By the middle of September, my surgery is heaving with children who have already fallen ill a couple of weeks into the new school term.
Tummy bugs, coughs and colds all seem to thrive once kids are jam-packed in the classroom all day.
I certainly notice this with my own children. I think the early mornings and long day at school can take their toll on the immune system, which is why I insist they get an early night.
The important thing is most of these back-to-school infections are usually mild and require minimal treatment at home with the help of a pharmacist or your GP.
Here is a comprehensive guide to the most common of school ailments – and how to tackle them...
KEEP ON TOP OF LICEWHAT ARE THE SYMPTOMS?
An itchy head – this may start three months after the initial infection of head lice.
‘They are parasitic insects between 1mm and 3mm long that live on the head and feed on human blood. Many people mistakenly call them nits, but nits are the hatched or dead eggs,’ says nurse consultant Christine Brown, who advises primary care trusts on head-lice policy.
WHAT CAN YOU DO?
‘Not everyone has itching. Check your children’s heads once a week,’ she recommends. ‘Lice look like dandruff but stick to the hair.
Look for live insects. Use silicone-based treatments such as Hedrin Treat & Go Mousse (£12, chemistdirect.co.uk) which coats the lice so they die.
Lice have developed resistance to previous pesticide treatments.’ You can comb out lice from wet hair using a special fine-toothed comb and normal conditioner.
However, clinical trials have shown this to be only 57 per cent effective and it is time-consuming.
WHEN TO SEEK HELP
Sometimes an allergic reaction to bites can cause dermatitis and infection. If your child has intense itching (and skin is bleeding) then see your GP.
DO THEY NEED TO BE OFF SCHOOL?
No. Children can return to school immediately after treatment – however, you must treat them. Under public health law it is a requirement that they be treated.
‘In extreme cases of neglect, social services might get involved,’ says Brown.
BEWARE SNEEZERS... WHAT ARE THE SYMPTOMS?Coughs and colds are usually viruses and spread by sneezing – children are notoriously hopeless at covering their mouths.
‘Sneezing, coughing and sniffing are inevitable for most children,’ says Dr Michael Markiewicz, consultant paediatrician at the Bupa Cromwell Hospital, West London.
WHAT CAN YOU DO?Cough syrups are unlikely to make much difference. Give paracetamol for a temperature.
WHEN TO SEEK HELP‘If a child has a very sore throat or isn’t sleeping because of high fever, see your GP,’ Dr Markiewicz says. ‘They may have a bacterial infection and need antibiotics.’
DO THEY NEED TO BE OFF SCHOOL?Only if a child has a temperature, but use discretion.
PAIN OF CHICKENPOXWHAT ARE THE SYMPTOMS?
Chickenpox is a viral infection causing a rash of clear blisters which spreads and causes pain and itching, eventually crusting over into scabs and dropping off. Children may have a fever.
WHAT CAN YOU DO?
‘Paracetamol relieves fevers and discomfort. Sedating antihistamines such as Piriton relieve itching,’ says consultant paediatrician Dr Jideofor Menakaya at Hillingdon Hospital, London.
‘Be aware that sedating medication may mask serious side effects.’
Experts warn against parents holding ‘chickenpox parties’ because although serious complications with this illness are rare, they do still happen.
Calamine lotion may help itchy skin or try ViraSoothe Chickenpox Relief Cooling Gel (£8.99, 75ml, boots.com), which doesn’t dry on the skin. Give plenty of fluids.
WHEN TO SEEK HELP
‘If your child has eczema they may benefit from the chickenpox vaccine before contracting the condition. Chickenpox on top of eczema can be very distressing,’ says Dr Michael Markiewicz.
Dr Menakaya adds: ‘Meningitis and encephalitis are rare but possible complications. If a child is floppy and unresponsive, not drinking or passing urine properly or has a high temperature, see a doctor.’
DO THEY NEED TO BE OFF SCHOOL?
Yes. Children are most infectious one to two days before the rash appears and until all the spots crust over.
HOW TO SPOT MEASLESWHAT ARE THE SYMPTOMS?
Measles is an infectious viral disease. Initially it is like having a cold, says Dr Jideofor Menakaya.
‘Then white spots on a red base appear in the mouth and a red rash appears behind the ears, spreading down the whole body.’
There were 964 confirmed cases in the first half of 2012, compared with 249 in the whole of 2010.
WHAT CAN YOU DO?
Normal children’s medications are appropriate such as Nurofen and Calpol. Encourage the child to drink plenty of fluids. See your GP if you suspect measles.
WHEN TO SEEK HELP
Complications include bacterial infections as well as pneumonia. ‘If a child has a temperature and is not responding, seek medical attention,’ says Dr Menakaya. ‘Rapid breathing with a high temperature is cause for concern.’
DO THEY NEED TO BE OFF SCHOOL?
Yes. Measles is a notifiable illness. The GP has to tell the Health Protection Agency of any confirmed or suspected cases. The school must also be informed.
