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How do I know if my child is too sick for day care?

How do I know if my baby is contagious?

I can't tell you how many times in my day that I am called on as the "Sugar Plums doctor". While I have seen most childhood illnesses in my time, I am not a doctor, even though "Dr. Ellick" has a nice ring to it. I would still advise my families to see the pediatrician if your child is sick. This article suggests that these contagious symptoms are more popular in the fall and winter months. I am sharing this article because I have seen these common illnesses throughout the year despite the season. Here are five of the most common contagious illnesses.

"The sick list: Spotting and treating 5 contagious illnesses and ailments your child may encounter."

"Many illnesses that are easily spread peak in the fall and winter months, and this is particularly true among kids as they settle into school routines among their equally germ-prone peers.

“If you’re talking about reports of clusters of cases that we hear from schools about, No. 1 and 2 are cold and flu-type symptoms and stomach virus-type symptoms,” says Matt Zahn, Orange County’s medical director of epidemiology.“And there really isn’t a close third.”

It’s almost a given that parents will encounter either of those two or one of the other contagious illnesses and ailments on the list. Here is a guide to their causes, how to identify symptoms and how to treat them. The treatments are based on scientific evidence and best practices, but your pediatrician might have recommendations better suited to your situation.


Influenza, commonly known as flu, is an infectious respiratory illness. Fall sparks the onset of flu season; it typically peaks in late December to February and then may stretch into May. While seasonal flu and the common cold share many symptoms, a fever is almost always present with the flu and is less common in colds.

“The big thing that distinguishes between flu and a cold for me is that the kids will be really achy with the flu,” says Dr. Angela S. Dangvu, a pediatrician at Pediatric & Adult Medicine in Tustin, a member of CHOC Children’s Network. “Their legs will ache, their back will hurt, whereas you wouldn’t normally see that with a cold. And just the way they look. … They just look sicker.”

Vaccination is the best method in preventing influenza each year. The federal Centers for Disease Control and Prevention recommends that everyone 6 months and older get a flu shot each new season in the fall. Children younger than 5, especially those younger than 2, and kids of any age with chronic health problems are at high risk of serious flu complications.

“Each year, schools are a big part of the spread of flu through the community, and when children get themselves vaccinated, of course the main goal for all of us is the child’s health, but the ripple effect could be that they don’t bring that germ home to family and (those) at high risk,” Zahn says. “There’s multiple layers of help that the vaccine can provide.”

Causes: Influenza is caused by viruses and spreads from person to person through coughs, sneezes and even talking. It is possible to contract it by touching a surface infected with the flu virus, then transmitting it to your mouth, nose or eyes, health experts say. The best way to stop the spread of influenza beyond getting a flu shot is by covering coughs and sneezes and consistent hand- washing with soap and warm water. Those infected should stay at home at least 24 hours after the fever has gone.

Symptoms: These include fever, chills, cough, sore throat, body aches, fatigue and stuffy nose.

Treatment: Antiviral drugs can lessen symptoms and shorten the duration of illness by one or two days, as well as prevent serious flu complications, such as pneumonia. Most of those who get influenza will recover within two weeks, but some will develop severe illness that requires hospitalization.

NOROVIRUS (and other stomach viruses)

The highly contagious norovirus is by far the most common of the stomach viruses. There are many types of norovirus, and you can get it more than once. It is the leading cause of disease outbreaks from contaminated food (food poisoning) in the U.S. It is often called the stomach flu, but it is not related to influenza.

It takes only a small amount of norovirus particles to make someone sick, and people are contagious from the moment they begin feeling sick to the first few days after they recover. The virus can spread quickly in enclosed places such as schools and day care centers, as well as cruise ships and nursing homes.

Causes: Norovirus causes inflammation of the stomach, intestines or both, known as acute gastroenteritis. Symptoms usually develop one to two days after exposure to the virus.

Symptoms: The most common symptoms are vomiting, diarrhea, nausea and stomach pain. Fever, headaches and body aches can also occur.

Treatment: No specific medicine exists, and there is no vaccine for norovirus, the CDC says. It cannot be treated with antibiotics because it is a viral, not a bacterial, infection.

“Most kids don’t see a doctor, and there is no easy test” to determine whether it’s specifically norovirus, Zahn says. “You tend to get better, (so) we don’t diagnose for sure it is norovirus, but we suspect that’s the main cause.”

The symptoms can lead to dehydration, especially in young children, so it’s important to make sure those who are sick drink plenty of water and rehydration fluids.


Pink eye, formally known as conjunctivitis, is common and spreads easily, affecting 6 million people annually in the U.S., federal health officials say. The Orange County Department of Education asks school districts to follow the American Academy of Pediatrics’ guidelines when it comes to excluding children from attending school because of pink eye. Those guidelines say kids with purulent cases (whites of eyes are pink or red and there is white or yellow mucus) or who have been diagnosed with bacterial conjunctivitis should be kept at home until treated.

