It’s anticipated that the Covid-19 virus will continue to circulate for the next few months, extending well into next year. However, as we approach winter, cold and flu infections will also begin to rise – leaving many parents struggling to spot the difference.

To help provide some clarity on this topic, Dr Andrew Raffles, Consultant Paediatrician at The Portland Hospital, part of HCA and Dr Ian Hay Ltd, explains how to tell if your child is suffering from Covid-19 or the common cold, and when they need to self-isolate.

Dr Andrew Raffles, says:

In children, COVID-19 presents very much like every other respiratory virus they come down with. Winter is coming and with it not just flu, but Respiratory Syncytial Virus – which causes bronchiolitis – a common respiratory infection in the under 2-year olds. In addition to this, adenovirus, rhinovirus, and flu viruses are also common in children.

The only reliable way to tell whether a child has the common cold and can still go to nursery or school is robust, reliable and rapid testing for coronavirus — and right now for most parents and children, this isn’t yet possible. That means that a lot of children and their parents will be asked to isolate because of non-COVID respiratory illness, whilst they wait for test results.

Why is it important to be able to tell a non Covid-19 illness from a Covid-19 illness?

For children, the main reason isn’t because Covid-19 is a severe illness in children, it generally isn’t, but the reason is because of the need to isolate children with Covid 19. This is because they seem to be one of the major ways in which the virus is spread to vulnerable adults. This disrupts schooling and also prevents carers and parents from working.

Older children testing positive

Recent data seems to show that the average age of a child with a positive Covid-19 test tends to be older, aged 11-15, than the typical child with a cold aged 2-8 yrs. Overall less than 2% of cases have been described in children under 18 years of age.

Children are particularly susceptible to the common cold, with the average child aged 6 months to 8 years having 8 colds per year. In most cases, children will experience sneezing, a sore throat, and a runny nose. Symptoms generally come on quickly, over a day or so and are less severe than flu, which tends to come on quickly – usually over 24 hrs and is generally accompanied by a high fever, of 38.5 or above which persists for 4-5 days .

For a common cold, children may have a fever which only lasts 2-3 days and it is unusual for them to experience muscle aches – however, this may happen in the flu and is not particularly unusual. It appears that the frequency of common colds is the very thing that protects children.

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Symptoms of a common cold

A runny nose accompanied by sneezing is one of the most common symptoms of a cold and is not associated with Covid-19, so children will not generally need to self-isolate at home.

Most of the symptoms associated with the common cold are a result of the body’s immune system trying to fight it. For example, the runny nose associated with a cold is caused by the immune system attempting to remove the virus from the nasal passages by producing excess mucus. Similarly, in the lungs, the extra mucus results in the coughing seen commonly with common colds

Common colds tend to last for around a week in both adults and children with no lasting effects: however, in some children, their symptoms may persist for a little longer or commonly one cold rapidly follows another, especially in nursery age children.

How to treat the common cold

In terms of good parenting and child care, the best ways to help relieve a child’s symptoms is to make sure they drink lots of fluids and get plenty of rest. Saline drops can help loosen up any dried mucus around their nose and over-the-counter paracetamol can help with any fever, pain or discomfort.

Seasonal influenza, or flu, is a common respiratory infection which can last from five to seven days. Symptoms in children may include a fever, dry cough, fatigue, and muscle aches. Some children may also suffer from ear pain, diarrhoea, a runny nose, and a sore throat. However, the fever tends to come on within 24 hrs.

Parents should contact their doctor if their child has any of the above symptoms to determine if they should be tested for Covid-19 or influenza. Unlike the common cold, the flu can be quite severe in children, so it is important they stay at home and rest. This will help with their recovery while also protecting other children from catching the virus and spreading it throughout the school.

What are flu symptoms to watch out for?

Flu symptoms will usually surface quickly unlike the coronavirus where symptoms may take up to fourteen days to develop. There are three main symptoms to look out for if parents suspect their child may have contracted the coronavirus which are a high temperature, a new and persistent cough, and a loss of taste and/or smell, although this can be difficult to detect in young children. Also, it now appears that diarrhoea and vomiting seem to be symptoms of Covid-19 in the young which are not often associated with adults.

If a child is displaying any of the above symptoms then it is important that they get tested and self-isolate at home straight away, to try to stop the transmission of the virus.

Many, if not the majority, of children are asymptomatic with Covid-19, and those that do have symptoms tend to find they are much milder than with adults. This means the virus could spread very quickly throughout a school so if it suspected that a child has the virus, they should stay at home and get tested as soon as possible.

Multisystem Inflammatory Syndrome

A more recently observed complication of Covid-19 in children is Multisystem Inflammatory Syndrome, an inflammatory disease which can lead to serious problems with the heart and other organs. While MIS- C is rare, it is important that children experiencing any of the below symptoms are seen by a medical professional straight away.

  • Fever
  • Rash
  • Vomiting or diarrhoea
  • Swollen lymph node in the neck
  • Cracked lips
  • Conjunctivitis

Many different conditions may cause the above symptoms; however, it is vital for children to get checked out as soon as possible, especially if their symptoms could be a side effect of Covid-19.

To conclude, children suffering from the common cold will usually experience symptoms such as nasal congestion and sneezing, so they should be safe to go to school if their symptoms are mild.

One of the biggest challenges for parents is being able to differentiate between a common upper respiratory tract infection or cold and Covid-19.  Many schools have strict rules regarding illness – most nurseries and schools require children with a fever to remain home until any fever has settled for at least 48hrs. Applying this rule rigorously should help protect the wider school community and any vulnerable adults.

If your child has a prolonged fever, lasting beyond 5 days, persistent cough, loss of taste and smell, and diarrhoea then it is best to keep them away from school and get them tested as soon as possible. Covid-19 is highly contagious so if it is suspected that a child has contacted the virus, their family should also self-isolate for a period of fourteen days.

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