Are You Sick? How to Tell Which Virus You Have

As most of us have shed our pandemic masks in favor of returning to less restricted socializing, some of the viruses we didn’t have to deal with for the last two winters have resurfaced—with a vengeance.

According to the Centers for Disease Control and Prevention (CDC), seasonal flu activity is “elevated across the country.” The respiratory virus RSV is 10 times higher than normal, and more than 40,000 new cases of COVID-19 are being reported daily.

So if you’re sick, our concierge primary care doctors in Jupiter want to help you figure out which of these highly contagious viruses may be causing your symptoms, and what to do about them.

The ‘Tripledemic’

The flu season began six weeks earlier than normal this year, with at least 880,000 reported cases as of the end of October, including 6,900 hospitalizations and 360 flu-related deaths. This is the highest number recorded since the 2009 H1N1 swine flu pandemic.

“The Southern Hemisphere has had a pretty bad flu season, and it came on early [there],” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Bloomberg News. So officials weren’t especially surprised when it hit early and hard here, too.

At the same time, the respiratory syncytial virus, or RSV, has been flooding children’s hospitals with cases. And while the media’s attention has largely been focused on children, RSV can also hit older adults and those who are immunocompromised.

Meanwhile, COVID-19 cases have leveled off, but as of the end of November, the CDC was reporting 281,000 new cases and 2,222 deaths a week, with cases expected to rise this winter.

And, of course, without universal masking, colds are also making a comeback. To make matters worse, it is possible to be infected with more than one virus at the same time.

Similar Symptoms

With all these viruses hitting at once, it’s doubly difficult to know which one you have, because all of them have overlapping symptoms.

“At this stage of the pandemic, it’s really difficult to differentiate between the flu, COVID, common colds, and even seasonal allergies,” Céline Gounder, an infectious disease specialist, epidemiologist, and senior fellow at the Kaiser Family Foundation, told CNBC’s Make It.

“I, even as an infectious disease specialist who’s been practicing for a couple of decades now, cannot differentiate just on an exam,” she said. “You really need to do a test.”

Early on, it was easier to tell the difference at least at least with COVID-19, because of such distinctive symptoms as loss of smell and taste and red eyes or toes. But Gounder explained that because most people now have some degree of immunity, either through vaccination or infection or both, our bodies aren’t reacting the same way. Second, the newer variants are behaving differently than the original strain.

Ways to Tell

It helps to know which virus you have because they are not treated the same. With COVID-19, you can receive antiviral therapies, which can short-circuit the severity of the illness. But the antiviral treatments you can get for the flu are different.

As for RSV, Vandana Madhavan, clinical director of Pediatric Infectious Disease at Mass General for Children, told HuffPost that doctor’s offices are overrun right now, and if you bring your child in for mild symptoms that might otherwise get better at home, there’s a risk they could pick up something else while they’re there.

So how do you tell? As Gounder pointed out, there’s no way to know for sure, but here are some typical symptoms of each.

Common cold:

  • sore throat
  • runny or stuffy nose
  • coughing
  • sneezing
  • headaches
  • body aches

Flu:

  • sore throat
  • runny or stuffy nose
  • muscle/body aches
  • cough
  • fever or chills
  • headache
  • fatigue

COVID-19:

  • sore throat
  • runny or stuffy nose
  • muscle/body aches
  • cough
  • fever or chills
  • headache
  • fatigue
  • diarrhea
  • nausea/vomiting
  • difficulty breathing or shortness of breath

The CDC notes that this list does not include all possible symptoms. Symptoms may change with new COVID-19 variants and can vary depending on vaccination status.

RSV:

  • runny nose
  • decrease in appetite
  • coughing
  • sneezing
  • fever
  • wheezing

The CDC reports that these symptoms usually appear in stages and not all at once. In very young children with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties. Almost all children will have had an RSV infection by their second birthday.

What To Do

With any type of respiratory virus, it’s important to keep from spreading the virus to others, especially those who may be immunocompromised or are otherwise at higher risk. There are tests for COVID-19 and the flu, but not for the common cold or RSV.

Stay home if you are sick and get in touch with us if you have any questions.

Call 911 if you see any signs of an emergency, especially with COVID-19, including:

  • trouble breathing
  • persistent pain or pressure in the chest
  • new confusion
  • inability to wake or stay awake
  • pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
  • if you think it may be an emergency

As the number of cases of all these viruses rise, it’s smart to take precautions. Wear a mask in crowded, poorly ventilated places, wash your hands frequently, eat well, and get plenty of sleep. 

And get your flu vaccine and a COVID-19 booster if you haven’t had one recently (there is no vaccine for RSV or the common cold).

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The Ouch Is Back—Why the Flu Shot Is Now Your Only Option

When the FluMist spray was introduced in 2003, the medical community rejoiced, hoping the nasal spray which became available in place of the annual flu shot would induce more people to get protected. Parents were happy, too, in being able to dodge the tears from their little ones.

Unfortunately, the Centers for Disease Control has decided that FluMist cannot be used for this upcoming flu season because it is ineffective. First licensed by the FDA in 2003, FluMist contained a weakened, live flu virus. The injection uses an inactivated virus. Early clinical trials seemed to show that the spray worked as well as or better than the shot, which led an estimated 20 million people to opt for FluMist last year.

In June of this year, however, the CDC released a study which showed that the nasal spray was effective only three percent of the time in children from two to 17 years of age during the 2015-2016 flu season. By contrast, the flu shot last winter was effective 49 percent of the time in adults and 63 percent in children. FluMist’s effectiveness rate seemed to plummet in 2013 when makers of the spray switched from including three strains of live virus (a trivalent) to four (a quadrivalent), although no one seems to be able to say how that impacted efficacy. The bottom line is, it’s not an option for the 2016-2017 flu season.

Keep in mind that the influenza virus kills thousands of people each year, so the flu shot is strongly recommended. Thus, the concierge physicians here at MD 2.0 Jupiter want to offer a few tips on how to make it a little less ouch-inducing for our clients.

1. Distraction seems to work best, not only for children but for adults, as well. Don’t look at the needle. Check out your smart phone, daydream about your next vacation, replay Sunday’s game in your head. Have your kids blow bubbles, play with a toy, eat a cookie (and don’t make a big thing out of getting a shot—treat it casually in front of them).

2. For fearful or pain-sensitive adults and children, let us know. We can administer a local anesthetic cream to the skin prior to the injection.

3. Hold your breath before and during the injection. This increases blood pressure which helps to decrease pain sensitivity.

4. Relax your muscles as much as possible before receiving the shot. Tensing up causes more pain both during and after the injection.

5. Apply either ice or a warm compress (try both to see which works best for you) to the site after the injection, and be sure to use your arm as much as possible in the ensuing hours to increase circulation.

6. If soreness persists after three days, call us! That’s why we’re here!