Medical Information

Head Lice Guidelines

Source: The source of the trouble is an insect – Pediculus Capita. Infestation is caused by contact.

Pediculus Capita is no respecter of persons, cleanliness, colour of hair, etc. Once the insect enters the hair eggs are laid and this initial insect may then burrow into the scalp where it is not apparent to the naked eye, or it may roam at will through the hair. At this stage you may notice a child scratching, although scratching is not necessarily a sign of infestation.

Development: The insect and eggs survive ordinary washing and shampooing. The eggs will hatch in about one week if left untreated. The eggs (nits) are about 1mm long and are firmly attached to the hair, one to a strand. When alive they are usually tiny, white and shiny, but can be opaque white on dark hair and blackish on blonde hair. The lice when hatched are about 2 mm long (almost like a tiny ant) and take on the colour of the hair; black, brunette, fair. They can be a pink colour in blonde hair.

Checking: This should always be done in natural daylight – either on the verandah or close to a window. It is virtually impossible to see the eggs in artificial light. The hair should be parted very carefully and held up to the light. To test if an egg is alive or not, it must be carefully eased off the hair and then placed where it can be squashed. If it makes a cracking or popping sound you will know it is a live egg. Checking should be done on a regular basis.

Treatment: The hair should be treated with any of the special shampoos or lotions which are recommended by your doctor. Please note that ordinary medicated shampoos will not get rid of head lice and lotions available directly from the chemist are often very mild and ineffective. After treatment, the hair must be carefully combed with a fine comb to remove as many eggs as possible. Start near the scalp and carefully draw the comb to the ends of the hair. Dead eggs appear like tiny flakes but will not drop off. They have to be removed either by hand or by combing. Vinegar in the rinsing water can be effective in loosening them. There is always the possibility of skin irritation arising from use of the shampoo and you are advised to follow carefully the instructions for each preparation. Great care should be taken that no shampoo or lotion goes into the eyes. If the infestation is particularly heavy, further treatment may be necessary within 24 hours. However, this will depend on the preparation you use; ensure you follow the doctorís or manufacturerís instructions. Should the treatment prove ineffective, your doctor should be consulted again. Thorough laundering and disinfecting of clothes and bed linen is advisable. It is also recommended that all members of the household have their heads inspected.

It is important that no child returns to school until all signs of infestation have cleared. Our school nurses will carry out a further check before the child returns to class. A clearance note from your doctor will also be required.

Dreaded Head Lice

Head louse (plural of lice) are tiny wingless parasitic insects that live among human hair and they are common in children from 3 to 12 years of age.

They are not dangerous and don’t spread disease but are VERY contagious.

Their bites may cause a child’s scalp to become itchy and inflamed so therefore it is wise to treat the head lice as soon as possible.

Nits (eggs) can look like dandruff, only they can’t be removed by brushing or shaking them off. They are usually tiny, white and shiny but can be opaque white on dark hair.

When the lice hatch they are about 2mm long and take on the colour of the hair which can sometimes be hard to see, they can be pink on blonde hair.

You may be able to see the lice or nits by parting your child’s hair into small sections and checking with a fine-tooth comb on the scalp, behind the ears, and around the nape of the neck.

Check in natural daylight as it is virtually impossible to see in artificial light.

To test if an egg is alive or not, it must be carefully eased off the hair placed where it can be squashed. If it makes a cracking or popping sounds you will know it is a live egg.

Treatment

It is advised that you visit your Doctor as they can recommend a medicated shampoo, cream rinse, or lotion to kill the lice.

We have found that the over-the-counter shampoos and lotions are not killing the head lice because they are often very mild.

After treatment, the hair must be carefully combed with a fine tooth-comb to remove as many eggs as possible. Start near the scalp and carefully draw the comb to the ends of the hair.

It is important that no child returns to school until all signs of infestation have cleared. The school Nurse will carry out a further check before the child returns to class.

Conjunctivitis is an infection of the clear layer which covers the white area of the eye. It can be caused by an allergic reaction or it can be viral or bacterial which is very contagious.

Symptoms:

Allergic conjunctivitis red, itch and watery eyes…itchy nose and sneezing can occur also

Viral conjunctivitis can cause red, gritty eyes with a watery discharge and can happen with flu-like symptoms.

Bacterial conjunctivitis may start off one eye and can move to the other can also cause red and gritty eyes. This type will however have clear or yellow pus-like discharge and can make the eyes stick together overnight when sleeping as a crust may form.

Treatment:

You must seek medical advice and they will advise you on the best treatment to use depending on what symptoms your child may have.

