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Saturday, November 3, 2007

Post#5 The Blame Game

As parents, we rarely want to see our children sick. Not only does it affect our children's temporary well-being, it often thwarts our everyday routine. Of course, we all know and accept (for the most part) that catching colds and vomiting are an immutable fact of life. As a pediatrician, I view children combating regular illnesses as a rite of passage; with each passing fever and sniffle, our immune systems become stronger, more mature and smarter.

Regardless, when our children become sick, it is sometimes hard not to dissect the past 72 hours in an effort to deduce which of our friends' children made little Johnny sick. Sometimes it is simply an innocent fact-finding mission with little malice or misgiving. Other times, however, we rack our brains, pursuing a mini witch hunt, until we have concluded who passed the unfortunate germ to our child.

From a public health standpoint, it is a well researched fact that an average healthy child will come down with 6-8 viral illnesses each year; if the child attends daycare, this number jumps to 8-12 viral episodes. Furthermore, it is also known that children will often shed a virus for several weeks, even after they themselves appear perfectly healthy. Viruses, especially during the winter time, are rather hardy and can survive for several hours on fomite surfaces, including door handles, countertops, grocery carts, toys, and wherever else they happen to slobber, touch, or lick (in other words everywhere!).

Thus, when investigating the possible places or people that a child may have acquired a germ, it really is a total crapshoot. And assigning fault, especially if there is any ill will involved (pun intended!), is a dangerous and inaccurate game to play.

I often counsel my families that they should resign themselves to the fact that their children will become sick multiple times each year, with the bulk of the illnesses occurring during the winter time (the lower humidity and increased tendency for people to remain indoors leads to a greater survivability and sharing of germs). With this in mind, I believe that it is an impractical standard for people to avoid public gatherings when their children have a simple viral illness (or vice-versa, to impose this standard on others). The fact of the matter is, most of the time, whether their "sick appearing" snotty child joins the party or not, there will be plenty of germs abounding regardless.

If we truly want to avoid becoming ill, we would have to essentially live in a bubble. Even the most cautious, Purell-addicted family will encounter their fair share of germs each year. And even if they only socialize with well-appearing children, some of these kids may still be shedding germs from an illness they got over several weeks prior.

A simple but practical set of guidelines I pass on to parents is as follows:

1. Babies under 3 months should avoid contact with sick children. Anyone who plans to physically touch the baby should always wash their hands thoroughly before playing with the child, no matter how healthy they appear.

2. If a child is harboring a significant illness such as chicken pox or scarlet fever, they should be quarantined from other children until they are no longer contagious. For a full list of illnesses that should be quarantined, a pediatrician should be consulted with a quick phone call. The scope of this discussion is too exhaustive for a simple blog.

3. If a child is playing happily but has some mild symptoms (i.e. runny nose, cough, mild non-bloody diarrhea), they should NOT be quarantined and free to attend church, school, birthday parties, political functions, poetry readings, etc.

There are other circumstances that also need more detail; for example, an immunocompromised member lives in the household. However, the above general rules cover most circumstances.

It is this author's opinion that playing the blame game with colds and viral illnesses can not only be inaccurate, but ultimately fruitless. Rather focus on the upside! Your child's immune system has just been battle tested one additional time, and this can only strengthen him in the long run. Perhaps, rather than consigning blame, you should send the offending germ donor a thank you note. And maybe a little Purell.


Coco and DillDill said...

No more post ?! I just found your blog and was hoping for more updates ! =D

mixoux said...

I recently found your blog and have enjoyed reading it. This particular entry gives me some relief. but also some worry. My son has been sick since beginning daycare! I am now keeping him home for a week in hopes he gets well before his open heart surgery on the 14th of this month. I guess I am relieved in knowing that getting sick so often is normal, but worried about what other viruses he may have caught in the last few days.

Thanks again for such an interesting blog!


Peter Jung said...

Thank you for your kind words. I hope your son gets the best care and recovers quickly.