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Winter Viruses — It’s that time of year again!

With still a few months of the cold and flu season left to get through, CHEO offers this information to help you sort through your child’s symptoms. Every year around this time, thousands of children come through the doors at CHEO’s Emergency Department with illnesses and symptoms ranging from upper respiratory infections, to colds, sniffles, fever, sneezing, and sore throats. For many children these are the symptoms of regular winter viruses that need to run their course. For the very young or for children with chronic health problems, they are cause for particular concern. As parents, we often wonder at which point to take our child to the doctor or hospital and what signs or symptoms to watch for?

Understanding winter viruses

RSV
Respiratory Syncytial Virus or RSV is a frequent cause of respiratory tract infection in infants and children less than four years of age. In many children, it is not much different from a common cold. Symptoms range from a stuffy, runny nose, coughing for up to three weeks, and noisy breathing which can sometimes be accompanied by a low-grade fever. In most young children, it results in a mild respiratory infection. Sometimes however, in infants and younger children, the RSV infection may develop into a severe infection in the lungs.

Rhinovirus
Rhinovirus is the most common virus causing colds in children and adults.

Influenza Virus
Influenza Virus can cause “the flu” or influenza at any age, and can sometimes cause an uncomplicated cold. A period of frequent influenza infections occurs each winter in North America. Influenza infection can often be prevented by a yearly influenza vaccination, in children and their families. Influenza has arrived early this year. Most of the circulating virus is influenza A/ Fujian. This virus is in this year’s vaccine. It is still not too late to receive influenza immunization (free of charge) at your family physician’s or pediatrician’s office, or at a City of Ottawa clinic. Everyone older than 6 months should receive this immunization.

Understanding Winter Viral Infections

Colds
The common cold leads to a runny nose, fever, and cough, in children and adults. Most colds last about a week. The runny nose associated with a cold can be thin or thick, and can be clear-coloured, or white or green. Many people with a cold feel mildly tired, or unwell.
Bronchiolitis

RSV is a common cause of bronchiolitis. In younger children, when the inner lining of the lungs becomes inflamed, it is referred to as bronchiolitis. This inflammation results in swelling and an increased production of mucous, which can get in the way of air going in and out of the lungs. Your child’s nostrils may flare and they may have difficulty breathing or breathe noisily (wheezy or harsh). Your child may also have a hacking cough, be irritable or lethargic. Watch for abnormally quick breathing, a weak cry or voice and lips and nails that are whitish or bluish. Children with these symptoms need to see a doctor right away.

The “Flu”
Like colds, children with mild flu may have symptoms of runny nose, sneezing, a mild cough and a low-grade fever. Unlike with colds, children with the flu often have a headache, aches and pains in the muscles, vomiting and diarrhea and sometimes a sore chest. Severe flu may resemble bronchiolitis with a decrease in eating and drinking, high fever, increased sleepiness and difficulty breathing.

Croup
Croup is a viral infection of the breathing passages just below the voice box. Croup usually starts with cold-like symptoms, with a runny nose, sore throat, and fever, which then progress to a barky or seal-like cough, and difficult and/or noisy breathing.

Viral infections are spread by:

  • Direct contact with an infected person,
  • Indirect contact such as touching a contaminated surface, and/or
  • Exposure to an infected person who may be coughing or sneezing.

Careful and frequent hand washing with warm water and soap for at least 15 seconds limits the spread of viruses. Extra care should be taken by carefully washing all toys, books, and common surfaces to avoid the spread of infection.

How to help your child at home

  • As a general guideline give your child plenty of fluids and ensure they get plenty of rest. Children lose a lot of fluid when they have a fever.
  • Acetaminophen (Tylenol®, Tempra® or Abenol®) or Ibuprofen (Advil® or Motrin®) may help your child with fever, aches and pains to feel more comfortable. Do not use Aspirin (ASA).
  • Saline drops and gentle suctioning of the nose with a nasal aspirator can help to relieve nasal congestion.
  • If your child has a bad cough, position them upright to ease coughing and breathing. A cool mist or humidifier may also help.

When to get help for your child

Children less than three months of age usually require a medical assessment immediately as they are more vulnerable. You should call your doctor or go to the hospital if your child:

  • Has trouble feeding or sleeping due to difficult breathing;
  • Is coughing more often and has noisy breathing (wheezing);
  • Is coughing to the point of vomiting;
  • Has trouble breathing; gasping for breath, sucking in at the base of the neck or between the ribs (in-drawing), or has a very fast rate of breathing;
  • Has limp, floppy limbs or body, with or without vomiting;
  • Is confused;
  • Is very sleepy and hard to wake up.

If you are unable to contact your doctor and are not sure whether or not to go to the hospital, you have a few options. You can call:

  • Your community health centre, or
  • The City of Ottawa’s Public Health Info Line (weekdays) at 613-580-6744, or
  • Telehealth Ontario, toll-free, 24 hours a day at 1-866-797-0000, or
  • Local CLSC (8-1-1) during the daytime, and after hours listen to the recording for directions, which give a telephone number to call in the Outaouais region
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