Animal Bites

Asthma

Croup

Ear Pain

Fifth Disease

Food Poisoning/Salmonella

Hayfever (Seasonal Allergies)

Hives

Lyme Disease
Meningitis

Mono

MRSA

NoroVirus

Pneumonia

Poison Ivy, Oak or Sumac

RSV (Respiratory Syncytial Virus)

Senioritis

Sprain and Strains

Strep Throat and Scarlet Fever

The Flu (Influenza)

The Stomach Flu (gastroenteritis)

Common Household Pets:

Hamster, cat, dog, guinnea pig, ferret, gerbil, rabbit, mouse

Do these pets carry a rabies risk? No.

Can I get infected from being bitten by my pet? Yes. Mouths of pets have bacteria and can infect you. As with all bites and cuts, you want to do the following:

1. Clean well with warm soapy water.

2. Apply antibiotic ointment.

3. Cover with bandaid/dressing and change when needed.

4. Keep a close eye on the bite site for signs that active infection is forming which include:

Redness

Warmth

Tenderness

Pus

If your pet or a friend's pet has bitten you, find out about the health of the pet:

• How has the pet been acting?
• Is the pet up to date on shots? This applies to dogs and cats.
• When in doubt, contact a vet to see if the pet needs to be evaluated for infection. Often a vet can tell you over the phone if a type of pet needs to be seen or will put a person at risk from a bit.

What animal bites do I need to worry about for rabies risk?

Wild animals and unimunized cats and dogs.  So, if you don't know the ownder of a cat or dog, those are the  cats and dogs to worry about. Also, all dog bites need to be reported to the local police by law.

Bites from the following animals need to be evaluated right away for rabies shots: bat, skunk, raccoon, fox, coyote, or large wild animal. Keep in mind that for bats, a bat in the house counts as a bat bite since bats often leave no bite marks.

Links For More Information

Dog Bite Law Site

University of Michigan Pet Bite Information

Technical Name: Asthma

NickNames: reactive airways, wheezing

What is it? narrowing and swelling of the tubes of your lungs that occurs when trigged by a variety of stimuli such as viruses, allergens, season changes, pets, insect stings

How is the diagnosis made? Asthma is frequent wheezing and is a clinical diagnosis that is usually given after a child has wheezed on more than one occasion and responded to bronchodilators such as albuterol.

Typical Ages: infancy to adulthood

Treatment: when I think about asthma therapy, my goals are to:

1. decrease the severity of the episodes

2. maximize airway function

3. keep the child doing what the child loves to do

Some kids just have episodic asthma when faced with their trigger such as a cold or weather change. These kids may just need treatment of that exacerbation with:

1. a bronchodilator to get the airway big again: albuterol inhaler

2. an antiinflamatory medication to eliminate the swelling: a steroid - either oral or inhaled

For kids with frequent exacerbations or symptoms that are starting to interfere with the actitities they love such as sports, preventative medications are available: inhaled steroids and an immune mediator called Singulair.

How will I know what is best for my child?

Your pediatrician will help you develop an asthma action plan for your child so you'll know what medication to use and when, including at school.

Can asthma be dangerous? The honest truth is that asthma can be very serious and can be fatal if not treated correctly. Any child having trouble breathing who has asthma needs to be seen right away - even in the middle of the night. So, if your child is having trouble breathing:

1. give your child a dose of albuterol by inhaler or nebulizer

2. go to the nearest emergency room or call 911

Will my child out grow asthma? May kids do "out grow" asthma meaning it is worse when they are younger but often asthma does persist in one way or another throughout a person's life. Your child's history over time will tell this story but keep in mind that there are many adults with asthma living full lives and doing great things!

Online Asthma Resources

1. KidsHealth Asthma Centers

• Parents
• Kids
• Teens

2. Does my baby have asthma?

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Technical Names: laryngotracheobronchitis

NickNames: croup, barking seal cough

What is it: infection of our trachea - the main tube in our throat

Typical Ages for Illness: infants and toddler most usually but occasionally younger elementary school children.

Typical Symptoms:barky, seal-like cough often worse at night; +/- fever; +/- trouble breathing. Often starts as a bad cold then suddenly worsens.

Etiology: most commonly parainfluenza virus types 1 and 2, but many winter/flu season viruses possible culprits including influenza, adenovirus and RSV.

