IT is winter, and along with the colder weather comes the usual bout of seasonal childhood illnesses.
Distinguishing between the various ailments can prove challenging for parents of babies and young children who are more vulnerable when it comes to typical winter ailments.
And with so many of these illnesses sharing common symptoms, it can be hard to know when it is warranted to be concerned.
Dr Omolemo Percy Kitchin, a paediatric pulmonologist at Netcare, says understanding the basics when it comes to the different types of common winter ailments can go a long way towards assisting parents in navigating typical winter ailments.
He says these basics include the common signs and symptoms, management, prevention, control and when it is advisable to see a doctor.
According to Dr Kitchin the most common winter illnesses among children include:
• Coryza: inflammation of the lining of the nasal cavity, better known as the ‘common cold’. It is derived from Greek word Ko’ruza, meaning nasal mucus.
• Influenza: (Flu) an infectious disease caused by the influenza virus.
• Allergic rhinitis: inflammation of the nose, sometimes referred to as hay fever.
• Bronchiolitis: inflammation of the bronchioles (small airways).
• Asthma: chronic inflammation of the bronchi (larger airways).
Don’t over medicate
One of the key factors that Dr Kitchin highlights is the overuse of antibiotics for the treatment of illnesses.
‘Many parents automatically expect a prescription for antibiotics to treat colds and other viral infections.
‘Not only will antibiotics not have the desired effect, it can have dangerous side effects and adds to the worldwide problem of antibiotic resistance.
‘Common colds, ‘flu and bronchiolitis are caused by viruses and therefore do not require antibiotics to treat them.
‘Parents and caregivers tend to think that an antibiotic will solve the problem – but antibiotics are only effective in treating bacteria and not viruses.
The nasty ones
Flu is potentially the most dangerous of the three conditions, specifically when it results in secondary complications such as pneumonia, which if very severe might require admission to the hospital and or the intensive care unit.
This is more common in individuals with compromised immune systems (elderly, very young, HIV/Aids patients) and they should have a yearly flu vaccination which
should limit the severity of the condition.
The public often confuses coryza – the common cold – and influenza.
‘Generally, when people say they have flu, they are actually referring to the common cold caused by the rhino virus.
Symptoms include a sore throat, cough, runny and/or blocked nose, and possibly fever.
‘Added to these symptoms could also be painful muscles, rigours, a general feeling of being unwell accompanied by a severe lack of energy.
Flu can result in secondary complications such as pneumonia, ear infections and sepsis.
‘Unfortunately, both the common cold and influenza have to work its way out of the body,’ Dr Kitchin says.
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The young ones
‘Children under the age of two are frequently susceptible to bronchiolitis.
‘It presents with a cough, fast breathing, difficulty in breathing, chest in-drawing and fever, and is commonly triggered by the respiratory syncytial virus (RSV) in 90% of cases.
‘Para-influenza and other viruses causing a common cold and influenza, may also be involved.’
Patients present with
• a cough, especially at night
• an itchy and runny nose with clear secretions that can be greenish in colour
• watery and itchy eyes, and sometimes swelling of the eyelids.
• dark discolouration (black rings) under the eyelids
Asthma
Asthma may present with a cough that is worse at night, a tight chest and wheezing.
Up to 40% of patients with asthma have allergic rhinitis, so these conditions often co-exist and form part of what we refer to as a united airway.
Taking a good history of asthma is very important, as the chest is usually clear on examination by a medical practitioner, unless the patient has acute symptoms.
Asthma is consequently often missed.
So, how are these illnesses managed?
A common cold or flu is treated symptomatically with nasal decongestants, fever control, nutritious meals and quality sleep.
The virus will work itself out of the system, over time.
For bronchiolitis, which is firstly treated symptomatically, patients might benefit from admission to hospital and oxygen via a nasal tube if the respiratory distress becomes severe.
Asthma should be treated with controller pump inhalation steroids through a spacer in young children, and a reliever in case of emergencies.
‘Asthma can be well controlled by using inhaled steroids, and hay fever through intranasal steroids.
To limit the risk of bronchiolitis, which cannot be prevented by itself, national guidelines recommend the use of prophylaxis before the respiratory syncytial virus (RSV) season starts for high-risk patients.
‘High-risk children can be defined as premature babies and children with congenital cyanotic heart disease.
Such children are born with an abnormally developed heart and blood vessels, resulting in low oxygen supply to the organs,’ he says.
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When to seek urgent treatment
Visit the emergency department if your child has• Difficulty breathing
• Severe allergic reaction (shortness of breath, lip/oral swelling, persistent vomiting, altered mental status)
• High fever with headache and stiff neck
• Suddenly finds it hard to wake up
• Sudden loss of sight, speech or movement
• Broken bone pushing through the skin
• Body part near an injured bone that is numb, tingling, weak, cold or pale
• Heavy bleeding or deep wound
• Serious burn
• Coughing or throwing up blood
• Fast heartbeat that doesn’t slow down
• Vomiting followed by dry mouth, not crying tears, no urination in more than eight hours (dehydration) or acting very sleep
• Rectal temperature greater than 39 degrees in children less than 2 months old
Phone an ambulance in case of
• Choking
• Severe difficulty breathing
• Head injury and the child is unconscious
• Injury to neck or spine
• Severe burn
• Seizure
• Bleeding that can’t be stopped
