When Your Child Brings Home More than Books from School

By Dr. Christopher Pergrem, Medical Director at Centennial Medical Plaza

It never fails, shortly after the bell rings to begin the new school year and the teachers handout the first assignments, a stream of children head to the nurse’s office. Being together in the classroom facilitates the exchange of fun and learning for children—and the exchange of a variety of germs. The task for parents, educators and physicians is to determine if the illness carried by these germs is viral or bacterial in order to determine the right treatment. The most common illnesses children bring home are viral in nature.

Stopping the Spread of Viral Infections

Viral infections easily spread throughout schools and homes. Unfortunately, the lessons on proper hand washing and hygiene measures that parents drill into their children at home are often forgotten at school. Kids can easily become distracted and forget to cover their coughs and sneezes or reach for a door or shared object before washing their hands. Within seconds, germs are transferred to several other classmates—including your child. As soon as your child reaches home, he opens the refrigerator to grab a snack or picks up the T.V. remote, depositing germs for everyone in the family to catch. 

Because viruses come on slowly, it may be one to two weeks before your child experiences the first symptoms of the virus he caught while sharing a ruler with a classmate. Meanwhile the germs have spread to everyone in your household—and to your work colleagues, friends, neighbors and anyone close to your family. 

Antibiotics Don't Help Colds

Once the illness makes its presence known with a variety of symptoms ranging from a sore throat to a cough to a fever, the real test begins: how to treat it. While antibiotics are the perfect answer to a case of strep throat, they flunk the test when it comes to viruses and should not be prescribed to treat a virus or its symptoms. 

In fact, antibiotic overuse can lead to antibiotic resistant bacteria that can pose a serious threat to your child in the future. 

Strep Throat or Virus?

So, how can you tell the difference between strep throat and a virus? A simple four-step checklist called the Centor criteria performed by a medical professional is most useful in determining whether a patient has a strep infection or a virus.

• Does the patient have a fever (typically defined as 38° C or 100.4° F)?
• Are the tonsils infected with pus pockets?
• Are the lymph nodes in the neck tender?
• Is there an absence of a cough?

If the patient scores four out of four, most physicians will provide treatment for strep throat without taking a culture test.  If the patient scores zero or one, the illness is treated as a virus. Patients who meet two or three criteria typically receive a rapid strep test and are treated according to the results.

The Centor criteria is not flawless and occasionally a child who meets all four criteria will not actually have strep throat, while another who doesn’t meet the criteria will have the disease. However, for the majority of patients, the Centor criteria accurately classifies the illness and prevents antibiotic overuse.

Unfortunately, viral infections can’t be cured with medications. Viral illnesses present with a myriad of symptoms —fever, runny nose, cough, sore throat, fatigue and muscle aches—and vary from patient to patient. Treating the symptoms and providing plenty of fluids are the best ways to make your child feel better. 

Most viruses last for 10 to 21 days (although it may seem like longer!) and symptoms gradually resolve.  Unfortunately, there are hundreds of thousands of different viruses and subtypes of viruses, and your child may pick up a new one while recovering from the first virus. Again, the best course of action is to be seen by a medical professional who can review the symptoms against the Centor criteria.

Flu: The Nastiest Virus

Fortunately, there is protection for one of the nastiest viruses—Influenza.  Providing your children with a flu vaccine helps to ensure they—and you—won’t suffer the significant symptoms that come with the flu.

There are also specific medications that may be effective in treating influenza and its symptoms.

Most of the "bugs" your child brings home from school will be viruses that are best treated with rest, liquids and symptomatic treatments. However, if you are unsure about the nature of the disease, or if your child has an underlying medical condition or is in great discomfort, your assignment is to schedule an appointment.

Tips for Staying Healthy

• Wash your hands—the proper way!
  • Wet hands with water and apply to your hands the amount of soap recommended by the manufacturer.
  • Rub hands together vigorously for at least 20 seconds, covering all surfaces and giving added attention to fingernails and areas where jewelry is worn. For younger children who may rush their hand washing, have them sing a short song like "Row, Row, Row, Your Boat," or the "Happy Birthday" song, which will ensure they wash for at least 20 seconds. Placing handwashing reminders at children's eye level will also help them become consistent hand washers.
• Rinse hands with water.
• Dry hands thoroughly with a clean or disposable towel.
• Use the towel to turn off faucet.
• Avoid sharing objects, such as utensils, cups and bottles.
• Cover your mouth and nose with a tissue when you cough or sneeze and wash your hands afterward. If a tissue isn’t handy, cough or sneeze into your elbow or upper arm, not your hands.
• Keep your sick child home to reduce spreading the disease.