Ear Infections are Surging: What’s the Cause?

We all heard about the massive spike in cases of influenza and RSV (respiratory syncytial virus) last fall. Pediatric departments at local hospitals were full to overflowing as record numbers of children became seriously ill.Infant crying due to ear pain

Unfortunately, that spike is now contributing to a surge in ear, nose, and throat (ENT) illnesses among kids. Ear infections, in particular, have skyrocketed—both in frequency and severity. And it isn’t only one- and two-year-olds who are suffering from this wave. A surprising number of older kids—who are typically past the ear infection age—are also coming down with ear infections.

What’s behind the spike?

The link between flu and RSV and ear infections is well established. Studies have shown that children who had a flu or RSV infection are more likely to develop an ear infection in the following weeks or months.

One of the biggest reasons is what’s called an “immunity gap.” The flu and RSV both weaken the immune system, making it easier for bacteria to infect the middle ear. The cough and congestion associated with these illnesses can also make it harder for fluid to drain from the middle ear, leading to an increased risk of ear infections.

Also, flu and RSV are both viral infections that attack the respiratory system, leading to inflammation and fluid buildup in the middle ear. When this fluid becomes infected, it can cause an ear infection.

Ear infections are particularly common in children. They have shorter and narrower Eustachian tubes than adults, making it easier for fluid to get trapped in the middle ear. Additionally, young children have a weaker immune system in general, making them more susceptible to infections.

Symptoms of mild ear infections

Mild ear infections can cause a range of symptoms, including:

  • Ear pain: A child may complain of a dull or sharp pain in their ear. The pain may be constant or intermittent.
  • Pulling or rubbing the ear: Children may try to relieve their discomfort by pulling or rubbing their ears.
  • Trouble sleeping: The pain may cause difficulty sleeping, especially when lying down.
  • Muffled hearing: The fluid buildup in the ear can make it harder for the child to hear.
  • Drainage from the ear: A mild ear infection may produce a small amount of yellow or white fluid from the ear.
  • Fever: Children with mild ear infections may have a low-grade fever, usually less than 101°F.

Watch for signs of severe ear infections

Severe ear infections require prompt medical attention. Parents should watch for these symptoms:

  • Intense ear pain: The most common symptom of a severe ear infection is intense pain in the affected ear. This pain can be constant and can worsen when the child lies down or chews.
  • Hearing loss: Severe ear infections can cause temporary or permanent hearing loss, especially if the infection persists for a long time.
  • Discharge from the ear: Yellow or green discharge may indicate a bacterial infection.
  • High fever: A high fever is a common symptom of severe ear infections, particularly in children. A fever of 100.4°F or higher is considered high and may indicate a serious infection.
  • Nausea and vomiting: Some children with severe ear infections may experience nausea and vomiting, particularly if the infection spreads to the inner ear or brain.
  • Dizziness and balance problems: Severe ear infections can cause dizziness and balance problems, especially if the infection spreads to the inner ear.
  • Facial weakness: In rare cases, severe ear infections can spread to the facial nerve, causing weakness or paralysis of the face on the affected side.

If your child experiences any of these symptoms, it's important to seek prompt medical attention. Early treatment can help prevent complications and reduce the risk of permanent hearing loss or other serious problems. Your child’s pediatrician may prescribe antibiotics or other medications to treat the infection. They may also refer you to a specialist like Iowa ENT Center for further evaluation and treatment.

When is it time for ear tubes?

In some cases, recurrent or severe ear infections may require surgical intervention, such as the placement of ear tubes. Ear tubes are small, cylindrical devices that are inserted into the eardrum to provide ventilation and drainage of fluid from the middle ear. They’re a common treatment option for children with frequent or severe ear infections that don’t respond to other treatments, such as antibiotics.

Here are some signs that it may be time to consider ear tubes:

  • Recurrent ear infections: The general guidelines for ear tubes is three or more ear infections within six months or four or more infections within a year.
  • Chronic fluid in the middle ear: Children with persistent fluid in the middle ear, even after an ear infection has resolved, may benefit from ear tubes.
  • Hearing loss: Kids with hearing loss due to recurrent or persistent ear infections may require ear tubes to restore normal hearing.
  • Developmental delays: If recurrent or severe ear infections are causing speech and language delays, ear tubes can help to improve hearing and reduce the risk of these problems in the future.
  • Pain or discomfort: Kids with severe or persistent ear pain or discomfort may be candidates for ear tubes.

We’re here to help

If you’re concerned about your child’s ear infection(s), Iowa ENT Center can help—and most insurance plans don’t require a referral to see one of our providers. Request an appointment online or call 515-223-4368.