Common Illnesses

  1. COMMON COLD
  2. FEVER
  3. GASTROENTERITIS
  4. CHICKEN POX
  5. EARACHES
  6. BURNS
  7. POISONING
  8. FIFTH DISEASE
  9. ROSEOLA
  10. TICKS

COMMON COLD:Sneezing, scratchy throat, runny nose - everyone knows the first signs of a cold, probably the most common illness known. The common cold is usually mild, with symptoms lasting 1 to 2 weeks. Children have about 6 to 10 colds a year. One important reason why colds are so common in children is because they are often in close contact with each other in daycare centers and schools. In families with children in school, the number of colds per child can be as high as 12 a year.

Causes
More than 200 different viruses are known to cause the symptoms of the common cold. Some, such as the rhinoviruses, seldom produce serious illnesses. Others, such as parainfluenza and respiratory syncytial virus, produce mild infections in adults but can precipitate severe lower respiratory infections in young children.

There is no evidence that you can get a cold from exposure to cold weather or from getting chilled or overheated. There is also no evidence that your chances of getting a cold are related to factors such as exercise, diet, or enlarged tonsils or adenoids. On the other hand, research suggests that psychological stress and allergic diseases affecting your nose or throat may have an impact on your chances of getting infected by cold viruses.

The Cold Season
In the United States, most colds occur during the fall and winter. Beginning in late August or early September, the rate of colds increases slowly for a few weeks and remains high until March or April, when it declines. The seasonal variation may relate to the opening of schools and to cold weather, which prompt people to spend more time indoors and increase the chances that viruses will spread to you from someone else.

Seasonal changes in relative humidity also may affect the prevalence of colds. The most common cold-causing viruses survive better when humidity is low-the colder months of the year. Cold weather also may make the inside lining of your nose drier and more vulnerable to viral infection.

Symptoms
Symptoms of the common cold usually begin 2 to 3 days after infection and often include:

  • Mucus buildup in your nose
  • Difficulty breathing through your nose
  • Swelling of your sinuses
  • Sneezing
  • Sore throat
  • Cough
  • Headache
  • Fever is usually slight but can climb to 102 degrees Fahrenheit in infants and young children.

Cold symptoms can last from 2 to 14 days, but like most people, you'll probably recover in a week. If symptoms occur often or last much longer than 2 weeks, you might have an allergy rather than a cold.

Complications
Colds occasionally can lead to bacterial infections of your middle ear or sinuses, requiring treatment with antibiotics. High fever, significantly swollen glands, severe sinus pain, and a cough that produces thick, colored mucus, may indicate a complication or more serious illness requiring a visit to the office.

Transmission
Cold viruses are spread by hands touching infected noses and mouths and then touching environmental surfaces, such as telephones, doorknobs, and stair rails, or other people. Those hands touching your eyes or nose will spread the virus. Cold viruses may also be acquired by inhaling drops of mucus full of cold germs from the air

Treatment
There is no cure for the common cold, but your child can get relief from cold symptoms by resting in bed, dinking plenty of fluids, gargling with warm salt water or using throat sprays or lozenges for a scratchy or sore throat, using petroleum jelly for a raw nose, and taking acetaminophen or ibuprofen, and over-the-counter cold medicines. Nonprescription cold remedies, including decongestants and cough suppressants, may relieve some of your cold symptoms but will not prevent or even shorten the length of your cold. Moreover, because most of these medicines have some side effects, such as drowsiness, dizziness, insomnia, or upset stomach, you should take them with care.

Antibiotics
Never take antibiotics to treat a cold because antibiotics do not kill viruses. You should use these prescription medicines only if you have a bacterial complication, such as sinusitis or ear infections. In addition, you should not use antibiotics "just in case" because they will not prevent bacterial infections, and there is a risk of having a reaction to the medication itself.

Prevention
There are several ways you can keep yourself from getting a cold or passing one on to others. Because cold germs on your hands can easily enter through your eyes and nose, keep your hands away from those areas of your body

  • If possible, avoid being close to people who have colds.
  • If you have a cold, avoid being close to people.
  • If you sneeze or cough, cover your nose or mouth.

Washing your hands with soap and water is the simplest and one of the most effective ways to keep from getting colds or giving them to others. During cold season, you should wash your hands often and teach your children to do the same. When water isn't available, CDC recommends using alcohol-based products made for washing hands.

