What is pertussis?

What is pertussis?
Pertussis, or whooping cough, is a highly contagious respiratory infection caused by the bacteria Bordetella pertussis.

Who gets pertussis?

Pertussis can occur at any age. Although most of the reported cases occur in children under five years, the number of cases in adolescents and adults is increasing, probably due to waning of vaccine immunity. Adolescents and adults and those partially protected by the vaccine may have milder disease which is not diagnosed as pertussis. Pertussis is thought to account for up to 7% of cough illnesses per year in adults.

How is pertussis spread?

Pertussis is primarily spread by direct contact with the discharges from the nose and throat of infected individuals. Frequently, older siblings or other adult household members who may be harboring the bacteria in their nose and throat can bring the disease home and infect an infant in the household.

What are the symptoms of pertussis?

Pertussis begins as a mild upper respiratory infection. Initially, symptoms resemble those of a common cold, including sneezing, runny nose, low-grade fever and a mild cough. Within two weeks, the cough becomes more severe and is characterized by episodes of numerous rapid coughs followed by a crowing or high-pitched whoop. A thick, clear mucous may be discharged with the coughing. These episodes may recur for one to two months, and are more frequent at night. Young infants, adolescents, and adults do not have these typical coughing spells. Older people or partially immunized children may have milder symptoms.

How soon after infection do symptoms appear?

The incubation period is usually 7 to 10 days, with a range of 4 to 21 days.

When and for how long is a person able to spread pertussis?

A person can transmit pertussis from the onset of symptoms to three weeks after the onset of coughing episodes. The period of communicability can be reduced to five days after appropriate antibiotic therapy is begun.

Does past infection with pertussis make a person immune?

One attack usually confers immunity comparable to that provided by vaccine.

What are the complications associated with pertussis?

Young infants are at the greatest risk for complications. Serious complications of pertussis include pneumonia, seizures, encephalopathy (disorders of the brain), and death. Less serious complications include ear infections, loss of appetite, and dehydration.


*The child needs to complete 5 full days of antibiotic treatment before returning to school.

Thank you..

Nurse Donna

The Scoop on Step Throat

"It could be strep throat." Have you ever heard a doctor or your mom say that when you're sick and you have a sore throat? I think we all have at one time or another.

Strep throat is a disease caused by tiny egg-shaped bacteria (say: bak-teer-ee-uh) called Group A streptococci (say: strep-toe-kah-kye). These bacteria cause 15% to 20% of all sore throats and are found in your throat and on your skin.

If a child has strep throat, the doctor will probably give him or her medicine called antibiotics. These kill the strep bacteria. That's good news because sometimes strep throat can get worse and cause problems with other parts of a kid's body. In rare cases, untreated strep can cause arthritis (say: arth-rye-tus) or heart problems from a disease called rheumatic (say: roo-mah-tik) fever.

Most of the time children get the medicine they need and recover from strep throat very quickly. After taking the medicine for 24 hours, you will feel a lot better and will no longer be contagious. However, it is really important to take all 10 days of the medicine to make sure you have treated the infection.

How Do I Get It?

If someone in your family or at school has strep throat, there is a chance you may get it. Strep throat is spread when healthy people come into contact with people who have it. When a person with strep throat sneezes or blows his or her nose and you are close by, or if you share the same forks, spoons, or straws, the bacteria can spread to you.

If you get strep throat, you will start to feel sick within 5 days after you have been around the person who gave it to you.

What Will the Doctor Do?

Your doctor will look into your mouth to see if your throat is red and your tonsils are swollen and covered with white or yellow spots. He or she will also look for small red spots on the roof of your mouth. Most of the time, strep will give you a sore throat, headache, stomach ache, and fever. Typically strep will not give you a runny nose or cough, and occasionally it won't give you any specific symptoms.

To prove that what you have is strep throat, your doctor may do one or two tests. First he or she can do a rapid strep test to check for strep bacteria. He or she will rub a cotton swab over the back of your throat. With this test, the doctor may be able to find out in less than 1 hour if you have strep throat.

If the first test doesn't prove anything, then your doctor may do a longer test called a throat culture. A swab from your throat will then be rubbed on a special dish and the dish will be left to sit for two nights. If you have strep throat, streptococci bacteria will usually grow in the dish within the next 1 to 2 days.

How Can I Get Better?

If you have strep throat, your doctor will give you an antibiotic (say: an-tye-bye-ah-tik), a medicine that kills bacteria. Usually the antibiotic used for strep throat is a form of penicillin (say: peh-nuh-sih-lun). You will take penicillin as a pill, a liquid, or a shot.

