What are the common causes of colds in children? How to identify the type of cold in children?

Children's cold is one of the most common diseases in children. It is an acute inflammation of the nose, nasopharynx, and pharynx caused by viruses or bacteria. The main clinical features are fever, nasal congestion, runny nose, sneezing, and coughing. Traditional Chinese medicine believes that this disease is a common exogenous disease caused by exogenous evil, also known as cold. Generally speaking, 80% to 90% of colds are caused by viruses, and there are more than 200 viruses that can cause colds; while 10% to 20% of colds are caused by bacteria. Infants under 1 year old are more likely to catch a cold because their immune system is not yet fully developed. Children are prone to catching a cold, which is related to the immaturity of their physiological and immune systems. Sometimes children's colds can spread throughout the body through the blood circulation, causing serious diseases such as sepsis, empyema, and meningitis that endanger their lives. Therefore, they must not be treated lightly as daily minor illnesses.

1. Incubation period: usually 2 to 3 days or slightly longer.

2. Mild cold: Only nasal symptoms, such as runny nose, stuffy nose, sneezing, etc., or accompanied by tearing, slight cough or throat discomfort, generally can be cured naturally within 3 to 4 days. Infecting the nasopharynx and pharynx, it can cause fever, sore throat, tonsillitis and congestion and hyperplasia of the lymphatic tissue on the posterior pharyngeal wall, or slight swelling of lymph nodes. Fever can last for 2 to 3 days to about 1 week. It is easy to cause vomiting and diarrhea in infants and young children.

3. Severe cold: systemic symptoms appear, with high fever at the beginning, and the body temperature can reach 39-40℃.

Causes of colds in children

1. Pathogens

Most of them are caused by viruses, which can account for more than 90% of the upper respiratory tract infections. Bacteria are less common. After viral infection, the upper respiratory tract mucosa loses its resistance, bacteria can take advantage of the situation and enter, resulting in suppurative infection.

1. Common viruses:

It is the most important pathogen of the common cold, and about 50% of upper respiratory tract infections are caused by this virus. It can cause upper respiratory tract infection, bronchitis and otitis media.

It is also a common pathogen of upper respiratory tract infection, but special methods are required to separate it. It can also cause acute gastroenteritis in infants and newborns.

So far, 2 major serotypes and 9 subtypes have been identified. It is the most common pathogen for respiratory tract infections in infants and young children, and is more common in newborns and infants under 6 months old, and can cause small epidemics. The virus has a strong pathogenicity to the respiratory tract of infants and young children, and the symptoms are severe, including rhinitis, high fever, laryngitis, pharyngitis, and can also manifest as bronchiolitis and pneumonia. However, for older children, it mainly manifests as upper respiratory tract infections, and lower respiratory tract infections are significantly reduced.

There are three serotypes: A, B, and C. Type A can cause a pandemic due to its drastic mutation of antigenic structure, which is estimated to occur every 10 to 15 years. Type B is less pathogenic to humans, and the epidemic is small and limited. Type C only causes subtle or mild upper respiratory tract infections in humans, and generally only causes sporadic epidemics. The virus mainly causes upper respiratory tract diseases in children, and can also cause laryngeal, tracheal, bronchitis, bronchiolitis and pneumonia.

There are four serotypes: 1, 2, 3, and 4. Type 1 is called "hemoadsorption virus type 2" (HA2), and type 2 is called "croup-like virus" type 1 (HA1). These two types often cause bronchiolitis and pneumonia, and croup often occurs. Type 1 is the main cause of laryngotracheobronchitis in children. Type 3 often causes pneumonia and bronchiolitis. Type 4 is called M-25, which seems to be less common and difficult to detect. It can cause upper respiratory tract infections in children and adults.

It is an enterovirus, small in size, belonging to the category of PicoRNAvirus. It can be transmitted through the respiratory tract and digestive tract and can cause respiratory symptoms.

Also known as Pneumoplasma or Pleuropneumonia-like organisms (PPLO for short), it not only causes pneumonia, but also upper respiratory tract infections, which are more common in children aged 5 to 14 years. The disease is more common in autumn and winter, and there is an epidemic every 3 to 4 years.

There are more than 30 different serotypes. The general population is susceptible, especially children. About half of the patients are latently infected. It mainly causes acute upper respiratory tract infections, such as nasopharyngitis, pharyngitis, pharyngoconjunctivitis and follicular conjunctivitis. About 2-4% of acute respiratory tract infections are caused by this virus. In addition, it can also cause the spread of pneumonia.

Among them, parainfluenza virus, respiratory syncytial virus and coronavirus are more common in upper respiratory fatigue infections.

