February 4, 2026 - As flu cases continue to rise, doctors are seeing a troubling increase in severe and sometimes life-threatening complications — particularly in children. 

While influenza is often dismissed as a routine seasonal illness, medical experts warn it can lead to infections that affect the lungs, brain, heart and other vital organs.

Mustafa Bakir, MD, a pediatric infectious disease specialist with OSF HealthCare, says the flu’s ability to damage the body’s natural defenses is what makes it especially dangerous.

Flu vaccination rates remain alarmingly low

January 20, 2026 - Since the end of the COVID-19 pandemic, the number of people becoming sick with influenza (flu) has drastically increased each respiratory illness season.

A major part of that, according to Mustafa Bakir, MD, pediatric infectious disease specialist with OSF HealthCare, is due to extremely low vaccination rates.

How vaccines strengthen natural immunity

January 20, 2026 - When a child suddenly refuses to walk days after recovering from the flu, it can be terrifying for parents, but doctors say a little-known condition called viral myositis is often the cause.

It’s a muscle condition most often seen in children during or shortly after common viral infections, especially influenza (the flu). While the condition can be alarming for parents, medical experts say it is usually temporary and treatable with proper care.

Mustafa Bakir, MD, a pediatric infectious disease specialist with OSF HealthCare, explains the condition, and what parents should do if this happens with their kids.

How vaccines strengthen natural immunity

January 12, 2026 - For many adults, especially those who grew up in an era when measles, chickenpox or the flu were simply “childhood illnesses,” it can feel natural to believe that getting sick is how the body builds strong immunity.

While infection does contribute to the immune “library,” modern vaccines offer a safer, more reliable way to add to that protection without the risks of serious illness, hospitalization or long-term complications.

As flu activity surges across the U.S. this winter, experts emphasize that vaccines remain one of the strongest tools for maintaining health and preserving natural immunity over a lifetime. Doug Kasper, MD, an infectious disease specialist with OSF HealthCare, shares why vaccines are such a powerful tool. 

Respiratory illness update | Friday, January 9

January 9, 2026 - Respiratory illness activity continues to be high across Illinois and Michigan. Hospitalizations for influenza, respiratory syncytial virus (RSV) and COVID-19 all increased ahead of the New Year. 

Data across the Ministry: 

More than 7,000 influenza tests were administered from 12/28 - 1/3 with a 23.3% positivity rate. 

Tests slightly decreased from the week before, along with the positivity rate - which was 30% the week prior.

Respiratory syncytial virus (RSV) continues to circulate throughout the region. Nearly 2,000 RSV swabs were administered between 12/28 - 1/3, with a 3.8% positivity rate. 

Roughly 5,000 COVID-19 tests have been administered in the above-mentioned time frame, with an 11.3% positivity rate for each of the last 2 weeks. 

In an effort to protect our patients, their family members and OSF Mission Partners - OSF will continue to offer complimentary masks to all guests and Mission Partners when entering any of our facilities. 

Visitor restrictions are in place, with a limit of two visitors 18 years of age or older, per patient at any time. Exceptions may be made for those under 18, as well as those in isolation for influenza-like illness, to promote the patient's emotional well-being. Exceptions may also be made for end-of-life or other extreme circumstances. 

As each situation may be unique and challenging, we graciously ask for patients to feel empowered and have a conversation with their OSF care team to discuss their situation.

Can't stop coughing?

January 6, 2026 - Can’t stop coughing? It’s a common question happening with all of the upper respiratory illness going around including colds, flu and RSV.

Maybe two weeks ago you had a virus, you treated the symptoms with antibiotics, you’re feeling much better, but the cough is just lingering. Juanbosco Ayala, MD, is a pulmonologist in the Intensive Care Unit (ICU) at OSF Little Company of Mary Medical Center in Evergreen Park, Illinois. He provides medical care to patients on a daily basis, especially people who have breathing disorders and lung disease, and explains potential reasons why coughs linger on the OSF Newsroom.

Staying healthy this holiday season

December 22, 2025 - Each winter, flu activity tends to rise just as families begin gathering for the holidays. This year is no exception. National surveillance data shows influenza circulating in many regions of the country, with ongoing activity expected through winter.

As travel, school breaks and holiday events increase, health experts emphasize planning ahead to stay well. Doug Kasper, MD, an infectious disease specialist with OSF HealthCare, shares tips for staying healthy this holiday season.

Scrub Smarter: Bathroom hygiene tips 

December 15, 2025 - Bathrooms are filled with germ-breeding objects, and your toilet isn’t the sole culprit. 

Showers, toothbrushes, soap dispensers and any surface can be added to the germy list, according to Kaylin Heinz, an infection preventionist RN with OSF HealthCare. Heinz offers some cleaning tips for the different areas of your bathroom that can be found on the OSF Newsroom.

Flu vaccine:

December 9, 2025 - Each flu season, families look for ways to protect themselves while juggling busy schedules – and for parents of children who fear needles, vaccinations can be especially challenging. This year brings a new, convenient option: a nasal spray flu vaccine that can be delivered directly to your home. Doug Kasper, MD, an infectious disease specialist with OSF HealthCare, speaks to the improvement in access, and decrease in anxiety for kids this provides. 

Outdoor safety:

December 2, 2025 - A good way to prevent winter illnesses is by staying safe outdoors. Maddy Draper, APRN, a provider at OSF OnCall, has tips about bundling up and more.

Hand hygiene:

November 25, 2025 - Emily Isom has a resolution for kids and their parents with holiday gatherings upon us: pledge to keep your hands clean and away from your face to prevent the spread of illness.

