El martes, Cook Children's Medical Center en Fort Worth atendió 572 pacientes en el departamento de emergencia. En los siete Centros de Cuidado de Urgencia hubo 842 pacientes. Entre el 10 de noviembre y 16 de noviembre Cook Children's Medical Center en Prosper evaluaron a 113 pacientes por Virus Respiratorio Sincitial (RSV, por sus siglas en ingles) y 29 resultaron positivos.

Cook Children's Medical Center en Prosper también ha notado un gran volumen de pacientes en la sala de emergencia. La mayoría de los pacientes admitidos ha sido debido a VRS, influenza o neumonía.

El aumento de las visitas al hospital se debe a una fuerte propagación del VRS y neumonía ambulante (mycoplasma pneumoniae) en Dallas-Fort Worth.

Cada año por estas fechas, los casos de VRS aumentan más rápidamente de lo habitual este año, dijo El Director Médico de Servicios de Emergencia, Dr. Taylor Louden.

"Hemos visto a más de 1,100 pacientes en los últimos dos días a través de la sala de emergencias, y ha sido es muy difícil para nosotros manejar este volumen de una sola vez", dijo Louden.

De los 972 pacientes examinados en Cook Children's Medical Center entre el 10 y el 16 de noviembre, el 39% de los niños tenían VRS o neumonía ambulante. De ellos, 224 dieron positivo para el VRS y 99 resultaron positivos para neumonía.

¿Qué es el VRS y cuando debo de ir a la sala de emergencia?

El VSR generalmente afecta más a niños menores de dos años y puede causar una acumulación de moco y congestión que dificulta la respiración de los niños. Los padres deben tomar precauciones para limitar la propagación del virus. Quédese en casa si están enfermos. La vacuna contra el VRS está disponible para mujeres embarazadas, bebes, y personas mayores.

Si su hijo está enfermo, los padres y cuidadores pueden ayudar a reducir el estrés en el sistema de servicios de emergencia sabiendo cuándo llevar a su hija a la sala de emergencia y cuándo programar una cita. Limitar el tráfico de la sala de emergencias a verdaderas emergencias ayuda a evitar que el sistema se sobrecargué.

Si su hijo está enfermo, pero no tiene problemas agudos, consulte con su pediatra. Si es posible, programe una cita con unos de los Centros de Cuidado de Urgencia en lugar de visitar la sala de emergencias.

El tratamiento para el VSR es monitoreando y tratando los síntomas. No hay cura para el virus. Muchas enfermedades respiratorias virales se pueden tratar en casa con descanso, hidratación y electrolitos. Para la congestión, los padres y cuidadores pueden usar solución salina nasal para diluir la mucosidad y succionarla con una pera.

¿Qué es neumonía ambulante?

Desde el verano casos de neumonía ambulante han estado alto, dijo Louden. Entre el 10 y el 16 de noviembre, 99 niños resultaron positivos para la enfermedad. A comparación del año pasado, durante la misma temporada, Cook Children's reportó menos de 10 de casos de neumonía ambulante entre agosto y diciembre.

La neumonía ambulante suele afectar a los niños en edad escolar. Algunos de los síntomas incluyen: fiebre leve, fatiga y tos. La mayoría de los casos de neumonía atípica se pueden tratar con antibióticos, pero si su hijo tiene neumonía y ha tenido fiebre durante más de cinco días y/o dificultad para respirar, busque atención de emergencia.

La neumonía, el VRS, la gripe y el COVID-19 pueden tener síntomas similares. La gripe y el COVID-19 también pueden incluir dolor de garganta, dolores de cabeza, dolores corporales, escalofríos y cambios/pérdida del gusto y el olfato. Los padres no deben acudir a atención de urgencia ni al departamento de emergencias para hacerse una prueba de RSV, gripe o COVID. Su pediatra puede realizar pruebas para todos estos.

En muchos casos, los médicos pueden evaluar y tratar a un paciente mediante una cita de salud virtual. Descargue la aplicación MyCookChildrens para programar una cita virtual de salud/telemedicina aquí.

¿Cuándo acudir la sala de emergencia?

