The Differences Between RSV, Croup, and Whooping Cough in Kids
|Expert Reviewed||Dr. Michael Mulick, D.O. Pediatric Cardiac Anesthesiologist|
Respiratory Illnesses in Children
If you have kids or are around children on a regular basis, you are very aware of a single truth: at any moment, illness can strike. Children are very susceptible to illnesses, especially at young ages, as their immune systems are not mature yet.
Even though some of these illnesses can be prevented with vaccines or other health measures, they still are a problem for children. As an example, recent outbreaks of pertussis, or whooping cough, have resurfaced, making it even more important for parents to keep their children healthy and from contracting this potentially deadly illness.
Knowing the symptoms of illnesses, as well as treatments and prevention, is key to keeping your children healthy.
There are many respiratory illnesses and disorders out there that affect children, but this article will focus on three.
Below is a list of three common (and serious) childhood respiratory illnesses, their symptoms, their treatments, and prevention.
These three common respiratory disorders in children are:
- Pertussis (Whooping Cough)
What Does RSV Mean?
RSV stands for respiratory syncytial virus
Fevers in Children
When the body raises it’s temperature above normal levels, above 98.6°F on average, it results in a fever. A fever is sometimes a sign that the body is fighting off something; it is not an illness itself. It can also result from basic changes in body temperature during the day, from working out, sleeping, playing, etc.
- For infants only a few weeks old, though, a fever can be a serious matter, especially if it is above 100°F rectally. If your baby has a fever at that age, call the doctor right away.
- For older babies and children, it’s recommended that you call the doctor if the fever is 102°F or higher. Your doctor will determine what to do based on your child’s behavior and activity level.
- For fevers lower than 102°F, it’s often recommended to give plenty of fluids and let the fever pass or to give plenty of fluids and acetaminophen or ibuprofen.
Calling a Doctor
If you are concerned about your child's health, don't be afraid call your doctor! Even if it is after hours, many pediatrician offices have on-call staff that you can talk to.
Croup vs Pertussis vs RSV
Infection of the upper airway caused by a virus, normally parainfluenza, but it also be caused by RSV
Respiratory infection caused by the bacteria Bordetella Pertussis. Often acquired from family members who have a milder form of the illness
Viral infection of the respiratory tract
Characterized by a low, barking cough remeniscent of a seal bark
Characterized by rapid, high-pitched coughing and a whooping sound while inhaling
Characterized by wheezing, rapid breathing, and a severe cough. Fever may also be present.
Cool-mist vaporizer, Tylenol, steroids, and fluids, though hospitalization and breathing tube intubation may be needed in severe cases
Tylenol, fluids, and antibiotics, hospitalization and oxygen therapy may be required in serious cases
Tylenol, fluids, anti-viral medication, a bulb syringe to suction mucous, and a cool-mist vaporizer, though hospitilzation may be required if the child is having difficulty breathin
Lasts 3-5 days but can last up to 2 weeks
Lasts weeks, sometimes up to a few months, potentially over 2 months if the child is young and has not been immunized
Lasts around 3-7 days, but some children may develop chronic lung disease
Calling 911 or Going to the Hospital
If your child is turning blue, having difficulty breathing, and wheezing heavily, don't hesitate to call 911 or take them to the hospital.
RSV Symptoms and Treatments
Symptoms: RSV or respiratory syncytial virus is an infection of the lungs. It is very common in children ages 0-2 but can affect older children as well. This illness begins like the common cold, with a runny nose, and a mild fever. For infants with underdeveloped lungs or young children who don’t fight off infections well, these cold symptoms turn to rapid breathing, bouts of coughing, irritability that is more than a cranky episode, and possible wheezing when coughing or trying to breathe. It’s best to call your doctor if these symptoms persist without seeming to get better.
Note: If your child seems to be in distress, immediately call the doctor, especially if breathing increases to around 50-60 breaths per minute. If untreated and your child gets worse, the RSV could turn to pneumonia or bronchiolitis, a swelling of the smallest air passages of the lungs.
Treatments: Just like with a normal cold, it is recommended that you use a cool mist humidifier, provide lots of fluids to the sick child, keep the child as comfortable as possible, and give acetaminophen (like Tylenol) as directed. If your child experiences severe symptoms, they may need to be hospitalized and given oxygen therapy and intravenous fluids. Do not hesitate to take your child to the hospital if they are having difficulty breathing!
