Mother, mother, I am sick

First responder.” As a parent or caregiver have you ever thought of yourself as one? As you know your child best, you rely on your gut instinct if something is amiss. Though you may not qualify in the strictest sense, lacking the training needed for the job which entails dealing with emergencies, think about the following. You are the first one to come to the scene, check the situation, and provide assistance before medical help arrives. You are the primary source of information for which the pediatrician forms the basis of his initial diagnostic impression.

In children, emergency room consults revolve around respiratory concerns, allergic reactions, dehydration, injuries, or infections. Focusing on the latter, allow me to provide you with the minimal basics so as to avoid that trip to the hospital.

In general, infections are either bacterial or viral. Fortunately, most common childhood illnesses are viral in nature, self-limiting, and only require supportive care.

Perfect examples include the “common cold” attributed mostly to rhinoviruses; roseola from human herpes virus 6 sometimes referred to as “baby measles,“ characterized by a three-day fever followed by a rash; gastroenteritis for which rotavirus is the most common and popular in the news lately; hand, foot, mouth disease mostly from the coxsackie viruses.

What to do? In all four examples, antibiotics are not warranted. Fever, which should be ideally documented, or pain may be managed with paracetamol. Ensure hydration with increased fluid intake or if warranted, oral rehydration solutions. Assess adequacy by observing the frequency of urination which should not be less than three times in a 24-hour period. In children experiencing diarrhea, avoid antimotility agents. For paracetamol, dosage in children is computed by weight and given with a minimum interval of four hours. Keep this out of reach to avoid accidental ingestion.

Serious infections. Those who are unimmunized or underimmunized are at a higher risk. Think of the myriad consequences or complications that may even lead to permanent disability, or even death from measles, mumps, rubella, polio, hepatitis B, hepatitis A, rotavirus, varicella (chickenpox), diptheria, pertussis, tetanus, Haemophilus influenzae type b, pneumococcal, influenza, and meningococcal infections. Routine vaccinations protect against these diseases. Currently, both global and national immunization coverage rates are beyond ideal, being lower than the thresholds set to achieve herd immunity, thereby leaving vulnerable populations at risk. From the latest surveillance report from the Department of Health in December 2022, vaccine-preventable cases such as measles have substantially increased from last year leaving us open to the possibility of another outbreak.

What to do? Have your children immunized against these diseases and catch up if needed.

With increasing mobility and travel being more accessible, the risk of disease exposure remains. Once you contract the illness, you are most likely to transmit the disease and be a moving threat to those who are unable to be immunized because of age or an immunocompromising condition. The cost and substantial overall burden to the family cannot be overemphasized.

How about other diseases with no available vaccines? If you have not realized it, you have all been “infection preventionists“ in your own capacity in the last two or nearly three years, helping interrupt the spread of viruses and bacteria. It is unfortunate that COVID happened, but on the upside, you have learned the importance of washing hands, using your mask appropriately, keeping your distance, avoiding direct contact with people who are ill, disinfecting surfaces, isolating when feeling sick, and handling potentially infectious waste.

Key points. First, in the presence of infection, initial management will always remain supportive. Second, immunizing your child with available vaccines may prevent serious infection. Third, adhering and observing to simple basic infection control practices is vital in avoiding disease.

“Mother, mother, I am sick; you don’t have to call the doctor that quick.”

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