Achoo! Cough, Cough

This week's guest columnist is Stephanie Barrow, MD, Family Practice Resident at Ochsner University Hospital & Clinics in Lafayette.

If the pandemic subsides this spring, we'll all relax: no more masks or distancing, no more COVID tests to keep kids in school. However, your sigh of relief will be replaced by the achoo cough hack snort of your child’s common cold.

Remember colds? As a child, runny nose, sneezing and coughing were a regular occurrence for me. In August as school started, or after Christmas break, every time I went back to school, I caught one. Before COVID, the average kid got eight colds per year. With masking, distancing and hand washing, we haven't seen these much. After all, the “Novel Coronavirus” is a regular Corona cold virus gone bad. All those things preventing COVID transmission also stopped cold viruses.

What are colds? They’re viruses that invade your nasal passages, throat and lungs, having received it from someone who coughed on you. The virus penetrates the cells lining your airways, takes over the chemical machinery they use to function and replicate, and makes them replicate insane amounts of the virus instead. The cells burst, releasing the new copies to infect more cells. Soon your immune system ramps up strategies to expel the intruders. Coughing, sneezing, and running noses sweep them out (where other folks can pick them up). After 3-5 days, your antivirus mechanisms clean up the leftover invaders, and you get better.

There's no cure for colds. Antibiotics don't kill viruses; they kill bacteria, a different kind of bug. Helping your immune system is your only way to get better quicker, like resting and drinking fluids. Symptom control like pain medicines, vaporizers and cough drops ease the misery. Cold medicines don't: they don’t work – and can make younger children irritable. Who wants that?

Another symptom of cold viruses (like we discussed above) is fever. When kids get fevers, many parents freak out. Mine did, and they'd tank me up with Ibuprofen. When panicking about fever, parents also stress about getting their child seen: at walk-in clinics? Wait to see their doctor tomorrow?  The ER?

Parents have reasons to fret. Why is she so tired and breathing so fast? Isn't his heart racing? Don't fevers cause seizures? Upon arrival, after some anti-fever medicine has kicked in, the child's wandering about the exam room, opening drawers and rattling the bed controls. “I swear he was really sick!” they say, as the skeptical doctor looks on.

To be fair, when kids have fevers, they look ill. They sleep a lot and eat and drink less. Fever does make hearts beat fast, and kids breathe fast, too. However, fever isn’t bad; it’s one way that bodies fight infection. Just like cooking food kills germs, your brain has a thermostat that senses when you’re sick and turns it up. When you’re feverish, it’s harder for infections to grow in you, and your immune system has a chance to wipe them out. Fevers don’t “cook” brains and rarely mean meningitis. Sure, a few toddlers have seizures with fevers, but that's a benign occurrence and they recover fine.

When do children with fevers need to be seen? If they’ve been coughing and snotting for longer than a week, or toasty longer than 3 days, that’s worth a look. If kids have sluggishness that’s worsening, or are progressively working harder to breathe, bring them in. When in doubt, call your doctor! They can advise you if you can wait until the next day or if it’s worth an ER trip. Don't panic until your doctor tells you!