Childhood Illnesses

Your friend’s child has a cold and they are coming to visit this afternoon. Your nephew has tonsillitis and slept over at your house last week. Your child has been vomiting all night and is supposed to go to crèche this morning. Do these scenarios sound familiar? One of the most difficult things to cope with as a new, or even second or third time round, parent, is knowing when it is safe for your child to hang out with their friends and when it is better to keep them home, away from the dreaded bugs that are ‘going around’.

The list below provides some of those much needed answers to questions like:
"Is it contagious?"
"How long before my child can go back to pre-school / care?"; or
"What can I do to help my child?"

This list is by no means exhaustive and not in any particular order, but provides information on some of the more common illnesses that your child may come into contact with in his or her early years. Remember, if you have concerns about your child’s health at any time see your doctor – you will know best when your child is unwell.



LIST OF COMMON CHILDHOOD ILLNESSES
BRONCHIOLITIS, CHICKENPOX, CONJUNCTVITIS, CROUP, DIARRHOEA, EAR INFECTIONS, GASTROENTRITIS, HAND, FOOT AND MOUTH, IMPETIGO, MENINGITIS, PNEUMOCOCCAL DISEASE, PNEUMONIA, SLAPPED CHEEK, THE COMMON COLD, TONSILLITIS, WHOOPING COUGH



KEY: Viral   Bacterial   Condition



BRONCHIOLITIS

What is it?
Bronchiolitis is an acute infection of the small airways of the lungs. It commonly affects infants and young children under the age of 2.

What are the Symptoms?
Bronchiolitis most often follows an ear infection, common cold, tonsillitis. Its major symptoms appear acutely with difficulty in breathing, an increase in rate of breathing and heart rate, wheezing and a hacking cough. In severe cases, the lips and/or tongue may become "blue". If your child becomes tired, breathing may become shallow and ineffective. Sometimes your child may vomit, so dehydration is not uncommon, particularly when there is poor intake of fluids. Symptoms usually last for 7-10 days.

Is it Contagious?
Yes - most cases of bronchiolitis are caused by viruses.
Coughing and sneezing is the main mode of transmission of the virus.

How is it Treated?
In mild cases, there is no specific drug treatment for bronchiolitis. It is important to ensure that your child is well hydrated, by encouraging frequent feeding of small volumes of fluid.
Secondary bacterial infections are not uncommon and, if suspected, need to be treated with appropriate antibiotics.
Remember that, in these cases, the condition is usually mild and settles over a period of a few days. Children who become dehydrated and are more restless or tired with increased breathing rate or difficulty in breathing may need hospitalisation.



CHICKENPOX (Varicella)

What is it?
A viral illness usually affecting children. One infection of chickenpox gives long lasting immunity and second attacks are rare.

What are the Symptoms?
Runny nose, cough, tiredness and general rash consisting of small rounded lumps. After 3 - 4 days small, blister-like tops begin to develop. The rash tends to be more noticeable on the trunk than on exposed parts of the body and may also appear inside the mouth, on the scalp and in the nose. At any one time there will be blisters in various stages of development.

Is it Contagious?
Yes - the infection is spread by droplets from coughing and direct contact with the moist blister. The incubation period is between 13 and 17 days. The infectious period is from 5 days before the sores appear during the coughing and runny nose stage and until all the blisters have formed scales or crusts – usually about 5 days.

How is it Treated?
There is no specific treatment, but phenergan syrup by mouth and lotions (ask your doctor) applied on the itchy blisters may be useful. If there is a high fever, paracetamol medication may be advised. Keep your child at home until all blisters have crusted. Remember to inform the school or pre-school!



CONJUNCTIVITIS

What is it?
Conjunctivitis is an inflammation of the thin, clear tissue, which lines the eyelids and eyeball and is very common. Conjunctivitis is caused by a viral or bacterial infection, hay fever, allergies, or, in babies, a tear duct that doesn't completely open or an infection from bacteria in the birth canal. This can be serious and cause sight problems if it isn't treated.

What are the Symptoms?
Usually red, sore, gritty, watery, itchy eyes. Possibly yellow or green discharge (pus), which makes the eyelids sticky.

