RSV infection

RSV infection

Overview The respiratory syncytial virus, commonly known as RSV, can cause lung infections. These infections are usually mild in healthy adults but can be serious in infants, young children or in people with weak immune systems.
What is going on in the body?

RSV can cause infections in the nose, throat, windpipe, smaller airways called bronchioles, and the lungs. RSV infection typically causes mild, common cold-like symptoms in adults and older children. In infants younger than 1 year, RSV can cause pneumonia or a lower airway infection called bronchiolitis. RSV can also cause pneumonia in people with weak immune systems, such as those receiving chemotherapy for cancer.
What are the signs and symptoms of the infection? The most common symptoms of RSV are those of the common cold:
1- runny nose
2- mild fever
3- sore throat
4- cough These are often the only symptoms in healthy adults and children older than 1 year. In the very young, the very old, people with chronic disease, and individuals with weak immune systems, symptoms can include:
5- difficulty breathing. In infants, this can often be recognized by fast breathing or wheezing, an abnormal sound made while breathing out. Abnormal chest movements during breathing or labored breathing are other clues. In serious cases, an infant may stop breathing, a condition known as apnea.
1- severe coughing
2- irritability
3- poor feeding
4- vomiting
5- redness of the eyes due to inflammation known as conjunctivitis
6- ear pain. An infant may be fussy or tug or pull on his or her ear to show ear pain.
7- cyanosis, a bluish tint to the skin, which occurs only in very severe cases
What are the causes and risks of the infection?

RSV is highly contagious and is spread from person to person. RSV is spread through contact with infected secretions from the eyes, nose, and mouth. These secretions are usually spread to the hands and then to objects that the contaminated hands touch. When a person touches these objects, he or she may acquire the infection. Children younger than 1 year are not only more susceptible to the virus, but are also more likely to be exposed because they often place objects in their mouths. Premature infants are at especially high risk. Children in day care centers are at a higher risk of infection than other children. RSV tends to occur in large outbreaks between late fall and early spring, with most cases in the winter. If infected, those at high risk of complications include:
1- premature infants
2- children with serious heart disorders such as congenital heart disease
3- children with lung problems, such as cystic fibrosis, an inherited disorder causing the secretion of thick mucus in the airways
4- anyone with a weak immune system, or immunodeficiency disorder
5- elderly individuals
6- adults with chronic lung problems, such as a chronic lung disorder called emphysema
What can be done to prevent the infection?

Though it makes sense to keep infants away from those with respiratory symptoms, there is no practical way to prevent most cases of RSV. Frequent hand washing, especially by staff of newborn nurseries and day care centers, may help prevent some cases. Children who have chronic disease, immune disorders, or a history of prematurity may have a monthly shot of palivizumab (i.e., Synagis) during RSV season to help prevent serious infection. This medication is made up of proteins that can prevent infection for a limited period of time. It is used only in children who are at high risk of having severe problems if they do get infected with RSV..
How is the infection diagnosed?

Diagnosis starts with the history and physical exam. This may be all that is needed to make the diagnosis if the child has typical symptoms, is younger than 1 year, if it is winter, and if there is a current outbreak of RSV in the community. A chest X-ray may help with the diagnosis and rule out other causes for the symptoms. If needed, a special test called an immune assay can be done on nose or lung secretions to detect RSV. This is commonly done when children are admitted to a hospital so that outbreaks within the hospital can be limited.

What are the long-term effects of the infection?

RSV accounts for as many as 125,000 hospitalizations of children under the age of one every year. Up to 2% of these children may die from the infection or its complications. If a person requires a ventilator to help with breathing, the severe infection as well as the ventilator can cause permanent damage to the lungs. Most people, however, recover completely from RSV and have no long-term effects. Children who develop breathing problems because of RSV may have a slightly increased likelihood of developing asthma later in life.
What are the risks to others?

RSV is highly contagious. When an outbreak of RSV occurs, up to 50% of the infants in a community may be affected.
What are the treatments for the infection?

Adults and older children with RSV usually do not need treatment. Over-the-counter medications to relieve symptoms can be used as needed. Infants with RSV or those with weak immune systems may be admitted to the hospital for monitoring and treatment. Treatment for RSV often involves the use of humidified or moistened oxygen. Special medications, such as albuterol, can be mixed with the oxygen to help open the airways. Fluids can be given through an intravenous line (IV), a thin tube connected to a vein in the arm. In severe cases, an antiviral agent known as ribavarin (i.e., Copegus, Rebetol, Ribasphere) may be given. In rare cases, a person may need to be connected to a ventilator.
What are the side effects of the treatments? Most treatments for RSV have few side effects. Ribavarin is not given routinely for RSV infections, because it is often ineffective and sometimes makes breathing worse. Rarely, an infant can contract a new infection or suffer lung damage from a ventilator.
What happens after treatment for the infection?

Most people recover completely and return to normal activities as soon as they feel able. A person may still have the virus in his or her secretions for 1-2 weeks after symptoms go away. This is important to remember in terms of spreading the infection. Children in day care may be asked to stay home for a few days to prevent an outbreak.
How is the infection monitored?

Those with severe breathing difficulty need close monitoring in a hospital until the condition improves. For those at home with RSV, any new or worsening symptoms should be reported immediately to the healthcare provider.

jaundice

Jaundice

Jaundice is a yellowish discoloration of the eyes and skin.
What is going on in the body?

Jaundice is a condition caused by too much bilirubin in the blood. Bilirubin is a yellowish-orange breakdown product of red blood cells. It is removed from the blood by the liver. Bilirubin is then processed by the liver, passed into the bile, and excreted into the stool. If bilirubin is not excreted, it builds up in the blood. Eventually, the bilirubin can get deposited into the surface of the body. This can cause a yellowish tint to the skin, eyes and lining inside the mouth.
What are the signs and symptoms of the condition? Jaundice is considered a sign of disease that has affected the level of bilirubin in the body. Those with jaundice may have no other symptoms. Other symptoms may occur, depending on the cause, including:

1- nausea and decreased appetite

2- vomiting

3- fever

4- weight loss

5- itching

6- dark urine

7- clay-colored stool

8- abdominal pain
What are the causes and risks of the condition?

Jaundice can be caused by:

1- immaturity of the liver, which happens in a large number of newborn infants. This is usually normal, goes away on its own, and results in no problems. It is more common when babies are born early, or premature.

2- liver disease, such as liver infection, damage from alcohol or other toxins or drugs, or cancer.

3- obstruction of bile flow, which may be caused by certain drugs, gallstones, or cancer.

4- destruction of a large number of red blood cells, which may occur due to inherited defects in red blood cells, medications, or infections.

5- inherited disorders that affect metabolism.
What can be done to prevent the condition?

In adults, two of the most common causes of jaundice are viral liver infection known as hepatitis, and alcohol. Alcohol does not cause this condition unless it is abused. A hepatitis B vaccine is available and can prevent some cases of viral hepatitis. Many cases of jaundice cannot be prevented.
How is the condition diagnosed?

The affected person as well as the healthcare provider usually notice jaundice. Further tests are usually done to determine the cause of the jaundice. These commonly include urine, blood, and x-ray tests.
What are the long-term effects of the condition?

Jaundice itself doesn't have any long-term effects. It is a description of the yellowish tint that occurs. However, the underlying cause of the jaundice may have severe long-term effects, including liver failure and death. Babies with jaundice may rarely develop brain damage if the level of bilirubin gets too high.
What are the risks to others? Jaundice itself is not contagious and poses no risks to others. If viral hepatitis is the cause of the jaundice, it may or may not be contagious. The forms of hepatitis that are contagious are usually spread by sexual contact or sharing of needles, such as by intravenous drug users.
What are the treatments for the condition?

Most cases of jaundice in a newborn do not need treatment. If newborn babies develop severe jaundice, they may be put under special lights that cause a chemical change in bilirubin. This change allows the bilirubin to be excreted by the body. For extremely high levels of bilirubin, babies may need special blood transfusions that trade normal blood for their high-bilirubin blood. Treatment for other types of jaundice depends on the cause. Medications, such as antibiotics, or surgery may be needed in some cases.
What are the side effects of the treatments?

The lights used to treat babies with jaundice may cause diarrhea, rash, overheating, and dehydration. If a transfusion is needed, infection may occur. All medications have potential side effects. These may include allergic reactions, stomach upset, and others. Specific side effects depend on the drugs used. Surgery carries a risk of bleeding, infection, and reactions to the pain medicines used.
What happens after treatment for the condition?

This depends on the underlying cause. The underlying cause may be treated or resolve on its own, causing the jaundice to go away. In this setting, no further treatment may be required and people can usually return to normal activities. In other cases, the underlying condition cannot be fixed. This is common with severe, permanent liver damage or cancer. In this case, treatment does not usually end.
How is the condition monitored?

This also depends on the underlying cause. Both the affected person and the healthcare provider can monitor the jaundice itself. Repeated blood tests can monitor the bilirubin level, liver function, and other factors. More specific monitoring depends on the underlying cause.

