Doctors to answer questions on winter's most common illnesses in children
Tom Smart, Deseret News
SALT LAKE CITY — 'Tis the season for sniffling, sneezing, coughing and wheezing and while the symptoms are just plain annoying for adults, the littlest, tiny victims can suffer more severe consequences.
Respiratory syncytial virus (RSV) is just like any other cold virus, but left untreated, it can land a baby or child with other risk factors in the hospital. For a very few, it spells an early death. But for most, it's a seasonal aggravation that could be avoided with the right prevention measures.
"Hand washing is important and keeping your kids separated from other sick kids is the best way to avoid it," said Dr. Alyson Edmunds. Keeping toys separated that may have been touched by sick kids and keeping babies away from second-hand tobacco smoke is also a means to steer clear of the highly contagious and most common childhood illness in the world.
"(Parents) just need to be smart about it," Edmunds said. "They shouldn't go to places where there are potentially a lot of sick people."
Keeping a young baby safe from the virus, however, doesn't have to border on being over-protective of them. It is safe to take them outside and around people, she said.
"Make sure everyone who touches the baby has done really good hand washing, especially during the RSV and bronchiolitis season," Edmunds said, adding that the most potent season runs from December until March. "You might not be sick but you could have easily touched something that has the germs on it, so everybody should be washing their hands, but especially before touching a baby."
Edmunds, a pediatric hospitalist at Intermountain Healthcare's Riverton Hospital, and Dr. Kristina Mckinley, also a pediatric hospitalist in the children's unit, will be featured on Saturday's Deseret News/Intermountain Healthcare Hotline, where they will take questions about RSV and pediatric asthma. From 10 a.m. until noon, people can call 1-800-925-8177 or post questions on the Deseret News' Facebook page, www.facebook.com/desnews.
According to the Utah Office of Epidemiology, RSV occurs primarily during the winter months and almost every child contracts it within their first two years of life. What is then troubling is that a third of them develop a more serious virus, bronchiolitis, when the infection settles into the child's lower respiratory tract.
Symptoms are much the same with the two, including a runny nose, wheezing, fast and labored breathing and inflamed airways, but Edmunds said RSV leads to bronchiolitis more often than any other common virus, up to 80 percent of the time. Premature babies or those with underlying health problems are at the greatest risk for hospitalization from the illnesses, as well as babies and children with compromised immune systems.
Much of the treatment for RSV and bronchiolitis includes treating the symptoms, much like adults are encouraged to do for symptoms of the common cold. But babies and young children can't typically tolerate the kinds of medications adults use.
For a fever, Edmunds said Tylenol can be administered and ibuprofen is OK after the baby reaches 6 months of age. Albuterol, a bronchodilator well tolerated by children, is sometimes offered in a clinical setting, but usually only prior to confirming a diagnosis, as doctors use a scoring system before and after the treatment to determine how much air is getting into a child's lungs.
If albuterol helps a child to breathe better, there is likely an underlying asthma problem, Edmunds said.
In the hospital setting, treatment of RSV and bronchiolitis involves supportive care. Doctors provide oxygen when it is not readily getting through, hydration through an intravenous line when the baby or child cannot eat or drink enough to keep them properly hydrated, and suction when mucus or secretions prove too plentiful.
"Everybody gets RSV, it's just like a cold and it goes around," Edmunds said. "It's just a lot more serious when babies or people with immunodeficiencies or heart and lung problems get it."
Most situations can be treated at home and with a pediatrician's care, but one in 10 might end up hospitalized. Most deaths, however, happen in the first six months of life and typically only when high-risk circumstances exist.
In addition to hand washing and keeping babies and young children in clean and smoke-free environments, Edmunds said doctors also encourage mothers to breast-feed their babies throughout the season.
"Human milk has a protective factor for decreasing the risk of RSV infection and antibodies to help babies fight infection," she said.
Saturday: A look at pediatric asthma
The Deseret News/Intermountain Healthcare Hotline focuses on RSV and pediatric asthma. From 10 a.m. to noon Saturday, Dr. Alyson Edmunds and Dr. Kristina Mckinley, both pediatric hospitalists at Riverton Hospital's children's unit, will answer questions. Call 1-800-925-8177, toll-free. Anyone can also post questions during that time on the Deseret News Facebook page, www.facebook.com/desnews, and the doctors will do their best to answer them.
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