Jaime Lewis (Host): This time of year, kids are heading back to school where germs and viruses have an ideal indoor environment in which to spread. While the winter months are usually peak time for illnesses, doctors say sickness season in many places is already well underway. Well, today I'm speaking with Pediatrician and Internist Dr. Christopher Wright from Le Bonheur Pediatrics to discuss how parents can prepare for this tricky time of year. This is the PedsPod by Le Bonheur Children's Hospital. I'm Jaime Lewis. Dr. Wright, thank you for joining us.

Christopher Wright, MD: Thank you so much for having me, Jaime. It's a pleasure.

Host: Well, is it just me, or does it seem like common illnesses, even COVID and RSV, are showing up sooner in the school year? Are you seeing children get sick earlier than usual?

Christopher Wright, MD: Well, I think the last few years in general have been kind of interesting for all of us, and that's probably an understatement of the year. Uh, but I think a lot of times we've been noticing that children seem to get sick more quickly in the season, especially with the back to school season. I especially have noticed a lot of years flu seems to have a really early peak, which is kind of surprising to us.

And I think it's kind of happening this year as well. Sometimes I think it's related maybe to how a lot of illnesses didn't circulate as much a couple of years ago at the start of the pandemic. And now we may be a little more quick to get ill with certain common illnesses.

Host: Well, what are some of those illnesses and symptoms that are bringing families into the doctor's office?

Christopher Wright, MD: It seems like we've had a little bit of all of the kinds of illnesses. I've seen definitely, as I think some of the news has covered, something of a moderate COVID wave, both with the adults I take care of and the children I take care of, but there's all the other run of the mill things too, like viral respiratory infections that we don't have a test for, or stomach viruses.

Maybe a little less strep throat lately, but a lot of the things that we often see all throughout the year coming up at this time of the year as well.

Host: I'm thinking back on when my grandparents told me that weather contributed to illness. Like if it rains, you're gonna wind up getting a cold. Does weather cause illness?

Christopher Wright, MD: I wouldn't say necessarily weather is the direct cause of illness, but it certainly seems to influence it in some ways. One of the things we often wonder about how weather might affect when people get sick is the cold weather, or sometimes in the summer, the hot weather can push us together, where we're inside, where it's warm, or where we've got the air conditioning.

Others also suggest that sometimes the cold weather can dry out our nasal passages and our airways, making our immune system not work as well and increasing the odds of us getting infected or maybe we don't sleep as well during the winter, or even the droplets that sometimes share germs across the room from one person to another are more stable in the dry, cold weather.

And it's probably a mix of these things and maybe some other things that aren't at the forefront. I think also non infectious illnesses can get worse with the weather too. I expect to always see a small surge in children suffering with an asthma flare up when the weather changes from hot to cold, or allergy season affecting asthma, or allergies to flare up. So it's a lot of different things coming together to affect when we all get sick.

Host: Well, here's a massive question. How can parents stay vigilant and keep their kids healthy?

Christopher Wright, MD: You know, that's a great question. And it's something that, you know, I think it's important for us to realize we live in this world that has a lot of germs and I always want to make sure we do our best to live full lives. But I think things that are easy for us to make sure to do is the thing they always tell you, wash your hands. And I think the recommendation is about 20 seconds, which is how long it takes to sing happy birthday. And we always tell people, cover your nose and mouth when you cough, stay away from others when you're sick, but those things aren't perfect. And so that's important to remember. I think good sleep helps our immune system stay strong and eating a healthy diet.

And I know that, you know, there's a lot of memories a lot of us have with masks and I think they're neither a force field against illness, but they can sometimes be a helpful tool in the right situation. Maybe if someone's sick at home, especially if the person who's sick is interested in trying to reduce the odds of them getting their family members sick. But all those things can help, but nothing is perfect.

Host: Right. For those runny noses, the sniffles, the coughs, what are some of the best ways to treat your child's symptoms at home?

Christopher Wright, MD: So, unfortunately, some of the challenges are that a lot of the over the counter treatments we have for these symptoms aren't perfect. I think sometimes the reason we see a lot of different medications treating similar symptoms over the counter is no one medication is dramatically superior to all the other ones.

Most of the time, runny nose and sniffles that we see from viral infections or colds, there's not a lot of great options we have to dry that up. That's a lot of times the inflammation from the immune system getting rid of the infection. Most of the over the counter decongestants that we think about a lot of times don't have as much efficacy against that as we might like.

The FDA actually finally acknowledged that phenylephrine, one of the decongestants in most over the counter decongestants don't work very well and doesn't actually work better than placebo and it's also not safe for young children. For allergic sniffles, of course, we have antihistamines and the nose steroid sprays that people can get the counter, that can be quite effective.

For cough, it depends on age. Young children need to cough to keep their airway open, to reduce the risk of developing pneumonia, and even more than older adults can't safely use most over the counter cough preparations, so if there's a question, always call your pediatrician, but most over the counter cough preparations for this age group are designed to soothe the throat for young children and not so much for suppressing the cough reflex.

It's important to always read those packages. I think for older children, my favorite cough active ingredient in over the counter medications is dextromethorphan. That's usually six and up for otherwise healthy children, but it's important to consult your pediatrician with you when you're unsure.

Host: All right. So you're sort of already answering my question, but when is it important for a parent to call their pediatrician rather than say Googling or taking matters into their own hands? When do they need a physician?

Christopher Wright, MD: I think the short answer is whenever you are concerned, that's why we're here. Part of the word doctor, it means to teach. And so sometimes our job is to guide people when they need some guidance on how best to take care of their child. So I tell parents to trust their instincts. And if they feel something's not right, give us a call and we'll figure out what we need to do.

But some things that I especially would want to know about for one of my patients is if the child is having high fevers that don't respond very well to fever reducing medications, difficulty rousing their child, concerns about their breathing or dehydration, difficulty urinating or unable to liquids down and stay hydrated if they've got a stomach illness, things that most of us, I think, would always want to call for the pediatrician, but things that especially we don't want to ignore if they could turn into something more serious.

Host: Well, Dr. Wright, thank you so much for your expertise. I appreciate it.

Christopher Wright, MD: Thank you so much. It's always a privilege.

Host: That was Dr. Christopher Wright, Pediatrician and Internist at Le Bonheur Children's Hospital. Want to learn more from experts on the PedsPod? Visit lebonheur.org, click on News and Events, and scroll down to Podcast.