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    Common Winter Illnesses In Children

    Mallory Williams Zorn, MD Deaconess Clinic Pediatrics 12/11/2018
    It’s “sick season”— kids everywhere are sharing germs with children at school, daycare and other activities. Some of these germs cause mild symptoms like a runny nose, but others can lead to life-threatening conditions. I want to share helpful information about common winter illnesses so parents, grandparents and caregivers know what to do, and how to help their child feel better.

    The Common Cold
    Most people will get more than one cold during the winter months, especially children in daycare or school. This virus occurs so frequently the word “common” is part of its name! The common cold is a virus that affects the upper respiratory system. Symptoms include nasal congestion, runny nose, cough, low-to-midgrade fever, and sore throat. (Body aches, high fevers, headache and/or chills are signs of flu or other infections.)

    The best support and treatment for a cold is symptom management. That usually means fluids and rest.  Nasal saline can thin out mucus and decrease inflammation in the nasal passages. If your child is over one year of age, a spoonful of honey can help with cough and sore throat. Orange juice may be something that kids will enjoy drinking and the extra vitamin C may be helpful and won’t hurt.  (Limit to 4-6 ounces per day, as juice has lots of sugar.) Over-the-counter cough and cold medication may be effective for adults, but it really doesn’t help kids under the age of 12.

    Most importantly, antibiotics are used for bacterial infections. The common cold is caused by a virus, not bacteria, and antibiotics do not treat viruses.

    Many coughs that accompany a cold are still a virus and part of the cold symptoms. Even “productive coughs” (where you cough up mucus and gunk that you spit out) can be just another part of the cold.

    Bronchitis is more than a cough. It is inflammation/swelling of the larger airways leading to the lungs. Bronchitis generally develops as a secondary infection—usually bacterial—that comes along after several days or even weeks of experiencing cold symptoms.

    If your child is having higher fevers with cough for 3-4 days, they should be seen by a doctor. The doctor will listen to the child’s breathing to determine if it’s bronchitis. Because bronchitis is (usually) a bacterial infection, treatment may require antibiotics.

    Children less than two years old often get lower respiratory infections from viruses. Bronchiolitis is a common illness caused by an infection of tiny airways – called bronchioles – that lead to the lungs. Symptoms start out looking like the common cold, but once inflamed, the airways swell and fill with mucus. This can lead to wheezing, difficulty breathing, and lack of interest in food and drinking.   

    Most children diagnosed with bronchiolitis are still treated with supportive care and can be managed at home.  Sometimes breathing treatments are prescribed.

    Any child in respiratory distress should see a doctor immediately—either in the office, urgent care or if overnight, the emergency department.

    RSV (Respiratory Syncytial Virus)
    RSV is a very common and contagious respiratory virus with symptoms that mimic a cold or the flu.
    For most babies and toddlers, the virus causes nothing more than a cold-like illness. However, premature infants, those under a year of age, and children with other health issues are at an increased risk of the virus developing into bronchiolitis and even viral pneumonia.

    If your child is age two or younger and has trouble breathing, or has a cough producing yellow, green, or gray mucus, or shows signs of dehydration, call your doctor. If diagnosed with a mild case of RSV, the provider will instruct you on how to care for the child at home. Kids with severe RSV may need to be hospitalized.
    No medication treats the virus itself. Antibiotics are used for bacterial infections, not viruses.  

    If your child seems very tired, breathes rapidly, or has a blue tint to the lips or fingernails, get medical attention immediately.

    Influenza (The Flu)
    Influenza is generally referred to as “the flu.” It is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs. Unlike a cold, the flu comes on suddenly and causes symptoms like chills, fatigue, severe cough, high fevers and body aches. People can experience a mild form of the flu or a severe case that requires hospitalization.

    Anti-viral medication such as Tamiflu can shorten the duration and severity of the illness if received within the first 48 hours of having symptoms. That’s why it’s important to call your doctor or visit an immediate care provider sooner than later.

    The most effective way to prevent flu in people of all ages is to get a flu shot every year. Simple actions such as washing your hands, staying away from people who are sick, and covering coughs and sneezes also help slow the spread of viruses like influenza.

    Stomach Viruses
    The “stomach flu” and influenza are not the same thing. When people say they have the “stomach flu” they are generally referring to viruses that cause vomiting and diarrhea – not a respiratory virus.

    While very unpleasant, most intestinal viruses simply need to run their course for 24 or 48 hours. Antibiotics or anti-diarrheal medication won’t treat the virus strain, so supportive care like drinking fluids and resting is most helpful. (Stay away from sugary drinks as they can lead to more diarrhea.)

    If your child has severe vomiting for a long period of time and can’t keep anything (including water) down, they’re at risk of being dehydrated. Call your provider, as he or she may either want to see your child or provide direction over the phone.

    Signs of dehydration include:
    •      Urinating less than 2-3 times in 24 hours
    •      Dry mouth
    •      No tears when crying
    •      Listlessness, being very lethargic, and not “acting right” beyond just being sick
    Where to take a sick child for treatment
    If you’re worried about your child, it’s always OK to make an appointment for medical evaluation. Even if they have a viral illness and there isn’t much that can be done about it, as providers, we’re glad to rule out any serious illnesses. We can also recommend the best treatment options.

    If you are established with a Deaconess Clinic provider (pediatrics, family medicine, etc.) and need an appointment, call the doctor’s office or schedule an appointment using MyChart. You can also send non-urgent messages via MyChart.

    If your child is sick in the evening, or over the weekend during daytime hours, Deaconess offers the only Pediatric Urgent Care in the region on our Gateway campus. Other Urgent Care and EXPRESS locations also provide care for children. Visit to schedule online, or to see wait times for walk-in care. You can use sorting and filtering tools to find the right level of care by symptoms, choose locations based on wait times or proximity to you, and more.

    Finally, if your child is severely ill overnight (breathing distress, high fevers in infants, etc.), the emergency department at both Midtown and Gateway Hospitals is always open.
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