Pediatricians look forward to the week after Labor Day. Kids go back to school, giving a slow
down to the crazy pace of summer physical season. Germs haven’t had time to circulate
amongst classrooms and families. We breathe in the sweet air of September and gear up for
the winter sick season. But, what’s that you say? Illness in August and September? Hospital
wards and ERs packed? What’s going on? Well, all of our distancing put a big damper on the
illness season last winter. Now, man oh man, are those germs eager to get out there and
spread. We are seeing illnesses in the office that we usually don’t see for a couple more
months. I thought a brief run down of what we are seeing would be interesting.
One of the most common germs we are seeing right now is respiratory syncytial virus, or RSV.
RSV is usually a winter bug in Minnesota but it is rampant right now. RSV causes cold like
symptoms in most people. In about a third of kids under one, they develop a lower respiratory
tract infection. Specifically, they develop “bronchiolitis”. This is different than bronchitis.
Bronchioles are the smaller airways in your lungs. These kids get a very junky cough. You can
often feel the popping and crunching in their lungs when you hold them. Other viruses can
also cause bronchiolitis but RSV is the most common. We have tried a host of treatments for
RSV without much benefit. Steroids, albuterol (what we use for asthmatics), epinephrine, and
antivirals have not been beneficial. Everyone is going to have RSV in their childhood, often
several times. About 1-3% of those kids will end up in the hospital, usually because they need
IV fluids or oxygen support. But most kids do just fine at home! We call these kids “happy
wheezers”. They sound absolutely awful but look happy and smiley, drink well, and get
through it without too much of a problem.
Another illness making an early debut this year is croup. Croup is a description of a cough, not
an actual germ. A “croupy cough” sounds like a dog or a seal has moved into your house.
Once you’ve heard it, you never forget that sound! We usually see an uptick of croup in the fall.
We started seeing it in the summer this year. We often will treat croup with steroids to reduce
the swelling that is happening just below the vocal cords. The steroids will not get rid of the
cough or the illness but it will open up the airway so oxygen can get through. A bit of a bark
to your child’s cough is ok. But if your child starts having noisy and raspy breathing with it,
especially when they are at rest, they need to be seen urgently.
Finally, I have to mention influenza. We haven’t seen any cases of flu in our office this year.
Last year, there was almost none. I must say, I am dreading what it could look like this year. I
can just see the evil flu villain rubbing its hands together and cackling as it prepares to reemerge.
Just in case you forgot, flu is usually a week of misery. High fever, headache, cough,
body aches, sore throat, and congestion are the hallmark symptoms. Some people will get an
upset stomach but isolated vomiting and diarrhea is not usually influenza. Sometimes,
depending on the situation, we use antiviral medication to reduce the duration of the flu. Lots
of rest, ibuprofen, and chicken soup are usually the mainstay of treatment. However, it’s
important to remember that flu can be much harder on our youngest patients. Kids under the
age of two-years-old are at a higher risk of hospitalization and complications from the flu. We
lose on average 150 kids to influenza in the United States each year. While not a guarantee,
the best thing you can do to prevent influenza is to get your child their flu shot. And the time
has come! Flu vaccines have arrived in our clinic. We have several flu clinics coming up in the
next couple of months Please call our office to get your child scheduled! 952-401-8300
