Category Archives: fever

Roseola

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Let’s say this first: anytime your infant or young child has a fever of 102°F for twenty-four hours, call the pediatrician.  The issue may be minor or serious, and the doctor should help you determine what it might be.

One possibility is roseola, usually not a series condition, which is yet another in the herpes family of viruses.  (It is not the same as the herpes strains that cause genital herpes or cold sores.)  It’s human herpes virus 6 (HHV-6) and is relatively common in children aged six months to two years.

Symptoms, in addition to the fever (which may last up to a week), may include a cough and runny nose, less appetite and mild diarrhea.  Finally, after the fever is gone, generally a slightly raised red rash will appear.  It usually starts on the torso before spreading to the rest of the body.

Roseola is contagious, and a child with a fever should be kept away from other youngsters until the fever is gone.  Once roseola is at the rash stage the child is no longer contagious and can return to daycare.  The incubation period is one to two weeks.

If the pediatrician suspects roseola in your child, you might be asked to treat the fever with age-appropriate doses of acetaminophen (always be sure to check dosing instructions and note that they have changed in the last few years) and keep him hydrated.  The doctor may want to talk to you again to make sure the child isn’t sick with something more serious.

You can find out more about roseola in the two articles from which our research was drawn, here and here.  Both articles were published by the American Academy of Pediatrics.

© MBS Writing Services, all rights reserved

Fifth disease: What is it? When to call the doctor.

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Fifth disease was given its name because it’s the fifth in a list of viruses that can cause rashes in children (the other four are chicken pox, rubella, measles and roseola). Its other name is Parvovirus B19. This might sound a little scary to you, since you may have heard of a canine parvovirus that is very serious for dogs. While in the same family as the canine virus, Parvovirus B19 is only a human virus and cannot be transmitted either from dogs to people or from people to dogs. In children, Parvovirus B19—fifth disease—is relatively common and generally quite benign.

 

Fifth disease in children is not usually dangerous, unless the child has anemia or an autoimmune disease. It’s contagious through the droplets of coughing and sneezing or through saliva (or from a pregnant mother to her fetus), and can show up 4 to14 days after exposure. Frequent hand washing is the best way to reduce the spread of viruses.

 

The first symptoms are similar to those of a cold: runny nose; mild fever; itching; soreness; headache. A few children experience achy joints.

 

After a week or so, a red rash may appear on the cheeks. It may, over the next few days, also appear on the torso and arms, buttocks and thighs. Within another week, the rash will likely fade. It might return, even months later, when the child gets overheated. By the time the rash appears, the child is no longer contagious.

 

When should you call our office? If your child has anemia, especially sickle cell anemia, or an autoimmune condition, call right away. Fifth disease can be dangerous for these patients. Also, if your child develops joint swelling or if symptoms worsen over time instead of improving, call us.

 

In normal cases, we treat symptoms with acetaminophen to reduce fever, or antihistamines to control itching. However, sickle cell patients and some others may need to be hospitalized because the blood counts can be seriously compromised. A pregnant woman with fifth disease should also be seen by a physician, because serious complications can occur.

 

Most of the information in this article came from the American Academy of Pediatrics article on the subject, which you can read here.

 

Fifth disease is more common late winter through spring, so you may want to keep an eye out for it this time of year. The good news is that most children will develop only mild symptoms that will go away without treatment.

 

 

 

© MBS Writing Services, 2015, all rights reserved

 

 

Stomach virus season

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Yes, we’re starting to see some fall/winter viruses that cause gastrointestinal (GI) problems. By the end of winter, Rotavirus will have been our most common offender, but now that kids are back in school, lots of viruses are happy. Families who get the viruses… not so much.

 

GI viruses like school, daycare and home settings because these places have children who haven’t always learned good hygiene practices. Prevention is always the best action against these diseases, so don’t forget to CLEAN door handles, toilet seats, other bathroom surfaces, television remotes. Also be sure to wash hands before cooking, serving and eating food.

 

Another way to hinder a virus is to keep your child home when she’s sick, preventing the spread to other children and adults. That may have been where she came into contact with the virus. Let’s not spread the “love.”

 

When can you send him back to school or daycare? Make sure he has been fever free for 24 hours (without a fever reducer), is able to tolerate small amounts of bland foods, has gone at least 12 hours since his last episode of vomiting and has had no more than 3 episodes of diarrhea in 8 hours.