2. Common bacteria:

Secondary bacterial infections that invade the upper respiratory tract are mostly caused by group A beta-hemolytic streptococci, pneumococci, hemophilic influenzae, and staphylococci. Among them, streptococci often cause primary pharyngitis. In recent years, foreign literature has mentioned that Branhamelis catarrhalis, one of the resident bacteria in the nasopharynx, can develop into a pathogenic bacterial infection in the respiratory tract.

2. Predisposing factors

The occurrence and development of upper respiratory tract infection depends not only on the type, toxicity and quantity of invading pathogens, but also on other inducing factors.

1. Host defense capabilities

Children who are malnourished and lack exercise, as well as those with allergies or immune deficiencies or low immune function, have reduced body defenses and are more susceptible to upper respiratory tract infections with more severe symptoms. Epidemics are more likely to occur in the winter and spring when the climate changes more frequently.

2. Environmental factors

Air pollution, crowded living, indirect inhalation of smoke, passive smoking, etc. can all reduce the local defense capabilities of the respiratory tract and promote the growth and reproduction of pathogens.

Strengthening exercise, improving nutrition and environmental hygiene are important in preventing colds.

1. Exercise

It is very important to use natural factors to exercise the body. For example, sleeping with the windows open frequently, outdoor activities and physical exercise are all positive methods. As long as you persist, you can enhance your physical fitness and prevent upper respiratory tract infections.

2. Pay attention to hygiene

Avoid the causes of upper respiratory tract infection: wearing too much or too little clothing, room temperature being too high or too low, sudden changes in weather, environmental pollution and passive smoking, etc.

3. Avoid cross infection

Wash hands after contact with patients. Wear isolation clothing when necessary in general childcare institutions and hospitals. Isolation not only protects nearby children, but also reduces complications in sick children. The ward should be ventilated, maintain appropriate temperature and humidity, and disinfect the patient's bedding and clothing in time to prevent the spread of pathogens. At home, adult patients should avoid contact with healthy children.

4. Drug prevention

Kamanshu, 5ml for infants and 10ml for children, oral administration, 3 times/d, 3 to 6 months as a course of treatment. Levamisole 2.5mg/(kg?d), 2 days a week, 3 months as a course of treatment. Chinese medicine Astragalus 6 to 9g per day, continuous administration for 2 to 3 months. The above drugs have the effect of improving the body's cellular and humoral immune functions. Children with recurrent upper respiratory tract infections can reduce the number of recurrences after application. The pediatric department of Beijing Friendship Hospital once used Chinese medicine Jiawei Yupingfeng Powder (formula: raw Astragalus 9g, Atractylodes 6g, Saposhnikovia 3g, raw oyster 9g, tangerine peel 6g, yam 9g, ground into fine powder) 2 times/d, 3g each time, orally. After 3 years of observation, it is believed that this medicine seems to improve the immunity of weak children and reduce the incidence of recurrent respiratory tract infections.

5. Vaccination

Recently, it is believed that the use of attenuated virus vaccines, by intranasal instillation and/or aerosol inhalation, can stimulate the production of secretory IgA on the surface of the nasal and upper respiratory tract mucosa, thereby enhancing the respiratory tract's defense against infection. A large number of studies have shown that secretory IgA is more effective than any serum antibody in fighting respiratory infections. Because there are too many types of enterovirus and rhinovirus, it is difficult to prevent them with vaccines.

Western medicine treatment of children's colds

1. Treatment

The main focus is on adequate rest, relieving exterior symptoms, clearing away heat, and preventing complications, while also paying attention to general care and supportive therapy.

1. Drug therapy

It can be divided into cause-elimination therapy and supportive therapy. In cause-elimination therapy, Chinese medicine is often used to treat viral infections. Some people extract secretory IgA from colostrum and drip it into the nose, 0.3-0.5 mg/(kg?d), divided into 6-8 times, for 2-3 consecutive days, with good efficacy. Penicillin and other antibiotics are used for bacterial infections. Most acute upper respiratory tract infections are viral infections. Antibiotics are not only ineffective, but can also cause dysbiosis of the body's flora, so abuse must be avoided. When combined with bacterial infections, such as pharyngitis or tonsillitis caused by beta-hemolytic streptococcus group A, penicillin is effective. If it is ineffective after 2-3 days, other pathogens should be considered. When the fever is high, first use a cold towel to wet the forehead and the entire head. In addition. General antipyretics such as appropriate amounts of aspirin or acetaminophen (paracetamol) can be used, and can be repeated every 4-6 hours according to the condition, but avoid excessive dosage to avoid sudden drop in body temperature, sweating, or even collapse. For children with mild cough, especially infants, it is not advisable to use a large amount of Chinese and Western cough suppressants.