Seasonal Issues: usually winter illness, sporadic cases during other seasons

How’s It Spread? person to person by respiratory droplets - i.e. getting coughed or sneezed on, or fomites - touching droplets on an object.

Incubation Period? 2 to 6 days

Symptom Duration: there is usually a few days of a early, cold like symptoms, then 1-3 days of the barky cough which tends to get worse over the first couple of nights before improving.

Treatment:

• cool steam, air - take child outside on front stoop if really barking
• possible steroids if cough is severe
• try taking the child into the bathroom with the shower running for steam

Call Your Pediatrician If:

• trouble breathing: fast rate, skin between abdomen or ribs sinking in
• stridor: tight, squeaky sound
• looking sick
• high fever
• drooling
• inability to talk a complete sentence

Prevention:

• good hand washing
• having the child cover his or her mouth when coughing, if possible
• cleaning toys and objects likely contaminated by respiratory droplets

School and After school Activity Issues

• may return to school when fever free for 24hours
• avoid large groups of kids if cough is not controlled to prevent further spread

Internet Resources for Parents

Kids Health Information on Croup

WebMD Information on Croup

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Technical Name: otalgia

NickName: ear pain

Causes: ear pain is a symptom that doesn't always mean ear infection.  The most common causes of ear pain include:

• Ear infection
• Ear irritation of ear canal
• Fluid in ear building up pressure
• Foreign body in ear canal
• Pain from the  mouth or neck

To learn more about the anatomy of the ear, click here.

Diagnosis: examination by a doctor will determine the actual cause.

Treatment: for all causes of ear pain, treating the pain early on is the most important factor. The definitive treatment for the pain will be dependent on the actual cause. Here are some considerations:

1. If a foreign body is present such as a bead, do not go after it, a doctor can remove it for you in the office. However, this is not something always easily done in a pediatrician’s office and may require either an emergency room or visit to an Ear/Nose/Throat specialist.
2. Ear Canal Infection/Irritation: ear drops are usually prescribed
3. True middle ear infection: this is also dependent on the cause. If viral, it will clear with time. If bacterial, most will clear with time in older kids and 10-20% will need an antibiotic. The standard of care today is to treat the ear pain for 2-3 days and start an antibiotic at that point if ear pain is persisting. Your pediatrician can guide you more specifically based on your child’s age, ear exam and history. Children under 2 years of age are still treated with antibiotics in the United States.

Other Treatment Issues:

What should I do if my child has ear pain in the middle of the night?

Give Tylenol or motrin and call your doctor for advice the following day. If you have been given ear drops for pain the past, these are ok if you ear is not draining. Never put drops into a draining ear without a doctor evaluating the ear first.

What should I do if my child has ear pain during normal business hours?

If your child is over 2, I’d suggest you give a dose of Tylenol or motrin and gage your child’s response. Knowing that an antibiotic will not be utilized in most case for a few days, you have time to watch and wait. However, if your child appears ill or markedly uncomfortable, if the ear is draining pus or blood, or if high fever is present, call your pediatrician’s office for advice.

Resources for more information:

Ear Pain Info from Children's Hospital Boston

Antibiotics vs  Waiting from WebMD

Swimmer's Ear (KidsHealth)

Middle Ear Infections (KidsHealth)

Flying With Ear Infections (KidsHealth)

Foreign Bodies in Ears and Nose

What is an ear infection?(For Kids from KidsHealth)

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Technical Name: Parvovirus B19

OtherNames:

Erythema Infectiosum (EI)

5TH Disease

What is it? A viral illness

Symptoms and Course:

Typically starts with a fever and mild viral symptoms such as tiredness, headache and cold symptoms, then  proceeds to a rash with slapped cheek appearance. Fever occurs in 15-30% of patient’s according to the AAP Red Book. The viral illness may occur a week before the rash. 10% of kids develop achiness of joints or true arthritis.

Spread: person to person via respiratory droplets, ie close contact

Incubation Period: 4 to 14 days, but sometimes up to 21 days, for initial illness with rash and joint symptoms occurring 2- 3 weeks later.

Diagnosis: usually clinical but a blood test can be done if needed.

Special Issues: there is often concern raised for pregnant women but risk of infection is very low given that most of us have likely been exposed during our lives. Pregnant women who are concerned about exposure should talk to their doctors about testing.

Treatment: supportive since illness is usually self-limited in it’s typical form

School Issues: Kids with the rash are  not contagious and may return to school and participate in activities.

