Back to School | JASE Medical

Part 2, Common Back to School Illnesses

Last week we reviewed head lice, colds and flu and pinkeye. Today we will look at impetigo.

Impetigo

Impetigo is a skin infection caused by one or both of the following bacteria: group A Streptococcus and Staphylococcus aureus. It is the most common skin infection in the age 2-5 group. On occasion adults may become infected, especially if they have another skin issue or are recovering from a cold or other virus.

Group A Streptococcus (group A strep) causes many different infections. These infections range from minor illnesses to very serious and deadly diseases., such as strep throat, scarlet fever, cellulitis, rheumatic fever and more.

Staphylococcus aureus (S. aureus or “staph”) causes skin and soft tissue infections such as abscesses (boils), furuncles, and cellulitis. Most staph infections are not serious, however staph infections can on occasion cause bone, bloodstream, and pneumonia. Methicillin-resistant staph aureus (MRSA) is an antibiotic resistant staph infection is becoming more common.

How impetigo is spread

  • Impetigo is highly contagious and can be spread from skin-to-skin contact, like in daycare and school environments where children are in close contact with each other.
  • People with scabies or other skin infections or injuries that break the skin are at an increased risk of impetigo.
  • Sharing washcloths and towels,
  • Contact with sores and rash through personal contact (hugging, playground play)
  • Not practicing correct personal hygiene- by keeping sores and blisters clean and removing excess crusty material as it builds up.

Symptoms and diagnosis

Symptoms include:

  • Impetigo starts out as red itchy blisters and sores, that easily spreads when scratched.
  • The blisters are filled with yellow or honey-colored fluid and ooze and crust over. Rash that may begin as a single spot but spreads to other areas due to scratching.
  • Sores usually start on the face and lips and can spread, arms, or legs and other areas of the body.
  • Patches of impetigo on the body (in children).

Treatment

Both S, aureus and group A strep impetigo are treated either with an antibiotic cream or in the case of a severe infection an oral antibiotic.

Your care provider can guide you in the best treatment option available. They may want to take a sample of the bacteria on the skin to determine if you have impetigo, however visual observance is how it is usually diagnosed.

Impetigo can take weeks to clear up. If the rash spreads or does not get better (after a week or so) following treatment, contact your care provider for further guidance. You may need to try another antibiotic.

NOTE: Most impetigo is caused by group A strep

Most cases of impetigo are treated with a prescription antibiotic cream applied directly to the affected area(s). Only severe cases and cases that aren’t healing may need an oral antibiotic.

Be sure to keep sores clean by daily cleansing with mild soap and water and patting dry. Wash soiled washcloths in hot water and dry on high heat.  Apply prescribed cream once skin is dry.

It takes about 10 days for sores to appear after someone is exposed to group A strep. If an oral antibiotic is indicated for group A strep impetigo it is usually treated with Amoxicillin-Clavulanate (one of the antibiotics in the Jase case)

If an oral antibiotic is indicated for S. aureus impetigo, your care provider may prescribe doxycycline (one of the antibiotics in the Jase case) or another antibiotic if needed.

Complications of untreated impetigo

Rare complications include:

  • Kidney failure
  • Glomerulonephritis
  • Scarring

Prevention

  • Use a clean washcloth and towel each time you wash.
  • DO NOT share towels, clothing, brushes, and other personal care products with anyone.
  • Avoid touching sores that are oozing. If you do, immediately wash hands, wipe hands on towel and immediately put the towel in the washer or if using paper towels, discard in trash immediately.
  • Keep your skin clean to prevent getting the infection. Wash minor cuts and scrapes well with soap and clean water
  • Avoid using hot tubs or swimming pools to prevent spread of impetigo to other parts of the body

 

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3 Common Back to School Illnesses Part 1 of 2

Part 1

As summer winds down, children across the nation are returning to school. Whether in public school or homeschooled they will be exposed to more germs as they interact with their peers.

Children aren’t exempt from the annual onslaught of germs. Every year teachers and those who work with children end up with colds, flu and other common illnesses that the new school year brings.

Let’s take a look at 3 common back to school illnesses.

  1. Colds, flu and coronavirus

Colds, flu and coronavirus are all highly contagious and can be almost impossible to avoid. Luckily these illnesses are usually not life threatening and can be managed with symptomatic treatment.

If your child is in a high-risk category, be sure to contact your primary care provider for guidance and follow their recommendations on vaccination and other preventative measures.

To build up and help fight these viruses:

  • Get adequate sleep. Especially during the school year, a set schedule is very important. Sleep is where your body repairs and heals.
  • Avoid sugar. Sugar brings the immune system down.
  • Eat plenty of fresh or frozen vegetables and fruits. At least 4-6 servings a day.
  • Vigorously wash hands in soapy water for 30 seconds.
  • Sneeze and cough into crook of elbow, or tissue. Discard tissue and wash hands.
  • Fresh air and exercise outside, weather permitting. This helps build up the immune system.