Kaposi's sarcoma

Kaposi's sarcoma

Overview Kaposi's sarcoma is a specific type of cancer that involves the vascular tissues of the skin or other organs and tissues.
What is going on in the body?
Kaposi's sarcoma, or KS, usually begins in certain vascular tissue. Blotches may be visible on the skin or in the skin cells of the mouth. These cells undergo cancerous changes and begin to grow uncontrollably. For people with intact immune systems, the cancer grows slowly, if at all, and rarely spreads. The disease becomes very aggressive if the person has an impaired immune system. Human immunodeficiency virus (HIV) infections and drugs given after organ transplant suppress the immune system. Until AIDS became widespread, KS was rarely seen. KS is common in people with AIDS.
What are the signs and symptoms of the disease?
A person usually will find an abnormal thickened purplish growth on the skin or on the mucous membranes inside the mouth. Any area of the skin can be affected. The growth may not cause any pain or discomfort. Inside the mouth or throat, it may be large enough to interfere with swallowing or breathing. Kaposi's sarcoma may also involve the gastrointestinal and respiratory systems.
What are the causes and risks of the disease? People with HIV infection are at very high risk for KS. After organ transplant, people are given powerful drugs to prevent rejection of the new organ. Those people are also at risk. KS is otherwise very rare, but may be seen in a lesser form in elderly men of Mediterranean origin.
What can be done to prevent the disease?
In an individual with HIV infection, it is possible to test for HHV-8, and if positive, to treat with antiviral medications specific for HHV-8. It is important to identify KS early in HIV-positive persons. This means skin areas and mouth should be regularly inspected by the person at risk and by a healthcare professional to find the lesions while they are still small. KS has been less prevalent since HAART (highly active antiretroviral therapy) has been used to treat people with AIDS.
How is the disease diagnosed?
If cancer is suspected, it must be confirmed by examining the abnormal tissue in the pathology laboratory. This can mean removing a piece of the tissue with a biopsy. Sometimes the whole tumor is removed, which is known as a resection. Additional studies such as specialized X-rays and blood tests may be performed to measure the extent of the disease, which is known as staging the disease.

What are the long-term effects of the disease?

If cancer is not successfully treated, it will spread in people with compromised immune systems. The spread of the cancer can destroy tissue around and press on other structures. If the cancer spreads to organs like the lungs, it will cause death.
What are the risks to others?

HHV-8 is a transmissible infection, though the means of transmission are still being studied. Sexual transmission is believed to occur. Therefore, as with other sexually transmitted infections, safer sex practices can reduce, but not eliminate, the risk of acquiring HHV-8.
What are the treatments for the disease?

Treatment for KS may involve chemotherapy (doxorubicin, daunorubicin, paclitaxel, vinorelbine), radiation, or immunotherapy. Aliretinoin topical gel may be used, or vinblastine injected into the KS lesions. Angiogenesis inhibitors may be used. Other local treatments involve laser therapy or cryotherapy. Occasionally, a combination of treatments is used. Effectively treating underlying AIDS, if present, is also important. As the AIDS is treated, the KS lesions usually regress with decreased risk of new KS lesions. The goal may be to control the cancer and reduce pressure from the tumor on other structures. New therapeutic regimens are being studied. However, KS is not likely to be cured.
What are the side effects of the treatments? The side effects of treatment depend on the specific therapy. Generally, treatment is designed to control the cancer and relieve symptoms. If the person with KS also has other medical conditions such as AIDS or has undergone organ transplant, those conditions may affect the person's well-being. Every effort is made to minimize side effects and maintain quality of life.
What happens after treatment for the disease?

The person will be monitored closely for recurrence and progression.
How is the disease monitored?

The lesion will be observed for changes. All other skin areas will also be observed because new KS lesions can develop. If organs such as the lungs are involved then X-rays will be used to follow the person's progress. The frequency will depend on the person's condition and the extent of the cancer.

arthritis

Arthritis

Arthritis refers to inflammation of a joint. The inflammation may cause pain, swelling, stiffness, and damage.

Symptoms vary according to the type of arthritis and how severe it is. However, common symptoms include the following:
1- difficulty with weight-bearing activities, such as walking, bending, and moving
2- joint deformity
3- joint pain and swelling
4- joint stiffness, especially in the early morning
5- limping or making other adjustments to protect the affected joint
6- warmth or redness in a joint
7- weakness of the joint

There are many types of arthritis, with a host of different causes, such as:
1- ankylosing spondylitis, which affects the spine and other joints
2- arthritis caused by mechanical problems, such as a bone fracture or dislocation
3- gout, caused by an accumulation of uric acid crystals in the joint
4- infectious arthritis, caused by infections such as Staphylococcus, Streptococcus,Lyme disease or gonorrhea
5- osteoarthritis, a degenerative process also known as wear-and-tear or degenerative arthritis
6- pseudogout, caused by an accumulation of calcium pyrophosphate crystals in the joint
7- psoriatic arthritis, an autoimmune disorder that is related to and often accompanies a skin condition of the same cause called psoriasis
8- reactive arthritis, which may develop after an infection of the urinary tract, bowel, or other organs
9- rheumatoid arthritis (RA), an autoimmune disorder in which the body makes antibodies to its own tissues
10- lupus, an autoimmune disorder which often includes arthritis and rash and may include heart, lung, kidney, and brain involvement
Some of the risk factors for arthritis are as follows:
11- aging changes in the bones and joints
12- bodywide infections that affect the joints
13- diabetes
14- genetic or hereditary tendency to arthritis
15- immunodeficiency disorders, such as HIV
16- injury to the joints
17- menopause, which increases a woman's risk for osteoarthritis
18- overweight or obesity• smoking, which doubles a woman's risk for RA


Reducing repetitive strain on muscles and joints may help prevent arthritis. Be on the lookout for any chronic aches and strains caused by work, hobby, or recreation-related activities. For example, if you think your work is causing joint symptoms, you may want to see about changing tasks or modifying your workstation. Regular exercise that does not abuse your joints may prevent arthritis as it creates healthier and more flexible joints.The exercise doesn't have to be strenuous. Just, just regular. And, being evaluated for sprained joints is recommended. For example, a severe ankle sprain that is not properly splinted may lead to osteoarthritis. Being overweight or obese increases your risk for osteoarthritis, particularly in the weight-bearing joints. Maintaining a normal weight may be one of the most important arthritis preventatives. Overweight and obese individuals are at far greater risk for osteoarthritis, particularly in the weight-bearing joints. Losing weight, or maintaining a normal weight, cuts your risk for arthritis. Some infections, left untreated, may lead to infectious arthritis. Early treatment of RA may prevent worsening of the disease.

Diagnosis of arthritis starts with a medical history and physical examination. Joint X-rays may be normal at first, perhaps showing some swelling. Later the X-rays may show narrowing of the joint space, roughness of the joint surface, or poor alignment of the joint. Bone spurs, which are calcium deposits at the edge of the joint, may also be seen. Blood tests, including a complete blood count, or CBC, rheumatoid factor, and antinuclear antibody can help detect some types of arthritis. Joint aspiration, which means removing joint fluid with a needle under local anesthesia, can sometimes provide useful information. Rarely, a magnetic resonance imaging, or MRI, is needed to determine the cause or extent of the arthritis.

If the arthritis progresses, joint function may keep declining. The person will have more joint pain, stiffness, and swelling. The amount and rate of decline depend on the type of arthritis and how well the available treatments work.


What are the treatments for the condition?
Treatment varies depending on the type of arthritis, the severity of symptoms, and the degree to which the condition has progressed. The age, general health, and activity level of the person also are factors to consider. Education about the disease can help bring about improved daily self-management and coping skills. Nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen (i.e., Advil, Motrin) naproxen (i.e., Aleve, Anaprox, Naprosyn) and aspirin, are often used to treat early symptoms of arthritis. NSAIDs come in over-the-counter and prescription varieties. In addition, some patients find acetaminophen (i.e., Tylenol) to be helpful. Two prescription COX-2 specific inhibitors, rofecoxib (Vioxx) and valdecoxib ( Bextra), were withdrawn from the U.S market because they may increase the risk of serious and potentially fatal cardiovascular events in some patients. One COX-2 specific inhibitor, Celecoxib (i.e., Celebrex), remains on the market. At the present time, all NSAIDs carry a black box warning about the possibility of increased cardiovascular risks. For some forms of arthritis, corticosteroids such as prednisone can work very well. Corticosteroids can be taken by mouth or injected into the joint. Depression and sleep disorders may be treated with low doses of antidepressant medicines, such as amitriptyline (i.e., Elavil). A wide variety of medicines are used to treat RA:
1- antibiotics, such as doxycycline (i.e., Adoxa, Doryx, Oracea, Periostat, Vibramycin) and minocycline (i.e., Minocin, Solodyn)
2- non-steroidal anti-inflammatories (NSAIDs) or acetaminophen (i.e., Tylenol)
3- corticosteroids, such as prednisone
4- the COX-2 specific inhibitor Celecoxib (i.e., Celebrex)
5- disease-modifying medicines may slow down the progression of the disease. The fastest acting, best tolerated and most commonly prescribed DMARD is methotrexate (MTX). Although often used alone, many studies have shown that the outcome of two or three of these medications used in combination, is more effective at managing the disease.
6- Other DMARDs used on their own or in combination with MTX, include hydroxychloroquine (i.e., Plaquenil), sulfasalazine (i.e., Azulfidine), azathioprine (i.e., Imuran), and leflunomide (i.e., Arava).
7- Older DMARDs, such as gold therapy (Myochrisine) and D-penicillamine are virtually never used anymore.
8- another option for treating RA is a class of drugs called biological response modifiers (BRMs), or biologics. In people with RA, proteins called Tumor Necrosis Factor (TNF) and Interleukin-1 (IL-1) are present in the blood and joints in excessive amounts where they increase inflammation (pain, swelling, and stiffness).
9- Biologics are specially engineered medications which block the effects of TNF or IL-1 and are used to treat moderate to severe RA. These medications work quickly to ease inflammation and are often used in combination with other DMARDs such as methotrexate.
10- BMRs in the U.S. include infliximab (i.e., Remicade), etanercept (i.e., Enbrel), and adalimumab (i.e. Humira), which block the effects of TNF.
11- Anakinra (i.e. Kineret) is an Il-1 receptor antagonist.
12- newer treatments include abatacept (i.e., Orencia) and rituximab (i.e., Rituxan)
If there is a bacterial infection of the joint, antibiotics are critical. The joint may be drained by repeated aspiration or by open surgical drainage. A change in diet may help some forms of arthritis. People who have arthritis might experience loss of appetite or anemia, which is a low red blood cell count. Frequent small feedings or protein supplements may be prescribed. Some medicines, such as oral corticosteroids, can stimulate the appetite and lead to weight gain. Losing excess weight can help, especially when the leg joints and other weight-bearing joints are affected. Foods high in protein, iron, and vitamins contribute to tissue building and repair. Physical activity is important in the treatment of arthritis. Thirty minutes of moderate exercise a day can help to prevent complications of arthritis, as well as heart disease, stroke, and diabetes. Low impact aerobics and water aerobics are two exercises that minimize joint stress. A recent study focused on adults with osteoarthritis who used tai chi, a form of Chinese exercise that uses slow, fluid movements. Study participants reported better management of their symptoms, along with improved physical and mental health. Surgery may be indicated when pain cannot be controlled or function is lost. Several types of surgery may be done:
13- arthroplasty, which is the partial or total replacement of a joint, such as knee joint replacement or a hip joint replacement
14- arthroscopy, a procedure that uses a small scope and instruments to get inside the joint without opening it
15- arthrotomy, which involves opening the joint through a larger incision
16- osteotomy, or realignment of the bone next to the joint
17- synovectomy, or removal of the lining of the joint
There has been a great deal of interest lately in the use of supplements in treating arthritis, especially for osteoarthritis. According to the Natural Medicines Comprehensive Database, several supplements are "likely effective" in treating osteoarthritis:
18- Glucosamine sulfate significantly improves symptoms of pain and functionality in patients with osteoarthritis of the knee in studies lasting up to three years. It seems to reduce pain scores by 28 to 41 percent and improve function by 21 to 46%. Glucosamine hydrochloride may not be as effective as glucosamine sulfate.
19- Chondroitin sulfate may also relieve the symptoms of osteoarthritis, but 2-4 months is required before significant improvement is experienced. Adding chondroitin sulfate to NSAIDs has been shown to be more effective than NSAIDs alone in osteoarthritis of the hip and knee and may allow lower doses or discontinuation of NSAIDs after 6-8 weeks of use.
20- Same has been shown in several clinical trials to be superior to placebo and comparable to NSAIDs, including the COX-2 inhibitor celecoxib (i.e., Celebrex) for decreasing symptoms associated with osteoarthritis and is associated with fewer side effects than NSAIDs. Symptom relief with SAMe may require up to 30 days of treatment compared to 15 days with NSAIDs.