Is it Contagious?
Yes, very - try to make sure your child doesn’t touch their eye, as the inflammation can spread to their other eye or to someone else. If they do touch it, wash their hands well. Ensure they use their own flannel, towels, pillows and bed linen. Don't send children or babies with conjunctivitis to pre-school if their eye is weeping, and to prevent re-infection, wash their hands often. The incubation period is 1 - 3 days. The infectious period is while there is discharge from the eye. Keep children home from pre-school during this time.

How is it Treated?
Wash your child’s eyes with a disposable cotton swab and a weak salt-water solution. Be sure to wash and dry your hands carefully before and after cleaning your child’s eye. Ask your doctor to show you how to clean the eye properly. Use eye drops or ointments prescribed by your doctor, and wash your hands afterwards.

Note: Cotton wool balls are not ideal because they can unravel, leaving cotton in the eye. Surgical swabs from your chemist or disposable eye make-up removal pads are best.



CROUP

What is it?
Croup is an inflammation of the voice box and windpipe. It usually occurs in babies and toddlers, but can occur in children up to six years. It is caused by a viral infection.

What are the Symptoms?
Croup generally starts like a common cold, with your child possibly having a slight fever, sore throat and runny nose.
A hoarse, barking cough and noisy breathing develops after several days. Your child may find it difficult to breathe in, and crying generally makes the barking cough and noisy breathing worse. The symptoms of croup are almost always worse at night.

Is it Contagious?
Yes.

How is it Treated?
Visit your doctor, as all children with croup should be taken to the doctor. Steam is the most effective treatment for croup, as moist, warm air helps clear the airways. Try sitting in the bathroom with the door and window closed and the hot taps running.
Stay with your child at all times and do not put your child in or near the hot water. Hold your child on your lap in an upright position, next to the running tap until the breathing has improved. Alternatively, keep the kettle boiling (out of the child's reach) by topping it up continuously. Special machines which produce a warm mist can also be bought (or possibly hired) from your local pharmacy. These are the safest and most effective option.
As croup is caused by a virus rather than bacteria, no antibiotics are given unless the child develops a bacterial infection as well. Paracetamol can be used to bring down any fever.



DIARRHOEA

What is it?
Diarrhoea is when bowel movements become watery, offensive, frequent and urgent.

What are the Symptoms?
Diarrhoea is a symptom of other conditions or diseases; it is not a disease in itself. Diarrhoea can often be accompanied with painful stomach cramps.

Is it Contagious?
No - diarrhoea is most commonly caused by a virus or germs, which have made their way into food or water. Other causes of diarrhoea include rich food, too much alcohol, emotional upheaval, reaction to drugs or food allergies. Some diseases can also cause diarrhoea.

How is it Treated?
Preventing dehydration is the main treatment in the initial stages of diarrhoea. Ensure children drink small amounts of clear lightly sweetened fluid every hour such as diluted lemonade, weak cordial, or oral rehydration solution (such as Gastrolyte) which can be bought at a pharmacy. It is very important to make sure that sugary drinks are well diluted.
Dehydration can cause serious problems, especially in babies, children, older adults and those with special health problems. See the doctor if your child:
- is passing very little or no urine
- looks dry around the mouth, and the skin on their hand does not bounce back into shape after being gently pinched
- looks listless and is difficult to wake up
- has sunken eyes
Remember children with diarrhoea are more at risk of serious complications from dehydration. If the diarrhoea does not start to slow within 12 hours, you should visit your doctor. Antibiotics are prescribed only in cases of severe diarrhoea and when the doctor knows what type of bacterium is to be treated.



EAR INFECTIONS

What is it?
Middle ear infections happen when germs or viruses get into the fluid in the middle of the ear behind the eardrum. They can be acute (happen just once) or chronic (not get better or come back again and again). Ear infections are very common in children, particularly those under seven years old.
During a middle ear infection, pus can build up behind the
eardrum, causing pain. Also, fluid can remain in the middle ear after an acute middle ear infection, and this is commonly called 'glue ear'. Glue ear makes it harder to hear.

