Managing Troublesome Cough in Children
I had an opportunity to listen to Dr Arnel Gerald Q. Jiao, a distinguished Pediatric Pulmonologist and he tackled this topic of great interest. The lecture was at Hotel Luna in Vigan, Ilocos Sur on September 12, 2024.
Cough is one among the common reasons why children are brought to clinic for consultations. And even after treatment, cough still persists.
Dr Jiao said that this is a case of a post-infectious/post viral cough. A cough that persists more than 3 weeks after URTI symptoms and this is due to an extensive inflammation and disruption of the airway epithelial integrity. This could last up to 8 weeks.
The pediatric population has a possibility of 6-8 upper respiratory infection/year and may be monthly in 10% of children.
Dr Jiao pointed out that the presence of a yellow or green nasal discharges or sputum does not automatically classify the condition to be bacterial in origin.
So, it is more important to be seen and to be assessed by a physician.
Recently, we have observed that cases of respiratory infection has overwhelmingly increased and this could be explained by the following:
1. Immunity Debt/ immunity gap
– because of the pandemic and children are not exposed to infections, there is lack of immune stimulation , decrease in herd immunity thus resulting to frequent infections
2. Immunity Theft
– children exposed to Covid 19 infection has acute and long term immune dysfunction
Another troublesome cough in children is associated with allergic rhinitis.
Dr Arnel Jiao stressed that cough associated with the following are usually allergic rhinitis:
– the eyes are involved
( itchy, watery)
– itching is noticeable
( allergic salute/ allergic crease)
– allergen exposure causes the symptoms
– personal or family history of allergies
– associated with asthma and atopic eczema
Cough has many etiologies. Children should be brought to a physician for history, for Physical examination and for laboratories if needed so that proper management and treatment can be instituted.
Parents should avoid self medication.