UKHSA warns of ‘common childhood condition’ with four key symptoms

The UK Health Security Agency ( UKHSA ) has urged parents to remain alert for symptoms of a “common childhood condition.” While som may have never heard of it, health officials say it can start with cold-like symptoms and gradually get worse.

The UKHSA writes: “Croup is a common childhood condition that affects the windpipe, the airways to the lungs, and the voice box. It mainly affects babies and young children.”

The condition is typically caused by viral infections, most commonly the parainfluenza virus. However, other widespread illnesses including influenza, common colds, and RSV can also trigger it.

In rare circumstances, croup can occur if a child ingests a small object, suffers a severe allergic reaction, or is exposed to chemical irritants. These viruses spread through direct physical contact, touching contaminated objects, or inhaling droplets from an infected person’s coughing and sneezing.

Signs and symptoms warning

The agency reminds parents that this illness “affects the windpipe, the airways to the lungs, and the voice box” and although it “mainly affects babies and young children, typically those aged between 6 months and 3 years”, it states that “most cases occur in 1-year-olds.”

Given we are still in January, the warning is particularly relevant, as “croup is most common during late autumn and early winter” and “a child can get croup more than once.”

An infected child is usually at their most contagious during the initial days of illness when fever and cold-like symptoms are present. At first, your child may exhibit cold-like symptoms, including a cough, runny nose, or a raised temperature.

Croup symptoms, like those listed below, typically appear several days later. These include:

• a distinctive barking cough that may sound like a seal
• a high-pitched, rasping sound when breathing in (known as stridor)
• a hoarse voice
• difficulty breathing

You may find that symptoms get worse at night. The UKHSA explain: “Croup is often worse at night due to a combination of factors: natural cycles of the body’s hormones (leading to increased inflammation and increased mucus production), lying flat (allowing mucus to pool and narrow airways, or worsening acid reflux to cause inflammation), and cooler/drier air irritating the throat.”

All of these “exacerbate the inflammation and swelling in the windpipe that causes the characteristic barking cough and stridor (noisy breathing).”

While adults can catch the same viruses responsible for croup, they rarely develop the ‘barking’ cough as their airways are wider and harder to block. Instead, these viruses may present as a severe cold, laryngitis or bronchitis. However, some serious cases can still arise and may need hospital treatment. 

Who to call – 111, your GP or 999?

You might need to contact NHS 111 or consult your GP if you suspect your child has croup. Although it’s typically mild, your child may require treatment.

NHS guidance is to seek emergency help immediately if your child:

• is struggling to breathe
• has blue, grey, pale or blotchy skin, lips or tongue
• is sleepier than normal or difficult to wake
• is unusually quiet, still, limp or unresponsive
• is very upset or restless with breathing difficulties that won’t calm down
• is drooling more than usual, finding it hard to swallow, or wants to sit rather than lie down

Treatment at home

Thankfully, croup often gets better on its own within 48 hours. If NHS 111 or your doctor confirms your child has mild croup, you can help them by:

• sitting your child upright rather than letting them lie down
• comforting them and keeping them calm, as crying can make symptoms worse
• giving them plenty of fluids
• checking on them regularly, including at night
• giving paracetamol or ibuprofen to ease a high temperature or discomfort

The health experts stress: “Do not put your child in a steamy room or get them to inhale steam, as this is no longer recommended. There is no evidence that it helps, and there’s a risk of scalding children with hot water or steam.”

Can I prevent my child from getting croup?

The UKHSA notes: “Vaccination can help protect against some of the viruses that cause croup, such as flu and RSV.”

Groups eligible for the flu vaccine in the current season include:

• pregnant women
• young children
• people with certain long-term health conditions
• older adults aged 65 years and over

A list of who is eligible is available here.

When can my child return to school or nursery?

Your child may resume attending once their temperature has gone back down to a normal level, and they feel recovered enough for them to do their usual activities, even if a cough lingers. That said, they should remain at home if running a temperature, experiencing unusual fatigue, or struggling with breathing difficulties.