What are the Symptoms?
You will usually be the first to know if your child has an ear infection. In very young children they are usually cranky, fussy and rub their ears. They possibly won’t hear, eat or sleep well. In older children they will usually complain of earache, a feeling that the ear is 'full', or that they can't hear well. Possibly have a fever, runny nose or a cough. If the infection is really bad, the eardrum may burst and pus will leak out of the ear.

Is it Contagious?
No. In children, the tube that goes from the back of the nose to the middle of the ear is shorter than in adults, so bacteria and viruses can find their way deep into the ear much more easily. Ear infections are more common in late winter or early spring and after a child has had a cold.

How is it Treated?
- Regular pain relief. Discuss with your chemist or doctor what type is best (do not give aspirin to children). To give your child maximum pain relief, make sure they take the medicine as directed, not only when they are 'crying' with pain.
- Gentle heat may help (eg. soak a flannel in hot water, squeeze out and place over the ear).
- Prop older children up on pillows to sleep: it may feel better if they lie with the sore ear on the pillow.
- Keep your child's ears dry and clean.
- Keep background noise in the home down. Loud noises can upset children with sore ears and make it harder for them to hear normal conversation.
- Always take your child to the doctor when they have an ear infection. The doctor can tell you how serious it is, whether or not treatment is needed, and what you can do to make your child more comfortable.
- Pain relief, nose sprays or decongestants (to take away the 'stuffed-up' feeling) may help. Antibiotics may be needed, but they do not always help: your doctor is the best one to decide when they should be given.
- If the ear is always getting infected, and it is not responding to antibiotics, your doctor may suggest grommets be put in the ear so air can get into the middle ear to ventilate it.



GASTROENTERITIS

What is it?
Gastroenteritis (tummy bug, food poisoning, traveller's diarrhoea, viral enteritis or intestinal flu) is a gut infection that causes stomach cramps, vomiting and diarrhoea. It is very common and is often caused by unclean food or water.

What are the Symptoms?
Usually the infection irritates the stomach and gut making the muscles tighten, causing vomiting or diarrhoea. You can get sick anywhere from 1 to 3 days after getting infected, depending on the bug. Possibly cramps, a gurgly, uncomfortable tummy, vomiting and watery diarrhoea, which may be bloody or mucusy. Also possible symptoms are feeling sick, shivery, having a headache and/or fever. It usually only lasts a few days, but may last longer.

Note: If your child becomes very weak, has trouble waking up, has sunken eyes, goes very pale, stops passing water or gets very dry skin and tongue see your doctor urgently.

Is it Contagious?
Yes. A tummy upset may be due to:
- a virus passed on by someone who may or may not have symptoms
- bacteria from food that is not fresh or well-cooked, unclean water, hands, cooking or eating utensils. Bacteria can also be spread by flies. Meat, poultry, dairy products, eggs, shellfish and parboiled rice are the most commonly affected
- amoebas or parasites
- poisonous food such as toadstools
The incubation period is 1 - 3 days. The infectious period is while vomiting and diarrhoea last and up to 7 days after the illness starts. Keep your child home from school until they are well, with no further vomiting or diarrhoea.

How is it Treated?
- Fluids – see Diarrhoea for details. Ensure your child drinks as much as they can, as often as they can (even if it is in little sips), especially after they have vomited or had diarrhoea.
- Rest.
- If your baby has a tummy bug, continue breast-feeding but give extra water. If they are bottle fed, give water on the first day, then watered down formula or milk from the second day.
- Children may not want to eat for a day or more. As long as they are drinking, don't worry. A light, clear broth and bland food when your child feels ready to eat.
- Most people get better in a few days. If they don't or if they are dehydrated, they may be hospitalised.



HAND, FOOT AND MOUTH

What is it?
Hand, foot and mouth disease (HFMD) is a viral infection most commonly affecting children under six years old. A typical sign is a rash affecting, as the name suggests, the hands, feet and mouth. In most cases, the course of the disease is relatively benign, but in some instances complications have been recorded.

