Back to school means back to the indoor breeding grounds for all sorts of malevolent bugs. Viruses, parasites, fungi and bacteria spread like wildfire in schools, latching onto carriers – namely, your kids – to ravage homes and workplaces.
Infections start to increase in September because "children are all back together again, in close proximity for long periods of time," says Donna Wiens, president of the Community and Hospital Infection Control Association of Canada. She adds that "schools often have pretty closed environments and some of them don't have the best ventilation."
A typical child gets six to 12 illnesses each year. Colds and flu are the most common illnesses, notes Ms. Wiens, but there are plenty of other highly contagious back-to-school bugs. Here's how to spot them.
Strep throat: A bacterial infection that causes inflammation and extreme soreness at the back of the throat. Students should stay away from school until it's treated, usually with antibiotics.
Impetigo (staph infection): A skin infection with symptoms including red bumps or blisters and possibly fever. Impetigo is spread through skin contact and treated with antibiotics.
Pinkeye (conjunctivitis): An infection of the eyelid lining that causes red, crusty and itchy eyes. Pinkeye with a white or yellow discharge is usually caused by bacteria and treated with antibiotics. (Viral conjunctivitis usually clears up on its own.)
Lice: An infestation of nits causing an itchy scalp. Children with lice can usually attend school if they are treated and avoid head-to-head contact as well as sharing personal items. Lice are removed using a nit comb and a shampoo containing 1-per-cent permethrin (insecticide).
Scabies: An infestation of mites that burrow into skin, causing rashes that usually appear between the fingers, in the groin area, between toes and around the wrists or elbows. Scabies can live off the skin for up to three days. To get rid of mites, everyone in the household should be treated with a prescription cream or lotion and all clothing should be washed in hot water and dried at high heat.
Pinworms: An intestinal parasite that causes intense itching in the anal area, especially at night. Pinworm eggs can live for up to two weeks on clothing, toilet seats and bedding. A doctor can diagnose pinworms and prescribe oral medication that can clear them up in about two weeks.
Ringworm: An infection caused by a fungus – not a worm – resulting in a rash that may be ring-shaped, itchy and flaky. Also known as "athlete's foot," ringworm proliferates on gym mats, shower and pool surfaces and is treated with oral or topical antifungal medication.
Hand, foot and mouth disease: An infection that causes fever and sores or blisters in the mouth, throat, hands or feet. Most people recover without treatment within 10 days, but patients may be contagious for weeks after symptoms are gone.
Gastroenteritis ("stomach flu"): An infection of the digestive tract accompanied by vomiting, diarrhea, fever and headache. (Gastroenteritis may be caused by bacteria and parasites as well as viruses). Most patients recover easily with rest and extra fluids.
Fifth disease: Also known as "slapped cheek syndrome," this illness often results in a bright red rash on the cheeks. There is no treatment and affected children may not feel sick, but the virus is most contagious several days before the rash. Pregnant women should consult a doctor after any exposure since the disease can cause miscarriage.
The following viral illnesses have become rarer in schools because of immunizations. But they may still affect an estimated 20 per cent of Canadian children whose vaccinations are not up to date, Ms. Wiens says.
Chickenpox: This illness begins with fever, followed by red spots that turn into fluid-filled blisters and then form scabs within four or five days. Acetaminophen may relieve fever but patients should not take aspirin as it increases the risk of getting Reye's syndrome, which can damage the liver and brain.
Mumps: A swelling of the salivary glands that may come with fever, headache and painful inflammation of the testicles, especially in teenaged males. There is no treatment, but acetaminophen, warm salt-water gargles and extra fluids can help relieve symptoms. As with chickenpox, taking aspirin increases the risk of getting Reye's syndrome.
Measles: An infection of the respiratory system, with symptoms including a cough, runny nose, red eyes and a fever that may reach 40 degrees Celsius, followed by a rash that starts on the head and may cover most of the body. Patients generally recover with rest but there is no specific treatment. Complications may include pneumonia, bronchitis and encephalitis (brain inflammation).
A prevention primer
Contagious illnesses in schools tend to spread through personal contact, shared items, contaminated surfaces or airborne droplets. Here's what you can do to help prevent school kids from going down for the count.
Teach hand hygiene. Proper hand hygiene can reduce school absences lasting four or more days by 66 per cent, according to a 2011 Danish study published in the American Journal of Infection Control. Kids in the three-month study were shown how to wash their hands thoroughly and given ethanol gel to disinfect hands three times each school day.
Show your child how to avoid spreading germs. Practice coughing or sneezing into an elbow instead of hands. Use tissue to blow and wipe noses, throw out the tissue and then wash hands. Discourage your child from sharing personal items such as makeup, hairbrushes, utensils, towels and clothing.
Boost the immune system. Help your child get at least an hour of physical activity each day, eat lots of fruit and vegetables, and sleep 10 to 11 hours each night.
Consult a doctor about whether your child should return to school. Household quarantine is the most effective way to control disease outbreaks, according to statistical models used in a 2011 study published in the journal BCM Infectious Diseases. Children can likely attend school if they have a slight cough, runny nose or mild sore throat. But in general, it's best to get a doctor's opinion.