Covid-19 cases in children on rise; watch out for these signs and symptoms, preventive measures

Experts say that many kids are suffering from high grade fever, persistent cough and diarrhoea as the Covid cases across the country are on rise.

Covid-19 cases in children have been on rise in the past few days in kids under 15 years of age and while the symptoms are mostly mild in the little ones, experts have warned parents to take Covid-appropriate measures for preventing spread. Considering kids are vulnerable to viral infections and diseases like RSV (Respiratory Syncytial Virus), flu, adenovirus and Covid are on rise, it's imperative to get them vaccinated if eligible, promote regular handwashing, and wearing masks (kids over 5 years). Children who have cough, cold, stomach flu and other flu-like symptoms should not be sent to school and get tested for Covid. Experts say one should not take the current surge in Covid cases lightly. Especially when it comes to high-risk children who have any kind of health complication like diabetes, asthma, heart disease among other issues, symptoms should be monitored closely. (Also read: All about XBB.1.16, new Omicron variant behind India's Covid-19 spike, from symptoms to risk factors)

Signs of Covid in kids

"In the past few days there have been reports of children less than 15 years getting infected with Covid. The cases though are mild and not very severe. The symptoms to watch out among kids remain same as we have seen in recent times which primarily include high fever, coughing, head and body ache, fatigue, runny nose to name a few which are very similar to other flu and adenovirus symptoms. In adenovirus though, other symptoms like redness of eyes, conjunctivitis and watery eyes can be seen through which we can differentiate between the two, says Dr. Kuldeep Kumar Grover, Head of critical care & Pulmonology - CK Birla Hospital, Gurgaon.

"Covid is a viral infection and like many other viruses, it has been around for some time. Symptoms of Covid like any other viral infection will be fever, cold, a bit of cough, stomach flu, diarrhoea, conjunctivitis, body pain etc. In adenovirus we see a little more conjunctivitis, swollen lymph nodes - these are just like tonsils that we have outside body also, lympth nodes are the tissue collections that can get swollen or painful just at the back of the neck or under the chin area. Other thing with Covid is that the symptoms are more gradual. The fever comes in gradually and may rise later on. In common flu, the symptom onset is usually very dramatic with sudden muscle ache, fatigue and high-grade fever. So, there's no real one sign that can help differentiate between Covid and other viruses," says Dr Poonam Sidana, Director Neonatology and Pediatrics, C K Birla Hospital Delhi.

"For the past one month, there has been a rapid rise in OPD footfalls of children who are suffering from symptoms like sore throat, cold, cough, diarrhoea, vomiting, abdominal pain and the fever which is high grade, reaching up to 103 degree or more. The cough is quite severe in these cases and in some cases even lasting for more than 3 weeks. Considering the symptoms of Covid, adenovirus, and RSV are similar, it's difficult for parents to distinguish between the two. While fever, cough, cold, abdominal issues, vomiting are more common in Covid and other viral illnesses that are spreading nowadays, red eyes, sticky eyes and conjunctivitis is more common in case of adenovirus," says Dr Somalika Pal, Senior Consultant, Department of Neonatology and Paediatrics, Cloudnine Group of Hospitals, New Delhi (East of Kailash)

Covid-19 Vs Adeonovirus: Difference between symptoms

"Flu viruses such as SARS CoV-2 and Influenza virus, predominantly causes respiratory tract illness, while Adenovirus, a DNA virus, causes a variety of illness in addition to respiratory tract infections, such as conjunctivitis, ear infections, gastroenteritis, hepatitis, myocarditis, meningoencephalitis etc. The symptoms are usually fever, sore throat, running nose, cough, body ache, fatigue, shortness of breath, diarrhoea etc. In most cases, it is difficult to differentiate these based on symptoms alone," says Dr Rohit Kumar Garg, Consultant, Department of Infectious Diseases at Amrita Hospital, Faridabad.

