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Wednesday, September 28, 2022

The common childhood infections

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To all parents, here is all you need to know about infections affecting  your children

Many diseases that appear during childhood or adult life may have their origins during development in the womb or in very early infancy. For example if a mother smokes during pregnancy, this exposes her baby to tobacco smoke, which has adverse effects on lung development.

Childhood respiratory diseases are very common, particularly in school children or in children with siblings. Having up to six respiratory infections per year is normal. Some of the infections are uncomplicated respiratory infections and can last up to two weeks.

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Some children have a genetic predisposition to develop respiratory diseases. Environmental factors such as tobacco smoke and air pollution also contribute to the onset of allergic disease, like asthma and other respiratory diseases. Once the disease is established, these factors may also trigger symptoms.

Many respiratory symptoms overlap and make differentiating the illnesses difficult, especially for parents. To make this easier I’ll use the next few paragraphs to explain some of the symptoms. It’s important for parents (especially first timers) to know them since it might save their child’s life someday. All we can do is be prepared because prevention is most definitely better than cure. Recognition of these symptoms is the first step towards preventing their escalation.

Symptoms of uncomplicated respiratory infections include runny nose, sore throat, red eyes, coughing, fever and swollen lymph nodes and hoarseness of the child’s voice.

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Symptoms of complicated respiratory illnesses include the following and if observed medical attention needs to be sought immediately.

Tachycardia (that’s a fancy medical term which means fast heartbeat; it can be accompanied by fast breathing).

Retractions (seeing a deeper outline of the ribcage or ribs than what is normal).

Coughing frequently, this may also be accompanied by vomiting.

Decreased activity (not playing or being usual self, the child is quieter than normal and stops talking, infants and toddlers are quiet, not making normal sounds. Older children are unable to talk normally, having to catch breaths between words.).

Wheezing (a high-pitched whistling sound heard when breathing out, this sounds almost musical),

Stridor (a harsh, raspy vibrating sound heard when breathing in. As it progresses, it can sound like an animal, particularly with coughing.)

Fever (keep track of the number of diapers the child is using or when the last time your potty trained child went to urinate.) I would recommend that parents buy and keep small electronic thermometers to help monitor their children at home, this helps keep track of the child’s health and can go a long way in preventing childhood disease or infection.

Pneumonia is an infection of the lung that causes fluid to collect in the air sacs. About 80% of the infections are viral and milder. Twenty percent are bacterial and pneumonia is not contagious. Bacterial pneumonia is usually more sudden and can improve significantly within 24 to 48 hours after taking antibiotics. Viral pneumonia is milder but can last two to four weeks. Cough suppressants should be avoided and antibiotics are prescribed if indicated. Hospitalization is very rarely necessary in otherwise healthy people. Studies have shown that in the coastal areas of the Gambia, the main causes of pneumonia are streptococcus pneumonia, followed by hemophilus pneumonia and staphylococcus aureus (these are bacterial infections) Another study reported an increased incidence of hospital admission for pneumonia, measurable up to 3 years after discharge. This is clear evidence that childhood pneumonia is an important problem in the Gambia.

Earlier, I mentioned the importance of having a thermometer at home. This is important but you should know how high you should let your child’s temperature get before you panic. The normal body temperature is 37°C (that’s about 98.6° F) but it can fluctuate within the day. Most fevers range from 38.3°C-40°C (101-104°F). Temperature can be taken by rectum, by mouth, under the arm, or in the ear. Rectal however, is best.

You should know that fevers are not harmful–they are a simply a sign that the immune system is working. So a fever means that your child is fighting an infection. Your child’s behavior is far more important than the actual temperature so you should never wake a child to take his or her temperature. A doctor needs to be consulted for all babies younger than six weeks of age if they have elevated temperature. Paracetamol is the safest medication to use to reduce fevers but consult your child’s physician to be sure you are giving the correct amount. Liquid ibuprofen is available by prescription and may be suggested. Never use aspirin without consulting your health care provider, it can cause severe complications. Consider a sponge bath, using room-temperature water if the fever hasn’t come down after 30 minutes. Lots of extra fluids are necessary with fevers. Keep track of the number of diapers your infant/toddler is using or when the last time your potty-trained child went to the bathroom to urinate. Febrile seizures may develop in 4% of children. While it is scary to watch, they are generally quite harmless. Consult your child’s doctor if your child has a seizure.

Croup is a disease seen mostly in toddlers. It is caused by a virus and lasts about five to six days. The classic symptom is hoarseness with a cough that sounds like a dog. It is usually part of a cold. Stridor develops later. Symptoms are generally worse at night. Children are quite contagious and there is no specific treatment. The child should be kept calm. Cough medicines are not helpful but mist, cool or warm can be quite helpful.

Bronchiolitis is most common around six months of age and is rarely seen after age two. The main symptom is wheezing. The wheezing generally lasts about seven days with 14 days of cough. The most common cause is from a respiratory virus (usually Respiratory Syncytial Virus, which is present in the cold months). Always exposing the child to cold conditions can predispose to bronchiolitis. It is spread by direct contact with respiratory secretions like a cough or sneeze. There is no specific treatment and antibiotics are not used when illnesses are caused by viruses. Bulb suction should be used on infants to help clear nasal passages, especially before feedings. A vaporizer in the bedroom is helpful. Common complications include ear infections.

Children commonly get middle ear infections which means that there are bacteria behind the ear drum. Pain is the main symptom and these infections are not contagious. Antibiotics are generally quite helpful and paracetamol can help with pain. Complications can include a small tear in the ear drum, which causes drainage to come out of the ear. This tear heals quickly.

Sinus infections are often signaled by pain and pressure in the face, thick nasal discharge, post nasal drip, fever, bad breath, nausea, and chronic (long-lasting) cough. Sinus infections are not contagious. Saline nasal sprays are helpful for opening sinus passages. Antibiotics may be prescribed if indicated. Consult your child’s physician before giving any medication to your child.

Pink eye is generally considered a contagious bacterial infection of the eye. Pink eye can also be caused by viral infections and allergies or irritants. In general, when the infection is bacterial, the discharge is thick and yellow and the eyelids stick together. The eye discharge is contagious. The viral form usually accompanies a cold and lasts about a week. If it is bacterial, the discharge generally stops after 3 days of antibiotics. Warm compresses are useful. Antibiotic drops or ointment may be prescribed.

To prevent your child from getting ill, wash your hands, especially before meals. Set the example for your family. The entire family should keep up with routine medical checkups and immunizations. Beginning at an early age, teach your children to sneeze into their sleeves or to use a tissue, and how and when to wash their hands. Make sure that everyone is getting enough sleep and drinking plenty of fluids. Avoid contact with ill people. If you have concerns call your child’s physician or visit the nearest health center. Always consult a physician before giving any medication to your child.

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