During weather changes, alternating between hot and rainy, young children with weak immune systems may easily contract epidemics, and their illnesses tend to be more severe and complicated than adults. Therefore, parents must take special care of their children closely to prevent and monitor possible epidemics in children.
Hand, Foot, and Mouth Disease
Caused by Enterovirus (EV) or Coxsackie virus infection, which spreads through saliva and feces of infected patients. Infection can be transmitted orally through contaminated hands, toys, water, or food. Patients can spread the virus 2-3 days before symptoms appear and up to 1-2 weeks after symptoms. The virus can be found in feces for several weeks or months after symptoms. Symptoms usually appear 3-6 days after infection and are mostly found in children under 5 years old.
- Observable symptoms include fever, rash on palms, soles, mouth, tongue, and gums. Symptoms usually resolve on their own within 7-10 days. Complications are rare but may include encephalitis and myocarditis. Therefore, if a child shows symptoms of hand, foot, and mouth disease, take them to see a doctor immediately.
- Treatment for hand, foot, and mouth disease is symptomatic, such as giving fever reducers (paracetamol). Some children may have multiple mouth ulcers, making it difficult to eat or drink adequately. Children may refuse to swallow saliva or allow mouth cleaning, causing slow healing of mouth ulcers. Local anesthetic may be given about 10 minutes before meals to reduce pain and help with eating and drinking. In severe cases, intravenous fluids may be necessary.
- Prevention includes avoiding close contact with infected children, teaching children to wash their hands regularly, and preventing virus spread by not sharing eating utensils or drinking containers. Infected children should be separated and not taken to public places to avoid spreading the virus to others. School-aged children should stay home for 1 week from the onset of rash.
Herpangina
Caused by viruses in the Coxsackie virus group A (Coxsackie viruses A serotype 1–10, 16, and 22) and Enterovirus. The disease spreads through contact with nasal mucus, saliva, secretions, and feces of infected individuals. Infection can occur by touching contaminated surfaces and then putting hands in the mouth. Symptoms appear about 3–14 days after infection. Patients can spread the virus from the first day of infection until recovery, approximately 1–2 weeks after infection. The high-risk group is children under 10 years old.
- Observable symptoms are generally mild but may include sudden high fever up to 40°C, headache, body aches, vomiting, and prominent pain in the palate and throat. Within 1 day, red spots appear on the soft palate, uvula, and possibly red bumps on the tonsils or throat. These may be small ulcers in the center of the blisters or inflamed areas around the ulcers, numbering 5–10. Fever usually subsides within 2–4 days, but ulcers may last about 1 week.
- Treatment for herpangina is symptomatic, including cooling the body to reduce fever and giving paracetamol. Antiviral or antibiotic drugs are not required unless bacterial infection is suspected. If fever does not subside within 3 days, is high, or the child cannot eat or drink milk, shows signs of dehydration such as dry mouth, reduced urination, or lethargy, take the child to see a doctor immediately.
- Prevention There is currently no vaccine for herpangina. The best prevention is thorough handwashing with soap and clean water, avoiding contact with saliva, nasal mucus, and personal items of infected children, including toys. Infected children should stay home from school for 7 days.
Dengue Fever
Is a viral infection caused by the dengue virus, which has 4 serotypes: dengue 1, 2, 3, and 4. The “Aedes mosquito” is the vector that transmits the disease. When an infected mosquito bites a person, it transmits the virus causing symptoms. These mosquitoes breed in stagnant water around homes, such as water containers, jars, or puddles.
- Observable symptoms include continuous high fever of 39-41°C for 2-7 days, flushed face, headache, bone and muscle pain, eye socket pain, loss of appetite, nausea, vomiting, abdominal pain under the ribs or epigastric area, bleeding such as petechiae on the skin, nosebleeds, gum bleeding, and in severe cases, vomiting blood. If abnormal symptoms occur, seek medical attention immediately.
- Treatment for dengue fever includes resting in a well-ventilated area, cooling the body with lukewarm or warm water for 10-15 minutes to relieve discomfort, and giving paracetamol for fever. Paracetamol should be taken at intervals of at least 4-6 hours. Aspirin or ibuprofen should be avoided as they increase the risk of bleeding.
Drink electrolyte solutions or fruit juice with a small amount of salt, sipping slowly. Plain water alone is not recommended. Eat soft, easily digestible foods and avoid black or red-colored foods and drinks such as red syrup, watermelon, or chocolate to prevent confusion between vomiting blood and food. Monitor symptoms according to the doctor’s advice, especially during the first 3-5 days after fever onset.
- Prevention of dengue fever involves preventing mosquito bites by eliminating Aedes mosquito breeding sites. Cover water containers tightly to prevent mosquitoes from laying eggs, change water in vases and water tanks every 7 days to break the mosquito life cycle, release larva-eating fish in permanent water containers such as guppies, bettas, or gouramis, improve the environment to be open, clean, and breezy to avoid mosquito resting places, and practice these measures regularly until they become habits.
Diarrheal Disease
Can be caused by both viruses and bacteria, commonly found in children under 5 years old. Initial symptoms include diarrhea more than 3 times a day. When a child has diarrhea or vomiting, they may become dehydrated and lose electrolytes. Parents must closely observe symptoms and seek medical attention immediately.
- Treatment for diarrheal disease has no specific medication but can be managed symptomatically. If the child cannot eat, intravenous fluids and electrolytes should be given. Fever should be treated by cooling the body and giving fever reducers. If the child has abdominal pain or bloating, give anti-gas medication. Once vomiting stops, the child can eat rice porridge or soft food.
- Prevention includes frequent handwashing with soap and water or hand sanitizer, proper waste disposal to prevent fly breeding, and eating food that is “cooked, hot, and clean.”
Currently, there is a vaccine for rotavirus diarrhea, administered orally and suitable only for young children. It is approved by the Food and Drug Administration for effectiveness in preventing the disease, reducing severity, and high safety. The first dose is given to children over 6 weeks old, with subsequent doses 4 weeks apart, totaling 2 or 3 doses depending on the vaccine type. For older children, focus on personal hygiene maintenance.
Meningitis
Is caused by pneumococcal bacterial infection. Infected children may have high fever, lethargy, seizures, and weakness in limbs. Parents must closely observe symptoms as young children cannot express their symptoms. If these symptoms occur, seek medical attention immediately.
Since pneumococcal bacteria spread through the respiratory tract, avoid taking children to crowded places or, if unavoidable, have them wear masks. Immunization is recommended with doses at 2, 4, and 6 months, with a booster at 12-15 months. For children starting vaccination at 7-11 months, give two doses two months apart and a booster at 12-15 months. Children aged 1-5 years who have never received this vaccine should get one dose, except those with low immunity or high risk of severe pneumococcal infection, who should receive two doses two months apart.
For more information
Child Health Center, Phyathai 2 Hospital
Tel. 02 617-2444 ext. 3219-3220