Prevention: Keep your children healthy by teaching them to wash their hands each time they cough in their hands or blow their little noses (parents should do the same!). It is also recommended to use a cool mist humidifier during the winter months as it helps to keep the nasal passages moist and makes for easier breathing during the dry winter months. Just be sure to clean it properly as harmful bacteria and mold can grow within the unit.
It is NOT recommended to give any cough suppressant or other cold medicines to children under the age of six as they have not been proven effective for that age group.
Why RSV Can Be Dangerous for Infants
Croup Symptoms and Treatments
Symptoms: Croup, or laryngotracheobronchitis, is a scary illness for a parent to witness (see my story). It most often occurs in both the springtime and fall as it can be triggered by allergies. It can be caused by a virus or bacterial infection of the respiratory tract, meaning it could be caused by an illness like RSV or other illnesses. As a viral infection, it causes inflammation of vocal chords and surrounding tissue. There may or may not be a fever, depending on what illness has brought on the croup. Sudden attacks most likely happen in the middle of the night, giving your child a barking cough (think: seal bark), a hard time breathing, and a very hoarse voice, which are distrubing for parents to deal with in the middle of the night.
Note: If your child experiences the above symptoms plus is blue from the lack of proper breathing, take him/her to the nearest emergency room immediately. It means that he/she is not getting enough oxygen from breathing and that there may be possible swelling in the throat from the illness.
Treatment: Just like for RSV, it is recommended to use a cool-mist humidifier, but it is also helpful to run a hot shower and let your child breathe in the steam. Try to keep your child comfortable, which may include giving acetaminophen as directed for pain from coughing. Fluids should be encouraged to keep the throat moist. Again, it is not recommended that you give any sort of cough or cold medicine to any child under the age of six.
If the croup is severe, it might be recommended by your doctor that your child receive breathing treatments from the hospital. The breathing treatment is usually a simple mist that is emitted from a mask worn by the child. Steroids are sometimes prescribed, depending on how severe the throat is swollen due to the illness. X-rays are usually done to determine the severity of the swollen throat and to detect any traces of possible pneumonia.
Prevention: The prevention of this illness would be the same for RSV. Wash hands, clean all surfaces that are regularly touched to clean away any viruses and try to use a cool mist humidifier on a regular basis. Also, if you are aware your child is sick, keep him/her away from other children or adults until he/she is feeling better.
At Home Treatments for Croup
My Son and His First Episode of the Croup Cough
The fall after my son turned one, he developed a cold, just like any other cold: a runny nose, coughing, and a slight fever. He was still running around, playing like he would any day. It wasn't until the nighttime that his cough changed. He awoke in the middle of the night, with a persistent, loud barking cough. It was so scary since I had never experienced it before and the doctor wasn’t available. Yet, the next morning, after taking some Tylenol, he was okay, playing and running around. My husband and I went to work, and my son went to my mom's house, all of us thinking he was well. While at my mom’s, he started showing signs of distress when he was breathing. She took him to the doctor (before this episode, we had given our doctor a signed note saying my mom could take him when we couldn’t be there) who sent him immediately to the hospital for a breathing treatment. I had to rush home from work to sit with my son in a hospital bed as he wore a little mask on his face. He looked so sad. It broke my heart to see such my tiny little child so sad. Along with the mask, he had an oxygen monitor on his finger checking the content of oxygen in his blood. He had to get x-rays and wait until his oxygen level was steady at 100%. After a few hours of the breathing treatment and determining that his oxygen level was okay, he was placed on antibiotics and sent home.
Croup vs. Whooping Cough: What's the Difference?
While there are some similarities between the two, Pertussis and Croup are different illnesses. Croup results in a seal-like barking sound as the larynx have become swollen and inflamed. While the symptoms of Croup can be severe (as was the case with my son), they do tend to go away in 4-5 days.
Whooping cough, on the other hand, tends to last for weeks, with some cases lasting months. The bacterial infection that causes the cough is nasty as it causes the child to repeatedly and aggressively cough until they run out of air. The child then has to inhale quickly and sharply, resulting in a whooping sound. The cough is highly contagious, and it is estimated that pertussis affects over 48 million people annually.