Children who present to school with Conjunctivitis will be sent home. Once treatment has commenced they can return 24 hours later.

Gastroenteritis is an infection of the gut and can cause diarrhea and vomiting. It can be caused by a range of germs and is usually a viral or bacterial infection.

Symptoms:

Your child may feel unwell, not want to eat or drink. Vomiting may occur 24-48 hours after these signs, following this diarrhea may occur which can last up to a week.

Observe for any signs of severe dehydration. Children may become listless, tired and have low amount energy.

In severe cases they may have very dry mucous membranes (mouth), sunken eyes, decreased urine output, headache and severe thirst or rapid heart and breathing rate. At this point you should see your Doctor.

The most important thing is to keep your child hydrated, stick to plane foods for example, bread, rice and bananas. If they don’t want to eat just keep encouraging fluids until they are more able for food. Little and often is better than nothing at all.

And don’t forget HANDWASHING is vital to stop the infection spreading.

If your child has these symptoms they must not attend school and must stay at home until 48 hours after their last vomiting/diarrhea episode.

Hand-foot-and-mouth disease is an illness that causes sores in or on the

mouth, on the hands, feet, and sometimes the buttocks and legs.

Caused by a virus called enterorvirus.

Infected people pass the virus to each other through contaminated food,

water, or objects and can also spread through coughing and sneezing.

The incubation period is 3-6 days.

Symptoms:

Tired, sore throat and fever.

A day or two later, sores or blisters may appear in or on the mouth, the

hands, feet and sometimes the buttocks.

Treatment:

For pain or fever Paracetamol or Ibuprofen can be given.

Stay away from spicy or acidic food and drinks.

Plenty of cool fluids to help with a sore throat. Cold foods such as flavored

ice pops and ice cream also may help.

Inform your Doctor if any pregnant women are in the household.

Impetigo is a common bacterial infection of the skin usually found around the nose, mouth, hands, and forearms. It can be itchy, cause children to scratch and spread the bacteria to other parts of the body.

Impetigo is very contagious and can be easily spread to other children.

There are the two types of impetigo, non-bullous impetigo (crusted) – the most common form – and bullous impetigo (large blisters).

Non-bullous begins as tiny blisters, which eventually burst and leave small wet patches of red skin that may weep fluid. Gradually, a tan or yellowish-brown crust covers the affected area, making it look like it has been coated with honey or brown sugar.

Bullous impetigo form larger fluid-containing blisters that first appear clear, then cloudy. These blisters are more likely to stay longer on the skin without bursting.

Treatment

You must see your Doctor if you feel your child has Impetigo, they will prescribe an anti-biotic and or creams depending on the severity and where it has spread.

Try to prevent your child from scratching the sores as much as possible. Cover sores with a watertight dressing to prevent the infected fluid and crusts from spreading.

Remember good hand washing is also key in preventing the infection spreading.

As the weather is changing, cough and colds are on the rise and more influenza can occur.

Symptoms:

Fever (<37.5), chills, muscle aches, headache, cough and runny nose. Children with a combination of these symptoms should stay at home until they are well enough to return. Influenza is highly contagious and can spread when a child inhales infected droplets in the air which have been coughed or sneezed by the infected person. To prevent this from spreading; hand washing is vital, never pick up used tissues, don’t share cutlery with others. Cover your mouth with a tissue when you cough or sneeze and then dispose of the tissue afterwards.

If symptoms persist a visit to your Doctor is advised; otherwise lots of rest and fluids should suffice. Paracetamol or ibuprofen can be used for temperatures or aches.

A child displaying these flu symptoms in school will be sent home.

Childhood Influenza Vaccination Subsidy Scheme (CIVSS) 2013/2014

Starting on 2 October 2013, children between the age of 6 months and less than 6 years may receive subsidized vaccination from private doctors who are enrolled in the Childhood Influenza Vaccination Subsidy Scheme.

For more information on this please visit www.chp.gov.hk or call the Vaccination enquiry line on 2125 2125.

Please notify the school nurse or teacher if your child has any of the above illnesses as soon as possible.

Chicken pox is also known as varicella-zoster virus (VZV).

It is very contagious, so an infected child should stay home and rest,

symptoms can begin 10-12 days after the contact with the virus.

Symptoms:

Flu-like symptoms; slight cough, fever, a runny nose, headache, fatigue, loss

of appetite or a sore throat.

An itchy rash that look like blisters will appear after 24-48 hours and can

appear anywhere on the body.

Chickenpox is contagious from about 2 days before the rash appears and

until all the blisters are crusted over.

A child with chickenpox should be kept out of school until all blisters have

dried, which can usually take about 7-10 days.

