This section is to explain some health issues that parents' of school age children may need to deal with. Please feel free to call if you have questions on any of these topics.
Head Lice
Head lice are tiny wingless insects that live on the human scalp. They are about as big as sesame seeds. Head lice live off the human by sucking the blood. Lice cannot fly or jump from one person to another; they can only crawl. Children can get head lice from head to head contact with other infested children. Head lice can only survive on humans. They cannot survive off the host for longer than 24 – 48 hours. Lice can be passed around on shared combs, brushes, hats, towels, linens, and other personal items that touch heads.
Please encourage your children not to share hats, combs, or other personal items with others. Linens and other personal items need to be washed in hot water and dried in a hot dryer.
Eggs (nits) are laid by the female louse and are about the size of a poppy seed. They are very difficult to see because their color easily blends in with the infested child’s hair. Eggs are laid and attached near the root of the hair. Nits can vary in color, from yellowish brown to white. As the hair grows, nits are usually found further from the root of the hair. Lice live approximately 30 days. Eggs hatch in 10- 12 days. It is very important that nits are combed completely out after shampooing with the lice killing shampoo and to continue to inspect and comb daily.
The most common symptom of lice infestation is itching of the scalp. Nits may be seen on hair strands at the nape of the neck, crown of the head, or around the ears.
When a student is identified with lice, that student must be treated with a lice killing shampoo. It is important that the directions of that shampoo be followed so it will be effective against the infestation. After using the lice killing shampoo, use a fine tooth comb to help remove the nits. Please continue to check for lice and nits on a regular basis.
Check all family members on a regular basis to prevent reinfestation.
Pertussis (whooping cough)
Pertussis is spread through contact with the germs when an infected person coughs into the air. It starts out as cold symptoms with a mild cough and the cough becomes more severe. The coughing episodes can last from 4-6 weeks and often occur more frequently at night. Children receive immunizations against pertussis and this helps reduce the severity of the disease. Two products were licensed by the FDA in 2005 as single dose booster vaccines to provide additional protection against pertussis in individuals 11-64 years of age. Early diagnosis and antibiotic treatment also help reduce the severity, as well as preventing the spread. If your child has a cough or if you have any concerns regarding your child’s health, contact your child’s physician. If you or your doctors have further questions, please contact Public Health-Dayton and Montgomery County at 937-225-4508 or 937-496-7699.
Reye’s Syndrome (Reye-Johnson Syndrome or RS)
Reye's Syndrome is not a reportable condition in Ohio. RS may follow a common viral illness, such as the flu or chickenpox. Some signs and symptoms of Reye Syndrome (RS) is an acute illness characterized by persistent vomiting and neurologic dysfunction, sometimes progressing to delirium, coma and death. The typical patient is recovering from a viral illness when onset of severe vomiting occurs. This vomiting, usually considered the onset of RS, is persistent, uncontrollable and very often unresponsive to antiemetic medication. Severe vomiting will be accompanied by a change in mental status, the classic manifestation of RS. Manifestations range from lethargy to delirium, seizures and respiratory arrest. If left untreated, or if treatment is delayed, the case may progress through deepening levels of coma to death. Some severe cases who survive may experience varying degrees of physical and/or neurologic impairments. The diagnosis is based on clinical presentation as well as laboratory findings. There is no single test diagnostic for RS. No specific agent is found to cause RS. Research has demonstrated an association between Reye’s and the ingestion of aspirin during chickenpox and respiratory illnesses. The occurrence of RS typically occurs as isolated cases, although outbreaks of RS have been reported in association with increased influenza activity, particularly influenza B and influenza A (H1N1). RS follows the seasonality of influenza and chickenpox illness. Almost all RS cases are young children, adolescents and teenagers. The yearly incidence of RS has been decreasing steadily since 1980 when the association between aspirin ingestion and RS was first reported. The decline in the incidence of RS in the U.S. is thought to be due to the decrease in the use of aspirin in treating children with flu-like illness or chickenpox. RS is not communicable person-to-person.
Influenza (“flu”)
If your child has a sudden onset of fever, chills, headache and sore muscles he/she probably has the flu. Runny nose, sore throat, and cough are sometimes common. The communicable period is 24 hours prior to the onset of symptoms through 3 days after onset. Method of transmission can be direct or indirect contact with discharge from nose or throat. Children with a fever and those who feel ill are to be excluded. Hands should be washed after contact with soiled tissues.
Fifth Disease Erythema Infectioum
Fifth disease is a virus that presents a facial rash that is intensely red with a “slapped cheek” appearance. This spreads to the trunk and extremities, and clears centrally looking “lacey.” Generally clears in one week, recurs if person gets warm or upset up to a month. The communicable period is up to 5 days prior to, and, to a lesser extent for 2 days after the appearance of the rash. According to the Ohio Dept. of Health there is no exclusion unless the child has a fever or is uncomfortable. Hands should be washed after contact with secretions or soiled tissues.