What are the side effects of the treatments?
Medicines used to treat arthritis may cause stomach upset, allergic reaction, and decreased resistance to infection. Surgery may cause bleeding, infection, or allergic reaction to anesthesia.


What happens after treatment for the condition?
Most types of arthritis require lifelong treatment. Exercises to maintain range of motion and muscle strength are very important.


How is the condition monitored?
A healthcare provider will monitor the person's level of comfort and function of the joint. Any new or worsening symptoms should be reported to the healthcare provider.

Tips for Treating the Flu

Unlike some other infections, when the flu is uncomplicated, it doesn't usually require medical treatment. Your child's doctor may prescribe an antiviral medicine (if symptoms are reported within 48 hours of the onset of illness), but these medicines usually only shorten the course of the infection by just 1 or 2 days, and most times are only used when a child is at risk of serious complications.So how can you help your child feel better in the meantime?Offer your child plenty of fluids (fever, which can be associated with the flu, can lead to dehydration). If your child is tired of drinking plain water, try ice pops, icy drinks mixed in a blender, and soft fruits (like melons or grapes) to keep him or her hydrated.Encourage your child to rest in bed or on the couch, with a supply of magazines, books, quiet music, and perhaps a favorite movie.Give acetaminophen or ibuprofen for your child's aches and pains (do not give aspirin unless your child's doctor directs you to do so).Dress your child in layers. When your child feels warm, you can peel a layer or two, and when he or she feels chilly, layers can be easily added.Have your child call a close relative or far-away friend to help lift your child's spirits.Help your child by taking care of yourself and the other people in your family! If you haven't done so, ask your doctor whether you (and other family members) should get a flu shot. Also, wash your hands thoroughly and often, especially after picking up used tissues.If your child's doctor recommends a prescription medicine to ease your child's symptoms, be sure to call before you go to your local pharmacy. Because the flu can strongly affect many areas of the United States, many pharmacies may have difficulty keeping certain medicines in stock.

Influenza (Flu)

Influenza, commonly known as "the flu," is a highly contagious viral infection of the respiratory tract. Although the flu affects both sexes and all age groups, kids tend to get it more often than adults. The illness even has its own season — from November to April, with most cases occurring between late December and early March.
Signs and SymptomsThe flu is often confused with the common cold, but flu symptoms are usually more severe than the typical sneezing and stuffiness of a cold.
Symptoms of the flu may include:
fever chills headache muscle aches dizziness loss of appetite tiredness cough sore throat runny nose nausea or vomiting weakness ear pain diarrhea Infants with the flu may simply seem sick all of a sudden or "just don't look right." The flu discussed here is not the same strain of virus as the avian flu.
DurationAfter 5 days, fever and other symptoms have usually disappeared, but a cough and weakness may continue. All symptoms are usually gone within a week or two. However, it's important to treat the flu seriously because it can lead to pneumonia and other life-threatening complications, particularly in infants, senior citizens, and people with long-term health problems.
ContagiousnessSpread by virus-infected droplets that are coughed or sneezed into the air, the flu is contagious. People infected with the flu are contagious from a day before they feel sick until their symptoms have resolved (usually about 1 week for adults, but can be up to 2 weeks for young kids).
The flu usually occurs in small outbreaks, but epidemics tend to occur every several years. Epidemics (when the illness spreads rapidly and affects many people in an area at the same time) peak within 2 or 3 weeks after the first cases occur
About the Flu VaccineThe flu vaccine usually is offered between September and mid-November, although it may be given at other times of the year. It reduces the average person's chances of catching the flu by up to 80% during flu season. Because the vaccine prevents infection with only a few of the viruses that can cause flu-like symptoms, it isn't a guarantee against getting sick. But even if someone who's gotten the shot gets the flu, symptoms usually will be fewer and milder.
Flu vaccines are available as a shot or nasal mist. Given as an injection, the flu shot contains killed flu viruses that will not cause the flu, but will prepare the body to fight off infection by the live flu virus. Getting a shot of the killed virus means a person is protected against that particular type of live flu virus if he or she comes into contact with it.
Because the nasal mist contains weakened live flu viruses, it is not for people with weakened immune systems or certain health conditions. It is only for healthy, non-pregnant people between the ages of 2 and 49 years.
People who got the vaccine last year aren't protected from getting the flu this year because the protection wears off and flu viruses constantly change. That's why the vaccine is updated each year to include the most current strains of the virus.
Kids under 9 who get a flu shot for the first time will receive two separate shots a month apart. It can take about 2 weeks after the shot for the body to build up protection to the flu.
Getting the shot before the flu season is in full force gives the body a chance to build up immunity to, or protection from, the virus. Although you can get a flu shot well into flu season, it's best to try to get it earlier rather than later. However, even as late as January there are still 2 or 3 months left in the flu season, so it's still a good idea to get protection.
Who Is Considered High Risk?In times when the vaccine is in short supply, certain people need it more than others. The Centers for Disease Control and Prevention (CDC) often will recommend that certain high-risk groups be given priority when flu shot supplies are limited. The CDC does not anticipate a shortage this year, but it's difficult to predict how many doses will be used. Call your doctor or local public health department about vaccine availability in your area.
The American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), and the CDC currently recommend that these high-risk groups be given the flu shot:
kids 6–59 months old anyone 50 years and older women who will be pregnant during the flu season anyone who lives or works with infants under 6 months old residents of long-term care facilities, such as nursing homes any adult or child with chronic medical conditions, such as asthma health-care personnel who have direct contact with patients kids ages 6 months to 18 years on long-term aspirin therapy out-of-home caregivers and household contacts of anyone in any of the high-risk groups People who should not get the flu shot include:
infants under 6 months old anyone who's severely allergic to eggs and egg products (ingredients for flu shots are grown inside eggs, so tell your doctor if your child is allergic to eggs or egg products before he or she gets a flu shot) anyone who's ever had a severe reaction to a flu vaccination anyone with Guillain-Barré syndrome (GBS), a rare condition that affects the immune system and nerves anyone with a fever Preventing the Flu From SpreadingThere's no guaranteed way — including being vaccinated — to prevent anyone from getting the flu. Avoiding large crowds can help, but it's often impossible to keep kids cooped up.
Here are some practical ways to help prevent the spread of the flu:
Wash your hands thoroughly and frequently. Never pick up used tissues. Never share cups and eating utensils Stay home from work or school when you're sick with the flu. Cover your mouth and nose with a tissue when you cough or sneeze. TreatmentCases of the flu rarely require specific medical treatment. But some kids with chronic medical conditions may become sicker with the flu and need to be hospitalized, and flu in an infant can also be dangerous. For a severely ill child or one with other special circumstances, a doctor may prescribe an antiviral medicine that can ease flu symptoms, but only if it's given within 48 hours of the onset of the flu.
These at-home tips can help most otherwise healthy kids cope with the flu. Have them:
drink lots of fluids to prevent dehydration get plenty of sleep and take it easy take acetaminophen or ibuprofen to relieve fever and aches (but do not give aspirin unless your doctor instructs you to do so) wear layers, since the flu often makes them cold one minute and hot the next (wearing layers — like a T-shirt, sweatshirt, and robe — makes it easy to add or subtract clothes as needed) When to Call the DoctorCall the doctor if your child:
has flu symptoms has a high temperature seems to get better, but then feels worse than before has any trouble breathing, seems confused, or seems to be getting worse For the most part, though, the flu is usually gone in a week or two with a little rest and tender loving care.

