Bronchiolitis (and RSV)
We are currently seeing cases of bronchiolitis, a viral illness (sometimes caused by RSV -- "respiratory syncytial virus") that occurs most often in children under age 2. This virus typically occurs in epidemics during the winter and the early spring. "Bronchioles" are the smallest airways in our lungs, and "itis" means these airways are inflamed, or irritated, by the virus. When these airways get inflamed in young children, they often will start to "wheeze," meaning air and the oxygen in it have difficulty getting through these narrowed, swollen airways.
With a case of bronchiolitis, your infant's symptoms may begin with a runny nose, a fever, and a harsh, tight cough. If it progresses to wheezing, your child may start to breathe rapidly and "pull" with his/her abdomen and rib muscles with each breath. Please call us for an appointment if your child's breathing becomes labored or difficult.
If your infant was born premature (under 32 weeks) or has cardiac or lung conditions, and your child is younger than 2 years of age, your child is at a greater risk of complications from RSV bronchiolitis. A product containing a specific antibody to RSV has been approved for monthly administration to help prevent RSV infection in these high-risk children. This form of antibody against RSV has the advantage of being able to be administered once a month by intramuscular injection. In large, controlled studies, this product has been shown to decrease hospitalization from RSV infections in these high-risk infants.
Colds and Upper Respiratory Infections
Colds, upper respiratory infections, and URIs are common terms we use to describe viral illnesses that cause nasal congestion, runny nose, sneezing, sore throat, fever, and cough. The fever usually lasts for 2-3 days, and the cough with congestion and runny nose may last for 5-10 days. The typical preschool-age child may experience 6-10 colds per year. Most colds resolve on their own with rest and fluids, but some may lead to ear infection, sinus infection, asthma attack, or other complications. If you are concerned about the possibility of one of these complications, please have your child seen in our office for an evaluation.
We are currently seeing children and adolescents with cough, typically one of the most prominent and bothersome symptoms of viral respiratory infections at this time of year. Coughing is an important and beneficial reflex that our bodies need to clear secretions and to keep open our major airways during the course of a viral cold or upper respiratory infection. However, severe or persistent cough can be associated with asthma, pneumonia, sinus infections, and bronchiolitis, and should be evaluated by your health care provider.
We are currently seeing cases of croup, a viral respiratory illness that most often is caused by the parainfluenza virus. The cough and breathing that are associated with croup make it distinctly different from other viral colds or respiratory illnesses. This is because the parainfluenza virus infects and irritates the voice box, the vocal cords, and the windpipe. The cough is worse at night, and it has a distinct bark that sounds much like a seal's bark. Associated with the barky cough, your child may have difficulty when inhaling air, making a labored and whistling sound when breathing in -- called stridor. Humidified air and fluids often are the most helpful treatments. Please call the office to have your child evaluated by the doctor if he/she has symptoms of croup.
Hand-foot-mouth disease is a common viral illness caused by the Coxsackie A-16 virus (a member of the enterovirus family). Its name describes the location of the rash during the illness.
Typically children experience fever and small blisters in the mouth in the first few days followed by small blisters on the hands and then feet. Sometimes the rash is seen in the diaper area as well. The mouth blisters can be painful. Ibuprofen or acetaminophen can be given as needed for pain relief. It is important to make sure your child receives plenty of fluids. Cold liquids may provide pain relief as well.
Call our office for an appointment if you think your child may be showing symptoms of dehydration during this illness (urinating less than every 8 hours, dry mouth, or lethargy); if the fever persists after the first 3-4 days; or if you cannot keep the pain under control.
Among the many viruses we see causing respiratory illness right now, the influenza virus (commonly called "the flu") can be particularly severe. Infection with the influenza virus causes sudden onset of a fever, chills, dry cough, and muscle aches. Other symptoms include headache, fatigue, sore throat, and nasal congestion.
Some children are at increased risk of more serious illness from influenza, because of conditions such as diabetes, asthma, immunity problems, or being treated with immune-suppressing medications. They are especially vulnerable to complications, and should get vaccinated as soon as possible. The "Seasonal Flu Shot” that has been administered to many people this year protects against Influenza A, B and H1N1.
