Common Childhood Illnesses:
Respiratory Illnesses and Rashes
Part 2
Slide 1: Welcome to the online course, “Common Childhood Illnesses: Respiratory Illnesses and
Rashes.” This is part two of a three-part series. This course is hosted by the Texas AgriLife
Extension Service Online Child Care Training Program. It provides quality continuing education
training for childcare providers, in addition to parents and other caregivers of young children.
This course should take approximately 1 hour to complete and will introduce you to the
common upper respiratory illnesses and rashes that occur during childhood.
This course is presented in a voice-narrated format that allows you to follow along with the
PowerPoint slide presentation. A high-speed Internet connection is required to complete this
course. Course content is divided into multiple sections, which are shown in the menu bar on
the left. The course outline enables you to complete and/or review content at your own pace.
In the next section, you’ll be directed to complete a brief, multiple choice pre-learning
assessment. Once you have completed the pre-learning assessment, you may advance to the
course content by clicking the “Next Section” button at the bottom of the page. At the
conclusion of the course, you will be directed to complete a post-learning assessment that will
determine if you successfully passed the course.
If at any time you wish to take a break from the course, simply log out and return to the course
when you are ready to continue. When you sign back in to the course, you will be taken directly
to the section where you left off. To review a section you have already completed, click on the
desired section on the left menu bar.
Slide 2: The objective of this course is to introduce you to the common upper respiratory
illnesses and rashes that occur during childhood. A best-practice treatment that supports the
body system is outlined for your reference, including advice about when to seek medical
attention, if necessary.
Unless you are a licensed get-well care center, you will not be allowed to admit ill children to
your childcare facility. Special notations will be given to symptoms and/or illnesses that are not
allowed to be admitted to the childcare facility.
Slide 3: Respiratory illnesses are diseases that affect the respiratory system.
A rash is an outbreak or an eruption of the skin, sometimes with raised areas. Rashes can be
caused by many things, including bacteria, allergies, and viruses. In this course, we’ll focus on
rashes that are caused mainly by bacteria and viruses.
Slide 4: During the first half of this course, we will discuss respiratory illnesses. The respiratory
system consists of a group of tissues and organs that make it possible to breathe. It includes the
nose, mouth, voice box, windpipe, bronchial tubes and their branches, lungs, and the blood
vessels and muscles associated with breathing. When parts of this system are affected by
illness, it’s difficult to breath.
Today, we’ll be discussing the respiratory illnesses that are listed on this slide: the common
cold, influenza, asthma, whooping cough, croup, and RSV.
Slide 5: The common cold is an upper respiratory illness that’s caused by a virus. In fact, it’s
caused by over 100 different viruses, with the rhinovirus being the most common.
Symptoms of the common cold include nasal congestion, sneezing, runny nose, sore throat,
headache, and cough. It’s called the common cold because there are over a billion colds in the
United States each year. A family will have more colds than any other type of illness in their
lifetime. Colds are the most common reason to miss school or work.
Colds are very contagious, and they can quickly spread through an environment due to
aerosolized germs when someone sneezes or coughs. Surfaces can be contaminated when they
aren’t properly cleaned and disinfected.
Teach children to cover their cough with their upper sleeve. Also sneeze into a tissue when
available; otherwise, use the upper sleeve. Proper hand hygiene is important to prevent the
spread of the common cold. Also avoid touching your eyes, nose, and mouth.
Older children with a cold may be treated with over-the-counter cold and cough medications.
These medications aren’t recommended for children under the age of 6. Keep children’s noses
clean, and use a nasal bulb syringe with infants and young children to suck out any mucous.
Relieve stuffiness with alternative care, which includes chicken soup, vitamin C, zinc, and
Echinacea. Alternative treatments are safe for most individuals. Some may be allergic to
Echinacea, and some herbal therapy may interfere with other types of medications. Therefore,
talk with a doctor before trying alternative treatments.
The common cold isn’t an excludable condition, but if a fever is present, the child must remain
home until 24 hours after the fever is gone, without the use of fever-reducing medicine.
Slide 6: Influenza, which is also known as “the flu,” is an illness that is caused by a virus. It
typically affects the upper respiratory system, which consists of the nose, mouth, sinuses, and
throat.
Symptoms of the flu include: a sudden fever of 100.4 ˚F or higher, dry cough, sore throat,
muscle aches and pains, runny or stuffy nose, headache, and a lack of energy. Some may have
diarrhea, nausea, and vomiting, which is more common in children.
