by Diana Koelliker, MD
Croup is an upper respiratory illness caused by a virus. The virus affects the tissue around the level of the vocal cords and causes swelling, which can lead to noisy breathing and a bark-like cough. It is typically seen in children ages 6 months to 5 years, although it is occasionally seen in older children. The illness is most prevalent in the fall and winter months, but can occur year round. Transmission of the illness is by respiratory droplets (coughing or sneezing) and/or direct contact. Most children with croup will have a hoarse voice, runny nose, fever and the characteristic bark-like or croupy cough. The illness usually lasts about 4-6 days with a peak of symptoms around the 2nd or 3rd day. In the majority of cases, the disease is mild and self-limited (meaning it gets better without any intervention).
Occasionally, children can exhibit more severe airway obstruction and may require nebulized medication or even hospitalization. Research has shown that a single dose of oral or injected steroids (like Dexamethasone) can shorten the course and lessen the severity of the symptoms. Treatment of croup is aimed at encouraging fluid intake and treating fever with acetaminophen or ibuprofen. Additionally, humidified air, in the form of a vaporizer or humidifier is helpful in lessening the symptoms.
Because croup is caused by a virus, antibiotics are not necessary or effective in the treatment. It is contagious, so ill children should not go to school and good hand washing/general hygiene should be observed to prevent spread of the virus. You should contact your doctor if your child has a croupy cough to discuss treatment options.
Dr. Koelliker is Board Certified in Emergency Medicine. She and her husband, Dr. Paul Koelliker, moved to Farmington, NM after their residencies. They worked as Emergency physicians at San Juan Regional Medical Center for 6 years.
Diana balances her time between work and time with her family and friends. Her 5 year old son, Jackson, is energetic and keeps her running. She loves skiing, jogging, playing softball and mountain biking.