What is Croup?
Croup is a condition that develops quickly in children and is usually caused by a viral infection in the upper airways, which is localised in the throat and surrounding tissues. It’s characterised by a barking cough.
It’s fairly uncommon and affects more boys than girls.
It usually occurs in young children aged 6 months to three years of age, and in most cases clears up spontaneously in 24 to 48 hours.
Very rarely, croup is a sign of something much more serious, such as epiglottitis, which is a serious condition causing swelling in the back of the throat.
How do you get croup?
The virus can either be transferred through airborne droplets produced by coughing and sneezing, or passed from one person to another by touch. From the hands, the virus may enter the mucous membrane of the eyes and nose.
Croup is usually caused by the parainfluenza virus, although there are many other possible viral causes. These include the RS virus, influenza virus type A, rhinovirus, adenovirus, and Coxsackie virus.
If a child has had croup before, it may recur when they have a cold, as this is a viral infection.
After the age of three, these symptoms decrease in severity.
Less commonly, croup may be due to an allergic reaction to pollen or house dust mites, or inhaling a small foreign body, such as a peanut.
What are the signs of croup?
- A characteristic rough, barking cough.
- Hoarseness and noisy breathing.
- The symptoms often occur at night when the child has been lying down for a couple of hours.
What should one be especially aware of?
- The child becoming more tired.
- Difficulty breathing.
- Blueness around the mouth, nose and nails.
Seek urgent medical help if any of these problems occur.
What can you do yourself?
- Calm the child as much as possible.
- Keep calm yourself. Obvious signs of uneasiness an anxiety will upset the child. Reassuring a sick child can have a positive response on relieving the symptoms of croup.
- Sit the child up, which will allow them to breathe more easily.
- There is no evidence that using steam or a humidifier has any effect on relieving symptoms.
- Inhaling steam may lessen the symptoms – to create steam, try sitting the child in the bathroom with the hot tap running.
- If your child wants to eat, give only small snacks they can eat easily without choking.
- Encourage the child to drink plenty of fluids.
- If the child has a fever, they should wear as few clothes as possible and not be put under warm bedclothes.
- Use ibuprofen or paracetamol to help bring their temperature down.
How does the doctor make a diagnosis?
- The diagnosis is made on the symptoms of the typical cough with viral symptoms.
- If the doctor wants to know which micro-organism has caused the disease, a swab from the throat can be taken for examination. You should not look in your child’s throat yourself because it could trigger a serious throat obstruction if your child has epiglottitis, rather than croup.
- An X-ray may be needed, but only if the child is ill enough to need hospital admission.
Croup usually clears up without a problem in three to four days. However, the coughing may last some time longer.
The disease usually gets worse at night when the child is lying down.
Additional problems that may rarely be caused by croup include:
- severe breathing problems and lack of oxygen
- blocking of the airways (obstruction). This is rarely seen but is life-threatening.
How is croup treated?
Since the disease is a viral infection, it cannot be treated with antibiotics.
Serious cases of croup result in admission to hospital where the patient will be given oxygen, corticosteroids and adrenaline through a nebuliser.
Children who suffer from recurrent croup may be given a single dose of steroids to be kept at home and used if their infection seems particularly severe.