THE DOCTOR IS IN
OP / ED BY DR. ADIL MANZOOR
Viral infections are quite common among people of all ages. Still, children under 5 years (particularly those under 2 years) are more susceptible to viral infections. This is because they have yet to build the required immunity to fight off most viral infections.
One of the most common viral infections that affect kids is “Flu,” short for “Influenza”, although it could be used to refer to other illnesses sometimes. Flu is a respiratory illness caused by the Influenza virus. It usually presents with symptoms like fever, muscle aches, headaches, cough, tiredness, sore throat, etc. A major difference between people infected by the flu and those infected with the cold virus is that people infected with the flu usually feel sicker and want to stay in bed all day.
Adults and children might have similar symptoms for flu most times. However, there are some differences. Symptoms like stomach upsets, nausea, diarrhea and abdominal (stomach) pain are more likely in younger children. Newborns and infants might have very high body temperatures with no other accompanying symptoms. The flu could also result in other complications in young children, such as croup (infection of the throat and vocal cords), pneumonia (infection of tiny air sacs in the lungs) and bronchiolitis (infection of tiny airways that leads to the lungs).
Most of the people who are infected with the flu virus tend to recover on their own. However, children under the age of 5 should be taken to their pediatrician for evaluation for high fever especially during this season where we are seeing very high influenza activity. Children with chronic conditions, such as asthma, diabetes, and nervous disorders, are also prone to more severe forms of flu and should be seen by their pediatrician as soon as possible if flu is suspected.
Just like most respiratory virus infections, the flu virus is spread by contact with droplets released by infected persons into the atmosphere. This also makes kids more prone to infection as they constantly touch their eyes, face and mouth during the day. Therefore, necessary precautions must be taken to keep their environments, belongings and even caregivers clean and safe to prevent infection.
According to the CDC, it is also advisable for everyone six months and above to get a yearly vaccination against the flu. This is because there is a usual yearly flu outbreak during the fall. Then the vaccine itself wears off after some time, although it is sufficient for an entire flu season (usually November to April).
RSV (Respiratory Syncytial Virus) is another major cause of respiratory illness in young children. RSV infection is so common among children. In fact, almost all children are infected by RSV in their first 24 months (about 2 years). RSV could also infect adults but usually milder in adults and older children. It could be more severe in younger children, particularly premature infants, infants younger than 6 months, and children with weakened immune systems.
RSV usually presents with symptoms such as runny nose, sore throat, mild headaches, decreased appetite, and cough, which may progress to wheezing. Infants are also likely to present with other symptoms like irritability, decreased activity and apnea (pauses while breathing). Both children and adults might develop a fever when infected with RSV. However, fever may not always occur with RSV infections.
Like the flu virus, RSV has a yearly seasonal outbreak. The RSV outbreak usually occurs in the United States during fall, winter and spring. Unfortunately, the RSV virus does not yet have a vaccine that could be used for protection. Also, being infected by the virus does not prevent reinfection. This means that the precautionary measures against infection of RSV are limited to proper hygiene. Notwithstanding, healthcare providers usually administer palivizumab, a monoclonal antibody, to babies at high risk of infection during the RSV season.
Some of the other viruses responsible for viral respiratory infections in children are rhinoviruses, parainfluenza viruses, enteroviruses, coronaviruses, human metapneumovirus and certain strains of adenovirus. These viruses have similar symptoms and means of transmission to the RSV and flu viruses. Other common non-respiratory viral infections that affect children include measles, mumps, rubella, chickenpox, etc.
Fortunately, many of these viral infections can now be prevented by vaccines. In addition, most of these viruses result in self-limiting infections that resolve on their own. However, the children should be given plenty of rest and fluids. Drugs like Acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDS) could also be administered to manage the fever and aches. It is important to note that antibiotics do not assist in treating viral infections.
This article was written by Dr. Adil Manzoor DO, a Board-Certified Internist & Board Eligible Pediatrician, who works as a Hospitalist, and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice Mobile Medicine NJ.
References
- Influenza in children – PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722601/
- Flu Shots for Children, CDC: https://www.cdc.gov/vaccines/parents/diseases/flu.html
- RSV in Infants and Young Children, CDC: https://www.cdc.gov/rsv/high-risk/infants-young-children.html
- Respiratory Syncytial Virus (RSV) (for Parents) – Nemours KidsHealth: https://kidshealth.org/en/parents/rsv.html
- Overview of Viral Respiratory Tract Infections in Children – Children’s Health Issues – MSD Manual Consumer Version: https://www.msdmanuals.com/home/children-s-health-issues/viral-infections-in-infants-and-children/overview-of-viral-respiratory-tract-infections-in-children
