For many adults, thinking about sick days conjures up fond childhood memories of staying home, watching TV or favorite movies all day and eating chicken soup.
But in the moment, getting sick is rarely fun for kids, especially if accompanied by a visit to the emergency department or the intensive care unit.
Children across the Lehigh Valley returned to school this week, and that means that certain communicable diseases will be increasing in prevalence as children come into contact with sick classmates.
“Anytime you put kids together, whatever they have, they’re going to share,” Jennifer Janco, chair of pediatrics for St. Luke’s University Health Network.
Janco said the most common illnesses doctors see once the school year starts up are COVID-19, pertussis — also known as whooping cough — influenza, strep throat and respiratory syncytial virus.
Janco said most healthy children will be able to handle these illnesses in stride; however, that is not a guarantee. Flu, for example, can lead to severe illness, including neurologic or respiratory complications, in even healthy children, particularly if they are unvaccinated.
“Every year we see children hospitalized with the flu, and every year we see children die from influenza, and the large majority are children without underlying health conditions,” Janco said.
Dr. Daniel Ly, pediatrician at Lehigh Valley Health Network, part of Jefferson Health, said that because many of the diseases that spread in schools are respiratory infections, there is a chance that they can progress into different types of pneumonias.
Some children will be more prone to more severe outcomes depending on the illness. Janco said a child with asthma will likely be more affected by respiratory illness and a child with a seizure disorder may have seizures triggered by high fever.
“You have to look at the individual child. There are kids that are out there with underlying chronic conditions or illnesses that put them at higher risk for complications from routine illnesses,” Janco said. “So as we prepare for the upcoming school year, making sure that children have their medications up to date is one of the big things we focus on.”
Janco said that trying to prevent the spread of illness is important to avoid kids unnecessarily missing school. Vaccines are available for COVID-19 and Janco encouraged parents of young children, especially, to get them the shot as they may have no natural immunity. The flu shots are just starting to become available at this time of year and Ly said that now or the next couple of weeks are the perfect time to get children vaccinated. There is also an RSV vaccine, though that is aimed primarily at infants. Janco added that there are vaccines for pertussis and measles, both of which have become more common in recent years.
Ly said that encouraging children to learn hand hygiene is also critical.
“Especially before kids eat lunch at school, before and after they use the restrooms in school, as well as when they get home from school,” Ly said. “Hand sanitizer is totally fine to use unless the hands are still visibly dirty, then we would recommend using soap and water. It’s difficult for children but try your best to have them wash their hands for at least 20 seconds. So generally, that’s singing the happy birthday song to you twice, or singing the ABCs.”
He added that parents should encourage children to cough or sneeze into their elbow or a tissue instead of their hands as part of hand hygiene. Ly said that a balanced diet, drinking plenty of water and getting enough sleep are also critical for keeping a child’s immune system strong.
Parents should consider taking their children to the emergency department if they notice that their child has a high fever. Parents should always take their child to the ER if they have a fever of 105 degrees or higher but they should also pay attention to how long the fever has lasted and how their child is handling it. However, she added that they recommend contacting a child’s primary care doctor first instead of going to the ER for a prolonged fever.
Janco said signs that a child may not be handling a fever particularly well are that they have an altered mental status or are dehydrated, which may result in the child being sleepy, not having saliva in their mouth, not making adequate urine at regular intervals, having a pale and listless appearance or crying without any tears. Ly said a fever lasting more than three to four days is cause for concern.
For infections that spread to the lungs, Ly said signs that parents should look out for is if their child looks like they’re breathing faster than normal, wheezing, breathing so hard that you can kind of see the outline of their ribs, or inability to catch their breath catch their breath.
Janco said if a child is unimmunized or underimmunized, a fever may indicate something possibly more severe and contagious and additional caution is warranted before taking a child to the ED.
“Instead of going to the ER where they may spread that, it is probably better for them to call their primary care doctor who can assess what their symptoms are, what their risk is of different infections, and maybe develop a plan for them at that point,” Janco said.