Strep Throat/Scarlet Fever
Strep Throat is a streptococcal infection. Symptoms are fever, red throat with pus spots, tender and swollen lymph nodes (glands), symptoms are variable. Scarlet fever will have these symptoms as well as a sandpaper like rash on skin and inside mouth,” strawberry tongue,” high fever, nausea, and vomiting. The communicable period is until 24 hours of appropriate antibiotic therapy has been completed. Child may return to school 24 hours after appropriate antibiotic therapy and fever free. Avoid direct contact with nose and throat secretions of infected person. Hands should be washed.
Chickenpox or Varicella
Chickenpox is a skin rash which progresses to blisters and then scabs. Eruptions occur in crops and all three stages may be present simultaneously. Covered body areas are most often affected. A slight fever and malaise are also typical. The communicable period is 1-2 days before the rash appears, through the maximum of 6 days after appearance of vesicles. Avoid direct and indirect contact of drainage from lesions or respiratory droplets. Hands should be washed. A vaccine is available for chickenpox.
Common Cold
Acold is thegeneral term for “coryza,” or an inflammation of the respiratory mucous membranes caused by a variety of viruses. Communicable period is prior to the onset of symptoms. Runny nose, sneezing, scratchy throat, chills, and malaise are few of the symptoms. It may resolve itself from 2 to 10 days. Avoid contact with nose and throat secretions and tissues. Wash hands often.
Viral/Aseptic Meningitis
Viral Meningitis is generally caused by viruses and occurs primarily in young children. Meningitis is an irritation of the covering of the brain and spinal cord. Symptoms generally include fever, headache, lack of appetite, stomach pain, nausea and vomiting, and stiff neck. These symptoms generally go away with no permanent damage after a few days to a week.
Should your child develop any of these symptoms in the next few weeks, contact your family doctor (or the health department if you do not have a family doctor), and tell him/her that your child might have been exposed to viral/aseptic meningitis, and now is feeling unwell. You will be advised on further action if needed, if any.
The virus is present in the bowel movement and saliva of infected persons. People become infected only swallowing the virus, either from fecal material of from respiratory droplets from infected persons. Spread of the virus can be reduced and controlled with a few simple measures: 1) Wash your hands thoroughly after changing a child’s diaper; 2) Wash your hands and your children’s hands thoroughly washed after using the toilet; 3) Wash you hands and your children’s hands before eating; 4) Do not share drinking cups.
If you have questions, please contact the Montgomery County Combined Health District at 937-225-4508.
MRSA (Methicillin Resistant Staphylococcus Aureus)Staphylococcus Aureus
MRSA is a bacteria, commonly referred as “staph.” Occasionally, “staph” can get into the body and cause infection such as pimples, boils, impetigo, cellutitis, or folliculitis (infected hair follicle). A laceration or an abrasion may become infected with “staph.” MRSA can emerge as a skin infection among otherwise healthy individuals.
Strategies for MRSA prevention and control is to clean all areas that are in use on a daily basis and encourage frequent hand washing. The plan of action is to be proactive concerning MRSA are as follows:
Common factors for transmitting and contracting MRSA:
Contact from skin to skin
Contaminated surfaces and shared items
Crowding
Compromised skin integrity
Cleanliness
Key prevention: Know the signs and symptoms of MRSA.
It may be blister like, pus filled bumps, may be a seeping lesion, may look like an infected bug bite, and inflammation (redness at the site or lesion)
Keep wounds that are draining covered with clean, dry bandages.
Clean hands regularly with soap and water or an alcohol based hand
gel.
Maintain good general hygiene.
Do not share personal use items.
Do not share water bottles.
Do not participate in contact sports with uncovered draining wounds.
Clean equipment and other environmental surfaces.
Hand, Foot, and Mouth Disease (Coxsackie Virus)
Hand, Foot and Mouth Disease is generally a raised rash particularly on palms, soles, and areas around the mouth. It progresses to blisters, then scabs. It can cause sores in the mouth, making it difficult to swallow. It is transmitted in direct contact with a person’s infected respiratory secretions or indirect contact with items freshly soiled with the secretions. Virus may be found in feces/stool up to a month after symptoms have resolved. Oral secretion is infectious while sores are present in mouth. Avoid direct and indirect contact of discharge of secretions or feces. Give careful attention to hand washing.
The number one line of defense to prevent the spread of disease is to wash your hands! Please stress the need for good hand washing technique. Hand sanitizers are good for short term, and until you can get to running water and soap. Remind them to wash their hands for at least 20 seconds, or as long as it takes to sing “Happy Birthday” twice. Keep hands away from face!
Please keep your child home for 24 hours after a fever. They should be without a fever for 24 hours with NO fever reducing medication given prior to returning to school. Reducing the fever does not make them any less infectious, but hopefully it makes them feel better. Follow the same rule for diarrhea and vomiting as you do with the fever about keeping them home for 24 hours. You don’t want your child to contract another illness while trying to get over the original illness. Encourage your child to get their much needed rest during this busy time of the year. Following a well balanced diet from all the food groups may help in preventing other illnesses as well.