What's Going Around?


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.

For more information: See also Eye - Allergy

Bronchiolitis (and RSV)

We are currently seeing cases of bronchiolitis, a viral illness (sometimes caused by RSV -- "respiratory syncytial virus" but other viruses are responsible) that occurs most often in children under age 2 years. This virus typically occurs in epidemics during the winter and the early spring. "Bronchioles" are the smallest airways in our lungs, and "itis" means these airways are inflamed, or irritated, by the virus. When these airways get inflamed in young children, they often will start to "wheeze," meaning air and the oxygen in it have difficulty getting through these narrowed, swollen airways. Your child does not need to be tested for RSV unless is being hospitalized as the treatment is the same.

With a case of bronchiolitis, your infant's symptoms may begin with a runny nose, a fever, and a harsh, tight cough. If it progresses to wheezing, your child may start to breathe rapidly and "pull" with his/her abdomen and rib muscles with each breath. Please call us for an appointment before your child's breathing becomes labored or difficult.

If your infant was born premature (under 32 weeks) or has cardiac or lung conditions, your child is at a greater risk of complications from RSV bronchiolitis. A product containing a specific antibody to RSV has been approved for monthly administration to help prevent RSV infection in these high-risk children. This form of antibody against RSV has the advantage of being able to be administered once a month by intramuscular injection. In large, controlled studies, this product has been shown to decrease hospitalization from RSV infections in these high-risk infants. Despite recommendations there are so many restrictions that many infants do not benefit from this albeit expensive treatment.

Colds and Upper Respiratory Infections

Colds, upper respiratory infections, and URIs are common terms we use to describe viral illnesses that cause nasal congestion, runny nose, sneezing, sore throat, fever, and cough. The fever usually lasts for 2-3 days, and the cough with congestion and runny nose may last for 5-10 days. The typical preschool-age child may experience 6-10 colds per year. Most colds resolve on their own with rest and fluids, but some may lead to ear infection, sinus infection, asthma attack, or other complications. If you are concerned about the possibility of one of these complications, please have your child seen in our office for an evaluation.

For more information: See also Colds , See also Sinus Pain or Congestion


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.

For more information: Previous diagnosis of asthma, see Asthma Attack , If you are coughing because of an Asthma Attack, see Asthma Attack , Any Chest Pain , If you have a Common Cold, see Colds , See also Colds , See also Cough , Barky cough and hoarseness, see Croup , If Earache is your main concern, see Earache , Wheezing but no previous diagnosis of asthma, see Wheezing (Other Than Asthma)


Among the many viruses we see causing respiratory illness right now, the influenza virus (commonly called "the flu") can be particularly severe. Infection with the influenza virus causes sudden onset of a fever, chills, dry cough, and muscle aches. Other symptoms include headache, fatigue, sore throat, and nasal congestion. Treatment is still fluids, rest and fever control for the majority. Other treatments may be needed if vomiting or coughing. The antiviral agents (ie Tamiflu) has SIGNIFICANT side effects including vomiting, delusions, hallucinations and paranoia and should only be used if you have a more serious underlying illness and not like it is being prescibed at the present time in this community.

Some children are at increased risk of more serious illness from influenza, because of conditions such as diabetes, asthma, immunity problems, or being treated with immune-suppressing medications. They are especially vulnerable to complications, and should get vaccinated as soon as possible. The "Seasonal Flu Shot" that has been administered to many people this year protects against Influenza A, B and H1N1. Yes it is not as effective as had been hoped, but it is still the best first line defense against the flu and can shorten the illness.

Please get a vaccination if you and your child have not yet had it this year!

Strep Throat

Strept throat occurs year round and has seasonal peaks. 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 a swab of your child's throat is necessary, and antibiotics will be needed if the strep test is positive. You cannot diagnose strept throat via telemedicine.

Tips for summer safety and fun in the sun

Always wear sunscreen and this needs to be no more than 50 and must be put on indoors before going outside. If using a spray, use lots and regardless reapply spray or lotion often.
Wear hats and sunglasses when out. Sunburns do cause cancer.
Avoid being out in the sun in the midday when the sun's rays are the strongest.

To prevent heat stroke, don't exercise outdoors when it is extremely hot. Drink plenty of water.

NEVER leave your child in a car even for "that minute".

Don't eat foods that have been left out after a couple of hours and even less if above 90 degrees.

Please wear insect spray containing at least 30% DEET at least to protect against mosquitoes that can carry some deadly diseases. There are vaccines in early stages for Zika. Stings from bees and wasps are painful and deadly serious if allergic to them.

Check out the CDC.gov website on more summer safety and have a safe one.

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.

For more information: 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 or Pedialyte 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 a significant decrease in the amount they are voiding, and does not make tears, or appears limp or lethargic, they may be dehydrated and we will need to see them in our office. There are medications available to help with vomiting that are available by prescription.