Fever and ARVI in children this fall: home care, when to see a doctor, and when to call 112

In the fall, kids catch colds more often: they go back to school and preschool and spend more time indoors, where viruses spread easily. Many parents know the pattern: a child seems perfectly well in the morning, and by evening has a runny nose, a cough, weakness, and a fever.

In the majority of cases, ARVI will run its course on its own and won't need any specific treatment at all. The parent's role is to know how to look after their child at home, when to call the pediatrician, and what symptoms to be concerned about.

Look at the temperature as well as the child's general state of health: how they're breathing, how much fluid they're taking in, how they respond to you, whether they're urinating as normal and whether they can carry on with their normal day.

Fever is a natural reaction to infection, so don't just look at the thermometer reading. Look at your child's breathing, their level of activity, their ability to drink, and any other symptoms. If their condition deteriorates or any of the warning signs emerge, then don't delay in getting them to see a doctor.

What are the symptoms of ARVI in children?

ARVI is a group of acute viral respiratory infections caused by a number of different viruses. The symptoms will therefore vary from child to child.

The most common symptoms include:

• Fever;

• A runny or blocked nose;

• A sore or scratchy throat;

• Cough;

• Weakness and sleepiness;

• Headache;

• Reduced appetite;

• Body aches;

• Sometimes vomiting or diarrhea.

Flu tends to start all at once, with fever and severe weakness appearing very rapidly. With a common cold, the symptoms tend to develop more gradually.

A rise in temperature is the body's natural response to infection. A temperature of 38°C or above would generally be regarded as a fever, but again you have to look at the child as a whole and not just the thermometer reading.

What to do at home if your child has a fever

If your child is generally well, can drink fluids, and is breathing comfortably, they can often be looked after at home with monitoring.

1. Make sure your child drinks enough fluids

When a child has a fever, they lose more fluids, so it's important to be offering them drinks regularly.

Suitable options include:

• Water;

• Fruit compote;

• Tea;

• Fruit drinks;

• Breast milk for infants;

• Other drinks your child is used to.

Don't give your child a lot to drink all at once. Offer small amounts more frequently.

Look out for the signs of dehydration: less frequent urination, dry lips and mouth, no tears when crying, and unusual tiredness or weakness.

2. Don't force your child to eat

Children often lose their appetite when they're unwell. If your child won't eat, don't force them.

In the first few days of illness, what matters most is that they drink enough fluids and stay comfortable. Their appetite will usually come back as they start to feel better.

3. Don't bundle your child up

If your child has a fever, don't dress them in lots of layers or pile on blankets.

Their clothes should be comfortable, and the room should be well ventilated.

Don't try to cool the child down quickly with cold water or cold sponging.

4. Measure the temperature correctly

It's best to use a digital thermometer and follow the instructions on it.

Record your child's temperature and the time it was taken especially if your child has been sick for several days. This will help you monitor the course of the illness and will be useful information for the doctor.

5. Don't give fever reducers just to change the number

If the child is reasonably well, then a high temperature doesn't necessarily need reducing.

Acetaminophen (paracetamol) or ibuprofen can be used if your child is unwell, in considerable discomfort or in pain. The dose must be the correct one for the child's age and weight, and you must follow the dosing instructions for that particular medicine.

Don't give aspirin to a child unless a doctor has specifically prescribed it. Don't alternate acetaminophen and ibuprofen on your own unless a doctor has told you to.

Should your child stay at home?

Yes. If your child has a fever and noticeable ARVI symptoms, it's best to keep them at home and give them the time they need to recover.

Your child can go back to their normal activities when their symptoms are improving, and they have been fever-free for at least 24 hours without the use of any fever-reducing medication.

This also helps to reduce the risk of infecting other children.

When should you contact your child's pediatrician?

An ambulance isn't always required. In many cases, contacting your pediatrician or family doctor is enough.