Cough and Cold Medicine Abuse

Chugging cough medicine for an instant high certainly isn't a new practice for teens, who have raided the medicine cabinet for a quick, cheap, and legal high for decades. But unfortunately, this dangerous, potentially deadly practice is on the rise.
So it's important for parents to understand the risks and know how to prevent their kids from intentionally overdosing on cough and cold medicine.
Why Do Kids Abuse Cough and Cold Remedies?Before the U.S. Food and Drug Administration (FDA) replaced the narcotic codeine with dextromethorphan as an over-the-counter (OTC) cough suppressant in the 1970s, teens were simply guzzling down cough syrup for a quick buzz.
Over the years, teens discovered that they still could get high by taking large doses of any OTC medicine containing dextromethorphan (also called DXM).
Dextromethorphan-containing products — tablets, capsules, gel caps, lozenges, and syrups — are labeled DM, cough suppressant, or Tuss (or contain "tuss" in the title).
Medicines containing dextromethorphan are easy to find, affordable for cash-strapped teens, and perfectly legal. Getting access to the dangerous drug is often as easy as walking into the local drugstore with a few dollars or raiding the family medicine cabinet. And because it's found in over-the-counter medicines, many teens naively assume that DXM can't be dangerous.
Then and NowDXM abuse is on the rise, according to recent studies, and easy access to OTC medications in stores and over the Internet could be contributing to the increase.
The major difference between current abuse of cough and cold medicines and that in years past is that teens now use the Internet to not only buy DXM in pure powder form, but to learn how to abuse it. Because drinking large volumes of cough syrup causes vomiting, the drug is being extracted from cough syrups and sold on the Internet in a tablet that can be swallowed or a powder that can be snorted. Online dosing calculators even teach abusers how much they'll need to take for their weight to get high.
One way teens get their DXM fixes is by taking "Triple-C" — Coricidin HBP Cough and Cold — which contains 30 mg of DXM in little red tablets. Users taking large volumes of Triple-C run additional health risks because it contains an antihistamine as well.
The list of other ingredients — decongestants, expectorants, and pain relievers — contained in other Coricidin products and OTC cough and cold preparations compound the risks associated with DXM and could lead to a serious drug overdose.
Besides Triple-C, other street names for DXM include: Candy, C-C-C, Dex, DM, Drex, Red Devils, Robo, Rojo, Skittles, Tussin, Velvet, and Vitamin D. Users are sometimes called "syrup heads" and the act of abusing DXM is often called "dexing," "robotripping," or "robodosing" (because users chug Robitussin or another cough syrup to achieve their desired high).
What Happens When Teens Abuse DXM?Although DXM can be safely taken in 15- to 30-milligram doses to suppress a cough, abusers tend to consume as much as 360 milligrams or more. Taking mass quantities of products containing DXM can cause hallucinations, loss of motor control, and "out-of-body" (disassociative) sensations.
Other possible side effects of DXM abuse include: confusion, impaired judgment, blurred vision, dizziness, paranoia, excessive sweating, slurred speech, nausea, vomiting, abdominal pain, irregular heartbeat, high blood pressure, headache, lethargy, numbness of fingers and toes, facial redness, dry and itchy skin, loss of consciousness, seizures, brain damage, and even death.
When consumed in large quantities, DXM can also cause hyperthermia, or high fever. This is a real concern for teens who take DXM while in a hot environment or while exerting themselves at a rave or dance club, where DXM is often sold and passed off as similar-looking drugs like PCP. And the situation becomes even more dangerous if these substances are used with alcohol or another drug.
Being on the LookoutYou can help prevent your teen from abusing over-the-counter medicines. Here's how:
Lock your medicine cabinet or keep those OTC medicines that could potentially be abused in a less accessible place. Avoid stockpiling OTC medicines. Having too many at your teen's disposal could make abusing them more tempting. Keep track of how much is in each bottle or container in your medicine cabinet. Keep an eye out not only for traditional-looking cough and cold remedies in your teen's room, but also strange-looking tablets (DXM is often sold on the Internet and on the street in its pure form in various shapes and colors). Watch out for the possible warning signs of DXM abuse listed above. Monitor your child's Internet usage. Be on the lookout for suspicious websites and emails that seem to be promoting the abuse of DXM or other drugs, both legal and illegal. Above all, talk to your kids about drug abuse and explain that even though taking lots of a cough or cold medicine seems harmless, it's not. Even when it comes from inside the family medicine cabinet or the corner drugstore, when taken in large amounts DXM is a drug that can be just as deadly as any sold on a seedy street corner. And even if you don't think your teens are doing it, chances are they know kids who are.

Common cold

From the sniffles and sneezes to a sore throat and annoying cough, the common cold usually catches up with us at one time or another. With kids getting as many as eight colds per year or more, this contagious viral infection of the upper respiratory tract is the most common infectious disease in the United States and the number-one reason children visit the doctor and stay home from school. Causes Most colds are caused by rhinoviruses (the name comes from "rhin," the Greek word for nose) that are in invisible droplets in the air we breathe or on things we touch. More than 100 different rhinoviruses can infiltrate the protective lining of the nose and throat, triggering an immune system reaction that can make your child's throat sore, his or her head ache, and can make it hard for your child to breathe through the nose. Air that's dry - indoors or out - can lower your child's resistance to infection by the viruses that cause colds. And so can being a smoker or being around someone who's smoking. People who smoke are more likely to catch a cold than people who don't - and their symptoms will probably be worse, last longer, and are more likely to lead to bronchitis or even pneumonia. But despite what old wives' tales may have you believe, not wearing a jacket or sweater when it's chilly, sitting or sleeping in a draft, and going outside while your hair's wet do not cause colds. Signs and Symptoms The first symptoms of a cold are often a tickle in the throat, a runny or stuffy nose, and sneezing. Kids with colds may also have a sore throat, cough, headache, mild fever, fatigue, muscle aches, and loss of appetite. The discharge from your child's nose may change from watery to thick yellow or green. Contagiousness Colds are most contagious during the first 2 to 4 days after symptoms appear, and may be contagious for up to 3 weeks. Your can catch a cold from person-to-person contact or by breathing in virus particles that are spread through the air by sneezing or coughing. Touching the mouth or nose after touching skin or another surface contaminated with a rhinovirus can also spread a cold. Prevention Because so many viruses cause them, there isn't a vaccine that can protect against catching colds. But to help prevent them, kids should: try to steer clear of anyone who smokes or who has a cold. Virus particles can travel up to 12 feet (3.7 meters) through the air when someone with a cold coughs or sneezes, and even secondhand smoke can make your child more likely to get sick. wash their hands thoroughly and frequently, especially after blowing their noses. cover their noses and mouths when coughing or sneezing. not use the same towels or eating utensils as someone who has a cold. They also shouldn't drink from the same glass, can, or bottle as anyone else - you never know who might be about to come down with a cold and is already spreading the virus. not pick up other people's used tissues Researchers aren't sure whether taking extra zinc or vitamin C can limit how long cold symptoms last or how severe they become, but large doses taken every day can cause negative side effects. The results of most studies on the value of herbal remedies, such as echinacea, are either negative or inconclusive, and few properly designed scientific studies of these treatments have been done in children. Talk to your child's doctor before you decide to give your child any herbal remedy or more than the recommended daily allowance (RDA) of any vitamin or supplement. Duration Cold symptoms usually appear 2 or 3 days after exposure to a source of infection. Most colds clear up within 1 week, but some last for as long as 2 weeks. Treatment "Time cures all." That may not always be true, but in the case of the common cold, it's pretty close. Medicine can't cure the common cold, but it can be used to relieve such symptoms as muscle aches, headache, and fever. You can give your child acetaminophen or ibuprofen based on the package recommendations for age or weight. However, aspirin should never be given to children younger than 12, and all children and teens under age 19 should avoid aspirin during viral illnesses. Use of aspirin by kids or teens with colds or other viral illness may increase the risk of developing Reye syndrome, a rare but serious condition that can be fatal. Although you may be tempted to give your child over-the-counter (OTC) decongestants and antihistamines to try to ease the cold symptoms, there's little or no evidence to support that they actually work. In fact, decongestants can cause hallucinations, irritability, and irregular heartbeats in infants and shouldn't be used in children younger than 2 without first consulting a doctor. Some ways you can help ease cold discomfort include: saltwater drops in the nostrils to relieve nasal congestion (you can buy these - also called saline nose drops - at any pharmacy) a cool-mist humidifier to increase air moisture petroleum jelly on the skin under the nose to soothe rawness hard candy or cough drops to relieve sore throat (for kids older than 3 years) a warm bath or heating pad to soothe aches and pains steam from a hot shower to help your child breathe more easily But what about chicken soup? There's no real proof that eating this soothing, warm concoction can cure a cold, but sick people have been swearing by it for more than 800 years. Why? Chicken soup contains a mucus-thinning amino acid called cysteine, and some research shows that chicken soup helps control congestion-causing white cells, called neutrophils. The best plan, though, is not to worry about whether to "feed a cold" or "starve a fever." Just make sure your child eats when hungry and drinks plenty of fluids like water or juice to help replace the fluids lost during fever or mucus production. Avoid giving your child caffeinated beverages, though, which can cause frequent urination and, therefore, increase the risk of dehydration. When to Call Your Child's Doctor Your child's doctor won't be able to identify which specific virus is causing your child's cold symptoms, but can examine your child's throat and ears and take a throat culture to make sure the symptoms aren't from another condition that may need specific treatment. (If your child's symptoms get worse instead of better after 3 days or so, the problem could be strep throat, sinusitis, pneumonia, or bronchitis, especially if your child or teen smokes.) Taking a throat culture is a simple, painless procedure that involves brushing the inside of the throat with a long cotton swab. Examining the germs that stick to the swab will help the doctor determine whether your child has strep throat and needs treatment with antibiotics. If symptoms last for more than a week, appear at the same time every year, or occur when your child is exposed to pollen, dust, animals, or another substance, your child could have an allergy. If your child has trouble breathing or wheezes when he or she catches a cold, your child could have asthma. You should also see your child's doctor if you think your child might have more than a cold, or if he or she is getting worse instead of getting better. Also call the doctor if your child has any of these symptoms: coughing up a lot of mucus shortness of breath unusual lethargy/tiredness inability to keep food or liquids down or poor fluid intake increasing headache or facial or throat pain severely painful sore throat that interferes with swallowing fever of 103 degrees Fahrenheit (39.3 degrees Celsius) or higher, or a fever of 101 degrees Fahrenheit (38.0 degrees Celsius) or higher that lasts for more than a day chest or stomach pain swollen glands (lymph nodes) in the neck earache Like most virus infections, colds just have to run their course. Getting plenty of rest, avoiding vigorous activity, and drinking lots of fluids - juice, water, and noncaffeinated beverages - all may help your child feel better while on the mend. Keeping up regular activities like going to school probably won't make your child's cold any worse. But it will increase the likelihood that the cold will spread to classmates or friends. So you might want to put some daily routines aside until your child is feeling better.

