Protect your family from the new respiratory virus

As reported officially by the CDC this week, in the last month hospitals in Illinois and Missouri reported an increase in emergency department visits and hospitalizations for respiratory symptoms. Since then, reports of similar illness are coming in from many other states, scattered across the country. Here in Georgia, our own Children’s Healthcare of Atlanta microbiology team is reporting a lot of cases. Most (but not all) of the children with more severe illness had pre-existing lung disease (like asthma).

The illness seems to be mostly affecting children. Most cases begin with ordinary, cold-like symptoms—and it’s likely that most cases actually never develop into anything more than that. The reported cases, so far, may well be a “tip of the iceberg” effect, where only the sickest children get tested and identified. These are the kids who develop trouble breathing and low oxygen levels, and often need intensive care. It’s quite likely that most children with this infection quickly recover after a cough, sniffles, and runny nose. Of the cases reported so far, only about 1 in 4 or 5 runs a fever. Probably, most children and adults who have this infection don’t seek medical care, and very few of them (so far) are even being tested for the likely viral cause.

Most of the reported cases are testing positive for a specific virus, called enterovirus D68. That virus was first identified in California and 1962, and until now had rarely been a reported cause of illness. The enterovirus group, as a whole, contains a lot of other viruses that cause a whole bunch of different symptoms—fevers, respiratory illnesses, GI problems, heart disease, rashes, and neurologic problems. Pediatricians and others who take care of kids are used to seeing tons of enterovirus, which usually strikes in the summer, most typically as hand-foot-and-mouth disease, or as a fever. So we’re used to these kinds of viruses, even though this specific one is a newly-recognized member of the family. We’re not 100% sure, yet, exactly how D68 is transmitted, but other enteroviruses spread though respiratory drops and in stool, and can remain infectious for a long time on contaminated surfaces.

As with many viral infections, prevention is the best strategy. Common sense things can really help: keep your kids home when they’re sick, and don’t send your kids off to play with sick children. Encourage your kids to wash their hands and use hand sanitizer frequently. Get a good night’s sleep and moderate exercise. Keep your child up-to-date on vaccines—though there is no specific vaccine for this enterovirus, bacterial and viral co-infections with influenza and pneumonia can be prevented. If your child has asthma (or any other respiratory problems), make sure that you’re keeping up with all prescribed treatments, so things are less likely to spiral out of control when an infection strikes.

If your child does get sick with cough, look out for these symptoms:

  • Having trouble breathing. You may see individual ribs poking out with each breath, or the depression at the bottom of the neck sinking in. Children with trouble breathing usually breathe fast, and sometimes breathe noisily.
  • Having trouble speaking. If you can’t get good breaths in, you can’t typically complete sentences and talk normally.
  • Seeming listless, with low energy. Children with serious respiratory compromise may not be getting enough oxygen to their brains. They can seem “foggy” or “out of it.”
  • Drinking poorly. Younger children and babies may have a hard time eating and (especially) drinking when they’re really ill.
  • Looking blue or pale.

If you’re seeing those kinds of symptoms, take your child to the doctor right away, or head to the emergency department. Even if things don’t seem quite that bad, if you’re worried, don’t hesitate to call for help.

Most children who are getting enterovirus D68 infection will do just fine. Some of you have probably already had children with this, and didn’t even know it. Every year, we see spikes of infections like this, caused by a variety of viruses like RSV, metapneumovirus, or influenza. Though there is no specific therapy for most of these, we’re pretty good at recognizing who needs extra help, and we can provide good supportive care when it’s needed. It sounds scary when you see news of a new, bad infection—but in truth, this isn’t very different from other infections we’re used to dealing with. We need to stay vigilant and keep our eyes on whatever’s out there making our children sick, but there’s no reason to get too worked up over this latest challenge.

Posted in Uncategorized | Comments Off

Welcome!

Pediatric Physicians, PC is a friendly and welcoming medical practice for your children. Our two offices in Alpharetta and Roswell are staffed by devoted, board-certified pediatricians, practicing the best state-of-the-art pediatric care from newborns to teens, including a 100% commitment to keep your children up to date on vaccines.

We’re easy to reach by telephone–no annoying phone tree!–and there’s plenty of free parking right at the doors of both offices. Same-day sick appointments are always available.

We’re here when you need us, and we’re here to help.

