Similar symptoms make COVID-19 in kids comparable to other summer respiratory viruses. As the situation evolves, it's helpful to understand the seasonal risks for all respiratory viruses in children and learn about the layers of protection to reduce your child's risk of getting sick.

By Amanda Krupa, MSc
March 18, 2020
Samii Beebe

Your children have boogers dripping from their noses. Before letting your mind "go there," know this symptom of an upper respiratory virus could come from any one of over 200 different respiratory viruses; the novel coronavirus is just one, and COVID-19 is the disease caused by SARS-CoV-2, the new virus discovered in December 2019.

The risk of COVID-19 today remains low to you and your children, however as the situation evolves into the summer, it's helpful to understand the seasonal risks for all respiratory viruses in children—because as parents, we really can't tell one toddler booger from another without having it officially tested. Here's what to know.

COVID-19 Symptoms vs. Summer Respiratory Viruses

In the summer months, the viruses that pediatricians tend to see most come from the family of enteroviruses—which can cause upper respiratory symptoms like a "common cold" with fever, cough, congestion, runny nose, sore throat, and occasional vomiting and diarrhea. Not fun, especially in the sun.

"A lot of parents come in and tell me their child has 'the flu' or the 'stomach flu'," says Nusheen Ameenuddin, M.D., a pediatrician in Rochester, Minnesota. Influenza is a separate kind of virus though—and it's one we have a vaccine for. The problem is with the rest of the respiratory viruses out there."

The symptoms seen in any enterovirus infection depend on the particular type of enterovirus causing the illness, according to Liz Donner, M.D., a hospital-based pediatrician at Baylor in San Antonio, Texas, and creator of the My Friend the Pediatrician Facebook page, which posts daily evidence-based pediatric advise for parents—including broken-down updates on COVID-19.

Without specialized testing, Dr. Donner says it would be "very difficult for a parent to tell apart the symptoms of an enterovirus from the novel coronavirus that's causing COVID-19," which are reportedly a fever, cough, congestion, runny nose, sore throat, and occasional diarrhea.

Testing for Respiratory Viruses

As of today, knowing exactly which respiratory virus is causing your child's symptoms is not always necessary. (See the section below on what to do if your child gets sick). Dr. Donner said viral testing happens right now in children who become severely ill or require hospitalization. This is usually done using a nasal swab that gets sent to the lab for processing. "We have rapid viral testing for viruses such as RSV and influenza, but most other viruses take several hours or even days in the lab before they can be interpreted," she said.

How to Prevent Summer Respiratory Viruses

When it comes to reducing your child's risk of a respiratory virus this summer, Dr. Ameenuddin says it all about "adding different layers of protection." Social distancing is one of those layers—and it's actually something you've probably done already and not realized it. Think back to the time just before you and your baby were discharged from the hospital. Along with giving you advice on your car seat and safe sleep, the pediatrician also gave you strategies for how you could best "cocoon your newborn"—a concept Wendy Sue Swanson, M.D., originally wrote about in her 2014 parenting book, Mama Doc Medicine. She writes that cocooning "provides a family of surrounding protection by having every single child and adult immunized against whooping cough, influenza, and other vaccine-preventable illnesses."

"I always tell my patients to blame me if they have a sick relative who really wants to see the baby," says Dr. Ameenuddin. "Maybe people are more socially conscious of recommendations in the winter, but all pediatricians recommend cocooning a newborn until two months of age, regardless of the season."

So, now that COVID-19 has sequestered many of you at home with your children, it's time to bring back those recommendations you received when you first became a parent:

  • Wash hands often with soap and water for at least 20 seconds. If soap and water are not readily available, use a hand sanitizer that contains at least 60 percent alcohol.
  • Cough and sneeze into a tissue and throw it away after each use. Teach kids to cough and sneeze into their arm or elbow, not their hands—and help correct any nose picking.
  • Clean and disinfect. You can clean frequently touched surfaces and objects daily using a regular household detergent and water prior to disinfection. For disinfection, a list of COVID-19-fighting products is available here. Always follow the manufacturer's instructions for all cleaning and disinfection products.

Get more Centers for Disease Control and Prevention (CDC) advice here.

And when it comes to leaving your home? Schools and businesses that serve children and families throughout the country have sent email communications regarding COVID-19 with specific ways they would be implementing added layers of protection in their facilities.

Wings Dance Studio in Lockport, Illinois—one of the many dance studios across the nation that traditionally culminates the end of the season with a May or June recital in a packed auditorium filled with proud grandmas and grandpas—sent out an email on March 12 to parents listing out additional cleaning efforts they've put in place, such as adjusting aspects of classes and recital routines to discourage close contact and wiping barres, props, equipment, and doors in between classes. The next day, March 13, parents received notification the studio would be closed through March 28.

When asked about her plans for the recital and dance summer camps at the studio, Wings executive director Shannon Labus says she really can't plan too much at this point. "My hope is that we are able to navigate this creatively and still have our big show, but each day will bring new information and decisions. The situation seems to change hourly."

What to Do If Your Child Gets Sick

If your child has been exposed to COVID-19, or you are concerned about your child's symptoms, the American Academy of Pediatrics recommends calling your pediatrician immediately.

"When children are exposed to COVID-19, their immune systems may recognize and clear it more quickly," wrote Dr. Swanson in a recent post on her blog. "For example, if your child had a cold a month ago from another, more typical coronavirus, the immunity produced during that cold is likely around and will partially protect against a COVID-19 infection. We will know more as time unfolds."

It's frustrating to have a sick child, and even more frustrating when you can't give them something to feel better. In general, Dr. Donner recommends rest, fluids, and the occasional Tylenol or Motrin for fever and discomfort—not antibiotics.

"The times that we do give antibiotics are when we have evidence of a bacterial infection," says Dr. Ameenuddin, who notes that it is possible for a child to get sick with a respiratory virus and develop a secondary bacterial infection like pneumonia—which does, depending on the circumstances, need antibiotics.

In pediatrics, Dr. Donner says the two main reasons kids are hospitalized are breathing problems and dehydration. Signs of respiratory distress include rapid or labored breathing, turning blue or pale, or sucking in between the ribs with each breath. In infants, Dr. Donner said you may notice flaring of the nostrils or bobbing of the head to breathe. "These are all red flags that warrant urgent medical attention" (i.e., go straight to the ER). You know your child is staying hydrated as long as they are able to urinate or make good wet diapers at least three times per day, says Dr. Donner.

Will Life Be Normal by Summer?

According to Dr. Ameenuddin, it's possible that if the peak trends downwards and the COVID-19 situation is not at pandemic levels, things could return to normal in the coming months. "And if months down the road, it turns out that someone told us we overreacted, then that's OK," she says. "Then we've been successful."

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