Isom, a certified medical assistant in pediatrics at OSF HealthCare, often sees young people biting dirty fingernails and not washing their hands properly. She has a primer here.

Hand, foot and mouth disease (HFMD):

November 7, 2025 - One viral infection to pay close attention to this season is hand, foot and mouth disease (HFMD).

HFMD typically impacts young children, but adults and older children can get it, too. It causes painful red blisters in the mouth and throat, and on the hands, feet, and diaper area. HFMD is most common in children who are in child care because young children need frequent diaper changes and help using the bathroom. They also tend to put their hands in their mouths.

Find more information about symptoms and treatment options here. 

RSV hospitalizations 2024: 

November 6, 2025 - There was a steep decline in respiratory syncytial virus (RSV) hospitalizations among infants last RSV season, offering welcome relief this time around. Health officials point to the new vaccines and preventive antibodies as the driving force behind the turnaround.

Read about the stark drop in RSV hospitalizations in the full article here. 

COPD 2025:

November 4, 2025 - It’s something Michael Daley, MD, sees in the emergency department often and especially this time of year: chronic obstructive pulmonary disease, or COPD.

Dr. Daley, who provides care at OSF HealthCare, says while there’s no cure for COPD, medicine has come a long way to improve your quality of life with the disease.

Read the full story here.

Pneumonia 2025:

November 3, 2025 - Pneumonia.

It’s a hard enough word to spell, let alone remember how to prevent and treat it. With respiratory illness season here, it’s time for a reminder about how to avoid this possibly deadly condition.

Read the full story with OSF emergency department physician Fred Burke here.

Viral sore throat vs. bacterial sore throat: 

October 22, 2025 - With temperatures cooling, Awad Alyami, MD, an OSF HealthCare pediatrician, says we’re approaching the peak season for sore throats. Many cases have time-tested treatments, but some can have serious complications.

Dr. Alyami says a sore throat is an infection that causes inflammation in your throat. They’re annoying and painful, bringing symptoms like difficulty swallowing or talking and swelling of glands and tonsils. Causes can include tonsil stones, heartburn and allergies. But most commonly, causes break down into two groups: viral and bacterial.

Viral sore throat symptoms:

• Often comes with coughing or a runny nose
• May occur with cold, flu, or COVID-like symptoms
• Usually mild and can be treated at home with rest, hydration, and over-the-counter medicine

Bacterial (strep throat) symptoms:

• Sore throat with fever
• White patches on the back of the throat or tonsils
• May cause neck swelling in more serious cases
• More common in children
• Needs medical treatment to prevent complications like dehydration

Read the full story here. 

Respiratory distress in sick children:

October 7, 2025 – Respiratory distress can develop quickly in children, often from viral infections like RSV or influenza. Knowing when to seek care is vital, says Dr. Kelsey Grimes, a pediatrician with OSF HealthCare. “During work-time hours, you can call your pediatrician’s office and try to get a same-day appointment,” she says, noting that emergency care or 9-1-1 may be needed in severe cases. From using nasal saline and humidifiers at home to recognizing emergency signs, proactive steps help parents protect their children’s health. Read the full story here. 

Full guide to the 2025 flu, COVID-19 and RSV season (original article): 

September 15, 2025 – Across the board, late 2024 to early 2025 was recognized as a “rough” respiratory illness season.

“It was the season we had been predicting for five years, and we had a conjoining of three diseases," says Brian Curtis, MD, vice president chief medical officer for OSF Medical Group, part of OSF HealthCare, headquartered in Peoria, Illinois.

RSV (respiratory syncytial virus), influenza and COVID-19 were all heavily circulating communities in the winter months, all at the same time.

This puts a tremendous strain on the entire medical system for so many people to all get sick at once, Dr. Curtis adds. From a clinic setting, to an emergency department (ED) setting and everything in between, an influx of patients at the same time can impact how quickly people can be seen for other health concerns. 

Dr. Curtis says the 2024 respiratory illness season had reverted to a traditional pattern of RSV and Influenza circulating in the fall and winter months which is a "normal" respiratory illness season. Influenza started circulating in October and November and peaked in January and February (2025). RSV "reared its head" in the late winter, Dr. Curtis adds, which is generally expected. Along with COVID circulating through the same period. The confluence of these three viruses made a difficult busy respiratory season.

How does this impact the 2025-2026 season? 

"You don't know," Dr. Curtis points out.

There are a few key factors to pay attention to which will help paint the picture over time.

-          How effective the influenza vaccine is

-          How many people receive the flu vaccine

"Flu vaccines are ready. So, if you're ready, we're ready. People can start getting it now, and I'd recommend getting it by the end of October," Dr. Curtis says.

You can schedule an office visit through OSF MyChart to receive a vaccine at any OSF Medical Group – Primary Care location, or by visiting an OSF OnCall Urgent Care or OSF PromptCare walk-in clinic. You can also be seen at these locations for several health concerns like viral illnesses. OSF OnCall Urgent Care also offers the option to make a reservation ahead of time but also accepts walk-in patients.

-          How many high-risk individuals receive the RSV vaccine

There are two one-time RSV vaccines. The adult vaccine, which is a vaccine in the traditional sense, for people who are high-risk. This is supposed to help train your immune system to recognize and fight off certain viruses or bacteria, without getting severely ill.

Those who can receive the shot include pregnant women (who are 32 to 36 weeks pregnant who will deliver during the RSV season), all people 65 and older, and those 50 and older who have serious health conditions such as chronic heart disease, chronic lung disease, severe diabetes and a weakened immune system. 

