Bronchiolitis (and RSV)
We are currently seeing cases of bronchiolitis, a viral illness (sometimes caused by RSV -- "respiratory syncytial virus") that occurs most often in children under age 2. 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.
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 if 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.
For more information:
See also Wheezing (Other Than Asthma)
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
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See also Sinus Pain or Congestion
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.
COVID-19 FAQs
What is COVID-19?
Coronaviruses are a large family of viruses. Some cause illnesses in people and others spread among animals including camels and bats. In people, the coronavirus family causes illnesses like the common cold. Almost everyone gets one of these viruses at some point in their lives. Most of the time the illness only lasts a few days.
The COVID-19 virus is a new coronavirus that can cause respiratory illness and spread from person to person. Because it is a new virus, humans haven’t yet established natural immunity to it which is why it is spreading around the world. Many people with COVID-19 have a mild respiratory illness, some get very sick, and a small number of people die from the infection. Studies at present seem to show that healthy children are largely spared the serious and life threatening forms of COVID-19. The population most vulnerable to COVID-19 are older adults and people with underlying chronic illnesses.
What are the symptoms of COVID-19 in children?
Symptoms for COVID-19 are characterized by mild presentation including cough and fever. There also can be a runny nose and sore throat, and diarrhea may be seen in children more freqently than in adults. Loss of taste and smell is seen in some children and teens infected with the virus and is uncommon in other cold/flu illnesses. Shortness of breath is a less common but a more concerning symptom. If your child has a fever, runny nose and cough, but looks well, provide lots of fluids, monitor closely, and call us with any concerns. If your child’s symptoms worsen, or if your child has any respiratory distress or shortness of breath, then contact Eden Park immediately for guidance.Thankfully at this point, COVID-19 appears to be a relatively mild illness for the vast majority of children. You should care for your child as you would with other illnesses (encourage rest and fluids, use fever-reducing medications for comfort, etc.) and monitor particularly for any increased work of breathing. If you have concerns at any point regarding how your child is doing, give us a call. The providers and staff at Eden Park are here and prepared to ensure your child remains safe throughout their recovery.
Can I get my child tested?
Testing for COVID-19 is available at Eden Park Pediatrics. We have the ability to do rapid tests when indicated and can perform the swab to send the tests out if needed. Both tests are done by swabbing the anterior inner aspect of the nose. The current recommendation is for testing of symptomatic patients on day 3-5 of symptoms, and testing asymptomatic contacts on day 5 after exposure.
What are the recommendations for isolation and quarantine?
If you or your child is diagnosed with COVID-19 you should isolate at home and away from family members if possible for ten days after the onset of symptoms. When able, this means a separate bedroom, bathroom and no shared rooms for eating or socializing. Understanding this is impossible for small children, parents need to quarantine at home if they test negative for ten days after the last day of exposure to a potentially infectious contact. That means mom's quarantine starts on day 10 of the child's isolation, and starts over again if anyone else in the household tests positive. We understand this is difficult and arduous and also confusing, so we would be happy to answer any additional questions that you might have about these current recommendations.
Quarantine can end after 7 days if you remain asymptomatic and have a negative test 5d after exposure.
How do we treat COVID-19?
The best treatment is supportive care; just like you would treat other viral respiratory illnesses. This includes rest, fluids, and fever-reducing medications for comfort. Antiviral medications are being developed (think Tamiflu) but are not yet available for use in children who are not ill enough to be hospitalized.
What is Eden Park peds doing
We are doing everything we can to ensure that every patient, family member, and visitor remains safe and healthy in our offices. We’ve added extra cleaning and sanitizing precautions and have arranged separate offices to be used for sick and healthy children. We will continue to track recommendations from the AAP, CDC, state and local health departments, and other sources.
Should I reschedule my child's well child visit?
Right now, we’re urging everyone to keep all well visit appointments, because that recommendation follows CDC guidelines, and because it’s always critical to keep kids up-to-date on routine care and immunizations. The CDC recommends that we minimize disruption to daily life to the extent possible. We have arranged for only preventive visits in healthy children to be done at the Lancaster office and the Mount Joy offices, and the infectious sick visits to be done at our Brownstown office. Sick patients will be brought directly into a patient room once they’ve arrived at the office to minimize any waiting room time.
When will my child be able to get immunized?
Currently there is one covid-19 vaccine approved for emergency authorization for use in children older then 5 years old. We are currently offering that Pfizer vaccine for children in our office. The dose of the vaccine is different for children 5-11 years of age (1/3 that of the adult dose for those over 12y), and is also a 2 dose series with the second dose scheduled 3 weeks after the first. This vaccine is recommended by the American Academy of Pediatrics and by the CDC for all children 5 and older.
Can I breastfeed my infant if I have or might have COVID-19
A mother with confirmed COVID-19 or who is symptomatic should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast. For more information on COVID-19 and breastfeeding, click here.
Croup
We are currently seeing cases of croup, a viral respiratory illness that most often is caused by the parainfluenza virus. The cough and breathing that are associated with croup make it distinctly different from other viral colds or respiratory illnesses. This is because the parainfluenza virus infects and irritates the voice box, the vocal cords, and the windpipe. The cough is worse at night, and it has a distinct bark that sounds much like a seal's bark. Associated with the barky cough, your child may have difficulty when inhaling air, making a labored and whistling sound when breathing in -- called stridor. Humidified air and fluids often are the most helpful treatments. We may also decide to give your child oral steroids to help with the stridor. Please call the office to have your child evaluated by the doctor if he/she has symptoms of croup.
Flu Season
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 a sudden onset of fever, chills, dry cough, and muscle aches. Other symptoms include headache, fatigue, sore throat, and nasal congestion.
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.
Please get a vaccination if you and your child have not yet had it this year!
Learn more about the flu and see the most up to date information here.
Hand-Foot-Mouth Disease
Hand-foot-mouth disease is a common viral illness caused by the Coxsackie A-16 virus (a member of the enterovirus family). Its name describes the location of the rash during the illness.
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. Sometimes 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.
For more information:
See also Mouth Ulcers
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See also Rash or Redness - Widespread
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.
For more information:
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.
For more information: See also Vomiting with Diarrhea, Vomiting without Diarrhea
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 7-14 days. Call us if the fever lasts greater than 3 days or if symptoms last longer than 2-3weeks or if your child has been exposed to COVID-19.
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 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.