The purpose of this card is for parents/guardians who are calling as their child has been in contact with a contagious disease and they need advice. The three main groups we want to find are children with symptoms, children without symptoms and pregnant people who have been in close contact with the case. We have provided an information link for each disease to be sent to the parent/guardian.
Hand, Foot and Mouth
HFM is a contagious disease caused by viruses, often seen in young children at nursery or primary school.
There are commonly 2 stages of HFM:
- Sore throat, high temperature and loss of appetite
- Mouth ulcers and a rash ( raised spots on hands and feet, sometimes groin and bottom )
Treatment is supportive cares, making sure the child is able to drink fluids and take simple pain relief. A pharmacist can supply sprays, gels and mouth washes for pain relief of ulcers and rash.
Scarlet fever
Scarlet fever is a bacterial infection (caused by Strep pyogenes / Group A Streptococcus) and is treated with antibiotics.
Symptoms are usually a flu-like illness followed by a body rash, tongue swelling and red cheeks. The rash often feels rough like sandpaper and the tongue swelling can have a white coating with little bumps (often referred to as a ‘strawberry tongue’).
Scarlet fever can lead to complications if left untreated, eg chest infection, ear infections, meningitis and rheumatic fever (affects the heart).
Whooping cough
Whooping cough, also called Pertussis, is a bacterial infection (caused by Bordetella pertussis) and is treated with antibiotics.
Symptoms are usually a flu-like illness, followed by a prolonged period of coughing bouts with a “whoop” sound. Children may also have difficulty breathing, turn blue/grey and vomit post coughing.
Whooping cough can be very dangerous, especially in young children, as they can become dehydrated, have breathing difficulties, develop pneumonia or have seizures.
Treatment for whooping cough depends on duration of infection and age. Antibiotics may not reduce symptoms, but may help stop it spreading to others. Children, especially younger children and those with complex medical conditions, may need supportive care in a hospital setting to help with their breathing.
Chickenpox
Chickenpox is caused by the Varicella Zoster virus and is common, usually getting better without treatment after 2 weeks. Chickenpox is contagious so the child will need to isolate from others until all the spots have formed a scab.
There are commonly 3 stages of Chickenpox, alongside high temperature, aches + pains, and loss of appetite:
- Small red spots appearing anywhere on the body
- Spots become blisters and are very itchy
- Blisters become scabs
Pregnant people who have been exposed to a child with chickenpox and have not have chickenpox themselves need an urgent appointment. This is because the need an urgent blood test to check for immunity and may need a course of antiviral medication (acyclovir) or in-hospital treatment. This blood test is not done at the GP Surgery as it would take too long for the result to be returned ie more than 24 hours. This is why we recommend the pregnant person to go to A&E.
Measles
Measles is a viral illness that is highly contagious.
The first symptoms of measles can be a flu-like illness, then the child develops spots in the mouth and a rash.
If you get measles while pregnant, it may harm the unborn baby. It can cause miscarriage, stillbirth, premature labour and low-birth weight infants. Two doses of the MMR vaccine protects 99% if people against the virus.
Post-exposure prophylaxis can be offered to pregnant people and those at high risk. This is either the MMR vaccine or immunoglobulins through an intravenous drip, but this must be done with urgency. This is why we send pregnant people to A&E in order to have the blood tests and treatment if required.
Norovirus
Norovirus is a contagious vomiting bug that usually self-resolves in 2-3 days after symptoms start. It is important patients stay off school / work until no vomiting or diarrhoea for at least 2 days, and to not visit hospitals or care homes in this time.
Norovirus is dangerous if the child cannot maintain adequate fluid intake (they become dehydrated) leading to electrolyte imbalances and/or renal failure.
Hepatitis A
Hepatitis A is a viral illness that is usually self-limiting and benign, but can uncommonly cause liver failure. The virus is most commonly spread by infected faeces and poor hygiene.
Common symptoms include flu-like illness, followed by signs of liver distress ie upper abdominal pain, dark pee, itchy skin and yellowing of the skin. Some patients may be vaccinated against Hepatitis A, especially if they are a healthcare worker or have travelled to countries where it is more prevalent.
There is no treatment for Hepatitis A and is more focused on the symptoms eg itch or abdominal pain.
Meningococcal
Meningoccocal disease is a bacterial infection (caused by Neisseria meningitidis) and is treated with antibiotics.
This bacteria can cause meningitis (infection of the lining that covers the brain) and septicaemia (blood poisoning).
Symptoms of meningitis include severe headache, stiff neck, sensitivity to light and drowsiness. This disease can progress extremely rapidly and children can become sick very quickly.
- The rash is non-blanching which means when it is pressed it does not fade. This is because the rash is due to damaged blood vessels just under the skin (petechial rash).
- The stiff neck is due to inflammation of the lining of the brain and spinal cord.
Close contacts of patients with meningococcal meningitis are likely to be given antibiotics following discussion with a regional health protection unit. This is why they are added to the Duty Doctor list.
Influenza
Children with complex medical conditions are at higher risk of deteriorating and this is why we ask for this as part of this card. If the patient is not high risk, then their symptoms can be triaged like any other cold and cough.