Avian flu

You've probably heard news reports about a potentially dangerous avian flu. And like many people, you may be wondering how to react to the frightening headlines about people having died of the bird flu and the possibility of the flu someday spreading rapidly around the world, infecting humans.
While the bird flu can be serious, unless you have household chickens and live in a country where there's an outbreak now, the bird flu probably is not an immediate health threat for you or your family. Experts believe only 160 people have contracted the disease since it was identified as a threat 8 years ago.
The avian flu that has affected birds and people in Asia, Europe, Africa and the Middle East, is different from the flu that many people get during the cold-weather months. Poultry - like chickens and turkeys - tend to get infected with the bird flu by migrating waterfowl (like ducks, geese, and swans), and spread it to other birds through their infected feces, saliva, or secretions. The people who have gotten sick or died from the bird flu in Asia have had direct contact with infected birds, or surfaces that have been contaminated by them. This strain of the bird flu - which is called H5N1 - can't be spread from person to person.
Experts are concerned that this flu could mutate (undergo a genetic change) into a new form that can spread from person to person. Right now there's no vaccine for the bird flu, so they're worried that if it does mutate, it will be difficult to stop and will cause a pandemic, which is a global outbreak.
Health officials around the world are taking precautions to make sure that the bird flu doesn't spread, and to keep people safe from it if it does. Many countries - including the United States - aren't importing poultry from countries where there have been avian flu outbreaks.
Meanwhile, scientists are working on developing a vaccine to keep people from getting the avian flu.
In most places, there's no immediate threat from bird flu. All the same, the best thing you can do to safeguard your family from any contagious illness is to practice good hand-washing habits, teach your child to do the same, and take proper food safety precautions. (Never eat undercooked or uncooked poultry, and wash any kitchen surfaces where you have handled or worked with any uncooked meat.)
If you're traveling to a country where there has been a bird flu outbreak, it's best to talk with your doctor and look to agencies like the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). (Scroll to the end of this article for contact information.)
Here are some more answers to questions about avian flu.
What Is Avian Flu?
It is a form of the flu (influenza) virus that usually only infects birds and sometimes infects pigs. There are many different strains of the avian flu. Some of those strains only cause mild symptoms in birds, ruffling their feathers and reducing their egg production. Other strains, including some of the H5 strains, are more dangerous - they spread quickly, cause more severe symptoms, and are almost always fatal to the birds.
An estimated 160 people have contracted the H5N1 strain of the flu, and about half of them have died. In an effort to keep the flu from spreading, hundreds of birds in those countries have been destroyed. The WHO is estimating that it will take at least 2 years to contain this outbreak of the bird flu.
Where Is the Avian Flu an Urgent Concern?
Over the past couple of years experts have recorded and confirmed outbreaks of H5N1 among birds in countries in Asia, Europe, Africa, and the Middle East.
Could Avian Flu Become a Concern in the United States?
The strain of flu virus that has spread in Asia, the Middle East, and Eastern Europe has not been found in birds - or humans - in the United States. There's a very low risk that people in the United States will get infected with the avian flu unless there's a global outbreak.
But this strain of the virus has been around since 1997. And the longer it lingers, spreading among birds in Asia, the more opportunities there are for the virus to infect people. The more people that are infected with the virus, the more opportunities the virus will have to mutate into a form that could spread from person to person. That could lead to a pandemic.As a precaution, the United States is not importing any birds from countries that have reported outbreaks of the bird flu.
How Do Birds Spread the Flu to Other Birds?
Researchers think that migrating birds, like ducks, geese, and swans can carry and spread the virus to other birds but generally don't get sick from it. Bird flu can sicken domesticated birds, like chickens and turkeys, and kill them.
A bird can get the bird flu from another bird by coming into close contact with its infected feces, secretions, or saliva, or surfaces, dirt, or cages that have been contaminated by them. That's why researchers think live bird markets, where birds are kept in close quarters, are places where the virus has rapidly spread.
The virus also can spread from farm to farm if birds' infected feces and saliva get on farming equipment, like tractor wheels, clothing, and cages.
How Has Avian Flu Spread to Humans?
Experts think that the people who were infected by the bird flu had direct contact with infected poultry. They lived in rural areas where many families have small household poultry flocks, and slaughter, defeather, and butcher poultry themselves. Poultry also roam freely in some of those areas, and there are lots of opportunities to be exposed to their infected feces.
Can a Person With Avian Flu Spread it to Other People?
It's unlikely that a person who gets infected with this strain of the avian flu would spread it to other people. All human cases of bird flu so far have happened because people came into close contact with infected birds.
What Are the Symptoms of Avian Flu in Humans?
The symptoms of bird flu in people tend to be similar to the typical flu: fever, cough, sore throat, muscle aches. But this flu also can lead to eye infections, pneumonia, and severe coughing and breathing problems.
What Are the Signs of a Pandemic?
If clusters of people start showing symptoms of the flu around the same time, in the same place, in a country where it's known that the virus is spreading, it would signal that the virus has mutated and is spreading from person to person. Doctors and public health officials would try to find out how the people got sick, and use that information to try to track and stop the disease from spreading.
What Are Public Officials Doing to Prevent the Spread of Avian Flu?
Officials in Japan, Korea, and Malaysia have announced that their local outbreaks have been controlled, and that there's no more of the virus there.
Even so, the WHO has started stockpiling antiviral medications and created an emergency plan in case there is a pandemic. The agency is providing guidance for all nations to do the same and is closely monitoring countries where there have been outbreaks, watching for further cases and any possible mutations.
U.S. President George Bush announced a plan that includes stockpiling medications to help reduce effects of the flu, producing more flu vaccine, and developing a vaccine for the avian flu.
Should I Stop Eating Chicken and Turkey?
It's safe to eat properly cooked chicken, turkey, and any other poultry in the United States. But do not eat raw (uncooked) or undercooked poultry or poultry products. When you're cooking, separate raw meat from cooked or ready-to-eat foods. Don't use the same cutting boards, knives, or utensils on uncooked meats and other foods. Heat can destroy flu viruses, so you should cook poultry until the temperature of the meat reaches at least 158 degrees Fahrenheit (70 degrees Celsius).
How Can I Protect My Family From Avian Flu?
If you plan to travel to a country where there has been an outbreak, avoid any contact with chickens, ducks, geese, pigeons, turkeys, quail, or any wild birds. Stay away from live bird markets, local poultry farms, or any other settings where there might be infected poultry. Avoid touching surfaces that could have been contaminated by bird saliva, feces, or urine. Look to agencies like the CDC for travel advisories.
At this point, if you live in a country where there's not a bird flu outbreak, there aren't any special precautions you need to take. But in general, hand washing keeps viruses and other contagious illnesses from spreading. So no matter where you live or how healthy you are, be sure to frequently and thoroughly wash your hands with soap and water, particularly after going to the bathroom and before preparing meals and eating, and after taking care of a sick person. Encourage your child to develop healthy hand-washing habits.
Can the Flu Shot Prevent Avian Flu?
No. There is no vaccine currently available for the avian flu, although there is one under development. However, experts stress that the strains of common flu virus that circle the globe each year are much more likely to pose a threat to human health during flu season. And in this case protection is available for that. So you may want to think about getting a flu shot for yourself and your family to help you stay well during the flu season, which runs from November to April, particularly if any of you are considered to be in a high-risk group. Pregnant women, babies from 6 to 23 months old, anyone who lives with or cares for infants under 6 months old, and people with certain chronic medical conditions are all considered high risk.
What's the Treatment for Avian Flu?
Doctors hope that antiviral medications will help keep the flu from spreading if it mutates and becomes contagious to humans. These medications can't cure the bird flu, but they can make the symptoms less severe. Still, flu viruses can become resistant to these drugs, so they may not always work. More studies are underway to determine how effective these medications are.
Can My Pet Bird Get Infected With the Avian Flu?
Your pet bird could contract the avian flu if it is exposed to another bird that's carrying the virus. So it's important to keep your bird and its food and water inside, away from any place where it could be exposed to infected migrating or domestic birds. That way your pet won't be at risk for getting the bird flu.
In addition, there are many precautions you can take to guard against the bird flu virus and other illnesses.
Don't allow your bird to drink or eat from ponds or other places that migrating birds may have flown over.
Keep your pet bird's cage clean.
Wash your hands after handling your pet bird, cleaning its cage, or after having any contact with your bird's secretions.
If you have any questions about your bird's health, talk with your veterinarian.
Government officials from the United States and other countries have stopped importing live birds and bird products (like meat and eggs) from countries where there have been outbreaks of the bird flu. So if you buy a pet bird, it should not have been exposed to the virus.
That said, there is an illegal market for buying and selling exotic birds and other animals. So just to be safe, before you buy any animal to keep as a pet, find out where it was born and raised. If you have any questions, contact a veterinarian, officials with the U.S. Centers for Disease Control, or the World Health Organization. (See Additional Resources tab)
To Learn More About Avian Flu:For more information about the avian flu from organizations like the CDC and the WHO, see our additional resources tab at the top of this article.