 

Contact our office if diarrhea and vomiting don’t subside within three days or if diarrhea is bloody, if there’s been no urine output for 10 hours, or if the fever is high or doesn’t subside. We have a nurse available for advice on the phone, and we often can call in prescriptions for nausea for older children, unless we think they need to be seen in the office first.

 

More information? See our blog from last spring which includes a link to the American Academy of Pediatrics article on Rotavirus. Also, our blog regarding when to be concerned about a fever.

 

Stay healthy this winter!

 

 

 

© 2014, MBS Writing Services, all rights reserved

 

 

 

Measles

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You’ve been hearing about measles outbreaks in the news lately.  Also called rubeola, measles is a respiratory disease caused by a virus.  It causes a rash over the entire body, a fever and runny nose.  According to the Centers for Disease Control and Prevention, “About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia.”  Measles can also, rarely, be fatal.  Between one and two children in 1000 who get the disease will die from it.  The disease can also strike adults.

If you thought measles was a disease left in the past, think again.  An outbreak this year in Ohio (374 cases in 4 months) has health departments all over the country concerned, because such an event can happen anywhere.  The Ohio outbreak began when unvaccinated people traveled abroad to places where measles is more common because a larger percentage of the population is unvaccinated.

It’s no coincidence that we used the word “unvaccinated” twice in that last sentence.  The reason measles is spreading again in the United States is because of a drop in MMR (Measles, Mumps and Rubella) vaccinations.  Those who decide not to be vaccinated (or to have their children vaccinated) put themselves, their families and their communities at risk for dangerous diseases.  As with most diseases, those at highest risk are the very young, the very old, and those with compromised immune systems.

The MMR vaccination is required for students in Scott County Schools, and HIGHLY recommended for all other children.  The State of Kentucky requires two doses of the MMR vaccine before your child can enter school.  If you have concerns about vaccinations, talk to your pediatrician.

Remember that the extremely rare risk of a reaction to a vaccination is much smaller than the risk of being unvaccinated against a dangerous illness.

© 2014, MBS Writing Services, all rights reserved

Sunburned!

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As the summer gets going into full swing with Independence Day weekend, days by the pool and in the backyard, and lots of sports, sun exposure is always a concern.

How do you keep your kids healthy, happy and sunburn-free while still giving them lots of time outdoors?  And when sunburn does occur, how should you treat it?

Prevention.  Check out our blog from last summer about sunscreens here.  Bottom line:  use sunscreen liberally and limit sun exposure.  You don’t have to get a sunburn to cause long-term skin damage.

Babies and toddlers.  See this detailed article from the American Academy of Pediatrics (AAP).  Very young children are especially vulnerable to sunburn and heat stroke.  Under 6 months they should be kept out of direct sunlight and in the shade as much as possible.  Use the sun cover on the stroller.  Take a canopy to the older kids’ soccer games—it’s not only a good place to put the infant, but the rest of the family can get out of the sun, too.  Be aware that reflective surfaces, like sand or the concrete around pools, can still allow for sunburn even when you’re under an umbrella or other cover, no matter what your age.

In addition to limiting time outside in the hot part of the day, here are other considerations for the very young:

  • Dress them in lightweight, light colored clothing that covers arms, legs and the head.
  • Use sunscreen on any exposed skin.  There are several types that are appropriate for tender baby skin.  Don’t ever spray directly onto the face, but into your hand first.
  • Put a brimmed hat on babies and toddlers, or spray their scalps with sunscreen.  A fully-brimmed hat can protect scalp, ears, and partially protect face and neck.

Possible skin damage.  Don’t forget that everyone, even those with darker skin, are at risk of skin damage from the sun.  Exposure over time can lead to skin cancers later.

Treatment.  Sooner or later, most everyone will have a sunburn no matter how hard you try to prevent it.  What to do?  It depends on the severity.

  • Minor burns (red, warm to the touch) can be treated with cool compresses, acetaminophen and rest.
  • More serious burns can cause blisters, fever and chills, headache or other feelings of malaise, even infection.  If the burn is very serious, call your pediatrician.

So, by all means enjoy the summer sun, just be careful of getting too much exposure!

© 2014, MBS Writing Services, all rights reserved

Appendicitis

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Do you ever wonder whether abdominal pain warrants a call to the doctor, or even a visit to the emergency room?  How can you tell?

