There are many illnesses that commonly occur during the winter. Depending upon the age and health of your family members they could end up being serious.
In the first installment of our series on Common ENT Conditions in Winter, we discussed the common cold, influenza, and bronchiolitis. In this second and last installment of the series, we discuss croup, pneumonia and strep throat.

What is croup?

Croup is an infection of the airway that creates a hard cough that sounds like a bark. The infection narrows the upper airway and makes breathing difficult. It usually affects younger children under the age of three because their airways are narrow. Croup can make breathing difficult and create a wheezing sound with the intake of air. Although the child may be sick and the cough can be frightening for parents, croup can be treated at home and most cases do not require hospitalization. (About five percent result in hospitalization.)

What causes croup?
Croup is caused by a virus and usually begins with the symptoms of the common cold like a runny nose and a cough. However, croup will cause the cough to worsen into a barking cough. Children contract croup by coming into contact with a virus, usually the parainfluenza virus. These viruses are coughed into the air and children come into contact with the droplets that contaminate toys, door handles, and other surfaces. If the child touches the virus and then touches his or her ears, nose, mouth or eyes, the virus can enter their body and infect them.

How is croup diagnosed?
A physician diagnoses the croup by listening to the child’s breathing and looking at the child’s throat. In some cases an x-ray may be ordered to see if there is congestion in the lungs.

How is croup treated?
Most cases of croup can be treated at home in the following ways:

• Keep the child warm and comforted because crying and agitation will worsen the cough
• Use humidifiers that add moisture to the air which helps to soothe the child’s throat
• Drink lots of liquids; the more hydrated the child is the better positioned the body is to fight the infection
• Get lots of rest and sleep
• Over-the-counter pediatric medications that fight fever can help to reduce the discomfort of croup

Do not give a child under the age of two cold medications. They are not safe for them. In addition, cold medications will not treat the croup because it is caused by a virus. Cold medications only address the symptoms of illnesses caused by bacteria.

Preventing croup
Preventing croup is a matter of avoiding contact with the germs that cause it. The best way to stop the spread of any disease or illness is hand washing. Teach your children to wash their hands frequently with soap and water or hand sanitizer. And since croup is somewhat of a contact sport, you can try to keep them away from other sick children and adults, i.e., limiting play dates.

 

What is pneumonia?

Pneumonia is an infection of the air sacs in the lungs. It can strike people of any age and is most dangerous for the very young and the elderly. Some people have mild cases of pneumonia while for others it can be a life-threatening illness. Pneumonia can be especially dangerous for those with other chronic health conditions or compromised immune systems. It can strike one or both lungs simultaneously.

The signs and symptoms of pneumonia can include the following:

• Chest pain
• Cognitive changes in adults older than 65, i.e., fogginess, confusion
• Cough
• Fatigue
• Fever, sweating and chills
• Nausea, vomiting or diarrhea
• Shortness of breath

What causes pneumonia?
Pneumonia is caused by bacteria, viruses and certain fungi. The infection fills the air sacs of the lungs with fluid or pus.

There are four different types of pneumonia based on the type of germ that causes it:

1. Bacterial pneumonia: This type of pneumonia is caused by different types of bacteria including streptococcus pneumoniae, chlamydophila pneumonia and legionella pneumophila. People with a weakened immune system or those with chronic diseases such as kidney disease are at higher risk of contracting bacterial pneumonia.
2. Viral pneumonia: This type is caused by viruses and is the most common type contracted by the very young and the elderly. It is usually less serious and runs a shorter course than bacterial pneumonia.
3. Mycoplasma pneumonia: This type of pneumonia is highly contagious and spreads quickly. It is commonly referred to as “walking pneumonia” and spreads quickly through shared living environments like nursing homes and college dormitories.
4. Fungal pneumonia: This type of pneumonia is restricted to those who work closely with the soil or birds. If a large amount of the fungus found in the soil or bird droppings is inhaled, fungal pneumonia can result. It can be especially tough for those living with compromised immune systems or chronic disease.

Pneumonia is also classified by the environments in which it is contracted.

1. Hospital-acquired pneumonia: Contracted during a hospital stay, it can pose a higher risk because it can be resistant to antibiotics and may be contracted by a person who has already been compromised by another illness.
2. Healthcare-acquired pneumonia: This type is contracted by people who live in healthcare facilities like skilled nursing and long-term care facilities, or those who spend a lot of time receiving care in outpatient clinics.
3. Community-acquired pneumonia: This type of pneumonia is contracted outside of healthcare settings.
4. Aspiration pneumonia: This type of pneumonia occurs as the result of inhaling food, drink, or saliva into the lungs. When this occurs, it is usually in an individual who has suffered a brain injury or has trouble swallowing.

How is pneumonia diagnosed?
A physician will first listen to the person’s lungs to begin the diagnosis of pneumonia. Blood tests may be taken to determine if an infection is present. In addition, the physician may order a chest x-ray to see if there is fluid in the lungs. A test called “pulse oximetry” will determine the level of oxygen in the blood because pneumonia can reduce those levels. Another test called a sputum test will analyze fluid from the lungs (sampled after being spit up) to determine the type of infection causing the pneumonia.

