What's Going Around?

Allergies

Seasonal allergies, or hayfever, are very common at this time of year. Typical symptoms include watery, itchy, red eyes; a clear runny nose; sneezing; and an itchy palate or throat. The most common triggers are trees in the spring, grasses in the spring and early summer, and weeds in the fall!

Effective non-sedating medications are available for children over the age of 2 without a prescription for treatment of seasonal allergies. These include loratadine (generic Claritin), cetirizine (generic Zyrtec), and fexofenadine (generic Allegra). These medications can be given as needed for allergy symptoms. If you think your child has seasonal allergies and he or she is not responding to medication OR if you are not sure, please make an appointment in our office.

Many children do not require allergy testing if they respond to treatment with medication as needed.

Bronchiolitis (RSV and wheezing in infants)

Bronchiolitis is a viral infection of the lungs, which affects primarily infants and toddlers. Some or all of the following symptoms are present with bronchiolitis.

  1. Wheezing: a high-pitched whistling noise when your child breathes out. You may actually hear this yourself, or a physician may hear wheezing when she listens to your child.
  2. Rapid breathing: at a rate of 40 breaths per minute or faster.
  3. Hard or Labored breathing: You may notice that your child looks like he is pulling in around the rib cage, or the ribs are visible with breathing. Also, look for abdominal breathing, where the belly is going in and out with each breath.
  4. Cough: a very prominent component of bronchiolitis. The cough is usually frequent, tight, and productive of mucous.
  5. Fever: may or may not be present, and may be as high as 104-105 degrees.
  6. Runny nose and congestion: is usually present, and usually there is A LOT of nasal drainage.

Cause

Bronchiolitis is caused by a narrowing and congestion of the smallest airways in the lung (the bronchioles). It is a viral infection, and there is no medication or antibiotic that will treat the virus itself. Any respiratory virus can cause bronchiolitis, but the Respiratory Syncytial Virus (RSV) is the most common cause. Older children and adults can catch RSV, but their symptoms are usually mild, like a common cold. It is spread by coughing or sneezing at a range of six feet or less, or by hand-to-nose or hand-to-eye contact. People do not develop permanent immunity to the virus, which means they can be infected more than once. Subsequent infections are usually less severe. People often confuse bronchitis with bronchiolitis. They are not the same thing. Adults may be treated with antibiotics for bronchitis. Bronchiolitis does not respond to antibiotics.

Expected Course

Bronchiolitis usually starts with a runny nose and congestion. Within 2-3 days, the patient starts coughing, wheezing, and potentially breathing hard. The wheezing and tight breathing usually become worse over 2-3 days and then begin to improve. Overall, the wheeze may last up to 7 days, and the cough up to two weeks. The most common complication (which occurs in about 20% of infants) is an ear infection. A lesser complication (which occurs in about 1-2% of children) is bacterial pneumonia. Fever usually comes at the beginning of the infection. If your child develops a new fever over 100.4 for more than 24 hours later in the course of the illness, it may signify a secondary infection, and your child should be seen.

Home Treatment

  1. Your child can be given Tylenol every 4-6 hours, or Motrin every 6-8 hours as needed for fever or comfort.
  2. Warm fluids for coughing spasms - Thick sticky secretions in the back of the throat can cause coughing spasms. Warm liquids relax the airway and loosen the secretions. Offer warm juice if your child is over 4 months old. Infants less than 4 months can have warmed Pedialyte or Infalyte.
  3. Humidity- Since dry air may make a cough worse, running a cool mist humidifier in your child's room may help.
  4. Suctioning the nose- With a congested nose your child may not be able to drink. Since most stuffy noses are blocked by dry secretions, suctioning may not be enough. Saline nasal drops or warm tap water will help loosen the mucous. Place 2-3 drops of saline in each nostril, wait about one minute, then bulb suction out. You can occlude the other nostril to get better suction. You can repeat this several times until breathing through the nose becomes more comfortable. Avoid over-suctioning, which may produce swelling or bleeding in the nasal passageway. You can also try putting your child in a very steamy bathroom to facilitate nasal drainage.
  5. Feeding- Encourage your child to drink plenty of fluids. You may have to offer smaller, more frequent feedings.
  6. DON'T SMOKE!Tobacco smoke aggravates coughing. Do not let anyone smoke around your child or in your home. Unfortunately, even an adult who smokes outside and then comes into a home exposes a child to a large amount of pollutants that are very aggravating to the lungs of infants of children.

