Viral respiratory illness signs and symptoms and severity definitions
Updated October 16, 2024
There is no single sign or symptom of illness that is diagnostic for viral respiratory infections like COVID-19, influenza or other viral respiratory infections. Consider the following symptoms:
- Fever
- Cough (new or worse)
- Shortness of breath
- Extreme fatigue
- Muscle aches (i.e. myalgia)
- Runny nose, stuffy nose (e.g. congestion) or sneezing
- Sore throat or difficulty Swallowing
- Headache
- Nausea and/or vomiting
- Diarrhea
- Loss of sense of smell**
- Loss of sense of taste **
** These symptoms are more specific to COVID-19
See: Helpful information about common respiratory viruses (Tool 31)
Respiratory illness characterized by predominately serious illness
- Illness is more than “a bad cold” in many or most of those affected
- Illness may be remarkable in its suddenness and accompanying extreme fatigue (prostration)
- Affected individuals generally are not up and about while ill
- Eating and drinking are likely to be affected
- There are complications such as pneumonia (viral or secondary bacterial), heart failure or septicaemia in residents or staff for whom pre-existing frailty or underlying chronic illness is not a satisfactory explanation for such complications
- Illness may be prolonged, with cases taking longer than expected to recover
Respiratory illness characterized by predominately mild illness
- Illness is mild and “common cold-like” in most of those affected
- From onset (or within a day or two), activity levels, including eating and drinking, are not markedly different than usual
Note: There may be individual exceptions due to an underlying, pre-existing illness that makes certain individuals very susceptible to complications from any respiratory infection.
Viral respiratory illness follow up definitions
Please note: If two or more organisms are identified (e.g. COVID-19 and influenza), consult Public Health (PH) to determine the appropriate follow up.
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Influenza outbreak |
Two or more confirmed resident cases within seven days on a unit or floor – may vary depending on facility layout and movement of health care workers (HCW)/residents. |
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COVID-19 Enhanced monitoring self-management (*) |
Care community to self-manage one or more resident COVID-19 cases by following measures listed in the COVID-19 enhanced monitoring (EM) checklist – one or more case.
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COVID-19 Enhances monitoring with Public Health support (*) |
In addition to the care community following COVID-19 enhanced monitoring (EM) checklist – one or more case.
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COVID-19 outbreak |
Outbreak declaration is at the discretion of the MHO based on the number of cases identified on a unit, transmission trends, severity of illness and/or operational impacts. |
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Non-Influenza/non-COVID-19 outbreak (e.g., RSV) |
Outbreak declaration is at the discretion of the MHO and is based on the situation reported by the care community to Public Health. Public Health will consider the following criteria for an outbreak declaration:
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(*): In general, management of cases and infection control measures will be at the unit level. There may be units in the care community that are on different measures. As well, depending on the care community layout and movement of staff/residents between units, two or more units may be put on the same measures.
Staff cases - COVID-19 and influenza:
- Are no longer required to be reported daily to public health.
- Facilities are encouraged to use Tool 28 as a line list to track cases and use the staff checklist available (COVID-19), as needed, for situational assessment and preventative/control measures.
- Facilities should be able to provide information (e.g., how many staff are sick with respiratory illness and how many are positive for influenza or COVID-19) if asked by Public Health.