What's Going Around?

We have been seeing a lot of pneumonia this winter.  Mycoplasma has been the presumed cause, but there are other causes, both viral and bacterial.  It is important to differentiate the cause, because we don't want to put your child on unnecessary antibiotics.  If you are concerned your child's cough isn't running the usual course of an Upper Respiratory Infection / Cold because it is lasting longer than expected, is getting worse as opposed to better, is accompanied by a high fever for 72 hours or more, or you're just worried about how they are breathing, call the office or come to walk-in to have your child evaluated by one of our physicians.  Read more here:  Cough, Cough under 1 year of age 

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

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.

For more information: See also Cough

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 and children under 2 years of age.  They are especially vulnerable to complications and, if over the age of 6 months, should get vaccinated as soon as possible. 

For most everyone, treatment is supportive.  In other words medicines like Tylenol and Ibuprofen to address the fever, sore throat and body aches and plenty of rest and fluids.  But in severe cases hospitalization may be necessary to provide oxygen and other supportive measures.  Oseltamivir (Tamiflu) is an option for those listed above who are at increased risk of severe disease.  Tamiflu very minimally decreases the likelihood of coming down with flu if exposed, but it is not a panacea.  When exposed to flu, Tamiflu reduces risk of contracting flu from 5.6% to 2.6% (3% reduction) or from 17% to 3.4% (13% reduction) for exposure to a direct household flu contact.  Tamiflu can also can be used to treat the flu if given within the first few days of illness.  However, when used to treat an influenza infection, it reduces the duration of the disease by only 1/2 to 1 day.  In addition, Tamiflu has the very common side effect of causing nausea and vomiting, especially in children.  There are other more serious side effects including seizures and hallucinations, that, although uncommon, are even more problematic and why we reserve the use of Tamiflu to just those patients at highest risk.

The best thing you can do to prevent severe illness in your children is to get them the flu vaccine!  If your children have not yet had the flu vaccine this year, we are still offering it - and it will have protective effects within a few weeks of receiving the vaccination.  If your child does contract influenza and you are worried that they are in need of supportive measures that you are unable to provide, call the office to talk with our nurses, schedule an appointment or come to our walk-in clinic weekday mornings at 7:30am.