Childhood Infectious Diseases

Overview

Children are susceptible to illness throughout their first few years of life while their bodies develop immunity to pathogens. Infectious illnesses account for a substantial share of the yearly burden of 10 million deaths among children under the age of five. This figure includes 36% of the 4 million neonatal fatalities caused by sepsis, pneumonia, diarrhea, and tetanus. While it is difficult to prevent your child from being unwell, the following recommendations can help you avoid certain terrible viruses and manage any diseases that do come home from school.

 

Why do children get sick from day care/school?

Germs spread rapidly in child care facilities and schools because children play in close quarters. Diseases can be transferred through the air when a sick kid coughs or sneezes, or by direct contact when a sick child touches infected portions of their body and then touches toys or other children, who may then touch their mouth, nose, or eyes. Day care facilities and schools take safeguards by encouraging children to practice proper hygiene, such as washing their hands and keeping their toys clean. They also keep ill children separate from other children and do not allow sick children to attend.

Most children will have a cold or an illness at some point throughout their childhood. If a sick kid attends child care or school while contagious, they may transfer their disease to other children or adults. This is why it is critical to keep your ill kid at home or away from child care or school, and to watch for early signs and symptoms.

Many childhood infections, fortunately, result in lifetime immunity in the affected youngster. This, however, is not always the case. Chickenpox, for example, is far less common than it was 15 years ago and is usually mild when caught by a kid who has had a chickenpox vaccination.

Unfortunately, many of these diseases are most infectious before the afflicted youngster exhibits any symptoms, making transmission among peers much more likely. Skin changes are prevalent at some stages of each of the following disorders, which can assist identify between the many kids' infectious diseases and help you determine when and if you should call your child's doctor.

There are several infections that can spread in child care centers and schools. Most are minor ailments that can cause discomfort, but others might be dangerous.

 

Pneumonia

Pneumonia is the greatest infectious cause of mortality in children under the age of five, killing an estimated 700,000 children each year. Every minute, a kid dies from pneumonia in many areas of the globe, despite the fact that the condition is fully avoidable and readily handled with medications.

Pneumonia-related child fatalities are significantly connected to malnutrition, a lack of good water and sanitation, indoor air pollution, and insufficient access to health care. All of these causes, along with poverty, make pneumonia a disease of inequality, concentrating in the world's poorest people.

But simple protective, preventive and treatment solutions do exist: 

• Protective measures such as exclusive breastfeeding, proper supplemental meals, and vitamin A supplementation help to keep youngsters healthy and disease-free.
• Immunizations, decreased home air pollution, clean drinking water, sanitation, and hygiene all contribute to protect children from sickness.
• Antibiotics are essential in the treatment of pneumonia. Although recommendations for antibiotic therapy for pneumonia are frequently based on identifying the causal bacterium, this is unusual and challenging in ordinary clinical care, hence empirical antibiotic therapy is used. Because S. pneumoniae and H. influenzae are the most prevalent causes of children pneumonia in poor countries, the WHO advises first-line therapy with oral cotrimoxazole or amoxicillin for nonsevere pneumonia.

 

Childhood Meningitis

Meningitis is an infection that can be lethal. It is also linked to an increased risk of chronic morbidity and developmental impairment. Furthermore, despite therapy, between 20% and 50% of survivors experience neurological sequelae.

• Symptoms of meningitis

Meningitis symptoms can emerge in any sequence. Some may never appear. There may be no rash in the early stages, or the rash may disappear with pressure. If you are concerned about yourself or your kid, get medical attention immediately. Trust your instincts and don't wait for a rash to appear. Meningitis, septicaemia, and meningococcal illness can cause the following symptoms:

• • A high temperature
  • Cold hands and feet
  • Vomiting
  • Confusion
  • Breathing quickly
  • Muscle and joint pain
  • Pale, mottled or blotchy skin
  • Spots or a rash
  • Headache
  • A stiff neck
  • A dislike of bright lights
  • Being very sleepy or difficult to wake
  • Fits (seizures)

Although poverty, hunger, and overcrowding are significant risk factors for meningitis, delayed and ineffective case care is a major predictor of poor outcomes. The introduction of effective vaccinations has significantly lowered the global burden of meningitis. Hib, pneumococcal, and N. meningitiis vaccinations are among those available.

