Coughs and Colds in Children

Coughs and colds are usually caused by a virus infection. They normally clear away on their own, and antibiotics are usually of no use. Paracetamol or ibuprofen may ease some of the symptoms. Make sure the child has enough to drink.

What causes coughs and colds and what are the symptoms?
Most coughs and colds are caused by viruses. Many different viruses can infect the nose and throat. They are passed on by coughing and sneezing the virus into the air. An average primary school child has 3-8 coughs or colds per year. Sometimes several coughs or colds occur one after the other. A child who lives with smokers has an increased risk of developing coughs and colds.

• The common symptoms are a cough and a runny nose. The cough is often worse at night. Coughing does not damage the lungs. A coughing child will not choke or stop breathing.

• In addition, a child may have: a raised temperature (fever), a sore throat, headache, tiredness, and be off their food. Sometimes children vomit after a bout of coughing.

• A build up of mucus behind the eardrums may cause dulled hearing or mild earache.

What are the treatments for coughs and colds?
There is no magic cure! Typically, symptoms are worse in the first 2-3 days, and then ease over the next few days. An irritating cough may linger for up to 2-4 weeks after other symptoms have gone. Antibiotics do not kill viruses, so are of no use for common coughs and colds.
Treatment aims to ease symptoms whilst the immune system clears the virus. The most useful treatment is to give paracetamol (Calpol, Disprol, Tixymol, etc) to ease aches and pains, headaches, and fever. Ibuprofen is an alternative. Also, make sure your child has enough to drink. Dehydration (low body fluid) may develop if a child has a fever and does not drink much.
You can buy various other 'cold remedies' and 'cough mixtures'. There is little evidence that they do much good, but some people find them useful. Note: they often contain several ingredients. Some may make children sleepy (which may be useful at bedtime). Some contain paracetamol, so be careful not to give more than the maximum dose of paracetamol if you are already giving the child paracetamol. Some contain a decongestant which may help to ease a bunged up nose. (But note: do not give decongestants to children under two years old.)
Another popular treatment for a bunged-up nose in a baby is to put a few drops of saline (salt water) into the nose just before feeds. Some people feel that this helps to clear the nose to make feeding easier. There is little scientific evidence as to how well this works, but it may be worth a try if feeding is difficult. You can buy saline drops from pharmacies.

What symptoms should I look out for?
Most coughs and colds get better without complications. Sometimes a more serious 'secondary' bacterial infection develops from an initial virus infection. For example, an ear infection, pneumonia, etc. Symptoms to look out for that may mean more than just a cold include:

• wheeziness, fast breathing or difficulty breathing 

• persistent earache

• a cough that persists longer than 3-4 weeks

• persistent high temperatures

• drowsiness

• chest pains

• any symptom that you cannot explain

See a doctor if any symptoms develop that you are concerned about. Doctors are skilled at checking children over to rule out serious illness. They may not be able to prescribe anything more effective for a common cough or cold, but a check-over can be reassuring.

Colds in Adults and Older Children

An average adult and older child can expect 2-4 colds a year. Usually, symptoms peak after 2-3 days and then ease off over a few days. A cough sometimes lingers for up to three weeks. There is no magic cure! Treatment aims to ease symptoms. The main treatment is to take paracetamol or ibuprofen which can ease fever, aches and pains.

What is a cold and what causes it?
A cold is an infection of the nose and upper airways caused by a virus. Many different viruses can cause a cold. This is why colds recur, and immunisation against colds is not possible. Children tend to have more colds than adults as adults have built up immunity to many viruses. Adults and older children have an average of 2-4 colds a year.
(Young children of primary school age or below have an average of 3-8 colds a year. See separate leaflet called 'Coughs and Colds in Young Children'.)

What are the symptoms of a cold?

• The common symptoms are a blocked (congested) nose, a runny nose, and sneezing. At first there is a clear discharge (mucus) from the nose. This often becomes thick and yellow/green after 2-3 days. It may be difficult to sleep due to a blocked nose.
  You may feel generally unwell and tired, and you may develop a high temperature (fever).
  Sometimes there is a mild sore throat, hoarseness and a cough.
  A build up of mucus behind the eardrums may cause dulled hearing or mild earache.

Symptoms typically peak after 2-3 days and then gradually ease off. Symptoms have usually gone within a week, but in some cases they can take three weeks to clear completely. In particular, a cough may linger for up to three weeks, often when other symptoms have gone. The symptoms, particularly cough, tend to be worse and last longer in smokers.

What are the treatments for a cold?
There is no magic cure for the common cold! There is no treatment that will shorten the length of the infection. Treatment aims to ease symptoms whilst your immune system clears the virus. Note: antibiotics do not kill viruses, so are of no use for colds. The most useful treatments are:

• Paracetamol or ibuprofen which will ease fever, sore throats, aches and pains.