Fever and body aches may last up to 3 to 5 days. The cough and lack of energy may last up to 2
weeks. The flu has been described as feeling like you were ‘hit by a bus.’ There’s no cure for the
flu; it has to run its course
People at higher risk of complications from the flu are pregnant women, children younger than
2 years old, the elderly, and those with chronic health conditions such as asthma or diabetes.
Some complications of the flu include pneumonia, ear infections, sinus infections, and
dehydration. While the majority of flu cases are mild and most people feel better after treating
the flu symptoms at home for several days, it can be dangerous. In severe cases, those infected
with the flu virus will be hospitalized, and some may even die from complications.
“What can I do?” may be your first question. Well, there’s a lot we all can do by preventing the
flu from spreading. This includes staying healthy, getting the flu shot every year, practicing good
hand hygiene, covering our coughs and sneezes, keeping surfaces properly cleaned and
disinfected, planning and preparing for the flu, and limiting contact with others while sick.
Healthy people with no underlying health conditions can treat the flu at home unless
complications arise. Stay home and get plenty of rest while your body heals and fights off the
illness. Drink plenty of fluids like water, juice, and electrolyte drinks, such as Gatorade or
Pedialyte, for rehydration. Run a cool mist humidifier, but be sure to clean it regularly according
to the owner’s manual instructions to prevent mold. The humidifier and extra fluids will thin the
mucous in your throat and sinuses, making it easier to breathe and helping with rehydration.
Take over-the-counter medication to treat the symptoms. To reduce pain and fever, take
acetaminophen, such as Tylenol; ibuprofen, such as Advil or Motrin; or aspirin. Do not give
aspirin to someone younger than 20 years old due to risk of Reye’s syndrome, which is a rare
but serious illness.
Children who are less than 2 years old, pregnant women, the elderly, and those with a chronic
health condition like asthma or diabetes should visit a doctor when they become ill with the flu.
These individuals have an increased chance of having complications from the flu.
A doctor can prescribe an antiviral medication that will help make the flu symptoms less severe.
Antiviral medications are reserved for those who may have complications. Complications
include ear infection, sinus infection, dehydration, and pneumonia.
It’s important to seek medical attention immediately if someone develops: stiffness in the neck
along with fever; symptoms that worsen each day; rapid or difficult breathing; chest pain; blue
or gray skin color; coughing up colored mucous; confusion; light-headedness; difficulty waking
up once asleep; seizures; persistent vomiting; or symptoms that start to get better and then get
worse. Always call or visit a doctor if you are concerned.
The flu is an excludable illness only when the fever is present. A child needs to be removed
from care until the 24 hours after the fever is gone, without the use of fever-reducing medicine.
Slide 7: Asthma is a disease that affects the lungs. It’s a long-term respiratory condition in
which the airways in the lungs are constricted by narrowing and mucus secretion. It interferes
with normal air movement in the lungs and causes wheezing. An asthma episode is often in
response to an allergen, cold air, exercise, or emotional stress. When someone has asthma,
they can experience and be plagued with repeated life-threatening attacks. Asthma isn’t
curable, but it’s highly manageable. It can best be managed under the care of your health
professional. Proper medical treatment, along with strategically avoiding contact with known
indoor and outdoor environmental triggers, allows most people with asthma to live a long,
healthy, active, and productive life. The key is proper control and management.
According to the Centers for Disease Control and Prevention, asthma is one of the most
common chronic childhood diseases.
A person with asthma may display the tell-tale symptoms of tightness in the chest; coughing;
wheezing, which is a high-pitched whistling sound when the person is breathing in and out;
having difficulty breathing; shortness of breath; and nighttime or early morning coughing fits.
Even though these symptoms are considered the most common, they can vary in frequency and
intensity from person to person and can change throughout the individual’s life.
Asthma may also be asymptomatic, which means that the person is not experiencing any
symptoms. Asthma can be dormant, or asleep, for a long time, even years. It can then be
triggered when an irritant or trigger is presented.
Many of the asthma symptoms we’ve mentioned can be from illnesses other than asthma. This
is why it’s important to consult your health care provider to determine whether the illness a
person is experiencing is actually asthma or some other illness.
Anyone can develop asthma, but it’s more common to develop asthma at an early age. Asthma
gives no preference for age, gender, or nationality.
Children younger than 5 years of age are harder to diagnose since their symptoms may be due
to other childhood conditions. More often, the diagnosis of asthma has been known to occur in
young children 6 years of age and older. A qualified health care provider is the only one who
can properly diagnose someone with asthma.
