RSV

Most children have been infected with Respiratory Syncytial Virus (RSV) before their second birthday. It’s very common and similar to a bad cold. Although it is usually nothing to worry about, it can lead to more serious infections like pneumonia, so it is important for parents to know the symptoms and treatment.

RSV causes the same symptoms as the common cold:
• stuffy/runny nose
• sore throat
• cough
• earache
• fever
• lack of energy
• fussiness in babies

RSV usually gets better with home treatment: control your child’s fever with acetaminophen or ibuprofen, promote rest and comfort, and make sure your child’s airway is clear (you may need to suction) so he/she can breathe well enough to eat and sleep. It may take a week or two before a child with RSV is fully recovered.

However, if the symptoms get severe or lead to pneumonia, you need to call your pediatrician. Babies under 6 months, children with immune problems, or children with heart or lung problems are especially susceptible to complications and should be seen by a doctor if RSV is suspected.

And as always, the best prevention is to practice good health habits. Make sure your child washes his/her hands often, don’t be around or share food/drinks with other children who are coughing/sneezing, etc. And, as always, make sure you child gets all the recommended vaccines.

The Statistics Behind Vaccines

If you're like most, you know vaccines are important in keeping our children healthy and disease free, but you may not know exactly what diseases your children are being protected from. So what are the actual statistics on how various vaccines have prevented illness and death? Below are the disease and death rates from the Centers for Disease Control and Prevention since the introduction of various vaccines.


Vaccine: DTaP
Diptheria—In 1920 there were 147,991 reported cases of diptheria causing 13,170 deaths. In 2002, one case was reported in the United States.
Tetanus—Tetanus continues to kill 300,000 newborns and 30,000 birth mothers a year in areas of the world where the immunization is not available.
Pertussis (Whooping Cough)—Before the immunization, there were around 260,000 cases reported each year leading to around 9,000 deaths. Worldwide there were 9,771 cases reported in 2002.

Vaccine: HIb
Haemophilus Influenza type b (bacterial meningitis)—Before the vaccine, HIb killed 600 children a year and infected over 20,000. In 2005 only 34 cases were reported.

Vaccine: PCV
Pneumococcal—Since the vaccine was introduced, disease rates in children have declined 70 to 80 percent.

Vaccine: IPV
Polio—Before the vaccine 13,000 to 20,000 new cases were reported each year. In 2000 no cases were reported.

Vaccine: MMR
Measles—Measles continues to be one of the most infectious diseases in the world, and researchers estimate that if the vaccine were stopped, there could be some 2.7 million deaths worldwide from the disease.
Mumps—Before the vaccine there were an estimated 212,000 cases of mumps annually. In 2002 there were 270 cases reported.
Rubella—Before the vaccine it is estimated that rubella led to 20,000 infants born with severe disability, 2,100 neonate deaths, and 11,250 miscarriages.

Vaccine: Varicella
Varicella (Chickenpox)—Before the vaccine there were around 4 million cases annually, leading to 11,000 children hospitalized and 100 deaths each year. In 2002 there were 9 reported deaths from chickenpox.

Vaccine: HepB
Hepatititis B—In 1982, 22,177 new cases of the disease were reported. In 2002 only 7,996 cases were reported.

Vaccine: Smallpox
Smallpox—The vaccine for smallpox began to be widely used in 1900. At that time there were about 1,000 deaths caused by the disease each year. By 1977 smallpox had been eradicated.

Ask a Nurse

Today's post will answer a question from one of our readers. Darbie in New Mexico asked:

What advice can you give for when to take your children to the doctor when they have a fever? My mother-in-law would take her children to the doctor if they were a bit warm, but I don't think that ONLY a fever with no other symptoms is a problem and wouldn't take my child to the doctor.

Unfortunately there is no exact formula for when you should take your sick child in to the pediatrician, but here are a few tips to help guide parents in determining if they should call the doctor:

* The best indicator of your child's health status is his/her behavior. Your child may have symptoms of a cold, but if he/she is running around and playing like normal, a doctor’s visit is probably not necessary. If, however, your child is not acting normally, is very sleepy, refuses to eat or drink, doesn't want to play, and is irritable, these are probably signs that the illness is a little more serious.

* Fever is a common response to infection and should always be monitored. But fever alone is not a reason to take your child into the doctor. Many fevers can be managed at home with antipyretics like Tylenol or Motrin. However, if your child is less than 3 months old and has a temperature greater than 100.4, you should call your pediatrician. An infant's immune system is less developed, and what would be considered a mild illness in a child or adult can be serious in a newborn. Also, if you are unable to manage your child's temperature with medication at home, you should call your doctor.

