Upper Respiratory Tract Diseases (URTI)

What Are Upper Respiratory Tract Diseases?

Most winter illnesses are infections, that is, microbial diseases. They occur as a result of colder weather in the winter months, increased air pollution, living in crowded and cramped environments, and the constant transmission of colds, to which children in particular are exposed. In winter, in addition to upper respiratory tract infections such as the common cold, throat infections, sinusitis and laryngitis, lower respiratory tract infections such as bronchitis and pneumonia also increase in children.

These viruses spread quickly as the weather cools because they can stay alive for up to 48-72 hours even on inanimate surfaces. Viruses can be transmitted by direct contact or by droplets. Viral particles remain suspended in the air in the form of droplets when a person sneezes, coughs or even just breathes. Each virus has a different particle size. Viruses with small particles can reach the lower airways much more easily.

While a five-year-old child may get through viral infections in winter as a simple upper respiratory tract infection, a newborn baby may get through the illness as bronchitis or pneumonia. Because the immune system of newborns is not yet developed, they need to be protected more carefully. People with immune problems and allergies are at somewhat greater risk for lower and upper respiratory tract diseases. In children with allergies, the airways narrow and become blocked, and bacterial and viral colonization can occur very easily on top of this.

Knowing the diseases well, knowing the facts about antibiotic use, avoiding unnecessary medication, and learning how to measure and reduce fever make this period easier for both the child and the family. 

You can look at the Respiratory Tract PCR Test Panel performed in our laboratory. This way you can find out which microorganism is causing the illness.

The Most Common Diseases Are as Follows;

-Rhinitis (Common Cold)

Rhinitis, known as the common cold (coryza), is a disease that affects the upper respiratory tract, especially the nose. It is considered normal for school-age children to have this illness an average of 3-5 times a year. The disease is caused by viruses and is spread by droplets, that is, saliva particles released into the environment during sneezing or coughing. These droplets both spread into the environment and are transmitted by contact after landing on hands and objects.

-Influenza (Flu)

Influenza is caused by viruses called “influenza viruses”. Flu germs are transmitted by droplets and spread through coughing and sneezing. Symptoms vary according to the type of virus. In some cases the illness can be somewhat more severe and the child feels sicker.

-Middle Ear Infection (Otitis)

With upper respiratory tract diseases, nasal congestion also affects the ear, and an infection usually develops in the middle ear. The infection causes pain and fever. It is the most common group of diseases in childhood after the common cold and influenza. Two thirds of children up to three years of age have at least one middle ear infection. This frequency decreases after the age of 10.

Middle ear infection is one of the most important causes of school absence. This condition needs to be taken seriously because of the danger of causing hearing loss. Middle ear infections, which often occur because of colds and flu infections, can also be caused by enlarged adenoids and by the Eustachian tube, the ventilation tube of the middle ear, being shorter, straighter and wider.

-Sinusitis

Inflammation of the air-filled cavities within the frontal bone, the upper jaw bone and the bones around the nose is called sinusitis. It is known that 6-13 percent of children up to three years of age have sinusitis. When children have an upper respiratory tract infection and their resistance drops, these infections block the small channels leading to the cavities that provide ventilation within the mouth. Nasal congestion, runny nose, swollen tonsils in the throat and pharyngitis prevent the sinuses from being ventilated. As a result, infection develops in the closed spaces.

-Pharyngitis 

Pharyngitis is one of the most common diseases in winter. Although it is mostly of viral origin, it can also be bacterial. It occurs when the body's resistance cannot overcome the common cold.

-Acute Pharyngitis (Tonsillitis)

Transmitted by droplets, acute pharyngitis begins with cough, runny nose, fever and weakness. The complaints gradually increase and the child's general condition deteriorates.  If it is not treated on time and correctly, it can lead to a middle ear infection related to the tonsils, and, if the infection is caused by streptococci (a type of contagious germ found mostly in the tonsils), to rheumatic heart disease.

-Laryngitis

Laryngitis, croup It refers to inflammation of the larynx in the throat region.

-Bronchiolitis

This disease, in which the infection affects the small distal airways, is seen mostly in children between 6 months and 2 years of age.

-Bronchitis

This common disease usually occurs when the viruses that cause upper respiratory tract infections settle in the main bronchi. Therefore, although very rarely, a simple upper respiratory tract infection can turn into bronchitis within days.

-Pneumonia

Pneumonia, which can be defined as the filling of the air sacs in the lungs with an inflammatory fluid, is seen mostly in children with heart disease or a previous lung disease, and in premature births. In pneumonia, a disease transmitted by viruses or bacteria, the child has serious respiratory distress and looks ill. If bacteria cause the disease, antibiotics are required.

Points to Consider in Respiratory Tract Diseases in Children

1. The child should drink plenty of fluids such as fresh fruit juices and herbal teas, and be soothed with a lukewarm bath. It is recommended not to force a child who has no appetite during this period to eat
2. Ventilating and keeping the environment cool as much as possible and taking the child outdoors also speeds up the recovery process
3. A sick child should not be sent to school. School administrations and families should show the necessary sensitivity on this issue
4. No one should smoke in the home
5. Viral infections begin to improve within 3-5 days
6. If no improvement is seen, a doctor must be consulted.

What Are the Symptoms of Upper Respiratory Tract Diseases?