Yersiniosis

Yersiniosis is a relatively uncommon infection caused by bacteria called yersinia. It is typically contracted through the consumption of undercooked meat products, unpasteurized milk, or water contaminated by the bacteria.
Usually, a child with an infection caused by the yersinia bacteria recovers within a few days without medical treatment. But in some cases, doctors prescribe antibiotics.
The typical symptoms of yersiniosis include fever, stomach pain, and bloody diarrhea. Sometimes, older kids who get these infections also get pain in the lower right side of the abdomen. If your child has these symptoms, it's a good idea to call your child's doctor.
If your child is an infant, it's particularly important to call your child's doctor as soon as symptoms appear to prevent the infection from leading to other health problems.
What Causes Yersiniosis?Three main types of yersiniosis affect people. In the United States the form that most commonly causes infections is yersinia enterocolitica, which are bacteria that thrive in cooler temperatures. There is only 1 confirmed case per 100,000 people each year in the United States.
The bacteria can infect the digestive tracts of humans, cats, dogs, pigs, cattle, and goats. People can contract it by eating or handling contaminated foods such as raw or undercooked meat, or by drinking untreated water or unpasteurized milk that has been contaminated.
An infant can be infected if a parent or caretaker handles contaminated food without cleaning up adequately before handling the infant's toys, bottles, or pacifiers.
Signs and SymptomsSymptoms of yersiniosis, which typically appear 4 to 7 days after exposure and can last up to 3 weeks, may include:
fever abdominal pain nausea vomiting diarrhea that may be streaked with mucus or blood In older children, this infection also can cause fever as well as pain in the right lower part of the abdomen, which can mimic appendicitis. Doctors can distinguish between yersiniosis and appendicitis by analyzing a stool sample
In rare cases, the infection can cause a skin rash or joint pain that appears a month after the initial symptoms. But these symptoms go away without treatment.
TreatmentDiarrhea caused by yersiniosis generally goes away on its own, though in some cases antibiotics are prescribed. In infants, however - particularly those who are 3 months old or younger - yersiniosis can develop into a more serious condition called bacteremia, an infection of the blood. Infants who contract yersiniosis are usually treated in a hospital setting.
Depending on the severity of the diarrhea, your child's doctor may suggest modifying your child's diet for 1 to 2 days and encouraging your child to drink more fluids (which may include special drinks that replace body fluids quickly). If your child is having large amounts of diarrhea, be on the watch for signs of dehydration (a low level of body water). These include:
severe thirst dry mouth or tongue sunken eyes dry skin infrequent urination in infants, a dry diaper for several hours PreventionTo reduce the risk that your child will contract yersiniosis, it's a good idea to take the following precautions:
Don't allow your child to eat raw or undercoooked meat. Drink and serve only pasteurized milk or milk products. Wash hands with soap and water particularly before eating and preparing food; before touching infants or their toys, bottles, or pacifiers; and after contact with animals or handling raw meat. Use separate cutting boards for meat and other foods. Clean all cutting boards, countertops, and utensils with soap and hot water after preparing raw meat. Always cook meat thoroughly before you eat it, especially pork products. Dispose of animal feces and sanitize anything they have touched. Avoid drinking directly from natural water sources such as ponds and mountain streams, particularly if the water is near farmland where cattle, pigs, or goats are raised. As you care for a family member who has diarrhea, remember to wash your hands thoroughly before touching other people and before handling food. If your pet dog or cat has diarrhea, wash your hands frequently as you care for them, and check with your veterinarian about treatment and/or contagiousness.

Shigella

Shigella are bacteria that can infect the digestive tract and cause a wide range of symptoms, from diarrhea, cramping, vomiting, and nausea, to more serious complications and illnesses. Infections, called shigellosis, sometimes go away on their own; in others, antibiotics can shorten the course of the illness.
Shigellosis, which is most common during the summer months, typically affects kids 2 to 4 years old, and rarely infects infants younger than 6 months old.
These infections are very contagious and can be prevented with good hand washing practices.
Signs and SymptomsShigella bacteria produce toxins that can attack the lining of the large intestine, causing swelling, ulcers on the intestinal wall, and bloody diarrhea.
The severity of the diarrhea sets shigellosis apart from regular diarrhea. In kids with shigellosis, the first bowel movement is often large and watery. Later bowel movements may be smaller, but the diarrhea may have blood and mucus in it.
Other symptoms of shigellosis include:
abdominal cramps high fever loss of appetite nausea and vomiting painful bowel movements In very severe cases of shigellosis, a person may have convulsions (seizures), a stiff neck, a headache, extreme tiredness, and confusion. Shigellosis can also lead to dehydration and in rare cases, other complications, like arthritis, skin rashes, and kidney failure.
Some children with severe cases of shigellosis may need to be hospitalized.
ContagiousnessShigellosis is very contagious. Someone may become infected by coming into in contact with something contaminated by stool from an infected person. This includes toys, surfaces in restrooms, and even food prepared by someone who is infected. For instance, kids who touch a contaminated surface such as a toilet or toy and then put their fingers in their mouths can become infected. Shigella can even be carried and spread by flies that have touched contaminated stool.
Because it doesn't take many Shigella bacteria to cause an infection, the illness spreads easily in families and child-care centers. The bacteria may also spread in water supplies in areas where there is poor sanitation. Shigella can be passed in the person's stool for about 4 weeks even after the obvious symptoms of illness have resolved (although antibiotic treatment can reduce the excretion of Shigella bacteria in the stool).
PreventionThe best way to prevent the spread of Shigella is by frequent and careful hand washing with soap, especially after they use the toilet and before they eat. This is especially important in a child-care setting.
If you're caring for a child who has diarrhea, wash your hands before touching other people and before handling food. (Anyone with a diarrhea should not prepare food for others.) Be sure to frequently clean and disinfect any toilet used by someone with shigellosis.
Diapers of a child with shigellosis should be disposed of in a sealed garbage can, and the diaper area should be wiped with disinfectant after use. Young children (especially those still in diapers) with shigellosis or with diarrhea of any cause should be kept away from other kids.
Proper handling, storage, and preparation of food can also help prevent Shigella infections. Cold foods should be kept cold and hot foods should be kept hot to prevent bacterial growth.
Diagnosis and TreatmentTo confirm the diagnosis of shigellosis, your doctor may take a stool sample from your child to be tested for Shigella bacteria. Blood tests and other tests can also rule out other possible causes of the symptoms, especially if your child has a large amount of blood in the stool.
Some cases of shigellosis require no treatment, but antibiotics often will be given to shorten the illness and to prevent the spread of bacteria to others.
If the doctor prescribes antibiotics, give them as prescribed. Avoid giving your child nonprescription medicines for vomiting or diarrhea unless the doctor recommends them, as they can prolong the illness. Acetaminophen (such as Tylenol) can be given to reduce fever and make your child more comfortable.
To prevent dehydration, follow your doctor's guidance about what your child should eat and drink. Your doctor may recommend a special drink called an oral rehydration solution, or ORS (such as Pedialyte) to replace body fluids quickly, especially if the diarrhea has lasted 2 or 3 days or more.
Children who become moderately or severely dehydrated or those with other more serious illnesses may need to be hospitalized to be monitored and receive treatment such as intravenous (IV) fluid therapy or antibiotics.
When to Call the DoctorCall the doctor if your child has signs of a Shigella infection, including diarrhea with blood or mucus, accompanied by abdominal pain, nausea and vomiting, or high fever.
Children with diarrhea can quickly become dehydrated, which can lead to serious complications. Signs of dehydration include:
thirst irritability restlessness lethargy dry mouth, tongue, and lips sunken eyes a dry diaper for several hours in infants or fewer trips to the bathroom to urinate in older children If you see any of these signs, call the doctor right away.

