In these times of pandemic, a cough can be a worrisome thing. Not only is it a prominent sign of COVID-19, but it can also be part of a constellation of symptoms heralding more serious lung diseases. Moreover, when children develop a cough, it can be particularly troubling given their increased susceptibility to disease and the immaturity of their immune systems. Let's explore the subject of croup cough.

What is Croup?

Croup is an infection of the upper airways that occurs most frequently in children, often less than five years old. It is characterized by a barking, seal-like cough, along with hoarseness, difficulty breathing, and signs of the common cold (runny nose, sore throat, etc.). In the United States, it causes 7% of hospitalizations in children below five years old, usually between six months and three years of age. Given these statistics, it is easy to see why croup would be a cause for concern for most parents. 

What Causes Croup and its Cough?

The swelling of the upper airways causes obstruction, leading to the characteristic cough sound associated with croup. Because of this, a child may have both audible and difficult breathing.

Croup is commonly caused by viruses, the most common of which is the parainfluenza virus. Other viruses include influenza A and B, measles, adenovirus, and respiratory syncytial virus (RSV). To a lesser extent, bacteria such as Staphylococcus aureus, Streptococcus pneumonia, Haemophilus influenzae, and Moraxella catarrhalis also cause croup. 

What is the Treatment for Croup?

Croup is a self-limiting condition, which means it will resolve on its own. However, in severe cases, your doctor may prescribe a combination of steroids, epinephrine, oxygen, and intubation to help ease symptoms.  

Here are some tips on how to look after your child with croup at home:

• Stay calm
• Sit your child upright
• Comfort them if they are distressed, as crying can worsen the symptoms
• Give them plenty of fluids
• Do not let your child inhale steam
• Do not give them cough or cold medicines
• Consult your doctor

How Can I Tell Croup Cough from COVID-19 Cough?

While croup and COVID-19 share similar symptoms like cough, runny nose, and difficulty breathing, here are some things to consider in differentiating them: 

• Time of year – croup occurs in the fall or winter months while COVID-19 exists all year round
• Other symptoms – COVID-19 may involve more symptoms than croup, such as headache, digestive problems, and loss of taste and smell
• COVID-19 exposure – Contact with a confirmed COVID-19 case may make it likely that your child may have contracted the virus

In this case, the only way to get confirmation is by consulting your doctor and getting your child tested. 

Summary

Croup can be a difficult illness for children to deal with. To prevent it, ensure a clean environment at home, wash toys and frequently used items, and avoid leaving the home if only for essentials. In this way, we can also lessen the spread of COVID-19. 

Mikaela Millan

Mikaela is a dentistry clinician at the University of the Philippines.