Croup is a common airways infection affecting babies and young children. It usually affects those between six months and three years old but can affect younger and older children too. It affects the upper airways – the throat and nose – to cause a distinctive barking cough and a harsh sound (stridor) when they breathe in. A low-grade fever and blocked or runny nose and a hoarse voice may also develop. Croup is commonly caused by a virus called the parainfluenza virus. Usually, croup can be managed at home and clears up within 24 to 48 hours. However, if children also develop difficulty breathing or look short of breath, it is important to seek urgent medical attention.
If you think your child has croup, you should take them to your doctor. They will take a history and decide on the severity of your child's symptoms and how they should be treated. Your doctor may consider prescribing a short course of oral steroid medication to reduce inflammation in your child's throat. Mild croup can be treated at home. It is important to ensure your child is drinking plenty of fluid in order to prevent dehydration. Keeping your child calm and comforted is helpful, as agitation can aggravate symptoms. In terms of medication, simple painkillers such as paracetamol or ibuprofen can relieve pain and reduce fever. It is advised not to use cough syrups as the effectiveness is unclear and some contain ingredients that may make children drowsy which could be potentially very dangerous if their breathing is affected.
If your child's symptoms are getting worse or they are severe, your doctor will advise you to attend the hospital for further treatment. Severe difficulty breathing may require adrenaline to help improve symptoms. This can be delivered via a nebuliser which allows your child to breathe the medication in. If their oxygen levels are low, this can be given as needed via a mask. Rarely does croup develop into a serious condition. In these cases, your child may require intubation (a tube is inserted down their throat) to help them breathe. Try to keep in mind that it is very rare for children to die from a croup infection.
Croup is caused by a virus, and so it's best to maintain good hygiene methods such as regular hand washing, making sure you cough or sneeze into a tissue and throw it away immediately, and clean surfaces thoroughly. Some routine childhood vaccinations protect against some of the infections that can cause croup, so it is strongly recommended to keep your child up to date with the vaccination schedule. These include the MMR (measles, mumps, and rubella) vaccine and the DTaP/IPV/Hib vaccine that protects against tetanus, diphtheria and polio, whooping cough and Haemophilus influenzae B. Ultimately children will catch a lot of viruses that usually cause only mild illness, and their immune system builds with these infections. It's very difficult to stop your child mixing with others to prevent infections, as many children will have infections at any one time, and it's part of their normal social development (and immune development) to interact with each other.
Croup is contagious and can spread from one infected individual to another. It is passed on through respiratory droplets from coughing or sneezing or coming into contact with infected surfaces. A person with croup is infectious for about three days after the symptoms have started, so it is always best to keep children home until their symptoms or fever has resolved. It's rare for adults to catch the infection, although it's usually mild if they do.