Childhood Illness

Bronchiolitis

•  This disease usually affects children under the age of 2 with a peak age of 3 to 6 monhts, and is a common, sometimes severe illness
• Viral respiratory infection
• Bronchiolitis begins as a mild upper respiratory infection that, over a period of 2 to 3 days can develop into increasing respiratory distress with wheezing and a "tight" wheezy cough
• Spreads via sneezing and direct contact

•  The infants breathing rate may increase substantially, and the infant may become irritable and restless. If the illness is severe enough, the infant turn bluish (cyanotic), an indication of a critical emergency
• The effort to breathe may become more difficut with flaring of the nostrils and the muscle between the ribs retracting as the child tries to inhale air. This can be exhausting for the child, and very yound infants may become so fatigued that breathing becomes difficult to maintain.
• Bronchiolitis is seasonal and is more frequent in Autumn and Winter. Some children develop only a sub clinical infection, with minimal symptoms. After 12 months more than half of all infants have been exposed to RSV

•  See your Doctor for advice
• Seek urgent medical assistance if your child is having difficulty breathing

 Chicken Pox (Varicella-zoster virus)

• Highly contagious
• Incubation period is during 10-21 days after exposure
• Spread through direct contact with person or lesion or droplets from coughing or sneezing
• Contagious period occurs from 2 days before the rash develops until all blisters have formed a dry scab
• Avoid contact with pregnant women

•  Headache, fever and sore throat
• Rash/small blisters surrounded by pink areas
• Child will usually become itchy
• Blisters will gradually burst and leave a scab (about 5 days after appearing)
• Blisters can even appear in the mouth, on the white of the eyes or on the genitals

•  Give paracetamol
• Cool baths or cloth compresses
• Topical cream (see your pharmacist for advice)
• Complications can arise - seek medical assistance if you become concerned

 Common Cold

• Upper Respiratory Tract Infection
• Coughing & Sneezing
• Child will remain contagious until symptoms clear

• Headaches
• Blocked or runny nose
• Sneezing & coughing
• Sore throat
• Fever

• Symptomatic treatment only
• Seek medical assistance if you become concerned

 Conjunctivitis

• Inflammation of eye membranes
• Highly contagious via contact

• Discharge from the eye.
• Eyes may be stuck together, especially after sleeping.
• Eye/s may appear blood shot & be itchy

• Antibiotic drops may be necessary
• Use moistened fresh cotton wool and bath the eye from the outside in towards the nose. (Preferable with normal saline)
• Wash your hands regularly, especially after each treatment.
• Do not share towels etc while discharge is present.

 Constipation

• Breastfed babies may have 7-10 days between bowel motions. They rarely become constipated
• More common in bottle fed babies
• Older children can be constipated after the introduction of new foods.

• Infrequent & difficult passing of stools
• Often with hard pellet like stools
• Pain on passing a stool
• Occasional bleeding and mucous from the rectum.

• Increase fluids
• Stool softener may be needed
• A warm bath
• Increase fibrous foods (older children)
• Allow child time to sit on the toilet
• Massage the stomach area & participate in regular exercise
• Seek medical advice if this is a regular problem

 Cough

• Usually part of an upper airways infection.

• The cough may be dry or produce phlegm
• Similar to a cold
• Look for signs of whooping cough, croup, bronchiolitis or pneumonia.
• Fever can be present, if persistent consider seeking medical assessment

• Increase fluids
• If a bacterial infection is present; antibiotics may be needed.
• Seek medical assistance if symptoms persist or you become concerned

 Cradle Cap

• Build up of natural oils and dry scaly skin forming a yellow-brown crust on the scalp

• May have an unpleasant odour.
• Ranges from mild to quite marked crusting

• Massage scalp with a warm baby oil, leave on overnight and wash off.
• The crust may need to be assisted off the scalp. Gentle rubbing in of a baby shampoo or by using a fine tooth comb can help.

Croup

• A viral illness causing acute inflammation of the upper respiratory tract.
• Commonly affects younger children and babies.
• Involves airways becoming swollen & narrow
• Infection occurs through coughing and sneezing
• The 2nd or 3rd day will see symptoms peak.

• General cold symptoms at first
• It is characterized by a seal like harsh barking cough
• Stridor (noisy breathing), hoarse voice and often fever
• Symptoms usually worse at night.
• Get urgent medical help if there is difficulty breathing restlessness and drooling

•  Initial treatment: place the children into a steamy room e.g. Run a hot shower and allow the bathroom to steam up. Do not place the child in the hot water.
• See your doctor if you suspect croup.
• Call an ambulance (111) if attack becomes severe
• Sleeping near to your child to monitor their condition is often a good idea.

 Dehydration

• Most common cause is due to prolonged vomiting and/or diarrhoea.
• Less common causes are due to excessive heat exposure

• Listless and apathetic 
• Urine output is decreased
• Dry mouth
• Increased thirst.
• Eyes and fontanelle may appear sunken
• Skin will remain gathered after being pinched (late sign indicating more severe dehydration)

• Seek urgent medical attention.
• Maintain or increase the intake of fluids to prevent further dehydration
• Give electrolyte solution.