Resources

CDC Parvovirus Information

KidsHealth Fifth Disease

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The recent Peter Pan peanut butter contamination with Salmonella is frightening. I had a jar in my cabinet of the tainted product as did many of you. In fact, we had eaten out of a jar with the 2111 code on it. Thankfully, my family has remained symptoms free as will most people who eat the peanut butter since the bacteria are sticky and the product may not be uniformly contaminated while some products could be more contaminated than others.

Here's what to look for if you have come into contact with the 2111 Peter Pan peanut butter jars, and with food poisoning in general:

What symptoms should you watch for? The same as the stomach flu - fever, abdominal pain, diarrhea, vomiting.

When would symptoms occur if from tainted food? Within 6-72 hours of eating the food. So, if days have gone by, again, don't worry.

When in doubt, call your pediatrician.  Stool can be tested for Salmonella and this is one of the few intestinal infections we can treat with an antibiotic.

Internet Resources

Salmonella Infections (KidsHealth)

Food Safety (KidsHealth)

Food Poisoning (CDC)

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Technical Names: Urticaria, Angioedema

Nicknames: Hives, welts

(from Pediatric Physical Diagnosis Electronic Atlast, Zitelli and Davis)

What are hives? Raised, red, itchy lesions on the skin that often come and go and can coalesce together in to larger, red, itchy areas. Unlike other rashes, these come and go and move about the skin.

What Causes hives? Hives occur from allergic reactions. These can be to medications but more commonly to something in the environment or a virus. In most situations of hives, we never determine the actual cause.

Some hives are caused by physical changes in body temperature such as exposure to cold, heat or extreme exercise. Some people get hives when they are nervous. Bug bites can cause hives and so can the sun.

Hives occur because the allergen, the thing we are allergic to, triggers the release of chemicals in our cells. These chemicals, histamines, cause the hives and itchiness.

How long do hives last?

Hives can come and go for days to weeks.

Treatment:

• antihistamines: over the counter benadryl or claritin; prescriptions
• antiitchy lotions such as Avreno, Sarna, Calamine

When to Call Your Doctor

• hives associates with drooling or trouble breathing
• hives associated with ingesting food
• hives associated with red eyes or swollen joints
• hives associated with fever

All these symptoms may mean a more serious allergic reaction is occuring - call your pediatrician or 911.

Internet Resources for Parents

Hives Resource Center MedicineNet

American Academy of Dermatology Hives Page

Internet Resources for Teens and Kids

Help With Hives (KidsHealth)

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Technical Names: Allergic Rhinitis

Nicknames: Hayfever, Allergies

What it is: allergic reaction to something in the environment such as pollen, dust, molds, animal hai. It is an overreaction of the immune system - a "normal" reaction on overload. People can grow in and out of allergies throughout their lives. Genetics determines some predisposition but environmental factors can also overload the immune system.

Seasonal Issues:

Many people have season allergies particularly around season change times. Some people are allergen specific and others have year 'round allergies.

Symptoms:

Symptoms are different person to person but include some of the following:

• runny nose
• sneezing
• itchy skin
• watery eyes that may appear red
• wheezing or cough

Treatment:

Symptoms specific and may include:

• avoidance if possible of offending allergen (eg. if allergic to cats, avoid cats)
• antihistamines: over the counter and prescritpion
• expectorant for nasal congestion
• saline nose spray
• eye drops
• other medications as indicated by symptoms

When to Call Your Doctor

• symptoms interfering with activities
• symtpoms interfering with sleep
• trouble breathing
• worsening itchy rash

Internet Resources for Parents

All About Allergies (KidsHealth)

Internet Resources for Teens and Kids

For Teens

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Technical Names: Lyme Disease

Lyme Map: Lyme has a definite geographic distribution. According to the CDC you'll find Lyme in these three areas:

• Northeast: Massachusetts to Maryland.
• North-central states: especially Wisconsin and Minnesota.
• West Coast: especially northern California.

Nicknames: Lyme Disease, Lyme

What it is: tic-borne infection from ticks of the Ixodes genussed by the bacteria borrelia borgoferi

Typical Ages for Illness: any

Typical Symptoms: Lyme Disease has three stages.

