Back to school

Back to school? It shouldn’t be that scary!

Be it nursey, primary or secondary school, it is always a year full of sicknesses for your little ones. Children like to be very “touchy feely”, they like to show affection and play with each other. It, therefore, should not come as a surprise that diseases spread extremely quickly in schools. In today’s blog, I will be talking about the most common illnesses in school children that we encounter in a pharmacy. I will especially touch on the most contagious diseases and ways to recognize, prevent and treat them.

Head lice

Unfortunately, there is a certain stigma attached to head lice. Most people believe that head lice is a sign of dirtiness, but that is not true. However, it is worth knowing that it’s the most common condition that we come across in pharmacies. It is especially very common in children aged 4 – 11. Head lice are tiny insects that live in hair. Nits are the empty egg cases attached to hair that head lice hatch from. They can only spread by direct head-to-head contact; they cannot fly, jump, swim or spread by objects.

Although they are largely harmless, they can live in the hair for a long time if not treated and can be irritating and frustrating to deal with. Head lice can be difficult to spot, even when the head is closely inspected. They are very small whitish or grey-brown insects that range from the size of a pinhead to the size of a sesame seed. Symptoms may include: small white eggs or nits (egg cases) in the hair behind the ears or at back of the neck, an itchy scalp, a rash on the back of the neck and feeling as though something is moving in the hair.

The best way to be sure of head lice is to use a special comb called a “detection comb”, which is a comb with very fine toothed combs. Once you find a live louse, you must use treatment and these can be purchased from any pharmacy. There are many different types and forms of treatment, therefore, be sure to speak to a pharmacist before purchase.

It's very difficult to prevent head lice. You may want to consider regular detection combing – for example, on a weekly basis – if you're concerned about your children or yourself. Lotions and sprays don't prevent head lice and should only be used if a live louse has been found in your own or your child's hair. Staying off work or school and washing clothing and bedding on a hot wash are unnecessary, as it's unlikely to help prevent the spread of head lice.

Hand, foot and mouth disease

Hand, foot and mouth disease is a common infection that causes mouth ulcers and spots on the hands and feet.

It is especially most common in children under 10 – but can affect older children and adults as well.

The initial symptoms of hand, foot and mouth usually include fever, feeling unwell, loss of appetite, coughing, sore mouth and throat and abdominal pain. After a couple of days, these symptoms can then progress to the presentation of mouth ulcers. Ulcers can often make it hard to swallow but it should resolve within a week. Soon after the mouth ulcers appear, you will probably notice a rash made up of small, raised red spots on the skin. These typically develop on the fingers, the backs or palms of the hand, the soles of the feet, and occasionally on the buttocks and groin. The spots may then turn into small blisters with a grey center. The spots and blisters can sometimes be itchy or uncomfortable and typically last up to 10 days.

If you suspect your child has it, it is best to keep them hydrated by giving them lots of water, prepare foods that are easy to swallow such as soups and give over the counter painkillers to ease the sore throat and fever. Hand, foot and mouth is a viral infection, therefore antibiotics will not help. The disease is self-limiting and should clear on its own. If symptoms are not getting better after 7 days, there is discharge or pus coming from the ulcers, if your child’s temperature is 39C or over, your child develops seizures or shows signs of dehydration then you must seek medical advice immediately.

Scarlet fever

Scarlet fever, also called scarlatina, is an infection that causes a blotchy, pink-red rash and is most common in young children. The typical symptoms of scarlet fever will include a sore throat, headache, high temperature, being sick and swollen glands in the neck. This may then be followed by:

1. A rash – the rash will feel like sandpaper, made up of blotches that typically start on the chest/tummy area and turns white when you press a glass on it.
2. A red face – the cheeks will appear very red almost like it has been sunburnt.
3. A white or red tongue - Sometimes a white coating may form on the tongue. This peels away after a few days, leaving the tongue red and swollen. This is known as a "strawberry tongue".

