What's Going Around?
Most common fall illnesses

It's back to school time. We all know that your kids are going to pick up more than just new friends and new brain connections. They will also pick up lots of germs from their new circle of buddies. During the first few weeks of the fall season our office switches from the quiet, end-of-summer mode to the hectic, "every school-age child is getting sick" mode.

Here is a discussion on the most common fall illnesses, how to treat them, how to avoid them, when to worry, and when not to worry. These include Strep throat, non-strep sore throats, pink eye (conjunctivitis), coughs and colds, high fevers with general aches and pains, and viral meningitis.

BOOST YOUR CHILD'S IMMUNE SYSTEM DURING THE BACK-TO-SCHOOL SEASON
Want to help your kids avoid these illnesses altogether? Here are some ways you can boost their immune system and keep them in school:

• Echinacea - this natural herb will enhance your own immune system. Many research studies have proven its effectiveness. Click here for dosing information for you and your kids.

• Vitamin C - this simple vitamin can fight off invading germs. Younger kids up to age 6 will benefit from around 250 mg per day. Older kids and adults can take 500 mg per day. Available as a powder, chewable, or capsule.

• Fruits and vegetable supplement - the immune-boosting properties of nature's food is remarkable. If your kids won't eat enough fruits and vegetables, I recommend Juice Plus fruit and veggie supplements. Click here to learn more.

• Zinc - this mineral is a safe and effective way to boost the immune system. Children up to age 6 years can take 10 to 20 mg per day. Older kids and adults can take 20 to 40 mg per day.

• Probiotics - the common name used for this is Acidophillus. These are healthy bacteria that live in our intestines and help with our immune system. The best species of probiotics are lactobacillus and bifidobacteria. Available as liquid, powder, and capsules, children and adults can take as directed.

• Avoid weakening your own immune system - Click here to read what habits can weaken your own immune system.

STREP THROAT, AND NON-STREP VIRAL SORE THROATS
Sore throats are the MOST COMMON back-to-school illnesses because they are very contagious. Some sore throats are caused by a bacteria called strep, which can be treated with antibiotics. Other sore throats are caused by virus, which CANNOT be treated with antibiotics.

Here's how to tell which kind your child has:

Signs of strep throat:

• Sudden onset of moderate to severe sore throat.

• Fever is very common to strep throat, although viruses can also give you fever. Fever over 101° for more than three days is more likely to be strep throat.

• Very red throat with bright red spots on the back of the palate and white pus on the tonsils. One note, however, is that some viruses can also look this way, and sometimes strep may not look this bad.

• Known exposure to someone with strep throat.

• Age older than three years - it is uncommon for a child less than age 3 to get strep throat.

• Swollen neck glands.

• Pain with swallowing or pressing on the neck glands - simply having pain during coughing usually is not strep throat.

• No other symptoms besides sore throat and fever - strep throat usually does not cause multiple symptoms such as runny nose, cough, and congestion. If you have multiple symptoms, it is less likely to be strep.

• Headache, stomachache and vomiting can, however, occur with strep.

• Rash - there is a characteristic rash that sometimes accompanies strep throat. This appears as fine, red pimples all over the trunk (chest, abdomen and back) that feel rough, almost like sandpaper. This rash, with strep throat, is called Scarlet Fever. Do not worry, this is not serious like it used to be. It is simply the body reacting to a toxin produced by the strep. It does not mean the infection is more serious, and it goes away with treatment.

Signs that your child is more likely to have an untreatable virus, and not strep:

• Age 3 or younger.
• Multiple cold or flu symptoms.
• Throat not very red.
• Child not acting very sick overall.
• Throat pain only when coughing, but not when swallowing or pressing on throat.

So what do you do when your child starts complaining about a sore throat?
Do not run your child to the doctor at the first sign of a sore throat. Wait a day or two, or more if your child is not acting ill. See which direction the illness is going. If your child begins to fit the picture of strep throat above, then go see your doctor.

One good thing about Strep throat is that you can safely delay treatment for up to one week without risking any worse complications.

Click here for a complete guide to everything you need to know about sore throats.

PINK EYE
There are many different causes of red eyes, but the one we mostly see during the back-to-school fall season is bacterial and viral pink eye.

• Bacteria - when the eyes are red with yellow or green drainage oozing or crusting in the eye throughout the day and night, then bacteria are usually the culprit. The eyelids may also be swollen. Affects one or both eyes. This can be treated with antibiotic eye drops.

• Virus - when the eyes are very red, but there is no drainage, or only a small amount of drainage or crusting upon waking up, then it is probably viral conjunctivitis. Usually affects both eyes. This does not need antibiotic eye drops.

