A no-nonsense guide to childhood illnesses
Childhood illnesses have been in the news a lot recently. Read our guide to help you know the difference between being aware and being worried about a childhood illness.
Whether it’s scary stories of missed diagnosis, sensational headlines about killer bugs, or helpful awareness campaigns like the Government’s recent drive on sepsis, chances are you’ve never been more alert to the signs and symptoms of potential problems. But there’s a fine line between awareness and worry, so here’s our facts-only guide to some of the problems that have been making the news.
Sepsis (also called septicaemia) is an abnormal reaction to infection. This infection might come from something that’s usually harmless, such as a scratch or cut, or be related to an illness such as chickenpox or meningitis. Whatever the source, though, in sepsis the body overreacts, reducing he blood supply to vital organs. It is estimated to affect just 200 in every 100,000 children a year in the UK, and in around 1,000 cases it is fatal. This obviously makes it very rare, but it’s still something you absolutely must be aware of.
‘If we catch it early and give the right antibiotics to control the source of the infection, sepsis is treatable and the survival rate is very high,’ says Dr Ron Daniels from the UK Sepsis Trust. The problem is that the symptoms of sepsis – which in a child include both a high (above 38°C) and a low (under 36°C degrees) temperature, problems breathing, floppiness and a change in behaviour including lack of interest in food or surroundings – mimic those found in many other conditions. This is why even doctors can find it hard to diagnosis.
‘I’d never heard of sepsis when my daughter Layla, now four, came down with it at 13 weeks, I just knew she wasn’t right,’ says Hayley. ‘She was hardly feeding, not urinating, had a painful cry and couldn’t get comfortable. Her temperature was also 40°C. I only realised how serious it was when the doctor said she was too sick for them to care for her and she had to be transferred to London. I now realise how lucky we were that she survived.’
The essential advice
If your child has a bug or infection, is rapidly getting worse and the symptoms seem different to any previous illness they’ve had, it could be sepsis. You’ll find a full list of symptoms to watch for at nhs.uk/sepsis or sepsistrust.org. ‘If any develop, ask your doctor to consider sepsis, explain exactly why you’re so worried and don’t take no for an answer,’ says Dr Daniels. However, there are some symptoms that warrant urgent action. New NHS advice says that if your child has an infection, and also suffers any of the following, bypass your doctor and instead call 999 or go to A&E immediately just in case.
- Looks mottled, bluish or pale
- Is very lethargic or difficult to wake
- Feels abnormally cold to touch
- Is breathing very fast
- Has a rash that does not fade when you press it
- Has a fit or convulsion
Group B Strep
Around 20-30 per cent of people carry group B streptococcus (GBS). Normally it lives in the gut and, in 22 per cent of women, the vagina, with no symptoms or health risk. However, if it’s present during labour the bacteria can pass to the baby. Again, often this is harmless; but sometimes it can cause an infection in the days or few weeks after birth. This infection creates symptoms such as high temperature and breathing difficulties and, if not treated can develop into life-threatening conditions including blood poisoning, meningitis or pneumonia.
Jenny had no idea she was a carrier until her daughter Susanna, now 14 months, became sick when she was eight hours old. ‘I noticed she was very cold and purple. She was also grunting. I pressed the buzzer on my bed for help and they took her straight to the Special Care Baby Unit. I felt it was my fault as the bacteria was passed on from me. Seeing her so helpless in the incubator, not knowing if she was going to get better was awful but she’s now doing very well. Her consultant is delighted with her.’
Group B Strep affects around one in 1,000 babies born each year in the UK and, says Professor Philip Steer from Group B Strep Support, is the cause of one third of all new born infections overall.
The essential advice
Most cases of Group B Strep can be prevented by the use of antibiotics during labour, but to take advantage of this you need to know that you’re carrying the bug. Some NHS areas will offer testing at 35-37 weeks if they think you’re at a higher risk, or if you ask for the test, but many don’t - so you might want to consider private testing.
The gold standard test is called the ECM test, which uses samples from your vagina and rectum. ‘It’s a very simple test that you do yourself at home and results are returned within 24 hours,’ says Professor Steer. It costs around £35. To find organisations offering the test visit gbss.org.uk.
There are an estimated 3,200 cases of bacterial meningitis and associated septicaemia every year in the UK. ‘Children under five years old, and particularly those under a year, are most at risk,’ says nurse Claire Donovan from Meningitis Now. ‘It’s a relatively rare disease but it is life-threatening and diagnosis in the early stages can be difficult.’
The essential advice
The good news is that there are vaccines for some types of meningitis and they are very effective. New figures suggest that as a result of the meningitis B jab, introduced to the NHS vaccination programme in September 2015, cases have dropped by 42 per cent. So it’s important to ensure your child has all the jabs they are eligible for. Right now the MenB jab is only given to children under one but, depending on levels of stock, you may be able to pay for older children to be vaccinated privately.
