Saturday, February 16, 2013

Adenovirus Infections

photo source: Shutterstock
It's been a relatively sick winter season, and I keep hoping it is winding down.  But as one season winds down, another starts.

This week my eyes have been watering and burning and my nose is a little stuffy. (I think my nose would be worse if I didn't do twice daily nasal washes - I am a true believer in them!)

But my eyes are driving me nuts. I first thought it was due to allergies since earlier this week I knew that local pollen counts were up, but as I consider what I'm seeing in the office, I wonder if I have a mild adenovirus. (Yes, even doctors have a hard time determining what is going on. This is why I say to never trust someone when they say "it's just my allergies." Make them wash their hands!)

We start to see adenovirus this time of year. I don't test for it but when I start seeing certain trends, I suspect it's here.  It causes many types of symptoms, different in different people.

Red eyes without mucus discharge is one common finding. It is not "pink eye" or bacterial conjunctivitis, but we have many kids sent in from schools and daycares because they think it's "pink eye." I usually just write a note that eye drops are not needed and they can return to daycare since it is a virus.

I have seen quite a few red eyes this week...

Other symptoms are much like a common cold: fever, runny nose, cough, swollen glands, and sore throat. It can cause wheezing in infants and croup (yes, we're seeing those now too).

Sometimes vomiting and diarrhea are due to adenovirus - and right now we are blaming all the stomach problems on the new Sydney Norovirus, but it could be something more typical too.

Prevention is key with any illness. Continue to wash hands and surfaces well all year long, not just when the flu is in the news. Keep sick family members home if they are sick to avoid spreading germs to others.

Most children with adenovirus can be treated at home.

  • Treat with a pain reliever/fever reducer as needed for comfort. Remember it is not how high a fever is, but how a child acts that is most important (as long as they are over 3 months and immunized). 
  • Push fluids. 
  • Use a humidifier or vaporizer if the air is dry to help the airway. 
  • Use saline rinses or sprays in the nose as tolerated. 
  • Kids over 1 year can use honey for cough. I don't recommend cough medicines since they haven't been shown to work, are expensive, and have side effects. 
  • And for those red, burning, watery, itchy eyes: cool compresses. Since allergy season overlaps with adenovirus season and they symptoms are very similar, you can try age-appropriate allergy medicine to see if it helps the red, itchy, watery eyes. Watch for yellow mucus discharge of the eyes. Since kids rarely wash their hands before rubbing their eyes, they are more likely to secondarily infect their eyes with repeated rubbing of irritated eyes. 
  • Wash hands frequently!
When to see your doctor:
  • Sore throat and fever in children should be evaluated for Strep throat by a throat swab and test during business hours. Strep throat can look exactly like a sore throat from adenovirus or other viruses, so it needs to be tested before appropriate treatment can be determined.
  • If there are breathing problems such as rapid breathing, ribs sucking in and out, child is not able to complete a sentence due to shortness of breath, or other concerns your child should be seen ASAP.
  • If your child looks dehydrated (no tears, dry mouth, poor urine volume) he should be seen ASAP.
  • If the eyes are red with discharge, your child should be seen during business hours to see if antibiotic eye drops are needed. 
  • A child with symptoms of a urinary tract infection (symptoms may include fever, painful urination, frequent urination, blood in urine, or urinary accidents) should have their urine tested for infection. If symptoms are mild, you can wait until business hours, but if associated with high fever, vomiting, or other concerns, bring in for assessment ASAP.

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