•  La temperatura mayor de 100.4F o 38°C en bebes menores de dos meses, es una emergencia médica.
•  Si su hijo tiene fiebre por más de tres días, comuníquese con su pediatra o el centro de cuidado de urgencia.
• Preocupación por deshidratación.  En bebes deshidratados habrá menos pañales mojados o falta de lágrimas. La fontanela hundida puede ser un signo de deshidratación.   
• Su hijo está respirando inusualmente rápido y se puede ver la piel entre las costillas.
• Su hijo requiere más su inhalador de rescate o los síntomas de asma empeoran

Síntomas

Síntomas de Virus Respiratorio Sincitial (RSV, por sus siglas en ingles) en bebes menores de 6 meses:

• Irritabilidad
• Letargo
• Apetito reducido
•  Episodios en donde dejan de respirar
•  Fiebre

Síntomas en bebes y niños mayores de 6 meses:

• Mocos
• Congestión
• Apetito reducido
• Tos
• Estornudos
• Fiebre
• A veces sibilancias

¿Cómo prevenir?

•  Nunca es tarde para vacunarse. Llame a su pediatra para obtener la vacuna contra el COVID-19 y la influenza.
• Adopte buenas prácticas de higiene como cubrirse al toser y estornudar.
•  Lavarse o desinfectarse las manos a menudo.
•  Limpiar las superficies que se tocan con frecuencia.
•  Si usted o su hijo se sienten mal, quédense en casa para prevenir la propagación de enfermedad. Tome tiempo para descansar y manténganse hidratado.

There’s been a ton of surprises related to the COVID pandemic and skipping flu season last year was another one I never saw coming.

Masks and social distancing definitely played a role but the absolute lack of cases was still shocking.

So, will we get lucky again this year?

I doubt it.

And here’s 3 reasons why:

1. Social distancing and masking are going away or gone. And we all want to get to that place…but it does mean we’re likely to have flu cases spread among classmates and families.
2. Skipping a flu season last year may make individuals more vulnerable to flu this year. Our bodies haven’t seen flu for almost two years. And just like our other colds went wild in kids this fall, flu could do the same this winter.
3. A mild or absent flu season last year may make people more likely to skip their flu shot this year. “Do we really need one after last year?” is a common question I have been asked.

What can you do to protect your child and their friends?

Get them their flu shot. Now’s not the time to get cute. Just do it.

Start to work with your child on hand-washing and covering their coughs. We need to protect ourselves and others.

Keep your child home if they are sick. If something seems to be brewing, give it a day to develop at home.

Speaking with Yahoo! News this week, Jason Terk, M.D., called the summer surge 'unprecedented.'

“If you look at typical RSV, it’s a type of illness that we see usually starting in late fall into the wintertime and then goes away usually by late winter, early spring," he told the online publication. 

Dr. Terk, a pediatrician at Cook Children's Pediatrics in Keller, says serious cases of RSV can occur but are rare.

“Most of the time RSV causes an illness that is entirely manageable at home with use of the usual things that we recommend for viral respiratory infections — nasal saline, suctioning and humidification,” he says. “If there’s a worsening of the respiratory status or they have a hard time breathing, then they need to be seen by their physician.”

Read the full story here.

With the beginning of summer well underway, I have seen many kiddos in the office with a very typical summer rash. It’s a rash that usually appears on the hands, feet, and around the mouth, giving it the name Hand, Foot, and Mouth Disease (HFMD). It’s caused by a group of enteroviruses that are common in the summer months. While this big group of viruses can cause more serious illnesses, this presentation of illness is typically mild and commonly infects infants and toddlers. While it can affect older children and adults, it is less common and these individuals typically have milder symptoms of the disease, if any. 

The most common symptom of HFMD is the rash for which the disease is named. The rash usually begins as tiny little red dots that get bigger and then look like small blisters. The areas that are typically affected include the skin around the mouth, mucous membranes inside the mouth (including tongue/back of throat), hands (including the palms) and feet (including the soles), as well as buttock and diaper area.

Other symptoms of HFMD include fever, runny nose and sore throat. Like all other viruses, treatment involves supportive care and caring for symptoms, including the use of fever-reducing medications as well as pain control. While rash is typically not bothersome or painful, the lesions in the mouth can cause sore throat or mouth pain. There is no particular treatment necessary for the rash, as it will typically self-resolve within two weeks. It is important to watch for any spots that look like they are oozing or not healing well because secondary bacterial infections can occur. If you have any worries, call your pediatrician as we can usually diagnose this by examining your child and getting a history of the symptoms. 

“When will this cough ever go away?”

These and similar questions have been the topic of the last month at my practice.

And while I know parents are annoyed and I’m annoyed and the kids are annoyed - everyone’s annoyed - most of the time we don’t need to be concerned.

