From strep throat to RSV: Winter health cheat sheet

Winter-health-safetyParents, we’re with you. We know that kids spread germs like wildfire. We know that even a simple cold can mean some sleepless nights. And we know that being prepared can makes things at least a tad bit easier.

When it comes to common childhood winter illnesses, knowledge is your best defense. So brush up on your winter ailment know-how, and head into the cold season armed with a good strategy.

Strep throat

Strep throat is a bacterial infection caused by group A streptococcus. Sore throats are common in the winter, but strep is usually associated with more severe symptoms including:

  • severe sore throat
  • swollen lymph nodes in the neck
  • inflamed and red tonsils
  • tiny red spots or white patches on the back of the palate and tonsils
  • fever (greater than 101 degrees F)
  • headache, nausea, vomiting, body aches and rash

Strep throat is diagnosed by swabbing the tonsils to test for group A streptococcus. If the test is positive, your child’s pediatrician will prescribe antibiotics. Be sure to administer your child’s antibiotics for the number of days instructed by your health care provider, even if she seems like she’s made a full recovery.


Croup is a viral illness most commonly caused by the parainfluenza virus. What begins as a typical upper respiratory tract infection (like the common cold) then causes swelling of the larynx (voice box) and trachea (wind pipe). Typical croup symptoms include:

  • runny nose and congestion
  • a barky cough
  • fever
  • stridor (a high-pitched sound heard when a child breathes in)

Because croup is caused by a virus, antibiotics are not effective in its treatment. Your pediatrician might prescribe medications and breathing treatments to help decrease swelling and to allow your child to breathe more comfortably. In severe cases, hospital treatment might be indicated to closely monitor and treat your child. Otherwise, supportive measures such as keeping air humidified; bringing your child into cold, dry air; and keeping her as calm as possible will help your child breathe easier.

Whooping Cough

Whooping cough (pertussis) is a bacterial infection associated with intense coughing fits. Typically, a characteristic “whoop” sound is heard as the person breathes in throughout the coughing spell. About 75 percent of children infected are under the age of 5. The course of whooping cough can last several weeks, with three stages.

The first stage can last from one to two weeks and is categorized by a mild cough, low-grade fever, and runny nose. The middle, or acute phase, is when the severe coughing fits emerge and may last for several weeks. During the recovery phase, which typically begins between weeks four and six, the cough starts to decrease. However, the cough, though less severe, may last for up to eight weeks after the recovery phase has begun.

To support your child at home, the best things you can do are:

  • Encourage your child to eat small, frequent meals (coughing fits can sometimes cause vomiting).
  • Encourage your child to drink plenty of fluids.
  • Decrease stimuli that may provoke coughing, including active play, crying and feeding.

Your child will likely receive antibiotics to help treat pertussis. Those living in the household may be prescribed antibiotics as well to decrease the chance of contracting the disease. In some cases, a child may need to be hospitalized for supportive care.

Infants are at particular risk of complications related to pertussis. The Centers for Disease Control and Prevention recommends a Tdap vaccine for pregnant women to help boost a fetus’s immunity. It’s also important for caregivers and the family to be immunized in order to help decrease the risk of spreading the disease to younger children.


RSV, or respiratory syncytial virus, is a viral illness that can cause upper and lower respiratory tract infections. Children under the age of 1 who are infected with RSV are more likely to develop bronchiolitis (lower airway inflammation) and, in some cases, pneumonia (infection in the lobes of the lungs). Symptoms of RSV include:

  • lethargy and irritability
  • poor feeding
  • fever
  • cough
  • wheezing
  • rattling in the child’s chest
  • episodes of apnea (when a child stops breathing for 10 seconds or more)

Children 6 months or younger, or with other health problems, are most at risk for developing severe cases of RSV. Most of the time, RSV can be treated on an outpatient basis. Up to 2 percent of children may need to be hospitalized for closer monitoring and supportive care.

Prevention is key

Of course, the ideal is to prevent these illnesses in the first place. The best preventive measures are usually the simplest. But that doesn’t mean it’s easy to get your kids to follow them. Continue to encourage:

  • frequent hand washing—it’s your greatest barrier to the spread of infection
  • covering the mouth and nose when coughing and sneezing
  • avoiding sharing of utensils, cups, etc.

What you can do to help your child

There’s a lot you can do to support your child through any of these winter illnesses, including:

  • Give over-the-counter pain medications to help reduce discomfort.
  • Encourage her to drink plenty of fluids.
  • Promote rest.
  • Humidify the air.
  • According to this study published in Pediatrics, vapor rub can be effective in decreasing nighttime cough. Please note that some children may experience skin irritation. Vapor rub is not recommended for children under the age of 2.
  • Keep the nasal passages as clear of excess mucous as you can.
  • Elevate the head when sleeping to help support comfortable breathing.
  • Keep a close eye on your child’s breathing.
  • Notify your pediatric health care providers of any changes in your child’s condition.

You should notify your pediatrician or call 911 immediately if your child displays signs of respiratory distress such as: rapid breathing, nasal flaring, retractions (pulling in of the chest wall) or bluish lips or fingertips (can indicate poor oxygenation).

Get more winter health and safety tips for families.

Meaghan O’Keeffe, RN, BSN, is a mother, writer and nurse. She worked at Boston Children’s Hospital for nearly a decade, in both the Cardiac Intensive Care Unit and the Pre-op Clinic. She is a regular contributor to Thriving.