What You Should Know About Parenting: Seasonal Childhood Diseases (Spring/Summer)

Hello.
I am Yoshihiko Iwama, Director of Iwama Children's Clinic.

In this issue and the next, we will focus on [Seasonal Childhood Diseases].

Based on questions I often receive from patients, this time I will write about the characteristics, points of caution, and treatment methods for childhood illnesses that are prone to spreading in spring and summer.

*While recent infectious diseases tend to occur year-round, this article is based on the periods when they are generally considered most common.

[① My 3-year-old's runny nose won't stop. Can children get hay fever?]

As spring approaches, the number of children coming to the clinic with moms and dads worried about hay fever increases. To conclude, small children can also get hay fever.

However, there are conditions for a definitive diagnosis.
When I receive questions from moms and dads worried about their child's hay fever, I explain the following four conditions for diagnosing hay fever.

① Someone in the family has been diagnosed with hay fever (family history)
② All four symptoms are present: <sneezing, runny nose, nasal congestion, itchy eyes> (the four symptoms of hay fever)
③ The symptoms in ② appear at the same time every spring (reproducibility)
④ Blood test results show antibodies to cedar pollen, etc. (antibodies)

In the case of the child in your question, the only symptom is a runny nose, so a definitive diagnosis cannot be made based on this alone.I recommend visiting a pediatrician to have them examined, including the possibility of a cold or other infectious disease.

In the first spring that hay fever develops, the reproducibility mentioned in ③ has not been met, so I think it is difficult to get a definitive diagnosis immediately.

If diagnosed with hay fever, taking almost the same measures as adults is effective.

・Refrain from going out when pollen levels are high
・Do not bring pollen into the room
・Avoid drying laundry outside
・Use an air purifier
・Humidify the room
・Stay hydrated
・Maintain a regular lifestyle and diet

[② Are there any infectious diseases to be careful of in the spring?]

Spring is a season when children (babies) often experience group life for the first time. Children who have only lived at home until now will start attending nursery schools, kindergartens, elementary schools, etc., and begin living with many friends.As a result, the opportunities to catch illnesses (infectious diseases) they have never had before will increase.

The characteristics, points of caution, and treatment methods for common infectious diseases are summarized below.
Also, as mentioned above, these infectious diseases tend to occur year-round.

Streptococcal infection

It is characterized by a fever of 38 to 39 degrees, a severe sore throat, and red bumps on the tongue (strawberry tongue). It is difficult to distinguish from pharyngoconjunctival fever, also known as pool fever, caused by adenovirus, which is common in summer.

In the case of streptococcal infection, because there is a risk of serious complications such as rheumatic fever, which can damage the heart, or acute glomerulonephritis, it is necessary to treat it thoroughly with antibiotics.

Mumps (epidemic parotitis)

Mumps is a disease with symptoms similar to the swelling of the parotid gland (under the ear) caused by a common cold.In the case of mumps, children cannot attend school or nursery for 5 days after the swelling begins.

A doctor's permission is required to return to school or nursery. It is possible to distinguish between a common cold and mumps through a blood test.

Complications of mumps include aseptic meningitis (1 in 100 people) and hearing loss (1 in 1,000 people).Hearing loss caused by mumps rarely heals. Please watch the progress of your child's symptoms carefully.

For infection prevention and complication prevention, I recommend vaccination (voluntary vaccination). It can be administered from 1 year of age.

[③ Are there any infectious diseases to be careful of in the summer?]

<Hand, foot, and mouth disease, herpangina, pool fever (pharyngoconjunctival fever)>
These three are sometimes referred to as the "three major summer colds of childhood."

It is becoming difficult to distinguish recent infectious disease outbreaks by season.They have fewer seasonal characteristics than before.

Hand, foot, and mouth disease

It is characterized by vesicular rashes on the palms, soles of the feet, insteps, and mucous membranes of the mouth, and may also be accompanied by a fever for about 1 to 3 days.

