Beat the back-to-school illness

Have you ever wondered why your seemingly robust child suddenly gets frequently ill upon starting school? This is because the classroom is a perfect breeding ground for infective organism to flourish. Children, who tend to cough or sneeze without covering their mouths and noses or doesn’t know how to wash their hands properly after going to the toilet or playing with toys or animals, unknowingly spread these organism around and infect themselves or their classmates.

Some of the common illnesses that may easily be passed on inside the classroom are the following:

Hand Foot and Mouth Disease is caused by Enteroviruses that causes skin rash, oral sores and fever. It can spread via direct contact or by contact with contaminated objects or surfaces. The virus can be found in the saliva, nasal secretions, fluid from the skin blister and the feces. There is no specific therapy needed but supportive care can be provided such as analgesics to relieve fever and pain.

Scarlet fever is caused by the bacteria called Group A beta-hemolytic Streptococcus.  Patients may present with fever, sore throat, vomiting, abdominal pain, rash that has a rough feel (like rubbing a sandpaper), “strawberry tongue” characterised as red bumpy appearance of tongue may also be present. A positive quick strep test would entail treatment that includes appropriate antibiotics to eradicate the bacteria and avoid rheumatic fever to develop. The quick test may be negative in 30 per cent of patients hence a throat culture is warranted if Strep infection is highly suspected.

Conjunctivitis, commonly called pink or red eye, may present with eye itchiness or pain, redness in the sclerae, swollen eyelid and sticky eye discharge that is present throughout the whole day. Most cases are self-limited but topical antibiotics may reduce complications and relieve symptoms faster.

Chickenpox, a highly contagious disease caused by the Varicella-zoster virus, may present with fever, fatigue, and itchy fluid-filled rash that forms scabs in stages. The virus can spread by direct contact from the fluid in the rash or through breathing in the virus that was coughed out or sneezed by the infected person. The infected person can spread the disease 1-2 days before the rash appears and until the rash has dried up and turned into scabs which is usually around six days.  Testing the fluid from the skin lesions can confirm the diagnosis.

Measles, also a highly contagious disease that is easily spread via direct contact or by breathing in the virus that was coughed out or sneezed by an infected person. The virus may remain active for up to 2 hours in the air or on surfaces. After exposure, there is a 7-10 days symptom-free period then high fever, cough, colds and conjunctivitis develop. No specific treatment except supportive care and oral Vitamin A administration. Because of vaccination, there has been a significant reduction in cases but it still remains one of the leading causes of death in children worldwide due to complications such as encephalitis and pneumonia.

Whooping cough (Pertussis) a highly contagious bacterial respiratory infection that can be spread by breathing in the bacteria that was coughed out or sneezed by the infected person. Signs and symptoms may appear as early as 7 days to as late as 6 wks after exposure. Initially, it will present as a mild cough and colds that may last up to 2 weeks with or without a low grade fever. After this mild stage, severe repeated bouts of coughing followed by a “whooping” sound is noted. Testing nasopharyngeal secretions would confirm the diagnosis. Early treatment with appropriate antibiotics is important to relieve symptoms faster and prevent further spread.

Influenza can be passed on via direct contact or through contact with contaminated surfaces. Symptoms develop within 1-7 days upon exposure and include: fever, cough, colds, sore throat, muscle pain, headache and tiredness. Vomiting and diarrhea may also occur. Quick test is available using nasopharyngeal secretions.  Patients may recover on their own after a few days but some may develop complications such as pneumonia, bronchitis or otitis media. Treatment is mainly supportive care but antiviral drugs may be given to severe cases or high risk patients such as the very young and very old patients.

It is a daunting task to keep your child healthy but there are ways to prevent your child from getting sick.

Review and update vaccines. Ask your doctor whether your child is lacking some of their primary shots or needs to get some booster shots, then get vaccinated as soon as possible. The flu strain differs every year that is why everyone is encouraged to be given shots annually and usually before winter time.

Stay away from germs. Practice proper handwashing with regular soap and water or by using a hand sanitiser especially after going to the toilet, before eating, after touching animals/toys and after blowing the nose. Advise your children not to share utensils and cups with anyone. Refrain from touching the nose, mouth and eyes especially if handwashing is not possible.

Help boost the immune system. Eat healthy nutrient-rich foods. Avoid eating junk, highly processed foods. Get a good night sleep of at least 8 hours. Exercise regularly to boost energy. Steer clear of stress by helping your children develop a good study habit and avoiding cramming the night before the test.

Stay at home when sick. When your child do get sick, remember to keep them at home until they are free of the symptoms for 24 hours. This is to prevent them from infecting others and spreading the illness further. 

by Dr. Cynthia Dacanay - Family Medical Practice Hanoi