Common problems of children in winter

November and December are the month for annual exam of children. Now a days even the students of kinder garden faces exams in many subjects. After exam they usually go out for travel in different places along with parents. So November and December are important months for the children as well as for the parents. But unfortunately during these months many diseases may put them in trouble.
Common diseases that occur in children during winter include Bronchiolitis, Pneumonia, Asthma, Sore throat and fever, Rhinitis, Flu, winter diarrhoea, Scabies etc.
Bronchiolitis: It is the commonest respiratory problem of children younger then 2 years. After mild coryza, cough, runny nose, the young healthy child starts respiratory distress. There are hurried respiration along with wheeze and chest in-drawing. Fever may or may not be present. Babies are not toxic. They may have feeding problem. It mimics Pneumonia but actually it is not Pneumonia.
It is a viral disease and the commonest cause is respiratory syncytial virus. It is a contagious disease. Humidified oxygen is the ideal treatment option for this disease.
Pneumonia: Another common and relatively serious disease of children is Pneumonia. Fever, cough, respiratory distress with some toxicity is the usual presenting feature in this disease. X- ray confirms the diagnosis.
It may occur due to bacteria or viral infection. In children mainly due to bacteria, early diagnosis and prompt antibiotic treatment are necessary to cure the disease. Hib and Pneumococcal vaccine may help to reduce the incidence by developing immunity.
Asthma: Winter is not the cause of Asthma but during winter dust, pollens are abundant and they provoke Asthma attack. Chronic cough, wheeze, respiratory distress, chest tightness may need immediate treatment for relief.
Salbutamol inhalation alone is enough in intermittent Asthma. But in mild or moderate persistent Asthma, some steroid inhalation is necessary along with Salbutamol inhalation. In severe Asthma, hospital management is mandatory. Montelucast for prolong time may reduce the attack.
Rhinitis and Influenza: They are very common viral disease in winter. Symptomatic treatment with Paracetamol and antihistamins is needed. Sometimes nasal decongestant drops may be used. Antibiotic usually does not have any role. It takes 5-7 days to be cured. Hand washing and strict maintenance of personal hygiene may help to reduce the spread of the disease.
Tonsillitis and Pharyngitis: Fever, throat pain, malaise, headache and difficulty in feeding arouse the suspicion of the condition.
By inspecting the oral cavity and pharynx, diagnosis can be done confidently. Ten days Penicillin or Amoxicillin is necessary to get rid off the disease. If not given proper and prompt attention Acute Glemerulonephritis (AGN), a common kidney disease of children or Rheumatic fever may develop in the long run as complication.
Winter diarrhoea or Rotavirus diarrhoea: Frequent passage of liquid watery corn soup like stool with development of dehydration is the presenting feature of this disease. It may be accompanied by vomiting and fever. Correcting dehydration by oral rehydration saline (ORS) is the mainstay of treatment. Breast milk should be continued if the baby is on breastfeeding. But if the baby becomes lethargic, s/he may need hospitalisation for intravenous saline.
Antibiotic has no role, as it is a virtal disease. Rotavirus vaccine and proper hand washing may help in preventing the disease.
Scabies: Intense itching with burrows and scratches in between fingers, armpit, genital region and in other parts of the body is not uncommon in winter. Scabies is a contagious disease caused by mites.
It need treatment of all the family members at a time. Simple 5% Permethrine cream application solve the problem. Personal hygiene is important to prevent the spread.
Cleaning the used clothes with soap water and ironing them properly reduces the spread of the disease.
Take care of your children. Teach them to maintain personal hygiene. Ask them to make a habit of hand washing. Breast milk, vaccination and proper nutrition are important to prevent many disease. Be happy and healthy.

The writer is a Professor of Paediatrics at Community Based Medical College (CBMC), Mymensingh.
E mail: mmukkhan@gmail.com