Respiratory Syncytial Virus (RSV) and croup are common respiratory illnesses in children, often causing concern due to their impact on breathing. Differentiating between these conditions can be challenging, especially when relying solely on a child’s cough sound. This article clarifies the distinctions between RSV and croup, detailing their characteristic coughs, other symptoms, and indicators for seeking medical attention.
How the Coughs Sound
The sound of a cough helps differentiate between croup and RSV. Croup presents with a distinctive “barking” cough, often compared to a seal. This sound results from swelling in the upper airway, specifically the larynx and trachea, which narrows air passages. The narrowed airway forces air through a smaller opening, producing the harsh, barking noise. This cough may become more pronounced at night.
In contrast, an RSV cough sounds wet, wheezy, or persistent. RSV affects the smaller airways in the lungs, known as bronchioles, leading to inflammation and mucus buildup. This lower airway involvement can cause wheezing, a whistling or rattling sound, as air struggles through constricted passages. The cough may also be accompanied by fast, shallow breathing. While these cough sounds are distinctive, their intensity can vary, and other accompanying symptoms are also important for accurate differentiation.
Other Key Symptoms
Beyond the cough, other symptoms distinguish between croup and RSV. Croup often begins with cold-like symptoms such as a runny nose, sore throat, and a mild fever, preceding the barking cough. A high-pitched, noisy breathing sound, known as stridor, can also occur, particularly when inhaling, and may worsen when the child is upset. Hoarseness or a raspy voice is another symptom associated with croup’s laryngeal swelling.
RSV also presents with cold-like symptoms, including a runny nose, sneezing, and a fever. However, RSV can progress to more significant respiratory distress, especially in infants. Symptoms can include wheezing, a high-pitched whistling sound, particularly when breathing out, and rapid or labored breathing. In severe cases, RSV can cause bronchiolitis, an inflammation of the small airways in the lungs, leading to increased work of breathing, irritability, and decreased appetite.
When to Seek Medical Attention
Knowing when to seek medical attention is important for both RSV and croup, as both can lead to significant respiratory distress. For croup, immediate medical attention is necessary if a child exhibits stridor at rest, meaning the noisy breathing sound is present even when calm. Other warning signs include severe difficulty breathing, noticeable retractions where the skin pulls in around the ribs or neck with each breath, or a bluish tint to the skin around the mouth or fingernails, indicating lack of oxygen. Significant drooling or difficulty swallowing also warrant urgent evaluation.
For RSV, similar signs of respiratory distress signal the need for prompt medical care. These include very fast breathing, flaring nostrils, grunting sounds with breathing, and visible chest retractions. Poor feeding, lethargy, or signs of dehydration, such as reduced urination or a very dry mouth, also indicate a need for medical assessment. Infants under two months old with a fever above 100.4 degrees Fahrenheit, or any child with a sustained fever over 104 degrees Fahrenheit, should be evaluated by a healthcare provider.
What Are RSV and Croup?
Respiratory Syncytial Virus (RSV) is a common, highly contagious respiratory virus infecting the lungs and breathing passages. While it often causes mild, cold-like symptoms in older children and adults, it can lead to more serious conditions like bronchiolitis and pneumonia in infants and young children. RSV is a common cause of hospitalization in this age group. RSV circulates seasonally, with outbreaks often occurring from fall through spring, peaking in winter months. Almost all children experience an RSV infection by two years of age.
Croup, also known as laryngotracheobronchitis, is usually caused by a viral infection, most commonly the parainfluenza virus. The infection leads to swelling around the voice box (larynx) and windpipe (trachea), narrowing the upper airway and causing characteristic symptoms. Croup primarily affects children under five years old, with peak incidence often before age three, and is more prevalent during late autumn and early winter months. Symptoms are often worse at night.