Treatment of asthma includes prescribed medication and an action plan to reduce the exposure
to individual triggers. Triggers may include secondhand smoke, pests, dust mites, pet dander,
mold, mildew, pollen, and combustion products.
Slide 8: Whooping cough, which is also known as pertussis, is a highly contagious bacterial
disease. It produces uncontrollable, violent coughing fits that make it difficult to breathe. The
whooping sound comes from when a person with whooping cough tries to breathe in between
coughs. It’s an upper respiratory infection caused by the Bordetella pertussis bacteria.
Whooping cough is a very serious disease and can cause permanent disability and even death
to infants. It’s easily spread from one person to another through aerosolized droplets of germs
from a person’s sneeze and cough.
Symptoms of whooping cough include a runny nose, fever, and diarrhea that usually develop a
week after exposure to the disease. The coughing episodes come 10 to 12 days later. The
coughs usually end in a “whoop-like” noise. Vomiting is common during the coughing fits, and a
child may lose consciousness. It’s common for infants to choke on their vomit during a coughing
spell.
A doctor will prescribe antibiotics to treat whooping cough. Cough medications and
suppressants should not be used since they aren’t helpful.
To protect children from whooping cough, they should receive the DTaP vaccine, which is part
of the recommended childhood immunizations. During a whooping cough, or pertussis,
outbreak, unimmunized children under the age of seven shouldn’t attend school or public
gatherings due to their increased likelihood of acquiring this severe illness.
Whooping cough is an excludable condition, and a child must be removed from care until after
completion of five days of antibiotic therapy.
View the fact sheet, Whooping Cough (Pertussis).
Activity: Learn more about pertussis by visiting the CDC’s pertussis website:
http://www.cdc.gov/pertussis/about/index.html
Slide 9: Croup is the swelling and inflammation of the vocal chords and windpipe, and it’s
common in infants and children. Croup is caused by viruses, bacteria, allergies, and inhaled
irritants, with viral croup being the most common cause. It’s marked by a repetitive, harsh
cough that sounds like a barking seal.
Cold-like symptoms appear before the cough. A child may develop difficulty breathing, and the
symptoms of croup are generally worse at night. It usually lasts 5 to 6 nights, but it rarely last
for weeks. If it lasts more than a week, a doctor should be seen.
Croup generally isn’t serious, and most cases can be treated at home. If necessary, your doctor
can prescribe medication. A cool mist humidifier or steamy shower will help moisturize the air,
thinning the mucous in the air passages and making it easier to breath. Acetaminophen, such as
Tylenol, can be given to lower fever. Avoid any cough medications unless you first consult a
physician. A doctor can prescribe steroids, which can be effective in relieving the symptoms of
croup.
Prevention includes washing hands frequently and avoiding close contact with those with
respiratory infections.
Slide 10: Respiratory syncytial virus, or RSV, is a very common virus that leads to mild, cold-like
symptoms in adults and older healthy children. It can be more serious in young babies,
especially those in certain high-risk groups.
RSV is the most common germ that causes lung and airway infections in infants and young
children. Most infants have had this infection by age 2. Outbreaks of RSV infections most often
begin in the fall and run into the spring.
The virus spreads through aerosolized droplets from coughs and sneezes. RSV often spreads
very rapidly in crowded households and day care centers. The virus can live for 30 minutes or
more on hands. The virus can also live for up to 5 hours on countertops and for several hours
on used tissues.
Symptoms vary with age and usually appear 4 to 6 days after coming in contact with the virus.
Older children usually have only mild, cold-like symptoms, such as a cough, stuffy nose, or lowgrade fever.
Infants under age 1 may have more severe symptoms and often have the most trouble
breathing. Their symptoms include breathing difficulty, cough, fever, stuffy nose, and wheezing.
Mild infections go away without treatment.
Call your health care provider if breathing difficulties or other symptoms of this disorder
appear. Any breathing difficulties in an infant are an emergency. Seek medical attention right
away. Rarely, RSV infection can cause death in infants. However, this is unlikely if the child is
seen by a health care provider in the early stages of the disease.
Children who have had RSV may be more likely to develop asthma.
A simple way to help prevent RSV infection is to wash your hands often, especially before
touching a baby. It’s important to make certain that other people, especially caregivers, take
steps to avoid giving RSV to your baby. Avoid kissing a child, and avoid crowds.