 

• Medical Treatment

The mainstay of treatment for suspected bacterial meningitis is rapid antibiotic therapy, which must begin before the findings of CSF culture and sensitivity are known. This necessitates the selection of an antibiotic that is known to be effective against the common bacterial infections found locally. A growing number of Hib strains that produce -lactamase are resistant to ampicillin (a -lactamase is an enzyme that degrades penicillin class medicines such as ampicillin).

Chloramphenicol resistance is seen in a reduced proportion of chloramphenicol acetyltransferase-producing bacteria. Furthermore, the fraction of S. pneumoniae CSF isolates resistant to penicillin, ceftriaxone, and cefotaxime has risen. Cefotaxime (or ceftriaxone) alone or in combination with ampicillin is now used to treat either suspected or proven bacterial meningitis (preferred). If this is not accessible, ampicillin in combination with either gentamicin or chloramphenicol may be used. If sepsis is suspected, patients should be treated with ampicillin or penicillin combined with an aminoglycoside until meningitis is confirmed.

 

Diarrhea

Significant progress has been achieved in lowering child fatalities from diarrhea in recent years. However, diarrhea remains a primary cause of death among young children, particularly in humanitarian contexts.

Diarrhea killed around 480,000 young children worldwide in 2019, accounting for 9% of all fatalities among children under the age of five. Simple effective therapies, such as oral rehydration salt and zinc, may have rescued these youngsters. Oral rehydration salt is expected to prevent 70 to 90% of fatalities caused by acute watery diarrhea, whereas zinc is estimated to reduce diarrhea mortality by 11.5%. Appropriate fluids, breastfeeding, sustained feeding, and the administration of antibiotics selectively are also important.

Bloody diarrhea is a symptom of invasive intestinal infection and is associated with intestinal damage and nutritional deficiency, as well as systemic signs such as fever. It is responsible for roughly 10% of diarrheal episodes and 15% of diarrheal fatalities in children under the age of five globally. Although doctors frequently use the terms interchangeably, dysentery is a distinct condition characterized by the frequent passage of distinctive, small-volume, bloody mucoid feces, stomach pains, and tenesmus.

Although less common than acute diarrhea, bloody diarrhea lasts longer, has a greater likelihood of complications and case fatality, and is more likely to impair a child's growth. Agents that induce bloody diarrhea or dysentery, such as Shigella or particular E. coli, can also cause a kind of diarrhea that is not clinically bloody, albeit mucosal injury and inflammation are present, and fecal blood and white blood cells are generally identifiable by microscopy.

 

• Evidence-Based Intervention

Over the last 30 years, the use of oral rehydration solution (ORS), improved nutrition, increased breast feeding, better supplemental feeding, female education, measles immunization, and sanitation and hygiene improvements have all contributed to significant decreases in diarrhea morbidity and mortality. Syndromic diagnosis is critical for effective care and is significant both programmatically and epidemiologically.

The best outcome for diarrhea requires that mothers recognize the problem and seek medical attention as soon as possible; and that health workers provide ORS or other fluids to prevent or treat dehydration, dispense an appropriate antibiotic when necessary, advise on appropriate feeding, and provide follow-up, particularly for children at high risk of serious morbidity or death. Low osmolality ORS and zinc supplementation (10-20 mg/day) have recently resulted in dramatically better diarrhea results.

 

Ear Infection

There are several forms of ear infections. Acute otitis media (middle ear infection) is an infection of the middle ear. Otitis media with effusion is another illness that affects the middle ear. This syndrome develops when fluid accumulates in the middle ear without resulting in an infection. Fever, ear discomfort, or pus buildup in the middle ear are not symptoms of otitis media with effusion. Swimmer's ear is an infection of the ear canal's outer wall. Swimmer's ear is not the same as a middle ear infection. 

Common symptoms of middle ear infection in children can include:

• Ear pain
• Fever
• Fussiness or irritability
• Rubbing or tugging at an ear
• Difficulty sleeping

 

• Treatment of middle ear infection

A doctor can identify a middle ear infection by talking about your child's symptoms and examining him or her. The doctor will check the eardrum and look for pus in the middle ear of your child.

The immune system of the body can frequently fend off middle ear infection on its own. Antibiotics are not always required for middle ear infections. However, serious middle ear infections or infections that persist more than 2-3 days require antibiotics to be administered immediately.

For mild middle ear infection, your doctor might recommend watchful waiting or delayed antibiotic prescribing.

