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Upper Respiratory Viruses

by Sue Hubbard, M.D.

I have been on call over the last weekend and I am beyond sounding like a broken record as I explain to parent after parent, “we are at the height of upper respiratory season”.

When you take weekend call in our practice you see patients in the office, you make hospital rounds at several hospitals and you also are taking phone calls from the answering service.  With that being said, parents are having a hard time understanding “how is it possible that my child is sick AGAIN?”  Said child was sick 2-3 weeks ago with something that seemed like the SAME thing, and here we are AGAIN.  You don’t even have to see their faces, you can hear the concern, disbelief and exhaustion in their voices!

So, after finishing up hospital rounds and seeing all sorts of sick kids (these were not the hundreds seen in the office mind you, but the few that were sick enough to be hospitalized) it seemed like a great time to review respiratory illnesses.

There are literally hundreds if not thousands of upper respiratory viruses that cause many similar symptoms, which are typically congestion, cough, scratchy throat, fever and just feeling “cruddy”.  A typical young child (under the age of 5 yrs) will get 7–10 of these viruses during a season which means at least one a month.  Unfortunately, this often means that parents with young children are also sick and it is even harder to take care of your child when you are sick and feeling terribly yourself.  Double whammy for sure!

When discussing the frequency of upper respiratory infections parents wants to know “which virus is causing this?”  Surely you can name the virus, or do a test to confirm the virus or SOMETHING!!   Well, we can often name the viruses that are in the community, but again, naming the virus often does little good in diminishing the symptoms or expediting the length of the illness.

Today was a good example of that as I was seeing our hospitalized patients. I saw a 6 month old with parainfluenza virus (this has nothing to do with flu either, so confusing), who had been admitted with croup and cough and needed oxygen.  Both of her parents are sick with colds too (probably due to the same parainfluenza virus).

The next room was a 18 month old with wheezing who needed oxygen and bronchodilator treatments,  and he was found to have metapneumovirus.  Yet again, his 3 year old sibling and mother were coughing away and blowing their noses, somehow the father was yet to be sick and he felt quite smug!

Several more rooms and 2 more children who had RSV and they too were coughing, having a hard time breathing and needed oxygen.

Lastly was a child with rhinovirus who had developed a viral pneumonia and also required oxygen.  The point of this is that despite the fact that we “named” their viruses it really did not help very much in their overall care.

All of these patients were under the age of 4 years, were otherwise healthy children and needed to be admitted to the hospital for a viral upper respiratory infection which required supportive care in order to maintain their oxygen levels.  In just one morning, I saw 4 documented different viruses, all causing similar symptoms and definitely lots of concern, exhaustion and frustration for their parents.  The best news is that they were all improving and would be going home over the next several days. Unfortunately, there will be new cases to fill their rooms.

The list of respiratory illnesses seems just endless and by this time of year everyone, including children, parents and their doctors are “over it”.  In other words, when is this going to end?  We probably have 6 – 8 more weeks of this and then the viruses will diminish as the weather gets warmer and more humid.

Viruses like cold dry temperatures like we have during the winter months .With warmer temperatures we will all spend a l more time outdoors and germs are not so easily spread.

I too am hopeful for the end of upper respiratory season, as I was innocently sneezed on today by the little 6 month old with croup, and her mother said, “Dr. Sue, guess you will be the next one to be sick.”  Washing hands, and praying that I am immune.

That’s your daily dose. We’ll chat again tomorrow.

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One Response to “Upper Respiratory Viruses”

  1. Erin says:

    This winter has been exhausting. My son is 5 1/2 and has battled croup since he was 5 weeks old. This winter? 6 times since September 25, 3 x since new years. 3 rounds of Dex since new years and his dr doesn’t want to give him a 4th. So…what to do? He hasn’t slept through the night in months. He is worn out from the cough; black circles under his eyes and very pale. He asks daily when his cough will go away. :(

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