Please get a vaccination if you and your child have not yet had it this year!
Mouth Blisters (Herpangina)
Herpangina is an illness caused by a virus, with small blister-like bumps or ulcers in the back of throat or the roof of the mouth. The child may have a high fever with the illness.
Herpangina is a common disease in children and is usually seen in children between the ages of 1 and 4, most often in the summer and fall. Good handwashing is necessary to help prevent the spread of the disease.
Treatment for herpangina is to help decrease the severity of the symptoms. Since it is a viral infection, antibiotics are ineffective. Treatment may include increased fluid intake, and acetaminophen for fever and pain.
If the child is not taking fluids well and there is concern about hydration, you should bring the child in to the office.
Pertussis (Whooping Cough)
We are currently seeing an increase in cases of Pertussis in our community. Pertussis, or whooping cough, is a respiratory illness that begins with mild cold symptoms and progresses to a severe cough. The cough comes in spasms and is sometimes characterized by a high-pitched whooping sound followed by vomiting. Classic pertussis lasts several weeks with some cases lasting 10 weeks or longer. Pertussis is most severe when it occurs in the first 6 months of life, particularly in those who are unimmunized or who are born prematurely. Older siblings and adults with mild symptoms are an important reservoir of infection for young children and infants. Pertussis is diagnosed clinically and confirmed with laboratory tests.
While antibiotics have minimal effect on the course of the illness once the classic whooping cough has begun, they are recommended to limit the spread of the illness. Confirmation of the illness by a medical provider helps guard against the overuse of antibiotics in the setting of a viral illness and subsequent development of organisms that are resistant to antibiotics. Control measures: All household contacts of young infants should receive a pertussis vaccine booster. Others who are unimmunized or under-immunized should complete the recommended schedule of immunizations (see our website for the recommended vaccination schedule). Household contacts and other close contacts of those who have been diagnosed with pertussis should receive prophylactic antibiotic treatment to prevent transmission of the disease. Students and school staff with a confirmed diagnosis of pertussis should be excused from school until they have completed a five day course of antibiotic therapy.
We are currently seeing children and adolescents with "pink eye." Also known as conjunctivitis, this condition can be caused by either a viral or bacterial infection. Viral pink eye typically appears as red and watery eyes, and is accompanied by common viral cold or upper respiratory symptoms. This type of pink eye should resolve itself as the viral cold improves. Bacterial pink eye usually appears as red eyes with yellow or green discharge. Upon awakening, the eyes often are matted shut with dried discharge. This type of pink eye also may be associated with a viral cold, but the bacterial eye infection itself requires antibiotic eye drops to cure. Good handwashing is very important because both viral and bacterial pink eye infections are very contagious.
We are currently seeing quite a bit of strep throat. If your child has a fever, sore throat, headache, or stomachache without any other viral symptoms like congestion or cough, it may be strep throat. Bacteria, called Group A strep, cause this type of sore throat. To diagnose strep throat, your physician will require a swab of your child's throat, and antibiotics will be needed if the strep test is positive.
Upper Respiratory Infection
We are currently seeing children and adolescents with viral upper respiratory infections: severe nasal congestion and secretions, sore throat, occasional vomiting and fever for 2-3 days. These symptoms are followed by a dry, persistent cough that may last for 5-10 days.
Vomiting and Diarrhea
We are currently seeing viral illnesses that cause vomiting and diarrhea. Usually called viral gastroenteritis, the virus causes inflammation and irritation of the stomach and the intestines, leading to vomiting and diarrhea. This illness, often called the "stomach flu", typically lasts 1-2 days, with diarrhea lasting a few days longer.
It is important to make sure that your child does not get dehydrated with this condition. Offer Gatorade or Pedialyte in small amounts every 20 minutes until your child can keep liquids down. If they are unable to keep liquids down, back off for 2 hours, then try the small amounts again. If your child has few wet diapers and does not make tears, or appears limp or lethargic, they may be dehydrated and we will need to see them in our office.