The A-Z of common illnesses in school children

How to know when it is more than the common cold.
How to know when it is more than the common cold. 

Why do children get sick so often?
Bacteria and viruses are two distinct causes for infections in children.  Often a child will get a viral cold and then later on develop a secondary infection with bacteria which then turns into a condition such as a chest infection. It seems bacteria tend to infiltrate a body that is already "run down" fighting the viral infection.

For this reason parents worry about and monitor their baby’s illnesses very closely because of the delicacy of their immature immune systems. This is why doctors recommend breastfeeding because they know the natural antibodies found in breastmilk protects babies against many of them in addition to administering vaccines against some highly infectious diseases (such as measles, whooping cough and mumps which are now much less prevalent among school aged children as a result).

By school age children are still building up their immune systems to the many infections caused by the bacteria and viruses that they are exposed to on a day to day basis, and attending school increases your child’s propensity to becoming sick because the majority of common childhood illnesses are contagious and caught from classmates, and are likely to be passed on to siblings at home.

Parents who have sent their children to childcare prior to them starting school would already be aware of this and may feel as though one of their children is constantly sick between the toddler years and the teenage years. “The average school age child can expect 3-8 colds a year and 2-3 bouts of viral gastroenteritis,” says Dr Julia Driscoll, a GP who sub-specialises in children’s health.

This can make it difficult for parents to distinguish between a common illness and a serious illness, with many parents inclined to overlook symptoms or worry that simple illnesses are worse than they are. “I think parents tend to visit the GP a bit quickly on most occasions - I understand they need reassurance but a cold takes on average 2 weeks to run its course,” says Dr Julia. “But there are of course some symptoms that parents should never ignore.”

So how can I tell what to do when my child is sick?
Depending on what the illness is, the easiest way for parents to know if an illness is developing into something worse is by seeing how the initial symptoms progress. It may be frustrating for parents with a child complaining of pain and discomfort to visit the GP only to be told to take their child home to rest and drink plenty of fluids instead of a prescription but the fact is with most illnesses pharmacy medications are used to mask the symptoms until the illness has passed through the child’s system, rather than treating the illness itself, which needs time to clear up on its own.

Antibiotics act to treat the illness itself, but they can only be prescribed for bacterial infections. The key to ensuring antibiotics have the desired effect of getting rid of the illness they have been prescribed for, is to use them as directed. If people do try and use them for viruses it will increase the risk of bacteria becoming resistant to the antibiotic.

However if your child displays any of the following symptoms in conjunction with an otherwise simple illness, parents should act immediately in seeking medical advice:

- A fever that lasts more than 48 hours or a fever that reaches 39.5 degrees Celcius or higher at any time.

- Difficulty breathing or sudden wheezing.

- Excessive sleepiness or confusion.

- A seizure, especially one that is related to any possible ingestion of poison. Febrile convulsions sometimes happen when very young children have a high temperature but it’s always best to see a doctor to be completely sure of the reason for the fever.

- Severe vomiting and/or diarrhoea that continues for longer than 24 hours as it could possibly lead to dehydration.

- Rashes that appear suddenly and spread quickly and occur in tandem with any of the things listed above.

- The presence of blood such as coughing up blood or blood in your child’s urine or vomit which is more than a few streaks such as large clots or an ongoing, steady flow of blood.

There are several illnesses that incite fear into all parents such as meningitis which is rare but life-threatening. Lots of the symptoms of meningitis mimic side effects of colds and the flu but children who display these symptoms without any of the 6 major indications of serious illness listed above are more likely suffering from one of the following common illnesses:

Children who have parents with allergies are more likely to develop allergies. The most common allergies are animal fur or dander, mould, dust mites, pollen, insect bites and certain foods such as nuts, eggs, seafood and dairy products.

Allergies reveal themselves in several ways including rashes, hayfever, asthma and anaphylaxis. The discomfort caused by rashes and the runny eyes, runny nose and sneezing associated with hayfever are much less serious in comparison to asthma and anaphylaxis.

Asthma is an inflammation of the lungs small breathing tubes (bronchioles) that occurs when the a trigger or allergen causes the airways to tighten and close as an inappropriate immune response to a perceived threat, causing an asthma attack which can be serious but treatable. People need to stimulate the airways to open again with medication, using inhalers and nebulisers.

Anaphylaxis is an emergency situation that requires an adrenaline shot to be effective and prevent all the systems in the body shutting down, including the nervous, respiratory, and cardiovascular/circulatory systems.
Generally allergies can be managed by having the child avoid being within distance of the allergen but sometimes it is unavoidable and in those cases treatment with antihistamines and topical skin treatments is suggested by doctors.

Chickenpox is an offset of the herpes virus that lives within the body for years after initially being contracted (and it can possibly reappear as shingles years later in adults).

Chickenpox is very contagious, causing a rash across the entire body, plus possibly flu-like symptoms such as fever. It is most harmful to people with deficient/immature immune systems which is why there is a vaccination to protect children from getting it and passing it on to pregnant women and very young babies but it is not yet as uncommon as measles. General treatment includes skin creams and oatmeal baths to relieve itching until the rash subsides, and children’s paracetamol or ibuprofen for the flu-like symptoms.

Common cold
Because there are so many different strains of viruses and germs, children are susceptible to many colds throughout their school years, especially in the colder months because cold air and air conditioning systems dry out the nasal passages, making it possible for viruses to thrive and be caught more easily from other people.

The main symptoms are a runny nose, coughing and/or congestion. These symptoms are distinguishable from allergies which aren’t necessarily related to infection.

