From strep throat to RSV: Winter health cheat sheet

sick-girlParents, we’re with you. We know that kids spread germs like wildfire. We know that even a simple cold can mean some sleepless nights. And we know that being prepared can makes things at least a tad bit easier.

When it comes to common childhood winter illnesses, knowledge is your best defense. So brush up on your winter ailment know-how, and head into the cold season armed with a good strategy.

Common winter infections

Strep throat

Strep throat is a bacterial infection caused by group A streptococcus. Sore throats are common in the winter, but strep is usually associated with more severe symptoms including:

  • severe sore throat
  • swollen lymph nodes in the neck
  • inflamed and red tonsils
  • tiny red spots or white patches on the back of the palate and tonsils
  • fever (greater than 101 degrees F)
  • headache, nausea, vomiting, body aches and rash

Strep throat is diagnosed by swabbing the tonsils to test for group A streptococcus. If the test is positive, your child’s pediatrician will prescribe antibiotics. Be sure to administer your child’s antibiotics for the number of days instructed by your health care provider, even if she seems like she’s made a full recovery.

Croup

Croup is a viral illness most commonly caused by the parainfluenza virus. What begins as a typical upper respiratory tract infection (like the common cold) then causes swelling of the larynx (voice box) and trachea (wind pipe). Typical croup symptoms include:

  • runny nose and congestion
  • a barky cough
  • fever
  • stridor (a high-pitched sound heard when a child breathes in)

Because croup is caused by a virus, antibiotics are not effective in its treatment. Your pediatrician might prescribe medications and breathing treatments to help decrease swelling and to allow your child to breathe more comfortably. In severe cases, hospital treatment might be indicated to closely monitor and treat your child. Otherwise, supportive measures such as keeping air humidified; bringing your child into cold, dry air; and keeping her as calm as possible will help your child breathe easier.

Whooping Cough

Whooping cough (pertussis) is a bacterial infection associated with intense coughing fits. Typically, a characteristic “whoop” sound is heard as the person breathes in throughout the coughing spell. About 75 percent of children infected are under the age of 5. The course of whooping cough can last several weeks, with three stages.

The first stage can last from one to two weeks and is categorized by a mild cough, low-grade fever, and runny nose. The middle, or acute phase, is when the severe coughing fits emerge and may last for several weeks. During the recovery phase, which typically begins between weeks four and six, the cough starts to decrease. However, the cough, though less severe, may last for up to eight weeks after the recovery phase has begun.

To support your child at home, the best things you can do are:

  • Encourage your child to eat small, frequent meals (coughing fits can sometimes cause vomiting).
  • Encourage your child to drink plenty of fluids.
  • Decrease stimuli that may provoke coughing, including active play, crying and feeding.

Your child will likely receive antibiotics to help treat pertussis. Those living in the household may be prescribed antibiotics as well to decrease the chance of contracting the disease. In some cases, a child may need to be hospitalized for supportive care.

Infants are at particular risk of complications related to pertussis. The Centers for Disease Control and Prevention recommends a Tdap vaccine for pregnant women to help boost a fetus’s immunity. It’s also important for caregivers and the family to be immunized in order to help decrease the risk of spreading the disease to younger children.

RSV

RSV, or respiratory syncytial virus, is a viral illness that can cause upper and lower respiratory tract infections. Children under the age of 1 who are infected with RSV are more likely to develop bronchiolitis (lower airway inflammation) and, in some cases, pneumonia (infection in the lobes of the lungs). Symptoms of RSV include:

  • lethargy and irritability
  • poor feeding
  • fever
  • cough
  • wheezing
  • rattling in the child’s chest
  • episodes of apnea (when a child stops breathing for 10 seconds or more)

Children six months or younger, or with other health problems, are most at risk for developing severe cases of RSV. Most of the time, RSV can be treated on an outpatient basis. Up to 2 percent of children may need to be hospitalized for closer monitoring and supportive care.

What you can do to help your child

There’s a lot you can do to support your child through any of these winter illnesses, including:sick-boy-300x240

  • Give over-the-counter pain medications to help reduce discomfort.
  • Encourage her to drink plenty of fluids.
  • Promote rest.
  • Humidify the air.
  • According to this study published in Pediatrics, vapor rub can be effective in decreasing nighttime cough. Please note that some children may experience skin irritation. Vapor rub is not recommended for children under the age of 2.
  • Keep the nasal passages as clear of excess mucous as you can.
  • Elevate the head when sleeping to help support comfortable breathing.
  • Keep a close eye on your child’s breathing.
  • Notify your pediatric health care providers of any changes in your child’s condition.

