Guest contributor Leigh B. Grossman, M.D. is the Medical Alumni Endowed Professor of Pediatric Infectious Disease and the Associate Dean for International Programs in the School of Medicine at the University of Virginia. She has edited and authored five books on infectious disease care and prevention, including her most recent, “The Parent’s Survival Guide to Daycare Infections,” released in October 2016.
Fall is here, which – among other things – means that kids are back in daycare, preschool, and elementary school. After-school and weekend sports, various activities, playgroups, library groups, field trips, and bus rides all become the norm again. In each one of these locations, children convene and share whatever germs they've acquired.
So it comes as no surprise to any of us who have survived raising children that this fun fall season turns into a season of colds, coughs, flus, gastroenteritis, and what seems to be never-ending sickness.
Research shows that daycare, preschool, and early elementary age children have five to seven upper respiratory infections (colds, running noses, coughs) that are caused by common viruses each year. These infections occur most often when children cluster inside for prolonged periods of time – namely between September and May, a period of 8 months.
Thus, infections occur in normal, healthy children with normal immune systems an average of every month or every other month of the year. It's not the fault of the parents. It's not the fault of the daycare center or the school. It's not to be blamed on their diet or their sleeping patterns or whether they walked through a puddle of water in their bare feet in late October in Maine. It is normal!
Having said that, it's daunting for working parents or for any family to constantly have children with coughs, runny noses, fevers, congestion, inability to sleep well and/or be miserable with the aforementioned symptoms. It's also a threat to the adults in the house who become sick with these same germs and are forced to go to work with upper respiratory symptoms or take a sick day if they're too sick to go in. It's similarly difficult when one has multiple children in the household who are all dragging home their own infections from daycare or school and spreading them through the family.
However, these infections are a normal part of growing one’s immunity and we, as adults, have far fewer infections than we did as children because of our robust and well-established immune function.
Most of these primarily viral infections are mild, non-life threatening diseases that cause symptoms that make you miserable. Alternate childcare arrangements are required if your child has a fever, respiratory distress, or is too sick to engage in the normal daycare and school activities. The best thing you can do is plan for this to happen – because it will.
Some of these mild, viral infections may precede an ear infection, pneumonia, or even a bloodstream infection. However, these secondary bacterial infections following a viral illness are uncommon. The usual story is that the child has a cold that should be on the wane, but instead of the usual decline in symptoms over a period of a week to 10 days, you notice a fairly abrupt increase in the height of the fever, difficulty breathing, onset of vomiting, increasing discomfort or pain, or other new symptoms.
This should prompt a visit to your pediatrician to obtain an accurate diagnosis as to what's going on. It's possible that an antibiotic is required to now treat what may well be a secondary bacterial infection.
Vaccines have remarkably decreased the numbers of these secondary bacterial infections, but they can still occur with germs that are not represented in the vaccines that we have and recommend.
The good news is that each one of these childhood viral illnesses is another “vaccination” for your child – further protecting him or her against these germs that cannot be avoided. As your children get older, their immune systems become more developed and they will slowly have fewer viral illnesses. We all lived through this and they will, too.