The second vaccine is for very young kids, and it's a monoclonal antibody, which is a lab-made protein that works like natural antibodies and helps your body fight infections. It's called Beyfortus® (nirsevimab-alip). It's an injection for babies under 8 months of age entering their first RSV season.

If your child has serious health challenges like being on oxygen, having heart issues or lung issues, you might want to consider having your child receive nirsevimab into their second RSV season as well. But Dr. Curtis says to speak with your health care provider, as each situation can be unique. 

-          How members of the public respond when they are sick

Besides receiving your vaccines, hand washing, staying home when sick and covering your cough are three tips Dr. Curtis gives to not spread your germs to others. Last year, Dr. Curtis adds, people were returning to pre-pandemic behaviors such as returning to work in person while sick, which causes viruses to spread more rapidly. 

Flu vaccine myth

Dr. Curtis advises it’s never too late to receive your flu vaccine.

“If it's December or January and you haven't gotten it, you can still get it. It's still worthwhile and beneficial for you to do that. So don't think 'it's halfway through the season why bother now?' Flu doesn't care where it's in the season and it doesn't care who you are."

It's a myth to think that if you get your flu vaccine early, it won't protect you for the whole season. Dr. Curtis says that's just not true. 

What mild symptoms look like (and what to do)

Most mild cases of respiratory illnesses like RSV, COVID-19, influenza and rhinovirus or enterovirus (common cold) can be taken care of in the comfort of your own home.

"That could be a low-grade fever, cough, congestion and body aches." Dr. Curtis advises, "Tylenol and Motrin can be used, if your health circumstances allow for it, and then drinking fluids and having plenty of rest is the care for that."

Seeking medical care from a health care professional, in any type of setting, is not needed for people with mild symptoms. 

However, there are times when serious medical attention is required.

When it’s time to be seen by a medical provider

• Trouble breathing
• Unable to keep liquids down
• Fever not responding to Tylenol or Motrin
• People not acting like themselves mentally
• Serious illness lasting more than 7 days with no signs of improvement

What steps can you take now?

"The best thing you can do is take care of yourself and make sure your body is the healthiest it can be. That means prioritizing exercise, sleeping, eating right and limiting your intake of alcohol. Not taking care of your body can wear down your system and leave you susceptible to getting infections,” Dr. Curtis says.

OSF OnCall offers virtual options for patients to get care 24/7 through its Virtual Urgent Care. The appointment generally takes 5-10 minutes and gets sick patients a treatment plan within 30 minutes. No appointment is needed.

Video Interview Clips

Can’t stop coughing? It’s a common question happening with all of the upper respiratory illness going around including colds, flu and RSV.

Maybe two weeks ago you had a virus, you treated the symptoms with antibiotics, you’re feeling much better, but the cough is just lingering. Juanbosco Ayala, MD, is a pulmonologist in the Intensive Care Unit (ICU) at OSF Little Company of Mary Medical Center in Evergreen Park, Illinois. He provides medical care to patients on a daily basis, especially people who have breathing disorders and lung disease, and explains potential reasons why coughs linger.

“A lot of times it’s due to the local inflammation that persists. There’s not much to do for it, we typically recommend antihistamines, and sometimes you’ll have to cycle those,” Dr. Ayala says. “It’s usually something that subsides with time. But if it doesn’t, then obviously that may need to be looked at.”

Antihistamines can include Claritin-D, Benadryl, Allegra and more. These can be found over the counter and do not require a prescription.

For many, colder temperatures bring on an uptick in mucus in your throat. For this, Dr. Ayala says another over the counter option, Mucinex, may be a good choice for you.

Dr. Ayala recommends keeping a close eye on your symptoms. As more people are getting colds and viruses this time of year, it’s important to not let local hospitals get overrun if you can treat your symptoms at home.

“As long as you don’t have some of the red flags, like a persistent fever, high-grade fever that lasts more than one to three days. Something that won’t go away, despite using temporary measures like Tylenol or Motrin. If this persists more than two or three days, this might be something that needs to be looked at,” Dr. Ayala says.

Should you go to the doctor?

COVID-19, RSV, strep and the flu are very contagious, but usually can be treated at home. If you have symptoms such as cough or sore throat, but they are mild and you do not have a high risk health condition, you can take a COVID-19 test at home and treat your symptoms with over-the-counter medications. 

Go to the doctor if you…

Have symptoms that haven’t gotten better after 10 days, have difficulty breathing, or have a preexisting condition like diabetes, asthma, or COPD. If you have white spots on the back of your throat, this is a clear sign of an infection and will need medical intervention prescribed by a licensed medical provider.

How to stay healthy

Wash your hands, cover your cough and stay home if you’re sick.

All the talk each fall centers on colds, flu and RSV.  But one viral infection to pay close attention to is hand, foot and mouth disease (HFMD).

HFMD typically impacts young children, but adults and older children can get it, too. It causes painful red blisters in the mouth and throat, and on the hands, feet, and diaper area. HFMD is most common in children who are in child care because young children need frequent diaper changes and help using the bathroom. They also tend to put their hands in their mouths.

“Hand, foot and mouth disease is a pretty classic viral infection that’s most commonly affected in the younger age group under the age of five," says Asma Khan, DO, a pediatrician for OSF HealthCare. "The symptoms you typically see are mouth lesions, usually on the tongue or the cheeks. You also have a rash on the body, most often it's clustered on your hands and feet. Sometimes it can be a full body rash, and occasionally fevers and just feeling a little down and irritable.”