• Early: is a characteristic rash at the site of the tic bite called erythema migrans. Its main property is an expanding, red circle.
• The second phase is more disseminated: multiple erythema migrans patches occur in 15% of patients, other symptoms that can occur during this phase are arthritis, conjunctivitis, nerve palsies, headache and fatigue. Other uncommon issues can develop during this phase if untreated.
• Late disease is chronic arthritis of the large joints, usually knees. This is very, very uncommon in kids who have been treated.

Etiology: Borrelia burgdorferi , a spirochete bacteria

Seasonal Issues:  spring and summer when tics are out; geographic distribution includes New England, eastern mid-Atlantic states, upper Midwest in Minnesota and Wisconsin.

How’s It Spread? Via tic bite of infected tic

Incubation Period: 1-55 days with a mean of 11 days. Late symptoms occur months to years later.

Diagnosis: clinical if rash present; quick lab assay that will remain positive for life – so it can be used for diagnosis but not to confirm if treatment was effective.

Prevention: REMOVE THE TIC if you remove the tic with in 2 days, Lyme will not get transmitted from the tic to the person its attached to. So, the sooner than better. How to remove? Take a tweezers and grab the tic on the head. Gently pull up and the tic will release. Don’t worry if the tic’s small pincers stay attached to the skin – those don’t carry disease and will not cause harm.

Treatment:

Antibiotics for 14-21 days orally for early disease. More complicated disease and late disease needs to be treated longer and sometimes by IV antibiotics.

Call Your Pediatrician if your child has: A tic bite where a characteristic rash began to form.

School and After school Activity Issues: no restrictions. This is not contagious person to person.

Internet Resources For Parents

CDC Lyme Page

Tick Management Handbook

Tick Bite Prevention

Internet Resources for Kids and Teens

Lyme Info For Kids

Lyme Info For Teens

With the news in Boston recently of two co-eds at a local college getting diagnosed with bacterial meningitis, many people are alarmed. While a very contagious illness if you have contact with an infected person, this is not contagious like the flu. So, there is little concern for wide-spread community spread. But, meningitis can be tricky to diagnose and can be a very serious and sometimes deadly illness. Knowing what symptoms to look for in your child can help you catch it early and get your child to medical attention should there be contact you are unaware of.

Technical Names:  Meningitis or Spinal Meningitis

What it is:  an infection of the tissue that lines the outside of our brain called the meninges.

Typical Ages for Illness: any age

Typical Symptoms: fever, headache, stiff neck. light bothering eyes.

Etiology:  Bacteria and viruses. The bacteria we hear about in the news that the vaccine covers is Meningococcus.

Seasonal Issues:  Any season. Can occur in epidemics.

How’s It Spread? Close contact from saliva – kissing, sharing straws, sharing utensils, sharing cups.

Contagiousness: Bacterial meningitis is very contagious so it is important to not just treat the patient but the people the patient has had close contact with to contain the spread of illness.

Diagnosis:

• the definitive diagnosis is a spinal tap or lumbar puncture but sometimes for mild illness the diagnosis can be made clinically.

Symptom Duration: symptoms develop over a few hours to a few days before becoming severe enough for a person to be seen by a physician for a diagnosis to be made.

Treatment:

• antibiotics - possibly in the hospital if bacterial meningitis
• fluids
• other treatments depending on severity of illness
• pain control for headache
• treatment of contacts including immunization
• viral meningitis is usually like a bad flu and resolves within 7-1o days with only symptomatic treatment.

Call Your Pediatrician if your child has:

• high fever
• severe headache
• stiff neck causing worsening of headache or inability to actually bend at neck
• mental status changes

Prevention:

• Immunization! The links below have great descriptions of the history of meningitis vaccinations but immunization has drastically reduced the amount of childhood meningitis from bacterial that used to be big problems such as Haemophilus Influenza type b.

School and After school Activity Issues: As with other illnesses, fever needs to be cleared for 24 hours before returning to school if the illness is viral. If a child has bacterial meningitis, an infectious disease expert will help you figure out when your child is no longer contagious. Usually this is within a couple days of starting antibiotics.

Internet Resources For Parents

CDC Resource Sheet on Meningitis
Meningitis by KidsHealth

Internet Resources For Teens

What is meningitis? (KidsHealth)

Internet Resources For Kids

What is meningitis? (KidsHealth)

Technical Names:  Mononucleosis

Nicknames: Mono, The Kissing Disease

What it is:  systemic viral infection; gland swelling of throat and neck

Typical Ages for Illness: older school age/teenage

Typical Symptoms: fever, sore throat, swollen tonsils, headache, swollen neck glands, +/- rash, trouble drinking; swollen spleen; feeling tired; body aches

Etiology:  Ebstein-Barr Virus usually but other viruses can cause a similar illness

Seasonal Issues: 

How’s It Spread? Close contact from saliva – kissing, sharing straws, sharing utensils.

