Crestwood Pediatric Associates
Several confirmed cases of mumps has been reported at JMU in Harrisonburg, VA. Several more cases are suspected with test results pending. Mumps is a mild to moderate contagious viral illness that is spread through close (face-to-face) contact with an infected individual. Symptoms usually appear 12-25 days following exposure and include body aches, fever, and swollen or tender salivary glands. If you or someone you know is exhibiting these symptoms and has been exposed to mumps, you should contact your healthcare provider immediately.
Up to 10% of people who have received two doses (the routine schedule) of the MMR vaccine are still susceptible to infection from the virus. The Advisory Committee on Immunization Practices (ACIP) recommends that individuals in an outbreak setting receive a third dose of the MMR vaccine to prevent against infection. This recommendation is supported by a study performed at a university with over 20,000 students during a mumps outbreak.
To prevent the spread of mumps - or any virus - the following actions are recommended:
- Wash hands with soap and warm water
- Don't share food, drinks, or utensils
- Limit your contact with people who show symptoms of illness
- Clean surfaces that are frequently touched (doorknobs, tables, counters, bathrooms) with soap and water or other disinfectant
I’m sure everyone has been hearing in the news lately that influenza is peaking in the United States. We have never seen the CDC map of influenza showing it to be widespread throughout the continental United States.
This year we are having primarily Type A influenza of the H3 type. We are seeing some circulating type B as well. Clinically these two are indistinguishable presenting with headache, fever, body aches, chills, runny nose and cough. We would like you to call if you have these symptoms. We have an in office test , a nasal swab, that can show if your child has the flu that just takes about 15 minutes to perform.
If your child has the flu, we may recommend Tamiflu. This medication works best if we see your child within 48 hours of the onset of the fever.
The primary complication of the flu is pneumonia. If after the visit your child has increasing cough, shortness of breath, chest pain or increase in fever, we need to see them back in the office asap. We may need to do a chest x-ray or add additional medication to treat complications of the flu.
Of course, the best treatment is prevention. If your child has not had the flu vaccine, it is not too late. Please call and schedule to come in for one. We can even give flu vaccines to parents if you wish.
In order to prevent transmission of influenza, please remind your children to cover their cough. Have them wash their hands often. Do not send your child to school if they have had a temperature over 100.5 in the prior 24 hours. Never give Tylenol for a fever in the morning and send them to school later that day. If you have any questions about the flu, please give us a call. We look forward to hearing from you.
RSV is the most frequent cause of bronchiolitis (inflammation of the small airways of the lungs) in infants and young children
It accounts for 60% of all acute respiratory infections in children. RSV season begins in November peaking in January or February
and ends in May. RSV is passed from child to child through respiratory (nasal discharge, cough) secretions (the virus can remain viable on hard surfaces for up to 6 hours!). The incubation period is from 2-8 days.
Most common first symptoms are nasal congestion, runny nose, and sneezing followed by cough with increased difficulty breathing.
Infants are usually more severely affected than older children and can also develop lethargy, fever (though not always!), poor feeding, ear infections, secondary bacterial pneumonia, and apnea (cessation of breathing), which can sometimes result in hospital admission
RSV can be tested for in about 10-15 minutes with a simple nasal swab in the our office.
Therapy for RSV includes ensuring adequate hydration status and preventing dehydration along with supportive respiratory care (nasal suction with nasal saline drops with bulb syringe or NoseFrida. Occasionally, a nebulizer treatment may be tried if the infant is wheezing or has a significant family history of asthma. There is no role for steroids or antibiotics in the treatment of RSV as they will not improve symptoms.
Hand washing and use of alcohol-based rubs can help limit the spread of RSV; encourage and teach toddlers and older children to wash their hands frequently and cover coughs!
Respiratory Syncytial Virus Infection and Bronchiolitis
Giovanni Piedimonte, Miriam K. Perez
Pediatrics in Review Dec 2014, 35 (12) 519-530; DOI: 10.1542/pir.35-12-519
Parents are often wondering about healthy snacks for their children. Here are some ideas:
apple slices with peanut butter
baby carrots and fat-free ranch dressing
yogurt - Dannon Greek is lowest in sugar, watch other yogurt's sugar content which can be high, above 20 gms
Belvita bars or breakfast "cookies"
Any sliced fruits or vegetables
Whole grain crackers like Triscuits or wheat thins
Fruitables or Honest Kids drinks, water or 1% or skim milk if your child is over age 2 - avoid juice, soda and Gatorade or other sugary drinks except as a special treat occasionally.
Kids generally need 3 meals and 2 snacks per day. It is best to keep the snacks healthy, with only occasional junk food like potato chips, goldfish, white crackers, fruit snacks or candy.
We at Crestwood Pediatric Associates are concerned about the increasing use by our patients of retail based clinics or urgent care centers. Here are some important things to consider before you go:
Parents are often unsure when a problem arises when our office is closed if it can wait till the office opens in the morning. We have 24/7 on-call physicians that can help you make the decision to go to an urgent care center or ER, or if it can wait till the office opens in the morning.
We understand that children get sick at night and on the weekend. Our office is open until 9 PM most nights and on Saturday morning to give maximum flexibility in scheduling to our patients.
We remain your partner in your child’s care. We want what is best for your child as do you. Please consider the above carefully the next time you consider going to an Urgent Care Center.