Pertussis (Whooping Cough) Symptoms and Treatments
Symptoms: Whooping cough, also known as pertussis, is a contagious bacterial infection that is once again on the rise. It affects the lungs, bronchial tubes, and larynx. It is known for the ‘whooping’ sound a child makes as they are inhaling after coughing fits. The illness starts out as a regular cold, with a runny or stuffy nose, coughing, and a fever, but after about two weeks it progresses to forceful coughing along with the whooping sound in between coughing fits. The coughing is usually a dry cough (without mucus). There may also be a fever, loss of appetite and irritability. The cough can cause extreme complications in the child, such as vomiting, fainting, rib fractures, and brain injuries. This is due to the violent coughing fits caused by the bacteria, and it is highly contagious. Additionally, other serious complications can develop from severe cases of Pertussis such as pneumonia, seizures, and death.
Treatment: At home, the best you can do is provide plenty of fluids, encourage your child to rest and give acetaminophen or ibuprofen as directed. Keep the child away from any babies or infants—babies or infants who contract the infection can develop a secondary infection or pneumonia, which can be deadly for a baby.
Once you believe your child has this illness, call your doctor right away. They will most likely provide antibiotics to treat the illness. If your child is experiencing severe symptoms, hospitalization and oxygen therapy may be required.
Prevention: Prevention of this illness is again like the prevention of the other illnesses mentioned in this article: proper washing of hands and proper cleaning of surfaces touched by those infected.
The real prevention for this illness should be easy; it comes in the form of a vaccine that is typically given to children at a young age. The vaccine is the DTaP: it’s a vaccine that is given as a series starting when children are two months old. The reason why whooping cough is on the rise is for two reasons: some parents are choosing not to vaccinate their children for various personal reasons, and doctors are discovering that adults that have had the vaccine as children are no longer as protected by their childhood vaccination as much. In fact, many hospitals and doctors are offering the vaccine to new parents after they have had a baby to protect the baby before they can get the vaccine. Why? Whooping cough can be deadly to infants and young babies. It is also recommended that any family members or caregivers who will be around the baby should get an updated vaccine.
What Does Whooping Cough Sound Like?
Respiratory Disorders and Illnesses
There are many more respiratory disorders and illnesses out there that were not talked about in this article. Some of them require immediate medical attention. If you notice your child is having difficulty breathing do not hesitate to call your pediatrician or take your child to the hospital!
Know the Symptoms, Know How to Treat, Learn How to Prevent: Keep Your Kids Healthy!
Just by being aware of the symptoms of these common childhood illnesses, how to treat them and prevention of them, you may be able to keep your children healthy during the fall and winter months.
Remember: Sometimes you may not be sure about some of the symptoms or how to treat them. If you are unsure, don't try to diagnose your child on your own. Call your doctor and ask. He or she will be able to determine, based on the symptoms you tell them, whether or not it is necessary to treat your child medically. Also, remember to follow all directions when dispensing any type of medication, whether it be over the counter or prescribed.
Curtis, Glade B., and Judith Schuler. Your Baby's First Year Week by Week. Da Capo Lifelong; Cambridge, 2010.
Whooping Cough: Causes, Symptoms, and Treatment
RSV in Babies: What to Know
What Is Croup? What Causes It?
Dr. Frank Bures:
Dr. Michael Mulick
“Very helpful and resourceful! Parents out there just remember, do not be afraid to make that phone call to your doctor even if it’s during the middle of the night! Trust your intuition!”
Questions & Answers
My daughter has a cough but no fever. She acts normal in the morning but at night she gets the cough. What can it be?
For kids, coughs in the evening can often seem worse. It's mostly because if they are laying down, everything settles in their chest or drips down from there sinus cavities and makes them cough. It should subside in a few days, but if it seems like it is getting worse or she is struggling to breathe, I highly suggest speaking with your doctor.
Should a three-year-old with Croup be allowed out in snow? He has been taking a steroid for three days now, but no fever.
Fresh air is usually good for kids with croup. I don't see how a little bit of time would hurt, but you might want to consult with the child's doctor first.
My thirteen-year-old grandson had Pertussis in mid-December. He is still coughing every 20 to 30 seconds, and it's been four months already. He has missed four months of school, and shows no signs of improvement. We are at a loss of what to do for him. Do you have any suggestions?
Four months is an awfully long time to still be suffering from the effects of whooping cough. I highly suggest you speak with his doctor to see what might be going on.
© 2012 Marissa