salmonella infection

A salmonella infection is a foodborne illness caused by the salmonella bacteria carried by some animals, which can be transmitted on kitchen surfaces and in water, soil, animal feces, raw meats, and eggs. Salmonella infections typically affect a child's intestines, causing vomiting, fever, and other symptoms that usually resolve without medical treatment.
You can help prevent salmonella infections by not serving any raw meat or eggs, and by not keeping reptiles as pets, particularly if you have very young children. Hand washing is a powerful way to guard against salmonella infections, so it's essential to teach children to wash their hands, particularly after trips to the bathroom and before handling food in any way.
Salmonella BasicsNot everyone who ingests salmonella bacteria will become ill. Children, especially infants, are the most likely candidates to get sick from it. About 50,000 cases of salmonella infection are reported in the United States each year and about one third of those are in children 4 years old or younger.
The type of salmonella most commonly associated with infections in humans is called nontyphoidal salmonella. It is carried by chickens, cows, and reptiles such as turtles, lizards, and iguanas.
Another, rarer form of salmonella, typhoidal salmonella, is carried only by humans and is usually transmitted through direct contact with the fecal matter of an infected person. This kind of salmonella infection can lead to typhoid fever, which causes high fever, abdominal pain, headache, malaise, lethargy, skin rash, constipation, and delirium. It occurs primarily in developing countries without appropriate systems for handling human waste.
Signs and SymptomsA salmonella infection generally causes nausea, vomiting, abdominal cramps, diarrhea (sometimes bloody), fever, and headache. Because many different kinds of illnesses can cause these symptoms, most doctors will take a sample of a child's stool to make an accurate diagnosis.
Symptoms of most salmonella infections usually appear within 3 days of contamination and typically go away without any medical treatment.
In cases of typhoid fever caused by salmonella bacteria, early symptoms are the same. But in the second week, the liver and spleen can become enlarged, and a distinctive "rose spotted" skin rash may appear. From there, the infection can cause other health problems, like meningitis and pneumonia.
People at risk for more serious complications from a salmonella infection include those who:
have compromised immune systems (such as people with HIV) take cancer-fighting drugs have sickle cell disease or an absent or nonfunctioning spleen take chronic stomach acid suppression medication In these higher-risk groups, most doctors will treat an infection with antibiotics to prevent it from spreading to other parts of the body and causing additional health problems.
PreventionYou have many ways to help prevent salmonella bacteria from making your child sick. Most salmonella bacteria appear in animal products and can be killed by the heat from cooking. So it's important to make sure that your child does not eat raw or undercooked eggs, poultry, or meat.
Because salmonella bacteria can contaminate even intact and disinfected grade A eggs, avoid serving your child poached eggs or eggs that are served sunny-side up.
Salmonella also can be spread through cross-contamination, so when you're preparing meals, try to keep uncooked meats away from cooked and ready-to-eat foods. In addition, it's important to thoroughly wash your hands, cutting boards, counters, and knives after handling uncooked foods.
Some foods may contain unrecognized raw-food products and should be avoided. Caesar salad dressing, the Italian dessert tiramisu, homemade ice cream, chocolate mousse, eggnog, cookie dough, and frostings can contain raw eggs. Unpasteurized milk and juices also can be contaminated with salmonella.
Fecal matter is often the source of salmonella contamination, so hand washing is extremely important, particularly after using the toilet and before preparing food.
Take care to avoid contact with the feces of family pets - especially reptiles. Wash your hands thoroughly after handling an animal and ensure that no reptiles are permitted to come into contact with an infant. Even healthy reptiles (especially turtles and iguanas) are not appropriate pets for small children and should not be in the same house as an infant.
TreatmentIf your child has a salmonella infection and a healthy immune system, your child's doctor may let the infection go away without treatment. But any time your child develops a fever, headache, or bloody diarrhea, call the doctor to rule out any other problems.
If your child is infected and has a fever, you may want to give acetaminophen to reduce his or her temperature and relieve cramping. As with any infection that causes diarrhea, it's important to give your child plenty of liquids to avoid dehydration.

Rotavirus

Rotavirus most often infects infants and young children, and in children ages 3 months to 2 years, is one of the most common causes of diarrhea. In the United States, it leads to outbreaks of diarrhea during the winter and spring months. It is particularly a problem in child-care centers and children's hospitals. Almost all children have had a rotavirus infection by the time they are 5 years old. Severe infection, rotavirus gastroenteritis, is the leading cause of severe, dehydrating diarrhea in infants and young children.
Rotavirus infections are responsible for approximately 3 million cases of diarrhea and 55,000 hospitalizations for diarrhea and dehydration in children under 5 years old each year in the United States. Although these infections cause relatively few deaths in the United States, diarrhea caused by rotavirus results in more than half a million deaths worldwide every year. This is especially true in developing countries, where nutrition and health care are not optimal.
Signs and SymptomsChildren with a rotavirus infection have fever, nausea, and vomiting, which are often followed by abdominal cramps and frequent, watery diarrhea. Children who are infected may also have a cough and runny nose. As with all viruses, though, some rotavirus infections cause few or no symptoms, especially in adults.
Sometimes the diarrhea that accompanies a rotavirus infection is so severe that it can quickly lead to dehydration. Signs of dehydration include: thirst, irritability, restlessness, lethargy, sunken eyes, a dry mouth and tongue, dry skin, fewer trips to the bathroom to urinate, and (in infants) a dry diaper for several hours.
ContagiousnessRotavirus infection is very contagious. The virus passes in the stool of infected persons before and after they have symptoms of the illness. Children can become infected if they put their fingers in their mouths after touching something that has been contaminated by the stool of an infected person. Usually this happens when children forget to wash their hands often enough, especially before eating and after using the toilet. People who care for children, including health-care and child-care workers, can also spread the virus, especially if they do not wash their hands after changing diapers.
PreventionFrequent hand washing is the best tool to limit the spread of rotavirus infection. Children who are infected should stay home from child-care groups until their diarrhea has resolved. In hospitals, rotavirus outbreaks are controlled by isolating infected patients and ordering strict hand-washing procedures.
The American Academy of Pediatrics (AAP) recommends that the rotavirus vaccine be included in the lineup of routine immunizations given to all infants. The recommendation calls for three doses by mouth at around 2, 4, and 6 months of age.
The vaccine, which is called RotaTeq, has been found to prevent approximately 75% of cases of rotavirus infection and 98% of severe cases. Your child's doctor will have the most current information.
In 1999, a rotavirus vaccine was taken off the market because it was linked to an increased risk for intussusception, a type of bowel obstruction, in young infants. In more than 70,000 children studied, RotaTeq has not been found to have this increased risk.
Professional TreatmentAn infant or toddler who becomes moderately or severely dehydrated may need to be treated in a hospital with intravenous (IV) fluids to bring the body's fluid and salt levels back to normal. Most older children can be treated at home.
Your doctor may need to test your child's blood, urine, or stool to confirm that the diarrhea is being caused by rotavirus and not by bacteria. Because antibiotics do not work against illnesses caused by viruses, your doctor will not give your child antibiotics to treat a rotavirus infection.
Home TreatmentTo prevent dehydration, follow your doctor's guidance about what your child should eat and drink. Your doctor may suggest that you give your child special drinks that replace body fluids, especially if the diarrhea has been going on for longer than 2 or 3 days.
In general, kids with mild diarrhea who are not dehydrated should continue to eat normally but should receive more fluids. (Fruit juices and soft drinks can make diarrhea worse and should be avoided.) Those who have mild to moderate dehydration should be given an oral rehydration solution in small, frequent amounts to correct the dehydration and then should go back to eating normally. Children who are breastfed should be breastfed throughout. A child who is vomiting will need to eat smaller amounts more frequently. Follow your doctor's guidance and avoid giving your child store-bought medicines for vomiting or diarrhea unless your doctor recommends them.

Pinworm

Pinworm is an intestinal infection caused by tiny parasitic worms measuring about 5 to 10 millimeters (about half to one centimeter) in length. Other names for a pinworm infection are "seatworm infection," "threadworm infection," "enterobiasis," or "oxyuriasis."
One of the most common roundworm infections, pinworm infections probably affect about 200 million people across the world, including about one third of the population in the United States. Of all age groups, schoolchildren are most at risk for pinworm infections.
But if your child has a pinworm infection, don't worry. Pinworms don't cause any harm (just itching), and it won't take long to get rid of them. And people who have pinworms aren't dirty - kids can get pinworms no matter how often they take a bath or play in the mud.
How Do You Get Pinworm?
Pinworm infections are contagious. People become infected by unknowingly ingesting microscopic pinworm eggs that can be found on many different surfaces, including:
bed linens
towels
clothing (especially underwear and pajamas)
toilets
bathroom fixtures
food
drinking glasses
eating utensils
toys
kitchen counters
desks or lunch tables at school
sandboxes
The eggs pass into the digestive system and hatch in the small intestine. From the small intestine, pinworm larvae continue their journey to the large intestine, where they live as parasites - their heads attached to the inside wall of the bowel.
About 2 to 4 weeks after a person acquires the pinworm eggs, adult female pinworms begin migrating from the large intestine to the area around the rectum. There, they will lay new pinworm eggs, which trigger itching around the rectum.
When someone scratches the itchy area, microscopic pinworm eggs are transferred to their fingers. Contaminated fingers can then carry pinworm eggs to various surfaces, where they're able to live for 2 to 3 weeks.
If you're wondering if your family pet could give your child a pinworm infection, it can't. Pinworms don't come from animals.
What Are the Signs and Symptoms?
Often, a person can have a pinworm infection without having any symptoms. When symptoms are present, the most common one is itching around the rectum. After pinworm eggs are ingested, it takes about 1 to 2 months for itching around the rectum to begin.
The itching is usually worse at night and is caused by worms migrating to the area around the rectum to lay their eggs. When a child scratches the itchy area, the result can be eczema or a bacterial infection around the rectum. In girls, pinworm infection can spread to the vagina and cause a vaginal discharge.
If your child has a pinworm infection, you might also be able to see the worms in the toilet after he or she goes to the bathroom. They look like tiny pieces of white thread and are really small - about as long as a staple. You might also see them on your child's underwear when he or she wakes up in the morning.
How Is a Pinworm Infection Diagnosed and Treated?
Your child's doctor may ask you to help make the diagnosis of pinworm by placing a sticky piece of clear cellophane tape against your child's rectum. Pinworm eggs will stick to the tape and can be seen under a microscope in a laboratory. The doctor might also take some samples from under your fingernails to see if there are any eggs.
If the doctor finds that your child has a pinworm infection, he or she will probably give everyone in your family one dose of an antiworm medicine that will eliminate the pinworm infection. After 2 weeks, the doctor may give a second dose of antiworm medicine.
Although the medicine takes care of the worm infection, the itching may last about a week after the medicine is taken. So, the doctor may also give your child a cream to help stop the itching.
Routine household cleaning measures (including washing everyone's pajamas and bed linens) will also help reduce the spread of pinworm infection to the family.
When Should You Call Your Child's Doctor?
Consider calling your child's doctor if your child complains of an itchy rectum or always seems to be scratching the rectal or genital area.
You might also want to consider asking your child's doctor about pinworms, among other causes, if your child seems to have trouble sleeping or has begun to wet the bed. (Pinworms can irritate the urethra - the channel through which urine passes as it leaves the bladder and exits the body - which can lead to bedwetting).
Can a Pinworm Infection Be Prevented?
Here are a few ways you can help to prevent pinworm infections in your family:
Remind your child to wash his or her hands after using the toilet, after playing outside, and before eating.
Make sure your child showers or bathes every day and changes underwear daily.
Keep your child's fingernails short and clean.
Tell your child not to scratch around his or her bottom or bite his or her nails.
Wash your child's pajamas every few days.
If your child has a pinworm infection, all members of your household will need to be treated with medication. This will help prevent the infection from coming back in most cases.
As you're trying to get rid of your child's pinworm infection, remember that pinworms are quite common among kids and aren't harmful. By taking a short course of medication and following some preventative tips, your child will be rid of the worms in no time.

