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Childhood Respiratory Infections and Other Illnesses

What do I need to know about respiratory infections in children?

  • They are very common, particularly in children in daycare or school.
  • Having six respiratory infections per year is normal.
  • Some uncomplicated respiratory infections can last up to two weeks.
  • Many respiratory symptoms overlap and make differentiating the illnesses difficult, especially for parents and teachers.

What are the common symptoms in uncomplicated respiratory illnesses?

  • Runny nose
  • Sore throat
  • Red eyes
  • Hoarseness
  • Coughing
  • Fever
  • Swollen lymph nodes

What are some symptoms that may cause more concern?

  • Rapid breathing
  • Tight breathing
  • Wheezing — a high-pitched whistling sound heard when breathing out. Often associated with tight breathing.
  • Stridor — a harsh, raspy vibrating sound heard when breathing in. As it progresses, it can sound like a seal, particularly with coughing.
  • Fever

What is bronchiolitis?

  • It is most common around six months of age and does not occur after age two.
  • The main symptom is wheezing.
  • The most common cause is RSV, a respiratory virus present in the winter months.
  • It is spread by direct contact with respiratory secretions.
  • The wheezing generally lasts about seven days with 14 days of cough.
  • There is no specific treatment. A vaporizer should be used. Prescription asthma medications may be used if necessary.
  • Common complications include ear infections.

What is the common cold? Is there a cure for it yet?

There are at least 200 separate viruses that can cause colds, so unfortunately no cure is on the horizon.

  • Colds can occur at any age.
  • There is a wide range of cold symptoms, depending on the severity.
  • They are spread through direct contact with respiratory secretions.
  • They last about seven to 10 days on average, though the cough can last three weeks. Fever shouldn't last more than three days.

Treatment is symptomatic only. Nasal suctioning is helpful in infants. Decongestant nasal sprays should be used only for severe cases and only for a few days. Acetominophen (such as Tylenol®) is only for pain and fever. Fluids are always important, even if the child's appetite is poor. Most over-the-counter cold medications aren't very helpful. Never give leftover antibiotics from a prior illness or from another child.

Complications include ear infections, sinus infections, pneumonia, and eye infections.

What is croup?

  • Croup is a disease seen mainly in toddlers.
  • The classic presentation is hoarseness with a cough that sounds like a seal or a dog. It is usually part of a cold. Stridor develops later. Symptoms are generally worse at night.
  • It is caused by a virus.
  • Children are quite contagious.
  • It lasts about five to six days.
  • There is no specific treatment. The child should be kept calm. Cough medicines are not helpful. Mist, cool or warm, can be quite helpful.

What causes ear infections?

Children commonly get middle ear infections, meaning that there are bacteria behind the ear drum. Pain is the main symptom.

  • They are not contagious.
  • Antibiotics are generally quite helpful. Tylenol can help with pain.
  • Complications can include a small tear in the ear drum, which heals quickly.

What is pink eye?

Pink eye is generally considered a contagious bacterial infection of the eye. Pink eye can also be caused by viral infections and allergies or irritants. In general, when the infection is bacterial, the discharge is thick and yellow and the eyelids stick together.

  • The eye discharge is contagious.
  • The viral form usually accompanies a cold and lasts about a week. If it is bacterial, the discharge generally stops after 3 days of antibiotics.
  • Warm compresses are helpful. Antibiotic drops or ointment may be prescribed.

What causes sore throat?

Most sore throats, including the sore throat found in mono, are caused by viruses and accompany a cold. Strep (the Streptococcus bacterium) causes about 10% of cases, and the resulting infection of the throat and tonsils can look exactly like viral sore throat.

Viral sore throats generally last about three to five days. Strep usually responds to antibiotics within 24 hours. Mono generally lasts about a week but can cause symptoms for two to four weeks.

Symptomatic treatment includes gargling with salt water or a combination of Benadryl® and Maalox ® (1:1); corn syrup or hard candies; a soft bland diet; etc. Antibiotics are useful only for strep throat. Never give leftover antibiotics from a prior illness or from another family member.

Complications of strep include a rash known as scarlet fever, and more seriously, rheumatic fever, which can be prevented with proper treatment. Mono can be complicated by difficulty breathing if the tonsils get large enough. The liver and spleen may become enlarged; contact sports should be avoided for about four weeks.

Will my children get pneumonia if they are exposed to someone who has it?

Pneumonia generally presents with a cough, which is likely to bring up sputum. There may be some difficulty with breathing, such as rapid, labored, or painful respirations. There is often fever.

Other facts about pneumonia:

  • It is an infection of the lung that causes fluid to collect in the air sacs. About 80% of infections are viral and milder. Twenty percent are bacterial.
  • Bacterial pneumonia is usually more abrupt in onset and can improve significantly within 24 to 48 hours of antibiotics. Viral pneumonia is milder but can last two to four weeks.
  • It is not contagious.
  • Cough suppressants should be avoided. Antibiotics are prescribed if necessary.
  • Hospitalization is very rarely necessary in otherwise healthy people.

When is a runny nose a sinus infection?

Sinus infections are often heralded by pain and pressure in the face, thick nasal discharge, post nasal drip, fever, bad breath, nausea, and chronic cough.

  • They are not contagious.
  • Nasal sprays are helpful for opening sinus passages, as are decongestants. Antibiotics may be prescribed.

How high should I let my child's temperature get before I panic?

The normal body temperature is 98.6° F, but this fluctuates throughout the day.

  • Temperature can be taken by rectum, by mouth, under the arm, or in the ear. Rectal is best.
  • Fevers are not harmful, they are a sign that the immune system is working. Your child's behavior is far more important than the actual temperature. Never wake a child to take his temperature.
  • Most fevers range from 101° F to 104°F and last about three days.
  • Your health care provider needs to see all babies younger than six weeks of age if they have elevated temperatures above 101.6°F. Tylenol is the safest medication to use - consult your health care provider to be sure you are using the right amount. Liquid ibuprofen (such as Liquid Advil®) is available by prescription and may be suggested. Never use aspirin without consulting your health care provider. Consider a sponge bath if the temperature hasn't come down after 30 minutes. Lots of extra fluids are necessary with fevers.
  • Febrile seizures may develop in 4% of children. They are generally quite harmless.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 9/11/2009…#4022