Winter Illness

Winter is quickly approaching and we will see an increase in coughs, colds, fevers, flu and stomach bugs in all of our children. Most of these symptoms are caused by viruses with strange names like Rhinovirus, Influenza, Adenovirus or Norwalk virus (and many more) but occasionally there may be a more serious bacterial infection causing symptoms. So how can you prevent your child from getting sick and when should you be concerned and carry your child to the doctor? These are two important questions I am asked on a daily basis.

The best way to keep your child healthy during cold and flu season is to teach them good hand washing techniques and have them get the flu vaccine every year around October. You will also want to be sure your child is getting enough rest and eating a balanced diet with lots of fresh fruits and vegetables to keep their immune system healthy. If you have a very young infant you may want to consider limiting your outings to crowded places and keep them away from obviously sick family members. With all of these measures in place, they will likely still get sick. Many of our winter illnesses are spread through the air in small droplets when someone coughs or sneezes and your child simply inhales and the illness is spread. Also, preschool age children are notoriously bad at keeping their hands out of their nose and mouth, so they pick up illnesses from their friends very easily. Call your doctor’s office today to get your family vaccinated. Everyone over six months old should receive the flu vaccine every year.

If your child does become sick, when should you be concerned and bring them to the doctor? In general, if your child has a fever over 101 for more than 48 hours, especially if there are associated symptoms such as headache, sore throat, abdominal pain, or irritability in an infant, we should take a look. You should come in sooner if your child has trouble breathing, they have a rash with the fever or if the fever is not going down with a fever reducing medication such as acetaminophen. Often the doctor will examine your child and determine they have a virus and offer you advice about ways to help them feel better but no prescription. This is because viral illnesses require only supportive care and will go away in about three to seven days. As a mother of four children who have had countless viruses over the past 15 years, I understand the frustration parents feel when the doctor says, “It looks like a virus.” On the other hand, as a doctor I know how important it is to not over treat viruses with medications such as antibiotics. We also know that many of the cough and cold medications you find at the grocery store are not recommended by the FDA for children less than six years old. This is because they are not proven to be helpful and they can have bad side effects. The best thing to do for your child with a virus is to have them drink plenty of fluids, run a cool mist humidifier where they sleep, let them rest and offer them fever medications when the fever is making them uncomfortable.

But wait, what happens when your child doesn’t get better like the doctor said they would? Well, three to ten days after the beginning of a virus, children sometimes get sick with a bacterial illness called a ‘secondary infection.’ These are infections like ear infections, sinus infections or lung infections. When diagnosed with a virus at the first visit, your doctor will typically tell you to return if your child is not better in two to four days or if new symptoms develop. At the second visit an antibiotic may be prescribed if the doctor identifies a secondary infection. In some cases it is still the original viral illness and the child may simply be taking a bit longer to recover and they will still not be given a prescription. Parents will sometimes ask why I don’t just prescribe an antibiotic to prevent a bacterial infection.

The answer is simple – medications are chemicals and it is unhealthy to take antibiotics unless your body actually has a bacterial infection and as doctors we do not want to prescribe unnecessary medication which could harm our patients. Doctors and nurses need to work hard to teach parents about the importance of avoiding the overuse of antibiotics to treat viral infections. The time put towards educating families is well worth the benefit.

Winter is coming, so get your family vaccinated, teach good hand washing techniques to the children, and if your child is sick remember we are here to help and we will see them when you call. Have a happy and healthy winter season!

By Michelle Puzdrakiewicz, M.D.