To make sure the bacteria go away completely and don't spread to other parts of your body, you must finish all of the medicine. Your doctor will have you take the pills or liquid for about a week.
Your mom or dad may give you acetaminophen (say: uh-see-tuh-mih-nuh-fun) to get rid of aches, pains, and fever. You'll want to have soothing drinks, like tea and warm chicken soup. It's best to avoid spicy and acidic foods, such as orange juice, because they could irritate your tender throat.

Your doctor will tell you to stay home from school until you have been taking the antibiotic for at least 24 hours. This way, you won't spread the bacteria to others.

How Can I Prevent Strep Throat?

If someone in your house has strep throat, you might get it. But you can take these steps to prevent it:

* Make sure the person with strep throat covers his or her mouth when sneezing and coughing.
* Don't handle used tissues or other germy items.
* Wash your hands regularly, especially before cooking and eating.
* Wash dishes, drinking glasses, knives, forks, and spoons in hot, soapy water.
* Keep sores and cuts clean because strep can get in there and cause problems, too.
* Strep throat is no fun, but after feeling sick for 2 or 3 days, most kids start feeling better. In other words, they feel less streppy and more peppy!

Nurse Donna

Hello Parents....

Someone sent a comment over the weekend in which they shared a website with us that our younger children might find of interest. If it prevents the kids from passing thier germs from child to child it may be worth our taking a moment to check it out.

Thank you Maggie Brown.

http://www.germywormy.com/

Nurse Donna

The Importance of Establishing a Bedtime Routine

With more and more activities competing for your child’s waking hours, it is not surprising to hear that most kids are sleep deprived. A recent estimated that 62 percent of kids ages 9-13 do not get enough sleep and 70 percent wish that they could get more sleep. Of those children who are sleep-deficient, most required an additional hour or more of sleep per night to meet the recommended amount for children their age.

Experts recommend that school-age children receive 9.5 to 10.5 hours of sleep each night.What can parents do to make a difference in their child’s sleep habits? There is strong evidence in support of establishing a bedtime routine. Kids who reported having a bedtime routine were:

•more likely to get the recommended amount of sleep.
•less likely to be tired at school.
•less likely to wish for “much more sleep” than they usually get.

Part of establishing a bedtime routine is setting a time for your child to go to bed. Take the lead in setting your child’s bedtime: Children who reported that their parent “decides what time to go to bed” were more likely to get an adequate amount of sleep. In fact, they averaged 45 minutes more sleep nightly than children who chose their own bedtime.“One of the most troubling things in recurrent sleep deprivation is the effect on the immune status,” explains Kate Cronan, M.D., pediatrician and medical editor for KidsHealth. “One or two nights of poor sleep is not the issue— it is those children who repeatedly receive too little sleep.

What many parents do not realize is that without proper sleep, kids’ bodies are not able to fight infection as effectively. In addition to forsaking their physical health, sleep deprivation can also affect their outlook on life. “A tired adult understands why they may have a tough day when they are sleepy— and they soldier on,” she continues. “We cannot expect the same from our children. Parents need to help their children get the proper amount of sleep. In the end, it really will make a huge difference for the whole family.”

Tips for Establishing a Bedtime Routine:

Is it too late to start a bedtime routine if my child is elementary age? Not at all. KidsHealth.org, the most-visited Web site about children’s health, shares simple tips for establishing (or re-establishing) a bedtime routine with your child.

•Bedtime: Set a bedtime for school nights and stick to it.
•Prioritize: Make sure homework (or any other task your child needs to finish for the next day) gets done first to ensure your child can get to bed on time.
•Wrap it up: Thirty minutes before bedtime, encourage your child to finish any projects or activities, and begin the bedtime routine (wash face and hands, brush teeth, etc.).
•Unwind: Include activities in the routine that will help your child slow down and relax (like taking a shower or reading a book).
•Time together: Spend a few minutes recapping the day together. Not only is this a great chance to catch up with your child, but your voice and presence will help your child to relax.
•Good night: Say good night and remind your child to stay quiet and in bed.


Nurse Donna

* For more information about KidsHealth, please visit www.KidsHealth.org.

Fifth Disease IS Common in Children

Especially common in kids between the ages of 5 and 15, fifth disease typically produces a distinctive red rash on the face that makes the child appear to have a "slapped cheek." The rash then spreads to the trunk, arms, and legs. Fifth disease is actually just a viral illness that most kids recover from quickly and without complications.

Fifth disease (also called erythema infectiosum) is caused by parvovirus B19. A human virus, parvovirus B19 is not the same parvovirus that veterinarians may be concerned about in pets, especially dogs, and it cannot be passed from humans to animals or vice versa.

