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Is It a Cold, the Flu, or COVID-19?

Your child has a sore throat, cough, and a high fever. Is it COVID-19? Could it be the flu? Or just a cold?

All these illnesses are caused by viruses that infect the respiratory tract. All are contagious and can spread easily from person to person. And they cause some similar symptoms. So it can be hard to tell them apart.

Here are some things to look for if your child gets sick.

The Common Cold (Caused by Many Different Viruses)

Cold symptoms usually are mild. They often include a tickly throat, a runny or stuffy nose, and sneezing. If there's a fever, it is not high. A child with a cold usually feels quite well, and has a good appetite and normal energy levels.

There is no test for the common cold, and no specific treatment. It just needs to run its course.

The Flu (Caused by the Influenza Virus)

The flu can also be mild. Usually, though, kids with the flu feel worse than if they have a cold. They might have a fever that comes on suddenly, with chills, a headache, and body aches. They can have a sore throat, runny nose, and cough. And they feel generally miserable and tired and don't have much of an appetite. Some kids even have belly pain, nausea, vomiting, or diarrhea.

A doctor can check if someone has the flu by doing a test that looks for the flu virus.

Most kids with flu get better at home with plenty of liquids, rest, and comfort. In some cases, a doctor might prescribe an antiviral medicine to ease symptoms and shorten the illness. Some people get very ill and need treatment in the hospital.

Many cases of the flu can be prevented by getting a flu vaccine every year.

COVID-19 (Caused by a Type of Coronavirus)

Kids infected by the coronavirus may not have any symptoms, or their symptoms can be mild, like those of a common cold. Some can have more severe flu-like symptoms. So COVID-19 symptoms can look very much like those from a cold or the flu. But they can also look different. For example, they can include a loss of taste or smell, or a variety of rashes.

Sometimes kids develop symptoms several weeks after being infected with the coronavirus, as part of a condition called multisystem inflammatory in children (MIS-C). And rarely, kids might have symptoms that last for a long time, a condition known as long COVID.

To see if someone has been infected with the coronavirus, doctors can do a test that looks for a piece of the virus in the respiratory tract. They also can check for a past infection by doing a blood test that looks for antibodies.

Most people with a mild illness, including children, don’t need any specific treatment, and they get better with plenty of liquids, rest, and fever-reducing medicine. A very few kids ages 12 and up who have mild to moderate symptoms and are at high risk for severe COVID-19 can get a special medicine called monoclonal antibodies. It's given within 10 days of when symptoms start, and is meant to prevent severe disease, the need for hospital care, and death. High-risk teens who have been in close contact with an infected person or are likely to be exposed to an infected person also can get this medicine to prevent them from getting infected.

Some people get very ill and need treatment in the hospital. Rarely, doctors will give some medicines, such as antiviral drugs or steroids, to children in the hospital with severe COVID-19.

Safe and effective COVID-19 vaccines are available for adults and all children ages 5 and older. Booster shots are recommended for adults and kids 12 and older. Everyone who is eligible should get the COVID-19 vaccine and booster shot as soon as possible.

When Should I Call the Doctor?

If you have any doubts or questions, it's best to call your doctor. An illness that seems like a cold can turn out to be the flu or COVID-19. And other illnesses, like strep throat or pneumonia, can cause similar symptoms but need different treatment. Sometimes it's hard to know for sure which germ is causing the problem. Then, doctors might do some tests to find out.

Get medical care right away if your child:

  • seems to be getting worse
  • has trouble breathing
  • has a high fever
  • has a bad headache
  • has a sore throat
  • seems confused
  • has severe belly pain
  • has pain or pressure in the chest
  • has trouble staying awake
  • looks bluish in the lips or face

Call your doctor right away if your child has asthma or another illness and starts to feel sick with symptoms that might be the flu or COVID-19. The doctor might want to do some tests or start a specific medicine for the flu.

What Can Parents Do?

Common steps that help prevent the spread of germs also work well against the common cold, the flu, and COVID-19. It's always wise to:

  • Wash hands well and often. Wash for at least 20 seconds with soap and water or use hand sanitizer with at least 60% alcohol.
  • Avoid people who appear sick.
  • Clean surfaces that get touched a lot (like doorknobs, counters, phones, etc.).
Reviewed by: Karen A. Ravin, MD and Elana Pearl Ben-Joseph, MD
Date reviewed: January 2022