Here’s why I think kids have been sick A LOT for the last few months:

1. Cold and upper respiratory virus season were delayed due to masks and social distancing-which are starting to go away.
2. A season of terrible weather changes from hot to cool, dry to wet and everything in between and back again.
3. A wicked allergy season which tons of mountain cedar, pollen, grass, mold, etc. (Thanks to all the rain.)
4. The beginning of summer illness season with lots of fevers and rashes and insect bites and swimmer’s ear.

We see all four of these things every year, but we usually see them spread out over six months instead of crammed into two.

So what do we do?

Try to keep calm. Several mild illnesses don’t necessarily mean something bad is happening-it’s usually just bad luck.

Talk with your doctor. If you’re worried something else is going on, ask your doctor.

Consider testing if in addition to several mild illnesses, you have some severe illness or mild illness that doesn’t respond to typical treatments.

As of Dec. 5, hundreds of children have been tested for flu and RSV at Cook Children’s Medical Center, and none have come back positive. Ramon Kinloch, M.D., a pediatrician at Cook Children’s, believes this has to do with social distancing and masking due to COVID-19.

“A lot of it does have to do with the precautions we have been taking for COVID-19. When we are wearing a mask, we are less likely to spread those respiratory droplets that transmit RSV and flu viruses,” Kinloch said.

Dr. Kinloch says another reason he believes there haven’t been cases is that people aren’t around each other as much right now. With limited contact with those outside of our family units, the physical spread of the virus’ droplets is less likely to happen.

Though there haven’t been any cases yet, Dr. Kinloch believes infections will begin to rise, especially with families gathering for the holidays.

“We are beginning to see people get a little more relaxed, especially with there being a COVID-19 vaccine on the horizon. With that, we will probably begin to see a rise in the flu and RSV numbers,” Dr. Kinloch said.

Dr. Kinloch explained that in years past, Cook Children’s typically sees a slow start and then a huge spike of infections, and he doesn’t expect this year to be any different.

If you believe your child has the flu or RSV, you should look for symptoms such as a fever for more than two or three days, body aches, running or stuffy nose, and coughing. For infants specifically, one sign that could indicate RSV is fast breathing and retractions.

Dr. Kinloch says differentiating between the flu, RSV and COVID-19 can be tricky. While the symptoms are very similar, one distinguishing factor is the loss of taste and smell, which primarily accompany the COVID-19 virus.

“If a child says, “I can’t smell anything,” we have to distinguish if that’s a stuffy nose or if they literally can’t smell or taste anything. If that is the case, we would more likely be dealing with a COVID-19 situation,” Dr. Kinloch said.

The only way to know for sure if you or your child has either illness is by getting tested. Dr. Kinloch says even testing has its limitations and it all comes down to when you get tested, what symptoms you have, and your exposure. He warns that each case is different and parents should always reach out to their physician if symptoms are worsening and fever will not break.

“They are with them and they know them better than we do. If a parent is uncomfortable with how their child looks or they have a gut feeling, it’s always important to call their doctor and have them evaluated. I believe that parents are equipped to know when something is wrong with their child,” Dr. Kinloch said.

So how do I know if my child needs to be seen? Call your pediatrician if your child:

• Has more than three or four days of fever (temperature over 100.4 degrees)

• Has any type of sustained and fast breathing

• Is lethargic or limp

Dr. Kinloch says his best advice is to ensure you’re following all CDC guidelines and to remember, it’s about keeping each other safe. He advises all families to get the flu vaccine, wash your hands, and be sure to remember the guidelines amid the pandemic.

COVID-19 rates are soaring in Tarrant County and cases among children are no exception. As of Wednesday, Nov. 11, over 8% of all COVID-19 tests performed among physician offices, urgent care locations and the medical center are positive for the virus. This is up from 6.5% just one week ago.

High case numbers are being recorded in Tarrant County almost daily. On Monday, the county broke an all-time record with 1,525 COVID-19 cases. This was the fourth day in a row local health officials announced single-day highs.

“What we're seeing in kids is mirroring what we're seeing in adults, not just in Texas, but nationwide we're seeing increasing rates of transmission,” said Nicholas Rister, M.D., pediatric infectious diseases physician at Cook Children’s Medical Center. “The overarching theme that children do better with this disease than adults is still true. That’s not to say that some kids haven't gotten very ill, but compared to adults, especially elderly adults with a lot of other health issues, children have done quite well.”

Eight patients are currently hospitalized at Cook Children’s. Thankfully, the medical center has seen no pediatric deaths due to COVID-19. But that doesn’t mean parents should let their guard down.

