“What does RSV cough sound like in toddlers?”
I have a 2 year old toddler. I want to know what does RSV cough sound like in toddlers?
4 Answers
RSV cough does not necessarily have a characteristic sound, but there are other physical signs that can help with the diagnosis such as a coarse wheeze or rapid breathing. With that said, due to mitigation strategies put in place to reduce covid, RSV was pretty much non-existent this year.
The cough can vary from a productive cough to a dry, barky cough. May or may not have fever. The bad cases have respiratory distress.
Hello,
Thank you for your question, "What does RSV cough sound like in toddlers?"
A study in the European Journal of Pediatrics, "*Typical RSV cough: myth or reality? A diagnostic accuracy study*" from January, 2021, doi:10.1007/s00431-020-03709-1, found that Senior physician staff and aediatric nurses performed better than various bedside tests in diagnosing RSV by the sound of cough, but were not better that antigen tests by nasal swab. Pediatric residents in training needed at least 3.5 years of work experience to be able to make an RSV diagnosis based on cough sound. Even so, the residents were only 66% correct, and that's with training. None could validly distinguish RSV from other germs based on cough sounds. So, there is no reason to expect a parent to reliably identify RSV as a cause of cough in a toddler.
More important than the sound of cough, in my opinion, except for an inspiratory whoop that could represent Pertussis or whooping cough, is the effort of breathing associated with a cough. Cough is God's gift to mankind to prevent choking on respiratory mucus associated with illness. No cough, no clearance of mucus with resulting "drowning" on one's own mucus. The cough in itself is not dangerous. It's the effort of breathing with cough-associated illness that's important to recognize whether the cause is RSV, another virus, bacterial pneumonia or asthma. You will find this of interest:
https://www.healthychildren.org/English/tips-tools/symptom-checker/Pages/symptomviewer.aspx?symptom=Cough
Since a comfortable cough can be therapeutic in RSV or other viral illness by clearing mucus, let's discuss comfortable cough. In my mind, comfortable cough is painless, doesn't interrupt sleep, and is not associated with out-of-breathness, breathlessness, or windedness. Cough is a normal part of a cold and viral bronchitis, usually peaks in intensity by the 5-6th day, and diminishes over the next two weeks. An uncomplicated cold or bronchitis with cough usually lasts less than a month, often 2-3 weeks. Coughs that don't meet this pattern should be discussed with one's doctor. So, my recommendation is don't make decisions about the cause of a cough based on sound, but rather based on your toddler's total comfort, ability to rest and sleep, duration of illness and comfort breathing.
You might not remember that we can immunize against a number of causes of cough in a toddler: Influenza, Pertussis (whooping cough), Measles, Diphtheria, some bacterial pneumonias, and soon we should be able to include COVID-19. All these vaccines as well as the other routine childhood vaccines are very important. Of course, you can call your doctor if you are anxious or uncertain about these issues. I do recommend using the search window on www.healthychildren.org, the Academy of Pediatrics Family Web Site for more useful information.
Regards,
Dr. T
Thank you for your question, "What does RSV cough sound like in toddlers?"
A study in the European Journal of Pediatrics, "*Typical RSV cough: myth or reality? A diagnostic accuracy study*" from January, 2021, doi:10.1007/s00431-020-03709-1, found that Senior physician staff and aediatric nurses performed better than various bedside tests in diagnosing RSV by the sound of cough, but were not better that antigen tests by nasal swab. Pediatric residents in training needed at least 3.5 years of work experience to be able to make an RSV diagnosis based on cough sound. Even so, the residents were only 66% correct, and that's with training. None could validly distinguish RSV from other germs based on cough sounds. So, there is no reason to expect a parent to reliably identify RSV as a cause of cough in a toddler.
More important than the sound of cough, in my opinion, except for an inspiratory whoop that could represent Pertussis or whooping cough, is the effort of breathing associated with a cough. Cough is God's gift to mankind to prevent choking on respiratory mucus associated with illness. No cough, no clearance of mucus with resulting "drowning" on one's own mucus. The cough in itself is not dangerous. It's the effort of breathing with cough-associated illness that's important to recognize whether the cause is RSV, another virus, bacterial pneumonia or asthma. You will find this of interest:
https://www.healthychildren.org/English/tips-tools/symptom-checker/Pages/symptomviewer.aspx?symptom=Cough
Since a comfortable cough can be therapeutic in RSV or other viral illness by clearing mucus, let's discuss comfortable cough. In my mind, comfortable cough is painless, doesn't interrupt sleep, and is not associated with out-of-breathness, breathlessness, or windedness. Cough is a normal part of a cold and viral bronchitis, usually peaks in intensity by the 5-6th day, and diminishes over the next two weeks. An uncomplicated cold or bronchitis with cough usually lasts less than a month, often 2-3 weeks. Coughs that don't meet this pattern should be discussed with one's doctor. So, my recommendation is don't make decisions about the cause of a cough based on sound, but rather based on your toddler's total comfort, ability to rest and sleep, duration of illness and comfort breathing.
You might not remember that we can immunize against a number of causes of cough in a toddler: Influenza, Pertussis (whooping cough), Measles, Diphtheria, some bacterial pneumonias, and soon we should be able to include COVID-19. All these vaccines as well as the other routine childhood vaccines are very important. Of course, you can call your doctor if you are anxious or uncertain about these issues. I do recommend using the search window on www.healthychildren.org, the Academy of Pediatrics Family Web Site for more useful information.
Regards,
Dr. T
Can be a wet cough, a dry cough, or a "barking" cough. Should be checked by pediatrician to assess for airway potency
