Just when it seemed like the pandemic was waning, a new wave of viral infections has emerged – and this time, children seem to be the ones most affected. Last year, children’s hospitals across Washington state were overwhelmed with double the number of patients they usually see in the fall months. The primary culprit was RSV, a virus that causes respiratory illness.
As we move through fall and into winter, RSV is only one of several common childhood viruses that parents need to be aware of. Jesseca Eskander, nurse practitioner at Marysville Family Medicine, identifies the primary suspects.
RSV
Although few outside the medical profession had heard the name respiratory syncytial virus (RSV) before 2022, the majority of people have had RSV by the time they are two years old. It’s one of many viruses responsible for the common cold. Usually it’s not serious, but sometimes it can cause acute respiratory illness.
[Since the pandemic, RSV] “does seem to be more aggressive. At one local pediatric clinic they’ve been seeing 13 cases a day versus 13 total last season,” said Eskander. RSV is most common among children in daycare and those with older siblings (whose infections can be asymptomatic).
Infants and young children without much previous exposure and those with underlying respiratory health issues are most at risk, but adults are becoming seriously ill, too. In 2023, there is now a vaccine for RSV, which is recommended for infants and adults over 60.
COVID
By now most of us have some immunity to COVID-19, whether through vaccination, previous infection, or both. But COVID-19 isn’t gone, and it does affect children.
“The most common symptoms in children are fever and cough,” said Eskander. But children can display the same wide range of symptoms as adults, including loss of taste and smell. Eskander has seen at least one pediatric case of long COVID – where symptoms linger for more than four weeks after the initial infection. There is even some indication that a COVID-19 infection can leave some kids with weakened immune systems for months afterward.
Children infected with COVID-19 can develop a rare but serious complication called multisystem inflammatory syndrome in which the vital organs become inflamed. It requires hospitalization and is potentially fatal.
Anyone six months and older can – and should – be vaccinated for COVID-19. The specific vaccination schedule can vary depending on the manufacturer and your child’s age, so talk to your child’s primary care provider to make sure they get all the recommended doses.
Flu
The severity and prevalence of the flu varies widely from year to year. The past few years, thanks in part to pandemic protocols, the flu has infected fewer people. But as of last year, it was spreading around the country faster and earlier than usual, while making many people sicker. Even a mild case of flu is miserable and can last more than a week.
“Classic symptoms of an uncomplicated flu infection include fever, headache, body aches, fatigue, cough, and sore throat,” said Eskander. But a vaccine is available. Eskander hasn’t seen many cases of flu in Snohomish County yet, so it is not too late to get the flu shot for this season.
“Kids can get the flu shot and they should,” said Eskander. Your primary care provider can provide flu shots for children ages six months and up. At WWMG’s family medicine locations, your entire family can get their flu shots all at the same time.
Hand, Foot, and Mouth
Hand, foot, and mouth disease is caused by a family of enteroviruses. It’s a perennial childhood illness, primarily affecting infants to early elementary students. But Eskander says it’s been appearing in the community more frequently recently.
Hand, foot, and mouth disease causes painful blisters that can appear anywhere on the body but are most commonly found in the mouth and on the hands and feet. It can also cause fever.
“The main symptom is the sores in the mouth that look like small spots or blisters.” It spreads through body fluids, especially the fluid from the sores, but also mucus and saliva.
How To Tell Which Virus Your Child Has?
Because COVID-19, RSV and flu have so many symptoms in common, a diagnostic test is the only way to tell which (or how many) of them a child has.
“If we were to swab any given child, their results would probably show up with more than one virus. They just manifest the same way, with a cough, runny nose, sneezing,” said Eskander.
The higher viral load of multiple infections may cause a child to feel worse, but it doesn’t necessarily increase a child’s risk for hospitalization. Instead, Eskander says, the primary risk factor for hospitalization is being immunocompromised or having underlying health conditions.
Treatment for Childhood Viruses
If your kid gets sick, there’s no need to panic or rush out for a diagnosis, which won’t change the course of treatment very much, as a provider can generally only treat the symptoms of these viruses. But Eskander does recommend a telehealth consultation with your care provider as soon as your child falls ill to go over their exposure history, symptoms, and treatment advice.
Generally, you should keep sick children home from school, both so they can rest and recover faster and to avoid further spreading the virus. Offer lots of fluids and consider using nasal drops and a humidifier (or lots of warm baths and showers). Don’t use cough medicine, but Eskander says Tylenol or Ibuprofen can be given for aches or a fever over 100.4.
Viral infections can result in a secondary bacterial infection which should be treated with antibiotics. Your child should see their care provider if they start draining colored mucus, suddenly develop a fever several days into an infection, or run a fever that responds to medicine but doesn’t break for more than three days.
Prevention of Illness
To reduce the number of infections your child is vulnerable to, get yourself and your kids vaccinated when you can. The prevention methods used during the pandemic are still effective. It’s still smart to wash hands regularly, wear masks if you are sick, are around others who are sick, or are spending hours in crowded indoor spaces.
“Hand hygiene goes a long way,” said Eskander. Flu and many other viruses can live on surfaces, so washing hands and sanitizing objects, especially after someone has been sick, can prevent many infections. Healthy lifestyle choices like proper nutrition can also help keep the immune system in fighting shape.
Where to Get a Vaccine or Treatment
Few experiences in life are as scary as watching your child become seriously ill. Even though some viral infections are inevitable in childhood, fortunately most of the time they will pass on their own within a week or two, leaving your child with a stronger immune system. If you’re interested in having your family vaccinated, or need care for a sick child, request an in-clinic or telehealth appointment at one of our 7 primary care locations.