I am the mother of a four-year-old girl attending a pre-kindergarten class. Even though spring has already begun, eight of her classmates fell sick with pneumonia in the last couple of weeks. How could that happen? Is there any way to avoid spreading it among the children? R.T., Hadera Dr. Adi Klein, head of the pediatrics department at Hillel Yaffe Medical Center in Hadera, replies: Spring officially began on March 20, so one would expect pneumonia to fade away by now, but it seems that lung infections do not necessarily have a preference for one season or another. Almost half of our pediatric inpatients are now suffering from viral or bacterial pneumonia.
Pneumonia is not necessarily connected to the weather, even though there are many cases during the colder months. There is plenty of pneumonia during the spring, and even in warmer weather.
While the majority of children have been vaccinated with pneumococcal conjugate vaccine (commercially known as Prevnar or Synflorix) against disease caused by Streptococcus pneumonia bacteria, which was added to the basket of health services in 2009, there are still plenty of pediatric lung infections. Most kids with viral pneumonia are under the age of two. In such cases, it passes by itself (“self-limiting”) within a few days to a week; antibiotics should never been given for a viral infection.
Older children, especially those of school age, get bacterial pneumonia. Last week, we even had a girl who needed a surgical procedure to drain fluid from her lungs after she contracted pneumonia.
Nevertheless, parents must take their children to be immunized. Even though most of the children in my department who contracted pneumonia were vaccinated, their situation would have been much worse if they had not received the shot.
The vaccine approved for the basket five years ago has since been expanded to cover additional pneumococcus strains; it has reduced by more than 90 percent the life-threatening complications of pneumonia infections in children, which include meningitis and sepsis. The reason why we still encounter so many lung infections is that new strains have developed.
According to strict medical terminology, we usually call the bacterial kind of lung infection pneumonia, while the viral type is known as bronchiolitis. The difference is clinical, and the diagnosis is made with blood tests and cultures taken from the child.
The bacterium called pneumococcus that results in pneumonia is the most common cause of disease in children. It brings about not only lung infections, but also ear infections with symptoms such as fever and breathing difficulties, followed by stomach or chest pains. At a later stage, it can appear with a cough.
Another disease this bacterium causes is meningitis, which can be fatal if not diagnosed and treated in time.
Viral lung infections result from human respiratory syncytial virus (RSV). This is a major cause of lower respiratory tract infections and hospital visits during infancy and childhood. It begins as a fever and cough, often accompanied by a runny nose. But it may develop into shortness of breath so severe that the child needs an oxygen mask. The illness lasts for about a week, and the fourth day is usually the worst.
Sometimes, the viral infection can be accompanied by a secondary bacterial ear infection and perhaps even a lung infection. This is usually worse in premature babies and children who suffer from respiratory problems or other chronic illnesses.
Parents must be on the alert in such cases and take them to the doctor in time. During this illness, the child must receive plenty to drink and produce urine regularly.
If the child doesn’t urinate for more than six hours, he is apparently dehydrated; in such cases, quickly take him or her to a doctor, an urgent care center or a hospital emergency room. The cough is not so worrisome; the shortness of breath is. If the diagnosis is bacterial pneumonia (but not viral pneumonia), the treatment is antibiotics and sometimes oxygen support. If the condition is serious, antibiotics will be given by infusion.
When your child is ill with either a viral or bacterial infection, take care to wash their hands regularly with soap and water, and air out the home to reduce the risk of infecting others. ■ Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting.
Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to firstname.lastname@example.org, giving your initials, age and place of residence.
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