• Make sure you drink enough. A fever may cause you to lose extra body fluid by sweating. This may lead to mild dehydration which can make you feel more tired, and may cause a headache. Let your thirst be your guide. Hot drinks are often soothing too.

• A steam inhalation may help to 'clear the nose'. It has a temporary effect, but may be useful before bedtime to help you get off to sleep. However, beware of scalding yourself if you use hot water. A hot steamy shower is perhaps the safest option.

• A menthol sweet may also clear a bunged up nose for a while.
  

You can buy many other 'cold remedies' at pharmacies. There is little evidence that they do much good, but some people find them useful. For example, decongestant nose sprays, etc.
But remember, cold remedies often contain several ingredients. Some may make you drowsy. This may be welcome at bedtime if you have difficulty sleeping with a cold. However, do not drive if you are drowsy. Some contain paracetamol, so be careful not to take more than the maximum safe dose of paracetamol if you are already taking paracetamol tablets.

A note of caution
If you do use a decongestant nasal spray, do not use it for more than a few days. It can have an immediate effect to clear a blocked nose. However, the effect does not last very long. But note: if you use one for more than 5-7 days, a 'rebound' severe congestion of the nose may develop.

Are there any possible complications from a cold?
Most colds do not cause complications. A cold may trigger coughing, wheezing and shortness of breath in people with asthma or other lung diseases. Sometimes the infection travels to the chest, sinuses, or ears. Bacteria may thrive in the mucus so some people develop a 'secondary' bacterial infection of the chest, ears or sinuses. Therfore, consult a doctor if symptoms do not start to ease within a few days, or if you suspect that a complication is developing. In particular, symptoms to look out for that may mean more than just a cold include:

• fever, wheezing or headaches that become worse or severe.

•  fast breathing, shortness of breath, chest pains, or if you cough up blood.

• drowsiness or confusion.

• a cough that persists longer than 3-4 weeks.
  any symptom that you cannot explain and you are concerned about.

Flu and Flu Like Illnesses

Flu and flu-like illnesses typically cause a high temperature, muscle aches, a cough, and various other symptoms. Most people recover fully, but complications such as a chest infection or pneumonia develop in some cases. If you are at increased risk of developing complications, you should be immunised against flu each autumn.

What are flu and flu-like illnesses?
Influenza (flu) is caused by the influenza virus. However, many other viruses can cause an illness similar to flu. It is often difficult to say exactly which virus is causing the illness. Therefore, doctors commonly make a diagnosis of a 'flu-like illness'.
Each winter a different strain of the influenza virus causes an outbreak of flu which affects many people. During an outbreak of flu, if you get a 'flu-like' illness it is more likely to be caused by the influenza virus than by another type of virus. Note: bird flu (avian influenza) is different to the usual 'human' flu and is more serious. See separate leaflet called Bird Flu for details.

What are the symptoms of flu or a flu-like illness?
Typical symptoms in adults and older children include: high temperature (fever), sweats, muscle aches, a dry cough, sore throat, sneezing, and headache. You may also feel sick. The flu illness caused by the influenza virus tends to be worse than illnesses caused by other viruses which cause a 'flu-like' illness. Even if you are young and fit, flu can make you ill enough to need to go to bed.
Symptoms in babies and young children can include: high temperature (fever), sweats, a cough, sore throat, sneezing, difficulty in breathing, lethargy, poor feeding. Some young children have a febrile convulsion when they have flu.
Symptoms peak after 1-2 days, and then usually gradually ease over several days. An irritating cough may persist for a week or so after other symptoms have gone. Most people recover completely within 1-2 weeks.

What else could my symptoms be due to?
Other serious illnesses can have similar symptoms to flu when they first develop. For example, meningitis, malaria, or pneumonia. If you have a more serious illnesses, additional symptoms usually develop in addition to those mentioned above. Symptoms to look out for which may mean that you have a different and more severe illness include:

• Rash - in particular if dark red spots develop that do not fade when pressed.

• Stiff neck - particularly if you cannot bend your neck forward.

• A headache that becomes worse and worse.

• Dislike of bright lights - if you need to shut your eyes and turn away from the light.

• Drowsiness.

• Confusion.

• Repeated vomiting.

• Chest pains.

• Coughing up blood or blood-stained sputum.

Note: also, tell a doctor if you have flu-like symptoms, but you have been to a country within the last year where malaria is present. Symptoms of malaria can be similar to flu at first.

What is the treatment for flu and flu-like illnesses?
Your immune system will usually clear viruses that cause flu and flu-like illnesses. Treatment aims to ease symptoms until the infection goes.

• Paracetamol or ibuprofen will lower your temperature, and ease aches and pains.

• Have lots to drink to prevent dehydration (low body fluid).

Antibiotics
Antibiotics kill bacteria, but do not kill viruses. Therefore, they are not prescribed for viral illnesses such as flu or flu-like illnesses. However, they may be used if a complication develops such as a secondary bacterial chest infection or pneumonia (see below).