Incubation Period: 30-50 days

Diagnosis: clinical suspicion; can be confirmed by blood tests, the "monospot"

Symptom Duration: The acute symptoms can last 3-4 weeks but it can take 4-6 months to really feel better

Treatment: supportive – fluids, fever control, pain control. Very, very important that the kids stay well hydrated. The sore throat can last longer than you'd expect.

Call Your Pediatrician if your child has:

• Trouble swallowing or breathing
• Inability to drink enough fluids to stay hydrated
• High fever
• Rash
• Abdominal pain

Prevention:

• No contact sports until symptoms are resolved and the spleen is back to normal size (approximately 1 month)
• No school until fever free for 24hours
• Avoid close contact (sharing straws) for 6 months

School and After school Activity Issues:

Kids may need to adjust their activities to match their energy levels. Some kids bounce back easily while others feel drained of energy for quite a while after mono subsides. Pacing and rest and being flexible will help your kids get back to their usual routines without too much angst.

Internet Resources For Parents

Mono: General Info (KidsHealth)

Mono Info by MayoClinic

Internet Resources For Teens

What is mono? (KidsHealth)

How long is mono contagious? (KidsHealth)

Internet Resources For Kids

What is mono? (KidsHealth)

With all the press about MRSA, the "superbug", it is important to have the facts and know what to do if you find a skin infection on you or a family member that concerns you. Keep in mind that there are still many antibiotics available to treat MRSA so don't let the hype scare you. It can be serious but more often then not it is very, very treatable.

Technical Names: Methicillin Resistant Staphylococcus Aureus

NickNames: "the superbug", resistant Staph., Staph.

What it is: a bacterial infection that is resistant to a group of antibiotics.

Typical Ages for Illness: Any

Typical Symptoms: MRSA typically causes a skin infection akin to a very painful pimple or boil but can cause more serious infections sometimes such as bone infections, blood infections or pneumonia, all of which are very rare in otherwise healthy people.

Seasonal Issues: Can occur year roun.

How’s It Spread? By contaminated objects and person to person. The CDC sites "the 5 C's" as risk factors:  Crowding, skin-to-skin Contact, Compromised skin (i.e., cuts or abrasions), Contaminated items and surfaces, and lack of Cleanliness. (see MRSA in schools link below).

Diagnosis:

• There is often a high index of suspicion based on the appearance
• Culture of the wound/area is the gold standard to diagnosis

Treatment:

• incision and drainage of the skin lesion is curative much of the time
• antibiotics: orally or intravenous depending on severity and location

Call Your Pediatrician if your child has:

• a skin infection that worries you
• a skin pimple, red area on skin, or pustule that is large and painful

Prevention:

• good hand washing
• do not share personal objects such as towels, razors, bandaids
• good cleaning of public places such as gyms and hospitals where MRSA tends to live and get spread easily
• only use antibioitcs when you absolutely need to

School and After school Activity Issues

• no restrictions are needed if the area is undergoing treatment and is covered

Internet Resources:

For Parents

• CDC Podcast on MRSA
• CDC information on MRSA in schools
• CDC Community Acquired MRSA Page

For Kids and Teens:

KidsHealth Information on MRSA

Norovirus is a virus that causes the stomach flu and food poisoning. It is one of the 24 hour stomach bugs that spreads like wildfire through communities, daycare centers, schools and college campuses. Because there are many strains, people can get this illness more than once in a lifetime. It can effect any age.

Main Symptoms: Nausea, Vomiting, Diarrhea, Stomach Cramps

Spread: person to person

Incubation Period:12-48 hours

Duration of Illness: 1-2 days

Treatment Considerations: See The Stomach Flu

Internet Resources

CDC FAQ Norovirus Information

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Technical Names: Pneumonitis

NickNames: Pneumonia, Lung Infection

What it is: infection of the lung

Typical Ages for Illness: Any

Typical Symptoms: cough, fever, vomiting, abdominal pain, fatigue, decreased activity level and appetite, respiratory symptoms including shortness of breath, difficulty breathing, grunting or wheezing sound, breathing fast. Chest pain common when coughing a lot. Some children with more serious signs of respiratory distress will look gray or blue around the mouth.