What are the Symptoms?
A rash most frequently appears in the mouth, where the tops of the spots are rapidly eroded, leaving ulcers. The rash on the hands and feet is blister-like, but the ‘blisters’ often have a curious linear or arc shape. The rash may initially appear as solid red raised spots, which then develop the usual blister-like appearance. Occasionally the buttocks may be involved. There will also be several days of fever and vomiting. It is also common to have ‘blisters’ on the backs of the fingers and toes, and sometimes they may appear on the palms, the soles of the feet or in the groin area.

Is it Contagious?
Yes – the virus is mostly spread by poor toilet hygiene – eg.
no hand washing. The incubation period is 3 - 5 days. The infectious period is while the child is unwell.

How is it Treated?
As the illness is often benign, treatment is usually reserved for alleviating symptoms. Paracetamol can be given for fever, while fluid intake to maintain adequate hydration and bed rest aid recovery.



IMPETIGO (School Sores)

What is it?
Impetigo is a skin infection that is most common in children and occurs most often in late summer or autumn. Impetigo is found generally on the face, especially around the nose, mouth, arms and legs.

What are the Symptoms?
Impetigo usually starts as little blisters, which then break and start to weep - usually pus and sometimes clearer liquid. Yellow or brownish scabs then form, which can burn or itch.

Is it Contagious?
Yes, very – impetigo is caused by two types of bacteria, which make their way into the skin through cuts or scratches.
Do not send your child to pre-school with impetigo. An infected child should not use the same towels, linen or flannels as the rest of the family. Family bathing should be avoided until the sore is healed, and it is important to be on the lookout for other sores and start treatment early if you see any.
Everyone in the family must be careful about hand washing. Children can often be tempted to wash their hands more carefully if a new or special type of soap is bought. Pump packs are ideal.
Look out for antibiotic side-effects. Report any diarrhoea, tummy upsets or skin rash to your doctor or practice nurse. The incubation period is 7 - 10 days (variable). The infectious period is until 24 hours after antibiotic treatment has started, or until the sores have healed. Public Health Nurses will advise if children need to stay home from pre-school.

How is it Treated?
- Take your child to the doctor as soon as you suspect
impetigo. The doctor will probably prescribe antibiotics (oral or ointment). Do not share the ointment with any other members of the family, and throw it away after use.
- Impetigo sores can look alarming and may be difficult to manage, especially if they are on the face. Ask your doctor to show you the best way to clean the sores.



MENINGITIS

What is it?
Meningococcal disease is a severe infection caused by a germ often known by the name “Meningococcus". There are two main forms of the disease - septicaemia and meningitis.

What are the Symptoms?
The most important signs of these diseases are high fever, being very unwell and getting worse rapidly. As well as these signs, babies with Meningococcal disease may have the following symptoms:
- be hot and fretful, refusing feeds and vomiting
- crying with a high pitched cry or moaning
- go into a deep sleep and not be easy to wake
- have a rash with blotchy skin or red to purple spots or bruises

Is it Contagious?
Yes - the Meningococcus germ likes to live in people's noses and throats. It is passed from one person to another by coughing, kissing, sharing the same eating or drinking utensils and other close contact over a period of time. Many people come into contact with the Meningococcus germ during their lifetime. Most people remain well and develop body resistance before the germ causes disease.
Well people can carry the germ in their nose or throats for several weeks, and may pass the germ onto another person without knowing they even have it. A small number of people who receive the germ from another person develop meningococcal disease. The germ can cause disease at any age, but tends to affect children and young people most commonly, as they are less likely to have developed resistance.
The incubation period is 2 - 10 days; usually 3 - 4 days for meningococcal meningitis. The infectious period is for 24 hours after starting antibiotics.

How is it Treated?
The meningococcal disease is potentially fatal and should always be viewed as a medical emergency. Babies and children with meningitis can get sick very quickly. See your doctor straight away. Insist on medical help, day or night.
Viral meningitis does not respond to antibiotics; treatment is based on rest and good nursing care. Bacterial meningitis needs immediate treatment with antibiotics.
Antibiotics are given to kill off any meningococcal bacteria, which may be carried in the back of the nose and throat. This reduces the risk of passing the bacteria on to others.



