Common Infectious Diseases in Children

Seasonal flu

Seasonal flu (or influenza) is caused by various strains of the influenza virus. The usual symptoms are fever, headache, muscle aches, severe tiredness, sore throat and cough. Sickness and diarrhoea can occur, especially in children. It is sometimes accompanied or followed by chest infections that can be severe. It often occurs in epidemics, most commonly in the winter,

Flu is spread from person to person by cough and sneeze. It can spread rapidly within families and schools where there are many people living close together. Flu can be passed on to other people for 3-5 days after symptoms start.

There is no specific treatment but there are many remedies available from pharmacists to ease the symptoms. Children should not be given any preparations containing aspirin. If you are in any doubt about the contents of a "flu" remedy, please check with the pharmacist. Children affected by influenza should be encouraged to rest and drink plenty of water or other fluids. They should be encouraged to cover their mouths when coughing and use paper tissues when sneezing. Hand washing needs to be encouraged, and supervised for younger children.

Each year vaccines against the likely common types of the virus are prepared and should be given to people at risk, particularly the elderly and those with chronic heart, chest or kidney diseases. Healthy children and adults do not need immunisation, although children with asthma should be protected.

Whooping Cough

Whooping cough - or pertussis - is an infection of the respiratory system caused by the bacterium Bordetella pertussis (or B. pertussis). It's characterized by severe coughing fits that end in a "whooping" sound when the person breathes in.

The first symptoms of whooping cough are similar to those of a common

cold:

• runny nose

• sneezing

• mild cough

• low-grade fever

After about 1 to 2 weeks, the dry, irritating cough evolves into coughing fits. During the attack of coughing, which can last for more than a minute, the child may turn red or purple. At the end of a fit, the child may make a characteristic whooping sound when breathing in or may vomit. Between attacks, the child usually feels well.

Although it's likely that infants and younger children who become infected with B. pertussis will develop the characteristic coughing episodes with their accompanying whoop, not everyone will. However, sometimes infants don't cough or whoop as older kids do. They may look as if they are gasping for air with a reddened face and may actually stop breathing for a few seconds during particularly bad fits.

Pertussis is highly contagious. The bacteria spread from person to person through tiny drops of fluid from an infected person's nose or mouth. These may become airborne when the person sneezes, coughs, or laughs. Others then can become infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses.

The bacteria thrive in the respiratory passages where they produce toxins that damage the tiny hairs (cilia). This results in an increased inflammation of the respiratory passages, and the typical cough which is the hallmark of the infection

Infected people are most contagious during the earliest stages of the illness up to about 2 weeks after the cough begins. Antibiotics shorten the period of contagiousness to 5 days following the start of antibiotic treatment.

Whooping cough can be prevented with the pertussis vaccine, which is part of the DTaP (diphtheria, tetanus, acellular pertussis) immunization.

Experts believe that up to 80% of non-immunized family members will develop whooping cough if they live in the same house as someone who has the infection. For this reason, anyone who comes into close contact with someone who has pertussis should receive antibiotics to prevent spread of the disease. Young kids who have not received all five doses of the vaccine may require a booster dose if exposed to an infected family member.

The incubation period (the time between infection and the onset of symptoms) for whooping cough is usually 7 to 10 days, but can be as long as 21 days. Pertussis can cause prolonged symptoms. The child usually has 1 to 2 weeks of common cold symptoms, followed by approximately 2 to 4 weeks of severe coughing, though the coughing attacks can sometimes last even longer. The last stage consists of another several weeks of recovery with gradual resolution of symptoms. In some children, the recovery period may last for months.

To make a diagnosis of whooping cough, the doctor will take a medical history, do a thorough physical exam, and take nose and throat mucus samples that will be examined and cultured for B. pertussis bacteria. Blood tests and a chest X-ray may also be done.

If the child has whooping cough, it will be treated with antibiotics, usually for 2 weeks. Many experts believe that the medication is most effective in shortening the infection when it's given in the first stage of the illness, before coughing fits begin. But even if antibiotics are started later, they are still important because they can stop the spread of the pertussis infection to others.

Some kids with whooping cough need to be treated in a hospital. Infants and younger children are more likely to be hospitalized because they are at greater risk for complications such as pneumonia, which occurs in about 1 in 5 children under the age of 1 year who have pertussis.

While in the hospital, a child may need suctioning of thick respiratory secretions. Breathing will be monitored and oxygen given, if needed. Intravenous fluids might be required if the child shows signs of dehydration or has difficulty eating. Precautions will be taken to prevent the infection from spreading to other patients, hospital staff, and visitors.

Chickenpox

Chickenpox is a common infectious disease. It is caused by a virus called varicella zoster and is spread by sneezing and coughing or direct contact with broken chickenpox blisters. It is much more severe in adults than in children and can be a particular problem in pregnancy. Shingles (also known as herpes zoster) is a reactivation of the virus and will only develop in a person who has previously had chickenpox.

