Category Archives: viruses

What you need to know about Hepatitis A

If you’ve been listening to the news lately, you may have heard about the Hepatitis A outbreak in Kentucky. Over 300 people have been affected in an area that comprises several counties. Other states have also seen outbreaks. The source has yet to be confirmed, but some other recent outbreaks have been linked to tainted food.

Though it’s a highly contagious viral infection, Hepatitis A can be fairly easily prevented by getting vaccines and practicing good hygiene, like washing your hands.

There are several types of hepatitis. Here is a good article from the American Academy of Pediatrics that discusses Hepatitis A infections in children. According to the article, “Hepatitis symptoms tend to be similar from one virus type to another. Many of these symptoms are flu like, such as fever, nausea, vomiting, loss of appetite, and tiredness, sometimes with pain or tenderness of the liver in the right upper abdomen. A hepatitis infection is also associated with jaundice, a yellow discoloration of the skin and a yellowish color to the whites of the eyes. This is caused by inflammation and swelling of the liver with blockage and backup of bile (bilirubin) into the blood. This backup also usually causes the urine to turn dark orange and stools light yellow or clay colored. However, many children infected with the hepatitis virus have few if any symptoms, meaning you might not even know that your child is sick. In fact, the younger the child, the more likely she is to be symptom free. For example, among children infected with hepatitis A, only about 30% younger than 6 years have symptoms, and most of them are mild. Symptoms are more common in older children with hepatitis A, and they tend to last for several weeks.”

From the same article about how the virus is transmitted to children: “Hepatitis A is contracted when a child eats food or drinks water that is contaminated with the virus or has close contact with a person who is infected with the virus. Hepatitis A is present in the stool as early as 1 to 2 weeks before a person develops the illness. The infection can be spread in child care settings when caregivers do not wash their hands after changing the diaper of an infected baby or from infant to infant because most very young infants do not wash their hands or have their hands washed for them.”

Here’s the good news: Hepatitis A vaccines work! As a matter of fact, beginning with the 2018-19 school year, Kentucky will require all students K-12 to have received two doses of the Hepatitis A vaccine.

If your child is a patient at Georgetown Pediatrics and is at least one year old, we’ve already discussed this with you.

Are you unsure if your child’s vaccinations are up-to-date for the next school year? Give our office a call and we can access your vaccinations records.

Mosquitoes are back!

Leave a reply

During our recent warm spell, you may have heard the distinctive, high-pitched buzz of a mosquito passing by, and you realize that this is the beginning of several months of those little pests.

Pests they are, yes, but mosquitoes can also carry serious diseases. Some of the mosquito-borne illnesses are limited to tropical or subtropical areas, but some can also affect us here.

West Nile Virus, for example, is carried by mosquitoes and can infect humans and animals. It usually causes no symptoms at all, but in some instances can cause encephalitis, which can even be fatal.

Recently we’ve heard about the Zika virus. It is spread by mosquitoes (and can also be sexually transmitted). So far, the virus hasn’t come this far north except by someone who has traveled to an affected area, and those who returned infected from their travels have not spread it to others. To read about the possible spread of Zika to new areas this year, and to learn about its symptoms and results, you can find a series of informative articles by the Centers for Disease Control and Prevention (CDC) here. Zika is especially dangerous in pregnant women because it can cause very serious birth defects.

Good health means good prevention, so it is always advisable to keep insects at bay.

Avoid mosquitoes by remembering that they are most active at dawn and dusk, and they love damp, dark areas like woods, mulched gardens, areas around ponds, etc. Wear long-sleeved shirts and long pants when you think you may be exposed to mosquitoes, and use repellent. Never use a repellent on a child younger than two months, and never spray directly into a child’s face (spray it on your hands first, then rub onto the face). An article about insect repellents from the American Academy of Pediatrics (AAP) gives great information about repellents and children.

Be proactive in eliminating as many mosquitoes as possible from your home and yard. The Health Department of Northern Kentucky gives these suggestions on their website:
- Survey property for areas of standing water. Dispose of tin cans, old tires, buckets, unused plastic swimming pools or other containers that collect and hold water. Do not allow water to accumulate in the containers for more than two days.
- Install or repair screens. Some mosquitoes like to come indoors. Keep them outside with well-fitting screens on both windows and doors.

And, Dr. Riebel in our practice says that her favorite form of mosquito control for our area is the purple martin! These lovely birds love to fly around your yard in the evening, scooping up insects.

