Why It's Hard to Tell Them Apart
Flu and COVID-19 are both respiratory illnesses caused by different viruses, but they share many symptoms in children — fever, cough, fatigue, and body aches. The only reliable way to tell them apart is testing. But understanding the subtle differences can help you know what to expect.
Symptom Comparison
- Fever: Common in both. Flu fever tends to be sudden and high. COVID fever may be more gradual.
- Cough: Both cause cough. COVID more often causes a dry cough.
- Body aches: More prominent with flu.
- Loss of taste/smell: More specific to COVID, though less common in children than adults.
- Sore throat: Common in both.
- GI symptoms: Vomiting and diarrhea are more common with flu in children, but can occur with COVID.
- Onset: Flu hits suddenly. COVID symptoms often develop more gradually over 2-5 days.
What Parents Can Do at Home
- Test early. Rapid home tests or clinic testing helps guide treatment
- Manage fever. Use acetaminophen or ibuprofen as directed by your pediatrician
- Push fluids. Keep your child well-hydrated with water, broth, and electrolyte drinks
- Rest. The body needs energy to fight the infection
- Isolate if possible. Keep the sick child away from other family members
- Monitor breathing. Watch for fast breathing, retractions, or difficulty breathing
When to Call the Pediatrician
- Fever lasting more than 3 days
- Symptoms improving then suddenly worsening
- Refusal to drink fluids
- Signs of dehydration
- Suspected flu (Tamiflu works best within 48 hours)
When to Go to the ER
- Difficulty breathing or rapid breathing
- Persistent chest pain
- Severe lethargy — hard to wake up
- Blue or gray skin, lips, or nail beds
- Seizures
- Signs of severe dehydration
Prevention
- Annual flu vaccine for all children 6 months and older
- COVID vaccine as recommended by the CDC for your child's age
- Frequent handwashing
- Stay home when sick
- Cover coughs and sneezes
Key Takeaways
- Flu and COVID look very similar in children — testing is the best way to tell
- Contact your pediatrician early if you suspect flu — antiviral treatment works best within 48 hours
- Both are preventable with vaccination
- Seek emergency care for difficulty breathing, severe lethargy, or blue lips