“We have our cases of children, especially those with multisystem inflammatory syndrome (MIS-C), who have been very sick,” said Dr. Rister. “We’re certainly learning more about MIS-C and how to identify it. What we're seeing is kids coming in with prolonged fevers or unexplained fevers. We have to think ‘Could this be COVID? Either an initial COVID-19 infection or a child who's recovered from that, but is now having an inflammatory syndrome.’”

Dr. Rister says it is known that children can spread COVID-19 among other children and adults. He adds that most cases among children are linked to family gatherings, sports activities and community spread. He, along with the infectious diseases team at Cook Children’s, does not feel schools are a huge driver in the COVID-19 numbers at this point.

“Schools have done a great job trying to manage this, and we haven't seen the balloon in spread that we were worried about,” said Dr. Rister. “But even if there was no spread within a school, which is almost certainly there will be, we know children will get these infections from their families.”

He says as rates go up in our area, we should expect to see cases go up in schools, especially with many families planning to gather for the holidays in two weeks.

“If things keep going up and it gets harder and harder for schools to manage, they may change plans,” he said. “That's going to be an individual school and family decision.”

There is some good news to share. So far, Cook Children’s Medical Center hasn’t recorded a single flu case, which is somewhat surprising since flu typically begins ramping up this time of year. That doesn’t mean you should skip the flu shot though. Once flu does begin making the rounds, the flu shot is your best chance at protection.

Other precautions you can take to protect yourself from COVID-19 and other viruses include:

• Wear a mask when in public or around others outside of your family unit.
• Maintain social distancing of at least six feet from others.
• Wash your hands often with soap and water for at least 20 seconds. If soap and water aren’t available, use an alcohol-based hand sanitizer with at least 70% alcohol.
• Avoid gatherings.
• Don’t go to work or send your child to school sick.

All patients with exposure to COVID-19, regardless of symptoms, will need to quarantine for 14 days. This is required, regardless of test results, because COVID-19 can develop between two and 14 days after an exposure.

At Cook Children’s Urgent Care, a patient may be required to have two negative COVID-19 tests before their doctor or nurse practitioner will sign a form allowing the child to return to school. This will likely be the case if the child's symptoms are high risk for the virus. 

If a child tests positive for COVID-19, they will need to stay home for 10 days after the onset of their own symptoms. This could mean a quarantine longer than 14 days. 

Cook Children's Health Care System follows guidelines from the Centers for Disease Control and Prevention (CDC).

We also follow the Infectious Disease Society of America which has issued the following COVID-19 guidelines: 

• Intermediate to high clinical suspicion of COVID-19: A COVID-19 test should be repeated in 24 to 48 hours (different samples if indicated)
• Low clinical suspicion: No re-testing

All patients with high-risk symptoms should be tested for COVID-19 before returning to school based on physician or nurse practitioner discretion.

These symptoms include:

• Fever
• Cough
• Shortness of breath
• Body aches
• Loss of taste/smell
• Headache
• Sore throat
• Sustained vomiting or diarrhea (and usually a combination of the these symptoms)

“Our goal is to make sure we limit the spread of COVID-19 as much as we possibly can to keep everyone healthy,” said Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s. “If the first test gives a false negative result, we could potentially be sending a contagious child back into the classroom. That is why a second test is needed in cases of high suspicion.” 

All patients with low-risk symptoms and NO known exposure to COVID-19 can be tested before returning to school based on physician discretion. Low-risk symptoms include congestion or runny nose, rash or a single episodes of vomiting or diarrhea.

Click here to read more about COVID-19 testing.

And while I’m confident that we’ll get through it together, I need your help.

Ruling out COVID-19 for kids with symptoms (some mild, some more severe) has become the biggest reason for kids visiting our office. We’ve already seen kids getting sick as they go back to school and that makes me nervous about what the upcoming flu season is going to look like.

Because the symptoms of flu overlap with COVID-19 so much, it’s going to be difficult to tell whether flu or COVID-19 is causing your child’s flu-like illness. And, there’s no guarantee that a child can’t get both at the same time.

So with the flu season nearing, you probably have a lot of questions that need to be answered about this possibility:

• Does every child with flu-like illness need to be tested for both?
  • Probably.
• Does getting COVID-19 and the flu at the same time mean your child will be more at risk for severe illness?
  • Probably.
• Will we have enough COVID-19 testing available to continue avoiding unnecessary quarantines?
  • I hope so, but every time we test a child for COVID-19 because they have flu-like illness, we have fewer tests available.

