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A "Tripledemic" is Leaving Many Sick for Weeks and Months. Here's How to Tell if You Have a Cold, Flu, COVID, RSV or Strep.

Here’s what the symptoms signify.
FACT CHECKED BY Emilia Paluszek

Is it cold, flu, RSV, strep, or COVID? Thanks to years of sheltering in place, the public—and especially children—are far more susceptible to severe illness if they do catch anything. And the chances of catching something are pretty high right now, experts warn, with so many viruses circulating. "You can get really sick, perhaps more so than you would have normally because your immune system really hasn't been challenged as much recently," says Dr. Priya Soni, a pediatric infectious disease specialist at Cedars-Sinai Guerin Children's in Los Angeles. "It's important for parents to remember that we often treat these viruses the same way—with at-home care that includes fluids, rest and over-the-counter pain or fever reducers, as needed," says Andi Shane, MD, MPH, MSc, System Medical Director, Infectious Diseases at Children's Healthcare of Atlanta. "As a parent, it's important to trust your instincts: call your child's doctor if you have concerns and know the symptoms that warrant medical care," adds Dr. Shane. With so many of the symptoms of each virus overlapping, it can be tough to confirm just what someone might have without a test—but there are specific symptoms to be aware of, that are more likely to occur with some viruses than with others. Here are the symptoms of each virus to be aware of. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.



Ill man wearing grey sweater, yellow hat and spectacles, blowing nose and sneeze into tissue

Colds tend to be milder than the other viruses, and symptoms come on slowly over two or three days, unlike the flu which feels much more immediate. Fevers rarely accompany colds, so if you do have a fever, it's more likely to be the flu. COVID and RSV are also not likely to be accompanied by high fever. "Especially with the newer variants and people having been exposed through immunization or if they've had an infection before, we're seeing that more patients are now only mildly symptomatic, and they only have low-grade fevers, around 99 or 100," says Dr. Michael Chang, an infectious disease specialist at Memorial Hermann Health System in Houston. According to Penn Medicine, cold symptoms are usually felt approximately 2 to 3 days after coming in contact with the virus, although up to a week is not unusual. Symptoms are mostly felt in the nose, and include nasal congestion, scratchy throat, runny nose, and sneezing. Coughing, sore throat, and decreased appetite are also symptoms of cold. 



woman dealing with flu, virus at home, concept of how to keep your body healthy during flu season

Getting the flu tends to feel more immediate than cold, COVID, or RSV—according to Dr. Chang, people with the flu feel as if they've been hit by a truck. "Most people who have the flu (influenza) have a mild illness and don't need to see a doctor," says Pritish K. Tosh, MD. Common flu signs and symptoms include:

  • Fever above 100 F (38 C), though not everyone with the flu has a fever
  • A cough or sore throat
  • A runny or stuffy nose
  • Headache
  • Muscle aches
  • Chills
  • Fatigue
  • Nausea, vomiting or diarrhea (most common in children)

"With some rest and self-care measures at home, the average healthy person can expect to get better within a week, although a dry cough may last for several weeks. If you or someone you're caring for is at high risk of flu-related complications and you suspect the flu, call the doctor. For those at high risk of flu-related complications or who have severe flu, there's a greater chance that the flu might lead to pneumonia, bronchitis, sinus infections, and, rarely, hospitalization or death. The flu can also worsen chronic health problems such as asthma and congestive heart failure." 



Curly woman feeling bad and suffering from strong cough while having flu

According to Dr. Chang, people with RSV are less likely to feel the full body ache that usually accompanies flu and COVID-19. Coughing and high-pitched wheezing (especially in children) is a common symptom of RSV. "Of the three viruses, RSV. will tend to have the most mucus in your nose and throat and the most congestion," Dr. Chang says. As with any virus, don't hesitate to see a doctor if need be. "What we are seeing is record levels of RSV in young children. Usually, we see a spike in December or January, but it's earlier this year," says Scott Roberts, MD, a Yale Medicine infectious diseases specialist. "Right now, the problem really is just the volume of sick children. Kids can get quite sick from it, but we know how to help them. Children are admitted to the hospital for extra oxygen or other supportive measures such as positive pressure to help with breathing and keep the lungs open." "And if you or your child is sick, stay away from others until you are improving and fever-free," says Yale Medicine pediatric infectious diseases physician Thomas Murray, MD, PhD. "And if you have a baby, especially a newborn, be very careful about who visits in their first couple months of life. You only want people who are washing their hands and have no symptoms to be near the baby."



Young woman touching painful neck, sore throat for flu, cold and infection.

Strep A cases have been spiking across Europe and parts of the US, causing serious concern. "Group A strep have always been a very important pathogen that can cause very serious illness," says Dr. Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau Hospital in Long Island, New York. "It is a great concern that we are seeing an increase in serious cases across many locations."  Strep is a collection of bacteria which can cause a myriad of illnesses depending on the strain. According to the CDC signs of strep A are a sudden sore throat, pain when swallowing, fever, red and swollen tonsils, sometimes with white patches or streaks of pus, tiny, red spots on the roof of the mouth (petechiae on the soft or hard palate), and swollen lymph nodes in the front of the neck. If there is a rash, it's known as scarlet fever. Headache, stomach pain, nausea, and vomiting are also symptoms of strep A, especially in children. "Group A strep infection is presented in a few different ways, including severe pneumonia, sepsis, where the bacteria are in the bloodstream, toxic shock, severe skin infections and infections and other parts of the body where it normally shouldn't be like the bones and the joints," said Dr. Sam Dominguez with Children's Hospital Colorado. "If someone is having difficulty breathing. If they're more sleepy or difficult to arouse, if they're not eating or drinking like they were before, if they're not walking anymore. Those are all warning signs that they should be taken probably to the emergency room."



senior man with winter seasonal illness fever cold problems

A loss of taste and smell is more commonly associated with COVID than with flu, cold, or RSV. BQ.1 and BQ.1.1 are now causing 70% of cases in the US, according to the CDC. The most common symptoms being reported are a sore throat, runny or congested nose, sneezing, dry cough, and headache—all of which overlap with cold and flu. At the end of the day, the only way to know for sure is to get tested. "I don't think anybody would ever go, 'Hey, listen, I think you have a virus based on your symptoms,' and feel confident to say what virus that is," says Dr. Frank Esper, a pediatric infectious disease specialist at Cleveland Clinic. "For both flu and for COVID, we have antivirals that work if taken early after signs of symptoms," says Dr. Andrew Pekosz, a virologist and professor at Johns Hopkins Bloomberg School of Public Health. "So particularly if you're in a high-risk group, it's good to know that. … Those are important tools that we really have to keep using."


How to Stay Safe Out There

Nurse with face mask sitting at home with senior woman and injecting covid 19 vaccine.

Follow the public health fundamentals and help end this pandemic, no matter where you live—get vaccinated or boosted ASAP; if you live in an area with low vaccination rates, wear an N95 face mask, don't travel, social distance, avoid large crowds, don't go indoors with people you're not sheltering with (especially in bars), practice good hand hygiene, and to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

Ferozan Mast
Ferozan Mast is a science, health and wellness writer with a passion for making science and research-backed information accessible to a general audience. Read more about Ferozan