Other symptoms include sore throat, fussiness in infants and toddlers and a loss of appetite.

There are two main viruses that cause HFMD – coxsackie and enterovirus. There is usually a three to five day incubation period, when patients are infected and spreading the virus, before the initial onset of symptoms. The virus is spread through saliva, stool and respiratory droplets such as sneezing and coughing.

“There are very few complications with hand, foot and mouth disease, it’s usually more of a milder course," says Dr. Khan. "You may feel rundown for about seven to 10 days. On occasion if we have a more virulent strain of the virus, you can have more serious complications and those can be meningitis, encephalitis, or myocarditis but that has been rare. Sometimes there's a late strain of enterovirus that can be more related with those complications.”

According to Dr. Khan, the treatment is usually supportive care at home.

“It’s treating them comfortably with Tylenol and Motrin to help keep their pain down because those mouth lesions tend to be the one that’s most painful," says Dr. Khan. "The rash on the body typically is not. So we want to keep them continuing to eat and drink and then we want to make sure we really push fluids so if they're having a lot of pain in their mouth. They may not want to eat but as long as we can get them to drink and stay hydrated that’s the number one key.”

Dr. Khan adds that if your child has a high fever or shows no gradual improvement after a few days, it’s time to call your physician. 

HFMD typically occurs in the summer and fall seasons, but Dr. Khan says outbreaks can also develop in the winter. HFMD is similar to herpangina, another viral illness that is often seen in children ages three to 10. The difference between the two illnesses is that HFMD can form on the hands, feet and inside of the mouth while herpangina only forms in the mouth and throat.  

To prevent the spread of HFMD, Dr. Khan encourages parents to keep kids home from school and daycare while they have a fever or open blisters on the skin and in the mouth. Everyone in your home should wash their hands, especially after using the bathroom or changing a diaper, and before preparing food. Toys and surfaces should also be cleaned with a disinfectant as often as possible.

When is it safe for my child to return to school or child care? That is the biggest question Dr. Khan is asked by parents.

“The big criteria is fever. No child should be going to school with a fever. The fever should be gone for 24 hours," says Dr. Khan. "The rash itself is not clearly an indication to stay out of school, because a rash may take a good week or so to fully resolve, and the infectivity rate after that first week is really gone down. You don't necessarily have to keep a child out of school just because a rash has not resolved in a few days.”

For more information about HFMD, visit OSF HealthCare. 

 

Interview Clips 

What is RSV and who’s at risk

“RSV is a virus, one of the most common viruses in the pediatric population. It usually attacks the upper airway and the lungs,” says Kelsey Grimes, DO, outpatient pediatrician with OSF HealthCare. “It leads to a lot of inflammation and excess secretions. Oftentimes we get a runny nose, stuffy nose and an increased work of breathing, also known as respiratory distress. That’s the part that usually leads to us seeing them in the office, or them going to the emergency department and being hospitalized.”

RSV is the leading cause of hospitalization among U.S. infants, with the Centers for Disease Control and Prevention estimating around 58,000 to 80,000 hospitalizations and 100 to 500 deaths each year in children under five. The virus can lead to severe illnesses like bronchiolitis and pneumonia.

Prevention tools now available

In the fall of 2023, two major preventive products became available in the U.S.:

• A maternal vaccine administered during pregnancy (given between 32-36 weeks’ gestation)
• A long-acting monoclonal antibody for infants (0-7 months old) and some children (8-19 months old) at higher risk
• While these preventive products do not stop RSV infection entirely, their goal is to drastically reduce the severity of symptoms.

These tools mark a major shift in RSV prevention, including the monoclonal antibody product known as Beyfortus (also referred to as nirsevimab). The American Academy of Pediatrics reports that nirsevimab is expected to reduce the risk of severe RSV disease by about 80%.

What the data show: Fewer hospitalizations

“There’s still RSV. But we have seen a drastic decrease in hospitalizations and ICU stays, which is usually when kids get the increased work of breathing and need oxygen and support. When they're really little, it's hard for them to suck, swallow and breathe because of all the mucus and inflammation,” Dr. Grimes adds. “So sometimes even if they aren't being admitted for oxygen, it's because they're dehydrated.”

Recent surveillance data underscore how significant that decrease is. An analysis of the 2024-25 RSV season – the first with widespread availability of both maternal vaccination and the infant antibody – found hospitalization rates among infants 0-7 months old fell by approximately 28% to 43% compared to 2018-20 (pre-pandemic) seasons.

For the youngest infants (0-2 months), the declines were even sharper, around 45% to 52%.

These data signal that many severe RSV cases in infants may now be preventable, a major public-health milestone.

Side effects and practical details

“Most common side effects are local redness, swelling and pain to the area. We aren’t seeing any systemic signs with this injection,” says Dr. Grimes. “Some other vaccines have an increased risk of fevers, but with this vaccine, we’re just seeing, potentially, some localized effect from where the needle went into the thigh.”

Additional supportive measures for babies with RSV symptoms include suctioning the nose, using humidifiers or steam from hot showers, nasal saline spray and watching for secondary bacterial infections.

General prevention: stay home when sick, cough into your elbow, wash and sanitize hands and avoid contact with others when appropriate.

Why this matters

Because infants are especially vulnerable, and because RSV has long been the top reason for hospitalization among U.S. babies, these preventive tools arrive at a critical moment. The Centers for Disease Control and Prevention (CDC) recommends that eligible infants receive protection as early in the RSV season as possible, ideally within the first week of life if born during RSV season.

