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Rhinovirus – The Bug That’s Going Around

Rhinovirus seems to be the virus de jour in the last few weeks. In medicine, we often don’t go to the effort to do specific viral testing on kids who appear to have “just a cold.” The test is painful (a swab up the nose), is expensive (hundreds of dollars), and takes time and effort. If there was a cure, it would probably be worth doing more often. However, there are still plenty of reasons to test (e.g., a child who isn’t getting better, a child with an underlying immune problem, a newborn with fever). In the last few weeks, most of the kids we have tested for one reason or another have been positive for rhinovirus. So it is definitely going around.

What is rhinovirus and do I need to stress about it?

Rhinovirus is the most common viral infection in humans. It is the predominant cause of the “common cold,” although there are other viruses that cause colds. It typically infects the upper respiratory system. Random trivia: “rhino” comes from the Greek word meaning nose, so I always think of it as the bug that causes all your crummy runny/stuffy nose symptoms. Rhinovirus is the most common in the fall and spring.

Rhinovirus Signs and Symptoms

  1. Runny or stuffy nose
  2. Cough
  3. Sore throat
  4. Fever
  5. Headache
  6. Decreased appetite
  7. Muscle and body aches (can happen, but are atypical).

Rhinovirus Incubation

Everyone always wants to know where they got a bug (secretly we want to shake our fist and curse the person who possibly gave us the bug). Knowing the incubation period (the time it takes from exposure to showing signs of illness) will help in your detective work. The typical incubation period is 2 days. There have been reports of as short as 20 hours and as long as 4 days, but usually 2 days. The bug is passed via respiratory droplets (people coughing/sneezing around you) and from direct contact or touching (e.g., an infected child wipes his/her nose with his hand, touches a toy, then your child plays with the infected toy and later touches his/her own face).

Rhinovirus Treatment

In case you haven’t heard, there is no cure for the common cold. I’m working on it, but failing miserably. For now, treatment is all symptomatic. (See my article DECODING COUGH AND COLD MEDICATIONS for specifics.) As a quick reminder, rhinovirus is a virus and an antibiotic won’t help (since antibiotics only treat bacteria). So unless there is a complication (e.g., pneumonia, an ear infection), your doctor shouldn’t prescribe an antibiotic. In general:

  1. Treat fever, sore throat, and/or body aches with Tylenol (if over 2 months) or Motrin (if over 6 months)
  2. Run a humidifier
  3. Keep the nose as clear as possible
  4. Try OTC meds (depending on age of child and symptoms)
  5. Encourage fluids
  6. Rest
  7. Let time pass

Colds tend to go away on their own, so be patient. Rhinovirus typically lasts 7-10 days. Complications can happen (e.g., pneumonia, ear infections), but are uncommon. Complications tend to happen in children who are compromised in some way (e.g., have weakened immune systems, asthma). FYI, there is not a vaccine to prevent rhinovirus.

Rhinovirus Prevention:

  1. Wash your hands often
  2. Don’t touch your face (the virus enters through the mouth, nose, and eyes)
  3. Steer clear of sick people (if one of your children is sick, try to keep them away from the others as much as possible)
  4. Disinfect infected surfaces
  5. Improve your immune function (eat healthy, exercise, and sleep well)

Call your doctor if (because I’m worried about developing complications)

  1. Your sick child is under 2 months old (just about any bug under 2 months should be seen by a doc)
  2. The fever goes beyond 5 days or reoccurs (e.g., has been gone for 3 days and starts again)
  3. Any one of the symptoms is getting significantly worse when it should be getting better (e.g., after a week of coughing it should be gradually improving not getting worse)
  4. Your child is disproportionately symptomatic or miserable (e.g., a child shouldn’t cry inconsolably for hours with the common cold)
  5. Your child is having trouble breathing

Rhinovirus isn’t fun, but also isn’t the worst virus out there. If you or your child falls victim, take heart. It too shall pass.

Tips For Stopping A Bloody Nose

Most people have experienced a bloody nose. This time of year they are particularly common with allergy season. The nose gets irritated and easily bleeds from the picking and rubbing that ensues. Bloody noses are particularly common in Utah where the air is so dry.