WHAT IF YOU HAVEN’T HAD A MEASLES JAB
Anyone – adult or child – who hasn’t had the MMR or a single jab needs to have a booster vaccine. The HPA recommends that all children have both doses of the MMR vaccine.
THOSE PESKY PARASITESWHAT ARE THE SYMPTOMS?
Threadworms are contagious parasitic worms which lay eggs, usually at night, leading to an itchy bottom. If the eggs get stuck on fingertips, they can be transferred. Once ingested, their entire lifecycle takes place within the human digestive tract.
WHAT CAN YOU DO?
Medication is available at pharmacies. Try raspberry-flavoured Pripsen sachets (£2.69, expresschemist.co.uk) or Ovex tablets (£6.29, pharmacy2u.co.uk). Look for the active ingredients Piperazine and Mebendazole. Treat the whole family, but be aware they can’t be used by pregnant women and breastfeeding mothers.
‘You must repeat treatment after 14 days to ensure all the worms are dead,’ says nurse consultant Christine Brown.
‘Extremely good hygiene is vital to prevent spreading and causing further infection,’ she says. ‘Wash all towels and bedding. Bath children each morning to remove eggs laid overnight, disinfect loo seats and wash hands frequently.’
WHEN TO SEEK HELP
There is no other treatment. Your GP is unlikely to offer further solutions.
DO THEY NEED TO BE OFF SCHOOL?
‘There’s no need to keep them home following treatment but it’s probably a good idea to let the school know,’ says Brown. ‘The school will be discreet but may wish to take its own precautionary measures.’
TUMMY TROUBLEWHAT ARE THE SYMPTOMS?
Vomiting and diarrhoea – known medically as gastroenteritis – is inflammation of the digestive tract either by viruses or, more rarely, bacteria. ‘Bugs’ are often contagious and can spread quickly.
WHAT CAN YOU DO?
‘Keep children hydrated with flavoured Dioralyte or half-diluted lemonade,’ says Dr Michael Markiewicz. The salt and sugar in Dioralyte helps water to be absorbed. There is often little you can do if a tummy bug is going round – but regular hand washing, or an antibacterial/antiviral hand gel may help.
WHEN TO SEEK HELP
‘If a child is just vomiting it may be a more sinister problem such as a severe underlying bacterial infection,’ says Dr Markiewicz. ‘See a doctor if they have been continuously sick for 24 hours, or if they become floppy and drowsy.’
DO THEY NEED TO BE OFF SCHOOL?
‘Yes, children are infectious while they have symptoms. Don’t send them back for 24 to 48 hours after they were last sick.’
PERSISTENT COUGHSWHAT ARE THE SYMPTOMS?
Early symptoms of whooping cough – or pertussis – are cold-like. The second stage is characterised by intense bouts of coughing and bringing up thick phlegm.
‘The whooping sound occurs when the child has coughed a number of times and not had time to breathe properly,’ says Dr Markiewicz.
It can be contracted at any age, as the immunity provided by the vaccination wanes after a few years. There have been 3,523 cases this year and six pertussis-related deaths in infants.
‘We are very concerned about the continuing increase in cases,’ says Dr Gayatri Amirthalingam, immunisation expert at the HPA. ‘Parents should ensure that their children are vaccinated on time so that they are protected at the earliest opportunity.’
WHAT CAN YOU DO?
Antibiotics are necessary to prevent infection of others.
WHEN TO SEEK HELP
Whooping cough is dangerous in babies. If they go floppy they may need oxygen. ‘Babies with feeding or breathing difficulties should always be in hospital,’ says Dr Jideofor Menakaya. When older children have significant breathing difficulties, also seek medical attention.
DO THEY NEED TO BE OFF SCHOOL?
Yes and it may be a long haul – it is also known as the 100-day cough. ‘It’s disruptive. Children can’t go back to school until it’s gone,’ says Dr Markiewicz.
NEW TERM TANTRUMS‘Starting a new school is always stressful. It’s often hard to generalise about the best way to resolve children’s problems,’ says educational psychologist Professor Julian Elliott. He suggests solutions to three common situations.
THE PROBLEM: Your child screams and clings to you when you drop them off.
THE SOLUTION: Leave calmly with as little commotion as possible. Teachers are experts in dealing with such problems and in 99 per cent of cases, the child will soon be pacified.
THE PROBLEM: Your child is complaining of tummy aches or headaches.
THE SOLUTION: If the cause is anxiety or concern about events at school, do not give in to your first instinct and let them stay at home. This will often store up problems for the future. Discuss what the problem may be and reassure your child. If it is affecting their health or the distress continues, talk to the school. See your GP to eliminate a physical cause.
THE PROBLEM: Your child is suffering night terrors, disrupted sleep or not eating properly.
THE SOLUTION: Ensure they understand that you are taking their concerns seriously. Help them gain a realistic perspective. The unpredictability of school is often the problem.
