Understanding The Common Cold and Flu in Children

The common cold is one of the most common reasons parents bring children to see their doctor. On average children suffer from 6-8 colds per year, can occur at any time of the year, but tend to occur most commonly during the winter months. However, parents should be aware that the common cold is not caused by exposure to cold climates.  Instead it is caused by more than a 100 different types of viruses existing within our daily environment. Most children or adults acquire the cold by having direct contact with the virus by touching another person who has come into contact with the virus.  Viruses can also live on surfaces such as countertops, door handles and toys.  Children can also pick up a cold by breathing in air with virus particles spread by coughing or sneezing. Hence it is quite easy to pick up a simple cold.

How will I know if my child has a simple cold or something more serious?

There are a few key things to watch for that will guide you in knowing whether your child has a simple cold.  Colds usually only last between 3-7 days but may sometimes linger up to 2 weeks. Generally, children with colds have nasal congestion, runny nose and sneezing, which only lasts a short period of time.  They may also develop a cough near the end of their illness, usually when the other symptoms are already disappearing.  

There are some complications that occur in rare instances in children after a simple cold.  The most common complication after a cold is bacterial sinusitis where your child may develop a thick yellow or green nasal discharge.  However, this may just be a part of the normal cold, so there is no need to become alarmed unless the symptoms persist or your child develops other symptoms such as a fever.  Some lower respiratory tract infections may also develop after a cold including pneumonia or bronchitis.  Infections of the middle ear can either accompany or follow a common cold.  Hence there are some cases in which you should seek help from your doctor. If the cold has not gone away in more than 2 weeks you should seek help.  Other signs of a more sinister illness that you need to watch out for include: high fever, not tolerating fluids, dehydration, vomiting and diarrhea, neck stiffness, severe headache, unusual drowsiness, persistent crying, problems breathing and ear pain.  These indicate your child’s illness is more severe and doctor’s help is required.

What can you do if your child develops a cold?

 Most colds go away on their own and treatment should be aimed at relieving the symptoms in your child.  There is no place for antibiotic treatment in a simple cold, as they only work against bacteria and not viruses. To relieve nasal congestion and runny nose you can use a nasal decongestant purchased from most chemists. Some antihistamines may help but they are generally not recommended in children, as they cause drowsiness, dry eyes, nose or mouth. Sore throat and headaches may be relieved with Acetaminophen (Paracetamol, Panadol) or Ibuprofen (Brufen, Nurofen).  Remember to avoid Aspirin in children less than 12 years old as it can cause a severe illness called Reye Syndrome. Cough suppressants are generally not recommended. Generally children under 4 should no be given cold medications without first consulting your doctor.

The common cold in children needs to be distinguished from the more serious flu caused by the influenza virus.   The flu is also more common in winter months and spread in similar ways to the common cold. Children with the flu have muscle aches and pains, chills, high fever and a cough.  The symptoms last usually a few days, but the muscle aches may persist longer. In children it is not uncommon to see vomiting and diarrhea. Infants may show poor feeding and irritability.  Similar to the common cold, you should seek help if your child has the following: fever persisting more than 3 days, thick yellow nasal discharge, trouble breathing, extreme drowsiness, severe and persistent vomiting, seizure activity, not drinking fluids or showing signs of dehydration.

There are a few things you can do at home for a child with the flu.  Allow the child to get a lot of bed rest, drink adequate fluids, and control aches and pains with Paracetamol. Since children breathe through their nose, you should keep their noses clean by gently suctioning with a rubber bulb or humidifying the air. Similar to the common cold, antibiotics have no role in treating the flu.

How can I prevent the cold or the flu?

Ideally the best method is to prevent your child from getting the cold and flu in the first place.  This can be accomplished by frequent hand washing and using alcohol hand gel and avoiding touching the mouth, nose or eyes.  Avoid any close contacts with people who are ill.  Vaccination is available against the flu for children older than 6 months and is available as a nasal spray or as an injection. A second vaccine is available against the H1N1 ‘swine flu’ strain.  If your child has any underlying heart conditions, lung conditions including asthma or decreased immunity, you should consider vaccinating your child against the flu. Keep your child at home while the fever persists and once it disappears you can let them return to day care.  If you are unsure if your child has a simple cold or the more serious flu, or any other more worrisome signs, it is always best to seek guidance from your family doctor.

References:

Pappas DE, et al. The common cold in children. http://www.uptodate.com/home/index.html. Accessed Sep 28, 2010.

Fine S,. Flu in Children. Department of Internal Medicine, Division of Infectious Diseases, University of Rochester School of Medicine. http://www.emedicinehealth.com/flu_in_children/article_em.htm. Accessed Sep 28, 2010.