Causes: Pink eye has four main causes, two of which are contagious: viruses and bacteria. It can also be caused by allergens and irritants.

Symptoms: They vary somewhat but include redness and swelling of the whites of the eye and the inside of the eyelids and nonclear discharge.

“With allergies, eyes are watery or itchy, but if (kids) are having a good amount of discharge that (parents) are having to clean off their eyelashes, especially if the discharge is yellow or green, that’s more likely to be an infection,” which should be seen by a doctor, Dangvu says.

Treatment: If there is pain, sensitivity to light, blurred vision or the discharge isn’t getting better, a pediatrician can prescribe antibiotics.


Head lice are small insects that live in human hair and feed on blood. Lice die quickly without feeding, so removing them from your child’s head is key. They glue their eggs, or “nits,” to hair, so these can’t be removed with simple brushing.

“There really is a taboo to it, like ‘Don’t tell anyone I’m calling you about this,’ ” Dangvu says, but lice can happen anywhere and have nothing to do with cleanliness and socioeconomic status.

Causes: Kids can give head lice to others when they touch heads or share combs, hats, headphones or other personal items. Studies suggest girls get head lice more often than boys.

“Girls are more touchy with each other, taking selfies, touching heads,” Dangvu says. “It also has to do with the amount of hair, the length of hair.”

Symptoms: If you notice your child has a persistent, very itchy scalp, check yourself for lice. Nits are usually found about a quarter of an inch from the scalp and stick to the hair, unlike dirt or dandruff. The most common places to find them are at the neckline and behind ears.

Treatment: To get rid of head lice, you should comb your child’s hair with a specialized nit comb twice a day for two weeks (metal flea combs from pet stores work as well). Comb methodically and physically remove with your fingernails any nits that won’t comb out. Over-the-counter treatments with permethrin (Nix) and pyrethrin are available, or your pediatrician can prescribe treatments.

MRSA (staph skin infection)

Methicillin-resistant staphylococcus aureus (MRSA) is a bacterium that has become resistant to commonly prescribed antibiotics such as penicillin and amoxicillin. Anyone can get MRSA from contact with infected wounds or by sharing personal items that have touched infected skin. The risks of infection can be increased in activities or places that involve crowding, skin-to-skin contact and shared equipment or supplies, the CDC warns. This makes kids taking part in athletic activities more vulnerable, especially high-contact sports.

“For athletes, it tends to be more like wrestlers, where there’s direct body-to-body contact or things like the mats,” Dangvu says.

Causes: An estimated 2 in 100 people carry MRSA, according to the CDC; there is no data on how many MRSA infections occur. The CDC has issued prevention steps to athletes that include using hand sanitizers or washing hands at minimum before and after activities, washing uniforms after each use, wearing protective clothing, covering skin cuts with bandages and not sharing items that come into contact with skin.

Symptoms: It is common to mistake a MRSA infection for a spider bite at first. If your child has a wound that appears to be infected or is getting worse (it’s red, swollen, hot, painful and full of pus), have it checked by your pediatrician.

Treatment: The infection can be drained, and even though it is resistant to some antibiotics, it is treatable with other medications. The most serious MRSA infections may cause pneumonia and bloodstream infections.

For these and other ailments and illnesses, the Orange County Department of Education offers guidelines and recommendations to school districts as to when sick kids should not be allowed to go to school and when parents should seek medical attention.

First Aid (Thinkstock) What’s in your first aid bag? The emergency essentials every parent should have on hand to treat cuts, burns, broken bones and more

Kids don’t come with bubble wrap, and it’s a fact of life they at some point will bleed, sprain or break something, run a fever or get an infection. When things go wrong, emergency first aid essentials that are easily accessible are a must-have for homes and cars.

You can start with a ready-made kit or make your own. It’s best to keep all items together in a wearable backpack for use in an emergency, such as fire or evacuation because of earthquake or flood. Be sure anyone watching your child in your home knows where these items are.

First aid essentials to have on hand, based on advice from the American Academy of Pediatrics and other experts:

First aid manual for reference. Emergency contact list (nearest hospital, pediatrician name and number, child’s health insurer’s name and medical ID number) Band-Aids, gauze and tape Triple antibiotic ointment Hydrocortisone cream Liquid Benadryl Liquid ibuprofen and acetaminophen Any prescription medications used frequently (most doctors will authorize extra for a first aid kit), and an EpiPen if a family member has allergies Afrin nasal spray for nosebleeds Nausea medication Numbing spray (good for panicky kids in pain) Water bottle, for cleaning out wounds and to treat dehydration Alcohol wipes ACE bandages Instant cold compress Finger splint Small scissors Fine-point tweezers (And remember to replace what you use from your first aid bag. You don’t want to get caught short if and when your child gets hurt again.)

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