Pediatric pneumonia cases requiring hospitalization increased by 30% in Central Virginia this fall. While not a cause for panic, it does call for caution.
We can’t say with certainty what’s causing the spike, but we can answer many common questions we’re hearing from families.
What might be causing this rise in pediatric pneumonia?
In addition to increased Mycoplasma infections (atypical bacterial pneumonia), which are community acquired bacterial infections, we’re also seeing a spike in rhinovirus/enterovirus infections. These are two types of the many respiratory viral infections that typically rise with back to school, weather changes and more time together inside. It may be that there’s a new strain of rhinovirus or enterovirus that is more virulent than in the past, something that occurs every 6-10 years. We know viral infections can also lead to bacterial pneumonias (typical or atypical).
What care is provided in the hospital to children with pneumonia?
These children are provided supportive care in the hospital, which varies depending on their specific symptoms and needs. It may include hydration via an IV, or oral hydration by mouth or with a nasogastric tube (tube from nose to stomach) for children who are unable to drink. Oral is always preferred, especially now with the shortage of IV fluids due to production plant impacts from Hurricane Helene. They may also receive oxygen through a nasal cannula, mask or in very severe cases a ventilator (with a tube from the mouth into the breathing passages).
Antibiotics are an important component of care if a bacterial infection is suspected. We’ll also give steroids and albuterol to patients who experience an asthma attack in addition to their pneumonia.
Do you expect that this will improve or get worse as we continue through fall and winter?
It’s likely to worsen with pollen and mold counts rising triggering allergies, colder weather keeping everyone inside and the holidays bringing people together. Asthma is triggered by infection and cold weather, so we often see patients with asthma needing extra care this time of year as well.
When should I seek medical care for my child’s respiratory symptoms?
Not all cases of respiratory illness require care in a medical setting. That said, if you notice any of the following symptoms, we urge you to check with the pediatrician if possible or bring your child to the emergency room:
- High fever (higher than 100.4˚F for infants younger than 3 months, or higher than 102.2˚F in children older than 3 months) that lasts more than 2-3 days despite Tylenol and/or Motrin
- Inability to drink liquids or vomiting so much that they’re not urinating regularly (fewer than three wet diapers per day in an infant, using the bathroom less than once per day in older children)
- Dry lips or mouth
- Working hard to breathe/catch their breath (seeing their ribs with each breath, belly breathing more than usual, gasping for air, inability to speak if they’re typically verbal)
If your child has asthma, cough with wheezing, needing more than four breathing treatments per day, and working hard to breathe with no response to breathing treatments would all warrant medical assessment and care.
Should I try any care at home for my child’s respiratory symptoms before seeking medical treatment?
For mild symptoms, we encourage lots of liquids and Tylenol or Motrin for pain relief. Honey can help decrease cough but should only be given to children over 1 year of age (there’s a risk of botulism in little ones with immature digestive tracts). Children with asthma should follow their asthma action plan instructions.
If symptoms begin to cause concern, seek medical care right away.
What are the best ways to protect myself and my kids from getting sick?
Infection prevention measures are essential, including:
- Washing your and your child’s hands
- Staying home and away from others until symptoms are improving and there is no fever for 24 hours without the assistance of fever-reducing medication
- Getting the flu vaccine
- Staying up to date on COVID vaccines
- Getting all childhood vaccines on schedule
- Wearing a mask if tolerated, especially if you have a weakened immune system or are recovering from illness
Dr. David Marcello is chief of pediatric hospital medicine at Children’s Hospital of Richmond at VCU.