Treatment

Many viruses run their course. They provide immunity in the form of antibodies to help combat further exposure to the virus.

To alleviate discomfort associated with viruses:

  • Try over the counter or prescription decongestants, expectorants, cough suppressants and pain relivers as recommended by your primary care provider.
  • Studies on honey as a cough suppressant have been encouraging. Honey with lemon or tea has been a time-honored treatment for sore throats and cough.
  • Diffusers with essential oils such as mint or eucalyptus can help breathing and congestion.
  • A cool mist humidifier can provide relief.
  • Be sure to stay hydrated, especially if running a fever.

2. Head lice (not an illness, however they are common and pesky!)

Head lice are tiny insects that feed on blood from the scalp. They cannot jump or fly and are passed from person to person via direct contact, either from close contact with someone who has lice or sharing combs, brushes, clothing (hats, hoodies, coats)

Identify: If there is an infestation, all household members need to be inspected for lice. Because adult and nymph lice are very small, move quickly, and avoid light, they may be difficult to find. Use of a fine-toothed louse comb may facilitate identification of live lice. Nits (nits are

the empty egg cases attached to hair that head lice hatch from)

Nits frequently are seen on hair behind the ears and near the back of the neck.

Many times, dirt, dust and dander can look like lice and can be misdiagnosed.

Treatment:

Whether using an over the counter or prescription medication to get rid of lice, there are a few very important steps you need to take. A breakdown of the different types of otc and prescription medications from the CDC website can be found here:

Prescription and otc lice treatment

  • Use a fine-tooth comb after applying medication to hair. This removes the dead lice and eggs. Be sure to put on clean clothing after treatment and wash the dirty clothing. Be sure not to use conditioner before applying the lice medication.
  • Do not wash hair for 1-2 days after treatment to assure the lice have been killed
  • While treating for lice, wash all bedding and clothing that may have contact with lice. Wash in hottest water possible and dry on high heat.
  • Vacuum furniture that may have come in contact with lice. Head lice survive less than 1–2 days if they fall off a person and cannot feed; nits cannot hatch and usually die within a week if they are not kept at the same temperature as that found close to the human scalp.
  • Wash combs, brushes, hair clips, etc in hot water for at least 30 minutes to avoid reinfection.
  • Depending on the treatment, you may have to retreat 7-9 days after initial treatment to avoid reinfestation.
  • Note, some anecdotal treatments, with essential oils and mayonnaise (believed to suffocate the lice) may have some effect on killing the lice, however, it is believed that much of the effectiveness of this method is the use of the fine comb, pulling the lice and eggs out of the hair.

When treating head lice

  • Do not treat with same medicine more than twice. If the treatment isn’t effective the lice may have built up a resistance to it.
  • Keep medicine out of the eyes
  • Avoid further skin exposure and able. After using, wash hair in sink, to avoid showering or bathing.
  • For more tips on how to mitigate and treat head lice, visit the CDC website.

3. Pink eye. AKA Conjuctivitis

This is a condition where the conjunctiva, the thin membrane lining the eyelid and eye, becomes infected or irritated. This in turn can leave the white part of the eye pink or red due to the infection or irritation. Eyes become watery, itchy, and discharge, especially upon awakening can appear.

There are three types of pink eye, viral, bacterial, and allergic. Symptoms and treatment vary depending on type of pinkeye.

Viral conjunctivitis

Viral pink eye is caused by a virus such as a cold or other respiratory virus. It starts in one eye and can easily travel to the other eye, and even to other people as it is highly contagious. Antihistamines, decongestants, and eye drops can help symptoms of this type of pink eye.

It usually resolves within 1-2 weeks without treatment.

Bacterial conjunctivitis

This type of pinkeye is caused by bacteria and is highly contagious, just like viral pink eye. There is more mucus and crusty, greenish-yellow discharge associated with bacterial pink eye. Eyelids can stick together from this discharge upon awakening. This type of pink eye needs to be treated with topical antibiotics or drops. It can cause damage to the eye if not treated.

Allergic conjunctivitis

Symptoms include itchy, puffy, watery eyes. As the name implies, this type of pink eye is caused by allergens, such as pollen, pet dander, and dust mites. This type of conjunctivitis is found in both eyes at the same time, and treatment is symptomatic. Antihistamines and eye drops along with avoiding the allergen if possible are among the most effective treatments. Running a hepa filter in the bedroom can help reduce allergens.

Symptomatic treatments of all forms of pink eye

To relieve the discomfort of pink eye

Green tea and tulsi tea bags, steeped and cooled and placed over the eyes can offer some anti-inflammatory and irritated eyes.  Colloidal silver, an antibacterial solution, applied to outside of eyelids when dealing with viral and bacterial forms of pinkeye can help avoid spread of pink eye. Do not replace this with care provided by your primary care provider, however.

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Education Series: Back To School

Bedtime Routine 

A consistent sleep schedule is essential for children to tackle their day-to-day tasks. With school starting, it has never been more important to cultivate good sleep habits.

