Impetigo or school sores, is a very common skin infection that virtually every child will catch, but it may also occur in adults. Several different bacteria may be responsible, but the most common is Staphylococcus aureus (“golden staph”). This is a serious infection inside the body, but relatively mild on the skin. Impetigo spreads from one person to another by close contact, and sometimes an infected animal may act as a source. Once one sore develops on the skin, scratching with fingers can rapidly spread the infection to other parts of the body. It is more common in warm climates and in summer.
An itchy, red, raised, weeping or crusting sore appears. If there are a many sores, the patient may feel generally unwell, but normally there are no other symptoms. In newborn babies, impetigo may spread rapidly and become serious, so for this reason, infected children should be kept away from infants.
If necessary, swabs can be taken from the sores to confirm the diagnosis, determine the infecting bacteria, and select the correct antibiotic.
Treatment involves antibiotic mixtures or tablets, and an antibiotic or antiseptic cream (eg. mupirocin). Antiseptic soaps, not sharing towels and bedding, and careful personal hygiene can be used to prevent the spread of infection, and a child must be excluded from school until the sores start to heal. With correct treatment, the sores will heal without scarring in a few days.
See also BACTERIA; SCALDED SKIN SYNDROME
Imprinting occurs in the first few hours of life and is a form of learning that allows an infant to rapidly recognise its mother, and to adopt the behaviour of its parents.
See also BABIES; BONDING
Infantile or six-week colic is probably caused by spontaneous spasms of the small intestine, but no reason for these spasms has ever been proved. Some experts blame anxiety in the mother, particularly in a family without extended family support, for causing anxiety in the infant, and subsequent gut spasms.
The baby starts screaming for no apparent reason, draws the legs up and looks pale. After a few minutes, the attack subsides, and the infant appears normal, then after a short interval, the screaming starts again. This pattern repeats itself several times a day. No tests can be performed to confirm the diagnosis.
Changes in diet and formula, different foods for the mother of breastfed infants, alterations to feeding times and positions, increases or decreases in the degree of attention paid to the child, and antispasmodic drugs and paracetamol can all be tried, with varying degrees of success. The problem always goes away in due course, usually at 12 to 16 weeks of age.
Influenza (the flu or grippe) is a debilitating generalised viral infection caused by one of the more than 80 known strains of the influenza virus. Influenza was originally a disease of pigs and ducks, that passed to humans only after these animals were domesticated seven thousand years ago. It was once thought to be due to “influences in the atmosphere”, thus giving its name. The various flu virus strains are named after the places where they were first isolated. It spreads by microscopic droplets in a cough or sneeze from one person to another.
Muscular aches and pains, overwhelming tiredness, fever, headache, cough, runny nose, stuffed sinuses, painful throat and nausea are the main symptoms. It can be a very serious disease, but deaths are now rare except in the elderly and debilitated.
The diagnosis of influenza, and the specific form present, can be confirmed by a blood test that detects a specific immunoglobulin antibody. The test is not routinely performed as it does not change the treatment and often serves no useful clinical purpose.
Influenza can now be cured, but only if the antiviral medication (zanamivir or oseltamivir) is given within the first 36 hours of symptoms developing. Otherwise rest and time, aspirin, anti-inflammatory drugs and medications to help the phlegm and cough are given. A light nutritious diet that contains minimal fat, and a higher than normal fluid intake are sensible.
Influenza can be prevented by an annual vaccination in autumn, which gives more than 80% protection from contracting the infection, but only for one year as the formulation varies every year to match the strains of flu virus present in the community. Two injections a month apart are required for a first vaccination if under 18 years of age. It may be used in pregnancy and breastfeeding, but is used in children only if specifically indicated. Do not have a flu vaccine if suffering from Guillain-Barré syndrome, AIDS a high fever or if allergic to eggs, poultry products, neomycin, polymyxin or gentamicin. Side effects may include local discomfort and redness at the injection site, and uncommonly fever and muscle pain.
Influenza vaccine gives only limited protection, but this increases with subsequent doses. It should be given to persons over 65 years, persons with debilitating illness, persons with chronic diseases (eg: of the lung, heart, kidneys etc.), persons undergoing immunotherapy, all health and medical personnel and anyone who wishes to avoid catching the flu that season. The vaccine is safe in pregnancy, and actually gives the baby of the vaccinated mother some protection against influenza for a few months after birth.
Unfortunately the vaccine does not prevent the common cold, and many people who complain that their flu shot has not worked are suffering from a cold caused by yet another group of viruses.
Secondary bacterial infections of the throat, sinuses, lungs and ears may occur, which can be treated with antibiotics.
Influenza normally lasts for seven to ten days, and the vast majority of patients recover without complications.
See also COLD, COMMON; VIRUS
An intussusception is an uncommon type of obstructions of the small or large gut that is usually occurs in children.
A polyp growing in the gut is picked up by the waves of muscular contraction that normally move food along. As the polyp moves down the gut it pulls the piece of gut it is attached to along with it, to cause an infolding of the gut into itself. This is an intussusception.
The child has obstruction of the gut, severe intermittent waves of pain, red jelly motions and paralysis of the intestine. The intussusception can be relieved by a barium enema (special x-ray) or colonoscopy (passing a flexible telescope in through the anus) if the large bowel is involved, but in the small intestine surgery is necessary.
It is usually completely cured by appropriate treatment, but bowel perforation may rarely occur.