What's Going Around: Flu, RSV, COVID

Oct 05, 2023

by: Ali Lanyon

Posted: Oct 12, 2023 / 04:30 AM EDT

Updated: Oct 12, 2023 / 06:35 AM EDT

The CVS MinuteClinic in York reports viral upper respiratory infections, a few cases of COVID and strep throat.

The providers at UPMC Children’s Community Pediatrics in York and Spring Grove are seeing COVID, RSV and the flu this week.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics says cases of RSV have arrived. They are also still seeing scattered COVID cases.

However, the majority of coughs and colds are being caused by viruses that are not COVID or RSV.

They also saw an increase in pink eye and strep throat.

Dr. Joan Thode offered the following advice about bronchiolitis and post-nasal drainage cough:

“Babies and toddlers are notorious for wet, goopy-sounding coughs whenever they get sick. This is more commonly due to nasal drainage in the throat but sometimes can indicate a more serious infection or inflammation of the lungs. While it can be impossible to tell the difference in the cough sound, that sound is not as concerning as the child’s work of breathing. Regardless of the cause of the wet cough, if the child appears to be using a lot of energy and effort to get each breath, it is time for medical evaluation and diagnosis.

Bronchiolitis is a virus-induced inflammation of the tiniest of the airways in the lungs. This typically affects babies and toddlers, as their lungs and airways are the tiniest. The small airways can swell shut/fill with mucous, preventing oxygen from getting to the air sacs at the end. Fortunately the lungs have millions of these air sacs, so most babies will be able to compensate by using the ones that aren’t swollen shut.

When the body is at a decreased oxygen state, it tries to compensate with an increased breathing rate and breath volume, using the rib cage muscles to forcefully expand the lungs with every breath. The child’s belly will protrude with each breath, and there will be an exaggerated expansion of the ribcage, known as retractions. Sustained fast breathing or retractions are concerning signs that warrant medical evaluation.

Thanks for signing up!

Watch for us in your inbox.

Subscribe Now

Bronchiolitis follows a very typical course: It gets worse over the first four days, then starts to improve. The wet cough persists for about one to two weeks afterward. There is unfortunately no treatment to make bronchiolitis go away faster. The only treatment, if needed, is to provide oxygen to help the baby maximize the use of the air sacs that are still open. Our best advice is to trust your gut as a parent that your child’s breathing isn’t quite right and bring them to medical attention sooner rather than later.

As the lungs get rid of the excess mucous of bronchiolitis, the post-infection cough will sound wet as that mucous is coughed up and out of the lungs.

Viral coughing sounds wet due to mucous from the nose, not the lungs. As we all know, viral upper respiratory infections create a lot of nasal mucous, which naturally drains down the back of the throat, into the esophagus to the stomach and eventually out of the body.

The cough occurs as that descending mucous triggers the nerves at the top of the airway. These nerves respond as if the child is about to choke on food and immediately cause a protective cough to push the mucous away from the top of the trachea and the lungs. The blast of air through the thick mucous causes the cough to sound wet.

Viral coughs tend to occur after the start of nasal drainage and persist after the virus is done due to the continued drainage of the accumulated mucous in the nose. At night, when a child lies down for sleep, gravity causes the mucous to pool in the back of the throat, and this wet cough can sound even worse. Coughing “fits” are more likely at night or early morning because the mucous has had enough time overnight to accumulate a larger volume in the back of the throat, requiring a lot more coughing to clear.

Again, unfortunately, there is no way to speed up this drainage process. The wet cough following a “cold” will typically not cause high rates of breathing or significant retractions, as the lung’s ability to get oxygen is not affected by postnasal drainage. Thus, they may have a similar sounding wet cough to a peer with bronchiolitis, but they are much less likely to have true respiratory distress.”

Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.