Oct 7, 2013

Children's Health: Heads, Shoulders, Knees and Toes (and more...)


Yes, it's that time of year for parents. Now that the thrill of not having to entertain the children or pay for holiday care has worn off, the morning trip to school is getting darker, and we are entering the season of tummy bugs, flu and.... 'Head lice' - those two small words that get parents itching with frustration and real (or imagined) infestation. Head Lice are the scourge of the classroom in today's Western world, where, thankfully, infestation is a word rarely associated with humans. Sad but true, many an evening is taken up with treating, shampooing and combing, to the cries of 'Stop combing my ears!' and 'When will this be over?!' from the little darlings. So first, a few common myths to dispel:

1. Nits actually refer to the eggs, not the insects that lay them. Nits are pale and shaped a bit like a computer mouse - unlike the lice which are brown. They can be found 'glued' to the hair shaft, meaning they can only be removed using conditioner to loosen them, and a special, very fine-toothed comb. Empty egg shells may also be found. The lice themselves must be eradicated using a special over-the-counter solution, and fortunately, many of today's preparations don't contain traditional insecticides

2. Lice crawl rather than jump (unlike fleas) so they can only be caught from an infected head coming into contact with another - as when children (or adults) sit, play or sleep in close proximity

3. Bed sheets do not have to be washed: The lice in no way wish to leave their lovely, warm, well-stocked larder for your linen. Well, there's one thing off your minds...

Other health issues that get parents worrying at this time of year include winter vomiting illnesses such as the norovirus (short for 'Norwalk' - a place in Ohio, where a large outbreak occurred in a school during 1968). Norovirus is the most common stomach bug in the UK, affecting all ages. It is famous for its virulence and intensity of symptoms which can render hospitals to shut down wards in order to contain or fend off an outbreak. As well as person to person contact, the virus can also spread by aerosolisation and subsequent contamination of surfaces.

Key advice for children infected is to avoid dehydration by taking in plenty of fluids, and importantly, they should stay away from school for 24 hours after symptoms end. Unfortunately, as the Norovirus doesn't have a protective lipid (fat molecule) membrane, it is less susceptible to alcohol and detergent than bacteria, although chlorine-based disinfectants will render it inactive. Another major downside is that any immunity gained is usually temporary and incomplete after infection.

Flu or influenza is also something for parents to be prepared for. An annual flu vaccine for children is available on the NHS for all two and three year olds, which is given as a nasal spray, and is on offer from this autumn. In some parts of the country, primary school children between the ages of four and 11 will also be offered the vaccine, and over time, all children between two and 16 will be vaccinated each year against flu using the nasal spray.

Whilst the spectre of a global epidemic, such as the 1918 Spanish Flu (which infected a staggering 40% of the world's population, and killed around 50 million people) may seem far off, rest assured, pathologists and epidemiologists are kept very busy around the world by checking incidence and spread patterns: Flu epidemics could spread far and wide, as with Swine Flu in 2010, which was the first flu epidemic for 40 years. (NB Although the Swine Flu strain of the virus may have originated in pigs, it is now a wholly human disease.)

Verrucas are another 'stone in the shoe' of many parents: Warts that appear on the sole of the foot. All warts are caused by the HPV (Human Papilloma Virus) which causes an excess amount of keratin (a hard protein) to develop in the top layer of skin, forming a hard, rough, texture. Verrucas are more common in children and teenagers than adults, especially those who go swimming regularly. Wearing flip flops around the pool is advisable to prevent infection, as is the wearing of a protective sock if infected. Verrucas can also be treated using a solution containing active ingredients such as salicylic acid, and removal is advisable if they are painful, and to prevent them spreading. In fact, most warts are harmless and clear up without treatment, but it can take up to two years for the viral infection to leave the system, and for the wart to disappear.

Diseases aside, it's also worth noting figures from the Health & Social Care Information Centre which show that eye-examination rates among the under-15s have fallen to a 10-year low, with only 19% having their eyes checked. The figures also reveal that 14 per cent of eight-year-olds show signs of tooth decay.

The infographic at the top of this blog reflects what parents are really worried about: See the 'Top 10 Health Concerns' according to a publication last year by Jane M. Garbutt Randall Sterkel Shannon Gentry, Michael Wallendorf and Robert C. Strunk - 'What are parents worried about? Health problems and health concerns for children'. A total of 1,119 parents completed the survey. Social concerns were removed: We'll save those are for another blog...