There is a surprising amount of misinformation out there on how to handle bloody noses. Here are the quick facts:

How to stop a bloody nose:

  1. Firmly pinch the end of the nose, so the nose is completely closed. The idea is to apply pressure to the area that is bleeding so the body can make a clot. Pinching the bridge of the nose is just an old wives tale. (That would be like applying pressure in your armpit to get a cut on the forearm to stop bleeding. It’s better to apply the pressure to the cut itself).
  2. Sit straight up or slightly forward. You do not want the blood to drain down the throat. Better to spit out any blood than to swallow it. Blood in the stomach is nauseating. The last thing you need is vomiting to compound the situation.
  3. If the bleeding is profuse and won’t stop, apply something cold to the nose (just above where you are holding it closed). This will constrict the blood vessels and help slow the bleeding. An ice pack or bag of frozen peas works beautifully.
  4. Hold the nose firmly for a long time. When you stop holding your nose (to check to see if the bleeding stopped), and discover you’re still bleeding, then hold your nose twice as long the next time before checking again. For example, if you held your nose for 5 minutes but it continues to bleed, then hold it 10 minutes the next time before checking again.
  5. Don’t shove anything up the nose to create the clot (like a wad of toilet paper). Yes, it will act like a dam and temporarily stop it, but when you pull it out, you will likely pull out the clot and the nose will start bleeding again.
  6. Don’t blow the nose right after having had a bloody nose. Blowing will also disrupt the clot and start the bleeding again.

How to prevent a bloody nose:

  1. Don’t pick the nose. I know it sounds elementary, but nose picking is the number one reason kids get bloody noses.
  2. Run a humidifier in the room at night. Dried out nasal passages bleed easily.
  3. Treat nasal allergies.
  4. Lastly, apply a large glob of Vaseline with a Q-tip to the inside of the nose (just barely up the nose all around and on that first fleshy bump). I know it sounds disgusting, but it really works, especially if your child is having recurrent bloody noses out of the same side. Usually, there is a friable blood vessel that just needs a little TLC to get it to heal up.

The next time you or your child experiences a bloody nose, you’ll be able to handle it like an expert. Good luck!

Respiratory Bug (Coronavirus) Is Going Around

If you’re feeling like you’ve simply had enough of the miserable cough and cold bugs this season, you are in good company. I feel like it’s been a particularly bad season this year, and just when I think it is starting to let up, we’ve got a new bug on the forefront: Coronavirus.

Coronavirus is a common virus that causes mild-to-moderate upper respiratory illness. To date, there are 5 different Coronavirus strains that make people sick (that I’m aware of). The infamous SARS outbreak of 2003 and the Middle East Respiratory Syndrome (MERS) of 2012 are both Coronavirus strains. Fear not, the strain that we are seeing in our community right now though is not SARS or MERS. Random trivia, the virus is called Coronavirus because the little virions look like spikes on a crown under the microscope (take that piece of trivia to your next dinner party).

Coronavirus top 10 quick facts:

  1. Most people will get infected at some point in their life with Coronavirus.
  2. Young children are far more likely to get it.
  3. You can get infected over and over with it (there isn’t life-long immunity with it).
  4. Symptoms include: runny nose, cough, sore throat, and fever. (Kind of sounds like every other bug right?)
  5. It’s usually a fall and winter bug, which makes the outbreak in our community this time of year even more interesting.
  6. It’s easily spread from person-to-person through the air by coughing and sneezing, or via direct contact, like touching or shaking hands.
  7. There are no vaccines against it.
  8. Reduce transmission by frequently washing hands, staying away from sick people, and not touching your face.
  9. There is no cure. Treatment is all symptomatic (i.e., decongestants, humidifiers, fever medications, rest, fluids) until your body conquers the bug on its own.
  10. The diagnosis is made by a clinical test (swabs up the nose are easiest, but blood tests also exist). Most doctors don’t bother to test, since there isn’t a specific treatment anyhow and the test is costly, takes time, and isn’t comfortable.

Hopefully, you’ll manage to avoid this one, but in case you don’t, at least you’ll know what you’re up against. Stay healthy!