Croup is a viral infection of the voice box and windpipe that causes swelling around the vocal cords. It mostly affects children aged 6 months to 5 years, often in autumn and winter. It causes a loud, barking cough and a harsh sound when breathing in (stridor), usually worse at night. Most cases are mild and get better in 2 to 3 days, but severe croup can block the airway and needs urgent care.
Symptoms
A loud, barking cough like a dog or seal
A harsh, high-pitched sound when breathing in (stridor)
Hoarse voice
Runny nose and mild fever, often a day or two before the cough
Symptoms usually worse at night
Causes
Viruses, most often parainfluenza virus
Spread by coughs, sneezes and dirty hands
Young children have small airways that swell easily
Sometimes measles or influenza
Prevention
Wash hands often with soap
Keep sick children away from babies when possible
Keep the home free of smoke
Vaccinate on time, including the measles vaccine
Treatment
Keep the child calm and comfortable — crying makes breathing harder; hold the child upright on your lap
Give fluids often
Paracetamol for fever or discomfort, in the right dose for age and weight
A single dose of a steroid medicine (dexamethasone or prednisolone) given by a doctor reduces the swelling
Severe croup: oxygen and nebulised medicine in hospital
Do not give cough syrups, and do not try to look into or put anything in the throat
Common questions
Does steam help croup?
Steam has not been shown to help, and hot water can cause serious burns. Keeping the child calm, upright and in fresh, cool air is safer; get medical help if breathing is noisy at rest.
Is croup contagious?
Yes. The viruses that cause croup spread like a cold, so wash hands and keep the sick child away from babies. Older children and adults usually only get a cold from the same virus.