Studies show that although 40% to 60% of adults worldwide have laboratory evidence of a past parvovirus B19 infection, most of these adults can't remember having had symptoms of fifth disease. This leads medical experts to believe that most people with a B19 infection have either very mild symptoms or no symptoms at all.

Fifth disease occurs everywhere in the world. Outbreaks of parvovirus tend to happen in the late winter and early spring, but there may also be sporadic cases of the disease any time throughout the year.

Signs and Symptoms
Fifth disease begins with a low-grade fever, headache, and mild cold-like symptoms (a stuffy or runny nose). These symptoms pass, and the illness seems to be gone until a rash appears a few days later. The bright red rash typically begins on the face. Several days later, the rash spreads and red blotches (usually lighter in color) extend down to the trunk, arms, and legs. The rash usually spares the palms of the hands and soles of the feet. As the centers of the blotches begin to clear, the rash takes on a lacy net-like appearance. Kids younger than 10 years old are most likely to get the rash.

Older kids and adults sometimes complain that the rash itches, but most children with a rash caused by fifth disease do not look sick and no longer have fever. It may take 1 to 3 weeks for the rash to completely clear, and during that time it may seem to worsen until it finally fades away entirely.

Certain stimuli (including sunlight, heat, exercise, and stress) may reactivate the rash until it completely fades. Other symptoms that sometimes occur with fifth disease include swollen glands, red eyes, sore throat, diarrhea, and rarely, rashes that look like blisters or bruises.

In some cases, especially in adults and older teens, an attack of fifth disease may be followed by joint swelling or pain, often in the hands, wrists, knees, or ankles.

Contagiousness
A person with parvovirus infection is most contagious before the rash appears — either during the incubation period (the time between infection and the onset of symptoms) or during the time when he or she has only mild respiratory symptoms. Because the rash of fifth disease is due to an immune reaction (a defense response launched by the body against foreign substances like viruses) that occurs after the infection has passed, a child is usually not contagious once the rash appears.

Parvovirus B19 spreads easily from person to person in fluids from the nose, mouth, and throat of someone with the infection, especially through large droplets from coughs and sneezes.

In households where a child has fifth disease, another family member who hasn't previously had parvovirus B19 has about a 50% chance of also getting the infection. Children with fifth disease may attend childcare or school, since they are no longer contagious. Once infected with parvovirus B19, a person develops immunity to it and won't usually become infected again.

Parvovirus B19 infection during pregnancy may cause problems for the fetus. Some fetuses may develop severe anemia if the mother is infected while pregnant — especially if the infection occurs during the first half of the pregnancy. In some cases, this anemia is so severe that the fetus doesn't survive. Fortunately, about half of all pregnant women are immune from having had a previous infection with parvovirus. Serious problems occur in less than 5% of women who become infected during pregnancy.

Prevention
There is no vaccine for fifth disease, and no real way to prevent spreading the virus. Isolating someone with a fifth disease rash won't prevent spread of the infection because the person usually isn't contagious by that time.

Practicing good hygiene, especially frequent hand washing, is always a good idea since it can help prevent the spread of many infections.

Incubation
The incubation period (the time between infection and the onset of symptoms) for fifth disease ranges from 4 to 28 days, with the average being 16 to 17 days.

Duration
The rash of fifth disease usually lasts 1 to 3 weeks. In a few cases in older kids and adults, joint swelling and pain because of fifth disease have lasted from a few months up to a few years.

Diagnosis
Doctors can usually diagnose fifth disease by the distinctive rash on the face and body. If a child or adult has no telltale rash but has been sick for a while, a doctor may perform blood tests to see if the illness could be caused by parvovirus B19.

Treatment
Fifth disease is caused by a virus, and it cannot be treated with antibiotics used to treat bacterial infections. Although antiviral medicines do exist, there are currently none available that will treat fifth disease. In most cases, this is such a mild illness that no medicine is necessary.

Usually, kids with fifth disease feel fairly well and need little home treatment other than rest. After the fever and mild cold symptoms have passed, there may be little to treat except any discomfort from the rash itself. If your child has itching from the rash of fifth disease, ask the doctor for advice about relieving discomfort. The doctor may also recommend acetaminophen for fever or joint pain.

Complications
The majority of kids with fifth disease recover with no complications. By the time the rash appears and while it's present, they usually feel well and are back to their normal activities.

However, some children with weakened immune systems (such as those with AIDS or leukemia) or with certain blood disorders (like sickle cell anemia or hemolytic anemia) may become significantly ill when infected with parvovirus B19. Parvovirus B19 can temporarily slow down or stop the body's production of the oxygen-carrying red blood cells (RBCs), causing anemia.

