Viral Syndrome (Child)

A virus is the most common cause of illness among children. This may cause a number of different symptoms, depending on what part of the body is affected. Many viruses can cause multiple symptoms. These symptoms are called viral syndrome.

If the virus settles in the nose, throat, and lungs, it causes cough, congestion, and sometimes headache. If it settles in the stomach and intestinal tract, it causes vomiting and diarrhea. Sometimes it causes vague symptoms of feeling bad all over, with fussiness, poor appetite, poor sleeping, and lots of crying. A light rash may also appear for the first few days, then fade away.

A viral illness often lasts 3 to 5 days. But sometimes it lasts longer, even up to 1 to 2 weeks. Home measures are all that are often needed to treat a viral illness. Antibiotics don't help. But some viral illnesses, such as flu (influenza), may be treated with antiviral medicine.

Home care

Follow these guidelines to care for your child at home:

  • Fluids. Fever increases water loss from the body. For infants under 1 year old, continue regular feedings (formula or breast). Between feedings give oral rehydration solution, which is available from groceries and drugstores without a prescription. For children older than 1 year, give plenty of fluids like water, juice, ginger ale, lemonade, fruit-based drinks, or ice pops.  

  • Food. If your child doesn't want to eat solid foods, it's OK for a few days, as long as they drink lots of fluid. (If your child has been diagnosed with a kidney disease, ask your child’s doctor how much and what types of fluids your child should drink to prevent dehydration. If your child has kidney disease, drinking too much fluid can cause it build up in the body and be dangerous to your child’s health.)

  • Activity. Keep children with a fever at home resting or playing quietly. Encourage frequent naps. Your child may return to day care or school when the fever is gone and they are eating well and feeling better.

  • Sleep. Periods of sleeplessness and being grouchy (irritable) are common. Give your child plenty of time to sleep.

    • For children 1 year and older:  Have your child sleep in a slightly upright position. This is to help make breathing easier. If possible, raise the head of the bed slightly. Or raise your older child’s head and upper body up with extra pillows. Talk with your healthcare provider about how far to raise your child's head.

    • For babies younger than 12 months: Never use pillows or put your baby to sleep on their stomach or side. Babies younger than 12 months should sleep on a flat, firm surface on their back. Don't use car seats, strollers, swings, baby carriers, or baby slings for sleep. If your baby falls asleep in one of these, move them to a flat, firm surface as soon as you can.

  • Cough. Coughing is a normal part of this illness. A cool mist humidifier at the bedside may be helpful. Over-the-counter (OTC) cough and cold medicine has not been proved to be any more helpful than sweet syrup with no medicine in it. But these medicines can have serious side effects, especially in infants younger than 2 years old. Don’t give OTC cough and cold medicines to children under age 6 unless the healthcare provider has specifically advised you to do so. Also, don’t expose your child to firsthand or secondhand cigarette smoke. It can make the cough worse. Never give medicines meant for adults to your child. Talk to your provider or pharmacist if you have any questions.

  • Nasal congestion. Suction the nose of infants with a rubber bulb syringe. You may put 2 to 3 drops of saltwater (saline) nose drops in each nostril before suctioning to help remove secretions. Saline nose drops are available without a prescription. You can make it by adding 1/4 teaspoon table salt in 1 cup of water.

  • Fever. You may give your child acetaminophen or ibuprofen to control pain and fever, unless another medicine was prescribed for this. If your child has chronic liver or kidney disease or ever had a stomach ulcer or gastrointestinal bleeding, talk with your healthcare provider before using these medicines. Never give aspirin to anyone younger than 18 years who is ill with a fever. It may cause severe disease or death.

  • Prevention. Wash your hands before and after touching your sick child. This is to help prevent giving a new illness to your child. And to prevent spreading this viral illness to yourself and to other children. Have anyone who touches your child do the same thing. Teach all family members the correct way to wash their hands.

  • Handwashing. Wet your hands with soap and clean, running water. Lather the palms and backs of your hands, between your fingers, and under your nails. Scrub your hands for at least 20 seconds. If you need a timer, try humming the “Happy Birthday” song from beginning to end twice. Rinse your hands well and dry using a clean towel.

Follow-up care

Follow up with your child's healthcare provider as advised.

When to get medical advice

Unless your child's healthcare provider advises otherwise, call the provider right away if your child:

  • Has a fever (see "Fever and children" below)

  • Is fussy or crying and can't be soothed

  • Has an earache, sinus pain, stiff or painful neck, or headache

  • Has increasing belly (abdominal) pain or pain that isn't getting better after 8 hours

  • Has repeated diarrhea or vomiting

  • Has a new rash

  • Has signs of dehydration: No wet diapers for 8 hours in infants, little or no urine in older children, very dark urine, sunken eyes

  • Has a burning feeling when peeing

  • Has symptoms that get worse or has new symptoms

Call 911

Call 911 if any of these occur:

  • Lips or skin that turn blue, purple, or gray

  • Neck stiffness or rash with a fever

  • Convulsion (seizure)

  • Wheezing or trouble breathing

  • Abnormal fussiness or drowsiness

  • Confusion

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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