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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


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.


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.



See Also: 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 Colds Cough Barky cough and hoarseness, see Croup If Earache is your main concern, see Earache


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.



See Also: Cough It doesn't sound like croup, see Cough 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.

NOTE: Enterovirus D68: This fall season, an enterovirus that causes primarily respiratory symptoms has been seen in various regions of the country. Please refer to the Enterovirus D68 article in this What's Going Around? section.


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.



See Also: Mouth Ulcers Rash or Redness - Widespread


Influenza

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 sudden onset of a 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. The "Seasonal Flu Shot"  or the "Seasonal Nasal FluMist" that has been administered to many people this year protects against Influenza A, B and H1N1.

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



See Also: Flu Influenza - Seasonal Influenza Exposure


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.


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.



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.



See Also: Sore Throat 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.



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. 



See Also: Diarrhea Vomiting Without Diarrhea

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