Wednesday 18 September 2019

New term, new germs: 10 common classroom illnesses and how to treat them

September is almost upon us, and a new term means new germs. Arlene Harris outlines how to spot and treat some of the most prevalent back-to-school ailments

watch out for back-to-school ailments
watch out for back-to-school ailments
A rash could be a sign of scarlet fever or chickenpox

Arlene Harris

It's that time again, when parents up and down the country are frantically checking book lists (or trying to remember where they put them in June), buying uniforms and stockpiling stationery.

But with all the chaos of getting our children kitted out and back to school on time, many forget to think about the very real possibility of them catching any number of ailments shortly after the first term begins. We spoke to some experts to find out what the most common classroom illnesses are and how best to treat them.

"As a GP, public health doctor and mum to two small children, I am no stranger to common childhood illnesses," says Dr Fiona McGuire. "September can mean that, as well as juggling the morning routine, school pick-ups and homework, parents are also getting to grips with those back-to-school bugs - new term, new germs."

According to a spokesperson for the HSE, "There is no specific time when school illnesses are likely to occur, as it depends very much on what is circulating at the time in the community and what children then bring in to the childcare setting or school."

It can be hard to know when to keep your child at home and how best to help them when they are sick. Here, Dr McGuire and fellow medic Dr Nina Byrnes offer advice on how to spot and treat common ailments.

Impetigo

Impetigo is a very common skin condition in young children. Caused by bacteria it usually starts off as a red sore or blister before developing a golden-brown crust.

It's very contagious and needs to be treated with antibiotics, so your child should be kept off school until all the patches have healed or until they have been on antibiotics for 24 hours.

Conjunctivitis

Conjunctivitis is when the outer lining of the eye or eyelid becomes inflamed, becoming red, sore or itchy and can also cause eyes to water or to produce a sticky discharge. It can be caused by infections but also by allergies like hay fever and is very common in young children.

It's not necessary to keep your child off school if they are well enough to attend, but if their eye is very sore or itchy, or if there is a lot of sticky pus, you might want to keep them at home.

If there are other children in the school or class with conjunctivitis, your school might ask you to keep your child at home until they have recovered. Treatment includes eye drops or ointments - your pharmacist should be able to help, but if symptoms last longer than two days, bring them to the GP.

Head lice

Nits or lice are small wingless parasites about the size of a sesame seed when fully grown. They vary in colour from pale cream to grey-brown and while they can't jump or fly, they use their legs to cling tightly to the hair shaft and move quickly from hair to hair. They are very contagious amongst close contacts so can travel easily in classrooms and among family members.

The best way to diagnose lice is detection combing, which can be done on wet and dry hair with combs which have teeth no more than 0.3mm apart. This process may need to be done several times and there are also a number of treatments available. Chemical insecticides no longer work on lice as they have become resistant to them but there are non-chemical methods available.

Itching can persist for a few weeks after the hair has been treated but this does not necessarily mean the nits are still present.

Cold sores

The main cause of a cold sore flare is usually a dip in the immune system during a cold or viral infection. They commonly occur around the lips but can spread to other parts of the face or body and symptoms usually start with pain or tingling around the lip.

This is followed by the development of painful red blisters, which ultimately break, ooze and then form a yellowish crust. The usual duration of a flare is 10-14 days and they are highly contagious until the skin has fully crusted over and is healed.

Antiviral creams such as acyclovir can be helpful if applied at the first sign of a flare and can be purchased without a prescription at your local pharmacy. If symptoms are severe or if sores are near the eye it's important to see your GP, as prescription antiviral tablets will be required.

Scarlet fever

Scarlet fever is a common infection caused by bacteria called streptococci and mainly affects children under the age of 10.

In the early stage your child might feel a bit off-form, with a sore throat and a high temperature (over 38C). A day or two later, they will break out in a rash. This is usually pink or red and their skin can feel a bit rough, like sandpaper, to touch. The rash usually starts on their chest or tummy and their tongue can become a bit coated, which peels off and looks red and sore. It is treated with antibiotics but liquid paracetamol can make them feel more comfortable. Children should be kept off school until they have been taking antibiotics for 24 hours. If you have concerns, bring your child to the GP.

Hand, foot and mouth disease

Hand, foot and mouth disease is caused by a virus and is different to the 'foot and mouth' disease that farm animals get. If your child gets HFMD they will feel miserable, with a high temperature (over 38C), a sore throat and reduced appetite. They might get mouth ulcers and red spots on their hands and feet. The virus can spread in coughs, sneezes and faeces and also by touching the blisters of someone with the virus. It's very common in children under 10 and is highly contagious before the rash appears, but there is no need to keep children off school once the rash is visible.

There is no treatment apart from rest, lots of cool drinks and some children's paracetamol or ibuprofen. Talk to your GP if your child isn't drinking enough or if any of the blisters become red and pus-filled.

Tummy bug or gastroenteritis

A tummy bug with vomiting and diarrhoea is caused by germs, most commonly viruses, but can also be caused by bacteria or parasites. They can also cause a high temperature (over 38C), aches, pains and headaches - these can last up to a week but you can normally care for your child at home until they are better.

Gastroenteritis can happen at any age but is more common in young children who should be kept at home until 48 hours after their last vomit or bout of diarrhoea. For certain infections, like a type of bacteria called verotoxigenic E coli, your local public health doctor will advise you about when your child can return to school.

Lots of fluids and plenty of rest is often the only treatment. If parents are worried or if the child is dehydrated, drowsy, pale, has bloody poos, green vomit or diarrhoea for longer than a week, seek advice from the GP.

Slapped cheek syndrome

Slapped cheek syndrome is an infection caused by a virus called parvovirus. It can cause your child to have a high temperature (over 38C), runny nose, sore throat and headache. After one to three days your child will develop a bright red rash on their cheeks, hence the name 'slapped cheek'. They might also get a rash on their body which is usually pink in colour and can be itchy.

It's common amongst children but not serious and as the child is no longer contagious when the rash appears, there is no need to keep them at home if they are well enough to attend.

There is no specific treatment but if they are feeling unwell, children should rest at home and if they have a temperature or aches and pains, talk to a pharmacist. Plenty of fluids to drink and a non-perfumed moisturiser should also help.

Coughs

Most children will catch six to seven viruses per year, many with a cough which is usually caused by a cold or flu and gets better by itself after a couple of weeks. Children can go to school if they are well enough but if they have a high temperature, aches, pains, tiredness, sore throat and headaches, keep them at home for a few days.

Coughs don't require specific treatment but if your child is in pain or has a high temperature, talk to your pharmacist about liquid paracetamol or ibuprofen. If their nose is stuffy or blocked, saline drops or nasal sprays can help. You might need to bring them to the GP if they have asthma, heart or lung conditions, or if the cough isn't better after a few weeks.

Chickenpox

Chickenpox is a common childhood illness identified by a red rash which can cover the whole body. But before the rash appears, the child might have mild flu-like symptoms followed by an itchy rash. The spots usually appear in clusters and tend to be behind the ears, on the face, scalp, under the arms, chest, stomach, arms and legs, but can be inside the mouth and ears, on the palms of hands, soles of feet or inside the nappy area.

It's advisable to keep children at home while they are feeling unwell. Most have no lasting ill effects, but some have a more severe bout and should be taken to the GP if the skin becomes red and painful, if the child is unwell or if they have difficulty breathing.

⬤ For more information and advice, see mychild.ie and undertheweather.ie

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