PNEUMOCOCCAL DISEASE

What is it?
The bacteria Streptococcus pneumoniae causes infections in different parts of the body such as the sinuses (sinusitis) and in the ear (otitis media or middle ear infection). When it attacks other parts of the body it becomes ‘invasive’ resulting in very serious infections including pneumonia, septicaemia (blood poisoning) and meningitis (inflammation of the brain lining)

What are the symptoms?
Early stages of invasive pneumococcal infections may look like a case of influenza but can progress very quickly (within hours), resulting in hospitalisation.
- Pneumococcal pneumonia is the most common invasive form. Pneumonia starts with a sudden fever with shaking chills, chest pain, productive cough, shortness of breath and rapid breathing. As the infection worsens the heart rate increases and hypoxia (lack of oxygen) may be present. This can be life threatening.
- Pneumococcal meningitis and septicaemia are also very serious outcomes. The signs of infection are the same as meningitis and septicaemia (blood poisoning) caused by other bacteria and need immediate medical attention. A baby or child may have a fever, be crying or unsettled, refuse drinks or feeds, vomit, be sleepy, floppy or difficult to wake, dislike bright lights or have a rash/spots.
- Pneumococcal septicaemia (blood poisoning) often accompanies pneumonia or meningitis in infants under two years of age. The bacteria can also occasionally infect the heart muscle and very rarely affect other sites in the body such as joints and the abdominal cavity.

Is it contagious?
The bacteria are carried in the nose and throat and easily passed from person to person by coughing, sneezing and close contact.

How is it treated?
Most infants are born with some maternal protection (antibodies) against the bacteria. However, by six weeks of age it is likely that half the maternal antibodies have decayed.
Babies do not start to build their own strong antibodies against pneumococcal bacteria until about two years old.
Pneumococcal disease is treated with antibiotics. Over the last decade, many pneumococci have become resistant to some antibiotics; high levels of penicillin resistance are common. In recent months, Prevenar, a vaccine to immunise your child against pneumococcal disease, was made available for free for all babies born from January 1st 2008.



PNEUMONIA

What is it?
Pneumonia is an infection of the air sacs of the lungs. Usually only part of the lungs is involved.

What are the symptoms?
Pneumonia causes cough, fever and trouble with breathing. Breathing problems include:
- breathing faster than usual
- noisy or rattly breathing
- making a grunting sound with breathing
- putting a lot of extra effort into breathing
A child with pneumonia is usually very tired and can look unwell.
Viral pneumonia usually develops over days. It starts with a cold and a runny nose. Then there is a cough, and sometimes fever, before breathing problems develop.
Bacterial pneumonia usually develops faster, over a day. It causes high fever, a cough, and breathing problems. A child will be very tired and look quite unwell.
Sometimes bacterial pneumonia develops during a viral infection. If this happens, your child will usually start with an illness like a cold for a few days, and then become much sicker quite quickly.

Is it contagious?
The viruses that cause viral pneumonia are contagious. Most children and adults just get a head cold. Only a few will get pneumonia. Most bacterial pneumonia is not very contagious, so other people rarely catch it. Some sorts of bacterial pneumonia, however, can be contagious. It is wise to limit the possible spread of infection by keeping a child with pneumonia away from other children.

How is it treated?
Pneumonia affects your child’s breathing. Sometimes this makes it hard for them to get enough oxygen. Signs of not getting enough oxygen may include any of the following:
- looking very pale
- going blue in the tongue and lips
- becoming very sleepy and not easy to rouse
If your child has any of these signs, they will need to be given extra oxygen in hospital. This is usually given through nasal prongs (small soft plastic tubes) that fit into your child’s nose and carry a flow of oxygen.
Antibiotics do not help in viral pneumonia. It is not always easy to tell if pneumonia is viral or bacterial. Doctors tend to use antibiotics when it is not clear which sort of pneumonia a child has. If your child has bacterial pneumonia, they will need antibiotics. If your child is young or sick enough to be in hospital, antibiotics are often given by a drip.
A child with pneumonia may not eat well but they do need to drink fluids. If they are not drinking well enough, your child may need to be given fluids by an intravenous drip or by nasogastric feeding (feeding via a tube that is passed through the nose or mouth into the stomach).
A small number of children who are extremely unwell with pneumonia need more intensive hospital treatment.



