Young children are vulnerable to seasonal illnesses each year, but doctors now are seeing babies, toddlers and preschoolers facing three maladies that produce similar symptoms.

RSV, flu and COVID-19 are all possible diagnoses when a parent brings their tot to the doctor, urgent care or emergency room with a fever, cough, congestion, malaise, dehydration and other symptoms.

Dr. Richard Filiaggi, chairman of pediatrics at Butler Health System, said doctors are seeing an increase in diagnosis of these diseases, but not the increase in serious illness causing hospitalization being reported by the national media.

He said youngsters are being tested for RSV when they would not have in years past, and most are being tested for flu as well.

Filiaggi said he doubts the triple threat has to do with children’ immunities being lowered due to the isolation associated with COVID-19 over the past few years, but feels the three maladies could be intermingling to make more children sick.

“Maybe that’s throwing every immune system a curveball,” he said. “The three viruses known to cause illness are circulating at possibly a higher rate than before.”

Regarding the dire warnings heard in the media on the deadly consequences of RSV, Filiaggi said only premature infants and babies who are former preemies face potentially life-threatening results.

“For example, a 4-year-old who gets RSV, it causes a cough and sickness, but not a life-threatening situation,” he said.

Filiaggi said if a child is sick but not extremely sick, parents can give fever-reducing medicines like Tylenol or ibuprofen, ensure they are getting enough liquids, and are kept comfortable as the illness passes.

“If they are hit hard and fast with symptoms, they should go in (to see a doctor),” he said.

Regarding Butler County’s rate of illness among young children from these diseases, Filiaggi said case numbers remain at about the expected rate at this time of year.

“There are going to be high-risk individuals we’re going to worry more about, but as a population, we’ll get through this,” he said.

Dr. Megan Nash, a Butler Health System family practice physician in Slippery Rock, said the 2022-23 season is shaping up to be a double flu season.

“Typically we see more flu after Christmas, so it is unusual seeing it now and not in January,” Nash said. “We’ve seen tons of flu since after Thanksgiving.”

She said children over 6 months old with significant illness can receive antivirals such as Tamiflu if they are seen by a doctor within 48 hours of the onset of symptoms.

Nash said in about half of patients with the flu, that time limit has been exceeded and the patient is treated with fever-reducing medicines, fluids and rest.

She said UPMC Children’s Hospital in Pittsburgh is overwhelmed with RSV cases.

“There are definitely a lot of respiratory issues overwhelming the hospitals,” Nash said.

She has seen a few infants younger than age 1 coming in the sickest, with symptoms such as difficulty breathing.

She said unlike COVID-19 and the flu, RSV tests must be sent out, and results are not available the same day.

“If a kid isn’t sick enough to be sent to the hospital, I’m probably not going to do that RSV test because it’s not going to change how I treat them,” Nash said.

Her practice sees people of all ages, and about 25% are children.

Of those who came in sick, she sent only one to an emergency room. That patient was sent home from the ER, she said.

Nash has not sent any patients to UPMC Children’s due to respiratory illness.

Liz Williams, Ryan Gloyer Middle School nurse and chairwoman of the Seneca Valley School District nursing department, said Seneca Valley schools have seen an increase in absenteeism at all grade levels.

“We are just returning from a break, so some families may be out for an extended holiday,” Williams said.

She said the schools are seeing more students coming to classes feeling ill or being sent home ill.

To avoid the situation, Williams is asking parents to keep their students at home when they are ill and for 24 hours after a fever is gone without medication, or until they have gone 24 hours without vomiting or experiencing diarrhea.

She also recommends frequent hand-washing, especially before and after eating; maintaining a healthy diet; staying hydrated and getting enough sleep.

Sandy Ihlenfeld, executive director at the Butler Family YMCA, said she is not seeing a greater incidence of illness among children than in years past.

She added that attendance is much better than it was during the coronavirus pandemic.

“There are ebbs and flows, but it’s not any worse,” Ihlenfeld said.

She is also asking parents to keep their children home from swim lessons, day care and other Y activities if they are feeling ill.

“That does kind of help to keep the germs down,” Ihlenfeld said.