When kids get sick By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

With the approach of cold and flu season, a review of recurrent concerns expressed by parents may be in order. For the most part, this advice pertains to healthy kids and should be reviewed with you own physician.

Fevers are always a cause for concern. Core temperatures of over 38.5 C are usually the first sign of infection. They tend to precede other symptoms, but are closely followed by things such as muscle aches, loss of appetite, fatigue and vomiting. Many parents hesitate to use enough medicine, such as acetaminophen or ibuprofen, to bring it down. Typically, an exhausted parent will come home to find their child feeling "hot". They realize that the child is ill, but delay using meds hoping that it will pass. Medication is then started, but "just a bit" given. An hour later, the fever appears untouched.

This example illustrates two common errors. Many parents under-dose that first hit of medicine. It should be the maximum allowed on the label. Secondly, fevers have a natural tendency to rise during the evening and peak around midnight. Do not hesitate to give a second dose.

For kids who gag and vomit with medication, learn to use rectal suppositories. They are easier to use than you think, and can even be administered while kids sleep.

Most viral illnesses are silent predators. They gain a foothold in our body before we realize it. Most rashes seen with viruses such as roseola or parvovirus are the result of the immune system successfully combating the virus. There is little reason to keep these kids isolated at home. The non-sniffly kids can be more contagious than the sniffly ones, but it is visible symptoms that get the attention. A general guideline is that the more serious viruses such as influenza hit hard and fast. The transition from well to sick occurs in hours with influenza, while most colds progress gradually over days.

I have two rules about common respiratory illnesses in schools. The first is that they travel in packs. If a couple of kids in a grade two class have a cold, that cold will probably travel through most susceptible kids in the next two weeks. The only way to stop it is to send all the healthy kids home! The other rule is that the first bout of illness starts about a week after Labour Day. Once all those kids who have traveled all over have a chance to exchange new bugs, illness begins.

Some infections are minor and get more attention than necessary. Conjunctivitis is one such entity. Most times it can be treated without prescription and responds quickly, yet some parents equate it with the plague, and some nursery schools forbid attendance if afflicted.

Strep throat is one of the few bacterial infections that deserves treatment. The typical symptoms are intense sore throat, fever and absence of cough. In healthy kids, it is worth treating symptomatically for a day or two before seeking medical care.