Here are some things you can do to help your child and yourself (and me):

1. Get your child their flu shot. ASAP. The effectiveness of the flu shot does vary from year to year. It’s not perfect. But, it’s the best we have. And even decreasing the amount of flu by 60% this year will change the lives of those children: Avoiding not one but two tests. Avoiding the worrying during the waiting time and wondering if your child has flu, COVID-19 or something else.
    
2. Start practicing hand washing. Children need to be taught to wash their hands adequately and often.
    
3. Wear your mask, even in situations where you think it might not be necessary. It will not only protect against COVID-19, it will protect against the flu as well. We, as a health care provider and a society, cannot afford to have a terrible flu season this year.
    
4. Keep yourself and your child home if you are sick. This is important…every…single…year. But it is especially important this year. Don’t be the family that knocks over the first domino. Even if you aren’t seen by a doctor, waiting a day can be helpful to see if your simple symptoms progress or go away.

Let’s all do our part.

We can do this!

“It’s important to wash your hands before and after you eat, it’s important to wash your hands after you go to the bathroom,” said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children's. “Remember to do that with soap and water for 20 seconds. If you can’t use water, use hand gel.”

She adds handwashing is critical after you touch surfaces you share with other people.

“Handwashing with soap and water can prevent 1 in 3 people from getting sick with diarrhea and 1 in 5 people from getting a respiratory illness,” chief of the Waterborne Disease Prevention Branch of the US Centers for Disease Control and Prevention, Vincent Hill, said in an interview with CNN. "That is why handwashing is so important, especially at key times such as after using the bathroom, when preparing food, before eating, and after coughing, sneezing, or blowing your nose."

This year's theme of Global Handwashing Day, Hand Hygiene for All, calls for universal hand hygiene to beat the virus today and ensure better health outcomes beyond the pandemic.

"This day is an opportunity to design, test and replicate creative ways to encourage people to wash their hands with soap at critical times," the Global Handwashing Partnership noted. "After all, this simple behavior can save lives. For children, handwashing can cut diarrhea by almost one-half and acute respiratory infections by nearly one-quarter."

An easy way to help your children wash their hands properly is to pick a song to sing, like happy birthday, while they scrub.

“Keep yourselves safe. Help us prevent the spread of coronavirus that causes COVID disease and help us prevent the spread of influenza,” said Dr. Whitworth.

I hate that phrase and I know it never gives parents comfort when they hear it from doctors.

Doctors (I’ll admit I’ve said it too) usually say “it’s just a virus” to let parents know we don’t see anything that suggests a bacterial infection so your child doesn’t need antibiotics or other specific treatment. This is an infection caused by a virus and should go away over time. It’s meant to comfort mom and dad.

Then the appointment usually ends with “if things don’t get better to let me know.”

But it’s never JUST a virus when it’s your child, is it? As parents we know that viruses aren’t always simple and that kids can be VERY miserable and even get VERY sick.

RSV and flu still strike fear in the hearts of many parents. So much so that they’ll choose to have me test for them, even if I assure them it won’t change the treatment either way. But sometimes, the knowledge and the ability to put a name to it provides some level of comfort or the negative test gives them the ability to take a deep breath and relax (even though a no-name virus can be as scary as a named one).

We should take viruses seriously, after all they’ve been the cause of many of the most serious conditions the medical community has ever faced. Like I said earlier, once you catch a virus there’s not a whole lot doctors can do. We have to wait it out, try to treat the symptoms as we can and simply let things run its course.

That’s why the advancements that have been made in vaccines have been so essential. They were created to prevent the viruses before your child caught them or to lessen their severity if they did.

We don’t often think that these very serious conditions are viruses, but fortunately we have a vaccine for them:

• Polio which for many children might cause no symptoms at all or a mild upper respiratory illness, can also lead to devastating, permanent paralysis.

• Measles which for many children cause a syndrome with fever, rash and upper respiratory symptoms, can also cause pneumonia, death and a severe neurologic disease called SSPE which develops 5-10 years after the infection.

• Mumps which for many children caused fever, muscle aches and headache, can also cause infertility in males, meningitis and hearing loss.

• Hepatitis B which many believe to be a disease of adults (because it can be sexually transmitted and needle-borne) actually caused many infections in babies who contracted it from their mothers. Hepatitis B was less likely to be cleared by children which led to a 40 percent chance of liver cirrhosis and liver cancer.

Fortunately, for these viruses along with the flu, chicken pox and Hepatitis A, we can now protect kids with vaccines. We can protect them, not only from the suffering associated with the illness but also the devastating complications that can arise as a result of them.

How would it have felt to live in a time when these viruses were common?