You should contact a doctor if:

• The fever lasts for several days;

• Your child's condition gradually worsens;

• The fever or cough returns after an improvement and becomes more severe;

• Your child is drinking poorly;

• Your child is urinating noticeably less than usual;

• The cough becomes more severe;

• Your child develops ear pain, chest pain, or a significant sore throat;

• Your child is unusually weak or sleepy;

• Your child has a chronic medical condition;

• Your child is very young, and you aren't sure how sick they are.

Younger children need medical advice sooner. For example, a baby under 3 months with a temperature of 38°C or above needs an urgent medical assessment.

When should you call 112?

Parents need to tell the difference between the usual course of ARVI and the signs of a potentially serious condition.

Call 112 in an emergency, for example, if your child:

• Has difficulty breathing or is breathing unusually fast;

• Has visible pulling in of the chest during breathing;

• Develops bluish lips or a bluish face;

• Barely responds to people around them or is difficult to wake;

• Has a seizure;

• Experiences severe chest pain;

• Cannot drink and shows signs of significant dehydration;

• Experiences a sudden deterioration in their condition;

• Develops a returning fever or a worsening cough after a short spell of improvement, with a general deterioration in their condition.

These symptoms can signal complications of a respiratory infection and require urgent medical attention.

If the child loses consciousness, has very difficult breathing, or develops any other serious symptoms, then do not attempt to treat them at home or wait for the fever to go away.

What to watch for in young children

Infants and young children can get worse faster than older kids, so watch their behavior, not just their temperature.

Warning signs include:

• Unusual weakness or lethargy;

• Difficulty waking the child;

• Poor response to parents;

• Refusal to drink or breastfeed;

• Significantly reduced urination;

• Breathing difficulties;

• Unusually pale, grey or bluish skin or lips.

In children under 5, doctors look at age, breathing, activity level, skin color, and signs of dehydration to assess the risk of serious illness.

What to do if your child has a bad cough

Coughing helps clear the airways, so there's no need to suppress it without a reason.

Parents should be aware of how their child is breathing between the coughing spells.

If your child is breathing comfortably, drinking fluids, can talk or play as usual, and the cough is gradually improving, then home monitoring may be adequate.

However, if your child is having difficulty breathing, appears to be choking or gasping, is breathing very rapidly, or has the chest pulling in on inspiration, then you should seek urgent medical attention.

Should you give antibiotics without a prescription?

No.

ARVI is viral. Antibiotics are for bacterial infections and are of no use against a virus. Don't give antibiotics on your own for a runny nose, a cough, or a fever.

If the doctor suspects a bacterial complication, they will look at your child and decide whether or not to treat.

How to keep the rest of the family from getting sick

It's hard to completely stop a virus from spreading at home, especially when a young child is sick. You can, however, reduce the risk to the rest of the family.

Helpful measures include:

• Washing hands regularly;

• Ventilating rooms;

• Giving the sick child their own towel;

• Regularly cleaning frequently touched surfaces;

• Limiting close contact with other people while the child is ill;

• Covering the mouth and nose when coughing or sneezing;

• Getting enough sleep and rest.

Fresh air and good hygiene also help reduce the spread of viruses.

Where to find a pediatrician

If your child has had a fever for several days or is showing the signs of an ARVI, then it is important to get medical advice as soon as possible. You can find a pediatrician or family doctor in Tbilisi via clinic websites and online doctor booking services. These allow you to search for a doctor, view their profile, and see what times they have available.

If you're at all worried about your child, then don't delay getting medical advice. If your child is having difficulty breathing, has a seizure, has lost consciousness, or is otherwise in any danger, then call 112.

Key points for parents

ARVI and fever are very common in the fall, and the vast majority of children will go on to recover with nothing more than home care and monitoring. Parents do not need to get the temperature down to normal at all costs.

It is much more important to monitor breathing, fluid intake, urination, activity levels, and how the child responds to their surroundings.

If you are unsure about your child's condition, contact a pediatrician. If your child develops severe breathing difficulties, altered consciousness, seizures, bluish skin, or other emergency warning signs, seek emergency medical assistance immediately.

This article is for informational purposes only and does not replace a medical examination. Infants, children with chronic medical conditions, and children with severe symptoms may need medical assessment sooner.