Chickenpox is like a mild case of flu with an itchy rash. The rash is the most noticeable feature and starts out as crops of raised red spots. These develop into small blisters which eventually scab over in 3-4 days. Chickenpox is mainly a disease of children and is usually, but not always, a mild illness.

Chickenpox is highly infectious and is usually spread from person to person by cough and sneeze. The incubation period is two to three weeks. Children with chickenpox can pass it to others from 1-2 days before the rash appears until 5 days after the rash has started. A child who has had chickenpox will be immune for life. Because it is the reactivation of a virus, you cannot catch shingles. However, fluid from the blisters can spread the virus to other people, who will develop chickenpox if they have never had it before. The rash should be covered with a dry dressing until the blisters have dried up.

Chickenpox is highly infectious and it is very difficult to prevent it spreading from person to person. Getting the child to cough into a tissue and keeping them away from susceptible people should help prevent transmission of Chickenpox.

Mumps

Mumps is an infectious viral disease caused by the paramyxovirus. It mainly affects the salivary glands, but sometimes other parts of the body are affected. Mumps usually affects children but can affect any age group.

Mumps usually begins with 2 or 3 days of discomfort and an increasing temperature. This is followed by the onset of discomfort and swelling of the parotid glands, which are situated below the ears and normally cannot be felt. The swelling can be in both glands or just one side and can cause the earlobes to stick out and the face to appear swollen. The mouth may feel dry and swallowing can be painful. Symptoms usually last for 3 or 4 days but can last for more than a week. The mumps virus is a common cause of viral meningitis, which is usually very mild and has no after effects.

Mumps is usually spread from person to person by cough and sneeze. Less often, it may be spread by direct contact with the saliva of someone with mumps. People with mumps can pass it to others from shortly before the symptoms start until just after the swelling has gone.

The only effective way to prevent mumps is to immunise all children against it with the MMR vaccine as part of the routine programme of childhood immunisation.

Scarlet fever

Scarlet fever (also known as Scarlatina) is caused by the bacterium Streptococcus A. It often affects children between the ages of 2 and 10 years.

The illness usually begins with a sore throat, headache and fever. The rash normally breaks out on the second day and lasts between 3 and 6 days. The rash often starts with a mass of tiny bright red spots on the neck and chest and will usually spread over the body. The rash normally does not appear on the face but the cheeks will look very flushed. The rash goes white if you press on it. The skin often peels, especially on the hands, feet and groins. The tongue often has a thick white coating that peels after four or five days producing a strawberry like appearance.

Scarlet fever is infectious, especially in the home environment. The infection is spread person to person by touching or through cough and sneeze. The incubation period is short, between 1 and 3 days and people do not remain infectious for long once antibiotic treatment is prescribed.

Children with scarlet fever should be treated with antibiotics. After 48 hours of treatment, they will no longer be infectious. There is no immunisation available against the infection.

To prevent spread of the infection until 24 hours after starting antibiotics, the child's drinking glasses, eating utensils, sheets and towels should be kept separate from those belonging to other family members. These items should then be washed with hot soapy water.

Measles

Measles, also called rubeola, is a highly contagious respiratory infection that is caused by a virus. It causes a total-body skin rash and flu-like symptoms, including a fever, cough, and runny nose. Since measles is caused by a virus, there is no specific medical treatment and the virus has to run its course. But a child who is sick should be sure to receive plenty of fluids and rest, and be kept from spreading the infection to others.

While measles is probably best known for the full-body rash it causes, the first symptoms of the infection are usually a hacking cough, runny nose, high fever, and red eyes. A characteristic marker of measles are Koplik's spots, small red spots with blue-white centres that appear inside the mouth.

The measles rash typically has a red or reddish brown blotchy appearance, and first usually shows up on the forehead, then spreads downward over the face, neck, and body, then down to the arms and feet.

Infants are generally protected from measles for 6 months after birth due to immunity passed on from their mothers. Older kids are usually immunized against measles according to state and school health regulations.

For most kids, the measles vaccine is part of the measles-mumps-rubella immunizations (MMR) or measles-mumps-rubella-varicella immunization (MMRV) given at 12 to 15 months of age and again at 4 to 6 years of age.

Measles vaccine is not usually given to infants younger than 12 months old. But if there is a measles outbreak, the vaccine may be given when a child is 6-11months old, followed by the usual MMR immunization at 12-15 months and 4-6 years.

There is no specific medical treatment for measles. To help manage symptoms, which usually last for about 2 weeks, the child is given plenty of fluids and encourage extra rest. Kids with measles should be closely monitored. In some cases, measles can lead to other complications, such as otitis media, croup, diarrhoea, pneumonia, and encephalitis (a serious brain infection), which may require antibiotics or hospitalization.