Think about how you feel when you read stories about the polio-like illness that has been spreading across the country or how you feel when you hear that there are cases of measles in your community. Then imagine that you know someone or at least know someone who knows someone who has suffered from one of these disease personally.

Terrifying.

Imagine a doctor telling a family it’s “just a virus” in this environment. It wouldn’t fly.

I promise I’ll try to avoid saying “just a virus” but I’m thankful that it’s easier for me to get away with it today … thanks to vaccines.

I tell you that not to freak you out, but to let you know how common it is. Most cases are typically mild. When we see sever disease, it's often in immunocompromised patients and those cases are uncommon.

What's important to remember is the children who died in New Jersey were all medically fragile and had weakened immune systems.

I know this kind of news can be scary, so I thought I would take some time to answer a few questions you may have.

What is adenovirus?

For most children, adenovirus causes mild symptoms. Sore throat, pink eye, fever and common cold symptoms are the most frequent. The symptoms are typically similar to but much less severe than influenza and can also be mistaken for strep throat. Like most viruses, the initial symptoms go away on their own in a few days but upper respiratory symptoms such as cough and congestion can last up to two weeks.

There are multiple different types of adenovirus, some cause more severe disease than others. They are all spread by close personal contact and by droplets spread by coughing and sneezing. In addition, adenovirus is pretty resilient and can live on surfaces. It can also continue to be spread by people with weakened immune systems, even after the symptoms have resolved.

Should you be worried?

Because adenovirus is usually a mild illness, most parents don't have to worry about the virus. The situation in New Jersey is a tragic combination of factors that led to this terrible outcome. Multiple children who are medically fragile living in close quarters. In addition the type of adenovirus which affected the children is known to be one that causes more serious disease.

So, what if my child is medically fragile?

If your child lives or will spend time in a group rehabilitation home investigate their cleaning practices. There is little evidence to suggest that this rehabilitation center has made significant mistakes that caused the outbreak, but you can never be too careful.

Otherwise, keep you child away from illness as much as possible. If they are sick with upper respiratory symptoms, monitor them closely for sign of difficulty breathing and seek help quickly

For the rest of us, it's important to remember to keep our kids home when they are sick so that we do not put other children at risk.

For starters:

1. No, it's not that cattle disease with a similar name. Heehee. 
2. Yes, it's super contagious. 
3. Nope - no reason to freak out. We see it all the time. You probably had it when you were a kid.
4. Go get some popsicles. I'm gonna prescribe them.

Hand Foot and Mouth Disease (HFM from here on out) is caused by a virus. What does that mean? Come on - I know you're sick of hearing me say it - that means no antibiotics needed! Woo hoo! This is a virus which your strong kiddo can clear on his own!

Most of the time this happens in kids under 5. They catch it from day care or school classmates. Usually they catch it by getting oral secretions or fecal secretions in their mouth or airway from a buddy. I'll let your imagination run wild on the methods kids go through to experience this fun transfer of germs. It's really contagious.

People with HFM are most contagious during the first week of their illness. However, they may be contagious for weeks after symptoms go away. Some people, especially adults, may not develop any symptoms, but they can still spread the viruses to others.

This is a common SUMMER virus! But can happen any time of year.

Soon after catching it (like 3-5 days), kids start with a fever and a new rash. The fever is usually low (under 101) but can be high at times. Sometimes they have a runny nose, or other cold symptoms.

The rash is unique. They're red spots with/without thick bubbles of fluid.

Usually, they're on or in the mouth, and on the palms of the hands and soles of the feet. Hence the name. However, I joke with parents that it should be called "Hand-Foot-Mouth-Butt-Arms-Legs" because you can see the spots in other places, too.

HFM is commonly mistaken for other things. Often, parents worry about chicken pox. Remember - chicken pox is itchy and tender. HFM is not. People also mistake these for bug bites - again, not itchy like bug bites are.

The mouth sores hurt. They're typically the main complication I see with HFM - they hurt so much kids don't want to eat or drink. The eating I don't mind -but it's important that they drink. Load up on popsicles. All my "sugar rules" go out the door when a kiddo has HFM. Sometimes if it's really bad we will prescribe a mouthwash for pain.

Something else you should know - more than one strain of virus causes this bad boy. So kids can get it more than once. And if an older child/adult catches it? It can be more troublesome/painful than in a younger person.

It'll go away on its own. This can typically take 7-10 days. The fevers usually last just a couple of those days. Kids typically are just fine. It's actually adults that can experience the worst of it!

Hope this helps!