Rhinoviruses can live up to 3 hours on your skin. They also can survive up to 3 hours on objects such as telephones and stair railings. Cleaning environmental surfaces with a virus-killing disinfectant might help prevent spread of infection.


FEVER: A body temperature of 101 rectally (100' under the arm) or greater.

A very common symptom of almost any illness is fever. Even with relatively minor illnesses, body temperatures can occasionally become quite elevated When fevers are caused by viruses, as in colds and flu, antibiotics are not effective. However, antibiotics can be extremely effective in bacterial infections, and an examination of your child is necessary to determine both the cause and the proper therapy.

Please remember the degree of the temperature alone does not determine the severity of the illness. How sick the child looks and acts is most important.

Also, current research has shown that the natural body reaction of fever will help reduce the multiplication of virus and bacteria.

Once the cause of the fever has been established and treated, the next step is to control the temperature itself. This can best be accomplishedby taking the child's-temperature every four hours, and then administering the proper doses of Acetaminophen or Ibuprofen (Motrin or Advil). Frequently, the temperature will not normalize with Tylenol or Motrin, butthe fever should diminish.

The doses outlined on the next page of Acetaminophen (Tylenol, Tempra, Panadol, Datril, etc.) can be given every 4 to 6 hours. Motrincan be given every 6 hours.

For high fever, Tylenol and Motrin may be given in alternating doses every three hours: give Tylenol and then three hours later give Motrin,followed by another dose of Tylenol three hours later. Do not continue both medications for more than 24 hours without contacting the office.

Remember, a child with a fever requires extra fluids, and you should encourage as much liquids as the child will tolerate. A lukewarm bath is comforting, but be sure to stay with your child when he is in the water. DO NOT rub the child down with alcohol or ice water.

Potential Danger Signs:

  • Fever accompanied by headache and a stiff neck
  • Seizures or convulsions with fever
  • A child with fever who is difficult to arouse
  • Fever in an infant less than 3 months of age
  • Fever of 104.5 or over that does not respond to adequate doses of Acetaminophen

Call us immediately if any of the above symptoms occur.

Please see the dosage chart under the medicine cabinet.


GASTROENTERITIS: a viral illness resulting in vomiting, diarrhea and fever.

When your child has vomiting and/or diarrhea, he is unable to tolerate daily diet and any attempt to continue it will only make his condition worse. In addition, do not offer the child milk, as it is difficult to digest when the stomach is upset. We do, however, recommend a diet of clear liquids once gastroenteritis has been diagnosed.

CLEAR LIQUID DIET

  • Ricelyte, Pedialyte, or Lytren (best choice)
  • Gatorade (second choice)
  • Water or ice chips
  • Soft drinks (flat, no caffeine)
  • Clear Broth, Weak Tea, Popsicles
  • Jello (No apple or orange juice)

A thirsty child may try to drink large amounts of fluid at once, causing him to vomit. It is better to offer small amounts of clear fluid frequently. If even small sips are not tolerated, the child should be seen in the office.

After the child has been able to tolerate the clear liquid diet for 24 hours, and is requesting more to eat, his diet can be advanced to what is referred to as a "BRAT" diet.

A "BRAT" diet includes:

  • Bananas (fresh, dried or baby food)
  • Rice (puffed, steamed, ricecakes, rice crispies)
  • Apples (applesauce, apples fresh or dried)
  • Toast (no butter)

This diet is not only easy to digest, but also tends to firm up the child's stool. Once the BRAT diet is tolerated for a 24 hour period, the child's regular diet may be slowly re-introduced over the next few days.

Please call and check with our office before administering any medication. Usually gastroenteritis is better treated with a special diet.

POTENTIAL DANGER SIGNS

  • Persistent vomiting without diarrhea
  • Severe abdominal pain
  • Blood in vomitus or bowels
  • Inability to retain even small amounts of clear liquids
  • Dry mouth, decreased urination, dry eyes
  • Symptoms that worsen or do not improve after 2 days of treatment (24 hours in infants).

Call us immediately if any of the above symptoms occur.


CHICKEN POX: A mild, highly contagious viral disease, marked by an eruption of blisters on skin and mucous membranes.

