It’s back to school time again and no doubt more than
a few parents will be confronted with the child who is none
to keen on heading for the classroom. How often have you wondered
whether a child’s complaint of illness is “the
real thing” or just a ploy to get out of going to school?
Unnecessary absence from school may have a bad effect on a
student’s attitude, work habits and progress. You don’t
want to keep a child at home if he/she is not really sick;
but you do no want to send a sick child to school. A decision
must be made as to whether the child stays home or goes to
school. Below are some common signs and symptoms that will
help you to decide if your child is really sick and whether
he or she is fit to attend class.
FEVER
A fever is a warning that all is not right with the body.
The best way to check for fever is with a thermometer, which
every home should have. No child with a temperature over 100
F (37.8 C) should be sent to school.
COLD, SORE THROAT, COUGH
A child with a “mild” cold, but otherwise feeling
well, may go to school.
A child with a “heavy” cold and a hacking or productive
cough belongs at home even if there is no fever.
A child complaining of a mild sore throat with no other symptoms
may go to school. If spots can be seen in the back of the
throat, or if fever present, keep the child at home.
PAIN
Toothache – contact your dentist.
Earache – consult you doctor.
Headache – a child whose only complaint is a minor headache
usually need not be kept home. Frequent or persistent headaches
may indicate a serious health problem.
RASH
Rash or spots may cover the entire body or appear in only
one area.
Call you physician or school nurse if you are uncertain about
whether to send your child to school with a rash.
STOMACH ACHE, VOMITING, DIARRHEA
Consult your doctor if your child has a stomach ache which
is persistent or severe enough to limit his/her activity.
If vomiting occurs, keep your child home until he can keep
food down.
A child with diarrhea should be kept home.
Once you have made the decision that your child really is
unwell, you will need to consider whether or not the disease
is contagious, and how long your child will need to be kept
away from school. Below are some very brief guidelines for
some common childhood infectious diseases. This is by no means
a substitute for diagnosis, treatment and recommendation from
your clinic or family doctor.
Chickenpox (Varicella) - Appears as raised red spots that
change into blisters after a few hours, a rash usually presents
on trunk & face and a mild fever is present.
Incubation period is 10 - 21 days.
Method of transmission is via droplet spread, or direct contact
with discharge from the nose or throat.
The disease is contagious for up until 5 days after the blisters
appear.
Diptheria – The patient is generally unwell with sore
throat with patchy grey membrane on back of throat. Nasal
discharge may be bloody.
Incubation period is 2 -5 days.
Method of transmission is via droplet spread, or direct contact
with discharge from the nose or throat.
The disease is contagious for up to 2 weeks or until throat
cultures are negative.
Hepatitis A - Presents as fever, loss of appetite, nausea
with or without vomiting as well as fatigue, headache, abdominal
pain, may have jaundice (yellow skin and / or eyes).
Incubation period is 15 -25 days.
Method of transmission is via the oral – fecal route,
or through contaminated food, or dirty utensils.
The disease is contagious for up to 2 weeks after onset of
symptoms or 1 week after onset of jaundice.
Hepatitis B – Presents as fever, loss of appetite,
nausea with or without vomiting as well as fatigue, headache,
abdominal pain, may have jaundice.
Incubation period is 45 - 160 days (usually 60 – 90
days).
Method of transmission is via direct contact with body fluids
such as blood, serous fluid & semen.
This disease may be contagious for life. Care is needed when
handling body fluids from Hepatitis B positive patients.
Meningitis (Meningococcal or Haemophilus B) – Presents
as acute illness, fever, stiff neck, nausea, headache, with
or without a rash.
Incubation period is 1 - 10 days.
Method of transmission is via droplet spread, or direct contact
with discharge from the nose or throat.
Contagious for up to 24 hours after the onset of the disease.
All close contacts should be treated with antibiotics (Meningococcal
type).
Measles (Rubeola) – Presents with cough, fever &
watery eyes. Blotchy rash appears on 3-4th day over face and
trunk with white spots in the mouth.
Incubation period is 8 - 12 days.
Method of transmission is via droplet spread, or direct contact
with discharge from the nose or throat.
Contagious up until nasal discharge has disappeared or until
4 days after the rash has appeared.
Mumps – Patient is generally unwell with swollen glands
behind the jaw, and below the ear.
Incubation period is 12 - 25 days (usually 16 – 18 days).
Method of transmission is via droplet spread, or direct contact
with discharge from the nose or throat.
Contagious up until 9 days after the swelling has appeared.
Pertussis (Whooping cough) - Presents with spasmodic cough,
vomiting. Not all cases have the typical “whoop”
when they cough.
Incubation period is 6 - 20 days.
Method of transmission is via droplet spread, or direct contact
with discharge from the nose or throat.
Contagious up until 21 days after the cough begins or 5 days
after antibiotics have been started.
Rubella (German measles) - Usually presents as a mild illness
with swollen neck glands and a fine pink rash on face spreading
to face & limbs.
Incubation period is 14 - 21 days (usually 16 – 18 days).
Method of transmission is via droplet spread, or direct contact
with discharge from the nose or throat.
Contagious up until 7 days after the rash appeared. Special
care should be taken to avoid close contact with pregnant
women.
Tuberculosis (TB or TBC) – May present as asymptomatic
to chronic cough, fever, weight loss and generally feeling
unwell. Typically a close family member is carrier.
Incubation period is 14 - 21 days (usually 16 – 18 days).
Method of transmission is via droplet spread, or direct contact
with discharge from the nose or throat.
Contagious up until 14 days after the commencement of antibiotic
therapy
Typhoid fever –Presents as fever, headache, rash with
nausea, diarrhea or constipation.
Incubation period is 14 - 21 days (usually 16 – 18 days).
Method of transmission is via the oral – fecal route,
or through contaminated food, or dirty utensils.
Contagious up until 7 days after the commencement of antibiotic
therapy
Scarlet fever – Presents as with a sudden onset of
fever, vomiting, sore throat. A bright red rash appears on
2nd - 3rd day.
Incubation period is 2 - 5days.
Method of transmission is via droplet spread, or direct contact
with discharge from the nose or throat.
Contagious up until 24 hours after the commencement of antibiotic
therapy.
Strep. Throat – Same as for scarlet fever without the
appearance of the “scarlet” rash.
Impetigo (School sores) – Appear as small blisters
that burst & form thick yellow scabs. Often there are
more than one lesion.
Incubation period is 4 – 10 days.
Method of transmission is by direct contact with discharge
from lesions or sores.
Contagious up until 24 hours after the commencement of antibiotic
therapy (local or oral). Young children may need to be kept
at home, however older children may attend school as long
as the lesion is covered.
Pediculosis (lice) – Presents with scalp irritation,
or detection of lice eggs in hair.
Eggs hatch in 6 – 10 days.
Method of transmission is by direct contact with hair, combs,
hair brushes, hats, helmets, pillows etc.
Contagious up until after hair has been treated and hair is
nit and egg free.
Tinea Corporis (Ringworm) – Presents as round scaly
spots on the skin or scalp. May or may not be itchy.
Incubation period is unknown.
Method of transmission is by direct contact with lesion.
Contagious up until treatment has been started. Young children
may need to be kept at home, however older children may attend
school as long as the lesion is covered.
Scabies – Presents as small red spots typically between
fingers and elbow creases. The affected areas are very itchy.
Incubation period is variable.
Method of transmission is by direct contact with lesion.
Contagious up until treatment has been started.
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
