Attack of the winter viruses...
It’s that time of year again and if you have a child, it is almost certain, they will be exposed to one of these very common winter viruses. How they will respond to this contact is uncertain however and there are several measures that can be taken in order to treat symptoms along with these infections.
As I had mentioned in my previous post about antibiotics, childhood infections are most commonly due to viruses and less so bacterial, fungal or parasitic. I will therefore focus on introducing you to the most common viruses that are prevalent during the winter period.
RSV (Respiratory Syncytial Virus) and Bronchiolitis
This is a virus that predominantly affects the airways. It leads to a very common condition called Bronchiolitis. Bronchiolitis can affect the tiniest of babies (even a few days old) to older children too.
Symptoms start off very similar to the flu. Your child may have a runny/blocked nose and a bit of a cough sometimes with or without a fever. This then quickly becomes more of a persistent cough with breathlessness and wheezing (wheezing is a sound that usually happens when a child breathes out and you hear an additional whistling sound). They may well have lost their appetite and have periods of apnoea (stopping breathing).
As with all viruses, the best treatment is to treat symptoms and wait it out. I usually suggest
Regular calpol +/- Ibuprofen for fever and general irritability.
Regular nasal saline and suction to keep airways clear.
Regular hydration if they are off their food
Monitor symptoms.
This condition could last up to 3 weeks and may get worse. If their breathing becomes rapid (greater than 45 breaths/minute) or they are using their neck muscles extensively to breathe, they have blue lips or tongue or their temperature does not settle, this is an emergency and you should call 999 straight away.
You know your child best, always seek medical attention if you feel something is not quite right despite all your efforts.
Influenza Virus and the Flu
This virus obviously causes the Flu or Influenza and is common in all age groups; but the elderly, frail, people with weaker lungs and children usually are more vulnerable to this virus. Symptoms are runny/blocked nose, sore throat, aching joints, loss of appetite, fever and a headache.
The best way to treat this is similar to treating any viral condition. Calpol, hydration and measures to help clear airways if blocked are the main elements to treatment. I’m sure you are noticing a trend in treating viral illnesses J
Some people are offered the flu vaccine on the NHS and these groups are often the more vulnerable groups. The vaccine is available as a spray for toddlers and for younger children privately so please check with your GP if you think it may be for your child.
Parainfluenza, Adenovirus and Croup
Croup can be caused by a number of viruses including Parainfluenza viruses, RSV, influenza virus and others such as adenoviruses. This is a horrible illness and one that I have dealt with with Alyvia when she was 10 months old. This experience deserves an entire post in itself and will be coming very soon!
Symptoms can vary from mild to more severe. Breathing is what is mostly affected as Croup describes the condition when the windpipe becomes inflamed and narrows as a result of the infection. This results in children having significant difficulty in breathing through narrowed airways. It is painful to watch and understandably very worrying for parents.
Symptoms begin very similar to all the other viral infections I have already mentioned. Children start off with a runny nose and a dry cough. Within a few days however, symptoms can progress and become more severe with a rasping, barking cough, hoarse voice and significant difficulty in breathing. Appetite is affected and children can become very unwell.
The hallmark of this illness is the increase in breathing difficulty overnight. You will find that at nighttime, children may have periods of not being able to breathe at all with gasping for breath. They may start drooling as they cannot find the time to even swallow their own saliva due to the inability to breathe. Breathing in may produce a harsh sound…this is called stridor.
What to do? Call 999. Often things will not settle without steroids or a nebuliser and a period of monitoring in hospital. Remarkably you will find that during the day, symptoms may resolve or even go back to normal, but again at night, things flare up. This is classic croup. If you go to the hospital during the day, doctors may be fooled by your account of how your child was overnight as the difference in their presentation may be completely the opposite to what happened only a few hours ago.
Once they are settled, the usual measures of calpol, hydration and trying to keep the airways clear are the mainstay of treatment while you wait for the infection to resolve.
Herpes Simplex Virus (HSV), Cytomegalovirus (CMV), Epstein-Barr Virus (EBV), Adenovirus, Rubeola Virus and Tonsillitis
This group of viruses including some of the viruses mentioned that cause Croup and the flu, cause tonsillitis. A viral cause for tonsillitis is typically seen in children under the age of 5 years.
Symptoms are fever, sore throat, difficulty and painful swallowing, bad breath, airway obstruction, lethargy and malaise. Glands around the throat may also be enlarged. Children can become unwell for a few days but in some, symptoms can even last up to 2 weeks.
Treatment should be based on treating pain with pain-killers (Ibuprofen/Nurofen as this is also an anti-inflammatory agent and will help to reduce tonsillar inflammation), calpol, hydration, salt and water gargle four times a day. A good spray that is available over the counter is Difflam spray, which helps to also reduce inflammation.
Be aware that simple tonsillitis can progress into an abscess (caused by bacteria) and this would need urgent attention. If your child develops more pain in their throat, change of voice, drooling or difficulty in opening their mouth this may be an abscess and I would call 999.
Current indications for tonsillectomy are recurrent episodes of tonsillitis over consecutive years or a history of abscess requiring surgical drainage.
Rotavirus, Adenovirus, Norovirus and Gastroenteritis
These viruses lead to gastroenteritis; also known as vomiting or diarrhoea or both. The most common virus occurring in children is Rotavirus. It is usually caught from attending playgroups, nurseries or children’s centres. If children touch an object contaminated with the virus (excreted in the stool) and then put their hands in their mouths, they can catch it. Symptoms usually last up to a week.
Norovirus is also known as the ‘winter-vomiting bug’. It causes diarrhoea and vomiting and can also last up to a week. Not only does it affect children but adults too and many families have been known to be treated at once as it is very contagious.
Thorough hand-washing is key in preventing this from spreading.
Projectile vomiting, watery diarrhoea and nausea are the main symptoms and in children, some also may experience fever and abdominal pain. Watching for signs of dehydration is vital. These include dry mouth or tongue, reduced wet nappies, irritability and sunken fontanelles (in babies).
Treatment is hydration, hydration and hydration! Oral rehydration solutions aren’t vital at this stage unless dehydration occurs so don’t be concerned if you can’t get to the chemist to pick any up.
The vaccine to prevent Rotavirus is part of the childhood immunisation programme in the UK (given at 8 and 12 weeks) so many children will have some immunity from it.
I hope this topic allows you to better equip yourself when treating your children should they experience any of these viral infections. My aim is to try to reduce some of the uncertainty that us parents face when our children are unwell, especially if we have younger babies who cannot express their symptoms to us.
When faced with the above symptoms, simple measures are required to ease their suffering while you wait for the GP appointment or the infection to resolve.
Before I end this post, I just want to mention that I haven’t discussed Pneumonia or ear infections. Along with the above, they are more common in winter however the causative agent is usually bacteria rather than viruses. The treatment for bacterial infections is antibiotics.
I guess it’s time to wrap-up folks! ;)
Please do not however replace my advice with advice from a professional who has physically examined your child and has listened to your account. As always, trust your instincts too and speak up if you are concerned about anything.
Speak soon,
MCD
xxx