The Treatment of Childhood Diseases

1. Upper Respiratory Tract Infections

Upper respiratory tract infections (URIs) are the most common reason for children of all age groups to visit a doctor. Especially in children under the age of 5, acute respiratory tract infections are prevalent, and children in this age group may experience URI 3-6 times a year. During their first year of attending daycare or preschool, some children may even experience URIs up to 10 times.

Factors contributing to the frequency of acute respiratory tract infections include:

• Lack of adherence to hygiene rules, especially handwashing.
• Living in crowded places.
• Exposure to secondhand smoke.
• Inadequate nutrition.
• The presence of chronic illnesses.
• Compromised immune system.
• Use of immunosuppressive medications, such as in cancer patients.

URIs primarily affect the area from the nose to the vocal cords. In most cases, they are caused by viruses. Antibiotics are generally not necessary for treatment. The treatment includes supportive measures like reducing fever if present, relieving nasal congestion, offering plenty of fluids, and ensuring rest.

2. Common Cold

A common cold is a disease characterized by sudden-onset upper respiratory symptoms. It is prevalent in children under two years of age and can occur up to six times a year. The disease usually resolves on its own within 7-10 days, but, in rare cases, it may last up to 3 weeks. Rhinoviruses are the most common causative agents.

• Symptoms may include: runny or stuffy nose, restlessness, fever, diarrhea, vomiting, dry cough.

• Treatment is supportive, meaning that it includes measures to reduce fever if present and to relieve nasal congestion.

3. Nasal Congestion

Nasal congestion is a common condition in children that affects their quality of sleep and can hinder their feeding. It is often seen in cases of URIs. However, dry and warm air can also lead to nasal congestion in infants because the nasal passages in babies are narrower compared to adults.

Ensuring the child's intake of warm fluids can thin nasal secretions and maintain moisture in the nasal passages.

Nasal saline with a bulb syringe can help open the baby's nasal passages.

4. Influenza (Flu)

Influenza is a contagious disease caused by a microorganism called the influenza virus. There are various types of influenza viruses, with types A and B being the most well-known.

- What are the symptoms of the flu?

• High fever (measured rectally as 38°C or higher)
• Chills
• Widespread muscle and joint pain
• Headache
• Sore throat
• Dry cough
• Runny nose
• Sneezing
• Watery, red eyes
• Rarely, abdominal pain, nausea, vomiting, and diarrhea

- How does the flu spread?

The flu is transmitted through the respiratory secretions (e.g., coughing and sneezing) of individuals carrying the flu virus. It can also spread through contact with surfaces contaminated with these secretions. Crowded environments like schools, dormitories, barracks, and crowded public places facilitate its transmission. Exposure to cold weather, alcohol consumption, and smoking increases the risk of contracting the disease.

- How is the flu treated?

Rest is crucial. Adequate fluid intake is recommended, and fever-reducing medications should be used when necessary. Aspirin should not be used as a fever reducer. Antibiotics are not used for treatment. In severe cases or in those with chronic illnesses, antiviral medication, such as oseltamivir, can be considered within the first 48 hours.

5. Sinusitis

Sinusitis is the inflammation of the sinuses. In children who have had URIs, it is a bacterial infection of the sinuses.

- How can it be recognized?

Symptoms may include a runny nose, fever, cough, a foul taste or smell in the mouth, and, in older children, a headache. Inflammatory nasal discharge may be present.

However, one of the following three conditions indicates acute sinusitis:

1. Nasal discharge or cough lasting more than 10 days without improvement.
2. Pus-like nasal discharge and a fever above 39°C (102.2°F) for more than 3 days.
3. A worsening of URI symptoms, new onset of fever, or severe headache. These conditions typically occur along with one of the previously mentioned signs.

There is usually no need for X-rays to make the diagnosis of sinusitis. Appropriate antibiotics are used for sinusitis treatment.

6. Otitis Media (Ear Infection)

Otitis media, an infection of the middle ear, is one of the most common childhood diseases, particularly in children aged two and younger. Up to 90% of all children experience at least one episode of otitis media by the age of two. The middle ear is an air-filled space located behind the eardrum. Air is transported into the middle ear through the Eustachian tube, a narrow channel connecting the middle ear to the back of the throat. The role of the Eustachian tube is to equalize the air pressure in the middle ear with the atmospheric pressure. Vibrations produced by sound waves on the eardrum are transmitted to the inner ear via small ear bones (the hammer, anvil, and stirrup). These vibrations stimulate the nerves carrying sound to the brain. In babies, the Eustachian tube is shorter, lies flat, and contains more mucus-producing cells than in adults. The difference in anatomy makes infants more susceptible to ear infections.

Acute otitis media is an inflammatory infection of the mucosa lining the middle ear. Bacteria often cause it, and the infection reaches the middle ear from the nose.

- What are the symptoms?

• Severe ear pain
• Ear discharge
• Fever
• A history of a previous URI
• In babies: crying, restlessness, tugging on the ear, poor appetite, nausea, vomiting, diarrhea, hearing loss, ear fullness, dizziness.

- What precautions should be taken to protect children from acute otitis media?

• Breastfeeding passes antibacterial and antiviral factors to the baby, promoting resistance against ear infections. This means that breastfeeding is protective against acute otitis media. Breastfeeding reduces the risk of acute otitis media and delays the first attack.
• Therefore, it is essential to ensure that the child receives breast milk as much as possible.
• Children fed with bottles are more likely to develop middle ear infections. Another important aspect is the child's feeding position. Children fed in a lying position experience middle ear infections more frequently than those fed at approximately a 45-degree angle.
• Another essential point is ensuring that smoking is not allowed at home or in vehicles. Smoking can alter the structure of the cilia in the Eustachian tube, predisposing to middle ear infections.

When left untreated, middle ear infections can lead to prolonged accumulation of fluid and inflammation, resulting in hearing loss and various undesirable effects in individuals.