The CDC recommends children ages 3-5 years get 10-13 hours of sleep a night, children ages 6-12 get 9-12 hours of sleep, and children ages 13-18 get 8-10 hours of sleep each night. Sleep is critical to help prevent attention or behavior problems, injuries, poor mental health, obesity and type 2 diabetes. 

Here are some tips for good sleep and a balanced bedtime routine:

  • Set wakeup and bedtimes at the same time (including weekends)
  • Remove electronic devices from bedrooms
  • Incorporate soothing activities like a warm bath, brushing teeth, and a bedtime story
  • Avoid caffeine and large meals before bed
  • Keep the bedroom quiet and at a comfortable temperature
  • Keep your routine short and sweet

Healthy Snack Ideas 

After a long day at school, kids come home ready to eat! Here are a few simple snack ideas that are healthy, quick, and fun:

  • Hummus and veggies
  • String cheese and pretzels
  • Fruit kabobs with dip
  • Apple nachos (slice apples, drizzle with peanut butter and sprinkle with chocolate chips)
  • Green smoothies
  • Trail Mix
  • Crackers with cheese slices
  • Popcorn trail mix (popcorn, chocolate chips and peanuts)
  • Cheese quesadillas

Safety First Mindset 

As children are preparing to return to school, parents prep them with the essentials-school supplies, backpacks, new shoes, and new clothes. But one important tool they may miss is a safety first mindset. To help with back to school preparations, here are a few simple safety tips:

  • When walking to school use crosswalks, a safe route to and from school, and have them travel in a group
  • Wear a helmet when riding bikes or scooters to and from school
  • Teach children where pickup and drop-off zones are located
  • Dress children in comfortable shoes and clothing for outdoor activities and recess
  • Teach children about the danger of strangers and what to do when approached by one
  • Invest in a good backpack with 2 workable straps

Yearly Influenza Vaccine 

Doctors recommend the yearly flu vaccine for children 6 months old and older. The most crucial time to receive the vaccine is by the end of October before the flu begins spreading in your community. Shared supplies, close contact, extended periods of time together, and limited hand washing make schools the perfect place to spread Influenza. This virus spreads easily and can cause serious illness for young children and people with chronic conditions like asthma and diabetes. There are many benefits to getting the flu vaccine every year – reducing the risk of contracting the flu, reducing the severity of illness in people who are vaccinated and getting sick, reducing the risk of hospitalization associated with the flu, and helping protect people who you associate with. 

Separation Anxiety 

The transition back to school after summer ends can be a stressful time for both kids and their parents. Here are some tips to help ease your child’s back to school anxiety:

  • Visit your child’s school before the school year starts. Rehearsing the drop-off and taking a look at the classroom (if the building is open) can help relieve stress for your child
  • Research shows that the presence of a familiar friend during back-to-school transitions can improve your child’s academic and emotional adjustment. Plan a playdate with a familiar peer before school starts
  • Plan a rewarding activity for your child that they could earn by separating from parents to attend school
  • Validate and acknowledge your child’s worry. Going back to school can be a stressful time! But, like any new activity, starting school can start off as hard but soon becomes enjoyable

Lunch Time Ideas 

Keeping meals exciting and nutritious for kids can be a challenge! Packing school lunches can make it an even harder task. A healthy lunch consists of five main components. Milk, fruit, vegetables, grain and protein. Here are a few of our favorite kid-friendly food blogs so you don’t have to hunt them down:

  • Weelicious Catherine is mom to 2 kids and studied at The Institute for Culinary Education in Manhattan. Her blog focuses on quick, easy, nutritious recipes that are made using fresh, but minimal ingredients. 
  • Simple Bites Aimée is a former chef-turned modern homesteader and mom to 3 kids, 2 cats and a handful of chickens. Recipes are easy to prepare and feature unprocessed, seasonal ingredients. 
  • Teach. Eat. Love.Written by Anne, the blog was created out of her need to find healthy recipes her daughter would eat during the dreaded picky stage. You’ll find allergy-friendly recipes, lunch box ideas – even meals inspired by literature! 

Setting Goals 

Working towards and achieving goals give your child important skills such as planning, putting in hard work and managing time. Helping your child set goals before the start of the school year is a great way for them to stay motivated and on track. Make sure the goals have a purpose. Having a specific goal with a clear purpose helps to motivate your child. Don’t be afraid to adjust the goal as needed. Perhaps discuss the difference between a short-term goal and a long-term goal. If your child wants to give up, you can remind them of their purpose and cheer them on! 

Homework Help 

Setting goals and expectations for homework assignments with your child before they go back to school is always important. Setting aside time in the evening to help your child with their homework assignments can create good study habits and with the help of an adult, can motivate them to stay up-to-date on tasks. Try making “homework time” enjoyable for your child. Motivate them with something they can earn, or reward them for completing their homework on time. 

Back to school can be a stressful time! Make sure you and your child are prepared before the school bell rings.

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