Cold viruses, influenza (flu), COVID-19 and RSV spread quickly among school-age children. Knowing what to do and when to call the doctor can make a stressful season easier for the whole family.
November 1, 2025
Colds, Flu, COVID and RSV – They’re Back
When school is back in session, it’s not just homework and after-school activities that pick up. Runny noses, coughs and fevers often make their way through classrooms, too. Swati Patel, MD, a pediatrician at The MetroHealth System, says colds, flu, COVID and RSV can have similar symptoms and, in many cases, the same treatments.
“All of these viruses cause a runny nose, watery eyes, cough, tiredness and fever,” she said. “Most kids do fine with staying home, resting and drinking a lot of fluids.”
What’s The Difference?
Colds are the most common. Symptoms usually include a runny or stuffy nose, sneezing, sore throat and sometimes a mild cough or fever. Children may feel uncomfortable, but colds are typically mild and pass in about a week.
Flu (influenza) comes on faster and harder. Children with the flu often have a sudden high fever, body aches, headaches and extreme tiredness. The flu can lead to complications like pneumonia or require hospitalization. The flu vaccine will help your child avoid getting very sick from the flu. Peak flu season is November through February.
COVID-19 can look like both. Some kids experience fever, cough, sore throat and fatigue, while others may have an upset stomach, loss of taste or smell or no symptoms at all. COVID remains a concern because of its potential to spread rapidly and affect family members of all ages.
RSV is a common respiratory virus that can cause mild to severe infections, particularly in infants and young children. It is the leading cause of bronchiolitis and pneumonia in children under 2 years of age. Symptoms include runny nose, cough, fever, wheezing, shortness of breath, irritability and decreased appetite. Infants, toddlers and premature babies with RSV can be hospitalized to receive oxygen. All infants born during RSV season (typically October to March) should receive the vaccination.
When to Stay Home
- If your child has a fever, vomiting, diarrhea or severe cough, keep them home until symptoms improve.
- Schools may still have specific COVID-19 guidance — check with your district.
Fever-free for 24 hours is the green light to return to school and activities.
When to Call the Doctor
Call your MetroHealth pediatric provider or visit an Express Care location if your child:
- Has a fever higher than 102°F for more than three days.
- Has a fever of 104°F that doesn’t come down after taking a fever reducer such as Tylenol.
- Is breathing fast (more than 30 times a minute), wheezing or struggling to breathe (nose flaring or if you can see the ribs when trying to breathe).
- Seems unusually drowsy, confused or irritable.
- Shows signs of dehydration (very dry mouth, no tears, not urinating).
- Has underlying conditions like asthma or immune issues that put them at higher risk.
Go to the Emergency Department only if your child is struggling to breathe or isn’t responding when you call their name.
Remember: Fever itself isn’t dangerous — it’s the body’s way of fighting infection. But if a fever goes higher than 104°F, lasts more than three days, or doesn’t come down with Tylenol or ibuprofen, call your child’s healthcare provider.
Treatment: What Works and What Doesn’t
- Stay hydrated: Water, Pedialyte or Gatorade are good options. Drinking is more important than eating.
- Take antivirals for flu: Only helpful if started within 48 hours of symptoms. A prescription is required.
- Use immune boosters: Over-the-counter vitamin C, elderberry, vitamin D, and zinc may help, but too much can be harmful. Stick with safe amounts and avoid over-doing supplements.
Need to see a provider?
To schedule an appointment, call 216-778-2222, or see a full list of our pediatric providers.
Contributed By: Swati Patel, MD / Pediatrics
