Tis the Season - Winter Concerns

Most of the common infections of wintertime are spread when respiratory secretions come into contact with mucous membranes of the mouth, nose and eyes. Frequent hand washing is the most important method of decreasing and avoiding the spread of illness. Discourage your child from rubbing their eyes, chewing on their fingers, and picking their nose. Minimize contact with other sick children, to whatever extent is possible.

Another defense against infection is good nutrition. Trying to get your children to eat a healthy balanced diet with a variety of fresh fruits and vegetables will help the body's natural defenses. Ensuring your children get an adequate night's sleep will also aid the body's defenses.

Common Winter Illnesses

Croup
Croup is usually caused by a virus that creates swelling in the upper respiratory tract around the vocal cords. It usually is accompanied by cold symptoms and possibly fever. It causes laryngitis and a tight cough that sounds like a seal's bark. When croup becomes worse, it can often cause a crowing noise (stridor) when your child breathes in. Often the illness appears suddenly, in the middle of the night. It can last 5 to 6 days, and can change from mild to severe many times. Cool moist air often helps the symptoms, so run the cool mist humidifier all night. In serious cases, where the child has stridor at rest, (a crowing noise when sitting quietly in your lap) run a hot shower with the bathroom door closed. Once the room is steamy, sit in there with the child on your lap. You can also try going outside as the cold night air often helps. While there is not a cure for croup, anti-inflammatory agents, such as prednisone, can help alleviate the symptoms and shorten the course and is used in severe cases. Please refer to the Don't Panic Packet for when to call our office.

Influenza (" the flu")
Influenza is a viral illness that affects the respiratory tract (nose, throat, trachea and lungs. It is not an intestinal illness, as in stomach flu as many people mistakenly think. Influenza usually hits the Rochester area as early as late December and lasts until about March. The main symptoms are sudden onset of fever, (101-105), headache, muscle aches, runny nose, sore throat and a nagging, long lasting cough. Since there are so many types of influenza virus, with different ones appearing each year, it is possible to get the flu every year. Getting an annual flu vaccine may help prevent your child from getting the flu. The vaccine should be given to most children with asthma, cystic fibrosis and other lung disease, heart disease, diabetes and other chronic illness.

Treatment is primarily focused on the symptoms. For fever or discomfort, use acetaminophen (Tylenol) only. Avoid the use of ibuprofen (Advil, Motrin) or aspirin for flu symptoms due to the risk of a serious illness, Reye's Syndrome. See Fever in the Don't Panic Packet for proper dose.

The cough associated with influenza often lasts for 2 weeks. See Cough section for more information.

Strept Throat
Strept throat is an infection of the tonsils (tonsillitis) and throat (pharyngitis) caused by the Streptococcus bacteria. It is usually characterized by a sore throat, and fever, but can present with headache, abdominal pain, or vomiting. Although strept throat may have a typical appearance of white pus on the tonsils, a throat culture is necessary to determine if it is strept throat, since some viruses are able to mimic strept throat in appearance and symptoms. Viral sore throats never respond to antibiotics. However, Strept throat should be treated with antibiotics to prevent complications

Pneumonia
Pneumonia is a lower respiratory tract infection affecting the lungs. Pneumonia can be caused by either bacteria or viruses, and can occur as a secondary infection of a cold or the flu. It usually has a cough and fever, but can also present with chest pain, shoulder pain, back pain, abdominal pain or vomiting. Whenever a cold or flu suddenly gets worse, or fever at the end of the illness, you should see your doctor. Your health care provider can usually hear pneumonia on exam with a stethoscope. "Gurgling" breath sounds that are heard without a stethoscope or by feeling the chest are not usually caused by pneumonia. Sometimes your pediatrician or nurse practitioner my recommend a chest x-ray, based on the child's symptoms. Most pneumonia can be treated with oral antibiotics. If your child is having trouble breathing, has low oxygen saturation, or is vomiting, and unable to keep the medicine down, you may need to take your child to the hospital. Nebulization therapy (breathing treatments) may be used to help dilate the small airways of the lung to relieve mucus trapping.

Upper Respiratory Infections (URI) "colds"
The most common respiratory infection of winter is a cold. A two year old may have as many as 8 colds a year. They are characterized by nasal congestion, or runny nose, cough, sore throat, mild headaches, and an initial low fever (100 – 102). Most colds last between 1 to 2 weeks. Colds are caused by viruses. Antibiotics or cold medications will not stop or cure a cold.

Treatment is aimed at the symptoms to make your child feel more comfortable. Vaporizers or cool mist humidifier are helpful for breathing problems and congestion. Elevate the head of your child's bed to make breathing easier during sleep.

For a runny nose with lots of clear discharge the best treatment is blowing the nose for a day or two. Cough and cold preparations should be avoided under six years of age, and should only be continued if they improve the child's level of comfort. Remember that cold medicines will not cure or shorten the length of a cold. If used, these medications should be used based on the symptoms you wish to relieve. That is, a decongestant for relief of a very runny nose, or a cough suppressant for relief of persistent coughing. Colds can sometimes lead to secondary infections such as ear infections, sinus infections, and less commonly, pneumonia. Signs that your child maybe developing a secondary infection include the presence of ear pain, severe facial pain or headache, sudden worsening of the cough, or a fever that begins late in the course of a cold.