SLAPPED CHEEK (Fifth Disease)

What is it?
Slapped cheek (Fifth Disease - the fifth childhood disease with a rash to be discovered) is a mild illness that is most common in children between 5 and 14 years of age, but it can occur in younger children and adults. It is a viral illness with mild symptoms and a blotchy rash. The rash begins on the cheeks and spreads to the arms and legs.

What are the Symptoms?
- Rash, first appearing on the cheeks, often looks like "slapped cheeks"
- A rash spreading to the arms and legs about one day later, often has a "lacy" appearance
- Fever
- Joint pain
Your child will usually have non-specific symptoms, which might include fever, headache, muscle aches, sore throat, runny nose, tiredness, tummy ache etc. These mild symptoms usually last for 2 - 3 days, and it is during this period that the child is contagious. This is followed by a period of about one week during which most children are free of symptoms, before the rash part of the illness begins.
The rash phase of the illness usually occurs in three stages. Stage 1 is characterized by a bright red rash on the cheeks, which gives rise to the name slapped cheek. It is most pronounced when the child goes from a cool environment into a warm one. Stage 2 of the rash occurs 1 - 4 days later, with the appearance of a less intense rash on the trunk and limbs.
Toward the end of this stage there is a blotchy clearing of the rash, leaving a lacy pattern. Stage 3 of the rash usually lasts for longer than a week and can last for a month or more. It is characterised by coming and going of the intensity of the rash. These fluctuations are most marked when the child is hot. A child can appear to be completely recovered, only to have the rash reappear when he or she takes a bath.

Is it Contagious?
Yes - Slapped cheek is spread by coughing or sneezing and usually lasts for 5 days. It is quite contagious, with cases following each other by 4 - 14 days, but while the rash is present, the child is not contagious at all. The incubation period is 1 - 3 days.

How is it Treated?
No treatment is usually required for slapped cheek in children. Paracetamol may be given for fever or joint pain. Occasionally the rash itches, or the joints ache. If this is the case, symptomatic treatments such as oatmeal baths or paracetamol can be helpful. Recovery should be spontaneous and complete.

Note: Pregnant women who have been exposed to slapped cheek should discuss this with their obstetrician. Most of these babies do well, but the pregnancy should be monitored.



THE COMMON COLD

What is it?
The common cold is an infection, mainly of the nose and throat, caused by a virus. It lasts 2 - 3 days and does not cause serious illness in healthy people.

What are the Symptoms?
Usually a runny nose and weepy eyes. Possibly a cough, sneezing, sore throat, generally feeling off-colour. Also headaches, fever or loss of voice.

Is it Contagious?
Yes, very - the virus is spread from person to person by coughing or sneezing or by close contact eg. shaking hands.

How is it Treated?
Rest, keep up fluid intake, administer medication to take down fever and relieve headaches, use an inhalation, a decongestant rub such as Vicks, or nose drops, or try a cough medicine. Ask your doctor or chemist to recommend something for your child’s symptoms. See your doctor if your child doesn’t get better in 4 days, has sore ears, coughs green or thick yellow mucus, has pain in the chest, trouble breathing or has chronic health problems. A child with a very sore throat, high fever or a strange, high-pitched cry must be taken to the doctor. Antibiotics are not given for colds because they are caused by a virus, but they may be used to treat some bacterial infections following a cold.



TONSILLITIS

What is it?
Tonsillitis is when your tonsils become infected and swollen. Your tonsils are at the back of your throat on each side of your mouth. They help babies build up immunity to germs, but after the first year of life become unnecessary.
Tonsillitis is more common in children and can occur repeatedly or occasionally. Acute tonsillitis can last 4 - 6 days. Tonsillitis may also be part of glandular fever.
One of the germs that cause tonsillitis (Streptococcus) can also cause rheumatic fever or inflammation of the kidneys

What are the Symptoms?
The tonsils become red, swollen and painful or occasionally pus may form. Symptoms can also include a sore throat, fever, muscle aches and swollen glands on either side of the neck.