Call our office if:

  1. Breathing becomes labored or difficult. A good clue that your child is getting into trouble with his breathing is if he seems to be too tired from his breathing to drink fluids or play.
  2. Breathing becomes faster than 60 breaths per minute (when NOT crying).
  3. Wheezing becomes severe (very tight).
  4. If fever lasts more than 3 days.
  5. New signs or symptoms develop to indicate an ear infection (irritability, restless sleep, new fever, etc.)
  6. Any additional questions or concerns.

Cough

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.

For more information: Previous diagnosis of asthma, see Asthma Attack , If you are coughing because of an Asthma Attack, see Asthma Attack , Any Chest Pain , If you have a Common Cold, see Colds , See also Colds , See also Cough , Barky cough and hoarseness, see Croup , If Earache is your main concern, see Earache , Wheezing but no previous diagnosis of asthma, see Wheezing (Other Than Asthma)


Croup

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.

For more information: See also Cough , It doesn't sound like croup, see Cough , See also Croup , Tight purring sound when breathing out, see Wheezing (Other Than Asthma)


Enterovirus

We are currently seeing children and adolescents with infections caused by the enteroviruses, a group of viruses that often cause illness during the summer and the early fall months. The commonly used term "enterovirus" includes the coxsackie viruses, the echoviruses, and the enteroviruses. These viruses often cause a fever, and also may cause a rash, respiratory or cold symptoms, and vomiting with diarrhea. Hand-foot-mouth disease, a rash that involves those areas of the body, is a common enteroviral infection that occurs in children. More serious illnesses that are caused by these viruses include meningitis, heart infections, and eye infections. For mild illnesses caused by the enteroviruses, the best treatment is adequate rest, plenty of fluids, and fever control.

Enterovirus D68 (EV-D68)

Enteroviruses frequently cause mild illness in the summer and fall. This year, Enterovirus D68 (EV-D68), is a unique virus that shares features with the common cold viruses. Most infections are mild and self-limited and will last 5 to 7 days.Asmallgroup of children and adolescents, expecially those with asthma, are experiencing more severe respiratory symptoms with wheezing and shortness of breath. Note: for most cases, a test for EV-68 is not required because it will not affect the course of the illness.

No vaccines are available for EV-68 and there are not any antiviral medications that treat this virus.

If your child has a history of asthma:

  • Continue with your child's current asthma treatments
  • Make sure your son/daughter has his/her inhaler and other asthma medications at all times
  • If your child usually uses a controller medication (e.g an inhaled steroid) during the winter season or with colds, consider the possibility of starting the controller medication now.
  • Make sure your child's teacher or caregiver knows of your child's asthma

Call 911 ifyour child has severe symptoms:

  • Having serious trouble breathing (e.g. chest retracts or lips and/or fingers turn blue)
  • is unresponsive or difficult to arouse
  • Has slurred speech, paralysis, or severe headache

Make an appointment or call us if:

  • Your child's cold seems severe and/or he/she is uncomfortable with their breathing
  • Your child can't sleep due to the respiratory symptoms
  • Your child has ear pain or other significant pain that is not relieved with pain medication

Home Treatment

  • Frequent fluids, rest and fever management.
  • Frequent hand washing...cover your mouth when coughing
  • Avoid kissing, hugging and sharing drinks with people who are sick.
  • Disinfect surfaces in your house such as countertops and toys.


Hand-Foot-Mouth Disease

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.

For more information: See also Mouth Ulcers , See also Rash or Redness - Widespread


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.

Treatment

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.

For more information: See also Cough


Pink Eye

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.

For more information: See also Eye - Pus or Discharge


Strep Throat

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.

For more information: See also Sore Throat , See also Strep Throat Exposure


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.

For more information: See also Sinus Pain or Congestion


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, Pedialyte, or warm soda pop 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.

For more information: See also Diarrhea , See also Vomiting Without Diarrhea

Location

2007 95th Street
Lower Level, Suite A
Naperville, IL 60564
Phone: 630-848-1700
Fax: 630-848-1718

 
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