What should you do if your child has pink eye?
Do not rush into the doctor's office on the first day. Both viral and bacterial pink eye are contagious, and viral is even MORE so. Keep your child home for one day and see which of the two above scenarios fits your child best. If you suspect bacterial pink eye, call your doctor. There is no need to page your doctor after hours. It can wait until the morning to start eye drops.

Click here for a complete discussion on pink eye.

COUGHS AND COLDS
The back-to-school fall season is a field day for the common cold virus. After a fairly healthy summer, many children will catch a cold during the first few weeks of school. The first thing to realize is that some colds and coughs, even green noses and junky coughs, are caused by both viruses and bacteria. Therefore, antibiotics are usually not always needed.

Click here for a complete guide to deciding what to do for you child's cold and when to call your doctor.

THE SUMMER FLU VIRUS - MYSTERIOUS FEVERS AND ACHES
Although this is more of a summer illness, we also see it run into the fall months. It is fever with no other symptoms except general aches and pains. Whereas most parents expect some fever when their child is going through a bad cold or the wintertime flu, many parents are naturally worried when their children come down with high fevers and aches with no other symptoms.

Don't worry! This mysterious fever is probably the summer flu virus. It will run its course in a few days without any need for any antibiotics.

Main symptoms of the summer flu virus include:

• Fever - may be as high as 104°, and may last for up to five days.
• Headaches - this is a common sign, especially when the fever is higher.
• Sore throat
• Body aches
• Vomiting

Treating the symptoms

• Fever reducers such as Tylenol or ibuprofen if the fever is high or your child is miserable. Lower fevers (below 102°) in happy children do not need to be medicated. Click here for a complete discussion on treating fevers.

• Pain relievers such as Tylenol or ibuprofen, aside from treating the fever, will also help with the headache, sore throat, and body aches. You may find that ibuprofen works better for the general aches and pains from this virus.

• Click on vomiting for detailed instructions.

• Drink lots of fluids.

• Click on Tylenol or on Ibuprofen for dosage instructions.

• Antibiotics won't work because it's a virus, not a bacteria.

When NOT to worry - don't call the doctor
A general guideline for this illness is that if your child is feeling and acting well when the fever is down, then you can probably rest assured that there is nothing to worry about. Even if your child looks sick when the fever is high, the key is how he looks when the fever and aches are under control. Expect it to run its course in two to five days. If your child is doing fairly well, you don't need to see your doctor. If the fever runs more than three days, a doctor's visit is advised just to make sure.

Worried about strep throat? It is often difficult to tell if you have strep throat (treatable with antibiotics) or have a severe sore throat as part of this virus. See strep throat above for a detailed discussion.

When to worry - CALL YOUR DOCTOR
If your child is acting lethargic and looks very sick even when the fever is down, you should take your child to the doctor that day. If your child is vomiting (more than just a few times) and/or has severe neck pain (where the back of the neck, not the throat in front, is painful and so stiff your child won't look down), this could mean he has meningitis. You should see or page your doctor right away. See our longer discussion below on meningitis if your child has the vomiting and neck pain symptoms.

VIRAL MENINGITIS
This occurs when a normal cold or sore throat virus spreads into the lining of the brain or spinal cord, causing an infection. It is rare, as most such viruses run their course through our bodies without spreading to the brain. Viral meningitis is not treatable with antibiotics. Bacterial meningitis, on the other hand, is treatable. It is viral meningitis, however, that seems most prevalent during this summer season. Bacterial meningitis does not occur during any particular season.

Here are the five main symptoms of meningitis:

• Fever - will usually be high, over 103°.

• Severe head ache - this is not a typical headache. It is extremely painful.

• Vomiting - the irritation in the brain triggers persistent vomiting (more than just a few times).

• Neck pain and stiffness - this does NOT apply to sore throat pain in the front of the neck. It refers to severe pain in back of the neck. Looking down at your stomach (stretching the back of your neck) will cause severe pain. Some kids will refuse to look down at all. They will keep their neck rigidly stiff.

• Photophobia - this means that light hurts your eyes. Meningitis will cause someone to refuse to look into light, especially the bright sunlight.

How to tell if your child may have meningitis.

• If your child has all five symptoms, don't even call or page your doctor. GO STRAIGHT TO AN EMERGENCY ROOM.

• The key to meningitis is the neck pain and stiffness. So if your child has severe neck pain and stiffness, and one or more of the other four symptoms, call your doctor to be seen right away, or page the doctor after hours.

On the other hand, if your child does NOT have neck pain or stiffness, and DOES have the other symptoms, then it is much less likely to be meningitis.

• In fact, the first three symptoms above, without neck pain or stiffness, is probably the flu virus described first in this article.