Respiratory Infections

When a child experiences a runny nose, sore throat, red eyes, hoarseness, coughing, fever, and swollen lymph nodes, they may have an uncomplicated respiratory illness. These infections are very common in daycare children or school going children or even children with siblings and up to six infections a year is normal. However, severe symptoms include:

  • Breathing fast – having difficulty getting oxygen through the lungs
  • Retractions – visible outline of ribcage or ribs
  • Coughing – more frequent than usual
  • Lack of activity normal for the child’s age
  • Not talking appropriately
  • Wheezing
    • When one can hear the child’s lungs
  • Stridor – harsh, bark-like cough
  • Fever
    • A temperature higher than what is normal for the child.

Prevention from illness include:

  • Parents or guardians should wash their hands before meals
  • Immunizations should be up to date
    • Parents and guardians should be appropriately informed about the risks of not vaccinating their children at the proper time for each and every form of bacterial and viral infection
  • Annual physicals
  • Educate children to sneeze into their sleeve, use a tissue and wash their hands
  • Adequate hours of sleep
  • Drink plenty of fluids
  • Consult child’s physician.

Acute respiratory infections (ARIs) are either upper or lower respiratory tract infections (URIs or LRIs). The URT includes airways from nostrils to one’s vocal cords, and the LRT is the trachea to the alveoli. These infections can spread systemically and lead to inflammation as well as reduced ling function. Diseases which have the capability of becoming systemic include diphtheria, pertussis (whooping cough) and measles, all of which are preventable via a vaccination.

Respiratory tract infections can be fatal, so they must be managed promptly and accurately. Here is a list of causes:

  • URT
    • Rhinitis – common cold
    • Sinusitis
    • Ear infections – Hib, pseudomonas
    • Acute pharyngitis
    • Tonsillopharyngitis
    • Epiglottitis
    • Laryngitis
    • Most of these are viral
      • Rhinoviruses
      • Respiratory syncytial viruses (RSV)
      • Parainfluenza
      • Influenza
      • Adenovirus
      • Corona virus.
    • Acute pharyngitis
      • Streptococcal infections
      • Corynebacterium diphtheria
    • Acute ear infection
    • LRT
      • Pneumonia
      • Bronchiolitis
    • Pneumonia
      • Pneum.
      • Hib
    • Pneumonia
      • pneum.
      • Hib
      • Mycoplasma
      • Chlamydia p.
    • Bronchiolitis
    • Influenza
    • HIV.

Majority, if not all of these causes may be preventable if proper interventions are applied:

  • Vaccinations
    • Measles
    • Diphtheria
    • Pertussis
    • Hib
      • For infants and young children
      • Prevent meningitis
      • Prevent Pneumonia
    • Pneumococcus
      • 23 strains of pneu.
    • Influenza (annual).

Treatments for respiratory tract infections and severe pneumonia are intramuscular antibiotics, especially chloramphenicol. Nonetheless, parents should be made aware of both side effects of medications and the fact that these infections have serious consequences. If left untreated, viral and bacterial infections can lead to heart block – diphtheria, legionella – and some may lead to endocarditis – strep or staph infections. Moreover, some of these infections may cause other problems, such as renal failure as well. Each child has an individual case and each child should be individually managed. Unnecessary treatment should not be administered because many antibiotics have long-term side effects.


Figure 1 – Influenza. Spreading of influenza A (H5N1) viruses and efforts for potential pandemics.

Figure 1 – Influenza. Spreading of influenza A (H5N1) viruses and efforts for potential pandemics.