• • Watchful waiting: Your kid's doctor may advise you to monitor and wait for 2-3 days to see if your youngster requires antibiotics. This allows the immune system to battle the illness. If your child's symptoms do not improve, the doctor may advise him or her to take an antibiotic.
  • Delayed prescribing: Your child's doctor may prescribe an antibiotic, but you should wait 2-3 days before filling it. Your youngster may heal without the need for antibiotics.

 

Fifth’s Disease (Parvovirus B19)

The fifth sickness is a minor rash caused by the parvovirus B19. It affects children more than adults. After being infected with parvovirus B19, a person generally becomes ill with the fifth sickness within 14 days. This condition, also known as erythema infectiosum, was named after ranking fifth among historical classifications of frequent skin rash disorders in children.

The symptoms of fifth disease are usually mild and may include

• fever
• Runny nose
• Headache
• Rash

 

• Diagnosis

A "slapped cheek" rash on a patient's face can frequently be used to detect fifth illness. A blood test can also be performed to assess if you are vulnerable or perhaps immune to parvovirus B19 infection, or if you have recently been affected. This is not a normal test, although it can be done in exceptional circumstances. The blood test might be especially beneficial for pregnant women who have been exposed to parvovirus B19 and are suspected of having the fifth illness. Any pregnant woman who has been exposed to parvovirus B19 should notify her obstetrician or healthcare practitioner right once.

• Prevention & Treatment

There is no vaccine or treatment available to protect against parvovirus B19 infection. You may lower your risk of being sick or infecting others by

• • washing your hands often, for at least 20 seconds, with soap and water
  • covering your mouth and nose when you cough or sneeze
  • not touching your eyes, nose, or mouth
  • avoiding close contact with people who are sick
  • staying home when you are sick

You are generally not infectious after you have the rash. As a result, you may generally return to work or your child can return to school or a child care facility.

Pregnant healthcare professionals should be aware of potential hazards to their infant and address this with their doctor. To prevent the spread of parvovirus B19, all healthcare providers and patients should adhere to stringent infection control protocols.

Fifth illness is typically minor and self-resolving. Children and adults who are generally healthy usually fully recover. Symptoms such as fever, itching, and joint discomfort and swelling are often treated. People who develop issues from the fifth disease should get medical attention from their healthcare professional.

 

Chicken Pox (Varicella)

The varicella-zoster virus causes chickenpox, a highly infectious illness (VZV). It might result in an itchy, blistering rash. The rash develops first on the chest, back, and face, then spreads across the body, generating between 250 and 500 itchy blisters. Chickenpox may be fatal, especially in newborns, teenagers, adults, pregnant women, and those whose bodies have a reduced capacity to fight infections and illness (weakened immune system). The best approach to avoid chickenpox is to be vaccinated.

The best approach to avoid chickenpox is to be vaccinated. If they have never had chickenpox or have never been vaccinated, everyone, including children, adolescents, and adults, should receive two doses of chickenpox vaccine.

The chickenpox vaccination is extremely safe and efficient against the disease. The vaccination prevents chickenpox in the vast majority of people. If a vaccinated individual has chickenpox, the symptoms are generally milder, with fewer or no blisters (just red patches) and a low or no fever.

Almost all cases of serious disease are prevented with the chickenpox vaccination. Since the beginning of the varicella immunization program in the United States, there has been a more than 90% reduction in chickenpox infections, hospitalizations, and fatalities.

 

• Treatments at Home for People with Chickenpox

There are various home remedies that might help ease chickenpox symptoms and prevent skin infections. Calamine lotion and a chilly bath with baking soda, uncooked oatmeal, or colloidal oatmeal added may help reduce itching. To prevent the virus from spreading to others and to help avoid skin infections, keep fingernails short and scratching to a minimum. If you accidentally scratch a blister, wash your hands with soap and water for at least 20 seconds.

 

Hepatitis A

Hepatitis A accounts for 20% to 25% of all hepatitis cases in affluent nations. Hepatitis A is often spread by the fecal-oral route, which means that a person ingests contaminated feces from an infected person. If an infected individual does not thoroughly wash his or her hands after using the restroom, the illness may spread through the person's hands. Infected people are infectious for two to six weeks during the incubation phase.

Eating shellfish obtained from polluted water is another source of hepatitis A. Drinking water tainted with raw sewage causes hepatitis A outbreaks in developing nations.

Hepatitis A patients have a great prognosis with a self-limiting course and full recovery. Approximately 85 % of persons with hepatitis A recover in three months, and nearly all recover in six months. There is no chronic illness, and there are no long-term health consequences.

