Cold and flu in children

by Dr. Divya Srirangarajan

The monsoon and the changing weather heralds the onset of cough, cold symptoms in many children. If you have nasal congestion, a running nose, or you’re sneezing and coughing, your first thought may be that you have a cold. These are also signs of allergies. A cold also called “the common cold” is caused by a virus (infections). Many different types of infections are competent for colds. The signs and symptoms may vary; colds generally share some of the same essential components.

Here are some key characteristics of the common cold:

  • Common Cold has transmitted through virus droplets that a sick person sheds when he coughs or sneezes.

  • A sore throat along with a running, stuffy nose.

  • More severe cold can also cause headache, fever and body aches.

  • Restoration from a cold is usually fast. The normal duration of a cold is 7 to 10 days.

  • If symptoms last more than a week or two, the virus may have contributed to a more severe virus, such as a sinus infection, pneumonia, or bronchitis.

  • People with allergies may be more prone to catching a cold.

Flu is a form of cold caused by the flu virus. The flu season generally starts around these months peaking in the winter months. Common symptoms include fever, headache, body pain, cough, cold, tummy upset etc. Flu is a common winter illness for a healthy adult, but for children at risk, it can become severe such as progressing to pneumonia with breathing difficulty, excessive vomiting leading to inadequate oral intake, dehydration and multi-organ involvement. Ex preterm babies are predisposed to severe chest infections for whom early testing and treatment is mandatory.

Specific ways to limit flu in the community are

  • The flu vaccine, especially to be administered to vulnerable people like small children, elderly, children with asthma, blood, kidney or heart problems in whom flu can become very severe

  • Contain spread from one person to another by using a face mask, using disposable tissues for secretions, hand sanitizers, not going to a public area like school, office during illness.

  • Taking adequate rest and plenty of fluids to recover fast along with antivirals prescribed by the doctor.

  • A child when suspected of flu undergoes specific tests to confirm the virus by doing a nasal swab and started on antivirals. The contacts of the child can be given vaccine within three days of exposure to prevent from developing the disease or given prophylactic antivirals for five days.

Allergies happen when your immune system has a conflicting reaction to some substances. When your body is exposed to an allergy trigger (allergen), your immune system discharges chemicals called histamines. This release of histamines is what causes allergy symptoms. Some of the common symptoms of allergies and colds are sneezing, sore throat, coughing, running nose, nasal congestion, watery eyes. Differentiating cold and allergies is essential as treatment differ, Colds are more likely to cause fatigue, aches and pains, sore throat a fever whereas Allergies are more likely to cause wheezing, itchy eyes, skin rashes, such as hives or eczema. The ‘allergic salute’ in children due to an itchy nose, which they usually rub with an upward hand movement that looks like a salute.

Common allergy triggers can include:

  • Mould

  • Animal dander or saliva, such as from a cat or dog

  • Dust mites

  • Foods including tree nuts, peanuts, milk, and eggs

  • Seasonal allergens such as a tree, grass, and weed pollen

If your child has a frequent cough, cold especially in the cold season or cough/breathing difficulty after certain food substances, the primary cause is an allergy of your airways called hyperactive airway disease.

Some general measures to reduce allergies are

  • To keep your house dust and clutter-free, cleaning should be done when the child is not there, wet mopping to reduce dust particles, cleaning the window panes weekly, a periodic dusting of the carpet, curtains, woollen garments in the sun

  • No indoor smoke as in cigarette smoking or kitchen smoke, which should be controlled by having good exhaust/ chimney in the kitchen.

  • Pest control, as cockroach eggs, is known to be allergic.

  • Avoid exposure to cold air, construction dust etc.

  • Avoid foods like fried items, sweets, cold drinks or any particular food your child is allergic to.

  • Moderate exercise, yoga- pranayama (breathing exercises), and eating healthy food like fruits and vegetables reduce allergies and keep you fit in the long run.

  • If frequent allergies meet your doctor for anti-allergic medications.

There are various medications available to treat allergy based on severity and frequency of symptoms. Seasonal allergies are treated with medications only during a particular period. Medications include anti-allergy pills in the bedtime to nasal sprays for cold. Allergic wheezing is found commonly in Bangalore due to the cold weather, pollution and pollen. All childhood wheezing kids don't become asthmatics when they grow up, a majority of children with wheezing outgrow the ailment after six years. The mainstay of treatment for allergic wheezing kids is using inhaled steroids with a device called a spacer. There are myths regarding its side effects and addiction. The dose of the medications used is minimal and goes into the lungs with no side effects on the rest of the body.

Pneumonia is the infection of lungs, commonly caused by bacteria and viruses. Less common types of pneumonia can be caused by fungi, chemical consumption like kerosene, paint thinner etc. It’s a severe illness which is presented by high fever, fast breathing, poor appetite, vomiting and lethargy. The infection is more severe in young children who can have complications like cessation of breathing, fits and blood infection. Some of the pneumonia-causing germs can be prevented by vaccines like the pneumococcal vaccine, which should be given to children less than two years old and in older children who are predisposed to infections.

Some of the other infections which can present as cough, cold and fever are ear infections and sinus infections. Ear infections present with ear pain or irritability and constant crying in a small child and should be suspected when such symptoms are associated with fever. Ear infections are more severe and frequent in young children <2 years, non-breast fed babies, bottle-fed babies. Sinusitis is suspected in an older child with fever and persistent cough and nasal discharge. Sinuses are air-filled spaces in the facial bones which drain into the nose, these infections are treated with prolonged antibiotics.

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