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About children’s immunity, frequent acute respiratory viral infections and the treatment of diseases

Winter is a traditional peak in the incidence of SARS and influenza, and not only among children who go to kindergarten and school, but also among adults. The Village asked the immunologist Umar Khasanov the most common questions that worry parents: why does one child get sick often and the other rarely, is there a reliable prevention of SARS, which means the color of the discharge from the nose, is it worth worrying about coughing people in vehicles when antibiotics are needed.
The question that concerns almost all parents of kindergarteners: is it normal to get sick twice a month?
Watching how to get sick. If the disease proceeds without bacterial and fungal complications, nasal congestion and coughing lasts no more than two weeks, the child looks healthy outside the disease, the pediatrician did not reveal chronic diseases associated with an increased tendency to infections, then the norm. Often, parents consider constant illnesses a long runny nose, snoring in a dream, and coughing for several weeks without fever. There is even a myth that if the temperature does not rise, then something is wrong with the immune system. In fact, in the vast majority of cases, it is allergic (but often non-allergic) rhinitis, so it is necessary to examine the child for differential diagnosis and the selection of the right therapy.

It is also very important to pay attention to the frequency of the disease. For example, a child may have fever day after day every month. If there is periodicity, then it is necessary to exclude Marshall syndrome, periodic disease, hyper-IgD syndrome and some other auto-inflammatory diseases. With such a fever, it rarely puts a nose up or a cough appears.
Why do some children get sick constantly and others rarely?
Approximately half of the children do not have chronic diseases that would contribute to frequent respiratory infections, and they are almost healthy. In other cases, an examination is necessary in order to understand whether there are concomitant causes of the disease. An increased tendency to infections, for example, develops with some ENT diseases due to allergic or vasomotor rhinitis. In bronchial asthma, cystic fibrosis, diseases associated with protein loss (celiac disease, glomerulonephritis or intestinal damage in Crohn’s disease and UC) and endocrine diseases (diabetes mellitus, thyroid disorders), the risks of SARS also increase.

Frequent laryngitis, pneumonia, and prolonged coughing can occur due to gastroesophageal reflux disease. Latent iron deficiency is quite common (or, as it is also called, anemia without anemia) when hemoglobin is good, but at the same time there are all signs of its decrease: paleness and dryness of the skin, bluish sclera, palpitations, fatigue, emotionality, tearfulness, irritability and endless infections from SARS to frequent relapses of vesicular herpetic dermatitis.

To rule out these and other causes, you don’t need a platoon of doctors and countless tests. A competent pediatrician is needed and, in some cases, a small amount of laboratory examinations. If the doctor reveals alarming symptoms or red flags, he will be referred to narrow specialists.

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