-Rhinitis (Common Cold)

Symptoms of rhinitis appear 12-36 hours after the virus enters the body. In addition to these symptoms, which can be listed as runny nose and nasal congestion, sneezing, burning in the throat, dry cough, headache and sore throat, weakness and mild fever, burning, watering and redness of the eyes may also be seen.

-Influenza (Flu)

In the disease caused by viruses, the picture is somewhat more severe than in the common cold. Chills, high fever, headache and muscle aches may be seen. The headache increases with eye movements. A fever above 38.5 degrees usually lasts three days, and may be seen to last up to eight days. Due to influenza, complaints of chest pain, nausea, vomiting and abdominal pain also occur in the child.

-Middle Ear Infection (Otitis)

Edema caused by microbial infections leads to fluid accumulation in the ear and pain. Ear pain and discharge, and hearing loss accompanied by fever may be seen.

-Sinusitis

The sinuses produce different findings depending on where they are located. But the main symptom is pain caused by pressure above the eyes, at the sides of the nose and below the eyes. A localized headache may be accompanied by a change in tone of voice, fever, cough and postnasal drip.

-Pharyngitis

Dry cough, sore throat, a burning sensation in the throat, and mild fever are seen. If complaints such as fever, a burning sensation in the throat and difficulty swallowing continue after three days, a doctor must be consulted to investigate whether there is a bacterial infection.

-Acute Pharyngitis (Tonsillitis)

In tonsillitis, all or several of the following symptoms may be present;

1. Fever (may reach 39-40 degrees), chills, shivering
2. Swollen, red tonsils
3. Ear pain
4. Sore throat
5. Difficulty, pain or discomfort when swallowing
6. Weakness, malaise, widespread body aches, joint pain
7. Swelling, tenderness and pain in the lymph nodes in the neck
8. Headache  
9. Loss of appetite
10. Bad breath
11. Voice changes

In Children, in Addition to These Symptoms

1. Nausea
2. Vomiting
3. Abdominal pain may also accompany them.

-Laryngitis

A suddenly starting hoarse, barking cough, hoarseness and a coarse, deep voice are among its most typical symptoms.

-Bronchiolitis

Breathing becomes faster and wheezy, the cough increases, and the nose becomes blocked. Fever may not be seen, depending on the child's resistance to the virus.

-Bronchitis

In older children it presents with heavy phlegm, wheezy, rapid breathing and coughing fits. Fever usually does not exceed 38 degrees. The diagnosis is made according to the child's clinical picture and X-ray images.

-Pneumonia

The incidence of pneumonia increases especially as the weather gets colder. Put simply, the symptoms of this disease are the same as those of other upper respiratory tract infections. 

Cough, fever, chills, headache, weakness, abdominal pain and abdominal bloating are seen. However, the cough is more severe and productive, and the fever follows a higher and more persistent course.

Treatment Methods for Upper Respiratory Tract Diseases

The treatment methods for the most common diseases are as follows;

-Rhinitis (Common Cold)

There is no specific treatment for the disease. Medications directed at the symptoms are given. If there is pain and fever, over-the-counter syrups can be used.

When fever accompanies a cold, fever reducers that are not harmful to young children can be given. Saline drops or sprays may be preferred for runny nose and congestion. In such conditions, in which antibiotics are useless, the child needs to drink plenty of fluids and rest.

-Influenza (Flu)

It is recommended that the flu vaccine be given every year before the flu season starts, in October-November. However, if delayed, it is still beneficial to have it done until March. If it is being given for the first time, two doses are given one month apart; if it has been given in previous years, it is given once.

For the flu vaccine, a half dose is given between six months and three years of age, and a full dose to older children. An egg allergy is not an obstacle to the flu vaccine; only people who have previously had a severe allergic reaction to the vaccine itself should consult a physician before vaccination.

-Middle Ear Infection (Otitis)

Antibiotics are known to be effective in treatment. Its complications are very important because it can cause permanent deafness or infections of neighboring organs. Most cases of otitis resolve on their own; complications such as mastoiditis are rare but serious, so see a physician if swelling appears behind the ear.

-Sinusitis

If symptoms last longer than three days and are severe, antibiotics may be recommended. If sinusitis is not treated or an adequate dose of medication is not taken, as in middle ear infection, there is a risk of meningitis because the sinuses are adjacent to the brain and the organs inside the skull. It needs to be treated so that it does not pave the way for infections of neighboring organs.

-Pharyngitis and Acute Pharyngitis (Tonsillitis)

Most cases of pharyngitis are viral; antibiotics are given only for group A streptococcal infection confirmed by testing.

-Laryngitis

Cold steam therapy is used. Because vocal cord inflammation causes difficulty breathing, a physician must be consulted. In moderate and advanced stages, treatment with cortisone-containing medication may be given. Rarely, antibiotic treatment may be needed.

-Bronchiolitis

This infection, caused especially by the RSV virus in winter, resolves within 4-5 days. However, because their immune systems are weak, young children become vulnerable to bacterial infections as well in such cases. Sick children need to be monitored closely.

-Bronchitis

There is no specific treatment. It usually resolves on its own. Expectorants and bronchodilators may be used. Medical supervision is essential. In children whose general condition worsens during the clinical course or whose signs of recovery are delayed (if pneumonia is suspected), antibiotic support is used.

-Pneumonia 

If there are signs of respiratory failure, treatment is always carried out in hospital. However, if the patient's general condition and clinical findings are suitable, the patient can be followed at home with check-ups at certain intervals.