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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.

See also: Eye - Allergy | Eye - Allergy | 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.

Beyfortus is a monoclonal antibody with activity against RSV. Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens such as viruses. One dose of Beyfortus, administered as a single intramuscular injection prior to or during RSV season, may provide protection during the RSV season.

Beyfortus (Nirsevimab) is recommended for: All infants younger than 8 months of age born during RSV season or entering their first RSV season.

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.

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.

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.

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. A small group 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 if your 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.

Flu Season

Among the many viruses we see causing respiratory illness right now, the influenza virus (commonly called "the flu") can be particularly severe. Infection with the influenza virus causes a sudden onset of fever, chills, dry cough, and muscle aches. Other symptoms include headache, fatigue, sore throat, and nasal congestion.

Some children are at increased risk of more serious illness from influenza, because of conditions such as diabetes, asthma, immunity problems, or being treated with immune-suppressing medications. They are especially vulnerable to complications and should get vaccinated as soon as possible.

Please get a vaccination if you and your child have not yet had it this year!

https://www.cdc.gov/flu/season/faq-flu-season-2023-2024.htm

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.

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.

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.

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