2. Local treatment

If you have rhinitis, in order to keep the respiratory tract unobstructed and ensure rest, you should use pediatric nasal drops before eating and going to bed, 4 to 6 times/day, 2 drops in each nostril each time. Infants should avoid using oily nasal drops, as they may be inhaled into the lower respiratory tract and cause lipoid pneumonia. When older children suffer from pharyngitis or tonsillitis, they can rinse their mouths with light salt water or compound boric acid solution.

3. Treatment of complications

The treatment of common complications is an important part of dealing with acute upper respiratory tract infections, and appropriate measures must be taken according to the severity of the disease.

4. General care

Pay attention to rest and care. During the fever period, it is advisable to give liquid or soft food and drink plenty of water. Infants who are breastfeeding should be fed in small amounts and multiple times to avoid indigestion symptoms such as vomiting and diarrhea. The room temperature should be constant and maintain a certain humidity. Pay more attention when there are symptoms of laryngitis. In order to relieve sore throat and cervical lymph node pain, older children can use cold or hot compresses. When there is too much nasopharyngeal secretion, the prone position can be taken.

(II) Prognosis

The disease has a good prognosis and is self-limiting, and generally recovers in 5 to 7 days. Systemic symptoms such as spirit and appetite are often more important than body temperature and white blood cell count. If the diet and spirit are normal, the prognosis is usually good; those who are listless, sleepy, irritable, and pale should be vigilant.

Traditional Chinese medicine treatment of children's colds

Chinese medicine treatment

①Upper respiratory tract infection is called "cold" in traditional Chinese medicine. According to clinical manifestations, it can be divided into two types: wind-cold cold and wind-heat cold. Traditional Chinese medicine calls influenza "epidemic cold", and its clinical manifestations are similar to wind-heat cold, which is a severe case of wind-heat cold.

② When the heat is strong, it is easy to cause convulsions (heat shock);

③ Food stagnation can easily cause gastrointestinal symptoms such as vomiting and diarrhea. Regardless of wind-cold or wind-heat, the disease is located on the surface, and the treatment should be based on the method of relieving the exterior. Treat the wind-cold type with pungent and warm relieving the exterior, and treat the wind-heat type with pungent and cool relieving the exterior. In addition, tonsillitis is a common disease in upper respiratory tract infection, and its traditional Chinese medicine treatment is now described.

(1) Common cold

① Wind-cold cold: more common in older children in the early stages of a cold, with symptoms of aversion to cold, fever, no sweating, runny nose, headache and body pain, cough with sputum, pale red tongue, thin white tongue coating, and tight pulse. Treat with pungent and warming method of relieving the exterior symptoms. Prescription example: Musk 9g, Chrysanthemum 9g, Sophora japonica 6g, Nepeta spicate 3g, Forsythia suspensa 9g, Gypsum 9g.

② Wind-heat cold: seen in infants and young children, with severe fever, or sweating but not relieved fever, nasal congestion, runny yellow nose, red face, red throat, or cough with sputum, slightly red tip of tongue, thin white or yellow and white fur, floating pulse or slippery pulse. Treat with pungent and cool to relieve the exterior, clear away heat and detoxify. Prescription example 1 (for those with severe exterior heat): 9g of honeysuckle, 9g of forsythia, 6g of mint, 9g of isatis root, 15g of gypsum, 9g of burdock. Prescription example 2 (for those with severe interior heat): 9g of honeysuckle, 9g of forsythia, 9g of chrysanthemum, 3g of indigo, 9g of ground bone bark, 9g of white mulberry, 9g of raw earth, 9g of isatis root, 15g of gypsum.

(2) Influenza

The disease is acute and serious. The systemic symptoms are obvious and the symptoms of Yingfen are likely to appear. The treatment method of wind-heat cold can be used, and the addition and subtraction can be combined with clinical symptoms. According to the above types of common cold, the following medicines can be selected according to the symptoms:

① In case of high fever, add 6g of Scutellaria baicalensis; in case of high fever and dry stool, add Xiaoer Niuhuang San, 0.3-0.6g each time, 2-3 times a day.

② Summer cold, high fever, fatigue, nausea, vomiting, greasy tongue coating, add musk 6g and perilla 6g.

③For severe cough, add 9g of Peucedanum chinense and 6g of Apricot Kernel.

④ For high fever convulsions, add Uncaria rhynchophylla 9g, cicada shell 6g or mother of pearl 15g.

⑤ For those with food stagnation, add 9g of scorched hawthorn, 9g of Jianqu or 6g of radish seeds.

should:

1. It is advisable to eat food that can clear away heat and detoxify;

2. It is advisable to eat foods that have antibacterial and anti-inflammatory properties;

3. Eat foods rich in high-quality protein.

avoid:

1 Avoid eating spicy food;

2Avoid eating greasy food;

3 Avoid eating foods that are difficult to digest.