NEWARK, NJ --- Fall and winter are the peak seasons for childhood respiratory infections such as nasal congestion, coughing and wheezing. During this season, parents should pay special attention to a child who has persistent or lingering cough after a 'cold' or has frequently recurring episodes of respiratory symptoms. The possibility of asthma should be strongly considered, according to Sushmita Mikkileni, MD, director, Division of Pediatric Pulmonology at Children's Hospital of New Jersey at Newark Beth Israel Medical Center.
With asthma as the most common childhood disorder, responsible for missed school days and hospitalizations, Dr. Mikkileni points out that many children suffer frequent and repeated respiratory problems often mistaken for common cold symptoms, before being diagnosed with asthma and receiving the correct treatment.
"Most people think of asthma as an illness associated only with wheezing. Asthma often conjures up an image of a person clutching at their throats in severe respiratory distress." Although these symptoms may occur in severe asthma, the majority of people have mild to moderate asthma, she says.
The most common symptom of asthma is coughing. In fact, coughing can be the only symptom of asthma in children, explains Dr. Mikkileni. "Coughing and/or wheezing after exercise or at night are other symptoms associated with asthma. Besides respiratory infections, allergies can also trigger asthma."
Research shows that household pets, particularly cats and dogs, and dust, cockroaches and rodents also can pose a year-round trigger for asthma. Ragweed pollen and mold spores are common triggers in the fall, whereas grass and trees can trigger spring allergies. Cold air and exercise, considered nonspecific factors, can trigger asthma symptoms as well. And smoke is an irritant which makes asthma worse.
"All asthma triggers cause inflammation of the airway lining - an increased mucous production that blocks the airway, causing spasms of the muscles surrounding the airway. This squeezes the airway lining shut," says Dr. Mikkelini. "Coughing, wheezing and shortness of breath are caused only when there is a lot of blockage of the airways. But even if there are no symptoms, it is possible to have ongoing inflammation of the lungs."
Anti-inflammatory medications must be taken regularly to control
inflammation and asthma symptoms even if a child is symptom-free. "Once
asthma is diagnosed, if a child has daytime asthma symptoms more
than twice a week or nighttime symptoms more than twice a month,
regular use of anti-inflammatory medications is recommended," she
advises. "Bronchodilator medications are used to relieve blockage,
only when the child has worsening of symptoms. In addition to taking
medications, avoidance of triggers is important in managing asthma."
For children affected by asthma, parents and physicians must work together to develop and follow a written plan for managing asthma on a daily basis as well as during flare ups. It is important to know the medications prescribed and why they are prescribed. "Being empowered to manage one's own (or your child's) disease improves quality of life for the entire family," concludes Dr. Mikkileni.
For more information on pediatric asthma care, call Children's Hospital of New Jersey at Newark Beth Israel Medical Center at 1 800 THE-BETH. You can also visit The Pediatric/Adult Asthma Coalition of New Jersey website at http://www.pacnj.org.
Newark Beth Israel Medical Center, an affiliate of the Saint Barnabas Health Care System, is a 673-bed regional referral teaching hospital with specialized programs including heart and kidney transplantation, cardiac surgery, robotic surgery, oncology, and maternal/child health services. Children's Hospital of New Jersey is the state's premier hospital caring for children with specialized services to treat ill and injured children from newborn through adolescent years, including more than 30 pediatric specialties.
Date: March, 2006
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