Key takeaways for parents

• If you’re pregnant, especially in your third trimester, ask your provider about the maternal RSV vaccine.
• After your baby is born, if they’re under 8 months or have certain health conditions, ask about monoclonal antibody protection.
• Even with these tools, everyday precautions still help: hand hygiene, limiting exposure to sick contacts and monitoring for signs of worsening breathing or dehydration.
• Early treatment and care matter: If your baby is working harder to breathe, has decreased feeding, or seems dehydrated, seek medical attention promptly.

OSF OnCall, the digital arm of OSF HealthCare, offers virtual urgent care, a great option for people to be seen without ever stepping foot into an office. Virtual visits can allow your child to be seen and receive a treatment plan in less than half an hour. Additionally, OSF OnCall offers at-home monitoring for babies and toddlers with respiratory illnesses.

Difficulty breathing, or respiratory distress, is a medical emergency. If this happens with your child, take them to the nearest emergency department immediately.

Video Interview Clips

Pneumonia.

It’s a hard enough word to spell, let alone remember how to prevent and treat it. With respiratory illness season here, it’s time for a reminder about how to avoid this possibly deadly condition.

The basics

Fred Burke, MD, an emergency medicine physician who treats people at OSF HealthCare, says pneumonia is a lung infection caused by a virus or bacteria.

“The most common bacteria that causes it is strep pneumonia [in medical terms, streptococcus pneumoniae or pneumococcus]. The viruses that cause it are things like RSV [respiratory syncytial virus], flu [influenza] and COVID-19 [coronavirus],” Dr. Burke says.

In other words, you could get the flu, and it could progress to pneumonia. The phrase double pneumonia means it’s impacting both lungs. Dr. Burke says people with pneumonia could experience coughing, fever, chills and weakness.

“It can cause a consolidation in the lungs. That interferes with air movement,” Dr. Burke says. “You can also get fluid buildup and scarring in the lungs.” Consolidation refers to inflamed cells that form a mass.

Diagnosis and treatment

Dr. Burke says when someone comes to the emergency department with pneumonia symptoms, a health care provider could do a chest X-ray or CAT scan to confirm the diagnosis.

“If we find it’s from a viral infection, people have to ride it out. There’s no treatment for [the ailment itself]. But we can treat the symptoms. We can give Tylenol for fever or an inhaler for shortness of breath or wheezing,” Dr. Burke explains. “If it’s from a bacterial infection, we give antibiotic medication.”

The person could take antibiotics by mouth for one to two weeks. Or, if they are having trouble breathing, the medicine would be given through intravenous (IV) therapy. Either way, the goal is to stop the bacteria in the lungs from growing.

Another tactic is a bronchoscope, where a pulmonologist inserts a tube down your throat to break up mucus in your airways.

But Dr. Burke cautions: don’t let the guidance of some “ride it out” fool you. Pneumonia is a common cause of hospitalization and death worldwide.

“One complication is sepsis, when the infection spreads to the blood. That can cause organ failure,” Dr. Burke warns. “Pneumonia can also cause respiratory failure [when the lungs aren’t working properly]. Those people might require additional oxygen. Or if it serious enough, they might require intubation [a breathing tube down the throat] or be placed on life support.”



Is it contagious?

Yes, pneumonia can spread from person to person, Dr. Burke says. It’s often transmitted through respiratory droplets (coughing or sneezing on someone), but it can spread on surfaces as well. A child could touch a dirty doorknob then put their hands in their mouth, for example.

That’s why everyday hygiene is important. Wash your hands with soap and warm water thoroughly and often. Cough or sneeze into your elbow or a tissue. Stay home and away from others if you’re sick. These are especially important for people at higher risk for pneumonia: people with a history of strokes or seizures, people suffering from substance abuse, people with a compromised immune system (those with HIV or a transplanted organ, for example), smokers and people with chronic obstructive pulmonary disease (COPD).

The United States Centers for Disease Control and Prevention also outlines the guidelines for the pneumococcal vaccine. Talk to your primary care provider if you have questions about the shot.

“The vaccine comes from evidence-based medicine. Experts have done studies. It’s shown to be very effective in decreasing the severity of pneumonia,” Dr. Burke explains. “I would recommend people take the vaccine.”

Interview clips

Related stories

OSF HealthCare library: Pneumonia
Walking pneumonia strolling into little lungs
Protecting infants from RSV
Can't stop coughing?
Better breathing: How we treat COPD
‘Sepsis does not discriminate’
Do you really need that antibiotic?

“It’s important for parents and caregivers to know the signs of labored breathing, also known as respiratory distress,” says Kelsey Grimes, DO, outpatient pediatrician at OSF HealthCare. “This understanding can help them know when it's time for their children to receive immediate medical attention.”

When to seek help

OSF HealthCare has multiple options to use if your child is in respiratory distress.

“During work-time hours, you can call your outpatient pediatrician's office, or primary care provider's office, and try to get a same-day appointment,” Dr. Grimes says. “In that, OSF also has a pediatric nurse triage line where a nurse can provide guidance or recommendations based on the symptoms you tell them. In the evenings, we have the pediatric after hours clinic (2806 Knoxville Ave. Peoria, Illinois), which is a good option.”

Additionally, OSF has multiple OSF OnCall Urgent Care and OSF PromptCare locations. But oftentimes if you're concerned about breathing for your child, the OSF HealthCare Children's Hospital of Illinois pediatric emergency department or calling 9-1-1 is the right first step.”