Etiology: Many different germs can cause this including viruses, bacteria, fungus. Viruses are the most common pathogen for all ages.

Seasonal Issues: Can occur year round but more common in winter months

How’s It Spread? Person to person by direction contact with respiratory secretions - getting coughed or sneezed on, touching an object that was coughed or sneezed on.

Incubation Period: Develops 1 to 6 days after the onset of a viral infection like a cold or flu.

Diagnosis: Some cases of pneumonia can be diagnosed by the physical exam and others require a X-ray.

Symptom Duration:Before treatment, pneumonias are preceded by a bad cold or flu-like illness.  Once treatment starts, the cough can take 1-2 weeks to improve.

Treatment:

• antibiotics may be needed
• +/- breathing treatments such as inhalers or nebulizers
• fluids
• rest
• tylenol or motrin for fever and discomfort
• in cases of severe pneumonia, some kids do need to be hospitalized

Call Your Pediatrician if your child has:

• high fever, or fever not gone in 2-3 days
• vomiting or diarrhea and can't hydrate well
• lethargy
• sick appearance
• trouble breathing despite treatment
• blue or gray color to lips or fingernail beds

Prevention:

• stay home if sick
• good hand washing
• having the child cover his or her mouth when coughing, if possible
• cleaning toys and objects likely contaminated by respiratory droplets

School and After school Activity Issues

• may return to school when fever free for 24hours and able to eat and drink normally
• avoid large groups of kids if cough is not controlled to prevent further spread
• if on antibiotics, needs to be on them for 24 hours before returning to school
• activities should be curtailed until the child has the energy to participate without becoming winded or fatigued.

Internet Resources:

For Parents

KIDS Health Info on pneumonia

For Kids and Teens

KidsHealth Pneumonia Info for kids

KidsHealth Pneumonia Info For Teens

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Common and Technical Names: 

Poison Ivy: Toxicodendron rydbergii

Poison Oak: Toxicodendron diversilobum

Poison Sumac: Toxicodendron vernix

Plant Identification (source: Cornell Poisonous Plants Information Database)

Poison Ivy:

Poison Oak:

Poison Sumac:

What it is: Allergic reaction to urushiol oil from the poison ivy/oak/sumac leaves. The rhyme “leave three let them be!” can help kids remember to avoid clusters of three leaves together. 85% of kids can have allergic reactions to the oil.

Exposure Issues:

• Plants: poison ivy, oak and sumac leaves
• Non-plants: oil on toys and shoes that had been in contact previously with the oil; the oil can actually remain active for 1 year!

Typical Ages for Illness: any age in a susceptible person, someone who is sensitive to the oil

Typical Symptoms: rash and itching in the areas of skin in contact with the oil. This can be from direct contact with the plan or by fingers who touch the oil on the skin

Seasonal Issues:  The plants are perennial but have different appearances as the seasons progress. See KidsHealth for great pictures of poison ivy through the seasons.

Incubation Period: rash typically starts 1-2 days after exposure to the plant oil

Diagnosis: by the distinctive appearance of the rash which has a bubbly look. For a typical appearance of the rash click here.

Symptom Duration: the rash can take 2 weeks to clear. It is not contagious.

Treatment:

Symptomatic! Stop the itch!!!!

• over the counter products such as calamine lotion
• oatmeal baths and lotions: Aveeno is the name brand to look for
• antihistamines such as benadryl or claritin
• 1% hydrocortisone cream to small areas 2 times a day but do not use to large areas of the body or the face, or more frequently, without consulting your pediatrician
• local cold compresses

If these simple measures do not work and your child is very uncomfortable, call your pediatrician for further advice.

Exposure Prevention:

• Teach your children to recognize the poison ivy plant.
• Wear long pants, long sleeves, gloves and boots when in suspect areas.
• Use barrier creams such as Ivy Block.
• Remove plants if necessary (this should be done with caution—do not burn the plants since inhaling the smoke can lead to very serious reactions).

