
Is Croup Contagious?
Croup is contagious. Symptoms of croup usually develop two to three days after exposure to viruses that cause the disease.
Croup is contagious. Symptoms of croup usually develop two to three days after exposure to viruses that cause the disease.
Croup is an infectious pediatric illness of the respiratory system that involves predominantly the vocal cords (larynx) and windpipe (trachea) and to a lesser degree the upper airways of the lungs (bronchial tubes). The majority of a child's symptoms reflect the involvement of the larynx. Usually, croup is a viral infection and may be caused by many different viruses, including those responsible for the common cold and influenza. Rarely, it is caused by a bacterial infection.
The major concern in croup is the accompanying breathing difficulties as the upper airway narrows. Close monitoring of the child's breathing is important. The child should be especially observed at night or when napping for breathing difficulty. The doctor should be notified if the child is having progressive breathing difficulty, unusual drooling, agitation or restlessness, fever over 103 F, or if the parent feels frightened.
The breathing difficulties seen in croup can progress rapidly, turning into a life-threatening emergency. On rare occasions, a child must be rushed by an ambulance into the emergency room because of serious breathing problems. Signs of serious trouble include
While most children recover from croup without hospitalization, some children can develop life-threatening breathing difficulties. Therefore, close contact with the doctor during this illness is important.
Viral croup can have two distinct presentations, both of which are a consequence of swelling of the vocal cords resulting in a narrowing of the airway. The more common variety has symptoms of
The alternative and less frequent presentation are called "acute spasmodic croup."
These two different presentations are the result of the particular virus that has infected the child. Manifestations of croup vary from mild (common) to life-threatening (rare). The severity of symptoms is proportional to the amount of relative narrowing of the airway. The more severe the vocal cord narrowing the more effort is required to inhale. A severely sick child will refuse to lie down, demanding to remain in an upright position. They will show retractions of the skin above the collarbone and between the ribs with inspiration and may develop facial cyanosis (bluish skin discoloration). Apparent exhaustion and decreased respiratory effort are an indication of impending respiratory failure and are causes for immediate paramedic evaluation and transport to the emergency department of the closest hospital.
In general, the duration of symptoms of croup is five to seven days. More severe croup may resolve in 14 days.
Teens and adults may develop an upper respiratory infection caused by the viruses which cause croup in younger children. However, since the internal diameter of the upper airway (larynx and trachea) is much larger than in younger children, the classic barky cough, inspiratory stridor, and respiratory distress are rare.
Croup is contagious and is usually spread by airborne infectious droplets sneezed or coughed by infected children.
The diagnosis of croup is most commonly made by obtaining the characteristic history of sudden-onset of hoarse voice, barky cough, stridor during inhalation, and the possibility of low-grade fever. While the child may appear rather ill, the child does not have a look of pure panic or terror. There can be a high fever (> 103 F), sitting forward positioning, and excessive drooling. Recent exposure to another child with croup helps to confirm the diagnosis. Laboratory tests are rarely necessary and are mostly limited to severe situations where concern regarding a secondary bacterial infection may have developed and is superimposed upon the primary viral process. A particular X-ray orientation of the neck will often show a characteristic elongated narrowing of the region called a "steeple sign." Such an X-ray finding is confirmatory for croup. Rarely will consultation with an otolaryngologist (ENT physician) be necessary to have a direct visual examination of the patient's airway. Such a procedure is termed fiberoptic laryngoscopy and is indicated if there is a concern for an anatomical malformation of the upper airway, possible aspiration of a foreign object, or should the child rapidly deteriorates or does not respond to routine therapy in an anticipated manner.
Most infants are routinely immunized against the bacteria Haemophilus influenzae type B (Hib). When the child is not immunized against Hib, the possibility of a more ominous, deep bacterial infection called epiglottitis exists.
Croup can be frightening for both children and parents. Therefore, comforting and reassuring the child is the first step. Breathing difficulties can develop and worsen rapidly. Close monitoring of the child is important during the early phases of the illness.
Rarely, a patient may have severe respiratory symptoms that need treatment with inhalation therapy with epinephrine (adrenaline) in the hospital where he or she can be monitored continuously. These therapies provide a temporary (two-hour) reduction of symptoms but are commonly followed by a return of equally severe symptoms. This reappearance of symptoms is commonly termed a "rebound" phenomenon.
Side effects of epinephrine inhalation therapy include:
Because a virus usually causes croup, antibiotics are reserved for those rare occasions when bacterial infections cause croup or become superimposed on the viral infection.
Even though plenty of fluids are encouraged to avoid dehydration, forcing fluids is generally unnecessary. Popsicles are a popular means of providing fluid. Activity should be restricted to quiet play during the first days of the illness.
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There is no current vaccination to prevent croup. However, several laboratories are working diligently to develop one. The infectious virus is most commonly transmitted by coughing or sneezing. Touching objects contaminated with infectious viral particles also allows transmission of the virus. Airborne viral particles can be infectious for about one hour. Virus on objects remains infectious for several hours. Avoiding these exposures can prevent croup.
Chronic cough treatment is based on the cause, but may be soothed natural and home remedies.
Laryngitis is an inflammation of the voice box (vocal cords). The most common cause of acute laryngitis is infection, which inflames the vocal cords. Symptoms may vary from degree of laryngitis and age of the person (laryngitis in infants and children is more commonly caused by croup). Common symptoms include
Chronic laryngitis generally lasts more than three weeks. Causes other than infection include smoking, excess coughing, GERD, and more. Treatment depends on the cause of laryngitis.
Sore throat (throat pain) usually is described as pain or discomfort in the throat area. A sore throat may be caused by bacterial infections, viral infections, toxins, irritants, trauma, or injury to the throat area. Common symptoms of a sore throat include a fever, cough, runny nose, hoarseness, earaches, sneezing, and body aches. Home remedies for a sore throat include warm soothing liquids and throat lozenges. OTC remedies for a sore throat include OTC pain relievers such as ibuprofen or acetaminophen. Antibiotics may be necessary for some cases of sore throat.