The onset of Chicken Pox is indicated by a slight elevation of temperature, followed (within 24 hours) by appearance of the first eruptions. The temperature usually continues to rise further after the first blisters have appeared.

Chicken Pox may occur at any age, though it is less common in adults than in children. The incubation period after exposure is 14-21 days. The child remains contagious until all spots have dried and scabbed over.

Medications:

  • Acetaminophen - for fever
  • Benadryl (Elixir) -for itching
  • Baking Soda or Aveeno Baths -for itching
  • Aveeno Lotion/Calamine Lotion

Please call the office if child has prolonged vomiting or any other symptoms seemingly unrelated to Chicken Pox, such as lethargy, mental confusion, respiratory distress, or severe sore throat.


EARACHES

Most earaches seem to occur in the middle of the night. They result from infection at the eardrum, usually secondary to a cold. To treat the problem, give the child a dose of Tylenol or Ibuprofen appropriate for the child's weight, 3 drops of warm vegetable oil in the ear (or medicated drops like Auralgan), a decongestant like Sudafed, and a heating pad to the affected ear. Call the office first thing in the morning for an appointment, because without appropriate treatment middle ear injury could occur.


BURNS: Tissue injury resulting from excessive exposure to thermal, chemical or electrical agents.

Do not panic. Immerse the burn surface in cold water. Use a large bowl, the sink or the bath tub and try to avoid the direct pressure of running water.

Call the office for guidance. The child may have to be seen by the doctor, or in more extreme cases, by the emergency room.

With bums, treatment varies with the type and extent of bodily involvement.


POISONING: The ingestion and/or absorption of a toxic substance.

Poisoning is a very common household accident which, if not handled properly, can have disastrous consequences. As in most other accidents, prevention is the best course of action. All medications and household cleaning products should be kept out of the reach of children. In addition, you should have the number of the Poison Control Center near your phone.

However, when accidental poisoning has occurred, avoid becoming excited. Contact the Poison Control Center immediately at 1-800-222-1222. Attempt to identify the type and amount of the toxin by checking the container, questioning the child, noting any burns, stains, odors, or symptoms. Do not discard the poison; keep a sample of the toxin and the original container.

Dilute the poison at once with a large quantity of milk or water. DO NOT INDUCE VOMITING UNLESS INSTRUCTED TO DO SO.

When you call, please provide the following information: What was ingested, how much was taken, when it was taken, and what condition the child is in now.


FIFTH DISEASE

Fifth disease is a viral illness that is associated with an exanthem. Exanthem is another name for a rash or skin eruption. It is spread from one child to another through direct contact with discharge from the nose and throat. It can also be spread through contact with infected blood. It is moderately contagious and usually does not include a high fever, as seen with some other viral skin conditions.

What causes fifth disease?

Fifth disease is caused by the human parvovirus. It is most prevalent in the winter and spring and is usually seen in children 5 to 14 years of age. Outbreaks of the disease frequently occur in school settings.

What are the symptoms of fifth disease?

It may take between four to 14 days for the child to develop symptoms of fifth disease after being exposed to the disease. Children are most contagious before the rash occurs. Therefore, children may be contagious before they even know they have the disease. Also, about 20 percent of people with the virus do not have symptoms but can still spread the disease. The following are the most common symptoms of fifth disease. However, each child may experience symptoms differently. Symptoms may include:

  • There may be an early phase with the following symptoms, although this is not very common. If present, symptoms may include the following:
    • fever
    • headaches
    • red eyes
    • sore throat
  • The rash is usually the primary symptom of fifth disease. The rash:
    • starts on the cheeks and is bright red. The rash looks like slapped cheeks.
    • then spreads to the trunk, arms, and legs, and lasts two to four days.
    • may then continue to reappear if the child is exposed to sunlight, very hot or cold temperature, or trauma to the skin. This may continue for several days.

The most serious complication of the disease affects pregnant women. The virus that causes fifth disease can cause fetal death.

The symptoms of fifth disease may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

Warning:

Pregnant women who have been exposed to fifth disease need to seek medical attention immediately.

How is fifth disease diagnosed?

Fifth disease is usually diagnosed based on a medical history and physical examination of your child. The rash and progression of fifth disease is unique, and suggests the correct diagnosis. In addition, your child's physician may order blood tests to aid in the diagnosis.

