Every year, the autumn-winter period is full of respiratory infections in children. During this season, you may notice an increased number of infections that keep many parents and their children awake at night. What types of respiratory infections can be encountered this season? Are SARS-CoV-2 infections still the main cause of the problem?
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The current social media and television coverage of respiratory infections in children is on the rise. Often scrolling through is information about the viruses that currently cause most of them: RSV, influenza virus, SARS-CoV-2. In terms of bacterial infections, on the other hand, strep throat or scarlet fever often appear. What are the characteristics of each infection? Is there a possibility of diagnosis and appropriate treatment?
Viral respiratory infections
During autumn and winter, the main viruses causing respiratory tract infections are rhinoviruses, adenoviruses, coronaviruses, influenza and paragrpa viruses, RSV, enteroviruses. RSV(respiratory syncytial virus) is the virus that most commonly causes bronchiolitis. Infants are most at risk, where the course of the disease can be more severe. The infection can manifest as a runny nose, cough, fever, difficulty breathing (shortness of breath, shallow breathing), lack of appetite, dehydration. Often the respiratory secretions are thick and difficult for the child to expectorate. Currently, there is no specific treatment. The basis of treatment is symptomatic treatment: inhalations, antipyretics, nasal toilet. In cases of dyspnoea in the child, hospitalisation and oxygen therapy may be required. Unfortunately, there is no vaccination against RSV, but in Poland there is a programme for severely affected children, which provides vaccination with antibodies against RSV giving immunity in the early years of the child's life.
During this infection season, the influenza virus is a more frequent cause of medical visits than in previous years. A distinction is made between type A and B influenza. Symptoms are often high fever(sometimes difficult to control), headache, chills, weakness, dry, tiring cough, muscle aches and bone and joint pains. In this case, once the flu has been diagnosed, causal treatment (oseltamivir) and symptomatic treatment (antipyretics, inhalations, nasal toilet) can be applied.
There has been a lot of recent news coverage on the SARS-CoV-2 virus. It continues to occur, also causing fever, cough, runny nose, sometimes dyspnoea, diarrhoea. Due to the similarity of symptoms, often a medical examination alone is not sufficient to make a diagnosis. A thorough history during the visit is important. Tests that can quickly detect the cause of an infection are very helpful during this infectious season. Tests have become available on the market, with which RSV, influenza A and B and SARS-CoV-2 infection can be confirmed or ruled out in the course of a single swab. Given the possibility of causal treatment for influenza, performing the test in the first few days of illness offers the chance of a mild course of the illness.
As far as prophylaxis is concerned, vaccines for influenza and against SARS-CoV-2 are available in Poland. It is worth noting that for several years there have been vaccines against influenza for children from 24 months of age in two forms: intramuscular and intranasal in the form of an aerosol.
Respiratory infections in children, photo: panthermedia
Bacterial respiratory infections
While viral infections are the main reason for medical visits, it is important to remember that a viral infection that does not go away can be associated with complications. Pneumonia, otitis media, bronchitis and bronchiolitis, myocarditis, among others, may occur. Lack of improvement after several days of treatment requires a repeat medical examination. In the case of bacterial superinfection, the doctor may prescribe an antibiotic.
Recently, in addition to viral infections, streptococcal tonsillitis or scarlet fever (scarlet fever) may also be seen. Both diseases are caused by group A streptococcus. In the case of streptococcal tonsillitis, the symptoms are a severe sore throat, pain during swallowing, lack of appetite, nausea, vomiting and fever. You may notice plaques on the tonsils. If streptococcal tonsillitis is suspected, the doctor can perform a rapid cluster test for group A streptococcus and, if tonsillitis is confirmed, use so-called targeted antibiotic therapy. Scarlet fever also manifests itself with pharyngitis and symptoms similar to streptococcal tonsillitis, while there is also a fine-spotted rash on the body except for the skin between the nasal folds and the chin. In this case, the rash is quite characteristic, but it is also possible to perform the same type of test as for streptococcal tonsillitis itself and use targeted treatment. In addition to an antibiotic, topical analgesics for sore throat and antipyretics are used. There are no vaccinations for tonsillitis or strep throat.
Summary
Is there any way to protect against these diseases? The best form of prevention, in addition to the available vaccination against influenza and SARS-CoV-2, is basic hygiene: frequent hand washing, covering the mouth when coughing and the nose when sneezing, avoiding human clusters especially during the autumn-winter season, regular washing of children's toys. In addition, immunity is built up all year round through a healthy diet, physical activity or the use of vitamin D.
