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Bug O' The Week: Croup

Does your kid sound like Darth Vader?

This week’s germ spotlight is on a handful of viruses that cause ” croup“. Croup season has arrived when my little patients cough like a barking seal and sound like Demi Moore or Barry White. Here is some handy info:

Q. Why is croup special compared to the common cold?
A. Croup-causing viruses like the upper airway, right where the voice-box resides. A swollen voice-box causes the barking cough and hoarse voice.

Q. Why do kids have a problem with it?
A. The smaller your airway is to begin with, the smaller it will be when it is swollen from a viral croup infection. Your airway gets larger as you age. Kids under age three are the most affected. And, adults (yes, like you) are the least affected. So, a baby might have trouble catching his breath with croup and an adult might just have a hoarse voice (or “laryngitis”).

Q. How long does the virus last?
A. Croup is a 3-Night illness. For some unknown reason, croup is always worse at night and not really a problem during daylight hours (when your doctor’s office is open). At least it doesn’t last as long as most winter respiratory viral infections!

Q. When is croup a serious problem?
A. It’s a problem if your child makes a really high-pitched noise as he breathes-kind of like Darth Vader (called “stridor”) and looks like he is struggling to catch his breath.

Q. What should I do if my child sounds like Darth Vader?
A. Take your child into the bathroom and steam it up by running a hot shower. The steam helps relax the airway enough so your child can breathe comfortably. Alternatively, you can try walking out into the cold night air or opening up the freezer and letting your child breathe that air in (if you live in a warm locale like I do). If your child breathes more easily after that, great! See his doc the next day for evaluations and treatment. If he continues to have trouble, head to the nearest emergency room.

Q. Does my child need antibiotics for croup?
A. No. Because croup is caused by a virus, there is no antibiotic to make the infection go away. Time is the cure. But, if your child has stridor (a.k.a Darth Vader) on the first night, you have two very long nights ahead of you! Using a prescription steroid medication by mouth or by injection will help reduce the swelling in the airway. If your child has significant trouble breathing, he may also need an aerosolized breathing treatment given in a medical office or hospital setting.

- Ari Brown, MD, FAAP

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