Children's Services

Commonly Heard Terms

MEASLES

Measles is a serious infection caused by a virus. Measles was a very common childhood infection however today the measles vaccine provides protection against measles and has virtually eliminated all outbreaks in Canada. Ontario is in a measles elimination program. Any suspected cases should be seen by a physician immediately. Measles can make children very ill. Children with measles usually have a fever, runny nose, cough, red eyes, and sore throat. After a few days, a patchy red rash shows up behind the ears moving to the face and neck, eventually covering the whole body. One in 10 children may get an ear infection or pneumonia.

Measles is infectious from four days before the rash appears to about five days after the rash becomes noticeable. If another child has been diagnosed with measles and your child has had the MMR (measles, mumps, rubella) vaccine it is very unlikely that your child will develop measles if exposed.

Measles can be prevented by immunizations.

MENINGITIS

Meningitis is an infection of the membranes and fluid covering the brain and spinal cord. Both viruses and bacteria can cause meningitis.

Viral meningitis is characterized by fever, headache, vomiting, and stiff neck. It occurs most often in the late summer and fall. Complications of viral meningitis are rare and brain damage is extremely rare. Bacterial meningitis is a much more severe illness. Bacterial meningitis is most common in young children. Despite prompt diagnosis and treatment, five to ten percent of children die of bacterial meningitis and 15 to 30 percent sustain permanent brain damage.

Bacterial meningitis usually begins with fever. At this early stage of infection, it may be difficult or impossible to tell if meningitis is present. The illness may appear to be no more than a simple viral infection.

The child with bacterial meningitis then develops more serious symptoms, including: lethargy such as unusual sleepiness or listlessness due to the increased pressure on the brain; irritability and fussiness, due to headache and pain from the inflammation around the brain; vomiting and stiff neck. Seizures or convulsions may also occur, as well as a rash, which starts as tiny red spots and progresses to bruises.

Meningitis can progress very rapidly. Therefore in any child who has an illness with fever and a change in behaviour, because of the seriousness of meningitis, the child should be seen by a physician for immediate attention.

Be on the alert for the following types of behaviour or symptoms. In a child with fever, they are suggestive of a serious illness.

• excessive listlessness, drowsiness, sleepiness, or lack of interest in surroundings
• irritability, fussiness, crankiness
• inconsolable crying, high-pitched crying (or screaming), or weak cry
• poor skin colour or pallor
• rapid breathing (faster than 40 breaths per minute)
• difficulty breathing
• fever with rash
• excessive drooling

Meningitis is not spread very easily from child to child. The germs are in the saliva and secretions of the nose. These germs spread when people cough, sneeze, or blow their noses. Close contact between people is required for the spread of these germs. Sometimes it can spread within households or within child care centres. When one child has an infection, it can be prevented from spreading to other family members and other children in child care by treating them with an antibiotic. Physicians, in consultation with the local public health agency, can decide who should receive antibiotics to prevent the spread of infection. A vaccine may be used in special circumstances.

MIDDLE EAR ACHE

Otitis media is an infection of the middle ear. It is common in children and can occur in one or both ears. Ear infections usually follow a cold and can share the same symptoms of a cold including cough, runny nose, irritability, and fever. In young children you may notice that the child cries or tugs at their ears. Older children may complain of an earache, that the ear feels blocked, or that they have pressure in their ear.

Ear infections are diagnosed by a doctor's examination and are treated with antibiotics. It is important to take the antibiotics as prescribed by the physician. Acetaminophen or Ibuprofen can be given to treat fever and irritability.

Complications may occur as a result of ear infections. A physician should be notified if the child shows any of the following signs:

• fever over 39^oC in spite of treatment or fever lasts longer than three days
• excessive sleepiness
• rapid or difficult breathing
• hearing loss
• excessive fussiness
• skin rash

MIGRAINES

It may surprise you to learn children get migraine headaches just like adults. The most common cause of the headache is migraine which also tends to run in families. Migraines are different from a regular headache. Children with migraine often feel nauseated, and may even vomit. Migraine may be triggered by fatigue, exercise, or long periods in the sun. Also, food triggers can sometimes be identified, and it may be valuable to keep a record of what was eaten just prior to a headache, to see if a pattern emerges. Common culprits include nuts, caffeine (as in cola drinks), and spiced meats, among others. With time, both parents and children become experts in identifying the pattern of migraine. They can usually tell when an episode is beginning, and they know what to do. Be sure to have your child examined by a doctor to identify the problem.

Most children with migraine can be treated with simple measures. They frequently like to avoid bright light and loud noises, and may be most comfortable if they lie down in a dark room and try to sleep. You may also want to investigate pain medications. Often taking acetaminophen such as Tylenol is sufficient. It is important to give medication as early as possible. In an effort to avoid using medicine unnecessarily, parents sometimes wait to see if the headache will disappear on its own. The longer a migraine headache has been present, the more difficult it is to get rid of. Therefore, once you are familiar with your child's migraine pattern, treat it early rather than late. Be sure that school staff also know how to proceed.

Some migraine is particularly troublesome and doesn't respond to these simple measures. Consultation with a physician is strongly advised.

MUMPS

Mumps is now very uncommon. The vaccine that children receive at one year of age prevents almost all cases. If you think your child has the mumps, look for fever, headache, and a vague feeling of weakness and discomfort. Glands on one or both sides of the jaw are swollen and painful and your child may have difficulty swallowing. Symptoms can last for a week or two.

Mumps spread from person to person through the air. People with mumps may spread the virus up to seven days before the glands start to swell until as long as nine days later. It takes about two to three weeks to come down with mumps after being in contact with someone who has the disease.

There is no treatment for mumps. It is important to get lots of sleep and lots of fluids. Since the infection is caused by a virus, antibiotics have no effect.

For further information on mumps, don't hesitate to call your doctor or paediatrician. Mumps can be prevented by immunization.