Winter 2020 — The virus
Hylton I Lightman MD DCH(SA) FAAP
It’s been quite the sick season and it’s not even the middle of February yet. Your child is coughing or sneezing. The runny nose. The fever which can make even the most rambunctious child into an endearingly pathetic creature. Waiting rooms in pediatric and adult offices are overflowing with sick patients. In a not small number of cases, patients are complaining about being “frequent flyers” at the doctors’ offices.
We get it.
How “easy” it would be to diagnose strep throat, educate about and prescribe antibiotics, pray that patients are compliant with taking them, and then be done. Alas, that does not seem to be in the cards for winter 2020.
Because at the present time, so much sickness is viral driven. Yes, viruses are driving those sore throats and stomach pain. Viruses cannot and should not be treated with antibiotics. Rather viruses should be left alone – of course, they should be monitored – so they take their course, building the child’s immune system, despite the discomfort. In other words, there should be no antibiotics. More about that later.
Allow me to share with you some facts about viruses and children.
What’s a virus?
A virus is a germ that causes infections. Among the hundreds of viruses that abound, readers are most likely familiar with the common cold, bronchiolitis, ear infections, tonsillitis, mumps, chicken pox, and (groan), the flu.
Colds are common in child and the average school age child has at least six colds annually.
Further, it is typical for healthy children to have up to 12 viral illnesses per year in the first years of life.
Other typical happenings –
- That a child is recuperating from one virus and is socked with another
- Once one or two children are going to school or a babysitter outside the home, typically, the younger siblings pick up all those germs as their own and they become a revolving door of one virus after another
- As children get older, the frequency of catching viral illnesses usually lessens – but the younger family members are still vulnerable. Sorry.
What are the signs and symptoms of viruses?
- A blocked or runny nose
- Red, watery eyes
- Sore throat
- Rashes that turn white for a second or so after you push on them with your index finger. You can also press the side of a clear drinking glass over the rash and see if it blanches. Please wash the glass afterwards.
- Sneezing and/or coughing
- Vomiting and/or diarrhea
- Lethargy – wanting to sleep more than usual
- Lack of or decrease in appetite
- Feeling overall unwell
How do viruses spread?
They spread because children are in close contact with one another. There are tiny droplets from the nose due to sneezing or having a runny nose. There are also droplets from the mouth due to saliva or coughing. Viruses can also spread via exposure to vomiting or feces (especially when one has diarrhea). It is all about inhalation.
A child can be exposed to a virus yet the virus does not instantly appear in the child. Rather, it incubates for a bit. It may take a few days for symptoms to appear or it can incubate for up to 2-3 weeks.
In playgroups and schools, children are sharing toys, books and sitting practically on top of one another. That’s normal.
At present, there are many viruses that are causing infection in the neighborhood. We can have multiple infections at the same time. Besides the flu (A and B) who symptoms are ameliorated having had the flu vaccine, there are adenovirus (feels much iller and even seems to appear as if bacterial), rhino/entero, corona (the non-Chinese novel version) and RSV (respiratory synertial virus which causes wheezing in younger, vulnerable children.
What are some preventative measures that may lessen the chances of your child contracting a virus?
First, practice good hygiene. This includes regularly washing hands thoroughly with soap and water (it should be a child’s first activity when coming home from wherever). Don’t share cups or cutlery or anything that has been in another person’s mouth. Teach children how to sneeze or cough into their elbow. In fact, when kids come through the door from school, think about moving up bath time and getting them out of those germ-laden clothes. Also teach your children about “tissue etiquette” – They should use the tissue, throw it in the garbage can and then wash hands. Immediately.
Change the clothing of the older siblings when they return home.
Build your child’s immune system through plenty of sleep and a well-balanced diet replete with nutrients. Stay up-to-date with their well visits and immunizations.
So your child catches one of the many viruses that abound this winter. What’s a parent to do?
The best treatment is rest at home for a day or two. This means keeping your child home from child care, kindergarten or school until they are well again. Being absent from school for a seemingly innocuous virus seems to run against the grain for many parents. My colleagues and I get it – many parents are working outside the home and lining up child care can be quite the challenge. But please, please keep them home from school until they are well again. It will lessen the chances of another virus striking. You will help to break the merry-go-round of the germs.
Infants under 3 months of age are another story. Because they can become very ill on the turn of a dime, make sure they assessed by your pediatrician and monitored accordingly. Check for fevers and reach out to your pediatrician.
Viruses cannot be treated with antibiotics. Why? Because they cannot. Period. Parents are frustrated when told this but it’s important to know why antibiotics are a non-no here. Read further.
Overusing antibiotics, especially when they are not warranted, can backfire and cause harm. Why? It’s all about your gut. My gut, your gut, your child’s gut overflows with bacteria. The problem is antibiotics do not distinguish between “good” bacteria and “bad” bacteria. Antibiotics are there to destroy bacteria which is why it is not uncommon for side effects to include upset stomachs. Overgrowth of “bad bacteria” can cause severe, debilitating and even life-threatening illnesses.
While at home, here are some tips that can make your child (and therefore you, my fellow parents) more comfortable.
- When awake, give your child small amounts to drink. Example: Drinking a mouthful of water every 15 minutes. This will help to moisten the throat and, in turn, ease the sore throat, as well as push fluids which are important, especially of there is a fever.
- This also holds true for nursing or bottlefed babies.
- No appetite? This should not be a concern. Push liquids.
- Rest, rest, rest
- Use saline nose drops to clear a baby’s nose. This will make it easier to feed the baby
- Humidifier to moisten air
You may give your children acetaminophen or ibuprofen to be more comfortable (and that will make you more comfortable). Please don’t give aspirin. Check the instructions for proper dosaging. Make sure your child is not already getting other medications that already have acetaminophen or ibuprofen in them; read the ingredients on the packaging. Beware of some “so called natural immune enhances.” Most likely, your child will feel better within several days. However, he may be unwell for up to two weeks. A cough can linger for several weeks.
It is not uncommon for a virus to trigger a child’s asthma condition. Treat the asthma as you normally would and ever prophylactically. Speak to your physician.
When should you visit the pediatrician?
Schedule an appointment if:
- There are difficulties breathing
- If it is difficult to awaken your child
- The acetaminophen or ibuprofen do not lessen the pain
- Vomiting or diarrhea persists
- A high fever persists for longer than 48 hours
- A rash or spot does not turn white when you touch it
- If there is significantly reduced urine output
- Your gut feeling tells you that you need to
This, too, shall pass.
As always, daven.
The words of this author reflect his/her own opinions and do not necessarily represent the official position of the Orthodox Union.