Hugs,

Dr. Diane

Leaders from the Who called Zika a “public health emergency of international concern,” earlier in the week, because how fast the virus is spreading and the continued investigation into its link to babies born with abnormally small heads (microcephaly). Experts are also looking into the possible connection between Zika and a neurological condition called Guillain-Barré syndrome, which can cause paralysis.

No vaccine exists to prevent Zika virus. Mosquitoes that spread Zika virus bit mostly during daytime.

Click here for prevention information from the CDC.

Here's what we know from about the Zika virus from the Centers from Disease Control and Prevention:

1. The Zika virus is spread to people primarily through the bite of an infected Aedes species mosquito, the same mosqutoes that spread dengue and chikungunya.
2. The mosquitoes are aggressive daytime biters, prefer to bite people and live indoors and outdoors near people. Mosquitoes become infected when they feed on a person already infected with the virus. Infected mosquitoes then spread the virus to other people through bites.
3. A mother already infected with the Zika virus can pass on the virus to her newborn around the time of birth, but this is rare.
4. The CDC has not found any reports of the Zika virus spread through breastfeeding.
5. The CDC believes the virus could spread through blood transfusion. At this time, there have been no reports of this happening.
6. There has been one case of the virus spread through sexual contact.
7. The most common symptoms of Zika virus disease are fever, rash, joint pain and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week and severe disease requiring hospitalization is uncommon.
8. However, the Zika virus can be dangerous, especially to babies. Doctors are studying the link to the virus and microcephaly, a birth defect that causes abnormally small heads and brains.
9. There is no vaccine to prevent or medicine to treat Zika.
10. The CDC recommends “that all people, especially pregnant women, who are traveling to Brazil and other areas in Latin America, should take precautions to avoid mosquito bites to reduce their risk of infection with Zika virus and other mosquito-borne viruses such as dengue and chikungunya.”
11. The CDC asks that travelers protect themselves from mosquitoes by using insect repellent, wear long sleeves and pants, and stay in places with air conditioning or that use window and door screens.

“There is still a lot to learn about Zika virus and the potential risk to cause this particular birth defect,” said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s. “However, because it could spread to the United States, it is important that doctors and patients are aware of it. Like other diseases that were once thought to be isolated to tropical areas like chikungunya, many patients and doctors forget to think about them.”

About the source

Mary Suzanne Whitworth, M.D. is the medical director of Infectious Diseases at Cook Children’s, which offers care for children and teens with diseases caused by bacteria, parasites, fungi or viruses. Our team provides a broad range of services including diagnosis, inpatient and outpatient consultations, immune deficiency evaluations and treatment of recurring infections.

Are we there yet? “No. 5 more minutes.”

Are we there yet? “No. I will tell you when we get there!”

Did anyone hear this or something like it last week?

We’ve been asking a similar question to our favorite Cook Children’s microbiologist, Morgan Pence, Ph.D.

Is it here yet? No.

Flu season should be just around the corner, but it’s not here yet. Currently, there are only two regions showing Influenza activity across the state of Texas. Tarrant County is not one of those regions.

Flu season usually starts sometime in late October or November but occasionally we have later seasons. It appears that we are going to (knock on wood) make it till December before we see our first case at Cook Children’s this year.

There are few theories about why flu follows a seasonal pattern:

1.As weather gets colder and people are trapped indoors, the virus can more easily spread from person to person.

2.Colder temperatures lead to drier air. Dry air causes our noses to be drier which may make their defense against flu weaker.

3.Cold temperatures may allow the flu virus to live longer on surfaces.

Based on these theories, it’s possible that our warmer fall has caused a delay in the onset of flu season. With the colder temperatures last week, we may be reporting our first case soon.

Dr. Pence reports that our lab tested 74 specimens last week but none were positive for flu. She states, “Currently we are mostly seeing children with rhinovirus and RSV.” Rhinovirus causes the common cold. RSV can cause cold-like symptoms as well, but can be more severe in babies, especially those who were born premature.

What does this mean for you and your child?

1.If you haven’t yet, there’s still time to get your flu shot. (Even if the year starts late, it could still be a bad one).

2.Continue to teach your children to cover coughs and to wash hands.

3.Be aware if your child tests positive with a rapid flu screen, it may not be correct until flu activity is higher.

For now, Dr. Pence will still have to play the role of lab-mom.

Is it here yet? “No.”

Is it here yet? “No, probably 2-3 more weeks.”

Is it here yet? “No, but you’ll be the first to know!”

