SAN ANTONIO – Why are so many children sick right now?
That’s what many parents are wondering as RSV, flu and stomach viruses are running rampant through schools and daycares this fall.
Dr. Mandie Tibball Svatek, University Health pediatric hospitalist and UT Health SA associate professor answers some of parents’ most asked questions about RSV and other viruses.
*Editor’s Note: This Q&A was provided by University Hospital thanks to a partnership between KSAT and UH.
Q: Why do my kids keep getting sick?
Dr. Svatek: Currently we are seeing high rates of many different viruses affecting children within our area, including, RSV, Flu A, rhinovirus/enterovirus. Given all the different viruses, places like schools, daycares, stores, restaurants and other crowded places provide ideal opportunities for a child to have multiple exposures to these different viruses. Given the high number of infection rates, it is not unusual for a child to have one virus or multiple viruses. Their symptoms from one illness may not have completely resolved before they start to have symptoms from another virus.
Q: When can I send my child back to school after they’ve been sick?
Dr. Svatek: Many schools have their own guidelines for returning to school so it is important to call and ask if you aren’t sure. Typically it is recommended that a child be fever-free for 24 hours and not have symptoms like vomiting, diarrhea, mouth sores and rashes. Cough and congestion may still be present after some of the common viruses, but as long as other symptoms noted above have resolved, then cough and congestion can be allowed.
Q: They got better and within three days they had another fever. Can they get the same virus twice?
Dr. Svatek: If there are different variants of the virus in the community – such as the flu – then there is the potential to get repeat infections with those same viruses. This is similar to what has been seen with COVID-19 infections. It is also not unusual for a child to start daycare for the first time and to develop 8-12 viral respiratory infections within that first year. As a child’s immune system develops, the number of infections usually will decrease in time.
Q: When should I take them to the ED and when should I take them to Urgent Care or look for telehealth options?
Dr. Svatek: If your child does not appear well and has symptoms such as difficulty breathing, not being able to tolerate oral intake, a fever that does not resolve after 5 days or is getting worse, or you observe a change in mental status, then those are signs they should be taken to the ED.
Q: Is it important to know which virus they had? Should they get swabbed every time they’re taken to the doctor?
Dr. Svatek: A swab is not needed to identify viruses. If your child has flu-like symptoms such as fever, cough, congestion, headache, muscle aches and fatigue and they are presenting within the first 48 hours of symptoms then they can be tested, or the pediatrician may just decide without testing to start a medication such as Tamiflu to help shorten the duration of symptoms.
For COVID-19, a parent may choose to get their child tested for the following reasons.
- Patients who have symptoms consistent with COVID-19 should be tested immediately.
- Patients who are asymptomatic but have had close contact with an individual who has confirmed or probable COVID-19 should be tested at least 5 days after last exposure; however, these patients should be tested immediately if they develop symptoms consistent with COVID-19.
- Patients who are required to obtain screening tests based on local public health authorities, school districts, or other local organizations should be tested as required.
Overall it is important to contact your health care provider for your child to help guide you in decisions about testing and potential treatments for your child. The health care provider can also provide direction on when to return to school and activities that the child may be participating in.
Q: How do we boost their immune system?
Svatek: Vaccines such as the COVID vaccine and flu vaccine can provide protection and shorter duration of symptoms, should your child be exposed to these viruses. Keeping your child up to date on all vaccines is also extremely important to help protect your child from vaccine-preventable diseases. Eating a well-balanced diet is also important in keeping the body healthy.
Q: Once they are ill, what’s the best way to quickly flush the virus from their system?
Svatek: It is important to keep a child hydrated during their illness so giving them plenty of fluids is important. Treating the fever with fever-reducing medications can also make the child feel better as the virus runs through their body. Allowing a child to rest and stay out of activities will also help lead to an easier recovery.
Q: What can I do to prevent my child from getting sick? Masks? Distancing? Hand hygiene?
Svatek: Different viruses are spread in different ways either thru the air and/or on surfaces. Although they are not 100% effective, mask-wearing and hand-washing can be protective measures to help keep a child from getting sick. If there is a vaccine available, that is the most effective way of protecting against an illness.
Q: If one of my children is sick, how do I prevent others in the household from getting the virus as well?
Svatek: In your house it may be difficult to prevent spread to others, but it is especially important to have a plan to protect young infants, older individuals, and those who may have health problems that can be worsened by an illness. You can encourage and promote good hand hygiene at home, and clean surfaces that a sick child may have touched. You can also have family members to wear a mask and/or have the child wear a mask to potentially reduce spread to other individuals in the house, and separate those individuals that may be susceptible from those that are sick.
Q: The transmission of flu was lower than usual during the pandemic because many children wore masks in school and public places. Are we at a point where our children should again wear masks to avoid getting flu and other respiratory infections?
Svatek: Face masks for children 2 years and older can definitely be considered during this time where viruses such as the flu are predominant in our area. You may also consider mask-wearing for children when COVID infection rates are high, for those children that have a weakened immune system, and to protect other family members that may be at risk in the household as noted above.