Is it Contagious?
Yes - avoid close contact with anyone having an attack of tonsillitis, so as not to be infected.

How is it Treated?
- Visit the doctor - although most cases of tonsillitis are caused by a virus and cannot be treated with antibiotics, it is still important that a child with a sore throat visits the doctor.
- Rest - children and adults need rest to recover from tonsillitis
- Pain relief - Paracetamol for children may help relieve the pain and temperature. Use every four hours while the pain is severe
- Antibiotics may be prescribed
- Diet - plenty of fluids, especially if there is fever. Do not worry if your child has not eaten much for a few days, as long as they are drinking. Offer cold drinks, sips of ice to suck or ice blocks. Jelly and ice cream may be appreciated. Children should be taken to the doctor if they have not managed to drink anything for 15 hours
- Gargle - gargling with warm salt water can relieve sore throats, remove secretions and promote healing
- Surgery - Some people who have frequent bouts of tonsillitis will require an operation to remove the tonsils.



WHOOPING COUGH (Pertussis)

What is it?
Whooping cough is a highly infectious disease mainly occurring in children.

re the Symptoms?
Symptoms develop about 4 - 10 days after being exposed to the bacteria. Whooping cough usually runs a 6 week cycle in three stages, each lasting about two weeks - but it can last up to three months.
Stage 1 usually produces an irritating hacking cough at night, loss of appetite, sneezing and possibly a slight fever. It is not common, however, for whooping cough to cause a fever. It is highly contagious at this stage, but difficult to diagnose, as whooping cough can be mistaken for bronchitis. The bacteria will only show up in early nose and throat swabs.
Stage 2 begins after 7 - 14 days. It is known as the paroxysmal stage because of the coughing spells. These coughing spells may produce plenty of mucus and the cough may finish with a loud whoop. Choking on the mucus can cause vomiting. Many young children may not necessarily have the typical "whoop". The persistent coughing spells can cause a child to temporarily stop breathing. Complications are more likely to develop at this time.
Stage 3 (the convalescent stage) is when the coughing and vomiting starts to subside. Sometimes, the coughing can start again months later if the child develops an upper respiratory tract infection.

Contagious?
Yes - Whooping cough is usually caused by germs that enter the air passages and damage the lining of the windpipe and the main air passages in the lungs. The inflamed airways produce more mucus, which starts the irritating cough. The germs are passed from person to person by the infected mucus during coughing. The incubation period is 4 - 10 days. The infectious period is for 3 weeks from onset of symptoms if not treated with antibiotics, or for 5 days after antibiotic treatment has started.

How is it Treated?
Some cases of whooping cough can be treated at home depending on how severe the whooping cough is. Others will need to be treated in hospital. An antibiotic may be prescribed if a secondary infection has developed or to help make the disease less infectious to others. A child may be infectious for up to a month after the start of the cough, but if an antibiotic has been prescribed the infectious period is reduced to less than a week. Comfort and plenty of cuddles for young children will help recovery. Small healthy meals and fluids can be given to your child. Steam treatment (see Croup) may give some temporary relief. Cough medicine is of little value.
Caring for a child with whooping cough is hard work, especially as the cough is often worse at night. Ask family and friends to help so you can catch up with sleep.
Keep your child away from others to prevent infection spreading. If there is an outbreak of whooping cough and your child is not immunised they will have to stay away from their pre-school until the outbreak is over. Keep children away from pre-school for 21 days from onset of coughing or for 5 days after start of antibiotics.



CHILDHOOD ILLNESS INDEX SOURCES:
www.kidshealth.org.nz
www.immune.org.nz
www.familydoctor.co.nz
www.meningitis.org.nz
health-guides.nzpages.co.nz
Ministry of Health
www.xtramsn.co.nz health
www.everybody.co.nz
Dr Greene
Popsicle (WNPC – December 2003)

A Special Thank you to the Wellington Regional Parents Centre for the information on Childhood Illnesses