Notes from the Nurse
With the flu season upon us, it is important that we work together to keep our children healthy. Viruses/Common colds spread easily among children in schools. You can help prevent the spread of flu and common cold or help your child get better if he/she does get sick by following a few simple steps:
- Remind your child to cover his/her nose and mouth with a tissue when sneezing or coughing and dispose of the tissue immediately.
- Have your child wash his/her hands frequently with soap and warm water.
- Use hand sanitizer if soap is not available. Always follow with soap and water as it is available.
- Disinfect frequently-touched surfaces and shared items at least once a day.
- Teach your child not to touch his/her mouth, nose and eyes.
- If your child is sick and has a fever, keep him/her at home to prevent the spread of illness to others.
- Your child should be naturally fever free (temp below 100 degrees without Tylenol or Motrin) for at least 24 hours before returning to school. This is very important!
A good rule of thumb is to keep your child at home if he or she has a fever of 100 degrees or more. When a temperature is present in the morning prior to school (99 degrees or greater) it will only climb higher as the day progresses. If your child has cold or flu symptoms as well, please do not give Tylenol or Motrin to cover the fever and then send them to school. As soon as the medicine wears off, the fever will return and you will have exposed your child’s classmates and teachers to your child’s illness.
Flu is a serious illness and children with the flu should not come to school. Flu symptoms include fever, chills, cough, sore throat, headache, and muscle aches. You should contact the doctor if your child has these symptoms.
Cold symptoms include stuffy nose, sneezing, sore throat, and hacking cough. Colds often come on gradually, and are usually not serious. However, symptoms can become severe and you may need to keep your child at home to get rest and plenty of fluids to prevent worsening of symptoms. Again, if your child has a fever (100 degrees or more) he/she should stay at home until fever free for at least 24 hours.
Pertussis (whooping cough) is a respiratory tract infection caused by bacteria called Bordetella pertussis. Until there was a vaccine, pertussis was the leading cause of severe illness and death in children. Pertussis still occurs regularly in Nebraska, but since the disease is not always recognized in older children and adults, not all cases are reported.
How is pertussis spread? Pertussis (whooping cough) is spread by direct contact with respiratory droplets from infected people who are coughing or sneezing. Indirect spread through the air or contaminated objects occurs rarely, if at all.
Pertussis spreads easily through the air when an infected person breathes, coughs, or sneezes. A person can spread the disease while he or she has cold-like symptoms and for at least 2 weeks after coughing starts. Many babies and young children get whooping cough from adults or older brothers or sisters who don’t know they have the disease. Pregnant women with whooping cough can give it to their newborn babies. Because whooping cough is so harmful in babies, everyone around them needs to be up to date with vaccines—to make a circle of protection (cocooning).
What are the symptoms of pertussis infection?
Whooping cough starts with the following symptoms:
• Runny or stuffed-up nose
• Sneezing
• Mild cough
• A pause in breathing in infants (apnea)
After 1 to 2 weeks, coughing, which can be severe, starts; children and babies can cough very hard, over and over. When children gasp for breath after a coughing fit, they make a “whooping” sound. This sound is where the name “whooping cough” comes from. Babies may not cough or make this sound. Coughing fits make it hard to breathe, eat, drink, or sleep. Coughing fits happen more at night. Babies and young children may turn blue while coughing from lack of oxygen and vomit after coughing fits. Coughing fits can last for 10 weeks, and sometimes recur with the next respiratory illness.
When do the symptoms appear? Symptoms usually begin on average, 7 to 10 days after contact with the pertussis bacteria, but symptoms can range from 5 to 21 days after an exposure.
Are pertussis infections treatable? Yes, pertussis is treatable if antibiotics are administered during the catarrhal stage (1-2 weeks at start of disease progression; see above mentioned symptoms); the therapy may lessen the severity of the disease. After cough has been established, antibiotics have no discernible effect on the course of the illness but are recommended to limit spread of the organisms to others where the individual is no longer communicable.
How long is an infected person communicable? A person can spread the disease to others until five days of appropriate antibiotic therapy are completed. If pertussis is not treated, it can be spread to others for 21 days after the symptoms begin.
Should infected people be excluded from work or school? An infected person must not attend day care, school, and/or work until five days of antibiotic treatment are completed. If a person who has pertussis is not treated, he or she must stay home for three weeks after the beginning of the violent coughing.
What can be done to prevent the spread of pertussis? Pertussis vaccine is given in the same shot with diphtheria and tetanus vaccines. Immunization is required for childcare and school attendance. Children routinely receive pertussis vaccine at 2, 4, 6 and 15 months of age and a booster dose at 4 to 6 years of age (DTaP vaccine). Children should receive another booster shot at age 11 or 12 (Tdap vaccine) but can receive the vaccine as early as 10 years of age. All adults should substitute one 'tetanus booster' (recommended every 10 years) with a pertussis-containing booster shot (Tdap vaccine).
Other Seasonal Health Considerations
Head Lice can be transmitted by head-to-head contact with a person with head lice, wearing that person's clothing, using bedding of theirs, or using their comb or brush. It can be difficult to determine exactly where it came from or who has passed it on to someone else. It is important to check your child's hair routinely for head lice as finding problems early on will make it easier to treat. Also, it is important to stress to your children the importance of not sharing items such as hats, scarves, hair accessories, or hair brushes.
Frostbite is another hazard experienced in extremely cold weather. The onset of frostbite is usually characterized by a sharp pricking sensation and numbness but body tissue may freeze without awareness of numbness or pain. Just before freezing, the skin turns a bright red. Frostbite most commonly affects the feet. If frostbite occurs, running warm water over the affected area is the recommended treatment (if re-exposure is not expected).
Proper clothing is essential to protection from frostbite. Multiple layers of clothing are better than just one, because they provide better insulation and can be removed or added as needed. The key is to make certain there are no areas of skin exposed to the frigid air.
Children who want to go out and play in the snow should periodically come indoors to warm up and dry off, according to the Nebraska SAFE KIDS Coalition. Dress them with layers of clothing and be sure to cover ears, fingers and toes. Parents should avoid taking infants outdoors when the temperature is below freezing because infants lose body heat quickly. (Southeast District Health Department)
Mrs. Stubbendick