Ensure school-age children know when to wash - before eating and after playing on a playground at recess, using the restroom, and coming into contact wiht friends and classmates. Teach kids that it's important not to chew their fingernails or touch their faces.

"Hand-to-mouth transmission is a major way children are infected by viruses," said Vanessa Charette, M.D., a Cook Children's pediatrician in Fort Worth. "Keeping hands out of the mouth is a difficult behavior for certain children to master, but it's important that they do."

Little hands can pick up a lot of germs. At any given time, you have close to 150 different bacteria living on your hands, and 80 percent of illnesses are spread by direct human contact. For kids, stomach bugs, strep throat and other bacterial illnesses can spread quickly, particularly in environments such as schools and day cares.

"I also tell young children to keep their hands below their neck. They don't rub their eyes, such their fingers or pick their nose," said Kim Mangham, M.D. a Cook Children's pediatrician in Keller. "Kids can have all the germs in the world living on their hands, but they don't put their hands in their mouth, nose or eyes, they won't get sick."

Having trouble convincing your children to get with the hand hygiene program? Let them know that fighting the spread of germs can be pretty cool. A recent study published in the American Journal of Infection Control concluded that fist bumping transmits far few bacteria than handshaking.

They are not caused by holding (or kissing) frogs but, instead, are caused by viruses.

The virus that causes warts is contagious, but that does not necessarily mean that if your child touches a wart they will get one.

Warts will go away on their own without treatment (Say it with me now.). It never feels like that when it’s your own child, but I promise they will. It may take 6 months to 2 years but they will go away.

There are many strategies for taking care of warts at home. 

Over-the-counter (OTC) Meds

1. Bath or shower
2. Use an emery board to file the dead skin on the surface
3. Apply the topical wart remover
4. Cover the wart with a band-aid

Duct Tape

Place a strip (or ring if on the finger/toe) over the wart. This strategy may take weeks or months of coverage to work, but it does work (studies even show it)

Wart removal can be done, but I only recommend it for warts that are painful or in a location that makes activities (writing, etc) difficult. 

The most common types of removal are freezing and laser therapy.

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . View more from The Doc Smitty at his Facebook page. He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.

Along with vaccinations, hand-washing is one of the most effective ways to prevent flu. Alcohol based hand sanitizers are not effective against enterovirus 68, only good, old fashioned hand-washing.

Hand hygiene is especially important while children are attending school, where nearly every interaction carries the possibility of transmitting viruses.

“Children should wash their hands before and after going to the bathroom, as well as before eating or drinking,” Frank McGehee, M.D., a Cook Children's pediatrician in Fort Worth, said. “They should work the soap into a good lather and scrub for at least 20 seconds—the amount of time it takes to hum ‘Twinkle, Twinkle, Little Star.’ Have them scrub especially well around fingernails and jewelry.”

It’s also a good idea to have children wash their faces frequently during flu season.

Sometimes it's difficult to make your child take the time to wash his or her hands. How do you get your children to wash their hands? We would love to hear from you.

The mosquito was recently trapped in Benbrook, near the southwestern border of Fort Worth, and the test results were confirmed Wednesday Last year, TCPH reported its first WNV positive mosquito sample during the last week of June.

Most children with West Nile virus have only mild, flu-like symptoms that last a few days. Symptoms usually appear within three to 14 days of infection. If you expect your child has West Nile, it’s important to get the child seen by a pediatrician who can evaluate the child appropriately and if necessary refer the child to an Infectious Disease specialist or do the appropriate lab work.  

Parents can take care of themselves and their child by taking a few simple protective measures:

The majority of people (70-80%) who become infected with West Nile virus don’t develop any symptoms.

About 1 in 5 infected people will develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash.  The majority of those with this type of West Nile virus disease recover completely, but fatigue and weakness can last for weeks or months.

Less than 1% of people who are infected will develop a serious neurologic illness such as encephalitis or meningitis (inflammation of the brain or surrounding tissues).

• The symptoms of neurologic illness can include headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis.
• People with certain medical conditions, such as cancer, diabetes, hypertension and kidney disease are also at greater risk for serious illness.
• Recovery from severe disease may take several weeks or months. Some of the neurologic effects may be permanent.
• About 10 percent of people who develop neurologic infection due to West Nile virus will die.The elderly are more likely to have complications of West Nile Virus.

Treatment:

• No vaccine or specific antiviral treatments for West Nile virus infection are available.
• Over-the-counter pain relievers can be used to reduce fever and relieve some symptoms
• In severe cases, patients often need to be hospitalized to receive supportive treatment, such as intravenous fluids, pain medication, and nursing care.