 Diarrhoea

• A viral or bacterial infection

• Cramping and abdominal pain.
• Loos, watery and explosive bowel motions.
• Bowel motions may be discoloured & have very offensive smell
• Possible dehydration

• Seek medical advice.
• Ensure frequent hand washing occurs to prevent infection spread
• If applicable, continue to breastfeed
• Maintain fluid levels.
• Give electrolyte solution to older children.

 Ear infection

• Usually a viral infection with occasional secondary bacterial infection.
• Often follows a cold  
• Inflammation of the middle ear.

• Ear pain
• Fever
• Irritability
• Loss of appetite

• Visit your Doctor for medical advice
• Use antibiotics if infection is bacterial
• Use paracetamol for pain
• Warm compress on the ear
• Luke warm (not hot) olive oil dropped in the ear may give some relief.  Do not use if there is a known perforation of the eardrum, grommets are present or a draining ear

 Febrile Convulsion

• Brought on by sudden rise in temperature. (Only affects a small percentage of babies)

• Loss of awareness or consciousness
• Body can becomes stiff or floppy and may twitch or jerk
• Disorientation may occur at completion of fit

 Your immediate reaction:

• Stay with your child.
• Place in the recovery position.
• Maintain airway
• Seek medical advice
• Remove excess clothing and bring the temperature down (see below management of fever)

Call an ambulance if:

• Your child finds it difficult to breath
• Remains unconscious at the end of the fit
• The fit lasts longer than 5 mins
• If your child has a second fit following the first.

 Fever

• May be caused by a viral or bacterial infection or sometimes after immunization
• Overheating can cause fever in young babies.

• When a baby's temperature rises above 37.5oC, your baby is considered to have a fever.
• High temperature is considered to be over 39oC
• Baby may feel hot to touch.
• Baby may shiver or feel very hot.
• Rapid rise in temperature or prolonged high fever may cause a febrile convulsion in susceptible infants.

• To bring down the fever or to make the child more comfortable use paracetamol/ibuprofen
• Remove excess layers of clothing.
• Bath with a tepid sponge/cloth (water should be around 37oC). If the weather is warm allow a fan to blow lightly over the child.
• Increase fluids
• Seek medical advice if
• Your newborn (0-3m) has a fever.
• A high fever is present (39oC)
• Child has difficulty breathing or is lethargic and non-responsive 
• A rash is present
• You are concerned.

Flu (Influenza)

• Sneezing coughing
• Is contagious until symptoms clear

• High Fever & headaches
• Chills and sweating
• Tired & weak
• Joint pain
• Loss of appetite
• Chesty cough

• Give plenty of fluids
• Consider Paracetamol/Ibuprofen for high fever and comfort
• Nasal spray or drops. Ask your pharmacist for advice

Visit your doctor if:

• Ongoing high fever persist
• Breathing becomes difficult
• Intense headaches/stiff neck occurs
• Your child becomes lethargic
• You are concerned in any way

Gastroenteritis

• Can be a viral or bacterial infection.
• Dehydration can cause this illness to be very serious in babies

• Characterized by vomiting and diarrhoea
• Abdominal pain and cramps 
• Fever
• Dehydration
• Stools may contain blood

• Continue to breastfeed
• Offer extra water / electrolyte solution.
• Replace formula with water or electrolyte solution until vomiting stops.
• Wash hands after any nappy change or contact with vomit (highly infectious)

Seek medical attention if:

• Symptoms persist for more than 24 hours
• You think your child may be dehydrated
• You are concerned in any way. 

Impetigo (School sores)

• A bacterial skin infection.
• Highly contagious via direct contact

• Begins as small yellowish blisters.
• These then burst and leave a crust.

• See your Doctor for advice.
• Often antibiotic ointments / medicines are prescribed.
• Cover weeping sores dressing (non-stick). 
•  Ensure frequent hand-washing occurs
• Wash bedding and clothing daily
• Keep children away from school until cleared by a medical professional

Meningococcal Meningitis

• A highly contagious, acute bacterial infection
• Life threatening
• Septicemia (blood poisoning) and infection of the brain
• Contracted by droplet infection e.g. coughing sneezing, kissing, sharing drinks and food.

(Not all of these symptoms may be present):

• Severe headache
• Fever (that may not respond to paracetamol)
• High pitched cry
• Fatigue, drowsy, lethargic
• Stiff or painful neck
• Sensitivity to light
• Fontanelle bulges
• Convulsions.

More serious symptoms:

• Vomiting
• Cold hands and feet
• Cold shivers
• Severe aches or pain
• Rapid breathing
• Diarrhoea

• Seek urgent medical assistance
• If you suspect Meningococcal Meningitis insist on rapid treatment
• Vaccination is available as part of the routine immunization schedule

Prevention includes:

• Avoid sharing cups, eating utensils, toothbrushes or even whistles etc
• Children should be discouraged from sharing toys that have saliva on them.
• Do not share a pacifier or allow anyone to place it in his or her mouth - even to clean it.

