What is a cold?
The flu is the most common viral infection of the upper respiratory tract and can develop throughout the year, especially in winter and spring. Colds are divided into common colds and influenza.
Influenza, referred to as “flu”, is an acute respiratory infection caused mainly by influenza viruses. Influenza viruses are divided into three types: A, B and C. Type A antigens are highly susceptible to mutation, so influenza pandemics are caused by type A viruses, while types B and C are localized as small pandemics or epidemics. Wu Zhengjun, Department of Pediatrics, The First Hospital of Xiamen University
Common cold
The frequency of common cold, mainly acute rhinopharyngitis, is 3-6 times in a year in most children, while about l0% of children with recurrent respiratory infections can have more than 8 times in a year. 90% of the primary pathogens are viruses, among which rhinovirus and coronavirus account for 60%, in addition to influenza virus, parainfluenza virus, respiratory syncytial virus, adenovirus, coxsackievirus and echovirus.
The disease is generally self-limiting, usually 3-7 days. The symptoms of common cold are non-specific, often only the manifestation of rhinitis, while cough (32%), runny (35%), symptoms can last more than 2 weeks, coupled with the annual incidence of the disease 3-6 times, resulting in some children with a short interval between two common colds and is mistaken for “long-lasting ” or “secondary infection”.
What is recurrent respiratory tract infection?
Recurrent respiratory tract infections are defined as more than 7 upper respiratory tract infections in a year for children under 2 years old, more than 6 for children between 2 and 6 years old, more than 5 for children over 6 years old, or more than 3 lower respiratory tract infections for children under 2 years old and more than 2 for children over 2 years old.
What are the symptoms of a cold?
Fever, cough, runny nose, sore throat, vomiting and loss of appetite are some common symptoms when children are sick. After short-term treatment, most children can be relieved quickly, but there are some children with cough, wheezing, runny nose, nasal congestion at bedtime and snoring that persist or recur. If these symptoms recur or last more than 10 days, parents should stop simply thinking that it is a cold.
Is a prolonged cough (e.g. more than 2 weeks) a cold?
Generally speaking, the course of the common cold is about 7 days. If a child’s cough remains unresolved for more than 2 weeks, it should no longer be considered simply a cold that keeps on getting better and in Xiamen, the possibility of allergic cough should be considered. There is also the possibility of mycoplasma infection or chlamydia, which requires some pathogenic tests.
Is a recurrent runny nose a cold?
It is common to see some children who have a runny nose or even a pus nose after a cold, accompanied by nasal congestion and snoring at bedtime, which should be considered for allergic rhinitis, adenoid hyperplasia or sinusitis.
What are the dangers of nasal congestion or snoring during sleep?
In pediatric clinics, we often see children aged 1~2 years old with nasal congestion or snoring when they sleep after a cold or when they usually do not have a cold, or when they open their mouths to breathe because their noses are not clear. The other long-term danger is that the chronic lack of oxygen in the nose affects the normal development of brain function, resulting in poor concentration in class, reduced intelligence, and poor academic performance at school age.
There are many reasons for the above symptoms to persist. From the situation in Xiamen, the most common diseases are: 1) asthma, including cough variant asthma, which is also known as allergic cough; 2) allergic rhinitis; 3) recurrent respiratory infections; 4) adenoid hyperplasia; 5) sinusitis.
Is it a cold if my child sneezes in the morning or when the wind blows?
Allergic rhinitis mostly has a family history, i.e. one of the parents or grandparents has similar symptoms. In addition to sneezing, these children often have itchy nose and eyes and like to rub their nose and eyes, some also have eczema, asthma and other allergic diseases.
My child wheezes when he has a cold, what is it?
If the number of wheezing is more than 3 times, then you should see a specialist to confirm a possible diagnosis of asthma. Most children with asthma have wheezing triggered by a cold, and this wheezing is most pronounced at night or when they get up in the morning.
What is the cause of my child’s constant cold and fever?
Two possibilities.
One, it is possible that the child has a low immune function. But there is a big reason that it is caused by over-treatment. We often see such parents in the clinic, as soon as their children have a cold and fever, they immediately go to the hospital for injections and medication, some ask the doctor to give a drip, some run three or four hospitals in a day, resulting in the child’s immune function is impaired.
Second, chronic infectious diseases are not effectively controlled: such as sinusitis, tonsillitis, adenoiditis, etc. In our clinic, the second case is common.
In conclusion: cold is a common disease in childhood, and recurrent respiratory infections account for only about 10%, of which it should be noted that not all coughs, runny noses and sneezes are colds. The current over-treatment of children with colds is an important cause of recurrent respiratory infections in childhood.
Prevention and treatment of respiratory diseases
When my child has a cold, I give him some antibacterial agents such as Pioneerin and Erythromycin, right?