Antiviral drugs
Antiviral drugs called Zanamivir and Oseltamivir are sometimes used for flu. They do not kill the virus but interfere with the way the virus multiplies. Therefore, they do not cure flu, but may reduce the severity and duration of symptoms, and may prevent complications. If you develop flu, an antiviral drug may be prescribed if you are at increased risk of developing complications. Antiviral drugs need to be given soon after symptoms begin to be of any benefit. Also, an antiviral drug may be prescribed to certain people to prevent flu. For example, if you live in a residential home and there is an outbreak of flu in the home. Or, if you are at increased risk of complications and have been in close contact with a person with flu.

What are the possible complications of flu and flu-like illnesses?
If you are normally well, then you are unlikely to develop complications. You are likely to fully recover. However, see a doctor if symptoms change or become worse. Complications are more likely to develop if you are in any of the 'at risk' groups listed below.
The most common complication is a 'secondary' bacterial chest infection which may develop in addition to the virus infection. This can sometimes become serious and develop into pneumonia. A course of antibiotics will usually cure this. However, a secondary bacterial infection can sometimes becomes life-threatening, particularly in the frail and elderly. But note: with flu or a flu-like illness it is common to have a cough that lingers for 1-2 weeks after other symptoms have gone. Green sputum does not necessarily mean that you have a secondary chest infection. The symptoms to look out for that may indicate a secondary chest infection include: a recurrence of a high temperature, worsening of cough, shortness of breath, fast breathing, chest pain.
Other complications that sometimes occur include a sinus infection and an ear infection. Rarely, other serious complications such as brain inflammation (encephalitis) develop.

Who should be immunised against the influenza virus?
The Department of Health issues advice as to who should be immunised. This is reviewed from time to time. The aim is to protect people who are more likely to develop complications from flu. Current advice is that you should be immunised against the influenza virus each autumn if you:

If you are healthy and under 65 and do not fall into any of the above categories, then you do not need a flu immunisation. This is because you are unlikely to develop complications from flu.
The influenza virus gives good protection against the influenza virus, and lasts for one year. The vaccine is normally ready by the autumn each year. It is made from the strain of influenza virus that is expected in the coming winter. You need a yearly immunisation to keep protected.

For more information visit the General Health Issues Weblinks

 

With a cold, earache occurs when the Eustachian tube between the ear and the throat becomes blocked with mucus. This will usually settle after a few days but infection can occur and may cause a discharge from the ear.

Give paracetamol for the pain.

Contact your doctor if the earache persists for more than three days, if the ear is discharging, or if the pain is very severe.

Conjunctivitis often occurs with cold viruses. It is usually harmless and will disappear by itself.

Try bathing the eye with cool boiled water.

Contact your doctor if the eye is discharging pus, if it does not get better after five days, or if vision is disturbed.

Diarrhoea – Adults and Children over 1 year

Diarrhoea is defined as three or more liquid bowel movements in a day, and may occur with vomiting and abdominal cramps. It is usually caused by viral infections or food poisoning. Nearly all cases should clear themselves in two to five days, without needing to take any medicines.

Stop all food for several hours or until you are feeling better. Ensure that frequent drinks of water, dilute fruit juice or squash are taken, but stop all dairy products for three days. Eat bland food such as boiled rice or pasta, dry toast or crackers. Avoid spicy or fatty food, alcohol and coffee for at least 48 hours or until all symptoms have disappeared.

Contact your doctor if you are losing too much fluid and becoming dehydrated, if there is blood in the diarrhoea, if you may have picked up an infection abroad, or if the diarrhoea goes on for longer than a week. If your work involves handling food, you may need to stay off work and provide samples to send to the laboratory.

2. Diarrhoea – Babies

Give frequent drinks of water or dilute juice. Try and restart feeding after the first four hours. Breast fed babies will need an increased number of feeds.

Contact your doctor if symptoms persist for 24 hours, if the baby does not want to drink, is drowsy or has a high temperature.

3. Constipation

The most common causes of constipation are lack of high fibre foods, not drinking enough fluids or lack of exercise.

Try increasing fibre, drinking plenty of water and regular exercise.

Contact your doctor if you have blood or mucous mixed in the stool, or if your bowel pattern changes to intermittent diarrhoea as well.

Back pain is usually caused by muscle spasm and is felt as stiffness. It is mostly confined to the back, but can pass into the buttock or upper leg. Pain passing below the knee may indicate a more serious cause such as pressure on the spinal chord.

Keeping as active as possible can speed recovery and prevent long term problems. Take paracetamol, codeine or ibuprofen to enable you to keep active and continue with normal daily activities. Swimming, Yoga or Pilates exercises may help.

Contact your doctor if the pain goes to one leg and persists longer than a week, or if you get an area of numbness. If you are unable to pass urine, contact your doctor immediately.

Rest and elevate the affected limb, apply ice wrapped in cloth to the affected area. A compression bandage may help.