Nappy Rash

• Most babies experience nappy rash at one time or another
• Most common causes are:
• Ammonia dermatitis
• Friction rash
• Thrush (see under thrush)

• Rash of large red or purple spots or bruising (late sign)
• Fresh urine does not irritate the skin but if it sits in the nappy or on the babies skin then bacteria can break it down to ammonia giving the skin a scalded appearance (ammonia dermatitis)
• Friction when two surfaces run together such as nappy against skin or in chubby babies skin against skin

• Keep your babies skin clean and dry
• Reduce friction by giving your baby nappy free time
• Cornstarch powder can help as it reduces friction
• Change nappy frequently as wet or soiled nappies will make things worse
• Use gentle skin soothing products (see you chemist)
• Rinse nappies well and avoid harsh soaps

Non- Specific Viral Rash

• Viral infection.

• Usually appears as a red rash across the body.
• Usually lasts for a few days.
• Other symptoms may be present

• See your Doctor for advice.

Other bacterial Meningitis: e.g. Pneumococcal, Haemophilus Influenza

• A Bacterial Infection passed via saliva transfer, sneezing & coughing
• Vaccination can help prevent the risk of infection. 

Your child may present with some or all of the following:

• Fever
• High pitched cry in babies
• Sensitivity to bright light
• Vomiting
• Headache
• Stiff neck
• Bulging fontanels in infants
• Joint and/or muscle pain
• Irritability
• Drowsy/disoriented
• Loss of consciousness

Rubella (German Measles)

• Viral infection
• Serious consequences to a developing child may occur if a pregnant woman comes into contact with Rubella
• Infectious period is 7 days from before the rash shows and up to 7 days after the onset of the rash.
• Incubation period: 15-20 days.

• Mild fever
• Mild rash on body, neck and face.
• Joint pain
• Swollen glands
• Headache, cough, cold.

• A vaccination is available as part of the routine immunization schedule to prevent the disease.
• Paracetamol may be used to make patient more comfortable
• Increase fluids

Threadworm/Pinworm

• A parasite infestation.
• Infection occurs after ingesting a pinworm egg.
• Worm eggs can survive outside the body for up to 14 days, & may be more present in dirt & dust

• Itchy bottom
• Loss of appetite
• Worms may be visible in stools or from the anus - especially at night

• Seek medical advice
• Consider treating all family members and repeat Rx after 2w to prevent re infection
• Ensure frequent hand washing occurs.

Thrush

• A fungal infection.
• Usually caused by the yeast, Candida albicans.
• Infection can be transmitted by direct contact.

Oral Thrush:

• Red areas inside the mouth.
• A build up of cottage cheese like areas in the mouth or on the tongue.

Topical rash:

• Often occurs in areas covered by a child's nappy and on folds of skin nearby.
• Distinct red inflamed rash often with satellite lesions
• White spots (pustules) may be present

Seek medical advice.

• Oral Thrush:
• Antifungal drops or gel (by prescription).
• A mother's nipples may be infected also & should be treated.
• Teats from bottles may need to be thrown away  - or will need to be thoroughly sterilized.

Topical rash:

• Your doctor may prescribe an anti fungal cream. 
• Allow nappy free time.

Urinary Tract Infection

• A bacterial infection.
• More frequent in girls.
• If untreated, can cause damage to the kidneys.
• To prevent infection always wipe child's bottom from front to back

• High fever
• Increased urine output.
• Urination may burn or be painful
• Offensive odour
• Older children may experience day & nighttime "wetting" accidents.
• Infection can only be confirmed after a urine analysis.
• Stomach cramps followed by vomiting.
• Can been accompanied by diarrhoea.

• Seek medical advice.
• A urine sample will be needed for testing
• Antibiotics may be necessary
• Increase fluids.
• Follow up medical consultations may be required

Vomiting

• Usually caused by a viral infection.
• Dehydration may occur

More serious symptoms that need urgent medical attention:

• Vomiting after a head injury
• Vomit is a bright yellow or green colour
• Vomit contains blood
• Constant stomach pain
• High fever
• Dehydration

• If applicable, continue to breastfeed
• Offer extra water / electrolyte solution.
• Replace formula with water or electrolyte solution until vomiting stops.
• Seek medical attention if:
• Symptoms persist for more than 24 hours
• Your child is unable to keep down clear fluids.
• You suspect dehydration
• You are concerned in any way.
• Ensure frequent hand washing

Whooping Cough (Pertussis)

• A bacterial infection
• Highly contagious to an un-immunised child.
• Immunised children will be immune or can have a much milder version of the illness
• Spread via sneezing, coughing and direct contact
• Contagious period is from when symptoms start until coughing has stopped (up to 3 months)
• Incubation period is 5 - 15 days after contact with infected person.

• Initial symptoms are similar to a common cold.
• Cough develops where child may have a coughing spasm lasting for a minute or more.
• Characteristic "whooping" sound as the child tries to draw breath. (Whooping often not present in babies under 6m)
• Difficulty breathing
• Face may turn red or blue
• May vomit after an attack.
• May have no other symptoms between attacks.
• Babies and younger children are most at risk of needing hospitalization

• Seek medical advice
• Prevention is most successful through the routine recommended immunization schedule