 

Impetigo

Impetigo is a superficial skin illness caused by bacteria. Lesions with a red foundation that are open but close over to create a honey-colored crust are common. Impetigo is infectious and can spread across a home, with children reinfecting themselves or other members of the family.

• What causes impetigo?

Impetigo is caused by common bacteria, some of which are found naturally on the skin. When germs penetrate an open region of the skin, they cause an infection. The following are the most prevalent bacteria that cause impetigo:

• • Group A ß - hemolytic streptococcus
  • Staphylococcus aureus

Impetigo is more frequent in youngsters, although it can also affect adults. Poor hygiene and warm temperatures aggravate impetigo.

 

• What are the symptoms of impetigo?

Impetigo most commonly affects the face, neck, arms, and limbs, but the lesions can arise elsewhere on the body. Impetigo begins as a tiny fluid-filled vesicle. The lesion eventually ruptures and the fluid drains, leaving honey-colored crusts in its wake.

The lesions may all appear differently, with varying sizes and forms. Swollen lymph nodes may also be seen in the youngster (small lumps that are located mostly in the neck, arm, under the arm, and in the groin area). When a child's body is fighting an illness, lymph nodes swell.

Because the symptoms of impetigo might be confused with those of other skin illnesses, always visit your child's doctor for a diagnosis.

• How is impetigo diagnosed?

A comprehensive medical history and physical examination of the kid are generally used to diagnose impetigo. Impetigo lesions are distinct and can typically be diagnosed with simply a physical examination. In rare situations, a culture of the lesion may be ordered by the child's doctor to confirm the diagnosis and identify the type of bacteria present.

• What is the treatment for impetigo?

Specific treatment for impetigo will be determined by the child's physician based on the following criteria:

• • The child's age, overall health, and medical history
  • Extent of the condition
  • The child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Child or parent’s opinion or preference
    
    
• Treatment may include:
  • Oral antibiotics (for multiple lesions)
  • Topical antibiotic applied directly to the lesions
  • Washing daily with an antibacterial soap to help decrease the chance of spreading the infection
  • Proper hand washing technique by everyone in the household (to help decrease the chance of spreading the infection)
  • Keeping the child's fingernails short to help decrease the chance of scratching and spreading the infection
  • Avoid sharing of garments, towels, and other household items to prevent the spreading of the infection

 

Scabies

Scabies is a mite (tiny bug) infection marked by little red pimples and acute itching. This extremely infectious condition is frequently transmitted from person to person while they are sleeping in the same bed or in close intimate contact.

The itching is caused by mites digging into the skin and laying eggs, which hatch after a few days. People of all ages can get scabies. Scabies is more common in children and young adults.

• What are the symptoms of scabies?

It might take 4 to 6 weeks for a youngster to develop scabies symptoms after coming into touch with an infected individual.

Lesions produced by mites typically appear on the head, neck, palms, and soles of children under the age of two. Lesions between the fingers, on the hands or wrists, along the belt line, on the thighs or belly button, in the groin area, around the breasts, and in the armpits are common in older children.

The following are the most prevalent scabies symptoms. However, each child may experience symptoms in a unique way. Symptoms could include:

• • Itching, usually severe
  • Rash, with small pimples or red bumps
  • Scaly or crusty skin (with advanced conditions)
    
    
• How is scabies diagnosed?

A physician examines the skin and skin fissures to diagnose scabies. To confirm the existence of mites, a sample of skin obtained by scraping the skin can be inspected under a microscope.

• What is the treatment for scabies?

Scabies is curable, and most families have all members treated at the same time. The specific therapy will be selected by:

• • The child's age, overall health, and medical history
  • Extent of the infestation
  • The child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the infestation
  • Child or parent’s opinion or preference

 

Treatment may include:

• • Applications of prescription creams and lotions, such as permethrin and lindane solutions
  • Oral antihistamine medication (to help relieve itching)
  • In some cases, topical ointments are recommended

Furthermore, in order to destroy the mites, all garments and bedding should be washed in hot water and dried in a hot dryer. Clothing and other non-washable items (such as pillows and plush animals) should be stored in a plastic bag for at least one week.

 

Conclusion 

Some disease-causing microorganisms are easily transferred among children and teenagers in group settings such as schools, child care facilities, camps, and athletic events. Communicable illnesses are those caused by bacteria, viruses, parasites, or protozoa that spread from person to person. It is critical to notice whether someone in a group environment is unwell with a communicable disease so that appropriate medical care may be obtained and disease transmission can be avoided.