Do I have the flu, COVID-19 or RSV?

Heard of the triple threat this winter?

COVID-19, the flu and respiratory syncytial virus (RSV) are together driving a wave of respiratory illnesses.

But all three have very similar symptoms that overlap. 

We help you zero in on which virus you might have.

Wait, what’s RSV again?

It stands for respiratory syncytial virus, which causes respiratory infections.

RSV is one of about 200 viruses that can cause a cold — which is very common. 

Most cases of illness caused by RSV are mild.

But it can lead to serious illness for young children, the elderly and people with immunosuppressive conditions.

Contracting the virus can lead to chest infections such as bronchiolitis and pneumonia.

It can also cause ear infections and the coughing associated with the illness can worsen asthma symptoms. 

What are the symptoms of RSV?

Usually, the first symptoms are:

• fever
• runny nose
• coughing
• wheezing or difficulty breathing
• decreased appetite.

Typically, most cases go away after about two weeks.

But NSW Health says coughs associated with the virus can last for up to four weeks.

So what’s the difference between COVID, RSV and the flu?

All three have very similar symptoms that overlap.

COVID, influenza and RSV are all respiratory diseases, says Professor Hassan Vally, an epidemiologist at Deakin University. 

However, Prof. Vally says they have differences in the characteristics of the illnesses they cause, how they are transmitted and their impact.

“One of the most important differences between these diseases is who is the most susceptible to illness and severe disease,” Prof. Vally says. 

According to Prof. Vally:

• COVID poses the biggest risk to those who are older
• RSV poses the biggest threat to young children
• Inflluenza poses the biggest threat to young children, older adults and pregnant women.

“All of these diseases pose an increased risk in individuals who have underlying health conditions or are immunocompromised regardless of age,” Prof. Vally says. Adding that a key way to differentiate among viral infections is to monitor how quickly your symptoms ramp up.

What are the differences in symptoms?

As with all viruses that infect the respiratory tract, the broad symptoms experienced are quite similar in most people. “They include runny nose, cough, sore throat, sneezing and headache,” Prof. Vally says.

These are the symptoms for each:

But the only way to accurately determine which of these you might have is to get tested.

Are there differences in testing?

Yes, a few minor ones. Some pathology providers test for multiple viruses and may send you test results for RSV, influenza and COVID-19 at the same time. But this depends on your state and territory.

COVID

Rapid Antigen Tests (RATs) are available and can be purchased from pharmacies.

Some state and territory governments may still provide Polymerase Chain Reaction (PCR) tests.

Always check with your state or territory’s health department for more information.

RSV

RSV is only able to be diagnosed by presenting to your general practitioner (GP).

The virus can be identified by a PCR test (nose or throat swab), according to NSW Health. 

Flu

In case you missed the news, RAT tests are now available for the flu and COVID.

The first of these combo home tests was approved in September 2022.

Now several are on the market.

These tests let you check, with one test kit, if you are:

• infected with two types of flu (influenza A and B) and;
• SARS-CoV-2 (the virus that causes COVID).

The price of these combo kits advertised online varies from $8.95 to $59 (excluding delivery).

So it’s worth shopping around.

Which age groups are more vulnerable?

COVID-19

Increasing age is the most important risk factor for severe disease and death, with risk significantly increasing around 60-70 years of age.

The Department of Health and Aged Care says people who are unvaccinated or partially vaccinated are also at greater risk.

The risk of severe disease also increases for people with: 

• multiple and/or severe comorbidities
• people who are immunosuppressed
• people with a disability
• people experiencing frailty
• Aboriginal and Torres Strait Islander people
• people who are pregnant.

RSV

“Most children will be infected with RSV at least once before they turn two,” a Queensland Health spokesperson said.

“Infection provides some immunity to reinfection, so children under five years, but particularly infants less than six months of age are most at risk of severe outcomes”.

The following groups are also vulnerable to RSV: 

• people aged 65 years and over
• people with multiple and/or severe comorbidities
• people who are immunosuppressed .

Flu

For the flu, majority of at-risk groups are shared with COVID-19.

However, children under five and adults aged 65 years and older are most at risk of severe outcomes.

How do I protect myself?

It’s the same drill for all three viruses.

“In most cases, these diseases are mild and self-limiting,” a federal Department of Health and Aged Care spokesperson says. 

According to them, it should be managed by:

• staying home from school or work
• getting plenty of rest
• saying hydrated
• managing pain and fever with paracetamol or ibuprofen
• avoiding interaction with people at greater risk, such as residents of aged care.

Making sure you’re up-to-date with vaccinations is also vital, says Prof. Vally. 

“There are safe and effective vaccines available for COVID and influenza,” he says.

“Now is a good time to get your COVID booster if you are due and to get your annual influenza vaccine”.

Prof. Vally says if your symptoms are worsening or are severe, you should seek urgent medical attention.

“This is especially important for people in the higher risk groups”.

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