Not Every Cough Is Covid

Not Every Cough Is Covid
Aug. 82022

Now that we are spending more time exposed to groups of people without masks, we are also being exposed to respiratory viruses. Like Covid-19 these viruses travel in droplets from our noses and mouths. Our children are the ones most at risk from these viruses since most adults have immunity from previous exposure. While these other illnesses aren't usually as severe as Covid-19, they can still disrupt our families' lives and even lead to hospitalization. And unfortunately we don't have vaccines for most of these other respiratory illnesses. The only prevention remains good hygeine, distancing, and masks. Here are a few of these other illnesses.

First is “the common cold”, which is really a family of viruses called rhinoviruses. The reason we can't develop a cure or a vaccine for the common cold is that there are many, many of these rhinoviruses, and immunity against one does not protect against the others. Fortunately, for most of us a cold is not a serious threat, but we tend to spread it because we return to school or work while we are still contagious.

Just as common but more serious is influenza. The flu is not just a bad cold, and before the pandemic 35,000 people a year would die in an average year from this virus. Influenza is more serious for adults than children, but – unlike Covid-19 – the vaccine is much more effective for children than adults. In fact, there is evidence that if all the children 6 months to 5 years received the flu vaccine, no adults would get the flu. The difficulty with the flu is that its genetics shift every year, and a new vaccine is needed with each new flu season. There is also medication to reduce the severity of the flu. If you have high fever, headache and body aches, as well as cough and runny nose, you should be tested for influenza (as well as Covid-19).

Every spring as the flu season wanes we notice what looked like a new wave of flu-like illness. In many cases this is human metapneumovirus. In addition to being hard to pronounce this virus is hard to recognize. We now have tests that will identify which respiratory virus you have, but the tests are neither as available nor cheap as the flu tests. Also, there's no treatment or vaccine for h-mpv. It can leave you with a persistent cough, especially if you have asthma. Children are usually more susceptible to this virus than adults. It goes away on its own in 5 to 10 days.

Many of you realize that Covid-19 stands for coronavirus disease 2019. In fact, there are a lot of coronaviruses, and we've been exposed to them. Until Covid-19 coronavirus was no worse than a cold. They're still around. Why our exposure to these other coronaviruses hasn't protected us better is unclear.

Most parents recognize the barking cough of croup. This disease is caused by parainfluenza, and can be treated with a single dose of dexamethasone, a steroid. Other viruses can also cause croup, but parainfluenza is the most frequent cause.

One final virus that can be very serious to children – especially infants and toddlers – is respiratory syncitial virus or RSV. This virus is responsible for bronchiolitis, a kind of bronchitis or pneumonia that can lead to hospitalization. There is no vaccine for this disease even though researchers have been working on one for decades. There is a new drug that can protect against RSV. Although it is not a vaccine, it needs to be injected before the RSV season to provide protection. It is not yet available outside of investigational studies.

Please teach your children proper hygiene. Washing your hands frequently, especially after blowing your nose, can reduce spread. Coughing into your elbow is another way to protect others. Wearing a mask works. But the best way to protect others is to stay home when you're sick!

Robert B. Golenbock, MD

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