After dealing with children’s winter ailments, we can breathe more easily with the onset of summer although it is important to prepare and be informed about typical summer illnesses in children. Dr. Liat Ashkenazi-Hoffnung describes some common conditions prevalent in summer and recommends what to do in order to minimize their spread among children.
Diarrhea and Dehydration: Dehydration is a dynamic process, which left untreated, can affect functioning of the body's vital systems. The symptoms of dehydration are a dry mouth, minimal urine production, restlessness and tearless crying. Other indicators that can appear are headaches, confusion, dizziness and even loss of consciousness in extreme cases. Whenever dehydration is suspected, water should be given and medical care sought at the nearest first aid station or ER. An ambulance should be summoned if there is loss of consciousness.
Various pollutants, viruses and bacteria that cause diarrhea are common during summer. The intense heat causes an increase in bacteria present in food in restaurants and food stalls or kiosks leading to diarrhea, vomiting and dehydration in children. The percentage of water in children’s bodies is particularly high: 70% of body weight compared to 50% in adults. In order to avoid contamination, hand washing after the toilet, changing diapers, or before and after meals is essential. Refrain from eating foods that have been left in the sun, heat or unrefrigerated for a long time. Treatment mainly focuses on providing fluids to prevent dehydration.
In cases of severe diarrhea in infants and children, regular consumption of food is recommended including nursing and formulas without the need to dilute or change the formula. The child can be given any oral rehydration solution which contains a mix of salts which have been proven to reduce the need for intravenous rehydration.
In cases of recurring diarrhea (more than 8 times a day) or repeated vomiting in infants under two months, children with chronic diseases, suspicion of dysentery (high fever, blood in the feces) or dehydration (lethargy and lack of urination), a pediatrician should be consulted.
Heat Injuries: Children are more susceptible than adults to heat injury, and more so due to the sun-drenched Israeli summer, at the beach, pool or during hikes. Heat injuries occur when superfluous heat is produced at higher degrees than the body’s counter-ability to cool down. Heatstroke, the highest form of heat injury, is initially characterized by a headache, weakness, nausea, vomiting and a mild rise in body heat. Afterwards, body heat is likely to escalate to over 40 degrees with increased lethargy, rapid breathing and even seizures. In order to prevent heat injury, drinking water is essential. Strenuous activity should be avoided especially during the hottest hours of the day, while hats and light clothing should be worn. It goes without saying that children should never be left in a closed car, even for a short time. At any stage of heatstroke, medical advice must be sought immediately, while simultaneous efforts should be made to cool the body down (remove clothing, move the child to shade or air conditioning, splash cold water over the body). If the child is able, he should drink as much water as possible.
Sun Exposure: Over and above the possibility of heat injury, prolonged exposure to the sun is unhealthy for the child’s skin, since sunburn in childhood raises the risk of skin cancer in adulthood. Staying in the sun for long periods of time should therefore be avoided particularly during midday when radiation is at its peak. When being out in the sun for an extended time, the child’s head must be covered, and his sensitive skin should be protected by spreading SPF sunscreen of 30 every two hours. This should be repeated if the child goes in the water.
Mosquito Bites: Children spend more time outside in summer, dressed in light clothing and exposed to bites. Although the mosquito bite does not cause significant injury, it can lead to discomfort or infection. To avoid mosquito bites, screens should be fitted on all windows in the home and insect repellant creams containing active DEET or picaridin spread on the skin of infants under two months old. Treatment of mosquito bites includes cooling the affected area, spreading anti-itch creams such as aloe vera on the skin, or taking anti-histamine medication such as fenistil. Treatment aims to reduce discomfort and itching that can lead to skin lesions and subsequent infection.
Mediterranean Spotted Fever (MSF): This is a disease caused by a type of bacteria called Rickettsia that is transmitted to humans through tick bites. MSF appears mainly in the summer when both ticks and people abound outdoors. The disease is characterized by fever, headache and rash. Additional symptoms include muscle pain, vomiting and diarrhea. Left untreated, the disease can be fatal and therefore, where there is any suspicion of infection, a doctor must be consulted.
Jellyfish (Medusas) Sting: Children can suffer from jellyfish sting while at the beach in summer. The stings are painful, itchy, cause blisters and sometimes lead to loss of sensation in the affected area. In the event of a sting, wash to area with sea water or vinegar (beach lifeguards have a supply) but not with fresh water. Pain can be reduced by placing ice on the sting area or taking analgesics.
Danger of Drowning: To prevent drowning, do not swim in water or a pool without the presence of a lifeguard. Children under the age of 5 years must be supervised at all times and remain in eye contact. Water wings must be placed on their arms as well as on older children who cannot swim.
Outer Ear Infection: Much time is spent at the pool in summer. When entering the water, the outer ear canal can be exposed to infection. This leads to much tenderness in the ear, especially when the tragus (the cartilage projection in front of the ear canal) is pressed. Outer ear infections can occur anytime from repetitive cleaning of the ear canal with ear buds (which use should be avoided). Recommended treatment is antibiotic ear drops which usually lead to rapid improvement. In recurring infections, ear plugs should be used when swimming in a pool.