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Coughs, Runny Noses and the Sniffles

Here’s what you should know:  most healthy children get at least 6 colds per year. Thankfully, this number diminishes by adolescence.  Cold viruses can live on toys, phones, doorknobs, toilet handles, tables and other objects for up to 3 hours. The virus is then transmitted to the nose and eyes by normal face-touching habits. FYI:  According to research, airborne droplets of germ from sneezing or coughing may look cool when viewed in slow-mo, but are actually a rare means of virus transmission.

Why do we get runny noses in the first place?  When the germs that cause colds first infect the nose and sinuses, the nose makes clear mucus. This mucus is designed to wash the germs from the nose and sinuses. After 2-3 days, the body’s immune cells fight back, changing the mucus to a white or yellow color. As the bacteria that normally live in the nose grow back, they begin to appear in the mucus, which changes the mucus to a green color. All of these color changes are normal and do NOT mean the child needs an antibiotic.

Why do we cough?  Coughs serve a purpose: to clear the lungs and protect from pneumonia. Most coughs are due to a viral infection of the trachea or bronchi. Most children get coughs a couple of times a year as part of a cold.

What to do? The best treatment is to wait and watch. Cold-like symptoms are bothersome, but antibiotics will not make them go away any faster.  Remember, if you treat a cold, it will be gone in a week. If you don’t treat it, the symptoms will last 7 days.  Warm, clear liquids can help with coughs. Cough drops or hard candy (or in the case of small children, 1 tsp of corn syrup) will ease scratchy throats and coughs. At home, cold mist humidifiers may be helpful.

What about medication? Most OTC cold remedies don’t help. There is little to no evidence to prove treating kid’s colds or coughs with decongestants or cough suppressants has any effect whatsoever. Side effects do occur, as do overdoses, so beware—particularly of “combination” drugs designed to treat more than one symptom.  Remember that the cough is protecting the lungs; cough suppressant drugs will only reduce—not eliminate—the cough. Give cough suppressants only for dry coughs that interrupt sleep, school, or work.

When do students go home from school?  A child with fever of 100.4 or higher must be sent home from school and cannot return until fever-free, without the aid of anti-fever medication such as Tylenol or Ibuprofen, for 24 hours.  Children with continuous cough and/or difficulty breathing will also be sent home from school.

When should students see the doctor?  See a doctor for additional symptoms that may include earache, sinus pain, severe throat pain, fever of 100 or above for 3 days, yellow-green discharge from the eyes, the skin around the nostrils is raw or scabbed (impetigo), etc, a “wet” or productive cough, a non-stop cough, difficulty breathing.

What can we do at school for these students? Have students clear their nose either by blowing into a tissue or sniffing and swallowing, encourage lots of liquids, allow to suck on cough drops or hard candy (brought from home) to ease a scratchy throat. We do NOT have cough drops or cold medicine in the nurse’s office. We DO have Tylenol or Ibuprofen for headaches (if we have parent permission to administer). Remember to WASH HANDS frequently!

What about Whooping Cough?  Finally, there has been a lot of media attention lately surrounding Pertussis, also known as “Whooping Cough”.  Your best protection against pertussis is to keep you and your loved ones up to date with vaccinations. This includes DTaP vaccine for infants and children and Tdap booster for adolescents and adults. There is high vaccine coverage for children nationwide. However, protection from the childhood vaccine fades over time. Adolescents and adults need to be re-vaccinated. Adolescents should get a dose of Tdap at age 11-12. Adults should get a dose of Tdap instead of the Td booster .

If pertussis is circulating in the community, there is still a chance that a vaccinated person can catch this very contagious disease. Whooping cough starts like the common cold, with runny nose, sneezing, possible mild cough or fever. After 1-2 weeks, severe coughing begins. Infants and children with the disease cough violently and rapidly, over and over, until their air is gone and they’re forced to inhale with a loud “whooping” noise.  (This is where whooping cough got it’s name.) When you or your child develop a cold that includes a prolonged severe cough, it may be pertussis. Time to see the doctor.

Source material:

Schmitt, Barton D., M.D. “Your Child’s Health”