Q: My four-year daughter has a permanent cold. Her nose is always runny and she constantly complains of irritation in her throat. I have tried different antibiotics, but nothing seems to help. I noticed that her problem begun after she started school (baby class). Could she be picking up colds from her classmates? Is there something wrong with her immunity? Would giving her the flu vaccine help?
The first thing you need to do is to stop giving your daughter antibiotics. They will not cure her problem and can be potentially harmful to her.
A runny nose (also known as rhinitis) can either be caused by an infection (usually a virus) or by non-infective causes such as an allergy. None of these respond to antibiotics. Usually a runny nose that is due to a virus (common cold) lasts about a week and the body is able to clear it without the use of any medication.
The viruses that cause the common cold are found within our environment and can be passed on from person to person by sneezing and coughing. For this reason, it is not unusual to find individuals who spend large amounts of time with each other all having a cold at the same time.
Many nursery school teachers find that an entire class can be sniffling and sneezing due to this (the same thing happens to family members living in the same household). Unfortunately, there is nothing much you can do to prevent this. That said, your child cannot have a common cold that lasts an entire term.
Another cause of persistent rhinitis is allergies. Usually the runny nose is accompanied by an itchy throat and nose. Sometimes the eyes may be itchy as well.
Your child may also have eczema and features of asthma. The most common culprit for allergic rhinitis in the household are dust mites. Dust mites are tiny (microscopic) creatures that are present in all homes (regardless of level of cleanliness or social status).
They mainly live in bedrooms, mattresses, pillows and carpets as part of the dust. They prefer bedrooms (especially beds and bedding) because we shed skin cells for them to feed on, we provide them with water from our sweat and the warmth of the bed allows for them to breed. They usually cause no harm but some people are allergic to their droppings (faeces).
Another household culprit for allergic rhinitis are household pets. In Kenya, we tend to have more issues with cats, but dogs and birds can also be a problem.
Outside the house, pollen from plants/flowers can irritate your nose (popularly known as ‘hay fever’).
Symptoms of allergic rhinitis are due to the immune system reacting to the allergen (such as house dust mite droppings or pollen) and releasing chemicals which cause the lining of the nose to swell. One such chemical is histamine (this is why people with allergies get anti-histamine drugs).
Things in your daughter’s environment can cause her to have a runny nose. These are irritants and not really allergens. Common irritants include dust, smog, car fumes, smoke (including second-hand cigarette smoke) and strong odours such as perfumes found in detergents/fabric softeners, sprays and air fresheners.
In some children, change in weather or humidity can cause them to get swelling of the tissues in the nose causing it to become congested.
Persistent rhinitis can sometimes be complicated by the development of nasal polyps (small growths in the nose), sinusitis and ear infections. Finding the cause of your daughter’s persistent rhinitis can be a challenge (especially since the possible culprits are so many!).
Most of the time, persistent rhinitis can be managed by your child’s paediatrician so you need to start by taking your daughter for a check-up. If there are any concerns, the paediatrician may refer your child to an allergy specialist who may be a little more aggressive in their approach. In cases of sinusitis and nasal polyps, an ENT (ear nose and throat) specialist may need to be consulted.
DR MUKUHI NG’ANG’A will answer your questions on lifestyle and other diseases and medical issues for both children and adults. Send questions to: [email protected]