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


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 Colds If you have a Common Cold, see Colds Cough Barky cough and hoarseness, see Croup If Earache is your main concern, see Earache


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.


Enterovirus D68 (EV-D68)

Enteroviruses frequently cause mild illness in the summer and fall. This year, Enterovirus D68 (EV-D68), is a unique virus that shares features with the common cold viruses. Most infections are mild and self-limited and will last 5 to 7 days. A small group of children and adolescents, expecially those with asthma, are experiencing more severe respiratory symptoms with wheezing and shortness of breath. Note: for most cases, a test for EV-68 is not required because it will not affect the course of the illness.

No vaccines are available for EV-68 and there are not any antiviral medications that treat this virus.

If your child has a history of asthma:

  • Continue with your child's current asthma treatments
  • Make sure your son/daughter has his/her inhaler and other asthma medications at all times
  • If your child usually uses a controller medication (e.g an inhaled steroid) during the winter season or with colds, consider the possibility of starting the controller medication now.
  • Make sure your child's teacher or caregiver knows of your child's asthma

Call 911 if your child has severe symptoms:

  • Having serious trouble breathing (e.g. chest retracts or lips and/or fingers turn blue)
  • is unresponsive or difficult to arouse
  • Has slurred speech, paralysis, or severe headache

Make an appointment or call us if:

  • Your child's cold seems severe and/or  he/she is uncomfortable with their breathing
  • Your child can't sleep due to the respiratory symptoms
  • Your child has ear pain or other significant pain that is not relieved with pain medication

Home Treatment

  • Frequent fluids, rest and fever management.
  • Frequent hand washing...cover your mouth when coughing
  • Avoid kissing, hugging and sharing drinks with people who are sick.
  • Disinfect surfaces in your house such as countertops and toys.


Hand-Foot-Mouth Disease

Hand-foot-mouth and butt disease is a common viral illness caused by the Coxsackie virus  (a member of the enterovirus family) and occurs almost year round now.  Its name describes the location of the rash during the illness however it can be all over. Also about 6 weeks after the illness the nails will peel off but the new nail has already grown. Although not common in older children (over 10) it can happen and even in adults. 

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 and always on the palms and soles.  Often 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.

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


Tips for Summer Safety

Tips for Summer Safety and Fun in the Sun

1. Always wear sunscreen and need minimum of 15 to maximum of 50 with both UVA and UVB protection. This needs to applied before being at the pool or beach and reapplied frequently. Spray is fine if applied heavily. Remember hats, sunglasses and protective clothing and avoid the midday sun. Sunburns DO cause cancer.

2. Pool safety cannot be over emphasized and all pools need to be fenced and all children supervised.

3. To prevent heat stroke, don’t exercise outdoors when it is extremely hot. Stay hydrated by drinking plenty of water before, during and after an outdoor activity. Children are especially vulnerable to getting sick from the heat as they don’t cool as fast. Please never leave your child in a parked car, even for a minute.

4. Don’t eat salads or sandwiches that have been sitting out at room temperature for more than a few hours.

5. Pests of all kinds are back and some can cause serious illnesses like Zika and West Nile. Wear insect spray at a minimum of 30% DEET and this will last 3 to 5 hours. For children when back in the house, wash them and their clothing. Bees and wasp stings are painful and can be deadly serious if allergic to them.

6. More resources for summer safety and keeping kids safe can be found at the CDC.gov

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