Every year during the holidays, many of us are spending lots of time with family and friends and we often get the kind of holiday gift no one wants — a virus. Many people catch the seasonal flu virus, common cold or get sick from other infections. This can be particularly challenging with babies and children with developing immune systems.
Dr. Ameera Nauman, a pediatrician at OSF Medical Group in Alton, says if your child gets a cold, cough or congestion, the most important thing is to give fluids and use a cool mist humidifier-vaporizer as long as they don’t have asthma. For infants, nasal suctioning (use bulb syringe) with saline drops can help, along with controlling fever with medication, either Tylenol or Motrin.
You should seek immediate medical care if an infant or child shows signs of respiratory distress. Nauman advises to watch for tell-tale warning signs.
“They can see the baby’s ribs when the baby is breathing or they see the baby’s nostril’s flaring or the baby is grunting a little bit as if having a little bit of difficulty trying to breathe, then we encourage them to go to a more elevated level of care like an ER,” Nauman said.
What about fevers? Many winter viruses cause elevated body temperatures. With children, when should you be worried enough to seek medical care when your little one spikes a fever?
Nauman suggests giving a child acetaminophen or ibuprofen. Don’t give your child aspirin. It has been linked to a serious, potentially fatal disease called Reye syndrome.
Nauman says an infant less than three months old with a temperature of 100.4 or higher should be seen immediately to make sure they’re OK. Between three to six months, parents should consider having the baby seen by a medical professional if the elevated temperature persists.
“If the parent feels like even by day three or four the child isn’t doing well, not drinking or just sleeping all the time, I encourage them to just come into the office and make sure we’re not dealing with just a virus and maybe a bacterial infection we can help the child with by giving them an antibiotic,” she advised.
Flu is different than other viruses. Influenza (flu) is a very contagious viral infection that affects the air passages of the lungs. It causes a high fever, body aches, a cough, and other symptoms. It is one of the most severe and common viral illnesses of the winter season. It can lead to pneumonia and even death. Last flu season (October-May), there were 142 pediatric deaths caused by the flu.
Nauman says it can be difficult to tell if an infant has the flu. Babies under six months are especially vulnerable because they can’t be vaccinated. She stresses that’s why it is so important for everyone else to receive a flu vaccine. For children who were born prematurely or who have other chronic conditions, doctors can provide the antiviral drug Tamiflu within 48 hours of symptoms to shorten the course of the illness.
Adenovirus — Nauman says in children, adenovirus most often causes infections in the respiratory system, but it can also cause digestive tract infections, rashes, or ear and eye infections.
According to Nauman, “It’s a virus that sometimes takes a week, sometimes more, of high fevers and the child just looks miserable. So, it is one of the viruses where when we start seeing a constellation of symptoms, we’ll start thinking about adenovirus.”
Treatment for symptoms related to adenovirus will depend on the extent, age of the child and how long they’ve lasted. Nauman advises keep children hydrated and rested and seek immediate care if more serious, related conditions develop.
Here are some other common viruses seen in the winter:
Respiratory syncytial virus is a viral illness that causes symptoms such as trouble breathing. It’s the most common cause of inflammation of the small airways in the lungs (bronchiolitis) and pneumonia in babies. Most babies have been infected at least once by the time they are two years old.
Treatment — Nauman says RSV requires mostly supportive care at home but in more severe cases, a child might need hospital care including oxygen, an inhaler or antiviral medications. That is also the case for related conditions associated with RSV, including bronchiolitis and pneumonia. When in doubt, she recommends contacting your pediatrician for advice about whether medical or urgent care is required.
Bronchiolitis is an illness of the respiratory tract. It happens when tiny airways called bronchioles get infected. These airways become inflamed, then swell and fill with mucus, which can make breathing hard. It most often affects infants and young children because their noses and small airways can easily get blocked.
Pneumonia can be viral or bacterial and often begins after an upper respiratory tract infection (an infection of the nose and throat). In most cases, pneumonia is caused by a virus that does not require antibiotics. Bacterial pneumonia is treated with antibiotics taken by mouth at home. There are two types of vaccines that can help prevent pneumococcal disease. The vaccine that is right for your child depends on their age and risk factors.
Whooping cough, aka pertussis, was also known as the 100-day cough because it causes intense fits of coughing, can last for up to six weeks and it is highly contagious. It mainly affects babies and young children and can be deadly for those less than a year old. There have been outbreaks in areas with low vaccination rates. There is a vaccine and the Centers for Disease Control and Prevention recommends children get 5 DtaP shots over a series of time (protects against three diseases) for maximum protection. Call your health care provider if your child has symptoms that don’t get better, or get worse; new symptoms emerge, and with babies you see pauses in breathing instead of a cough.
Croup — Kids with croup have a virus that makes their airways swell. They have a telltale “barking” cough with a raspy voice and they make a high-pitched, squeaky noise when they breathe. Most children with croup get better in a week or so despite the alarming sound of their cough. Nauman says it’s best to sleep near your child in case breathing gets worse and you need to take your baby, toddler or teen to the ER. Nauman says when in doubt, bring your child in to be seen by a medical professional.
Keeping your child home from daycare or school — Nauman says most daycare providers are good about notifying parents when other children have been diagnosed with a contagious condition. If your child is contagious, keep them home.
“If they have conjunctivitis like an eye infection or what is commonly known as ‘pink eye’ or if they have strep, we will ask that you keep your child out until the child has received 24 hours of antibiotics so they are not as contagious,” she recommended.
Your child may return to school once they are fever-free for at least 24 hours, though they may need a bit more time to feel better. Nauman says ultimately, parents should use their best judgment to decide when a child is feeling well enough to return to school.
OSF HealthCare has more than one urgent care options including PromptCare and Urgo, which can be a great way to get your children evaluated quickly. You can also use OSF OnCall or call your child’s pediatrician for guidance. When symptoms are life-threatening, always seek immediate care at an emergency room and call 911 if a child stops breathing.