Treatment usually requires antibiotics; therefore, if you suspect anybody in your family has scarlet fever, you must seek medical advice immediately.Scarlet fever usually clears up within a week, although the skin may peel for a few weeks after the other symptoms have passed.

The infection is contagious from before the symptoms appear, until:

• 24 hours after starting antibiotic treatment
• Up to two or three weeks later if you don't take antibiotics

Infective Conjunctivitis

Infective conjunctivitis is the infection of the conjunctiva (the thin layer of tissue that covers the front of the eye). It can be either viral or bacterial. It is very common in young children due to the contagious nature of the condition. The most common symptoms are redness of the conjunctiva, discharge or pus coming from the eye, burning sensation in the eyes, sticky coating on eyelashes or a feeling of grit in the eye. 

Conjunctivitis can be easily treated with eye drops bought from the pharmacy for children over the age of two and it usually clears within 5 days.

When to see the doctor

• pain in your eyes
• sensitivity to light (photophobia)
• disturbed vision
• intense redness in one eye or both eyes

• in newborn babies (neonates) up to 28 days old, infective conjunctivitis can lead to a severe and rapidly progressive eye infection. If this is not treated, it can cause permanent damage to the child’s vision. If your newborn baby is found to have infective conjunctivitis, they will immediately be referred for specialist assessment and treatment. Their condition will be closely monitored. Complications of infective conjunctivitis are rare and most babies make a full recovery.

Chickenpox

Although chickenpox affects mainly children, you can get it at any age. It is a contagious viral infection.  Most children will catch chickenpox at some point. It's usually mild and clears up in a week or so, but it can be dangerous for newborn babies.

The initial symptoms may start a day or two before the rash appears and these can include feeling tired and generally unwell, a high temperature (fever) of 38C (100.4F) or over, a headache, feeling sick, aching, painful muscles and loss of appetite. You will then notice the development of rashes, which is the main symptom of chickenpox, and this manifests in 3 stages.

Three stages of the chickenpox rash:

• spots – red raised spots develop on the face or chest before spreading to other parts of the body

• blisters – over the next few hours or the following day, very itchy fluid-filled blisters develop on top of the spots. It's important not to scratch them as scratching could spread the infection to others and increases the chances of complications such as a more serious skin infection.
• scabs and crusts – after a further few days, the blisters dry out and scab over to form a crust; the crusts then gradually fall off by themselves over the next week or two. Chickenpox is contagious until every blister has scabbed over, which usually occurs by around five or six days after the rash started.

There is no cure for chickenpox, however, treatments that can be purchased from the pharmacy can help relieve symptoms. Paracetamol can be used to treat fever, calamine lotion can be used to ease the discomfort from the rashes and an chlorphenamine can be used to treat the itchiness – moreover, ensure the child is hydrated well.

It is important to prevent the child from scratching the rashes as they can becomes infected.  It can help to keep nails short and clean, tap or pat the skin instead of scratching it, wear cotton gloves at night (or socks over hands), bathe in cool or lukewarm water – dab or pat the skin dry afterwards, rather than rubbing it and wear loose, smooth cotton clothing.

Furthermore, antiviral medication or a treatment called immunoglobulin may be recommended if you're at risk of developing severe chickenpox for example if you have a newborn under 4 weeks old.

Cold and Flu

Please read our upcoming blog post named “Winter cold and flu” for more information on this condition.

Preventing the spread of contagious diseases

• Stay off work, school or nursery until you or your child are feeling better. 
• Use tissues to cover your mouth and nose when you cough or sneeze and put used tissues in a bin as soon as possible.
• Wash your hands with soap and water often – particularly after going to the toilet, coughing, sneezing or handling nappies and before preparing food.
• Avoid sharing cups, utensils, towels and clothes with people who are infected.
• Disinfect any surfaces or objects that could be contaminated – it's best to use a bleach-based household cleaner.
• Wash any bedding or clothing that could have become contaminated separately on a hot wash.

Special note:

This blog has been written with the intention of describing childhood illnesses. Treatment options can differ tremendously for adults, therefore, please ask our pharmacists for more advice if you suspect you have any of these diseases.