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What Is Going Around? Winter 2011

We see a lot of illnesses this time of year.  As seasons change, so do the viruses and bacteria that cause our children to get sick.  Here is a sampling of what we are seeing in the office:

 Influenza (the “flu”)

This is not the “stomach flu” with vomiting and diarrhea.  This is the respiratory viral illness, with high fevers, headache, bodyaches, cough, runny nose, and sometimes starts with a sore throat.  It is becoming more widespread here in Ohio (as of January 2011).  Symptoms can last 5-9 days. The best way to protect yourself is to have received a flu vaccine this fall.  If your child has the above symptoms, then he/she MAY have influenza.  Treat with fluids, and fever-reducing agents to make them feel better.  Call our office with questions.  Make an appointment if you are unsure or symptoms have gone on more than three days.  If your child is recovering from influenza, and then fevers return, or other symptoms develop, call our office for further advice.

 Gastroenteritis (the “stomach flu”)

Getting a flu shot will NOT protect you from this one.  This is a viral illness that usually starts out with vomiting, then goes into diarrhea.  Several viruses can cause this.  It tends to be very contagious and runs through the whole family.  The main treatment is to keep your child hydrated.  If vomiting, then small amounts of clear liquids, with electrolytes (such as Pedialyte) can be helpful.  Once the vomiting has gone away, then more foods can be given, but be sure to avoid full-strength juices and sugary snacks.  The vomiting usually lasts a day or so, then diarrhea happens for a few days, or even a few weeks.  Call our office if your child has bloody diarrhea, high fever, or has not urinated at least three times in a 24-hour period.

 Strep throat

We are not seeing a lot of kids with strep throat yet, but this IS the season.  Strep throat usually occurs in school-age kids, but may occur in younger children, especially if they have school-age siblings.  Strep throat usually presents with a sore throat and fever.  Other common symptoms are headache and bellyache.  It is very common to have swollen lymph nodes (“glands”) underneath the jawbone (mandible) that hurt when touched.  Occasionally, strep can also cause a deep red, rough-feeling rash on the body, along with all the other symptoms.  This condition is called “scarlet fever.”  It does not mean a more serious illness.  Certain strains of strep are more likely to cause scarlet fever than others.  The rash may be very itchy, last several days, and progress even if antibiotics are given.  The rash is not dangerous or contagious.

If you think your child has strep, then she/he needs to have a strep test done by swabbing the throat.  We do a rapid test in the office.  This test is very accurate, but not 100%, so if your doctor suspects strep to be the cause, she/he may send another throat swab for a test to be done at another lab.

Strep throat should be treated to avoid complications such as abcesses or rheumatic fever.

 Bronchiolitis (RSV)

Bronchiolitis is very common at this time of year.  Sometimes it is called a “chest cold.”  This illness is usually caused by a virus called “RSV.”  In very small babies, or premature infants, it can be quite serious.  Bronchiolitis can cause wheezing and fast breathing.  Appetite is often very poor with bronchiolitis.  Ear infections are also a common complication.  If your child is under six months old and you hear wheezing in his/her chest, or see very fast breathing, you should call our office.  Children older than six months tend to have less severe illness with bronchiolitis.  One of the problems with this illness is that the coughing and the wheezing can last a long time—sometimes longer than a month.  Most treatments are not very effective for bronchiolitis.  We treat the ear infections and any other complications that may arise.  Sometimes, if the illness is very severe, the child may need hospitalized and placed on oxygen to make sure they do well until they get over the problem.

 Croup

We usually see croup in the fall months, but there have been a number of cases even with this cold weather.  Croup starts out like a cold, then the child develops a harsh, deep, barking cough.  The cough often sounds like a seal, or a small dog barking.  The cough is usually much worse at night.  The patient may also have something called stridor. This is a sound that sounds just like wheezing, but the noise happens when the child breathes IN.  Usually, taking the child out into the cool night air helps this problem.  Sometimes sitting in a parent’s lap in the bathroom with a running hot shower (nice and steamy) can also help.  Croup usually occurs in children under 3 years old, but can occur in older kids.

If your child has had these symptoms, especially the worsening of the cough and stridor at night, then make an appointment to be seen in our office.

Ear infections

We see a lot of children with ear infections this time of year.  Usually, ear infections are complications of a cold (or “upper respiratory infection”).  The congestion and drainage causes fluid to build up in the middle ear, then bacteria can grow there.  Symptoms that suggest a possible ear infection include: pulling at the ears, trouble nursing or bottle feeding, trouble with lying flat, fever, or irritability out of proportion to the cold symptoms.  Ear infections are very common in children, especially if there is a family history, or they are with other children during the day.  Other factors that can make ear infections more common are: exposure to cigarette smoke, pacifier use, and family history.  Most of the time, ear infections are treated with antibiotics, especially if your child is very young.  If you have a school-age child with an ear infection, we may choose to watch them for a day or two before using an antibiotic.

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