When a child is healthy, this slowdown of red blood cell production usually goes unnoticed because it doesn't affect overall health. But some kids who are already anemic can become sick if their RBC production is further affected by the virus. The RBC levels may drop dangerously low, affecting the supply of oxygen to the body's tissues.

When to Call the Doctor
Call the doctor if your child develops a rash, especially if the rash is widespread over the body or accompanied by other symptoms.

If you're pregnant and develop a rash or if you've been exposed to someone with fifth disease (or to anyone with an unusual rash), call your obstetrician.


Nurse Donna

Winter Safety Tips..

Sled Safely

Sledding is a great way to have fun in the snow, but being careful is essential. According to the Consumer Products Safety Commission, approximately 46,000 sledding injuries are seen in hospital emergency rooms every year. Most are children under the age of 15 with head injuries

1. Choose a hill for your children to sled on that is away from trees, rocks and other obstacles.
2. Make sure there is no street traffic or frozen water anywhere near the bottom of the sledding hill - a sled may not always come to a stop exactly where you want it to.
3. Check your child's sled to make sure it is in good condition with secure handholds and steering that works.
4. Tell your child to never ride on a sled that is being pulled by a car or snowmobile.
5. Remind your child to always sled while sitting up with his feet forward. Lying on a sled increases the chance of head injuries.
6. Have your child wear a helmet while sledding.

Prevent Winter Sports Injuries

Children should wear helmets and eye protection while skiing, snowboarding and snowmobiling.

1. Make sure your child's helmet is specifically designed for the activity he is participating in.Helmets should be well-fitted to prevent shifting or jostling of the helmet.
2. Make sure children know to stay on marked trails while skiing, snowboarding or snowmobiling.
3. Child According to recommendations from the American Pediatric Association, children under 16 years old should never operate snowmobiles. Children younger than 5 should never ride on a snowmobile, even with an adult.
4.Keep Free from Frostbite and Hypothermia
5. Children are more susceptible to frostbite and hypothermia than adults. Be aware of the symptoms and know how to treat your child if either occurs.
6. Frostbite is when soft tissue, usually in fingers or toes, freezes. There are several stages of frostbite. If severe enough, frostbite can require amputation, but most often no permanent damage will occur if skin is warmed up carefully.

Symptoms:
� Numbness
� Blisters
� Soft or frozen doughy feeling to exposed skin
� Tingling and burning of frostbitten area upon re-warming
� Aching or throbbing pain upon re-warming
� Redness, swelling upon re-warming
� Blackness

What to do: If a child complains of numbness or pain in her fingers, toes, nose, cheeks or ears while playing outdoors, check to see if her skin is blistered, hard to the touch, or glossy. If so:
� Have her come inside immediately.
� Have the child move the numb part of her body to increase blood supply.
� Do not rub the skin to warm it up, as this can cause tissue damage.
� Immerse the frozen skin in warm water. (Make sure the water is warm but never hot so the tissue isn't further damaged.
� Get medical help if the area stays numb after warming.

Hypothermia occurs when too much heat escapes from the body and body temperature drops lower than its normal 98.6 degrees F to 95 degrees F or lower. While severe hypothermia can cause internal organ damage or lead to death, it is generally not something to be concerned about unless a person is trapped outdoors or in cold water for an extended period of time without proper protection.

Symptoms:
� Shivering
� Numbness
� Muscle weakness
� Drowsiness
� Incoherence
� Lowered body temperature
� Slow pulse

What to do:

� Call 911 for help.
� Bring your child to a warm place.
� Wrap your child in blankets to retain body heat.
� Don't expose your child to any direct heat sources like hot water bottles, heating pads, radiators or fireplaces.

Why Winter Safety is Important
Winter can be a fun season for children, but hospital emergency rooms and their doctors see too many children with head injuries, broken bones and other serious winter injuries.

According to the National SAFE KIDS Campaign, in 2007 there were:
17,000 estimated injuries among children from skiing and snowboarding
24,500 estimated injuries from sledding
1,500 estimated injuries from snowmobiles and equipment
According to the U.S. Consumer Product Safety Commission:
Each year there are approximately 5,740 emergency room visits due to snow thrower-related injuries. Don't let your child be a statistic. Avoid visits to your local emergency room by helping your child stay safe while having fun during.

Please keep in mind that the text provided is for informational purposes only and is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health professional before starting any new treatment or making any changes to existing treatment.

Nurse Donna

Congratulations Nathaniel.

Nathaniel Brantley now sees a much more colorful world, thanks to groundbreaking eye surgery that literally changed the 7-year-old's sight from black and white to color. (See story by clicking on the link below)
http://abclocal.go.com/kgo/story?section=news/health&id=6523160


Nurse Donna