Viral Infections In Children

Introduction

Viral infections are caused by the growth of microorganisms (called viruses) in the body causing illness. Infections caused by viruses are common among humans at an early age around the globe. An interesting fact regarding viral infections is that the severity of the same infection might be different in different people, and this is because of the age and the strength of the immune system.¹

Children frequently contract viral infections, a few even affecting the child in the mother's womb during the foetal stage. Most infections are self-limiting due to the defence mechanisms of the immune system. Some may be treated by antiviral medications available like the influenza virus.¹

Most of the time, preventive measures are sufficient to protect the child from infections, and hygiene plays an important role.^2,3 We need to observe any new sign (s) and/or symptom(s) in a child as early detection and response can help to manage these conditions effectively.

Mode of transmission of infections 

The most common ways by which an infection spreads are contact, droplet and airborne transmission.

By contact

Infections that spread by contact can be via:

Direct contact

Common sites where germs grow are the nose, eyes, mouth, stool, and skin. Holding hands, kissing, or nursing a patient causes contact and spreading of infections.

Indirect contact

An infected person touches his mouth/nose and then touches other objects, like door handles/knobs, electric switches, support bars/handles to stand in public vehicles, and even toys. Later, if another person touches the same objects, he can acquire the infection indirectly.

Droplet transmission

An infected person releases droplets full of viruses by sneezing or coughing and contact with these droplets spreads the same virus(es).

Airborne spread

Viruses stay in the air and flow in the direction of air. Anyone who comes in contact with the air containing the virus may catch the infection.

Viral infections are self-limiting, i.e., viral infections get cured with time due to the immune response of the body, most of the time. The intensity with which the virus impacts depends on the strength of the defence mechanism. The stronger the immune system, the less the intensity of viral infection.⁴

Infections types

Oral infections

• Viral infections of the oral cavity have symptoms like inflammation on either side of the gums, pain, and a thin layer that forms in the inner lining of the mouth²
• Viral infections affecting the nerves in the face send signals from the jaw and face to the brain which may cause paralysis of the facial muscles
• Viruses can cause cancer in the head and neck region by affecting the oral area first. Vaccinations at a younger age can help prevent such complications 

Influenza viruses

• Viruses of this category are affected by any change in the temperature and humidity. They are capable enough to survive for many hours in adverse conditions
• One of the most important aspects of influenza viruses is their readiness to evolve
• They get transmitted as droplets (comparably larger than others) and by direct contact and grow in the nose and at the back of the throat
• Symptoms include body pain, tiredness and fever. Recent advancements in vaccination and antiviral drugs provide a new outlook to cure influenza³

Respiratory viruses

Upper respiratory tract infections

In early life, most infections are in the upper respiratory tract. Their common symptoms are fever, cough, cold, ear pain and inflammation of the inner lining of the nose. In addition, feeding also gets hampered.⁴

Analgesics/painkillers and anti-fever drugs treat these symptoms. Decongestants are useful to make feeding easier.

Lower respiratory tract infections

Lower respiratory tract infections are a leading cause of mortality in infants. A few typical symptoms associated with it are difficulty in breathing manifested as widened nostrils, prominent neck muscles and chest retraction inwards. Chest wheezing and harsh breath sounds may also be observed.

A patient suffering from any medical condition in which immunity gets compromised is likely to catch other infections like the respiratory syncytial viral Infection, RSV, and this might be a threat to the life of the patient.^6,7

Gastrointestinal infections

Viral infection of the stomach can be lethal to children as it causes severe diarrhoea that leads to dehydration. In this type of viral infection, the stomach lining gets inflamed.

Oral rehydration is useful at the initial stage, however moderate or severe infections require patient admission to the hospital.^5,8

Human immunodeficiency virus (HIV)

Human immunodeficiency virus (HIV) is one of the deadliest viruses, as it intensifies the effect of already existing virus infections.¹⁰

Symptoms of viral infections

• Fever 
• Cough 
• Pain in the ears
• Excessive sleeping
• Lethargy
• Breathing difficulty
• Diarrhoea especially in children younger than 6 months
• Vomiting
• Black-coloured bloody stools 
• Decreased urination
• Dehydration

Diagnosis

• Electron microscopy is one of the oldest methods to observe viruses through the microscopic lens
• Histology is another method, used to detect viruses. Cells are taken and stained with a dye. The specific dyes react with viruses confirming their presence. Based on genetic material, viruses can be distinguished and further narrowed down to a specific type
• Immunofluorescence assay (IFA) is popular for virus detection because of its low pricing. Samples from the mouth and nose are taken and antibodies are tagged with coloured indicators. If there is the presence of any virus, then the sample gets coloured accordingly
• Blood tests: In viral infections white blood cells (WBCs) increase. This is because WBCs are related to the defence mechanism of the body. So, whenever the number of pathogens (disease-causing agents) increases, the WBC number also increases⁹

Preventive measures

• Hand washing is the easiest way to deal with widespread infection. Hand washing is mandatory for maintaining good hygiene Certain activities, such as preparing a meal require hand washing beforehand. Hand washing after a few activities is essential. They are:
  • Sneezing or coughing in the hands
  • Wiping the nose
  • Nursing a patient
  • Using the toilet
  • Helping a child use the toilet
  • Cleaning diarrhoea or vomit 
  • Changing diaper 
  • Handling pets
• Any kind of symptoms should be taken into account at an early stage either by parents or by the caregiver
• Recommended vaccines should always be given so that the child is protected against any viral attack

Treatment

Most viruses are self-limiting and self-curing due to the actions of the body’s immune system, and medicines, even over-the-counter drugs, are generally not required. If the severity increases then, symptomatic treatment is necessary for the patient.

However, if immunity is not well-developed fully due to a very early age, or is compromised, antiviral drugs are also available to reduce the severity of viral infections.^2,3

Summary

Viral infection is the growth of small-sized organisms known as viruses causing one to feel unwell. Viruses can spread by direct or indirect contact with an infected person, tiny droplets released from the mouth or nose, or sometimes through air.

They cause infections at many sites of the body and may not be limited to only one site. In some cases, they can cause cancer also. Viruses like HIV increase the effect of other viruses attacking the body.

A temperature rise is one of the most common symptoms of viral infection, and a few other symptoms include diarrhoea, cough, pain, and lethargy. Preventive measures can help to avoid many viral infections.

These infections are self-controlling, i.e., getting cured without any medicine because of the immunity of any patient. Symptomatic treatment is initiated in the beginning if required. Antiviral drugs may be considered at last.