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 summer, and weeds in the fall!

Effective non-sedating medications are now available for children over the age of 2 without a prescription for treatment of seasonal allergies. These include loratadine (generic Claritin), Claritin, and Zyrtec. 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.

For more information: See also Eye - Allergy


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, 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.

For more information: See also Wheezing (Other Than Asthma)


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.

For more information: See also Colds , See also Sinus Pain or Congestion


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)

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


SORE THROATS

SORE THROATS
VIRAL AND OTHER CAUSES
  • Colds.Most sore throats are part of a cold. In fact, a sore throat may be the only symptom for the first 24 hours. Then a cough and runny nose occur.
  • Viral Pharyngitis.Some viruses cause a sore throat without other symptoms. A cough and runny nose don't always become part of the illness. An antibiotic won't help.
  • Mono.Infectious Mono mainly occurs in teens and young adults. The main symptoms are sore throat, fever and widespread swollen lymph nodes. Like Strep, Mono also has pus on the tonsils. Patients with Mono also may have a large spleen. It's located in the upper left side of the stomach. Mono is diagnosed with special blood tests.
  • Post-nasal Drip.Drainage from a sinus infection can cause a sore throat. The throat clearing that goes with the drainage may cause most of the irritation. The sinus infection is more likely to be viral than bacterial.
  • Mouth Breathing.Breathing with the mouth open during sleep can cause a sore throat. After eating breakfast, it often goes away.
  • Abscess of Tonsil (Serious).A bacterial infection of the tonsil can spread to the surrounding tissues. The main symptoms are severe trouble swallowing, fever and one-sided throat pain. Often one tonsil is much bigger/more inflamed and more painful than the other. It's also hard to fully open the mouth. The peak age is teens.
  • Epiglottitis (Very Serious).A bacterial infection of the flap of tissue above the vocal cords. It normally covers the windpipe during swallowing. The main symptoms are severe sore throat, drooling, spitting and fever. It can shut off the airway. Needs a 911 response. Fortunately this is rare since introduction of the HIB vaccine (Heamophilus Influnza B).
STREP THROAT
  • Symptoms include sore throat, fever, headache, stomach pain, nausea and vomiting.
  • Cough, hoarseness, red eyes, and runny nose are usually not seen with Strep throat. These symptoms point more to a viral cause.
  • Scarlet fever rash (fine, red, sandpaper-like rash) is highly suggestive of Strep throat.
  • Peak age: 5 to 15 years old. Not common under 2 years old unless sibling has Strep.
  • If you think your child has Strep, call your doctor.
  • Your doctor will do a Strep test. If the test is positive, they will start treatment. There is no risk from waiting until a Strep test can be done.
  • Standard treatment is with antibiotics by mouth.
When and Whom To Call For Sore Throats
CALL 911
  • Severe trouble breathing (struggling for each breath, can barely speak or cry)
  • You think your child has a life-threatening emergency
Call Doctor or Seek Care Now
  • Trouble breathing, but not severe
  • Great trouble swallowing fluids or spit
  • Can't open mouth all the way
  • Stiff neck or can't move neck like normal
  • Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
  • Purple or blood-colored spots or dots on skin
  • Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
  • Fever over 104° F (40° C)
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent. Note: a Strep test alone is not urgent.

Call Doctor Within 24 Hours
  • Sore throat pain is severe and not better 2 hours after taking ibuprofen
  • Large lymph nodes in the neck
  • Pink rash that's widespread
  • Earache or ear drainage
  • Fever lasts more than 3 days
  • Fever returns after being gone more than 24 hours
  • Age less than 2 years old
  • Close contact to a person with Strep within last 7 days
  • Sores on the skin
  • You think your child needs to be seen, but the problem is not urgent (or needs a Strep test)
Call Doctor During Office Hours
  • Sore throat is the main symptom and lasts more than 48 hours
  • Sore throat with cold/cough symptoms lasts more than 5 days
  • You have other questions or concerns





Source: adapted from Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.

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