COUGHS & COLDS
A cold (locally known as “pilek”) is caused by
a virus that affects the nose and throat. It is the most common
infectious illness, especially for young children. Young children
may have 8 to 10 colds each year, with the highest number
usually being during the first two years in childcare or kindergarten
and school. A cold in itself is not serious but colds can
sometimes lead to other infections such as ear infections,
tonsillitis and bronchial infections.
WHAT IS A COLD?
A cold is an infection of the nose and throat usually caused
by a virus.
The most common signs of having a cold are sore throat, cough,
sneezing and a runny nose. They may have a fever but usually
their temperature is not very high.
What comes out of the nose is usually clear to start with,
then within about a day can become thicker, yellow and sometimes
green.
A blocked nose forces the child to breathe through the mouth
and this makes the throat dry and it feels more sore.
Usually children with colds don’t feel well. They may
have a headache and not want to eat much. Some children may
vomit and have diarrhea as well.
A blocked nose can be the most difficult part of a cold, especially
for babies because it makes it hard for them to feed and sleep.
(Babies are programmed to “nose breath” it is
very difficult for them to breath through their mouth. This
is why feeding becomes uncomfortable for babies with blocked
noses).
WHAT CAUSES A COLD?
Colds are can be caused by one of more than 200 different
viruses. This explains why people get so many colds, because
there are so many different infections to catch. The same
viruses sometimes lead to other illnesses such as sinusitis,
bronchiolitis, croup, or asthma.
WHAT ELSE CAN ‘LOOK LIKE ‘ A COLD?
Something stuck in the nose can cause a blocked nose or a
runny nose, but it is usually only on one side.
Hay fever causes sneezing and a runny nose (usually with itchy
eyes as well).
Influenza (or “flu”) causes children to feel ill
with headache, body aches and a raised temperature, often
without a blocked, runny nose.
ALERT! A doctor should see a child if the child seems unwell
& has a high temperature (over about 39 degrees Celsius)
that lasts more than a day or two, is short of breath, coughs
a lot, seems tired, is vomiting, or is in pain (e.g. from
ear ache).
Any child who suddenly starts to cough without being unwell
first, may have breathed something into the airways (choking)
and should be seen by a doctor. A child with a one-sided runny
or blocked nose may have something stuck in the nose and also
should be seen by a doctor.
CAN YOU PREVENT COLDS?
The time when people with colds are most likely to give them
to someone else is in the first 2 to 4 days after the cold
starts, especially when the person is sneezing, coughing or
has a very runny nose.
Colds are spread by little drops in the air from coughing
or sneezing, or by touching the nose or mouth of someone with
a cold and then touching your own nose or mouth, or after
touching something the person has coughed or sneezed onto.
Since colds are everywhere it is almost impossible to stop
getting a cold, but there are some things which may help.
Try not to let people with colds come too close. If anyone
has a cold, they should try not to pass it on. They should
stay home from childcare, school or work whenever possible.
Wash your own and children’s hands, especially after
coughing, sneezing or blowing noses and before eating.
Teach children and pembantus to cover their nose and mouth
when coughing or sneezing. They need to wash their hands straight
afterwards.
Use tissues, which are used once and then thrown in the bin,
instead of handkerchiefs. Discourage your staff and members
of the household from spitting or “open nose blowing”.
If this proves to be a problem provide a spit pot (spittoon),
which can be appropriately disinfected or disposed of.
There are no immunizations against colds, because of all of
the different viruses that cause them, and there are not likely
to be immunizations in the near future. The “Flu”
vaccine does not protect against the common cold but rather
certain strains of the Influenza virus
Eating healthy food seems to help, but even very healthy people
can get colds.
Extra zinc and Vitamin C may be of value. It seems that it
may shorten the time a cold lasts by a small amount. It does
not do any harm unless you take very large doses.
If a person has been near another person who has a cold, taking
Echinacea might prevent a cold developing. It also might be
useful in the very early stages of a cold, making recovery
quicker.
The air passages and lungs of babies and children are smaller,
more delicate and sensitive to the effects of the chemicals
in the tobacco smoke if they are around people who smoke.
Tobacco smoke irritates eyes, nasal passages and increases
the risk of catching more frequent colds and respiratory illnesses.
WHAT YOU CAN DO FOR A COLD
No treatment will cure a cold, or make it go away more quickly,
but you can help the patient feel more comfortable.
Rest (need not be in bed), and comforting are important.
Drinks. Extra fluids should be given. If a child doesn’t
want to drink much, try giving lots of small sips of water,
milk or juice.