Diarrhea

Most kids battle diarrhea from time to time, but the good news is that it's often caused by infections that don't last long and usually are more disruptive than dangerous. Still, it's important to know what to do to relieve and even prevent diarrhea.
Causes of DiarrheaDiarrhea — frequent runny or watery bowel movements (poop) — is usually brought on by gastrointestinal (GI) infections caused by viruses, bacteria, or parasites.
The specific germs that cause diarrhea can vary among geographic regions depending on their level of sanitation, economic development, and hygiene. For example, developing countries with poor sanitation or where human waste is used as fertilizer often have outbreaks of diarrhea when intestinal bacteria or parasites contaminate crops or drinking water.
In developed countries, including the United States, diarrhea outbreaks are more often linked to contaminated water supplies, person-to-person contact in places such as child-care centers, or "food poisoning" (when people get sick from improperly processed or preserved foods contaminated with bacteria).
In general, infections that cause diarrhea are highly contagious. Most cases can be spread to others for as long as someone has diarrhea, and some infections can be contagious even longer.
Diarrheal infections can be spread through:
dirty hands contaminated food or water some pets direct contact with fecal matter (i.e., from dirty diapers or the toilet) Anything that the infectious germs come in contact with can become contaminated. This includes toys, changing tables, surfaces in restrooms, even the hands of someone preparing food. Kids can become infected by touching a contaminated surface, such as a toilet or toy, and then putting their fingers in their mouths.
A common cause of diarrhea is viral gastroenteritis (often called the "stomach flu," it also can cause nausea and vomiting). Many different viruses can cause viral gastroenteritis, which can pass through a household, school, or day-care center quickly because it's highly infectious. Although the symptoms usually last just a few days, affected kids (especially infants) who are unable to get adequate fluid intake can become dehydrated.
Rotavirus infection is a frequent cause of viral gastroenteritis in kids. Rotavirus, which usually causes explosive, watery diarrhea, infects almost all children in the United States by the time they're 4 or 5 years old, although not all will show symptoms. Rotavirus commonly causes outbreaks of diarrhea during the winter and early spring months, especially in child-care centers and children's hospitals.
Another group of viruses that can cause diarrhea in children, especially during the summer months, are enteroviruses, particularly coxsackievirus.
Many different types of bacteria and parasites can cause GI and diarrhea. Here are a few that you may have heard about:
E. coli bacteria: Most E. coli infections are spread through contaminated food or water, such as undercooked hamburgers or unwashed fruit that came into contact with animal manure. E. coli infections, which usually affect kids during their first few years of life, also can be spread via contaminated swimming water and petting zoos. Salmonella enteritidis bacteria: In the United States, these bacteria (found in contaminated raw or undercooked chicken and eggs) are a major cause of food poisoning, especially during summer. Campylobacter bacteria: Infants and young adults are most commonly affected by these infections, especially during the summer. The bacteria are often found in raw and undercooked chicken. Shigella bacteria: Shigella infection (called shigellosis) spreads easily in families, hospitals, and child-care centers. Kids 2 to 4 years old are the most likely to be infected. Giardia parasite: Infection with Giardia (called giardiasis) is easily spread through child-care settings and contaminated water supplies, especially water parks and pools (the bacteria are resistant to chlorine treatment), children's "touch tanks" in aquariums and museums, and contaminated streams or lakes. Cryptosporidium parasite: Found especially in drinking and recreational water, this parasite often is the culprit behind diarrhea epidemics in child-care centers and other public places. Cryptosporidiosis often causes watery diarrhea that can last for 2 weeks or more. Diarrheal infections are a normal part of childhood for many kids, but diarrhea can be a symptom of a number of non-infectious diseases and conditions, especially when it lasts several weeks or longer. It can indicate food allergies, lactose intolerance, or diseases of the gastrointestinal tract, such as celiac disease and inflammatory bowel disease.
Signs and SymptomsSymptoms typically start with crampy abdominal pain followed by diarrhea that usually lasts no more than a few days. Infections with many of the viruses, bacteria, and parasites that cause diarrhea also can bring on other symptoms, such as:
fever loss of appetite nausea vomiting weight loss dehydration In cases of viral gastroenteritis, kids often develop fever and vomiting first, followed by diarrhea.
Preventing DiarrheaAlthough it's almost impossible to prevent kids from ever getting infections that cause diarrhea, here are some things to help lessen the likelihood:
Make sure kids wash their hands well and often, especially after using the toilet and before eating. Hand washing is the most effective way to prevent diarrheal infections that are passed from person to person. Dirty hands carry infectious germs into the body when kids bite their nails, suck their thumbs, eat with their fingers, or put any part of their hands into their mouths. Keep bathroom surfaces clean to help prevent the spread of infectious germs. Wash fruits and vegetables thoroughly before eating, since food and water also can carry infectious germs. Wash kitchen counters and cooking utensils thoroughly after they've been in contact with raw meat, especially poultry. Refrigerate meats as soon as possible after bringing them home from the supermarket, and cook them until they're no longer pink. After meals, refrigerate all leftovers as soon as possible. Never drink from streams, springs, or lakes unless local health authorities have certified that the water is safe for drinking. In some developing countries, it may be safer to drink only bottled water and other drinks rather than water from a tap. Also, exercise caution when buying prepared foods from street vendors, especially if no local health agency oversees their operations. Don't wash pet cages or bowls in the same sink that you use to prepare family meals. Keep pets' feeding areas (especially those of reptiles) separate from family eating areas. When to Call the DoctorCall your doctor if your child has diarrhea and is younger than 6 months old or has:
a severe or prolonged episode of diarrhea fever of 102°F or higher repeated vomiting, or refusal to drink fluids severe abdominal pain diarrhea that contains blood or mucus Call the doctor immediately if your child seems to be dehydrated. Signs of dehydration include:
dry or sticky mouth few or no tears when crying eyes that look sunken into the head soft spot (fontanelle) on top of the head that looks sunken lack of urine or wet diapers for 6 to 8 hours in an infant (or only a very small amount of dark yellow urine) lack of urine for 12 hours in an older child (or only a very small amount of dark yellow urine) dry, cool skin lethargy or irritability fatigue or dizziness in an older child Caring for Your ChildMild diarrhea is usually no cause for concern as long as your child is acting normally and drinking and eating enough. Mild diarrhea usually passes within a few days and kids recover completely with care at home, rest, and plenty of fluids.
A child with mild diarrhea who isn't dehydrated or vomiting can continue eating and drinking the usual foods and fluids, including breast milk or formula for infants and milk for kids over 1 year old. In fact, continuing a regular diet may even reduce the duration of the diarrhea episode, while also offering proper nutrition. Of course, you may want to give a child smaller portions of food until the diarrhea ends.
Antibiotics or antiviral medications are not prescribed for cases of diarrhea caused by bacteria and viruses because most kids recover on their own. But antibiotics are sometimes given to very young children or those with weak immune systems to prevent a bacterial infection (such as salmonellosis) from spreading through the body.
If the illness is caused by a parasite, it can be treated with antiparasitic medicines to cure or shorten the course of the illness. The doctor may order a stool test, in which a stool sample will be examined in the laboratory to see which specific germ is causing the diarrhea (bacteria, virus, or parasite).
Although you may be tempted to give your child an over-the-counter anti-diarrhea medication, don't do so unless your doctor gives the OK.
The primary concern when treating a diarrhea is the replacement of fluids and electrolytes (salts and minerals) lost from the body from diarrhea, vomiting, and fever. Depending on the amount of fluid loss and the severity of vomiting and diarrhea, your doctor will probably instruct you to:
Continue your child's regular diet and give more liquids to replace those lost while the diarrhea continues if there are no signs of dehydration. Offer additional breastmilk or formula to infants. Use an oral rehydration solution (ORS) to replace lost fluids in non-dehydrated children. Many of the "clear liquids" used by parents or recommended by doctors in the past are no longer considered appropriate for kids with diarrhea. Don't offer: plain water, soda, ginger ale, tea, fruit juice, gelatin desserts, chicken broth, or sports drinks. These don't have the right mix of sugar and salts and can even make diarrhea worse. Infants and small children should never be rehydrated with water alone because it doesn't contain adequate amounts of sodium, potassium, and other important minerals and nutrients.
Doctors often recommend that kids who show signs of mild dehydration be given oral rehydration solutions to replace body fluids quickly. These are available in most grocery stores and pharmacies without a prescription. Brand-name solutions often end in "lyte." Your doctor will tell you what kind to give, how much, and for how long. Never try to make your own ORS at home unless your doctor says it's OK and gives you a precise recipe.
In some cases, kids with severe diarrhea may need to receive IV fluids at the hospital for a few hours to help combat dehydration.
The best way to manage your child's diarrhea depends on how severe it is, what germ caused it, and your child's age, weight, and symptoms. So be sure to ask your doctor for recommendations about treatment.