Posted in Uncategorized | Comments Off

Free Kindle Ebook for Pediatric Sleep Problems

A friend and medical school classmate of mine, Dr. Sujay Kansagra, has just published a Kindle ebook on Amazon about pediatric sleep problems. It is very straightforward, easy to understand, and evidence-based.  Dr. Kansagra is the director of the Duke University Pediatric Neurology Sleep Medicine Program. Even better – it’s free for a limited time!

Posted in Uncategorized | Comments Off

Thanks for all of your referrals!

Almost all of our new patients come from word-of-mouth from families in our practice. The greatest compliment you could ever give us is to recommend our practice to your friends and neighbors. We’ll continue to work hard to keep your trust, and to help your children stay happy, healthy, and safe!

Posted in Uncategorized | Comments Off

Have a healthy and safe Labor Day weekend

Our offices will be closed Monday September 1. As always, one of our physicians is available 24/7 for emergency telephone consultations. We’ll be open as usual this Saturday (Roswell- by appointment only.)

If your child needs to be seen on Labor Day, the Kids Time Pediatrics locations have special holiday hours. Both the East Cobb and Alpharetta locations will be open from 1 to 4 in the afternoon on Monday September 1. They’ll also be open as usual this Saturday and Sunday from 1 – 7 pm. For after-hours care, your children will be better served by seeing a real pediatrician at Kids Time than an adult-trained provider at one of the retail clinics.

Posted in Uncategorized | Comments Off

Getting the most out of your child’s checkup

The Pediatric Insider

© 2014 Roy Benaroch, MD

In a recent post, I wrote about the value of a yearly checkup with your child’s doctor—it can be a whole lot more helpful than a quick sports physical at the local quickie-clinic. You can be sure to get the most out of your child’s checkups with these tips.

First, and most important at all, go to the visit. You’d be surprised how often children are brought by a cousin or aunt or sitter. Sometimes they bring a list of questions from mom—but what kind of a way is that to communicate? Even better: if both parents have questions, both of you should try to go to the physical. I like meeting both parents. And we’ll all get more out of the visit together.

Bring records of any visits with other doctors, Emergency Departments, and urgent care centers. If your child has been prescribed medications from other docs, bring those, too. Let’s use this as an opportunity to make sure all of the records and straight and all in one place.

Bring questions! A typed list, scribbled notes on a receipt, or a few words typed in a phone app—I’ve seen it all. Any kind of list is a good idea. You won’t get answers if you don’t remember your questions. Bonus pro-tip: put your questions in order, starting with the one you’re most concerned about.

If possible, don’t bring other children (especially young, distracting siblings). I know it’s not always practical, but if you can possibly set up a time for just the child, parents, and doctor to be in a room together, we can best focus on the star of the show. If you do have to bring siblings (and I understand, sometimes you just have to bring the whole family), try to bring something for them to do. Crayons, iPads, whatever you’ve got.

If for some reason you can’t make it on time, reschedule the visit. You’ll get more out of a rescheduled well check than a rushed well check. If you have to cancel, please call ahead of time—at my office, we always have a waiting list of people hoping to grab a cancelled slot. Do someone else a favor and call ahead of time if you can’t make it to your appointment.

Talk with your child in advance about what to expect. The doctor is going to check “down there”, which is OK for the doctor to do as long as mom or dad is in the room (when kids get older, I’ll ask mom and dad to leave—expect that by the teenage years.) We just want to make sure everything is OK, and that means everything. OK?

There may be some things you don’t want to talk about in front of the child. Maybe school problems, or bullying, or maybe there’s marital problems that are stressing your child out. These are all good questions, and sometimes it can be awkward to bring them up. If it’s a quick question, slip the nurse a note that you need a moment alone with the doc. If you think you need more private time with the physician, call ahead and ask how your doctor’s office likes to handle that. It’s unfair to leave a child alone in the room for a long time while you talk secretly with the doctor—and it makes the kids very, very nervous. It might be best to set up a separate time for parents to come in.

For visits with school-aged or other children, be prepared to let your child talk. I know you’ve got questions, too, and we’ll get to those—but I first want to make sure your child knows this is his visit. He gets to talk first. That drives some parents crazy, but that’s the way it works best.

A yearly checkup with your child’s doctor should be more than a time to get a form signed for soccer. It’s a chance to catch up and make sure someone is looking at “The Big Picture.” Parents and doctors both want to make sure that these checkups are valuable for the children and families. Be prepared, and you’ll get the most out of the visit.

republished from Dr. Roy’s blog

Posted in Uncategorized | Comments Off