Common Illnesses

April to September - Hand, Foot, and Mouth Disease | West Nile Virus and the Use of DEET | Fun in the Sun | Heat Stress in Exercising Children

September to April - Respiratory Syncytial Virus | Influenza (the flu) | Rotavirus

Hand, Foot and Mouth Disease:

Diagnostic findings include-
• small ulcers in the mouth
• a mildly painful mouth
• small water blisters or red spots located on the palms and soles and between the fingers and toes
• five or fewer blisters per extremity
• Sometimes, small blisters or red spots on the buttocks
• Low-grade fever ( over 100°F)
• Mainly occurs in children 6 months to 4 years of age

Hand, foot, and mouth disease is always caused by a Coxackie A virus. It has no relationship to hoof and mouth disease of cattle.

The fever and discomfort are usually gone by day 3 or 4. The mouth ulcers resolve in 7 days, but the rash on the hands and feet can last 10 days. The only complication seen with any frequency is dehydration from refusing fluids.

Avoid giving your child citrus, salty, or spicy foods. Also avoid foods that need much chewing. Change to a soft diet for a few days and encourage plenty of clear fluids. Cold drinks, popsicles, and sherbert are often well received.

Acetaminophen may be given for a few days if the fever is above 102°F.

Hand, foot, and mouth disease is quite contagious and usually some of your child’s playmates will develop it at about the same time. The incubation period after contact is 3 to 6 days. Because the spread of infection is extremely difficult to prevent and the condition is harmless, these children do not need to be isolated. They can return to school when the fever returns to normal range.

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West Nile Virus and the Use of DEET for Protection:

West Nile virus is spread to human by the bite of an infected mosquito. A mosquito becomes infected by biting a bird that carried the virus. You or your child cannot get West Nile virus from a person who has the disease. West Nile virus is not spread by person-to-person contact such as touching, kissing or caring for someone who is infected.

Most people who are infected with West Nile virus either have no symptoms or experience mild illness such as a fever, headache and body aches. Some persons may develop a mild rash or swollen lymph glands. In some individuals, particularly the elderly, West Nile virus can cause serious disease that affects brain tissue.

Symptoms of encephalitis (inflammation of the brain) included the rapid onset of severe headache, high fever, stiff neck, confusion, loss of consciousness (coma) or muscle weakness, and may be fatal.

There is no specific therapy for the treatment of West Nile virus. There is also no vaccine.

Being bitten by an infected mosquito will not necessarily make you sick. Most people who are infected with West Nile virus have no symptoms or experience only mild illness. If illness were to occur, it would occur within 3 to 15 days of being bitten by an infected mosquito.

Bug spray may reduce the risk of mosquito bites, but when using products with DEET for protection, follow these guidelines:

CHILDREN YOUNGER THAN 6 MONTHS
• Do not use insect repellent on skin
• Use other methods of protection, such as long-sleeved shirts, long pants, and mesh covers over strollers.

CHILDREN AGES 6 MONTHS TO 2 YEARS
• Use only one application of DEET (10% or less) per day and only in high-risk situations
• Apply repellent sparingly and not to face or hands.
• Avoid prolonged use
• Wash skin with soap and water when child returns inside.

CHILDREN 3 TO 12 YEARS
• Use DEET product containing 10% or less.
• Apply sparingly and not more than three times a day.
• Do not use on face or hands.
• Wash skin with soap and water when returning indoors.

PERSONS 13 YEARS AND OLDER
• Use products with 30% DEET or less.
• Apply sparingly
• Do not spray on face; instead, apply to hands, then rub onto face.
•Avoid contact with eyes.
• Wash skin with soap and water when returning indoors.

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Fun in the Sun:

Babies under 6 months-
• Avoiding sun exposure and dressing infants in lightweight long pants, long-sleeved shirts, and brimmed hats are still the top recommendations from the AAP to prevent sunburn. However when adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen with SPF of at least 45 to small areas, such as the infant’s face and the back of the hands.
For young children:
• Apply sunscreen at least 30 minutes before going outside, and use sunscreen even on cloudy days. The SPF should be at least 45.
For older children:
• The first, and best, line of defense against the sun is covering up.
• Stay in the shade whenever possible, and avoid sun exposure during the peak intensity hours - between 10 a.m. and 4 p.m.
• Use a sunscreen with an SPF (sun protection factor) of 45 or greater.
• Reapply sunscreen every two hours, or after swimming or sweating.