Call Your Pediatrician if your child has:

• wide spread areas of rash
• rash near the eyes or mouth
• any areas or the rash that appear infected, have frank push or appear red or angry looking, are tender, have red streaking, or the child has a fever

Internet Resources For Parents

American Academy of Dermatology Poison Ivy/Oak/Sumac Page

Children's Hospital Boston Information on Poison Ivy and After Care Instructions

Lucile Packard Children's Hospital

Internet Resources for Kids and Teens

American Academy of Dermatology Pesky Poisonous Plants Page

KidsHealth Information for Kids on Poison Ivy

KidsHealth info for Teens on Poison Ivy

Technical Names: RSV Bronchiolitis

NickNames: RSV, wheezing virus

What it is: viral infection of the small airways of the lung; can cause a true viral pneumonia as well.

Typical Ages for Illness: All ages; most severe in young and premature infants and children with heart and lung problems including congenital heart disease and asthma. Interesting fact: all kids become infected by RSV by the age of 2 and many of us get it multiple times throughout our lives.

Typical Symptoms:

adults: bad cold symptoms

older infants and children: similar to a bad cold

young infants: lethargy, trouble eating, fast breathing, cough, wheeze.

Etiology: Respiratory Syncytial Virus

Seasonal Issues:  occurs predictably between November to March

How’s It Spread? Direct contact with secretions - person to person or on objects.

Incubation Period: 4-6 days but can range from 2 to 8 days

Diagnosis: Usually clinical - based on symptoms and high index of suspicion given out breaks in community. Rapid assay test available in many offices and emergency rooms - most useful if a child needs to be hospitalized to control infection.

Symptom Duration: 7-14 days, as with most viral illnesses with the most intense symptoms early in the illness.

Treatment:

• cold treatment: saline nose spray and bulb syringe, humidifier
• +/- breathing treatments such as inhalers or nebulizers
• fluids
• tylenol or motrin for fever and discomfort
• some children do need to be hospitalized due to severe respiratory symptoms such as trouble breathing and needing oxygen, or due to underlying heart and lung problems.

Call Your Pediatrician if your child has:

• high fever, or fever not gone in 2-3 days
• vomiting or diarrhea and can't hydrate well
• lethargy
• sick appearance
• trouble breathing despite treatment
• blue or gray color to lips or fingernail beds

Prevention:

• stay home if sick
• good hand washing
• having the child cover his or her mouth when coughing, if possible
• cleaning toys and objects likely contaminated by respiratory droplets
• a medication called Synagis before RSV season is available for kids under 2 years of age that are high risk - premature babies younger than 35 weeks and congenital heart disease children. This is usually given starting in November as RSV season begins. Your pediatrician will alert you if your child falls into this group.

School and After school Activity Issues

• may return to daycare when fever free for 24hours and able to eat and drink normally, and breathing normally
• avoid large groups of kids if cough is not controlled to prevent further spread
• if on antibiotics, needs to be on them for 24 hours before returning to school
• activities should be curtailed until the child has the energy to participate without becoming winded or fatigued.

Internet Resources For Parents

General Info on RSV (KidsHealth)

General Info on Bronchiolitis (Kids Health)

How Lungs Work (KidsHealth)

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What is it? The inability for Seniors (typically) to focus due to a feeling that “they are done”. However, this can occur in all kids at various stages.

Symptoms:

Not applying as much effort in school work

Loosing interest in activities

Grades slipping

Lackadaisical attitude

What you should do as a parent:

• Talk to your child
• Talk to the school

The goal is to uncover from your child what is driving your child's thinking and motivation. Your job is to be helpful and to be a good listener. The school is your best ally in helping you talk to your child and explaining the big picture.

The Cure

GRADUATION! And, staying busy and involved well before then.

However, your Senior needs to understand that some colleges and universities are not as forgiving if grades slip too much. Scholarships and awards have been revoked so it is important to keep GPAs respectable. Many schools have helped by keeping kids busy with projects and fun class activities.

See Resources for more information and tips.

Resources For Parents

What to do about Senioritis (College Board Association)

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Technical Names: Sprains, Soft Tissue Injuries, Musculoskeletal Injuries

NickNames: twisted arm or leg, thrown joint

What it is: a pulling and/or tearing of the soft tissues of a joint, the ligaments, tendons, and muscles. The ankle is the most commonly sprained joint in kids and often sports related.

Typical Ages: Any and all ages.

Etiology: trauma - intentional and nonintentional, usually during play and sports

Seasonal Issues: Any and all seasons - some injuries are more seasonal and sports dependent.

