Clinical Update: There are many respiratory infections currently circulating. We are seeing high numbers of flu (influenza), RSV (particularly in young children), COVID, and other viral illnesses.

We realize that many of our patients are having a difficult time getting an appointment to be seen on the same day for an illness, and we are very sorry. We are doing the best we can and seeing as many patients as safely as possible. But our schedules have been filling up much more quickly than in the past. So, you may be directed to go to an Urgent Care or call back another day for an appointment.

In the meantime, here is some information that may help you determine what you might do:

INFLUENZA

• The flu is a respiratory illness caused by the influenza virus, and each year, new virus strains tend to circulate.
• Typical flu symptoms include sudden onset of fever, body aches, cough, congestion, runny nose and headache. You do not have to have a fever to have the flu but if you do, it is more likely.
• There is a rapid test for the flu and there are antiviral medications available for treatment for high-risk patients that can help lower the severity and length of illness. The antiviral medications work best if given in the first 48 hours.
• If your child has had the flu vaccine, he or she can still get the flu but it tends to be less severe. The goal of the flu vaccine is to decrease the risk of hospitalization and death from the flu.
• The most important thing your child can do with the flu is to drink plenty of fluids to stay hydrated and get plenty of rest. He or she can take acetaminophen and/or ibuprofen (if not contraindicated) for fever, body aches or headache.
• Your child is contagious until he or she goes 24 hours without a fever without any fever-reducers and symptoms are improving.
• This year, the flu started earlier than usual and has been more prevalent than in the past.
• You can find more information here:
  https://www.cdc.gov/flu/about/index.html
  https://familydoctor.org/flu-myths/

RSV (Respiratory Syncytial Virus)

• Symptoms include runny nose, cough, fever, decreased appetite, sneezing, and wheezing. Usually, symptoms appear in stages starting with runny nose & congestion and sometimes fever. Typically RSV will be at its worst by day 4 or 5.
• We can test for RSV with a nasal swab.
• Watch for signs of breathing difficulties, especially in young children. This would include flaring of the nostrils, grunting sounds with breathing, and retractions (where the muscles around the rib cage move in & out with each breath)
• There is no specific treatment for RSV. We recommended acetaminophen for fever (and/or ibuprofen in children over 6 months) and increasing fluid intake to prevent dehydration.
• Children infected with RSV do not usually need to be hospitalized but infants under 6 months have a higher risk and may need oxygen, IV fluids, breathing assistance so close observation is important.

COVID

• Yes, we are still seeing COVID cases.
• Symptoms of COVID vary from person to person and may include sore throat, headache, cough, congestion, nausea/vomiting, diarrhea, fever, loss of taste or smell, body aches, fatigue. It seems that sore throat and headache are particularly common with the current circulating strains. Some patients may only have one or two symptoms. You do not have to have a fever to have COVID.
• Unlike the flu, symptoms tend to come on more gradually.
• It is highly likely to have a false negative COVID test in the first 3 days of symptom onset. If you have symptoms and test negative, especially with a home test or a rapid test, please consider testing again on day 4 of symptoms. This is especially true if you have a known exposure.
• Here is an isolation and exposure calculator to help you determine if you need to isolate or quarantine and for how long:
  https://www.cdc.gov/coronavirus/2019-ncov/your-health/if-you-were-exposed.html

OTHER RESPIRATORY VIRUSES

• There are other viruses circulating that have a lot of the same symptoms of runny nose, cough, congestion, possibly fever. Adenovirus and rhinovirus are the most common. There is no test for these in the outpatient setting. But if you are negative for flu and COVID, you may have another viral illness.
• Viruses are NOT treated with antibiotics.
• You may have yellow or green colored mucus even with a viral infection.
• You can get a secondary bacterial infection after a viral infection that may require antibiotics (sinusitis or pneumonia) but typically that does not happen unless the viral infection hasn’t resolved in 7 to 10 days.
• Unless your child has asthma or other chronic medical problems, their body should fight off a viral infection within 7 to 10 days. Typically the first 3-4 days are the worst and you should see improvement from there.