However, not every type of meningitis can be protected against with vaccines, so it’s also important to be aware of symptoms. ‘The early signs of meningitis can be similar to flu and include fever, headache, nausea, vomiting and muscle pain. More specific signs include a fever with cold hands and feet, drowsiness, confusion, a stiff neck and a dislike of bright lights,’ says Claire.
And then there’s that rash. Meningitis can produce a rash that doesn’t fade if you roll a clear glass over it – CAN being the key point as not every child gets a rash.
‘I knew Max, now five, was ill but I had no idea how ill,’ says mum Rachel. ‘When the doctor said meningitis we were confused as he had no rash – until the doctor said to look closely. Then I could see he had a pinprick rash but nothing like the bright red spots I associated with the glass test. If I gave one bit of advice it would be don’t wait for the rash before asking for help.’
Recent high-profile cases of chickenpox leading to sepsis, or flesh-eating bugs, have brought an infection most mums think is harmless into the headlines. But should you worry? ‘For most children chicken pox is nothing more than a mildly uncomfortable illness which gets better on its own after five to seven days,’ says paediatrician Dr Andy Raffles from Dr Ian Hay Ltd London. ‘However, it is possible for some spots to become infected with bacteria, in some cases streptococcus A which, rarely, can lead to a serious infection which may spread to deeper tissues.’
Antibiotics can treat this but it can be very serious – even life-threatening. Chickenpox is most dangerous in children with impaired immunity or who are using steroids. If this is your child, speak to your GP as there is a vaccination available.
The essential advice
The normal chickenpox rash consists of red spots that blister and scab. If, however, your child’s skin starts to look very red and sore with chickenpox, or they start to develop secondary symptoms such as breathing problems, drowsiness, headaches or weakness, then get advice from a doctor.
Also, it’s strongly advised that you never give ibuprofen to a child with chickenpox, as it can increase the risk of more serious skin infections. ‘No one told me this and my son ended up with poxes on top of poxes – thankfully he was fine after two days in hospital,’ says Carrie, mum of James, three. You can give an antihistamine tablet which might help with itching.
A sudden rise in the incidence of whooping cough in 2012 is why all pregnant women are now offering a vaccine against the condition. This passes immunity onto the baby which lasts until their official vaccination. ‘The initial symptoms of whooping cough are similar to those of any cold – mild fever, runny nose, sneezing and a cough. About a week after there’ll be bouts of a more intense cough and between the cough, you sometimes hear a whooping noise as the child gasps for air. If you’re concerned your child might have it, see your doctor as it can be treated with antibiotics,’ says GP Dr Philippa Kaye.
The essential advice
If you’re pregnant, have the jab – recent research from Imperial College London found that only one in four mums actually do. Since the introduction of vaccination for mums-to-be, nine babies have died from whooping cough – eight born to mothers who had not had the vaccination. Also ensure that your baby gets all their boosters. It’s said that epidemics of whooping cough occur every four to five years, and considering the last big outbreak was in 2012 (with 9,300 cases), and that cases have been well above average for the past few years, we might be due for an increase in cases around now.
Mum Gina was terrified when doctors mentioned whooping cough when her daughter Caitlin, now four, started gasping for air when coughing. ‘It was like she couldn’t get enough air and so I rang 111. They listened to her breathing and advised I take her to A&E straight away, stopping to dial for an ambulance if she got worse on the journey. When I got to the hospital, she was actually diagnosed as having croup. The phone service had erred on the cautious side as I couldn’t remember if she’d been vaccinated or not – but her records showed she had. I was so relieved.’
Health headlines you needn't panic about
The papers said: cuddling cats can kill...
The facts: The report was talking about bacteria that cats can carry in their mouth or on their claws, that can pass to humans. What the headline didn’t tell you was, it’s extremely rare – US figures indicate that fewer than ten children per 100,000 are affected in a year – and in most cases, it causes only a fever, swelling and a nasty pustule.
The papers said: British children at risk from killer polio-type virus...
The facts: The virus is called enterovirus D68 and the headline was sparked by four children in Edinburgh being affected. ‘Yes, it is a member of the polio family but in most children it’s easily managed and just appears like a cold or flu,’ says private GP Dr Claire Thompson. ‘However, it can be harder to manage in immunocompromised children or those with breathing problems like asthma which is why it’s important to be aware if there is an outbreak in your area.’
The papers said: scarlet fever cases increase by 50% in a week...
The facts: Autumn and winter are prime scarlet fever season so that’s not unexpected, but the fact that the condition that produces a fever and sandpapery red rash makes headlines every time does need to be discussed. While it used to be a deadly disease, ‘Nowadays scarlet fever is completely treatable with antibiotics,’ says Dr Thompson. ‘It does spread like wildfire though, so keep affected children at home.’