What's Going Around?

Allergies

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


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


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.

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)


Enterovirus

We are currently seeing children and adolescents with infections caused by the enteroviruses, a group of viruses that often cause illness during the summer and the early fall months. The commonly used term "enterovirus" includes the coxsackie viruses, the echoviruses, and the enteroviruses. These viruses often cause a fever, and also may cause a rash, respiratory or cold symptoms, and vomiting with diarrhea. Hand-foot-mouth disease, a rash that involves those areas of the body, is a common enteroviral infection that occurs in children. More serious illnesses that are caused by these viruses include meningitis, heart infections, and eye infections. For mild illnesses caused by the enteroviruses, the best treatment is adequate rest, plenty of fluids, and fever control.

NOTE: Enterovirus D68: This fall season, an enterovirus that causes primarily respiratory symptoms has been seen in various regions of the country. Please refer to the Enterovirus D68 article in this What's Going Around? section.


Enterovirus D68 (EV-D68)

Enteroviruses frequently cause mild illness in the summer and fall. This year, Enterovirus D68 (EV-D68), is a unique virus that shares features with the common cold viruses. Most infections are mild and self-limited and will last 5 to 7 days.Asmallgroup of children and adolescents, expecially those with asthma, are experiencing more severe respiratory symptoms with wheezing and shortness of breath. Note: for most cases, a test for EV-68 is not required because it will not affect the course of the illness.

No vaccines are available for EV-68 and there are not any antiviral medications that treat this virus.

If your child has a history of asthma:

  • Continue with your child's current asthma treatments
  • Make sure your son/daughter has his/her inhaler and other asthma medications at all times
  • If your child usually uses a controller medication (e.g an inhaled steroid) during the winter season or with colds, consider the possibility of starting the controller medication now.
  • Make sure your child's teacher or caregiver knows of your child's asthma

Call 911 ifyour child has severe symptoms:

  • Having serious trouble breathing (e.g. chest retracts or lips and/or fingers turn blue)
  • is unresponsive or difficult to arouse
  • Has slurred speech, paralysis, or severe headache

Make an appointment or call us if:

  • Your child's cold seems severe and/or he/she is uncomfortable with their breathing
  • Your child can't sleep due to the respiratory symptoms
  • Your child has ear pain or other significant pain that is not relieved with pain medication

Home Treatment

  • Frequent fluids, rest and fever management.
  • Frequent hand washing...cover your mouth when coughing
  • Avoid kissing, hugging and sharing drinks with people who are sick.
  • Disinfect surfaces in your house such as countertops and toys.


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 , See also Rash or Redness - Widespread


Measles

With measles cases across the country breaking all records many families are contacting us to understand how they can best protect their children and themselves. This article was created to answer some of our frequently asked questions.

Measles is a highly contagious, airborne viral illness. So contagious, in fact, that if someone with active measles infection was in a room even 2 hours earlier, if anunprotectedperson walks in that same room they have a 90% chance of getting measles. The virus can be transmitted from 4 days before the rash becomes visible to 4 days after the rash appears. Inareas of the countrywhere there are numerous active cases and the virus is spreading, it is really important to make sure your family is protected.

The good news is that there is a safe and effective measles vaccine. Measles vaccine is currently part of two licensed combination vaccines: the MMR (measles-mumps-rubella) and the MMRV (measles-mumps-rubella-varicella). There is no currently available single component measles vaccine.

MMR is routinely first given to children at 12-15 months of age per the standard schedule.The second dose of MMR is routinely given between 4-6 years of age. The second dose is not a booster, but rather is intended to produce immunity in the small number of people who fail to respond to the first dose.

Between 2% and 5% of people do not develop measles immunity after the first dose of vaccine. This occurs for a variety of reasons. The second dose is to provide another chance to develop measles immunity for people who did not respond to the first dose. The second dose can be given as early as 4 weeks (28 days) after the first dose and be counted as a valid dose if both doses were given after the child's first birthday.

If you live in, or are traveling to, a region where there is a current measles outbreak and your child has only had their first vaccine, you should discuss getting the second vaccine early with your doctor. It takes 10-14 days for the body to build up protection from the vaccine. Why don't we give the second dose early for everyone? Unlike measles which gives lifetime immunity after those two shots, we know the mumps protection starts to diminish after 7-10 years. We don't want to create a new problem with more mumps in the future (already a problem at some college campuses and other places.)

How can I protect my infant who hasn't yet received the 12 month MMR? If your child isat least 6 months old, they can receive a shot early. However, this will be considered "dose zero" and will give them temporary protection. They will still need the routine two doses at 12-15 months and 4-6 years of age.

Children under 6 months of age are not eligible to receive MMR vaccine. Antibodies circulating from their mothers prevent them from having an appropriate response to the vaccine. Best advice for infants traveling to an outbreak area (either in the US or abroad)? Whenever possible: don't go.

What about parents, grandparents, aunts and uncles? For those people born prior to 1957, they are considered immune. Measles was widespread before the vaccine and because of the highly contagious nature of the virus, those persons are considered immune. Anyone, who had two doses of vaccine or has proven measles immunity by antibody titers (bloodwork) is considered protected. There is no indication for a third measles vaccine. If you are not sure, or had only one vaccine, the CDC has great informationhere.

Remember, we are not only protecting our families, but those vulnerable members of our community who cannot get the vaccine either because they are infants and too young, are undergoing treatment for cancer, have immune deficiencies or are immunosuppressed because they have had an organ transplant. Thank you for keeping our community as safe as possible and contributing toherd immunity. #VaccinesSaveLives

Mouth Blisters (Herpangina)

Herpangina is an illness caused by a virus, with small blister-like bumps or ulcers in the back of throat or the roof of the mouth. The child may have a high fever with the illness.

Herpangina is a common disease in children and is usually seen in children between the ages of 1 and 4, most often in the summer and fall. Good handwashing is necessary to help prevent the spread of the disease.

Treatment for herpangina is to help decrease the severity of the symptoms. Since it is a viral infection, antibiotics are ineffective. Treatment may include increased fluid intake, and acetaminophen for fever and pain.

If the child is not taking fluids well and there is concern about hydration, you should bring the child in to the office.


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 Sore Throat , See also Strep Throat Exposure


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, Pedialyte, or warm soda pop 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.

For more information: See also Diarrhea , See also Vomiting Without Diarrhea

157 Tomahawk Street (Rt 118) • Yorktown Heights, NY 10598
Phone: 914-248-0500 • Fax: 914-248-5478
Office Hours:

Monday:  9:00 am - 5:00 pm
Tuesday: 9:00 am - 5:00 pm
Wednesday:  9:00 am - 5:00 pm
Thursday:  9:00 am - Noon
**Phones open till 5:00 pm
Friday:  9:00 am - 5:00 pm
Saturday:  9:00 am - Noon

We are closed for lunch 12:30 pm - 1:30 pm.

 
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