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with Rod Moser, PA, PhD

Stories from behind the examining room door, as told by Rod Moser, PA, a primary care physician assistant with more than 35 years of clinical experience.

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Monday, September 10, 2012

Back to School Diseases – Here We Go Again

By Rod Moser, PA, PhD

Back to School

For the last several weeks, kids have been returning to school. Along with those new school clothes, backpacks, and school supplies, many will be returning with some new germs to share. Kids and contagious diseases tend to be inseparable pairs.

Respiratory (cold) viruses are the most common cause of school-borne diseases, and these viruses are fast. The time from exposure to disease can be as little as twelve hours. So, parents, fasten your seatbelts: Here come the illnesses (again).

Colds: It is called the common cold for a good reason. It is “common”, but it has nothing to do with cold. Even when the weather is still hot, respiratory viruses are everywhere. They are worse in the late fall and winter months when kids are concentrated into small areas with poor ventilation. Combined with children’s lack of personal hygiene, it doesn’t take long for a strain of respiratory viruses to infiltrate a classroom. Each community can have different strains, but because of summer traveling, sharing among distant communities is commonplace. A person can acquire an alien virus in London, spread it on the plane, and eventually bring it home to wherever home is – just like the movie, Contagion.

Strep: Strep infections are bacterial, not viruses, but strep infections rapidly increase when school starts. I saw at least a half-dozen, lab-diagnosed strep throats in the last two weeks. Kids can easily have strep for a few days before they have symptoms, and up to one out of five people are strep carriers — they harbor Group A beta-Streptococcal bacteria (the bad kind) without showing any signs of illness. A child with strep tends to have fever and a very red and sore throat. In my opinion, a rapid strep test (about 5-10 minutes) or a culture (2-3 days) should be done to confirm the diagnosis before blindly prescribing an antibiotic.

Head lice: There is nothing that strikes more fear in a family or school than head lice. These innocent and harmless creatures (yes, and yucky) can easily spread from child to child by direct contact, sharing a comb/brush, or even from hats hanging together in a school closet. Over the years, head lice have become more and more resistant to the over-the-counter lice shampoos and rinses, so a bit of persistence is required by parents and you need to follow the directions carefully. Nits (the tiny eggs near the base of the hair shaft) stick like glue and may need to be removed, one at a time, by nit-picky parents before a child can return to the crowded classroom. If over-the-counter methods fail, contact your medical provider for a stronger (and newer) prescription.

Flu: The stomach flu is not really a type of “flu” at all, so your annual flu vaccine will not offer any protection. The most common symptoms are vomiting and diarrhea – often at the same time, or one following the other. Like most viral illnesses, there is little that can be done to cure it, but there are good medicines to control the vomiting. Preventing dehydration is essential to managing this menace to kids, so plenty of water, juices, or electrolyte solutions are important. Most children have improved in a few days and can go back to school, but some symptoms can last up to a week.

The true flu (influenza) can be prevented (usually) by the annual influenza vaccine given in the fall of each year, which (hopefully) will cover all of the anticipated strains. Sometimes, the flu virus will change or mutate, reducing the efficacy of the vaccine. Influenza is still a major killer, mostly in the very young, the elderly, and those with other chronic illnesses. If you do get the flu, there are antiviral medications that can shorten the course and severity of the illness. If we all do our part and get the annual vaccine, it is very difficult for influenza strains to spread.

Conjunctivitis: While not all “pink eyes” are contagious, there is nothing like a red or pink eye that will send your child home from school or child care. The viral and bacterial strains are highly contagious and the bacterial strain requires prescription antibiotic eye drops. Many times, differentiating the two types are difficult, so even kids with the viral strain end up on antibiotic eye drops. Pink eyes caused by allergies or swimming pool chemicals are not contagious, but schools do not take any chances. Your medical provider may need to write a note so kids can return to the classroom. Parents will need to carefully wash hands, changes towels, and disinfect surfaces when pink eyes are among us.

Sexually-Transmitted Diseases (STDs): When you talk about back-to-school diseases, you cannot forget about the rise in cases of sexually-transmitted diseases in adolescents. Love-struck or attention-seeking teenagers as young as 13 are dabbling in sexual experimentation, even under the watchful eyes of their parents. When sexual play leads to intercourse (without condoms), STDs can happen. Chlamydia and/or herpes are the highest on the list and cases seem to peak when the school year commences, although cases occur year-round. The most effective tool in preventing STDs is education. Talk openly with your teenagers. Stress abstinence and safe sex but know that STDs and unintentional pregnancies still happen.

What you can do?  Unless you keep your children in a bubble or home-school them, exposure to others is going to subject them to an occasional illness (usually viral). Stress good hygiene practices, especially frequent hand-washing, and make sure they eat well and a good night’s sleep. When they come home from school, have them change out of their potentially contaminated school clothes to fresh, clean ones. Get those annual flu vaccines as soon as they become available, and keep your kids home when they are ill and potentially, the most contagious.

For teenagers who may be sexually involved or are “just thinking about it”, keep the parental line of communication open at all times. Your only chance of achieving behavioral change is through education and caring. Life was much simpler when you only had to worry about colds or pink eye…

Photo: Photodisc

Posted by: Rod Moser, PA, PhD at 1:00 am

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