Symptoms:

• pain, swelling, bruising, +/- deformity of affected joint. Varying degrees of difficulty using. The more symptoms, the more severe the sprain

Treatment:

• Rest-Ice-Compression-Elevation (RICE) for all injuries with swelling and bruising
• ibuprofen for pain and swelling
• no sports until pain free - this is particularly important for injuries with limitation of movement after the injury

Prevention: While many sports related injuries are hard to avoid, the chances of an injury are reduced if kids are conditioned properly for the sport, playing at an age-appropriate level, and rest for the recommended amount of time by a physician after an injury.

Return to School and Sports:

• 1-3 weeks, sometimes less and sometimes more. Very dependent on initial limitation of motion.
• Child needs to be able to use sprained joint normally and without pain before returning to sports

When to call the doctor:

• inability to use arm or bear weight
• extreme pain
• pain and function not improving with RICE and ibuprofen
• deformity or significant bruising
• any neurologic symptoms of the extremity: numbness, tingling, etc.

Internet Resources:

AAP: What is a sprain?

KidsHealth Sprain Care Sheet

For Teens: Handling Sports Injuries

Children's Hospital Boston Ankle Sprain Care

Technical Names: Streptococcal Pharyngitis

NickNames: Scarlet Fever, Strep Throat

What is it: infection of the throat involving the pharynx, tonsils or both

Typical Ages for Illness: school age kids and teens are the biggest population; can occur in adults; rare in children under 2 years of age.

Typical Symptoms:

sore throat and pain with swallowing; swollen neck glands

+/- abdominal pain and headache, common in school-aged kids

+/- fever

+/- sandpaper-like rash: when present, the illness is termed Scarlet Fever

+/-swollen tonsils with pus covering them

Etiology: Group A beta-hemolytic streptococci (Streptococcus pyogenes)

Seasonal Issues: outbreaks can occur year round but are more common from Fall to early Spring when people are more in doors and in close contact.

How’s It Spread? Person to person usually through direct contact or respiratory secretions (cough, sneeze)

Incubation Period: 2-5 days

Diagnosis: rapid strep test or throat culture at a doctor's office

Symptom Duration: symptoms can go away without treatment in a few days; with treatment, improvement typically occurs within 24-48 hours of starting antibiotics.

Treatment:

• antibiotics once diagnosis is confirmed
• fluids
• rest
• tylenol or motrin for fever and discomfort
• popcicles, throat lozengers
• other medications as determined by your child's doctor

Call Your Pediatrician if your child has:

• high fever, or fever not gone in 2-3 days
• vomiting or diarrhea and can't hydrate well
• lethargy
• sick appearance

Prevention:

• stay home if sick
• good hand washing
• having the child cover his or her mouth when coughing, if possible
• cleaning toys and objects likely contaminated by respiratory droplets

School and After school Activity Issues

• may return to school when fever free for 24hours and able to eat and drink normally
• needs to be on antibiotics for 24 hours before returning to school
• avoid large groups of kids if cough is not controlled to prevent further spread

Internet Resources:

For Parents From KidsHealth

Strep Throat Information

Scarlet Fever Info

For Kids and Teens From KidsHealth

The Scoop on Strep

Teen Info on Strep

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Technical Names: The Flu

NickNames:the flu, flu-like illness, flu syndrome

What is it: systemic, generalized infection - many organ systems potentially involved

Typical Ages for Illness: any age but the youngest and oldest of our population are the most vulnerable

Typical Symptoms: cough, fever, headache, fatigue, aches and pains, sore throat, runny nose, pink eye. Rarely vomiting and diarrhea. Some people, especially babies, can appear very sick.

Etiology:Influenza Virus; many other viruses cause a flu-like illness

Seasonal Issues:Typically a winter illness; wide spread outbreaks can and do occur.

How’s It Spread? person to person by respiratory droplets - i.e. getting coughed or sneezed on, or fomites - touching droplets on an object.

Incubation Period? 1 to 4 days, mean 2 days!

Symptom Duration:7-14 days - wide variation but most people take a solid 10 days to feel better. Typically the first week is the worst part and the second week like a bad cold.

Treatment:

• fluids
• rest
• tylenol or motrin for fever
• other medications as determined by your child's doctor

Call Your Pediatrician if your child has:

• high fever, or fever not gone in 2-3 days
• vomiting or diarrhea and can't hydrate well
• lethargy
• sick appearance

Prevention:

• the flu shot