Newswise Coping with the challenges of parenting can be particularly stressful for those concerned about the flu, COVID-19, or RSV. With an increase in cases this season, parents are seeking effective preventive measures and safety guidelines for their kids. Dr. Christopher Pierce, the interim chair of pediatrics at the Virginia Tech Carilion School of Medicine, offers insights on managing these three illnesses.

This year, doctors are currently seeing high numbers of flu and this started a bit earlier than historically, says Dr. Pierce. Yearly flu vaccines are needed to give our immune systems a "reminder" of how to fight the flu, there is some added immunity that repeat exposure plays as well.

The prevalence of influenza among children has decreased early pandemic but increased over the past two years, which Dr. Pierce attributes to the heightened exposure to COVID-19 during that period. There was minimal influenza activity from spring 2020 through early summer 2022, which was a direct result of masking and social distancing.

He also says RSV is still prominent, but has begun a decline. RSV is more difficult to track as it is not reportable as are Flu and COVID, which means there is not a good way to keep track of these numbers.

Dr. Pierce says it is important to look for key indicators to assess the severity of your childs illness. Parents should look for rapid breathing, using accessory muscles such as "tummy breathing or "head bobbing, and if older children are complaining of not breathing well, would warrant an emergent evaluation. He says to also watch their level of alertness and fluid intake. Nonetheless, he stresses that reaching out to the primary care provider is the safest way to evaluate a childs level of illness and get the best care.

To differentiate between the three, Dr. Pierce recommends getting tested. Influenza, COVID-19, and RSV can mimic one another, so knowing which symptoms align with which illness can help parents. Overall, COVID-19 symptoms tend to be milder in children and the flu is more of the fever/aches/malaise. RSV is different for premature and younger infants as it can trigger lower respiratory symptoms known as bronchiolitis (not bronchitis) which can lead to respiratory distress which requires hospitalization to manage.

His biggest piece of advice - get the flu vaccine. It is the safest and most effective way to prevent the risk of hospitalization and death from influenza.

- Written by Sarah Hern

Dr. Christopher Pierce is the interim chair of pediatrics with the Virginia Tech Carilion School of Medicine (VTCSOM) and an associate professor of pediatrics. He is also the Chief of General Pediatrics at Carilion Childrens. His leadership has been instrumental in establishing Carilion Childrens Tanglewood Center, which opened in 2021, as the anchor for pediatric care for the region. Dr. Pierce joined Carilion in 2001 as a general pediatrician.

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Expert shares advice for parents navigating pediatric influenza, COVID-19, and RSV this winter - Newswise