RSV, influenza or coronavirus. How to tell them apart?

RSV, influenza or coronavirus. How to tell them apart?

Respiratory infections are most common during the season between autumn and spring. They usually cause mild and non-specific symptoms, often referred to colloquially as the common cold, but can sometimes take a more severe course.

About 200 different viruses are responsible for their occurrence, among them the influenza virus, RSV virus and SARS-Cov-2. How to distinguish between them?

Characteristics of the influenza and RSV viruses and the SARS-CoV-2 coronavirus

  • RSV (short for respiratory syncytial virus) is an RNA virus in the Paramyxoviridae family that causes respiratory infections. RSV infections occur seasonally throughout the world.
  • Influenza is an acute infectious disease caused by several types of viruses in the Orthomyxoviridae family. Seasonal influenza is caused by influenza A and B viruses, and the flu season usually occurs between autumn and spring and lasts about three months. New variants of the influenza virus, for which there is no immunity in the population, can cause illnesses of pandemic scope.
  • SARS-Cov-2 virus (severe acute respiratory syndrome coronavirus 2) causes COVID-19 acute respiratory infectious disease and is responsible for a global pandemic starting in 2019.

Characteristic symptoms of viral diseases that attack the respiratory tract

The infection usually starts in the upper respiratory tract, involving the throat, larynx, nasal cavity, middle ear and paranasal sinuses. Typical symptoms include sore throat, runny nose, cough, earache, muscle aches, fever and headache. In viral infections, unlike bacterial infections, there is no purulent nasal discharge and the sore throat is less severe.

In the absence of appropriate treatment, the infection can spread to the lower respiratory tract, i.e. the trachea, bronchi, bronchioles and lungs. Symptoms such as increased wet cough, expectoration of secretions, a feeling of shortness of breath and chest pains may appear.

How can you get infected?

Both RSV and influenza virus and SARS-Cov-2 are spread by the droplet route, that is, through droplets of saliva excreted by an infected person when sneezing, coughing or even speaking. The aerosol can float in the air for some time, so direct contact with the carrier is not necessary for infection. Viruses suspended in droplets of saliva can also be deposited on objects and, after the virus is transferred from the contaminated object to the mouth area of the eyes or nose, cause what is known as contact infection.

How long do viruses infect?

The ability to infect can occur even before the first symptoms appear and lasts after they disappear. The period of spreading the virus before an infected person is usually:

  • SARS-Cov-2: about 2 days before the first symptoms and up to 3 weeks after infection
  • Influenza virus: the day before the onset of symptoms (in young children even a few days before) and the next 5-7 days
  • RSV virus: as long as 3-4 weeks after the onset of symptoms, which appear 4-6 days after infection

The answer to the question of how long the virus infects also depends on the patient’s immune system. People whose immune system is less efficient in fighting the virus infect longer. The period of infection of a given virus can therefore be prolonged in immunocompromised people, the elderly and children.

What are the symptoms of RSV?

In adults who have acquired immunity through repeated contact with RSV, the infection usually causes mild symptoms of upper respiratory tract infection. Children under the age of 2 are particularly vulnerable to the extension of the infection to the lower respiratory tract. RSV’s notoriety is due to its responsibility for about 50% of pneumonia cases and 90% of bronchiolitis outbreaks in infants.

What are the symptoms of coronavirus?

The course of SARS-Cov-2 virus infection varies. COVID can be asymptomatic or mild, and in some cases cause a life-threatening condition. Many of the symptoms of coronavirus infection also occur in the course of influenza. Complications can arise even after the disease has passed asymptomatically, causing symptoms of so-called “long covid”.

What are the symptoms of seasonal flu? Differences between influenza and Covid

Covid and influenza are characterized by a great similarity of symptoms and are difficult to distinguish without diagnostic tests. During infection, the following symptoms may occur:

  • A feeling of waking up, lack of energy, malaise
  • Muscle aches and pains
  • Cough and sore throat, aggravated when swallowing
  • Fever
  • A feeling of shortness of breath and difficulty breathing
  • Catarrh
  • Diarrhea (more common as a symptom of influenza)
  • Vomiting
  • Weakness or changes in the perception of tastes and smells (more common in SARS-Cov-2 virus infection)

Vaccination against viral diseases?

Viral infections are most dangerous for people with weakened or not yet developed immunity, which is usually the youngest, as well as the oldest patients, usually burdened with comorbidities. However, even if you do not belong to any of these groups, it is worth vaccinating against influenza and SARS-Cov-2 virus, because any viral infection is a risk of complications.

Read: Painful arm after COVID-19 vaccination

A vaccine for RSV?

Unfortunately, a vaccine for RSV has still not been developed, so the main weapon against infection is to maintain hygiene and avoid outbreaks.

What are the tests to detect viral diseases?

How to distinguish RSV from SARS-Cov-2 or influenza? So-called rapid antigen tests, which detect virus-specific proteins in a sample taken from the nose or throat, are used for diagnosis. The test can be performed on its own, and results appear after just a few minutes or so. An extremely sensitive method of detecting the SARS-Cov-2 virus is real-time PCR tests, which have a very low risk of false results.

The swab should be taken on an empty stomach or by maintaining an interval of at least 4 hours after the last meal.

Does the coronavirus test detect influenza?

COVID and influenza are caused by different types of viruses and are detected by separate tests. A positive test for COVID or influenza also does not rule out infection with the other disease. Combo tests are a convenient way to diagnose all three diseases.


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