Most Common Symptoms Of COVID Variant XBB In Kids

You’ve likely heard talk in the news about XBB1.5, an omicron variant that has become a dominant strain of the COVID-19 virus in the U.S. According to the latest data from the Centers for Disease Control and Prevention, XBB1.5 accounted for 27.6% of overall infections in the first week of January, inching closer to overtaking BQ.1.1 as the most common variant. In the northeastern region of the U.S., XBB1.5 has already become the dominant strain of the virus.

While for the most part this omicron variant is similar to previous ones, there are a few things to know about XBB1.5, especially if you believe that it may have hit your household.

Experts agree that symptoms tend to be the same as those we’ve seen before.

“I have not seen any evidence to suggest the main symptoms of XBB variant are different from previous variants,” Dr. Ruth Kanthula, a pediatric infectious diseases specialist at MedStar Health, told HuffPost.

Common symptoms in children can include:

• Fever
• Fatigue
• Achiness
• Sore throat
• Cough
• Nasal congestion or runny nose
• Headache
• Lost sense of smell or taste
• Shortness of breath or difficulty breathing
• GI symptoms such as nausea, vomiting and diarrhea

“It’s hard to tell about loss of taste and smell in young kids,” said Dr. Tanya Altman, a pediatrician and author of Baby and Toddler Basics. Altman says she has noticed that kids tend to be less interested in eating while they are sick, and ask for “more flavorful or spicy foods after they recover, which to me suggests their taste may not have fully recovered yet.”

Altman described the majority of COVID infections that she is seeing now as mild ― with kids having less serious symptoms than adults, such as shortness of breath. She added that children seem to be recovering quickly after testing positive.

“This could be due to the fact that most of the population has some sort of immunity from previous infections or vaccines, or the virus is now weaker, and I think it’s likely a combination of both,” she continued.

It’s important to note, however, that a child can have two respiratory viruses at the same time, which may cause their symptoms to be more severe. Other viruses in heavy circulation right now include RSV and the flu, which some have dubbed, along with COVID-19, the “tripledemic.”

The “main difference that has been observed with XBB variant compared to other COVID-19 variants is that XBB variant spreads quickly,” said Kanthula.

Because the XBB1.5 variant has quickly come to account for a large portion of infections, scientists think that it may be more highly transmissible than other variants.

“The XBB.1.5 variant has a mutation virologists believe is helping the virus better bind to cells and thus be more transmissible,” Johns Hopkins professor of molecular microbiology and immunology Andy Pekosz explained in a Q&A on the university’s website.

Practically, this means that the virus could infect many members of a household, or a school classroom, in a short amount of time.

In addition to being more highly transmissible, XBB1.5 also seems to be “immune-evasive,” according to Pekosz, meaning that there may be a lot of breakthrough infections in people who have previously had COVID, are immunized, or both.

If your child has any of the symptoms listed above, it makes sense to give them a COVID-19 test, which you can do at home or at your pediatrician’s office. Note that these tests will only tell you whether your child is positive for COVID-19, not which viral strain they have. Genetic testing to identify variants is done by other agencies and reported to the CDC.

Treat your child’s symptoms just as you would any other respiratory virus, with rest, fluids and acetaminophen/ibuprofen for fever or aches. As always, said Altman, “if your child has a fever for more than four days, isn’t keeping fluids down, has trouble breathing or looks really sick, call your pediatrician.”

For infants under 3 months, you should contact your pediatrician if they have a fever of 100.4 or higher or miss two feeds, as young infants can become very sick with different respiratory viruses.

The CDC guidance has not been updated, so the recommendation is for people who test positive for COVID-19 to quarantine for five days. Kids who have been fever-free without fever-reducing medication for 24 hours at the end of five days and aren’t exhibiting other symptoms can then return to school, where it is recommended that they continue to mask until day 10, or until they have two negative antigen tests taken 48 hours apart.

Note that the first day your child has symptoms or tests positive counts as Day 0, not Day 1 — so they may actually be home from school for six days instead of five. You’ll need to consult your school nurse or administration with any questions about your school’s quarantine policy.

While it’s frustrating to have to keep your child home from school, particularly if they’re not feeling ill, “COVID is one that you really don’t want to spread to others, especially those who are high risk, so please keep your kids home when sick, mask if you need to leave your house with sick kids and keep them away from others as much as possible,” said Altman.

The general treatments are simply rest, fluids and fever-reducing medication. If a child is hospitalized, other medications may be given to them by doctors. Remdesivir is an IV antiviral that doctors may give to children who are in the hospital. Paxlovid, which many adults take for COVID-19 infection, can be given to hospitalized children who are at least 12 years old and weigh at least 40kg (88 lbs.).

“I think the goal now is to learn to live with COVID, just as we live with flu, RSV and other contagious respiratory illnesses,” said Altman.

Stay home when sick, wash hands, disinfect surfaces, teach kids to cover their faces when they cough or sneeze, and mask when appropriate (such as days six to 10 of a COVID-19 infection.)

Even though XBB1.5 is known to evade immunity, “based on past experience we know that vaccination can protect against developing severe disease,” said Kanthula, so you should make sure your children have been vaccinated and had boosters.

Altman said she believes that the hybrid immunity of three doses of vaccination and one illness seems to offer the most protection against reinfection.

Altman noted that some schools are still requiring students to stay at home for 10 days after a positive COVID-19 test, and mentioned stories about college students deciding not to test for fear of missing classes.

“I would like to find a way for all kids to return to school and adults to return to work once fever resolved and symptoms improving, even if it means masking for an additional three days. I think this would help decrease spread of all illnesses, not only COVID,” she said.