What's Going Around?

Covid-19 is a viral illness that involves, but is not limited to, fever, cough, congestion, body aches, and difficulty breathing.

How is it spread? It is spread person to person through respiratory droplets. This can occur from an infected person coughing and sneezing then not washing their hands. This can also spread by sharing food/drinks. Not all infected people realize they have COVID-19. A person is contagious before symptoms even occur.

Treatment: Treatment includes rest, fluids, and antipyretic medications (fever reducers).

When to call the doctor: Your childhas a high fever, significant shortness of breath, or difficulty breathing.

Prevention

• Cover your cough or sneeze with a tissue or use the inside of your arm, then wash your hands immediately after.
• Avoid touching your eyes, nose, and mouth.
• Wash your hands.Our hands carry so many germs that are undetected by the naked eye. Wash your hands for 20 seconds or hum the happy birthday song twice. Wash in between your fingers, your palms, and under your nails. Wash your hands after blowing your nose, coughing, sneezing, using the bathroom, handling garbage, before, during, and after preparing food, after changing diapers or cleaning up a child who has used the toilet, and after touching frequently used objects.
• Clean and disinfect all frequently used objects and surfaces in your home and work space.
• Stay home if you are sick unless you are going to seek medical care. Please be advised that this illness is highly contagious and can greatly hurt the elderly and immunocompromised.

For more information on COVID-10, click the link below; the CDC is constantly updating information:

https://www.cdc.gov/coronavirus/2019-ncov/index.html

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.

Check out our facebook page for our flu clinic dates. We strongly recommend you and your child be vaccinated for Influenza if you have not gotten the vaccine yet this year!

Flu Season Information (CDC): https://www.cdc.gov/flu/about/season

Flu Vaccine Safety and Those at High Risk of Flu (CDC):https://www.cdc.gov/flu/highrisk/

We are currently seeing quite a bit of strep throat. If your child has a fever, sore throat, headache, stomachache, rash, vomiting, or diarrhea 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 prescribed if the strep test is positive. Strep throat is contagious, and patients must stay home until they are fever free for 24 hours. Strep throat is spread through respiratory droplets, and can be passed through coughing or sharing drinks/food. Make sure to wash yours and your childs hands often to prevent further spread.

Otitis externa, or swimmers ear, is an infection caused by bacterial or fungal growth in the ear canal. This is different from otitis media, or an average ear infection, because it occurs in front of the ear drum. Symptoms include itchiness, ear discharge, and the outer ear being painful to the touch. A common source of otitis externa is leftover water in the ear after swimming or showering. Treatment typically includes ear drops and ibprofen or acetominophen for pain as needed. Swimmers ear can be prevented by fully drying the ear canal after swimming, which can be done using a blow dryer on low heat.

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.

Beyfortus is a monoclonal antibody with activity against RSV. Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens such as viruses. One dose of Beyfortus, administered as a single intramuscular injection prior to or during RSV season, may provide protection during the RSV season.

Beyfortus (Nirsevimab) is recommended for: All infants younger than 8 months of age born during RSV season or entering their first RSV season.

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.

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.

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.Please call the office to have your child evaluated by the doctor if he/she has symptoms of croup.

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 if your 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 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, so Ibuprofen or acetaminophen can be given as needed for pain relief. It is important to ensure your child drinks 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)
• The fever persists after the first 3-4 days
• You cannot keep the pain under control.

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.

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.

We are currently seeing an increase in cases of Pertussis in our community. Pertussis, or whooping cough, is a respiratory illness that begins with mild cold symptoms and progresses to a severe cough. The cough comes in spasms and is sometimes characterized by a high-pitched whooping sound followed by vomiting. Classic pertussis lasts several weeks with some cases lasting 10 weeks or longer. Pertussis is most severe when it occurs in the first 6 months of life, particularly in those who are unimmunized or who are born prematurely. Older siblings and adults with mild symptoms are an important reservoir of infection for young children and infants. Pertussis is diagnosed clinically and confirmed with laboratory tests.

Treatment

While antibiotics have minimal effect on the course of the illness once the classic whooping cough has begun, they are recommended to limit the spread of the illness. Confirmation of the illness by a medical provider helps guard against the overuse of antibiotics in the setting of a viral illness and subsequent development of organisms that are resistant to antibiotics. Control measures: All household contacts of young infants should receive a pertussis vaccine booster. Others who are unimmunized or under-immunized should complete the recommended schedule of immunizations (see our website for the recommended vaccination schedule). Household contacts and other close contacts of those who have been diagnosed with pertussis should receive prophylactic antibiotic treatment to prevent transmission of the disease. Students and school staff with a confirmed diagnosis of pertussis should be excused from school until they have completed a five day course of antibiotic therapy.