(Written by Jen Tiller, Nurse Practitioner)

 

"Oh, looks like he has a viral sore throat today." "The cough? Probably 'just' a virus." "He's been throwing up? Sounds like a VIRUS."

 

Some of the three most frequently used words in pediatrics are "it's a virus." As parents, we hate hearing them, and as pediatric health specialists, we don't like saying them, either. This month, we would like to chat a little about common viral infections in children, why children seem to be so susceptible to them, and why it's so important to treat (or not treat) them appropriately.

 

Viruses - The Gift That Keeps On Giving - Many of the illnesses for which we routinely give vaccines are viral in nature - measles, varicella (chicken pox), hepatitis, mumps, and flu are some common ones. However, there are many viruses against which we cannot vaccinate. For instance, did you know that there are more than 300 viruses that cause the common cold? And, many of those viruses also cause stomach illnesses, such as diarrhea and vomiting? Rashes? Body aches? Headaches? Fever? Lions and tigers and bears, oh my! Below are some viral illnesses common during childhood, along with some associated symptoms:

 

• Enteroviruses - nonspecific febrile illness (fever without any other symptoms), hand-foot-mouth illness, rashes, vomiting, diarrhea, body aches, sore throat, runny nose, irritability, and cough are often found with these viruses. Almost 100 strains of enteroviruses are responsible for common childhood illnesses.

• Influenza viruses - the cause of "the flu" - cough, high fevers, body aches, headache, sometimes vomiting, and significant fatigue are common symptoms.

• Parainfluenza virus - bronchitis, croup, laryngitis/hoarse voice, cough, runny nose, sore throat. This virus is the most common cause of croup in children.

• Respiratory Syncytial Virus (RSV) - RSV is the most common cause of bronchiolitis (a common lower respiratory tract infection) and is called "the most important respiratory tract pathogen" of childhood. Clear runny nose and cough are followed by several days of audible wheezing, often causing the child to breathe faster than normal. This illness is extremely irritating to the lower respiratory tract, and children will often continue to wheeze with upper respiratory infections after the illness has resolved.

• Adenoviruses - Sore throat, conjunctivitis ("pink eye"), diarrhea, runny nose, fever, swollen lymph nodes, and cough are all common symptoms of this virus. There are over 50 serotypes of adenovirus that cause illness.

• Rhinoviruses - the most common cause of the "common cold" in adults, and very frequently in children. Runny nose, sore throat, cough, bronchitis, fever (usually lower that with adenovirus, flu, parainfluenza, or RSV). Rhinovirus is a very common precursor to sinusitis and ear infections in children, and is the most common cause of asthma exacerbations in school-age children. Over 100 serotypes of this virus are responsible for disease in children and adults.

• Epstein-Barr virus (EBV) - the cause of mononucleosis ("mono"). Children with mono will often have recurrent fevers, sore throat, swollen lymph nodes, and significant fatigue up to several weeks. A blood test, along with typical exam findings, will give us the diagnosis with this illness.

How can you tell if it's a virus or bacteria?

In many cases, your child's symptoms will often give us a clue as to whether or not the infection is bacterial vs. viral in nature. For instance, children with sore throats accompanied by runny nose, cough, and sneezing have a viral infection, since these symptoms do not match the presentation of strep throat. In children with diarrhea, if there is no blood in the stool, the infection is likely viral in nature, since there are many more viruses that cause diarrhea than bacteria.

Sometimes, length of time will often give us a good idea of the source of your child's illness. For example, in viral upper respiratory infections, we expect symptoms to resolve in 10-14 days. If, at that point, your child is still coughing or has a runny nose, especially if the drainage is colored, then we assume a bacterial component is present, and will treat with antibiotics. Also, children with diarrhea, illness should improve within 10-14 days. If not, we begin testing for bacterial illness, sooner if your child worsens or has new symptoms (i.e., fever) while ill.

 

Please know: our most IMPORTANT PRIORITY is your child's health and comfort.

If the picture is ever unclear, we will order testing to help clarify things. If your child is not improving, we will investigate further until we can figure out what is going on. Most viral illnesses will resolve without any complications - but sometimes, dehydration, ear infections, sinus infections, or other problems occur as a result of a viral illness. We will continue to work with you and provide expert, compassionate care for your child until he/she is back to his/her delightful self!

 

Why does my child seem to get so many viral illnesses?

Viruses are most commonly spread by contact or respiratory droplet. In other words, hand washing and avoiding others who are ill are the two most effective ways to prevent spread of viral illness. As we all know, children don't do either of these well - hence their higher rate of infection. Also, the time during which children are contagious with a specific viral illness is often unknown - some resources state as long as there is fever, others state, for instance, that children will often shed respiratory virus for weeks after becoming ill. Finally, many viruses are difficult to eradicate from surfaces such as toys, playground equipment, and the like.

 

Ok, so it's a virus. What do I do now?

For most viral illnesses, symptomatic care and time are the two most effective means of helping your child feel better. There may be complications that we will want to take guard against. Most importantly, we will want to know:

 

• Is your child taking fluids well? Is he/she urinating at least 3-4 times in a 24-hour period? If the answer is "NO," call us ASAP!
• Has your child had a fever for more than 3 days? If the answer is "YES," call us ASAP!
• Does your child's fever come down with Tylenol? If the answer is "NO," call us ASAP!
• Is he/she having trouble breathing? If the answer is "YES", call us ASAP!
• Does your child seem listless, lethargic, won't drink, or has a strange looking rash? If the answer is "YES", call us ASAP!

 

Be sure and check out our "symptom checker" on our website at www.treehousepedi.com - you can enter your child's symptoms and get helpful information on what to do next!

Though most viral illnesses resolve with rest, fluids, and TLC, some viral infections can cause significant illness, missed work and school days, and can sometimes be serious. Your child's health is our most important priority - let us know when your child isn't feeling well, and we will get to the bottom of it!

 

Our Nurse Practitioner Kristie Wilson and her family are proud to introduce their new baby girl...

 

Welcome to Treehouse Pediatrics... baby Kate!