One worry with children and teens is appendicitis.  The appendix is a small, tubular-shaped organ in the lower right abdomen, that has no known function.  Sometimes it can become inflamed and needs to be surgically removed.  If left alone, an inflamed appendix can rupture and cause very serious illness.

Appendicitis can occur at any age, and is often difficult to diagnose.

The American Academy of Pediatrics has a great article here about appendicitis.  The main symptom is pain, which begins as a “vague stomachache near the navel,” and then is described as a combination of a sense of fullness and pressure on the lower right side.  Here is the complete list of symptoms they give, some of which are similar to stomach viruses, and some of which are different:

  • “Persistent abdominal pain that      migrates from the midsection to the right lower abdomen
  • Nausea and vomiting
  • Constipation
  • Gas pain
  • Diarrhea
  • Low fever, beginning after other      symptoms
  • Tenderness in the right lower abdomen
  • Abdominal swelling
  • Elevated white blood cell count
  • Appetite loss.”

Call your doctor immediately if your teen or child experiences these symptoms.  Have him lie quietly and “don’t offer water, food, laxatives, aspirin or a heating pad.”  Any movement can increase her pain.  If appendicitis is suspected, a blood test (to determine white blood cell count) will likely be taken, possibly with other diagnostic tests.

 

© 2014 MBS Writing Services, all rights reserved

 

Stomach virus recovery

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“Stomach bugs” are making their rounds right now.  Rotavirus, in particular, is quite contagious and may have even made the rounds through every member of your household.  It causes diarrhea, vomiting, stomach pain, etc.  Sound a little too familiar?

What to do?

According to the American Academy of Pediatrics, usually, the virus goes away on its own.  Watch, though, for dehydration and high fever.  Dehydration can be serious in a small number of cases.  Give small amounts of fluids until the vomiting ceases.  Water is fine, but fluids like Gatorade can add electrolytes.  Stay clear of acidy drinks (like orange juice) and milk.

Be watchful regarding dehydration.  Pay attention to the frequency of urination.  The urine will become more concentrated and less frequent, but child should still be urinating.

While your child is sick, give a very bland diet:  avoid dairy, fried foods, fast foods, hot dogs, etc.  Some good foods are bananas, rice, applesauce and toast (BRAT).

However, it’s recommended that as soon as the stomach is settled, you should return to a balanced diet of fruits, vegetables and protein (meat, yogurt).

Call the pediatrician if diarrhea and vomiting don’t subside within three days, if there’s been no urine output for 10 hours, or if the fever is high or doesn’t subside.  See our blog about when to be concerned about a fever.

As always, stay healthy!

 

© 2014 MBS Writing Services, all rights reserved

When is a fever something to be concerned about?

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That’s a great question, because we probably get more calls about fevers than about anything else.

The American Academy of Pediatrics published a brief article about fever and treating it, reminding parents that fever is the body’s way of fighting an illness, and the reason to treat it is to make the child more comfortable.  They emphasize:

  • watching for signs of serious illness;
  • being careful of dosage amount based on the child’s weight;
  • keeping the child well-hydrated;
  • storing the medication in a safe place;
  • not waking the child up to administer the medication.

So, what should you be watching for, and when do you call the pediatrician?  Here we’ve quoted a list from the same article that we think is quite helpful:

“Call your child’s doctor right away if your child has a fever and

  • Looks very ill, is unusually drowsy, or is very fussy.
  • Has been in a very hot place, such as an overheated car.
  • Has other symptoms, such as a stiff neck, severe headache, severe sore throat, severe ear pain, an unexplained rash, or repeated vomiting or diarrhea.
  • Has immune system problems, such as sickle cell disease or cancer, or is taking steroids.
  • Has had a seizure.
  • Is younger than 3 months (12 weeks) and has a temperature of 100.4°F (38.0°C) or higher.
  • Fever rises above 104°F (40°C) repeatedly for a child of any age.

“Also call your child’s doctor if

  • Your child still “acts sick” once his fever is brought down.
  • Your child seems to be getting worse.
  • The fever persists for more than 24 hours in a child younger than 2 years.
  • The fever persists for more than 3 days (72 hours) in a child 2 years of age or older.”

Don’t forget:  since a fever is a sign of an illness, do NOT send your child back to school/daycare until his temperature has been under 101 for 24 hours.

Together, we’ll work at keeping your child healthy.

Artwork by Tori

Artwork by Tori

 

© 2013, MBS Writing Services.