Expert / 15 January, 2022 / Dr Andrew Raffles

Key Signs Your Child Might Be Suffering From A Virus And What You Should Do

The winter months have seen a significant rise in the number of children seeking medical attention for what were usually mild winter viruses, such as RSV, bronchiolitis, the common cold and paraflu.

As a result, many more children have been seen in emergency departments across the UK, as the symptoms cause so much anxiety and distress for parents and carers.

Whilst these viruses were generally suppressed during lockdown, the increase in social mixing as lockdown restrictions ease has heightened children’s exposure to them, thereby increasing their chances of contracting one or more of these viruses and becoming unwell.

But what is a viral infection?

A virus is a germ that can cause infections such as the common cold, most cases of tonsillitis and ear infections and influenza illnesses. A viral infection can affect various areas in the body, from the respiratory (Ear Nose Throat and Lungs) and gastrointestinal (bowels) systems to the liver, brain, and skin. Viruses are generally easily spread from person to person in droplets from the nose and mouth or via vomit or faeces.

It is not unusual for otherwise healthy children to catch a wide range and number of viral illnesses when they are very young, as their immune systems are still developing. The frequency will tend to reduce as children grow older.

The average child has 8 viral infections per year, that’s one every 6 or 7 weeks, and they are not evenly spread throughout the year; prior to lockdown and social isolation they were predominantly in the winter.

Some of the most common viral infections in children are:

• The common cold: caused by a virus called rhinovirus, but also by other types of coronavirus, which partly explains the immunity children have to the current pandemic caused by SARSCV19. These symptoms usually lasts for 1 – 2 weeks although any fever is usually for only 2-5 days
• Influenza: this is caused by one of several influenza virus. Symptoms appear similar to the common cold but are more severe and develop much quicker. Fever can last up to 7 days.
• Bronchiolitis: this is a viral infection predominantly caused by the RSV virus – but there are several other specific viruses that cause a very similar illness. Bronchiolitis usually affects children under 18 months but can occur up in children up to two years old. Older children and adults usually just get a cold with the virus. It is caused by respiratory syncytial virus (RSV) and has symptoms such as a blocked or runny nose, a dry cough, rapid or loud breathing and a high temperature. Babies under 2 years often get too breathless to feed, and this would be a reason to seek advice.
• Chickenpox: this infection starts off as red spots, which turn into blisters before scabbing over. It is contagious until the last spot has scabbed over. Antihistamines and moisturising lotions can help to ease symptoms, such as itching, however, chicken pox tends to get better on its own.
• There are many other virus illness in children, some have specific names, such as Measles, Roseola, Rubella (German Measles) but most are self-limiting and cause no long term harm

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What are the key signs your child may have a virus?

Some of the symptoms your child may exhibit if they are suffering from a virus include:

• a raised temperature of over 38C measured over 4 hours apart
• muscle aches
• coughing
• a sore throat
• a runny or blocked nose
• sneezing
• headaches
• congestion or pressure in the face and ears
• a loss of taste or smell
• red, watery eyes
• rashes that turn white (blanch) for a second or so after you push on them with a finger or glass
• vomiting
• diarrhoea
• lethargy
• loss of appetite

Many of these symptoms are the same as those displayed in adults with a virus but may persist for longer periods of time for children, particularly as children often get several viral infections one quickly after another.

How can you take care of children with a virus?

Childhood viruses cannot be treated with antibiotics. They are typically self-limiting, meaning they get better on their own. This means that the usual treatment is to ensure your child gets plenty of rest to help their immune system fight the virus.

Hydration

Keep your child well hydrated, ensuring they drink small amounts of fluid – frequently. This can help to soothe a sore throat, and replace fluids lost due to fever, vomiting or diarrhoea. Infants will need breastmilk or formula, or occasionally rehydration fluids. If your baby is suffering from a blocked nose, use saline nasal drops to clear their nose, which may help to make it easier to feed.

Painkillers

You can give your child regular paracetamol or ibuprofen if they are in pain or discomfort. However, make sure that you carefully check the label for the correct dose and that you are not already giving your child any other products, such as cough medicines, which contain paracetamol or ibuprofen.

GP advice

While most viruses are mild in children, those younger than three months of age may become very ill quickly and need to be assessed by a doctor. You should also seek the advice from your GP or paediatrician if your child is aged three to six and has a temperature of over 39C or is any age with a high temperature that has lasted over five days.

When to seek urgent medical attention

If your child has a loss of appetite, is showing a significant change in character or behaviour, is displaying signs of dehydration (such as not urinating, or a dry mouth) or has developed a rash alongside a fever you should seek medical attention. If you are concerned that your child may be developing signs and symptoms of sepsis – which may rarely complicate a viral illness – you should seek urgent medical attention.

It is very difficult to prevent children from catching a virus. However, you can strive to keep their immune system healthy through lifestyle factors, such as ensuring they eat a balanced, nutritious diet and get plenty of sleep.

Practicing good hygiene also minimises the chance of catching a virus or passing it onto others and so it is important to encourage children to practice healthy habits. This includes washing hands regularly, coughing or sneezing into an elbow, or preferably a tissue and discarding tissues into a bin after they have been used.

Vaccinations

Finally, I would recommend ensuring your child’s immunisations are kept up to date to prevent viruses such as measles, mumps, or chickenpox, and for older children, flu.

Written by Dr Andrew Raffles, Consultant Paediatrician at Dr Ian Hay Ltd and The Portland Hospital, part of HCA Healthcare UK

For more information contact HCAUK@thephagroup.com

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