How is pneumonia treated?
Pneumonia can be treated in many different ways, depending upon the age of the person who has it, their underlying health condition, and the severity of their pneumonia. Mild cases of pneumonia can be treated at home. More severe cases, individuals with compromised health, the very young and the elderly may be treated in hospitals.

Treatments can include:

• Antibiotics: This form of medication treats bacterial pneumonia. The physician will try to match the antibiotic to the type of bacteria causing the pneumonia for the best treatment.
• Cough medicines: Some people with pneumonia develop a cough. Cough medicine can suppress the cough and allow the person to rest and sleep. Discuss over-the-counter cough medications with your physician to determine the best one and the best dose. Do not give these to a young child without first checking with your physician.
• Pain relievers and fever reducers: These can help to relieve the aches, pains and fever that can accompany pneumonia. Take the one that works best for you, or one that you usually take, i.e., aspirin, ibuprofen or acetaminophen. Do not give these to a young child without first checking with your physician.

Preventing pneumonia
There are several steps you can take to try to prevent contracting pneumonia:

• Get vaccinated: Children, the elderly, and those with chronic disease and compromised immune systems should be vaccinated against pneumonia. It’s called a pneumococcal vaccine.
• Wash your hands: Hand washing is the best way to stop the spread of illness and disease, including pneumonia. Teach your children how to wash their hands properly and encourage them to wash their hands frequently with soap and water or hand sanitizer.
• Quit smoking: Smoking weakens the lungs and weakens the bodies defense against infection.
• Stay as healthy as possible: Eating healthy foods, exercising and sleeping at least 7 hours a night (adults) will keep your body as healthy as possible in case it needs to fight infection.

 

What is strep throat?

Strep throat is a bacterial infection that causes the throat to become red, swollen and sore. It may be painful and may hurt to swallow. Strep throat differs from a sore throat in that the pain may come on quickly. Not all sore throats are caused by strep throat, even though some of the symptoms may be the same. If you suspect that you or your child has strep throat it is important to see a physician and have it tested. Left untreated, strep can spread and infect the sinuses and the middle ear. Strep has also been known to develop into rheumatic fever if not treated properly.

Signs and symptoms of strep throat include:

• Throat pain that occurs quickly
• Pain when swallowing
• Tonsils are red and swollen with white patches
• Red spots appear on the back of the roof of the mouth
• Neck lymph nodes are swollen
• Fever, headache, generalized body aches
• Nausea or vomiting, especially in younger children

What causes strep throat?
Bacteria called streptococcus pyogenes causes strep throat. It is very contagious and can spread through the air when someone coughs or sneezes. The bacteria can live on contaminated surfaces such as doorknobs, toys, handrails and phones. If people touch these surfaces and then touches their eyes, nose or mouth, the bacteria can enter the body.

How is strep throat diagnosed?
A physician will conduct two tests, in addition to a physical exam, to determine if strep throat is present:

1. Rapid antigen test. This test works in minutes and is conducted using a sample that the physician takes from the throat on a swab. The test quickly detects if the strep throat bacteria is present.
2. Throat culture. This test takes longer because the sample taken from the back of the throat is grown in a culture in a lab. It takes several days for the culture to grow and confirm if strep is present.

How is strep throat treated?
Usually a physician will prescribe antibiotics to treat the bacteria causing the strep. It will begin to reduce the pain of strep within 48 hours and will also make it less contagious.

Other treatments may help to reduce the pain and discomfort caused by the strep:

Pain and fever reducers: Over-the-counter pain relievers can reduce the aches, pains and fevers that may accompany strep throat. Do not administer these to young children without first checking with your physician. Aspirin can cause complications in children, especially those with flu symptoms or chicken pox.

Rest: Your body needs rest to fight infection so get lots of it.

Water: Drink lots of water to keep the throat from getting dry. It will help with swallowing.

Soft foods: Eat soft foods only while recovering from strep throat. Avoid foods that are spicy, rough in texture, salty or acidic like tomatoes and oranges.

Gargle with salt and warm water: This will help to relieve throat pain. Mix ¼ teaspoon salt with an eight-ounce glass of warm water and gargle with it.

Humidifier: A humidifier will add moisture to the air and will help to ease the pain of strep throat.

Preventing strep throat
Hand washing: Hand washing is the number one way to prevent the spread of disease and illness and that includes strep throat. Teach your children to wash their hands properly and frequently using soap and water or hand sanitizer.

Don’t share: Do not share glasses or utensils when eating. Make sure to wash all dishes in hot water whether by hand or in the dishwasher.

Unfortunately, these illnesses are common in the winter months. Despite your best efforts you or your family members may contract them. If you do, check with your physician immediately to start treatment and prevent the illnesses from spreading to your family members, colleagues or schoolmates.