Colds can last up to 7-14 days just as a cold but they can develop into the flu, an ear infection, upper respiratory tract infection or even a more serious lower respiratory condition such as pneumonia when bacteria enter the system in addition the initial virus.

To ease your child’s discomfort when she has a cold, in addition to the usual suggestions of resting and keeping up fluids, use a humidifier to keep the air moist and elevate her head she is lying down at night.

This is an eye infection that can be caused by bacteria, a virus or sometimes allergies, and spreads through skin to skin contact. It is different to sticky eye which is caused by a blocked tear duct. Conjunctivitis takes 1-2 weeks to go away on its own, and eyedrops can help relieve itchiness and redness after cleaning the eye but because of the potential for greater damage to the eye, it is worthwhile to visit a doctor if your child seems to have this.

Constipation can appear on its own or it can be an offset of the flu or gastroenteritis as well as allergies and food intolerances such as dairy.

Boosting your child’s fibre intake and ensuring she drinks plenty of water will help cleanse out his digestive/intestinal systems and an oral laxative may be recommended by the doctor to help children pass stools if they are still constipated after a certain amount of time.

Diarrhoea is a common symptom in children with viruses, infections and allergies, and can be related to taking antibiotics to help treat these things, so it is usually nothing to be concerned about unless it appears with other more serious symptoms which may indicate poisoning or dehydration. Treating diarrhoea is usually done by addressing what is causing it, as well as drinking electrolyte solutions and staying hydrated but adjusting your child’s diet and encouraging healthy eating can also help.

Ear infections
Ear infections are very common in children because of the structure of the ear tubes, whereby when bacteria enter the ear tubes often because of a common cold, allergy or sinus infection swelling then prevents fluid from draining out properly, leading to inflammation, which is painful and often leads to a fever in children.

Otitis media is a viral or bacterial middle ear infection and otitis externa is in a viral or fungal infection of the external ear and ear canal, also known as swimmers ear which can occur more than once. They are generally not serious but doctors will recommend antibiotics when they are due to bacteria because untreated infections can injure the ear.

Any kind of blood or pus in the ear can indicate perforation of the ear drum and should be immediately reported to the doctor.

This is a skin condition where skin is dry and itches, and is spread by scratching and overheating, sometimes becoming infected and is linked to asthma and allergies, reacting to a irritant that can range from an allergen to chemicals in household products such as washing powder, shampoo and even scratchy clothing.
Keeping the skin moisturised and not scratching is the best way to avoid flare-ups in children as well as using prescription antihistamines and steroid creams when advised.

The flu is an airborne viral infection that cannot be treated with antibiotics, but rather over the counter cold and flu medications. It can be caught in the same way as a cold but is usually accompanied by fatigue, chills, fever, sore throat, swollen glands, abdominal pain, achy muscles, nausea, vomiting diarrhoea or vomiting.
The flu vaccine helps to protect against certain strains of the flu - but not all and not colds either. Again children’s paracetamol or ibuprofen can help to ease your child’s flu-like symptoms but flus can take up to two weeks to abate, although they should improve gradually each day during this time.

Gastroenteritis is one of the more common stomach and intestinal infections which can be caused by a virus, bacteria or parasite with the side effects of diarrhoea, nausea and vomiting, which your child may experience after food poisoning. Symptoms are similar to the flu but it is usually the colon or intestines that are infected and antibiotics can offered as part of the treatment if it is due to bacteria or parasites being present.

Appendicitis is the inflammation of the appendix and while children can experience similar symptoms to gastroenteritis when they have appendicitis. Parents should know if their child clutches their side or complains of pain that barely subsides after being given pain relief and should take children to the hospital straight away to avoid it rupturing.

Known to doctors as gastro-oesophageal reflux, an older child can continue to experience heartburn and chest pains after having this condition as a baby, and may vomit at times after meals. It is exacerbated by stress, and inflammation and ulceration in the oesophagus and stomach can indicate other medical conditions. Mostly dietary changes and using medications such as antacids that suppress stomach acid secretion are enough to help children cope with this.

Upper respiratory tract infection
Infections in the upper respiratory tract differ from infections in the lower respiratory tract because they involve only the nose, sinuses, pharynx or larynx, and not the trachea or the lungs. These types of infections include tonsillitis, rhinitis, pharyngitis, laryngitis and sinusitis in addition to the common cold, flu and ear infections.

Lower respiratory tract infections include bronchitis, croup and pneumonia which are more serious and involve bacteria or viruses getting past the nose and throat. Even simple tonsillitis can lead to a streptococcal infection becoming blood borne and developing into rheumatic fever. Doctors will be able to tell how far an infection has spread into the respiratory system during an examination and will offer antibiotics accordingly to prevent this.

Urinary tract infection
A urinary tract infection develops in children when the presence of bacteria in the genitals moves into the urethra, causing inflammation and infection that will make it painful and uncomfortable to pass urine, with an increased urge to urinate even when the bladder is empty and bringing fever and sometimes chills, and pain in the back or abdomen.

Often a UTI can be confused with thrush, which is a fungal yeast infection that develops when the skin becomes warm and moist in the genital area, causing a rash that spreads into the urethra.
Doctors can diagnose UTI’s by checking your child’s urine sample to see what bacteria is present and treating it with antibiotics, usually before it spreads into the bladder or the kidneys at which point it can become very serious. Sometimes UTI’s are related to underlying kidney or bladder problems and if so additional tests will be required to confirm this.

Facts verified by Dr Julia Driscoll, a GP sub-specialising in children’s health.