What is croup?
The infection of the voice box (larynx) and windpipe (trachea) is called a croup. The upper and lower portions of the breathing tube that joins the mouth to the top of the lungs are called the larynx and trachea, respectively. Viral infection is the cause of croup.
Croup is mostly seen in young children with age groups between 6 months and 3 years. Two or more bouts of croup are seen in some children.
Is Croup contagious or not?
Croup commonly occurs in winter in outbreaks or epidemics. Croup is contagious. It is a viral infection that spreads from person to person with close contact.
Is croup seen only in children?
After the age of six, croup is often less frequent. The same infections can infect older children, but it does not cause any croup as the breathing tube becomes stronger and wider.
Symptoms of croup
Some of the symptoms of croup include:
- Cough (Barking cough)
- Breathing problems
- Other symptoms like runny nose, hoarse voice, sore throat, etc.
A rough and barking cough is typically present due to laryngeal vocal cord enlargement and inflammation.
Inflammation is caused by the infection on the inside lining of the breathing tube, and a lot of thick mucus may also be seen, due to which there will be a narrowing of the breathing tube. It will be difficult to breathe if the narrowing becomes worse. Stridor, which is a noisy breathing sound, may be caused by the narrowed tube.
Other symptoms of croup may include a runny nose, hoarse voice, and sore throat. In certain situations, a cold may also be a symptom that manifests itself without any prior disease. In addition, there may be other cold- or flu-like symptoms such as high temperature (fever), feeling sick, not eating, and general aches and pains.
Croupy cough and cold symptoms may be seen during the daytime, which is not so severe, but the symptoms worsen at night. After 1-3 days, symptoms will peak and then improve. For a week or so, mild and irritating cough may last.
Rarely symptoms may occur in teenagers or adults. A virus infection that causes croup in young children may give an older kid or adult a cough or sore throat, but it is unlikely to cause the respiratory symptoms of croup.
Is croup considered a serious illness?
Mild symptoms are seen which sometimes become severe. Most of the children recover soon. Croup cough and cold symptoms are seen in most children. Mild breathing difficulty is also seen. One or two nights could be difficult for parents to nurse their kids due to cough.
Breathing can become difficult if severe narrowing of the breathing tube develops. If there is a narrowing of the breathing tube, then the child should get hospitalized. Usually, children admitted will be discharged within 24 hours as the symptoms improve quickly and, in some cases, children might need ventilator support to breathe for a short period till the inflammation and infection settle down. One in ten children with croup is admitted to the hospital for observation.
When is the medical help needed?
Seek a Paediatrician’s help if:
- The breathing symptoms get worse.
- (A). Rapid breathing.
- (B). Putting effort to breathe – with each breath, you may see the child’s chest or neck muscles being pulled in.
- The child becomes agitated or restless.
- The child looks unusually pale.
- If the temperature is high(fever).
- Child becomes blue.
- Usually sleepy child.
- Severe difficulty in breathing.
- Unable to swallow and drooling.
Treatment of croup
Always consult a Paediatrician if you have any concerns about your child. A doctor will advise on the treatment and need for hospitalization. The doctor may advise you to:
- Be calm and reassuring: Due to croup, the child may become distressed and cry. Make the child sit upright on your lap. Let the child find a comfortable position.
- Control high temperature(fever): The child may be more agitated and ill if the child has a fever, because of which breathing is often faster. To lower a fever, give paracetamol syrup.
- 1. Give cool drinks if the child is happy with them.
- 2. Cool air: Have a stroll outdoors, carrying the child upright in the cool fresh air as some people find helpful.
Things that should not be done:
- Cough medicines should not be given which contain ingredients that can make a child drowsy. For the child who may need extra effort to breathe, this may not help. Cough suppressants and decongestants have no proven benefit for treating croup. For children less than the age of 6 years, cough medicines are not suitable.
- As croup is caused by viruses, antibiotic medicines are not usually prescribed. Antibiotics do not kill viruses.
- Steam is not recommended as some children have been scalded by steam. It was thought it might loosen the mucus and make it easier to breathe.
- Do not attempt to examine the child's throat on your own. Let the doctor decide whether to examine the child’s throat or not as symptoms of croup may be rare due to a condition called epiglottis which causes swelling and could be dangerous by looking into the throat.
- A child with breathing difficulty should not be laid down or drink fluids if they don't want to, as this may increase their breathing difficulty.
Other treatment options:
Dexamethasone, which is a steroid medicine, is usually prescribed to reduce inflammation. Symptoms frequently subside with a single dose within a few hours. Illness is not shortened due to steroid medicines but helps in reducing the severity of breathing symptoms.
For moderate or severe difficulty with breathing, inhaled adrenaline(epinephrine) is used sometimes in the hospital, which helps in decreasing the swelling of the windpipe(trachea). Inhaled adrenaline (epinephrine) often improves croup symptoms within 30 minutes. Usually, after two hours of the treatment, the improvement disappears.
Croup causes mild symptoms that get better quickly, and sometimes the symptoms can be more serious, including problems with breathing. If there is difficulty with breathing, then hospitalization may be needed. Your child should consult a Paediatrician if you are worried.