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Summer Infections and Illnesses

What to look for

By Dr. Ben Kleifgen June 27, 2014
It’s summer time! Time for splashing in the pool, racing through the park, and enjoying seemingly unlimited freedom. Unfortunately, you and your family aren’t free of illnesses in the summer months. Without throwing a wet blanket on your warm-weather fun, here are some common (and not-so-common) infections to watch out for this summer.

Lyme Disease
Lyme disease is endemic to many states along the eastern seaboard, as well as the upper midwest, and it continues to spread across the country. It’s caused by bacteria transmitted in the bite of a deer tick. The classic first sign of Lyme disease is a rash that starts at the site of the tick bite. Often described as a "bull’s-eye," the rash is red, round, and spreading, but it is not tender. Lyme disease can progress to affect the joints, heart, and nervous system, but it is easily treatable with antibiotics.

What to look for
If you see a spreading red rash on your child or yourself, seek medical attention promptly. Even better, take measures to prevent tick exposure. Ticks love to hang out in leaf litter and brush, so keep areas where children play clear. You can treat clothes and gear with permethrin, and apply DEET-containing insect repellent to skin (avoid the face and hands in young children). Perform a daily tick check after playing outdoors, paying special attention to the underarms, ears, belly button, knees, hairline, and waist. (Ticks are small, sometimes as small as poppy seeds). Remove a tick by grasping its head near the skin with tweezers, then firmly pulling straight out. Do not scrape the tick, apply ointments, or hold a flame to the tick. A tick must be attached for 24-36 hours before it transmits the Lyme-causing bacteria.

Summer Viruses
Most summer fevers are caused by a group of viruses that come out of hiding when the weather gets warm. Enteroviruses, echoviruses, and adenovirus can cause all sorts of symptoms: fever, sore throat, vomiting, diarrhea, pinkeye, and rash. Coxsackievirus causes fever and painful blisters on the palms, soles, and/or throat. (It's also known as hand, foot, and mouth disease.) These viruses are spread through infected saliva or stool, so wash your hands after changing diapers or caring for a child who has these symptoms (and be careful about rubbing your eyes — a common but overlooked way of introducing infection). Although there are no specific medications to treat these viruses, you can treat the symptoms with acetaminophen and ibuprofen (if your child is older than six months). Make sure your child drinks plenty of fluid to avoid dehydration. (The cold liquid from an ice pop may help soothe a sore throat, although this is the only time you’ll hear me recommending a sugary treat!) In otherwise healthy children without underlying medical problems, the immune system will likely fight off these infections on its own in 7-10 days.

A few caveats:
  1. If a child has such a bad sore throat that she refuses to drink, she could become dehydrated and should see a doctor.
  2. These infections can be difficult to tell apart from strep throat, which is treatable with antibiotics, so it’s a good idea to contact your doctor for a fever plus sore throat to rule out strep.
  3. Some of these viruses can cause myocarditis (inflammation of the heart muscle) or meningitis (inflammation of the lining of the brain and spinal cord). Call your doctor if your child has neck pain, chest pain, difficulty breathing, listlessness, or lethargy.
Food Poisoning
Summer time means picnic time, which unfortunately sometimes means food poisoning. Eating food contaminated with bacteria can cause vomiting, diarrhea, fever, and abdominal pain. Typically, multiple people who ate the same food will be affected by the same symptoms. Examples of bacterial culprits include Staphylococcus aureus (aka staph), Campylobacter (raw/undercooked chicken, unpasteurized milk), Cryptosporidium, Salmonella (raw/undercooked eggs or meat, unpasteurized milk), E. coli (undercooked beef, contaminated raw vegetables), Shigella, and Yersinia. Symptoms usually start within a day or two and last less than a week (with the exception of Staph, which can start within hours but only lasts a day). Food contaminated with these bugs does not usually smell or taste bad.

What to do: You can prevent food-borne illnesses in several ways:
  • Wash your hands and all kitchen surfaces after touching raw meat.
  • Do not prepare meat or poultry at the same time as you prepare infant formula.
  • At the grocery store, wipe down the shopping cart and place the meat away from the child if he is riding in the cart.
  • Wash your hands after using the bathroom or changing diapers.
  • Avoid unpasteurized milk or cheese.
  • Do not let prepared foods, cooked meats, cheese, or anything with mayonnaise sit out at room temperature for more than two hours.
  • Cook all food thoroughly without interruption.
Usually, the only treatment is drinking plenty of fluids and eating a bland diet. Antibiotics are typically not needed, and sometimes make the illness longer or more severe. However, if your child develops dehydration or bloody diarrhea, or if she is less than one year old, call your doctor.  

Measles Outbreaks
Measles is not a summer-specific illness, but it’s worth mentioning because it is making a comeback and showing up in different parts of the country. Measles was declared eliminated from the United States in 2000 (although there were still sporadic cases). However, there have already been 477 cases and 16 outbreaks so far in 2014, the most in 18 years. While most of the cases involved international travel, some affected individuals were children who were unvaccinated because of missed opportunities or parent choice.

What to look for: Measles starts with a high fever and the 3 C’s: cough, coryza (runny nose), and conjunctivitis (pinkeye). Next, a blotchy red rash appears on the face and neck and spreads downward to the trunk and limbs. The illness can be complicated by pneumonia, diarrhea, or encephalitis (inflammation of the brain). Although the typical summer viruses discussed above are much, much more common causes of fever and rash, measles is something to keep in mind if you or a close contact have traveled internationally.

Of course, if you believe your infant is ill, be sure to take him or her to your family doctor or pediatrician right away. Hope you all have a safe, healthy, and fun summer!

Dr. Ben Kleifgen is a pediatrician with First Steps Pediatrics and Adolescent Medicine in western Pennsylvania and surrounding areas of West Virginia and Ohio. He graduated from Temple University School of Medicine and completed his pediatric residency at the University of Arizona in Tucson.