Croup – that ‘barking’ cough

THE common cold accompanied by a cough is nothing that parents with small children are not familiar with. But when this turns into a barking cough with shortness of breath, there is no mistaking the viral infection — croup.

“Croup, which is medically termed laryngotracheobronchitis, describes the different areas of the airway or [parts of the] respiratory tract that are infected — swollen larynx (voice box), trachea (windpipe) bronchi (air tubes that are a part of the lungs) — usually as a result of a virus,” said Dr Anona Griffith, paediatrician at Gateway Plaza, Old Harbour.

She pointed out that while the causative germ is usually viral, there are specific agents that usually cause the child to develop the condition such as parainfluenza, influenza A and B, respiratory syncytial virus (RSV) and mycoplasma.

The condition, which is caught by breathing in contaminated droplets from an infected person, affects small children, usually between three months and five years. It generally starts off as a common cold that progresses to produce noisy breathing and an irritating bark-like cough which is worse at night.

Dr Griffith noted that the condition is usually mild, lasting up to five days, and can be managed at home, but there are some cases which demand professional care.

“It can become life-threatening when the swelling becomes so much that it blocks the airway. At this point the baby may have difficulty breathing with flaring of the nose, pulling in of the muscles of the chest in between and below the ribs and in the neck, difficulty speaking, increasing restlessness and agitation, and becoming blue,” Dr Griffith noted.

She advised parents whose children are affected by the croup to keep them as comfortable as possible.

“Allow for comforting and cuddling, as emotional agitation and excessive crying can worsen coughing. Also, make sure to keep the child hydrated, wash your hands before handling the child, avoid any contact with any person that may be ill, especially with respiratory conditions, and use fever medications as prescribed if the child develops a mild fever,” Dr Griffith encouraged.

She noted other methods of treatment to include:

• Moistening or humidifying the air has been shown to be a documented effective treatment.

• Steroid therapy – inhaled, oral or nebulised may be offered as an effective treatment.

• The drug Epinephrine has also been documented as being effective, but is administered in the hospital.

• Antibiotics are usually not indicated, but can be used if there is a bacterial cause and this is usually confirmed by medical evaluation.

• Avoid over-the-counter cough syrups.

Dr Griffith said that if symptoms are excessive and go beyond five days, or if the child simply seems to be worsening with care at home, then medical attention should be sought. She says that in some cases the child may require admission to the hospital since they can receive more involved and professional care.