Have a safe and healthy warm-weather season, and try to keep mosquitoes and the diseases they carry at bay.

Roseola

Leave a reply

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.

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

Leave a reply

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.

Stomach virus season

Leave a reply

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!

Stomach virus recovery

Leave a reply

“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!

Keeping Healthy

Leave a reply

Cold and flu season is here. It arrives with colder weather as people spend more time indoors, in close quarters, where germs are more easily passed from one person to another.

Here are just a few reminders of how to help keep your family healthy.

Wash hands. Good old soap and water are still the best protection against contagious diseases that get passed through touching surfaces, shaking hands, etc. Get your family in the practice of washing their hands often. When soap and water are not handy, use hand sanitizer.
Get plenty of sleep. Being well-rested keeps your immune system stronger.
Don’t share. Okay, you teach your kids to share, but some things ought to be for just one person. Water and soda bottles, lip balm, musical instruments all fall into this category. If you have a youngster in child care, make sure the provider sanitizes toys and tables daily.
Cover. Cough or sneeze into a tissue. If there’s no tissue, use the crook of your elbow instead of your hand. Germs on the hand are more easily transferred to other people or surfaces.

Already have a cold? Continue to do all the above, and make sure you stay hydrated. Drinking plenty of fluids keeps mucous thin and your throat moist. Avoid caffeinated beverages.

It’s going to be a long winter, and your family will likely get colds at some point. Use the common sense advice above, and you may have fewer of them.

artwork by Kennedy

It’s time for flu vaccine!

Leave a reply

Georgetown Pediatrics has this year’s flu vaccine ready for your child. Here are a few answers to common questions about the vaccine.

Why get a flu vaccine? Influenza can be a very dangerous disease, and at the very least can make your child be sick for several days. With a vaccine, even if your child gets the flu, it is typically a milder case.
My child had the flu vaccine last year. Does she really need to have one this year, too? Yes. Each year the vaccine is specifically designed and manufactured to be effective against the expected flu outbreaks for that particular flu season. In addition, the vaccine is effective for a few months. For both of those reasons, the vaccine should be administered every year.
Should my infant or toddler get a flu vaccine? Yes, if he’s at least 6 months old. Children who are 6 months to 2 years old are especially susceptible to the flu and it can be very dangerous for them.
Should my child get the flu vaccine as an injection or as the nasal mist? That depends. The nasal mist is easier for most people to take, and is approved for those between the ages of 2 and 49. Since it is a live (though weakened) virus, the short-term side effects (cold-like symptoms) can be a little stronger as the body’s natural reactions take effect. Children who have a compromised immune system (or who have close contact with someone who has a compromised immune system) should get the flu shot instead of the nasal spray. Also, those with certain health conditions like asthma or wheezing, or conditions requiring long-term aspirin usage should take the shot rather than the mist. More information about the flu mist is found here.
Who should NOT get any flu vaccine? Check with your doctor if any of these conditions apply:
- NOTE: If your child has an allergy to eggs, she may still be able to take the vaccine. Check with your pediatrician.
- If your child or adolescent has had other vaccines within the past four weeks.

We have flu vaccine available now. Call for an appointment. And read more about influenza and the vaccines here.

artwork by Josh

To use or not to use antibiotics

Leave a reply

So your child has been coughing and sneezing for a week, has a bit of fever, a little green mucous coming from the nose, and has missed school or childcare, which causes you to miss work. You see the pediatrician to get a prescription for an antibiotic, but you walk out disappointed. Why didn’t they prescribe what you wanted?

Since penicillin was first manufactured in the 1940s, antibiotics have been quite successful in treating bacterial infections, reducing the spread of disease, and saving many lives. In the last few years, though, it’s been determined that overuse of antibiotics has led to the growth and spread of antibiotic-resistant bacterial infections.

Check out this article at USA Today.

Even so, your child’s pediatrician will not shy from using antibiotics when they are warranted. Here’s the thing: antibiotics are completely ineffective against colds or other viruses. Your child may sometimes feel better after taking antibiotics, simply because the virus began to subside on its own as the body fights back.

Research continues to create new antiviral drugs that will work against viruses (with much success in the area of influenza). In the meantime, don’t forget that antibiotics work only in the fight against bacterial infections, and also with some funguses and parasites. And if you do take an antibiotic, MAKE SURE YOU TAKE ALL THAT ARE PRESCRIBED. Stopping the course just because you feel better can lead to drug-resistant infections later on.

Corinne, age 5