Why labored breathing happens

“If your child has labored breathing, oftentimes in the pediatric population, the most common cause is a viral infection. With viral infections you get a lot of inflammation, mucus, snot, phlegm – all of that,” Dr. Grimes says. “Kids' airways are smaller. So, inflammation, even on the mild side, makes those airways even smaller. Then when they're plugged up with mucus, or phlegm, they are going to really struggle to breathe.”

Children with significant breathing difficulty may need oxygen support to help them recover. This can be done using high-flow oxygen therapy (HFOT), which delivers air and oxygen down into their respiratory tract. In these cases, hospitalization is required.

At home, nasal saline and suction may be recommended, as well as controlling fevers with Tylenol or Motrin.

Rhinovirus, RSV (respiratory syncytial virus) and influenza, among other virus strains, are common culprits that can cause labored breathing. When treated properly, symptoms should begin to improve after three to four days. However, if symptoms worsen, it could indicate an underlying bacterial infection. This may require antibiotics or even hospitalization, depending on the child’s age and severity of illness.

Protecting kids from germs

“Regular hand hygiene and making sure when we touch surfaces (doorknobs, countertops, etc.) that we're not rubbing our eyes or mouth after,” Dr. Grimes says. “Don't share drinks or bites of food. Do anything you can do to try and prevent germ exposure. It’s hard, because a lot of these kids are in day care, preschool and kindergarten. So, there are no boundaries, and the kids are up close and personal there. You try your best for good hygiene, but in the end, they are probably going to be exposed.”

Signs of respiratory distress

Dr. Grimes says the most important thing to watch out for is how fast your child is breathing. Respiratory distress can cause a child to breathe much faster, or sometimes slower, than normal.

Retraction breathing, or the visible “sucking in” of the skin between or below the ribs, is another red flag.

“This happens because the muscle underlying the skin is really contracting, working hard to get that air in and back out,” Dr. Grimes explains.

Retraction breathing can happen under the rib cage (subcostal), between the ribs (intercostal), above the collarbones (supraclavicular) or at the base of the neck (tracheal tugging). Flaring nostrils are also a warning sign.

Other concerning symptoms include:

• Drooling in children who are past the teething stage
• Blue discoloration around the mouth
• Head bobbing with each breath (an emergency sign)
• Sitting forward and extending the neck in a “sniffing position” to ease breathing
• Wheezing when breathing out
• Grunting when exhaling
• Lethargic behavior (confused, drowsy)

Care and comfort at home

For viral infections, medical teams focus on supportive care, especially fever control.

For babies 2 months old or younger, any high or low temperature warrants an emergency department visit. Do not give Tylenol at this age.

Once babies are over 2 months old, Tylenol may be given in the appropriate dose based on weight, always under guidance from your pediatrician. Once over 6 months of age, babies can receive Motrin, as their kidneys are more developed. Both medications can be given every six hours as needed.

“When kids are having fevers, signs of labored breathing increase as well,” Dr. Grimes notes.

Hydration is also extremely important. “Really make sure to push fluids when your kids are sick. Hydration is key in recovery.”

Parents can help clear their child’s airway by using nasal saline followed by gentle suction. Humidifiers can help loosen mucus, and standing in a steamy bathroom with the shower running hot can offer short-term relief.

The bottom line

Labored breathing can be a sign of serious illness, and early action is the best protection. Parents and caregivers who recognize the warning signs and know when to call their pediatrician or seek emergency care, can help ensure their child receives timely, life-saving support.

Making sure your child receives the recommended childhood vaccines is another way to ensure your child is protected against respiratory illness.

Video Interview Clips

OSF On Call, the digital health arm of Peoria, Illinois-based OSF HealthCare has enrolled nearly 80 more babies and toddlers in a program to monitor at home, those with respiratory illness. The program provides support for patients with a pediatric respiratory virus. Enrollment offers a connection to OSF OnCall care teams 24/7 and monitoring tools that will aid in proactive response to worsening respiratory virus symptoms, keeping infants and toddlers out of the hospital.

September through January of this year, the program enrolled 966 children compared to 890 a year ago. This comes as the Illinois Department of Public Health (IDPH) announced that after a one-week dip, the state’s overall respiratory illness level has ticked up again from Moderate to High, driven by a notable increase in emergency department (ED) visits and hospital admissions for flu.

The program requires a referral from a medical provider and is for babies and toddlers 5 and under with a confirmed diagnosis. Referrals can be made by providers in a hospital emergency department, OSF OnCall Urgent Care, OSF PromptCare, medical offices, or following hospital discharge.

Mary Stapel, MD, lead physician for Community Care for OSF HealthCare Saint Francis Medical Center says RSV and other respiratory infections can often be managed at home.

“For the more common cold type symptoms, we can recommend the conservative treatments at home nasal saline with some suctioning, a cool mist humidifier you know, just kind of frequent, small feedings to optimize keeping that child hydrated.”

Clinical Digital Care Supervisor Rose Smith, RN, says OSF OnCall was able to implement its 24/7 digitally enabled, at-home support program for RSV so quickly two years ago because of its experience with similar monitoring to help patients with chronic conditions such as diabetes and heart failure. Smith says parents and caregivers have loved it.

“They love having support anytime in the day, however they want to do it – text message, phone call, anything. They can send us pictures. We've really kind of taken that to tailor what parents need to feel comfortable taking their children home, you know, from a clinic; from the hospital during the scary time.”

An OSF OnCall software application provides education and notifications to report relevant signs/symptoms over 10 days. Smith says upon enrollment, parents or guardians receive a care kit for at-home use from their provider following a visit or a digital community health worker can deliver one.

