Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Croup and Asthma Season



Croup is a common problem in young children and is very active in our area right now. Croup is usually caused by several different viruses, occasionally by allergies or other irritants and rarely by bacterial infections.

Croup involves swelling of the area around the vocal chords and is similar to laryngitis in older children and adults. In small children with croup there is a barking inspiratory strider; it is a cough heard when the child breaths in. This is different from asthma which is a wheezing sound when the child breaths out.

Croup can be very dangerous in small children because of the very small size of their airways. Whenever a child with croup has significant difficulty breathing and a scary, choking cough, a doctor should be consulted right away. Treatments for croup include: a cool mist vaporizer, any effective cough suppressant, and occasionally inhalation treatments with adrenalin and other bronchodilators. In severe cases the child should be hospitalized and treated with IV fluids and medicines and "close" observation.

Viral croup is peculiar in that it tends to come in cycles. Every 5 to 7 years there is a major epidemic nation wide and in between that major epidemic there are annual flare-ups in which we will see dozens,if not hundreds, of cases of croup even throughout our community. Most of these are mild and can be treated at home with a cool mist vaporizer and cough medicine, but any severe cases should be seen by a doctor.

Asthma is different from croup in that it is usually caused by allergy to pollens, smoke, dust, animal danders and occasionally by food allergies. Asthma also flares up season-ally and particularly in the fall and spring. Right now in Louisiana we are having a major flare up in asthma because of the heat inversion effect of the late summer coupled with the tremendously high pollen counts, especially for ragweed. Certain weather changes such as a drop in barometric pressure and temperature and a rise in humidity seems to flare up asthma in Louisiana.

There are many new ways of controlling asthma and the best way in children is through inhalation treatments. This requires a nebulizer machine which comes in several different varieties. These are available for sale or rent at several places in Opelousas and surrounding cities. Most insurance companies cover the cost of these machines and the state medicaid system will pay for them if the proper letters are written and filed. Several other new medications including 24 hour slow released asthma medicines, safe cortisone sprays for severe asthmatics, and a medicine called "Chromalin Sodium" or "Intal", have greatly improved the ability for us to control asthma in almost all children. In the extremely severe asthmatic child, very close follow-up with the doctor is essential and taking advantage of things like the asthma camp every summer in Chicot Park or any other asthma support group such as the Asthma and Allergy Foundation in Lafayette are extremely helpful both to the child and the parent.

Since the treatment for asthma is improving and changing constantly, it is important to check with your physician on any new improvements which may be available to help your child.