Guidelines for parents to beat back-to-school bugs

Aug 24 2012

School bells are beginning to sound again across the country, so it will only be a matter of time until every parent comes face-to-face with a child who wakes up with a cold, fever or upset stomach.

"Every parent has experienced it - the hectic morning maneuvering of getting the household fed, dressed and out the door is suddenly interrupted by an inconsolable child who has a sore throat, upset stomach, sniffles or something worse," said Dr. Jacqueline Kaari, chair of the Department of Pediatrics at the University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine. "When that happens, parents need to be able to quickly assess their child and determine if he or she is well enough to go to school or needs to stay home, or if it's time to call the pediatrician. Sometimes, parents will guess wrong, but if there's one rule of thumb, it should be to always err on the side of caution."

According to Dr. Kaari, the average child will develop six or more infections per year, most of which are relatively mild. The close proximity to others in class and lunchrooms makes it easy for children to pick up and pass on a variety of illnesses.

Because sending a sick child to school risks both worsening the child's condition and spreading the illness to others, Dr. Kaari has provided the following guidelines to help parents make those early morning decisions.

Colds. Common viral infections that can cause coughing, sneezing, runny nose, sinus pressure, sore throat and mild body aches.

What to do: Use child-strength, over-the-counter (OTC) medicines and a cool mist humidifier to relieve symptoms. Children with colds can attend school unless their symptoms would keep them from participating in normal classroom activities. Because colds are caused by viruses, antibiotics are not an effective treatment. Instead, the cold just needs to run its course until the child recovers. Contact your pediatrician if a cough suddenly worsens or a fever develops.

Conjunctivitis ("pink eye"). A red, weeping eye(s) accompanied by a thick discharge that could become crusty when sleeping.

What to do: Contact your child's physician for treatment which may include antibiotic eye drops. When caused by a virus or bacteria, conjunctivitis can be highly contagious. Follow the physician's advice, but children can usually return to school 24 to 48 hours after treatment begins.

Fever. One of the best indicators of illness, often a companion to respiratory illness.

What to do: Give acetaminophen or ibuprofen for low-grade fevers. Encourage the child to drink lots of fluids and avoid fatty or fried foods that are hard to digest as fevers decrease stomach activity. Keep children at home if their fever is above 100.4 degrees Fahrenheit (38 degrees Celsius). Call a physician if a high fever lasts more than 24 hours or does not respond to medication, or if the child's condition worsens.

Flu. Striking more suddenly and more intensely than a cold, the flu causes a sudden, high fever with body aches.

What to do: Have your child vaccinated early in the flu season to protect against this illness. A child who comes down with the flu should stay home for several days, rest and drink lots of fluids.

Head lice. Tiny, crawling bugs (about the size of a sesame seed) that live on the scalp and feed on blood. Itching, a sense of something moving in the hair and sores on the scalp can be signs of head lice. Head lice are not a sign of poor hygiene. The insects cannot jump or fly and are spread by human contact.

What to do. Under bright light, check the entire scalp closely for lice or tiny white eggs (called nits), starting at the upper neck and behind the ears. Lotions and shampoos that can kill the lice are available as either OTC or prescription items. Keep the child home from school until the lice have been completely eradicated.

Ringworm. Despite its name, ringworm is a fungus, not a worm. It is spread by direct contact with an infected person or with a contaminated item or surface.

What to do: Look for small patches of skin that are red and scaly. The patches may also blister and ooze. Keep the area clean and dry and apply anti-fungal ointments or powders. Consult a physician when a ringworm infection is severe or persistent.

Sore throat. A "scratchy" throat could be due to allergies or a cold. A painful throat accompanied by a headache, fever or joint pain could indicate strep throat, a bacterial infection.

What to do: Have the child drink a few sips of water. If that relieves the symptoms, you are likely dealing with, at worst, a viral infection that can be resolved with a few days of rest, plenty of liquids and OTC pain relievers. If you suspect strep throat, follow the fever guidelines and contact your child's physician.

Stomach ache. Pain or nausea caused by a virus or food-borne bacteria, usually short-lived.

What to do: Keep children who have been vomiting home from school. Wait an hour after the child vomits and encourage small drinks of water. Gradually introduce clear liquids and bland foods throughout the day. Contact your pediatrician if vomiting persists beyond 24 hours, includes worsening pain at the belly button or lower right abdomen, or if the child vomits blood or green or yellow bile.

Whooping cough (pertussis). A highly contagious bacterial disease characterized by violent coughing, fever and a "whooping" sound when the infected individual tries to take a breath.

What to do: Make sure the child's vaccinations against whooping cough are up to date. Contact the child's physician if whooping cough is suspected as prescription medications may be able to help reduce the duration of whooping cough.

"Prevention is always going to be the best line of defense against any illness," Dr. Kaari said. "Immunizations offer vital protection against a host of diseases. Make sure children eat balanced meals and get lots of sleep. And take the time to teach children how - and when - to wash their hands. Twenty seconds of lathering - about the time it takes to 'sing' the ABCs - are enough to cause germs to slide off the skin and down the drain."