Kids Common Winter Illnesses

Fall and winter bring a multitude of viral infections. Most of these cause self-limited illnesses and require only symptomatic treatment, but some can lead to more severe infections, especially in children. Two of the most common winter viral illnesses in children are RSV infection and Rotavirus gastroenteritis.

Respiratory Syncytial Virus (RSV) causes infections such as bronchiolitis and pneumonia. Bronchiolitis is an infection of the air sacs. RSV season occurs every year and generally lasts from November through April with the peak of the season typically being February and March. Symptoms may include thick cloudy nasal discharge, harsh cough, fever, wheezing and difficulty breathing. An ear infection can commonly accompany the lung infection. Younger children and infants are more ill with this infection because they have smaller airways and therefore develop more wheezing and respiratory distress. The illness usually lasts about ten to fourteen days with the fourth, fifth and sixth days being the worst. Because this is a viral infection, there is no specific medication which will provide a cure. Treatment is symptomatic and, depending on the individual patient, may include nasal saline drops and nasal suctioning to clear the upper airway, bronchodialators (oral or inhaled) to help relax the muscles around the airways so that the airways open up and wheezing is lessened, oxygen therapy, and in some cases, oral steroids to decrease airway inflammation.

Many children, particularly those under six months of age, require hospitalization for several days if their infections is severe enough to impair feeding or oxygenation. Exposure to cigarette smoke makes symptoms significantly worse. Please call your doctor if your child is having difficulty breathing or feeding, or if they are very fussy. Premature infants are much more likely to develop severe disease from RSV because of their lung immaturity. Some premature infants may benefit from a preventative medication called Synagis. This is an injection of antibodies which specifically fight respiratory syncytial virus, and it is given once each month from November though April. Your pediatrician can discuss specific criteria for which infants might be helped by this medication. Research is on going for the development of a vaccine which may prevent RSV infection in the future. The virus is transmitted by respiratory droplets when one coughs or sneezes. Currently the best way to prevent the spread of RSV is to avoid contact with ill individuals and, most importantly, to wash your hands thoroughly and frequently.

Rotovirus causes an infection in the stomach and intestinal tract, and the main symptoms are vomiting, diarrhea, and fever. Vomiting is usually most significant in the first 48 hours of illness, and diarrhea generally starts on the second day of illness and lasts for six to eight days. The main danger of this infection is dehydration, which is more common in infants and toddlers.

Again, because this is a viral infection there is no specific medication which will kill the virus. Treatment is symptomatic while we wait for the body's immune system to fight the infection. Treatment includes modifying the child's diet temporarily so that the stomach can rest. This is done by giving clear fluids and bland starchy foods, which are easier to digest in smaller amounts frequently. Sometimes despite parents' best efforts, a child will require hospitalization to receive IV fluids for several days until they are able to tolerate fluids in their gastrointestinal tract. Please call your doctor if your child is not drinking enough to urinate four times each day, if they have more than six to eight episodes of vomiting in a day, or are acting lethargic. Rotavirus is transmitted though saliva and stools. To avoid the spread of this infection do not share food or drink with others, and wash your hands frequently, especially before eating.

Grace Fan, M.D., is a board certified pediatrician. She joined Longmont Clinic in July 2001.