It’s A Virus
By Jennifer Seawell, MD, FAAP
“It’s a virus.” We all love this answer (NOT!). When your kid is sick for the up-teenth day and you are starting to feel the heat at work, what you really want when you bring your kid to the doctor is for it all to go away. We’ve all been there. It’s hard to keep everything together on a GOOD day. And throwing in a virus is not welcome. Read on for more on this frustrating diagnosis.
“So you don’t know what it is then.”
Well, not exactly. There are gazillions of different viruses. And they are constantly shifting, changing, and mutating. (If you want a quick refresher course on what viruses are, you can read more about it in this Khan Academy introduction.
There are lots of tests to identify exactly WHICH virus. But here’s the thing. Tests are expensive. And many take days to come back. By the time you know your child’s cold was caused by a rhinovirus, they’re already improving. Health care costs are expensive. Most of the doctors I know work really hard to use your resources wisely.
It is much preferred to order expensive tests only when the answer has the potential for changing what we do and how we treat.
Being able to say which subtype of adenovirus your child has is not really all that helpful. Often, there are specific clues that will tell us the most likely culprit. And many times, the big offenders change by season. But knowing you have a metapneumovirus instead of a coronavirus isn’t useful information. Neat. But not useful.
“So there’s nothing you can do?”
Not exactly. There is nothing we can do to make a virus go away sooner than it is going to go. There ARE things we can do to help our kiddos feel better. Tylenol (acetaminophen) and Motrin (ibuprofen) can help bring down fevers. Check with your doctor on proper dosing for your kid. Saline spray can help break up thick mucous in your child’s nose. Honey will help a cough. Warm liquids soothe a sore throat. Extra snuggles give reassurance. Check out my Cold and Flu Survival Guide for a list of items to keep on hand.
Sometimes time and patience is the best medicine. And sometimes doing “nothing” is the best thing you can do. I know it’s not what you want to hear. And I know it is small consolation, but I don’t like to say it either.
It’s your pediatrician’s job to tell you what you need to know, not what you want to hear.
And please understand that we desperately want your kiddo to feel better sooner too. But wants don’t always change reality and we can’t always have what we want. (Darn it, my parents were RIGHT!!)
“Can’t you just nip it in the bud?”
Nope, afraid not. I have nothing at my disposal to make a viral infection go away sooner. If your kiddo is in the first day or two of a virus, it is probably going to get worse. You don’t like it. I don’t like it. But that’s how it goes sometimes.
Antibiotics are not helpful for viruses. They help bacterial infections. And antibiotics are not without side effects. Rashes, upset stomach, diarrhea, vomiting. And if that’s not enough, we have resistance to antibiotics to contend with.
As parents (and pediatricians) we can give supportive care. Keeping your kiddo hydrated and comfortable is that best thing we can do.
“But Susy’s kid did this exact same thing and then it turned into an ear infection”
Our bodies work hard to fight off viruses. Most of the time, the infection fades away and we go back to our normal everyday lives. But sometimes we end up with what docs refer to as “secondary infections.”
Secondary infections are infections that grab hold while we’re already knocked down from something else. They’re not all bacterial. It’s completely possible to come down with a stomach bug while fighting off a cold.
But some secondary infections are bacterial. Ear infections and pneumonia are a couple that can be bacterial secondary infections. (Although both of these also have viral forms as well.)
Unfortunately, there is no way to predict which of our kids will go on to have a secondary infection. So if that fever is hanging on past 5 days or they were improving and now they’re sick again, get them checked out.
“I brought my kid to the doctor and they did nothing and said he had a virus.”
Sometimes value comes from ruling OUT and not ruling IN. A diagnosis of a virus means that the ears aren’t infected. There is no strep throat. The lungs are clear and there is no pneumonia. There are no swollen organs. There is no evidence of cancer.
It is easy to be worried as a parent. Many of us are parents too. Sometimes the doctor part of my brain has to talk down the parent part of my brain. I get it. But sometimes “doing nothing” is the absolute best thing to do.
What questions do YOU have about viruses?
The Pediatric Ninja
This article is the professional opinion of its author and is not intended to take the place of medical advice, diagnosis or treatment from your personal physician.