Treatment for fifth disease:

Specific treatment for fifth disease will be determined by your child's physician based on:

  • your child's age, overall health, and medical history
  • extent of the disease
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

The goal of treatment for fifth disease is to help decrease the severity of the symptoms. Since it is a viral infection, there is no cure for fifth disease. Treatment may include:

  • increased fluid intake
  • acetaminophen for fever (DO NOT GIVE ASPIRIN)

Aspirin and the Risk of Reye Syndrome in Children:

Do not give aspirin to a child without first contacting the child's physician. Aspirin, when given as treatment for children, has been associated with Reye syndrome, a potentially serious or deadly disorder in children. Therefore, pediatricians and other healthcare providers recommend that aspirin (or any medication that contains aspirin) not be used to treat any viral illnesses in children.


ROSEOLA

Roseola is a viral illness that results in a viral exanthem. Exanthem is another name for a rash or skin eruption. Roseola is a contagious disease that usually consists of a high fever and a rash that develops as the fever decreases.

What causes roseola?

Roseola is caused by many viruses. The most common cause is the human herpesvirus-6 virus. It occurs mostly in children under the age of 3. Roseola is contagious, although the way it is spread is not known. It occurs mostly in the spring and fall.

What are the symptoms of roseola?

It may take between five to 15 days for a child to develop symptoms of roseola after being exposed to the disease. A child is probably most contagious during the period of high fever, before the rash occurs. The following are the most common symptoms of roseola. However, each child may experience symptoms differently. Symptoms may include:

  • high fever that starts abruptly
  • fever (may last three to four days)
  • irritability
  • swelling of the eyes
  • rash (As the fever decreases, a pink rash, with either flat or raised lesions, starts to appear on the trunk and then spreads to the face, arms, and legs.)

The most serious complication that can occur with roseola is febrile seizures. This means that as the child's temperature becomes high, there is a chance of the child having a seizure that is directly related to the fever.

The symptoms of roseola may resemble other skin conditions or medical problems. Always consult your child's physician for a diagnosis.

How is roseola diagnosed?

Roseola is usually diagnosed based on a complete medical history and physical examination of your child. The rash of roseola that follows a high fever is unique, and usually allows for a diagnosis simply on physical examination. In addition, your child's physician may order blood tests to aid in the diagnosis.

Aspirin and the risk of Reye syndrome in children:

Do not give aspirin to a child who has fever without first contacting the child's physician. Aspirin, when given as treatment for viral fevers in children, has been associated with Reye syndrome, a potentially serious or deadly disorder in children. Therefore, pediatricians and other healthcare providers recommend that aspirin not be used to treat any fever in children.

Treatment for roseola:

Specific treatment for roseola will be determined by your child's physician based on:

  • your child's age, overall health, and medical history
  • extent of the disease
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

The goal of treatment for roseola is to help decrease the severity of the symptoms. Since it is a viral infection, there is no cure for roseola. Treatment may include:

  • increased fluid intake
  • acetaminophen for fever (DO NOT GIVE ASPIRIN)

TICKS

  1. Encourage parents to check children every day for ticks
  2. Remove the tick promptly and carefully by using tweezers and grasp the tick near the mouthparts, pulling the tick in a steady, upward motion away from the skin.Don’t squeeze, crush or puncture the body of the tick, which may contain infectious fluids.Removing the tick within 24 hours after it begins to feed reduces the risk of infection.
  3. Use soap and water to clean the bite site or use rubbing alcohol or peroxide.
  4. Record the date and location of the bite.
  5. The child would not need to be seen if the tick has been removed unless the area indicates a local infection.If a rash appears or flu-like symptoms occur over the next 4-6 weeks (or sooner) the child then needs to be seen and evaluated for treatment.
  6. Antibiotic prophylaxis is not recommended until symptoms occur or there is a positive titer.We do not recommend a Lyme Titer unless the patient is symptomatic.
  7. Use an insect repellant with 30% or less of the active ingredient DEET.Do not use DEET on infants under 2 months of age. For infants under 2 months of age, mosquito netting can be sprayed, allowed to dry and then placed over the stroller for protection.

Center for Disease Control and Prevention regarding ticks link: http://www.cdc.gov/ticks/

May 2010 GFP