----------------------http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002531/
Slide 11: Our next slides will discuss common rash diseases that affect children. We’ll be
discussing Scarlet Fever; Measles; Fifth Disease; Hand, Foot, and Mouth; Chicken Pox; and
Roseola.
Slide 12: Scarlet fever is an infection caused by the group A strep bacteria, which causes a red
body rash along with strep throat. It’s a very treatable infection.
It begins with a fever and sore throat, with the rash then starting on the neck and chest. It
spreads all over the body and has a sandpaper-like feel. It usually starts to fade and peel away
in about a week or so, but it can last up to three weeks. Other symptoms include stomach pain,
muscle aches, headache, fever with chills, general feeling of being under the weather, swollen
red tongue, and bright red skin under the arms and in the groin bending lines.
A doctor will prescribe antibiotics to kill the strep bacteria. If not treated properly, scarlet fever
can lead to rheumatic fever.
Avoid contact with anyone who has scarlet fever, and wash your hands frequently.
Scarlet fever is an excludable condition, and a child needs to be removed from care until 24
hours of effective antibiotic treatment has begun and the fever has subsided.
Slide 13: Measles is an illness that’s caused by a very contagious virus. It’s spread through
aerosolized droplets of germs from coughs and sneezes. Measles isn’t as common as it was in
years past, but its rates have started to rise again. Measles is a vaccine-preventable illness.
Symptoms of measles include cough, fever, muscle pain, sensitivity to light, blood-shot eyes,
runny nose, sore throat, white spots inside of the mouth, and a rash. The rash usually appears 3
to 5 days after the first signs of getting sick and may last up to 4 to 7 days. It usually starts on
the head and spreads to other areas of the body. This itchy rash is generally flat and has
discolored areas and solid red raised areas that join together.
There is no specific treatment for the measles other than to relieve symptoms. These
treatments include running a cool mist humidifier, bed rest, and taking over-the-counter
medication, such as acetaminophen, like Tylenol. Call a doctor if you believe your child has the
measles.
Routine vaccinations are highly effective in preventing measles. Those who haven’t been
immunized or who didn’t follow the full immunization schedule are at high risk of getting
measles.
Measles is an excludable condition, and a child needs to be removed from care until four days
after the onset of the rash.
Slide 14: Fifth disease is a rash illness caused by the human Parvovirus B19. It occurs most
commonly in children. The tell-tale sign of fifth disease is a “slapped-cheek” rash on the face
and a lacy red rash on the body and limbs, which may be itchy. Other symptoms of fifth disease
include a low-grade fever and a general feeling of being “under the weather” a few days before
the rash breaks out. It might be mistaken as “just a cold” until the rash appears. The child
usually isn’t very ill, and the rash resolves in 7 to 10 days.
A person with fifth disease is contagious during the early part of the illness, before the rash
appears. By the time a child has the characteristic “slapped cheek” rash of fifth disease, he or
she is probably no longer contagious and may return to the school or child care center. This
contagious period is different than that for many other rash illnesses, such as measles, for
which the child is contagious while he or she has the rash.
Fifth disease is spread from aerosolized germs when one sneezes or coughs. The virus is
probably spread from person to person by direct contact, such as sharing drinking cups or
utensils. In a household, as many as 50% of susceptible persons exposed to a family member
who has fifth disease may become infected. During school outbreaks, 10-60% of students may
get fifth disease.
Fifth disease is usually a mild illness that resolves on its own among children who are otherwise
healthy. Treatment of symptoms such as fever, pain, or itching is usually all that is needed for
fifth disease.
Frequent and proper hand washing is recommended as a practical and probably effective
method to decrease the chance of becoming infected. Therefore, make hand washing a habit to
prevent the spread of this and other communicable illnesses.
----http://www.cdc.gov/ncidod/dvrd/revb/respiratory/parvo_b19.htm
Slide 15: Hand, Foot, and Mouth Disease, or HFMD, is an illness caused by a virus. It’s common
among children who are younger than 5 years of age. It may occur in adults, but that’s rare. It is
NOT related to the animal disease: hoof and mouth disease. They are totally different classes
and types of viruses.
The symptoms of hand, foot, and mouth disease begin with a fever, poor appetite, malaise or
feeling under the weather, and a sore throat. Two days later, painful blisters and ulcers form in
the mouth. Then the rash develops on the hands and feet, with flat or raised spots and blisters.
Sometimes, the rash is on the knees, elbows, buttocks, and/or genital area.