“So we have a pulse oximeter to monitor oxygen levels and their heart rate and then we have a thermometer, and we also provide saline spray, and then a bulb syringe. A lot of parents, when their babies are born, they use them in the hospital, but they might not know that they can use them to help relieve any secretions especially before feeding their children.”

Smith adds, it’s also important to clear the nose before a nap or bedtime. Parents also receive step-by-step written instructions as well as a video demonstration for how to use what’s provided in the kit.

Smith says parents who have a child in the program can request a video visit at any time. The OSF OnCall nurse will also recommend a video visit if needed.

“If they think their child looks off, we just have another set of eyes. The providers will look at it (to see if they need a higher level of care). Sometimes our nurses can tell the parents you know, ‘We think they need to be seen. Can we do a video visit just before you take your child out, especially now that it's colder out?’ You know, we don't want them if they're having trouble breathing to go outside, but we really just focus on what works best to still get them the care that they need.”

Dr. Stapel advises making sure you and everyone around you practices good hand hygiene, coughs into the inside of their elbow, and stays home from parties and other obligations if you are sick.

If you suspect your child has symptoms of RSV, the flu, or some other respiratory virus that don’t appear life-threatening, you can reach out to your pediatrician, primary care provider or OSF OnCall Urgent Care which also has a virtual visit option anytime.

Dr. Mary Stapel

Rose Smith

B-roll for OSF OnCall at-home pediatric respiratory monitoring

Author's note: This is part two of a four part story on infant nutrition misconceptions. Read part one here, part three here and part four here.



Bringing a new baby home raises the focus on their and mom’s well-being. Toward the top of the list: what and how the child is being fed.

Whether you choose to breastfeed or use formula, misconceptions about infant nutrition are everywhere. Xandra Anderson, a certified lactation consultant at OSF HealthCare, cuts through the noise.

• Do I need to change what I put in my body while breastfeeding?
  
  This covers a lot of ground, from a mom’s diet to whether she should abstain from alcohol, caffeine, tobacco and medication.

o    Diet: Healthy eating is always good. But Anderson says new moms generally don’t have to change their diet for breastfeeding. If your diet is heavy on certain things (like garlic or dairy) and you notice your baby is extra fussy, you can try changing your meals. A provider may also want to test your baby for allergies.

o    Alcohol and caffeine: Drink these in moderation and with precise timing, Anderson says.

“Babies are very sensitive to caffeine. If you have a cup of coffee and nurse right away, the baby is going to be awake for a lot longer than normal,” Anderson says.

“That doesn’t mean you have to not drink coffee. Just maybe not add three shots of espresso to your morning coffee,” she adds with a smirk.

For alcohol, Anderson says the drink will filter out of your breastmilk like it filters out of your blood. So after having a couple of alcoholic drinks, wait two to three hours before breastfeeding or pumping.

“The breastmilk isn’t ruined. You just need to give it time,” Anderson says.

But here’s a lifehack if mom feels full of breast milk and wants to pump right after having a drink: Go ahead and pump, and use the milk on your baby’s acne or in their bathwater. Just keep it away from their mouth.

“It’s antimicrobial. It’s antibacterial. It’s moisturizing,” Anderson says, singing the praises of breast milk. “Our babies are in the most perfect environment in the womb. Once they’re born, their world is cold, dark and dry. They can get dry skin, acne or cradle cap [greasy or flaky spots on the scalp]. Breast milk is a great way to prevent or heal those things.”

o    Medication and other health care issues: Anderson says most medication is safe to use while breastfeeding. In fact, it’s important to stay the course – for example, with mental health medication – so you can be the best mom possible. Talk with your health care provider if you have questions.

If you have a medical procedure, also get advice from a professional. For example, Anderson says if you get a hepatobiliary iminodiacetic acid (HIDA) scan for a gallbladder concern, you’ll be radioactive for around 24 hours. Don’t breastfeed during that time. Or if your breasts feel full and you have to pump, dump the milk down the drain.

o    Tobacco: Anderson admits it’s tough to kick the habit. But she reminds moms: infants are very sensitive to nicotine. It can disrupt the child’s sleep and feeding and even interfere with organ development. Secondhand smoke can increase the risk of a respiratory infection and sudden infant death syndrome (SIDS).

If you’re smoking with a new baby at home, do so after breastfeeding, then wait two to three hours before nursing again. Wear one jacket while smoking so you don’t get an odor or residue on a lot of your clothes or the baby.

Learn more

Read more about how to have a successful pregnancy and following years on the OSF HealthCare website.

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Freddie Freeman has plenty to be grateful for this holiday season. Not only did his Los Angeles Dodgers win the World Series in October, but the first baseman was named the series most valuable player.

But the best news for Freeman and his wife is that their young son is recovering after a scary bout of Guillain-Barré (pronounced Ghee-yan Bah-ray) Syndrome (GBS).

“Guillain-Barré Syndrome is an illness that we see often in adults, but we can see it in children as well,” says Asma Khan, DO, a pediatrician with OSF HealthCare. “It's an inflammation of the body. It's like an autoimmune disease but it's an inflammation where the body attacks its nerve cells.”

While experts aren’t sure of the exact cause of GBS, many people with Guillain-Barré exhibit early symptoms of an infection before a diagnosis is found. Freeman’s three-year-old son, Max, first started experiencing symptoms in July when he developed a viral infection. When Max was unable to stand or walk without being in pain, his parents rushed him to the hospital.

“Usually there's an illness about a few weeks prior to the onset of Guillain-Barré, within four to six weeks prior, and it's either a GI infection or upper respiratory infection,” says Dr. Khan.

