Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Certain Infections Reach Epidemic Locally

Category: Child Care



RSV pneumonia (respiratory syncytial pneumonia) is the most common pediatric pneumonia each winter in the United States. It is caused by a common virus which can cause a mild cold or croup but also can cause pneumonia in the lower lung fields. This year we are seeing more RSV pneumonia particularly in young babies from two months to a year than we have seen in the past ten to twenty years. Each pediatrician in town has admitted several cases to the hospitals and at least two have been sent by ambulance to Children's Hospital in New Orleans because of worsening pulmonary conditions. The signs of this pneumonia are coughing which can lead to wheezing and crackles heard in the chest with a stethoscope. The diagnosis is made by a test from the nasal secretions by a lab or the hospital and the impression can be made by your pediatrician or family doctor. Asthma is also very prevalent now and can easily be confused with RSV pneumonia so, if in doubt, check with your doctor. Most children with pneumonia will do fine even at home but young infants, particularly under six months, with a lot of wheezing and difficulty feeding and sleeping, may need to be in the hospital and treated aggressively with several therapies including oxygen, IV fluids, and even possibly antiviral inhalation treatments.



Chickenpox which increases every winter is very prevalent now among school age children and toddlers throughout our area. Chickenpox is usually easy to diagnose because of the outcropping of vesicles and pustules seen over most areas of the body which come out over a three to four day period of time. Also chickenpox is very contagious and most cases will occur after being exposed to someone else with chickenpox two weeks previous. The major treatment for chickenpox is to minimize scratching by giving the child Benadryl or some other anti-itch medicine. Also good cleansing of the skin with soap and water is important. Finally, Tylenol helps to decrease any fever and is important. Most cases of chickenpox can be diagnosed and handled at home; however, occasional cases become infected with a secondary bacteria and should be checked by your doctor. A child with chickenpox is contagious from the day prior to the sores breaking out till the last sore dries up. This usually lasts about one week. If your child has chickenpox please keep the child at home and do not bring him to school or day care.

Reye's Syndrome is a dreaded disease which can complicate chickenpox if the child is given aspirin. For this reason we avoid aspirin in any child with chickenpox or influenza and treat their fever and pain specifically with Tylenol. The signs of Reye's syndrome which would occur usually weeks after a chickenpox or flu episode include profound vomiting and decreasing levels of consciousness. If this condition is in any way considered in your child, see a doctor immediately.



Influenza or "flu" is a common disease throughout the world every winter. We are seeing many cases of flu in children and adults in our area now. The classic symptoms of flu include headache, fever, aches and pains and sometimes cough and runny nose. These symptoms are also typical of other numerous conditions from strep throat to pneumonia and so, if in doubt, it is best to check with your doctor. The best treatment for flu is rest, increased fluids and Tylenol. Again, in children there is a risk of Reye's Syndrome if you give a child with influenza aspirin, so stick with Tylenol. Flu is also the most common precipitator of pneumonia, particularly in adults, so if your flu syndrome does not seem to get better, you should check with your doctor and let him rule out pneumonia or any other complication from the flu.



Mumps seems to be on the increase in Louisiana again this winter as it was last year and many school children in neighboring parishes and in St. Landry parish are catching mumps. Even children who received the MMR vaccine at fifteen months seem to be catching it and so the American Academy of Pediatrics this year changed it's recommendation on that vaccine. They now recommend that even children who received it a fifteen months get a booster dose at junior high school, high school age or any other age considered high risk in a given area. Measles also seems to be on the increase and there have been many deaths around the country from measles in the past few years. This is another good reason to receive the MMR booster dose at whatever age your doctor recommends, probably from the sixth grade up through high school age.

Many dreaded diseases from our past are controlled today but we should not take them for granted. Whenever a child has an ill appearance, with or without fever, it is best to check with your doctor for wise counsel.