Treatment

Cool baths for the first 3-4 days, Oatmeal bath products/baking powder can

help to relieve itching.

Calamine lotion on itchy areas can also help.

See a Doctor if you are worried, the Doctor may prescribe an antihistamine

for the itch or antibiotics if sores have become infected.

If on immune-suppressant medication you must see your Doctor.

Lots of rest and sleep is important.

Anti-pyretic’s can be used for a temperature such as Paracetamol or

Ibuprofen.

If you take your child to the Doctor, let the office know in advance that your

child might have chickenpox. It’s important to avoid exposing other children

to the illness

Scarlet fever is a throat infection caused with group A streptococcus bacteria. It is this bacterium which causes a toxin to produce a scarlet-colored rash on the body.

Not all children are sensitive to this bacterium; some may display different symptoms. If the rash appears with other symptoms of strep throat it can be treated with a course of antibiotics once it has been confirmed with a throat swab.

A child with scarlet fever can spread the infection through coughing and sneezing.

Incubation period is usually 3-5 days.

Symptoms

A bright red rash which can be indicative of scarlet fever usually first appears on the neck and face and can spread to the chest and back. The rash may be itchy.

After approximately six days the rash should fade, skin may peel on the hands and feet.

A fever above 38 degrees Celsius.

A sore throat with swollen glands can occur. Sometimes white patches can be seen on the throat.

Treatment

For pain or fever Paracetamol or Ibuprofen can be given.

Plenty of cool fluids to help with a sore throat. Soft foods and warm soothing teas should reduce further irritation to the throat. Ensure your child is well hydrated.

If symptoms are not improving after 48 hours a visit to your Doctor is advised. Antibiotics can be prescribed for up to 10 days if Scarlet fever is confirmed.

A cool mist-humidifier adds moisture to the air which can help soothe a sore throat.

Plenty of rest is advised.

Sometimes called fifth disease or erythema infectiosum.

It most commonly occurs in children aged from 3 to 15 years, but anyone can be affected and it is an infection caused by the parvovirus B19 virus.

Slapped Cheek Syndrome is transmitted through droplets sneezed or coughed out by infected children.

Symptoms:

Children may get a runny nose or cold like symptoms, fever, headache, nausea and most commonly a rash.

The rash will typically look like a red scald to one or both cheeks and appear like the child has been slapped and may become blotchy. The rash can spread to the body, arms and the legs.

If the rash starts to fade certain stimuli for example a bath or exercise can reactivate the rash. It may take 1 to 3 weeks for the rash to completely disappear.

The incubation period is usually before the rash appears. This period can last 4-28 days, once the rash appears you are no longer infectious.

Treatment

As the fifth disease is a virus it cannot be treated with anti-biotics. Over the counter anti-pyretics can be used for a temperature and anti-histamines if the rash becomes itchy.

If a pregnant woman has been exposed to slapped cheek syndrome, she needs to go to her doctor straight away especially if they are in their first or second trimester.

To keep ourselves healthy and to stop viruses/infections spreading, we must

all wash our hands, it may sound simple but many of us don’t wash our hands

properly or for long enough. So below is the proper technique and information

about when to wash our hands.

5 Steps for Proper hand washing as per the Department of Health guidelines

1. Wet hands

2. Apply soap; RUB for at least 20 seconds; starting with your palms, the

back of your hands, between the fingers, the back of your fingers, your finger

trips and last but not least your thumbs.

3. Rinse with Water

4. Dry with Paper Towel

5. Use paper towel to turn off faucet and dispose of the paper towel

When to wash our hands as per the Department of Health guidelines

1. Before eating and preparing food

2. Before touching our eyes, nose and mouth

3. After using the toilet

4. After coughing or sneezing

5. After touching public equipment

6. When hands are physically dirty

Remember to look after your health we must eat healthy and include daily physical activity so switch off the TV and computer and get active.

Always start the day off with breakfast followed by a good night’s sleep, this is a sure way for energy for the day and helps you concentrate more.

Eat plenty of fresh fruit and vegetables as there are so many vitamins and nutrients in both to help keep you healthy.

Eat more whole grains as they deliver vitamin B which helps build muscles and bones.

Did you know not only do sports like basketball, netball, tennis etc. help us keep fit but household chores are also ways of keeping active!!! So kids offer to help hoover, dust or walk the dog…every little helps.

Parents, be role models for you children, take the stairs instead of the lift and allow children to be involved in the planning/preparation of meals if possible.

And don’t forget to drink plenty of water to keep hydrated because did you know water has so many benefits as you can see below……