Symptoms usually happen suddenly, can affect both sides of your body and start in the feet and legs. “We see signs of weakness,” says Dr. Khan. “We see some nerve issues where they have numbness, tingling, and weakness of the muscles progresses from your lower extremities, from your legs all the way up, and it can even reach your eyes, your lungs. So, it's progressive.”

While it’s rare, anyone can get GBS, but it’s more common in adults and especially in males. But Dr. Khan has seen a few cases in her pediatric practice.

“We notice the child having leg pain and refusing to walk or having an abnormal gait,” she says. “That's usually your triggering factor that you notice first, and then, upon evaluation, you notice weakness in the lower extremities, and then the reflexes are diminished or absent.”

The most severe problem is trouble breathing. Dr. Khan explains that as muscles and the chest wall get weaker, respiratory failure can occur. That’s the reason hospitalization is so important.

“We want to make sure they're eating okay,” she adds. “So as the weakness progresses, is it affecting their ability to swallow or choking? Do we need to give them a feeding tube? Do we need to give them fluids? And then the big thing that we need to really watch is respiratory status.”

Treatment includes plasma exchange, which filters out the antibodies in the plasma that are attacking the nerves. Another treatment, intravenous immunoglobulin therapy (IVIG), involves IV injections of immunoglobulins which are proteins that the immune system makes. IVIG can reduce the immune system’s attack on the nerves.

Physical, occupational and speech therapy may also be required, depending on the severity of the symptoms.

Dr. Khan says most people completely recover from Guillain-Barré Syndrome, but it can take six to 12 months, or longer. However, some people may experience lingering effects including weakness and fatigue.

Freeman has posted on his social media accounts that Max is back home and recovering. Still, the young boy has a long road ahead to regain his strength and learn to walk again.

For more information on children and Guillain-Barré Syndrome, visit the OSF HealthCare website. 

 

Interview Clips 

When it comes to oral health in kids, Emily Isom has seen it all.

Cavities, gum disease and infections, improper tooth alignment and tooth loss come to mind quickly. Not to mention all the missed school time dealing with these issues.

But she’s also seen plenty of young people who are the picture of good oral health. And she’s on a mission to make more of the latter.

“The mouth is the gateway to the body,” says Isom, a certified medical assistant in pediatrics at OSF HealthCare and a former dental assistant.

“A lot of people don’t think about what our oral health can do to us if it’s not being taken care of,” she adds. “It can cause heart disease, diabetes and respiratory infections.”

Everyday prevention

Isom says kids and their parents should commit to daily habits that will improve their oral health.

For infants without teeth, Isom says parents should use a soft, cool washcloth to wipe the child’s gums twice a day. This helps clear bits of food and milk that can lead to bad breath, irritation and cavities.

“Touching their gums will help when they are older. They’ll be okay with brushing their teeth. They won’t fight the parents about it,” Isom says. “So, it’s good to start [oral health care] early."

Older kids should brush their teeth for two minutes, twice a day. Floss once a day. When a child has two teeth that touch, it’s time to start flossing. That could happen from ages two to six.

Before you rinse out your mouth with water, don’t forget about the tongue, Isom says.

“If we do not brush our tongue, bacteria can sit on it. It can get what I call ‘tongue sick,’” Isom says. “Bad breath can also happen.”

Outside of the bathroom, Isom reminds us that sugary and starchy food and drinks are prime suspects in oral health issues like cavities. So, parents should offer those foods in moderation. Isom calls out sticky candy as an example. She says the sugar tends to sit on your teeth for a while. Isom also says starchy food like bread, potatoes, rice, pasta and cereal can sit between your teeth unless you floss right away.

Another must-know for parents with babies: don’t put your baby to bed with a bottle. Aside from a choking hazard, Isom says the constant stream of milk or formula can lead to cavities and corrosion. She also says this can cause infants to be fussy and demand a bottle more often.

It takes some convincing

A mother of a six-year-old, Isom knows that some kids won’t brush and floss willingly. They see it as a chore.

Her response: make oral health fun.

“Make a dental chart. Add stickers to it, morning and night,” Isom suggests. “Give them rewards like a little toy. After each cleaning, they can get a reward. Turn on music or a timer for two minutes [of brushing.] Get toothbrushes with their favorite characters on them.”

Dentist visits

Isom says children usually have regular visits with a dentist twice a year. Others with known mouth issues may go every three to four months. But see a dentist right away if you notice red flags: pain in the mouth, persistent bad breath, discolored gums or teeth, bleeding gums or trouble swallowing.

A regular dental visit usually includes a thorough cleaning of the teeth and gums followed by fluoride treatment.

“[Fluoride] protects the enamel of the teeth,” Isom explains. “It protects your teeth from cavities. It just makes your enamel really strong so you can eat the things you want.”

A dental professional may also perform X-rays on your teeth regularly.

Something else for parents to make sure the dentist has in mind: oral cancer screening.

“Those are huge,” for oral health, Isom says.

A dentist may use their hands to examine your mouth and neck. They could use a light or have you rinse your mouth with a blue dye. Each method looks for abnormal, possibly cancerous tissue.

At the end of a dental visit, you may be sent home with a prescription or just instructions to keep your mouth happy. For example, you may get a prescription mouthwash to help with gum disease.

Learn more

Read more about how to keep kids’ mouths in good health on the OSF HealthCare and U.S. Centers for Disease Control and Prevention websites. If you don’t have a family dentist, talk to your primary care provider about finding one. OSF HealthCare Children’s Hospital of Illinois in Peoria offers dental care for children with special needs.

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