"All respiratory viruses have common symptoms. Flu can cause small symptoms like sore throat, cough, low grade fever, mild body ache and headache, tiredness etc. This usually lasts for 2-3 days and usually children become fine. Whereas in covid, a patient can be asymptomatic or show mild symptoms like mild fever, runny-stuffy nose, dry cough, slight body ache-myalgia, mild gastrointestinal symptoms, abdominal issues. Whereas adenovirus infections have similar symptoms like flu but can also cause pink eyes- conjunctivitis, ear infections, swollen lymph nodes, gastrointestinal symptoms. If it becomes severe, it can cause bronchitis, pneumonia and can affect the nervous system, GI system severely and even cause meningitis and encephalitis, says Dr Vikas Maurya - Director and HOD - Pulmonology, Fortis Hospital Shalimar Bagh

Signs of severe Covid in kids

"Parents must be watchful of symptoms and if high-grade fever is lasting for beyond 5 days or the cough is worsening, if the kid is lethargic, unable to feed, finding it difficult to breath, diarrhoea is worsening or the lips are seen parched or peeled, it's a sign that your child may need hospital care," says Dr Pal.

"Some patients may develop severe illness, such as pneumonia. Symptoms like persistent fever, severe cough, shortness of breath, low oxygen saturation, troubled, fast, noisy breathing, may help to suspect severe illness," says Dr Garg.

Preventive measures for kids

"It is still critical for the kids and most importantly their parents to remain vigilant and protect themselves and their kids by teaching them to follow the Covid preventive measures in schools and nearby areas where they play with other kids like regular masking, self-hygiene and washing their hands and face frequently after coming from outside, sanitizing themselves properly at regular intervals. Also, parents are advised to undergo the RT-PCR test in case they see any symptoms as a precautionary step, says Dr Grover.

"Any child having fever, cough, cold, as a general principal should not be sent to school and get tested. Sports and other activities where kids are in close contact should be avoided in schools. Frequent handwashing, not touching nose or mouth is important. Kids over 5 years should be wearing masks and overcrowding in social gatherings and outings must be avoided," says Dr Sidana.

“It gets very difficult to send the children to school, as it becomes to control the spread as they would play and mix up with other students. The precautions the school must take is to send the children back home and ask them to stay there till they recover and get proper treatment, who shows symptoms like respiratory problems. Asking children to wear masks also becomes an important requirement for the school authorities to make it possible, and sensitizing them around this topic like asking them to follow a proper healthy diet, asking them to follow hygiene like washing hands regularly and not frequently mixing up with the students who show symptoms. These small precautions must be taken by students and the school authorities as well to minimize the spread of infection,” says Dr Maurya.

Why Covid cases have been on rise in India

Dr. Pavithra Venkatagopalan, Coronavirologist and Covid Awareness Specialist, Rotary Club of Madras NextGen sheds light on why the number of Covid cases have been on rise for a couple of weeks in India.

"The number of cases of coronavirus has increased in the last few weeks in India. We have to first look at if the number of tests has increased. We are a country that is quite crowded giving a lot of infections a good environment to breed. Nowadays, a lot of respiratory infections are going on and some of them are taking a long time to heal, people are suffering for a longer time. Typically, this has been the flu but doctors will diagnose you when you are going through a severe respiratory infection, and they will have you test for known respiratory infections which are flu and cold.

While the XBB 1.16 has a change in the spike that allows it to infect people easily, it does not have a direct impact on the number of hospitalisations," says Dr Pavithra.

Need for booster campaign

"It is also time for us to start with a booster campaign for Covid. It has to become like an annual booster that we all should be taking once a year. These thing matter, especially to people who are more vulnerable than the average population. Young children from 12-13 years onwards have been vaccinated, schools have had vaccination campaigns, most adults have had two doses, some have had one booster shot and some even had two booster shots. We have to work on the enthusiasm of people to get the annual vaccines as they become available so that the number of people carrying the infection will be reduced. This will help protect people whose immune systems are weaker like people with comorbidities, immuno-supressed people, people who have had transplants, women who are pregnant, and the population that can’t be vaccinated just yet. We have to bring that campaign back and increase awareness around vaccinations so that the number of people that can transmit the particles are reduced and thereby reducing the number of infections and severe cases," adds Dr Pavithra.

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