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This newsletter is being sent out because of an apparent spike in the appearance of a common but important pediatric illness in the community.
Bronchiolitis - A Number of Cases in the Community
 During the past week there have been a number of cases of children under the age of 6 with significant breathing problems. This is to be expected in the winter but there has been an increase in the specific condition known as bronchiolitis. It tends to be most problematic for children under 2 years of age but can affect older children too. The most common cause is respiratory syncitial virus. The illness lasts for usually 2-5 days. Most children will recover from it  without any more intervention than that which is needed for the common cold.
Runny nose, fever, dry (sometimes wheezy cough)
Symptoms to watch out for:
Respiratory rate over 50/minute
Respiratory retractions (ribs show more prominently when child breathes in and/or abdomen retracts in with breathin and/or use of neck muscles with breathing in
retractions of ribsIn the image to left you can see ribs more prominently when the child BREATHES IN
Extreme lethargy ( hard to define- but if you are concerned as a parent call us immediately)
Cyanosis (purple color to lips absolutely requires urgent evaluation)
Here is a very detailed on-line source of information from Up-To-Date:
Other illnesses that can be causing fever and cough:
Croup, pneumonia, bronchitis, a 'bad cold'
If you think your child may have gotten a foreign body in her throat she may have all the symptoms of bronchiolitis (without a fever). If you think this may have occured make a sweep with your index finger in the mouth. If no improvement, then hold your child over your knee ( face to the floor and head tilted down) and give 3 blows to the back. Sweep the mouth with your finger again and if no foreign body appears then give 3 blows in the same manner once again. Finger sweep one more time and call 911 if no foregn body is found and respirations have not improved.
Feel free to try my cell phone after hours if you are unsure if you have an emergency (but if you cannot get me call the on-call doctor or ER if necessary) Office number 617-666-9577  Cell phone for after-hours 617-230-7988
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