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Croup is a viral infection of the voice box and windpipe and epiglottitis is a bacterial infection of the epiglottis, the ‘flap’-like valve that guards the airway.

Both croup and epiglottitis are conditions that mainly affect children.


Croup The onset of croup is slow, usually after another illness, such as a cold or a sore throat. Croup will normally last three to four days and the child may have repeated attacks. Croup is often a mild illness but can get worse quickly, and is often worse at night.

• appear worse at night
• cold-like symptoms
• hoarse, ‘barking’ cough (like a seal)
• pale, cool, clammy skin
• may have a slight temperature
• may have breathing difficulty
• may have inspiratory or expiratory stridor (a shrill, harsh sound)

• reassure the child
• manage any fevers – the doctor may direct you to give them paracetamol if they have a fever. Follow the instructions on the packet regarding dose
• give frequent drinks to keep the child well hydrated
• if there is severe breathing difficulty, or, if the child is distressed, seek medical assistance.
• DO NOT examine the throat
• DO NOT use steam as it does not help and may lead to accidental burns

Croup can quickly become serious, so do not hesitate to get medical help. There is effective treatment for severe episodes of croup.

Humidification of the air is often recommended for croup but there is no information to prove that it has any benefits and increases the risk of burns from the hot water or steam.


Epiglottitis Epiglottitis is usually due to infection by the Influenza B bacteria. It is a life-threatening condition. It affects children in the two to seven year range with four years the most common age affected.

The infection of the epiglottis causes a gradual obstruction of the airway by the swollen tissue.

Epiglottitis is an emergency and requires urgent ambulance transport to hospital.

• skin often flushed and a high temperature
• child is quiet, doesn’t cough, leans forward and won’t talk
• appears anxious
• salivary drool, unable to swallow
• rapid onset over one or two hours
• child usually has an expiratory ‘purr’, though other noisy breathing is common

• call ‘000’ for an ambulance
• reassure the child
• keep calm
• allow the child to sit in a position of comfort, usually leaning forward and nursed, while in the sitting position, by a parent.
• DO NOT examine the child’s throat as this may cause complete blockage

When to seek help If the child has any of the following, go to a doctor or hospital straight away:

• The child’s breastbone is drawn in when they take a breath.
• The child becomes pale or blue (cyanosed).
• The child becomes restless, irritable and/or delirious.
• The child has a high temperature and is dribbling.
• The child has breathing difficulties.
• The child is not drinking enough;
• You become concerned for any other reason.