a child need medical assistance in a pediatric intensive care unit, or PICU, to treat complications from the infection.

Protecting Your Baby from RSV

The AAP recommends taking the following steps to limit your child’s chances for contracting respiratory syncytial virus:

• Wash your hands using soap and water and scrub for at least 20 seconds. Remind children to practice good hand hygiene at all times
• Keep your kids up-to-date on their immunizations and take your entire family to get a flu shot every year
• Limit your baby’s exposure to other children, crowds, and anyone who may have a cold
• If your child is ill, keep them home from school or childcare
• Teach children to cover their coughs and sneezes from a young age
• Try to keep your home germ-free. Disinfect objects and surfaces in your home regularly
• Avoid exposing your child to secondhand smoke
• If possible, feed your baby breastmilk. It contains unique antibodies that helps ward off and fight infections

If you believe your child has a moderate-to-severe case of RSV, bronchiolitis, or pneumonia, make an appointment with his or her pediatrician right away. Your child’s doctor will diagnose the infection by asking questions about symptoms and performing a physical exam. Some doctors will perform a nasal swab test to determine if the infection is respiratory syncytial virus or something else. In some cases, a child may need a chest x-ray or an oxygen saturation test to screen for chest congestion.

When Doctors Make Mistakes

Doctors make mistakes just like everyone else, but when the mistake is preventable and causes harm to a patient, you may want to consider filing a medical malpractice claim. Medical malpractice occurs when a doctor, hospital, or other health care provider deviates from their own professional standards of care and causes the injury or death of a patient. Some of the most common types of medical errors that endanger patients include failure to treat, misdiagnosis, delayed diagnosis, surgical errors, and anesthesia errors. If a doctor failed to diagnose your child with respiratory syncytial virus, bronchiolitis, or pneumonia and they suffered as a result, someone at our firm can help. If you would like to learn more, please contact a representative online now.

Philadelphia Medical Malpractice Lawyers at Galfand Berger, LLP, Advocate for Victims of Medical Misdiagnosis

If you have a question about filing a legal claim, contact the Philadelphia medical malpractice lawyers at Galfand Berger LLP today. Call us at 800-222-USWA (8792) or fill out our online form for a free consultation. Located in Philadelphia, Bethlehem, Lancaster, and Reading, we serve clients throughout New Jersey and Pennsylvania, including Allentown and Harrisburg.