What should you know about croup and RSV?

Croup mainly causes swelling around the upper airway, producing a barking cough, hoarseness and a harsh sound when breathing in. RSV commonly begins with cold symptoms and may move into the smaller airways, where wheezing, fast breathing or feeding difficulty can develop. A child may have either illness, both features, or another infection; symptoms alone cannot confirm the virus.

Fever and cough can accompany both conditions. Infants, premature babies and children with heart or lung problems may need closer observation because breathing and feeding can deteriorate quickly.

Keep the child settled, offer small frequent drinks and clear nasal mucus gently if congestion interferes with feeding. Keep smoke and strong scents away. Do not use antibiotics unless prescribed for a confirmed bacterial problem, because they do not treat viral infections. A clinician may recommend a steroid for croup or other support after examining the child.

A child health consultation is useful when the diagnosis is uncertain or the child is feeding less. Nebuliser treatment may be considered in a clinical setting for selected breathing problems, but home steam exposure can burn and should be avoided.

Get urgent help for noisy breathing at rest, ribs sucking in, pauses in breathing, blue or grey colour, marked drowsiness, inability to drink or much less urine. Emergency care is needed for severe struggle to breathe or reduced responsiveness. Arrange prompt medical review when an infant is worsening, feeds poorly, or develops persistent fever or a cough that is becoming more difficult.

Ask whether the pattern fits upper-airway croup, lower-airway illness or another cause; how to count wet nappies or assess drinking; and which signs mean you should return. Ask whether testing would change management and how to protect other household members.