VOL: 101, ISSUE: 03, PAGE NO: 30
What is it?
- Croup is the common name for laryngotracheitis (inflammation and narrowing of the larynx, trachea and bronchi caused by viral infection).
- It reduces airflow, causing breathing difficulty.
- It affects children aged six months to six years and boys are more commonly affected than girls.
- It occurs mainly in winter or early spring, usually in epidemics.
- Mild fever.
- A harsh ‘barking’ cough.
- Difficult, painful breathing, especially on inhaling.
- Inspiratory stridor (rasping) on inhalation, coughing or crying - usually only seen in severe cases, but can happen when the child is sleeping or resting.
- Symptoms often worse at night.
- They usually diminish after three days, although a mild cough may persist for a further week.
- If the child has serious breathing difficulties, the soft tissues of the neck and the area below the ribcage may pull inwards during attempts to inhale; the child may also be cyanotic.
- Croup is commonly caused by the parainfluenza virus; other viruses such as measles or the influenza virus may also cause it, but do not always lead to breathing difficulties.
- It is spread through airborne droplets or by touch.
- Children born prematurely or with narrow upper airways are more prone to croup.
- Rarely, it is caused by bacteria or an allergic reaction.
- Incidence of life-threatening, bacterially mediated croup declined significantly when diphtheria and Haemophilus influenzae type B vaccines became available.
- Diagnosis is on the basis of symptoms, especially the characteristic cough and appearance of the throat.
- The child should also be checked for fever, cold symptoms or recent viral illness.
- If symptoms are severe and do not respond to treatment, a neck X-ray may be necessary to rule out other conditions such as epiglottitis or a foreign object stuck in the throat.
- Most children recover without medical treatment.
- The condition can be distressing and parents should try to keep the child calm.
- Sitting upright or carrying the child in cool fresh air can aid breathing.
- Plenty of cool drinks will prevent dehydration.
- If the child has a fever, paracetamol liquid (Calpol or Disprol, for example) or ibuprofen should be given.
- The child’s clothing can be removed if the room is warm.
- Cough medicines that cause drowsiness should be avoided.
- The child should avoid smoky environments.
- Severe croup may lead to life-threatening airway obstruction, when admission to hospital for ventilation is required.
- Children born prematurely or those with a history of lung disease, such as asthma, may develop severe breathing difficulties requiring hospital treatment.
- Some children show allergic reactions to the croup virus, such as redness, swelling and respiratory distress.
- Some develop secondary infections such as an ear infection or pneumonia.
- Regular handwashing can help prevent transmission by touch.
- Avoiding contact with people with respiratory infections can help prevent airborne transmission.
Kids Health: www.kidshealth.org/parent/infections/bacterial_viral/ croup.html
NHS Direct: www.nhsdirect.nhs.uk