Food. Most people will lose their appetite for a couple of
days. This is not important. They will put back any lost weight
quickly when they are well again. It is not necessary to ‘feed
a cold’.
Paracetamol for a high fever (over about 38.5°C), sore
throat or painful ears, can help the patient feel more comfortable.
Do not give aspirin to a child or young person under the age
of 15 years, especially during a cold, since it may cause
a rare but very serious illness called Reye’s syndrome.
Antibiotics are generally over prescribed by the local clinics.
Antibiotics cannot cure a cold because it is a viral infection,
and they do not seem to stop children from getting asthma,
ear infections, or sinusitis.
BLOCKED NOSE.
Decongestant medicines may be useful for some, but they can
have upsetting side effects such as irritability, restlessness,
difficulty with sleeping, or drowsiness depending on which
is used. Decongestant medicines do not seem to prevent ear
infections. Nose sprays may be helpful for adults and older
children, they make the nose less runny and “stuffy”
Nose sprays should not be used for longer than 2 –3
days.
Children are not able to learn how to blow their nose before
they are about 4 years old, so they will need help to wipe
their nose. If the end of the nose becomes red and sore, petroleum
jelly (vaseline) smeared lightly around the nostrils can soothe.
Saline nose drops may be helpful for babies (get them already
made up from the chemist). A nasal sucker (available from
most chemists or department stores) can also help very young
babies clear the nasal passages. Use them before a feed or
before putting the baby down to sleep. Other nose drops may
be helpful for young children, but this needs to be discussed
with a doctor or chemist, because nose drops and sprays made
for older children and adults can be harmful for young children.
Vapor rubs that are rubbed onto the skin can be soothing and
help to open up the nasal passages. An old Balinese remedy
of lightly rubbing the juice of a small red onion beside the
nose and on the forehead is actually very effective in opening
up the nasal passages. Naturally avoid the eye area.
COUGH
Cough syrups are many and varied. Over the counter preparations
are baffling concoctions that claim to be the cure all for
any cough. Often the ingredients can oppose each other rendering
them useless. These are some good general guidelines for treating
a cough.
To suppress a “useless” aggravating dry cough
a syrup containing dextromethorphan is useful. This is present
in many of the cough mixtures that are available at your supermarket
or drug store.
If the cough is “wet” a steam inhalation is the
best treatment to liquefy the secretions. Care must be taken
when using steam with children. Often a steamy bathroom will
do the trick in this case.
For coughs that originate from a tickle in the throat, lozenges
that contain a local anesthetic agent (e.g. Tusselix cough
silencer lozenges) will help. Unfortunately these are not
available in Bali.
For coughs that cause broncho-constriction (tightness in the
chest) and wheezing, a broncho dilator should be used. A doctor
must assess and prescribe in this case.
Any person with a persistent cough should be assessed for
Tuberculosis. Even those who have received the Tuberculosis
vaccine are still susceptible to the disease (the vaccine
is about 60 – 70 % effective).
SORE THROAT
If the child has a very sore throat (does not want to eat
or drink for example), this could be tonsillitis and the child
needs to be seen by a doctor. For a mild sore throat, extra
cool drinks and some paracetamol may help. Locally available
lozenges such as “Degirol” or “FG Trochees”
can be very soothing.Do not give hard cough or throat lollies
to young children (e.g. under the age of about 5 years) because
of the risk of choking.
EYES
If eyes are slightly sticky in the morning, clean with clean
damp cotton wool balls. Use sterile water (e.g. aqua), and
a fresh wipe for each eye.
If they have a discharge or the eyes are red, see a doctor,
as this may be conjunctivitis.
WHEN TO SEE A DOCTOR
Any person who is still quite unwell after about 3 to 4 days,
who has a high fever (e.g. over about 38.5°C) which goes
for more than 24-48 hours, or who becomes more unwell, or
shows signs of pain (e.g. Vomiting, not drinking, shortness
of breath, pain when breathing, unusual sleepiness or crying,
a lot of coughing, difficulty hearing are all signs that the
child needs to be seen by a doctor.
PLANE TRAVELLING WITH COLDS
Try to avoid if possible taking any child who has a cold on
a plane trip, because the fall in air pressure can cause severe
ear problems and pain.
If you have to take a child with a cold, see a doctor before
the trip.
If the child or adult has had a recent cold, using decongestant
nose sprays, drops or medications 15 to 20 minutes before
takeoff and landing may help.
Until next edition stay happy, stay healthy and stay young!……..
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