The main viruses that cause it are enterovirus and coxsackievirus, but there are many types, and it is possible to catch it multiple times.Care must be taken as it can rarely become severe, accompanied by encephalitis.

When the blisters that form in the mouth burst, they cause stomatitis. Due to the pain, children may refuse to eat or drink.
In such cases, please be careful to prevent dehydration. (Tips on how to get them to drink fluids will be described later.)

Herpangina

The characteristics of herpangina are a severe sore throat and a fever of 39°C or higher that lasts for 1 to 3 days.When infected, the throat becomes red and swollen, and small blisters form at the same time as the fever.

Due to the severe sore throat, your child may refuse to eat or drink. Please be careful, as there is a possibility of dehydration, just as with hand, foot, and mouth disease.

The causative virus is mainly called Coxsackievirus group A. Since there are several types of this virus, it is possible to catch it repeatedly.

Symptoms subside in about 5 days.
However, even after recovery, the virus is shed from the mouth (respiratory tract) for 1 to 2 weeks and from the stool for 2 to 4 weeks. Caution is required when changing diapers, etc.

Pool Fever (Pharyngoconjunctival Fever)

It is called pool fever because adenovirus is transmitted through swimming pools. If there are symptoms of fever, sore throat (pharyngitis), and bloodshot eyes (conjunctivitis), it is diagnosed as pool fever.Doctor's permission is required to return to daycare or school.

Among the three major summer colds for children (hand, foot, and mouth disease, herpangina, and pool fever),it is characterized by a fever of around 39°C that lasts for a long time, from several days to a week.
Therefore, the period during which they cannot eat or drink is also longer, so sufficient care is necessary.

[④ What should I do about hydration and meal care when my child has an infectious disease?]

Preventing infectious diseases is difficult, and in the case of viral infections, there is often no definitive treatment. Care for a child (or baby) who has contracted an infectious disease is important, focusing on rest, nutritious meals, and sufficient hydration.

Above all, the most important thing is sufficient hydration.
If your child is not dehydrated and is still energetic, there is no major cause for concern even if they have a high fever or persistent diarrhea.

However, children who are feeling unwell may have difficulty consuming fluids. In such cases, please try the following methods.

・Offer fluids repeatedly
→ If your child cannot drink water all at once, please offer it at intervals. Give it slowly, one spoonful every 5 to 10 minutes.

・Change the temperature
→ Even if they cannot drink at room temperature, simply changing the temperature—making it cold or lukewarm—might make your child happy to drink it. (Especially if the throat is swollen, it is easier to drink when cold.)

・Try changing the container
→ Children who dislike a regular cup might drink heartily just by switching to a cup with their favorite color or pattern. For small children, it is also a good idea to try changing the vessel (container), such as using a training mug.

・Try changing the flavor
→ Try changing the flavor to something less stimulating, such as fruit juice, milk, barley tea, or cold soup.

・Change the consistency
→ For children who dislike oral rehydration solutions, they might drink jelly-like or thickened liquids. Why not give it a try? Giving them small pieces of ice is also effective.

[⑤ I am worried about whether my child is dehydrated]

There are several signs of dehydration.
Lack of energy, dry skin, mouth, or tongue. No tears when crying. Being listless and sleeping a lot, etc.

And please check if your child is urinating as usual.
If you check the frequency, amount, and color of the urine and they are no different from usual, you can assume that they are getting enough fluids.

For babies, you can check with their diapers.

If the frequency or amount of urine decreases, or if the color becomes dark, it means they are not getting enough fluids, so please try touse various methods to encourage them to drink as introduced earlier.

That is all for this article.

Thank you for always reading.
I hope this was helpful for moms and dads facing the challenges of childcare.

Iwama Children's Clinic
Director Yoshihiko Iwama
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※Please note that we cannot respond to individual consultations or questions within note.