No, it is not. As early as the 1960s, it was found that antibiotics could neither change the course and course of the disease nor effectively prevent bacterial complications of the common cold. Antibiotics can be used when complicated by bacterial infections such as purulent otitis media and sinusitis, but the indications must meet the diagnostic criteria for bacterial infections in these areas. Current clinical data show that 90% of children’s colds are caused by viruses, so antibiotics should not be given for the common cold.
What are the dangers of regular application of antimicrobials?
Firstly, it leads to the increase of bacterial resistance, secondly, it damages the organism’s function, such as the damage to the body’s defense system, thirdly, it increases the cost of treatment, and fourthly, it causes a false sense of security that may aggravate the disease or does not receive timely treatment. The most important point is that the misuse of antimicrobials has caused a large number of children with recurrent respiratory tract infections.
So what should parents do?
Symptomatic treatment is of primary importance, including rest, adequate hydration, fever reduction, and relief of khat symptoms. At the same time, nasal discharge that is sticky and opaque or discolored may still be viral sinusitis and no antibiotics are needed, unless such symptoms persist for 7-10 days without improvement or instead worsen, or are accompanied by fever, increased white blood cells, yellow pus sputum or pus nasal discharge, bacterial infection is considered and antibiotics are added while actively searching for the site of infection.
Clinical experience generally believes that close observation within the first 4 days of a cold may be unnecessary to administer antibacterial agents.
What should I do at home if my child has a sudden cold and fever?
Generally speaking, if the fever does not exceed 38 degrees, no antipyretic medicine can be used. 38~39 degrees can be taken orally as antipyretic medicine, such as pediatric Tylenol, Chen Gong Zaixin, Merlin, etc. If the temperature exceeds 39 degrees, physical cooling, warm water wiping, sleeping on ice pillow, fever reducing paste, and antipyretic injection can also be applied. It is forbidden to use Advil for children to reduce fever by intramuscular injection, because its toxic side effects are too great, as early as in 92 years the Ministry of Health has been expressly prohibited for children, the city’s major hospitals have also been eliminated. For children with a history of high fever and convulsions, it is important to have some convulsion prevention medication at home, such as luminal.
How is a chronic cough treated?
A very common cause of cough is allergic cough, and it is inappropriate to give antimicrobials for this type of cough. In this case, the treatment focuses on fighting allergic inflammation of the airways.
How should I treat frequent runny nose?
This kind of patient should first have an X-ray or CT examination of the sinuses and nasal tract. In the past six months, our department has collected 200 cases of typical sinusitis patients, often these patients do not come to the clinic with nasal symptoms as the main complaint, but often with asthma-like symptoms such as wheezing and coughing, etc. One patient, who had been treated as asthma for more than a year without improvement, came to my specialist clinic and once the sinus CT was taken, all sinuses were chronically inflamed and treated with anti-infection for 2 months. The so-called asthma symptoms have not occurred again for more than a year.
How to treat frequent snoring at night?
The most common cause is adenoid hyperplasia, often the child has a cold, cough and runny nose to the hospital to see the doctor to catch the medicine, the cold is well, but the accompanying acute adenoiditis is not paid attention to, repeated several times to cause adenoid hyperplasia. If there is frequent snoring, nasal congestion during sleep, and open-mouth breathing, you should go to the hospital for a lateral head nasopharyngeal film X-ray and, if necessary, respiratory sleep monitoring to determine the treatment plan to avoid damage to the brain.
What should I do if I keep sneezing?
It is likely that allergic rhinitis is on its way. Currently, allergic rhinitis is internationally classified as persistent or intermittent, and a proven method of prevention and treatment is recommended, which is the application of budesonide and fluticasone, generally for a period of three months, with the first month of treatment and the second and third months of consolidation. The vast majority of children can be well controlled. If mite allergy is identified, subcutaneous desensitization or sublingual desensitization is also available in our department.
How do I treat wheezing after repeated colds?
If the number of attacks is more than 3 times, then we should consider the possibility of asthma. At present, there are asthma specialist clinics in all major clinics in our city, so you can go there to confirm the diagnosis, and for children with frequent attacks, you should apply the international common inhalation therapy, such as promethazine and cozultone for preventive inhalation. The latest view on the treatment of asthma is that the earlier the treatment, the better the outcome. Aggressive and correct prevention and treatment can bring the disease under control in 80% of children before the age of 14.
Children with recurrent respiratory infections are still common in outpatient clinics, but other factors should be excluded first. For those who are really immunocompromised, they should undergo immunological examination and specific medication should be used for each case.
Parents should be reminded that many people mistake asthma attacks for “colds”. If a child has a long-term recurrent cough without wheezing and rarely has a fever, attention should be paid to whether the asthma is of the coughing type, which can be quickly controlled with anti-asthma treatment. Therefore, if your baby has the problem of “always having a cold”, it is best to go to a pediatric clinic to determine what the cause is and then use the correct medication.