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Heat Stress in Exercising Children:

• The intensity of activities that last 15 minutes or more should be reduced whenever high heat and humidity reach critical levels.
• Before prolonged physical activity, the child should be well-hydrated. During the activity, periodic drinking should be enforced, for example, each 20 minutes, 5 oz. of cold tap water or a flavored sports drink for a child weighing 88 lbs, and 9 oz. for an adolescent weighing 132 lbs, even if the child does not feel thirsty.
• Clothing should be light-colored and lightweight and limited to one layer of absorbent material to facilitate evaporation of sweat. Sweat-saturated garments should be replaced by dry garments.

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SEPTEMBER TO APRIL

Respiratory Syncytial Virus:

Respiratory Syncytial Virus (RSV) infects almost all children at least once before they are two years old. Most of the time this virus only causes minor coldlike symptoms. However, for some babies it can be more dangerous. In the first two years of life, RSV is the leading cause of pneumonia and bronchiolitis (a swelling of the small airways), and also can trigger other respiratory disorders such as asthma.

Infants born prematurely and term infants younger than six weeks are at increased risk for developing serious RSV disease.

Respiratory syncytial virus infection occurs most often from late fall to early spring. It comes only from humans and is highly contagious. The virus can live for several hours on a surface such as a countertop, a table, a playpen, or unwashed hands. It is spread by direct or close physical contact, such as touching or kissing and infected person, or contact with a contaminated surface.

For most children the symptom of RSV resemble the common cold and include
• Runny nose
• Coughing
• Low-grade fever

However, signs of more serious infection may include
• Difficult or rapid breathing
• Wheezing
• Irritability and restlessness
• Poor appetite

There are important steps you can take, especially in the first few months of your child’s life, to prevent exposure to the virus, including:
• Make sure every one who touches your baby washes his or her hands first.
• Keep your baby away from anyone who has a cold, fever, or runny nose, as well as from crowded areas like shopping malls.
• Keep your baby away from tobacco smoke.

Most minor cases of RSV infection disappear on their own within 5 to 7 days. RSV is a virus and therefore does not respond to antibiotics. Your pediatrician may elect to use antibiotics to treat secondary ear infections or pneumonia.

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Influenza (The Flu):

The flu can last a week or even longer. Your child usually will feel the worst during the first two or three days. Flu symptoms include
• A sudden fever (temperature usually above 101°F)
• Chills and shakes with the fever
• Headache and body aches
• Dry, hacking cough
• Sore throat
• Vomiting and belly pain
• Stuffy, runny nose

There usually are no serious complications from the flu. However, sometimes an ear infection, a sinus infection, or even pneumonia may develop. Talk to your pediatrician if your child’s ear hurts, his cough persists, or his fever lasts beyond three to four days.

The flu is spread from person to person in the following ways:
• Direct hand-to-hand contact
• Indirect contact (eg, if your child touches a contaminated surface like a toy or doorknob and then touches her eyes, nose, or mouth)
• Virus droplets passed through air from coughing or sneezing
In children older than one year, type A flu can be treated with antiviral drugs if given in the first day or two of the illness. This can speed recovery. Under some circumstances, antiviral drugs can be taken before exposure to the flu and prevent illness. This is particularly important for children with serious health problems who haven’t had the flu shot. Antibiotics can be used to fight bacterial infections but have no effect on viruses, including flu viruses. Extra rest and lots of fluids also can help your child feel better.

Good hygiene is the best way to prevent the flu from spreading to other family members.

Healthy children over 6 months of age are recommended to get a flu shot each fall, as is everyone in the household of a child of this age. For children younger than nine years, the vaccine requires two immunizations or shots given one month apart the first year it’s given. After that, only one dose is needed each year.

The vaccine is made from killed flu viruses. Most children are immune within 2 weeks of getting the vaccine. Side effects usually are minor and include soreness at the site of the injection and a low-grade fever. The flu shot can’t cause the flu.

If your child has had serious allergic reaction to eggs or egg products, he should be skin tested before getting the vaccine.

Scientists have developed a nasal spray flu vaccine. Unlike the flu vaccine given by injection, it’s made from living but weakened (attenuated) flu viruses. Live attenuated influenza vaccine (trade name FluMist®) is the first live-virus flu vaccine approved in the United States. It’s approved only for healthy children 5 years and older and healthy adults aged 18 to 49 years, and shouldn’t be given to children who have asthma.

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