* If your child has a cough or cold that does not get better within a week, you should take him/her to the doctor.

* A child that will not eating or drinking for more than 12 hours or one that has severe vomiting or diarrhea should see a doctor. Dehydration is a major concern in these cases.

* Ear pain accompanied by a fever is usually indicative of an ear infection. This may be a bacterial infection, and your doctor will generally prescribe an antibiotic.

Remember, you as parents know your children best and are usually the best judge of their health status. If you are at all concerned, you should never hesitate to call your pediatrician's office.

Oral Health

You may be surprised to learn that the most common chronic childhood disease is tooth decay. According to the Centers for Disease Control and Prevention (CDC), more than 40 percent of children have tooth decay by the time they reach kindergarten, making dental cavities five times more common than asthma and seven times more common than hay fever in children. Health care professionals know, however, that this is one disease that is very preventable. Here are some tips for giving your child a healthy, happy smile:

• Start with good oral care habits early—Even before your baby’s teeth come in you should start cleaning his/her gums twice a day using a clean, soft cloth. Good times to do this are after a morning feeding and before bedtime. When the child’s first teeth come in, you should continue cleaning with a cloth or use a baby’s toothbrush and water. All baby teeth should be in by age two, and around this time, you can begin to use a pea-size amount of fluoride toothpaste on the brush. Don’t start using toothpaste until your child is able to spit instead of swallow after brushing. All children should brush at least twice a day and floss once a day.
• Avoid sugar—Sugar reacts with bacteria in the mouth to form acid, which then causes tooth decay. Limiting the amount of sugar your children consume and feeding them fresh fruits and vegetables instead of cookies, candy, and soda is much healthier for their bodies and smiles!
• No bottles to bed—Milk, formula, juice, and other sweet drinks have sugar in them, and when a child sucks on a bottle filled with these liquids right before bedtime or a naptime, the liquid pools in the mouth and the sugars react and destroy the front teeth (known as baby bottle tooth decay or BBTD). If you do need to put your baby to bed with a bottle, fill it with water.
• Fluoride—Fluoride is a mineral that is beneficial to oral health because it actually strengthens tooth enamel and works to prevent tooth decay. Fluoride is found naturally in many foods and is added to drinking water in most cities and towns. Fluoride is also added to toothpaste (however, to avoid fluoride toxicity in young children, it is recommended children don’t use toothpaste with fluoride until they are old enough to spit it out after brushing).
• Regular dentist visits—Your child’s pediatrician should check your child’s general oral health at every visit. It is also important that you take your child to see the dentist regularly starting around the first birthday or six months after the first teeth come in.

Cold vs. Flu

When your child is sick, it is often hard to tell the difference between the cold and flu. Here are a few easy tips:

Influenza
• Sudden onset of fever, chills, sore throat, cough, runny nose
• Child may also have headache, muscle aches, tiredness, nausea, vomiting

Cold
• Stuffy nose, sneezing, scratchy throat, hoarse voice, dry cough
• Child may have slight fever
• Child generally keeps up with usual activities

More important than the symptoms is how your child is acting. Take your child to the pediatrician if he/she is not acting normally (e.g., is very sleepy, has little energy to play, is irritable and cannot be comforted, is having trouble breathing, or is not drinking). Any child younger than three months who has a temperature greater than 100.4 should see a pediatrician.

Preventing the Common Cold

It’s called the common cold for a reason. Within the first two years of life, your child will probably have between eight and ten of them. Although most colds are uncomplicated and go away by themselves in about a week, there are steps you can take to keep your family healthy, especially during the winter months.

• If you know someone is sick, keep your child away from that person.
• If your baby is under 3 months old, take special precaution to limit exposure to the cold virus. Because infants’ immune systems are not as well developed, a virus that causes mild illness in a child or adult can be much more serious for an infant.
• Teach your children to wash their hands frequently! Wash with soap and water or use an alcohol-based hand sanitizer. This really is the best way to prevent the spreading of infection.
• Try to keep your kids from touching their eyes, nose, and mouth. The membranes of these areas are the easiest place for germs to enter the body.
• If your child has a cold, teach him/her to cough or sneeze away from others and to use a tissue. (If they don’t have a tissue, they can use their upper sleeve or elbow.) If children use their hands to cover their mouth, they risk spreading the virus to every surface they proceed to touch—a toy, a sibling, etc.