While I'm sure many of you have been traveling to see friends and family this time of year, another happening place these days is your friendly pediatrician's office. And while I prepare for what I expect to be another full week in the office, I thought I would take this opportunity to share with you all what is out there (at least from my perspective in Southern California) and any recent information about these illnesses that may be of use to you this holiday season and beyond.
- Influenza (AKA "the flu"): Over the last couple of weeks I've seen an increased amount of Type A in children who have primarily not been vaccinated...which is good news for those who have been vaccinated this season. In fact, the Centers for Disease Control and Prevention (CDC) has confirmed the most common strain being seen so far this season has been included in the vaccine. The unfortunate news is this strain of the flu appears to be resistant to the antiviral medication often used to minimize the symptoms of the flu...which means your body will have to do most of the work in fighting off the ills of this infection. So I encourage all who haven't been immunized to discuss further with your physician. And one last thought...be prepared for other strains to surface this season.
- Respiratory Syncytial Virus (RSV): And I really dislike this one. I've seen plenty of young infants plagued by this one in the last few weeks. In adults and older children, it really isn't much more than a cold but in the younger ones it can become quite problematic. What this virus does is create a significant amount of nasal mucous...which ultimately clogs the airways. It can often lead to wheezing (like an asthmatic) and significantly compromised breathing. As I've mentioned some time ago, there exists an antibody which can be given intramuscularly each month during the fall/winter seasons to at-risk infants. So I do hope your child's physician has discussed this with you if your child may be a candidate but for those who want to double check, please feel free to take a look at the following CDC site...http://www.cdc.gov/rsv/clinical/prophylaxis.html. But the best way to avoid this? Just do your best to keep those with colds away from your infant and please wash your hands frequently.
- "Stomach Bugs": I use this term to describe the variety of viral gastrointestinal infections that I've seen these last few weeks. When I think things have calmed down a bit, a new stomach bug pops up...and often taking down the parents as well. Unfortunately, no special antiviral medications to be given here. The usual course of events includes vomiting for a day or so but when that resolves, the diarrhea is in full force and often lasting up to a week or two. The key concern here is maintaining adequate hydration which obviously becomes difficult to do when one can't stop running to the restroom every few minutes. For parents of children with the vomiting component of the stomach bug, I recommend small volumes (even just a tablespoon) every few minutes and then slowly advancing to greater amounts. Of note, there is a very effective and expensive anti-vomiting medication available via prescription but I certainly ask you discuss with your child's physician first. And when the vomiting ceases and your child is stuck with just the diarrhea, I recommend the BRAT diet (banana, rice (cereal), apple sauce, toast) and other starchy foods. I will also recommend some form of probiotics to replenish your child's digestive system with the good bacteria and hopefully slow down and firm up your child's stools.
So while I hope I haven't frightened anyone from taking their child out this holiday season, it does give some thought to whether the bears have it right by hibernating this time of year.
Dr. Jeremy