You should notify your pediatrician or call 911 immediately if your child displays signs of respiratory distress such as:

  • rapid breathing
  • nasal flaring
  • retractions (pulling in of the chest wall)
  • bluish lips or fingertips (can indicate poor oxygenation)

Prevention is key

Of course, the ideal is to prevent these illnesses in the first place. The best preventive measures are usually the simplest. But that doesn’t mean it’s easy to get your kids to follow them. Continue to encourage:

  • frequent hand washing—it’s your greatest barrier to the spread of infection
  • covering the mouth and nose when coughing and sneezing
  • avoiding sharing of utensils, cups, etc.

Best wishes for a happy and healthy winter.

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New York boy, 8, has life-saving heart surgery


Max Omphalius, 8, of Hopewell Junction, N.Y., was the Poughkeepsie Journal’s feature story this past Thanksgiving. Max was the youngest person ever to have a rare kind of open heart surgery that removed a life-threatening cyst in his heart. The cyst was discovered on a routine EKG screening when, other than feeling a little tired, Max displayed no symptoms of distress. Complications from an illness in May, however, signaled to Max’s parents that he would need an aggressive intervention.

Kim and Chuck Omphalius worked with their local doctors in New York to figure out the best plan of care for their son. They were advised to take Max to Boston Children’s Hospital, where the top-ranked pediatric Heart Center had the depth and breadth of expertise to skillfully handle such a complicated case.

Because only about 1 in 1,000 children born with a heart defect have a cyst, Max’s situation was incredibly unique. His cyst was attached to a heart valve, so removing it without damaging the valve would require extreme precision and preparedness. With help from advanced imaging and surgical techniques, Dr. Sitaram Emani and the Boston Children’s surgical team were able to remove Max’s cyst without causing any permanent damage to his heart.

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Childhood’s most prevalent disease: It’s not what you think

poor-child-with-leukemia-300x200Chloe laughed from her belly. A Popsicle left its mark on a yellow sunflower dress, and pigtails of dirty blonde curls dusted her cheeks as she walked. She had a gap between her front teeth, and when she smiled, her dark green eyes disappeared in a squint. She told me several times, “I’m going be a princess!” “Which one?” I’d ask. She’d throw her favorite blanket on her head and point to the smiling Cinderella.

Chloe’s kindergarten teacher saw bruises at recess earlier that day. Suspecting abuse, she brought the five-year-old to a medical clinic after school. We found swollen lymph nodes in her armpits and groin and called the child’s mother. A bone test the next day confirmed leukemia, childhood’s most common cancer. Treatment began.

Progress in the battle against childhood leukemia

Until the 1960s, all kids with Chloe’s type of cancer died within one year of diagnosis. But little by little, research advanced. Eventually, scientists found vincristine. The United States Food and Drug Administration approved the miracle drug in 1963, and today, therapies with vincristine cure 80 percent of kids with leukemia.

But when Chloe started vincristine, her dad was in jail. Her mom, between jobs and with a newborn boy, rinsed the baby’s paper diapers in the sink. “They’re just too expensive to throw away,” she said.

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“The right doctors and the right game plan” help teen with IBD

Kimberlee-Roy-300x207First grade is a time rich in reading, writing and recess. But for Kimberlee Roy, first grade was far from a jovial time.

At the tender age of 6, Kimberlee experienced the sudden onset of excruciating stomach pain and bouts of bleeding and diarrhea. “It got so bad that when I went to the bathroom, I would be yelling and crying because there was so much pain in my stomach,” recalls Kimberlee, now 16. “It was the worst pain I ever felt.”

In need of medical care, Kimberlee was admitted to a hospital near her hometown in western Massachusetts. After multiple tests and procedures during her three-week stay, Kimberlee was diagnosed with Crohn’s disease, a form of inflammatory bowel disease (IBD), a condition in which one or more parts of the intestinal tract become inflamed.

“I thought it was a stomach bug that would go away,” Kimberlee says. “Unfortunately, it didn’t.”

During the December hospitalization, she was prescribed anti-inflammatory medications and underwent a blood transfusion and a series of infusions of the intravenous drug Remicade.

She finally left the hospital two days before Christmas.

“Kimberlee’s doctor gave us the green light to go home for the holidays once he knew Kim was stable and we could handle all the medications, machinery and IV equipment that she needed,” says Tammy Roy, Kimberlee’s mother.

Throughout the next year, Kimberlee managed her illness until a severe allergic reaction to a medication stopped her in her tracks.

“After a discussion with Kimberlee’s doctor regarding other medical options, treatments and Kim’s health status, I asked for her to be transferred to Boston Children’s Hospital,” Tammy says.

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