Common complications of hand, foot, and mouth disease include dehydration due to difficulty
swallowing and not wanting to drink fluids. Rarely, it causes viral meningitis or encephalitis or
the temporary loss of a fingernail or toenail.
HFMD is highly contagious and is spread from person to person. The time period of contagion is
the highest during the first week of the illness, but the disease can stay in the body for WEEKS
after all symptoms are gone and still be spreading the disease. Adults with no symptoms may
also be spreading the virus without knowing they have the disease.
A person comes in contact with this disease through bodily fluids, including nose secretions,
saliva, blister fluids, and feces.
Prevention methods include proper hand washing. Wash hands for at least 20 seconds with
warm water and soap. Scrub briskly to ensure all portions of the hands are cleansed including
under fingernails, wrists, in between fingers, and under any jewelry.
Clean and disinfect surfaces, eating utensils, and toys. Cleaning is the removal of dirt and grime
with a detergent. Disinfecting is the killing of germs with a product that is EPA-registered. Dilute
bleach is both economical and convenient for disinfecting.
Practice social distancing and limit close contact by not kissing, hugging, or sharing food items
or drinks with ill persons.
To relieve pain and fever caused of HFMD, take over-the-counter medication, such as
acetaminophen, or Tylenol. You can also use mouthwashes or sprays to numb any mouth pain.
Seek medical attention, especially if you are concerned.
Hand, foot, and mouth disease is an excludable condition only when the fever is present. A
child needs to be removed from care until the 24 hours after the fever is gone, without the use
of fever-reducing medicine.
View the fact sheet, Hand, Foot, and Mouth Disease.
-----------http://www.cdc.gov/hand-foot-mouth/index.html
Slide 16: Chicken pox is a disease caused by a virus. It causes an itchy, blistery, full-body rash
and is very contagious since it’s airborne long before the rash appears. Chicken pox is very
common in childhood. Adults may get this illness as well, but it’s rare. Once you’ve had chicken
pox, you will most likely not get it again.
Ten to 21 days after being exposed to someone with chicken pox, a person may get the disease.
It usually begins with a fever, headache, and stomach ache. The rash then appears with small,
fluid-filled, itchy blisters. The blisters usually start on the face, scalp, or in the middle of the
body. The average child has approximately 250 to 500 blisters. They generally don’t leave scars
unless they are scratched and become infected. Even those who may have gotten the vaccine
might develop chicken pox since it’s not 100% effective. However, if a person does get chicken
pox after having the vaccine, their illness will be mild compared to those who didn’t get it, and
they can still spread the disease.
Treatment includes avoiding scratching the itchy blisters and keeping comfortable by wearing
loose clothing. Take oatmeal or cornstarch baths to soothe the skin. Take antihistamines, which
may help alleviate some of the itching. Apply hydrocortisone creams to soothe the itchy areas.
Do not give aspirin or ibuprofen, like Advil or its generic equivalent, to anyone with chicken pox
or younger than age 20 due to the increased likelihood of Reye’s syndrome and secondary
infections. Acetamenophen, like Tylenol, can be given as needed.
A chicken pox vaccine is now available and is highly recommended for prevention of this
disease. It is given at the first year checkup and then again as a booster at the 4-year-old
checkup.
Chicken pox is an excludable condition. Remove the child from care until seven days after the
onset of the rash, when the blisters have scabbed over.
Slide 17: Roseola is a disease that affects infants and young children and is caused by a virus.
The symptoms of roseola are a pinkish-rose color skin rash and a fever of 100.4 ˚F or higher.
Some will have eye redness, irritability, runny nose, sore throat, and pink or rose-colored raised
small sores or bumps.
The time between becoming infected and the beginning of symptoms is 5 to 15 days. The first
symptoms are redness of the eyes, irritability, sore throat, and a runny nose. The fever and a
pink or rose-colored rash then starts in the middle of the body and spreads out to the
extremities, including the neck and face. Small, slightly raised sores may be present.
There is no specific treatment for roseola because it usually gets better on its own, without any
complications. Treat the fever with cool sponge baths, or relieve any discomfort by giving
acetaminophen, like Tylenol. Do not give aspirin to someone younger than 20 years old due to
risk of Reye’s syndrome.
Prevention of roseola includes proper hand washing to prevent the spread of the virus.
Roseola is excludable condition only when the fever is present. A child needs to be removed
from care until the 24 hours after the fever is gone, without the use of fever-reducing medicine.
-------------http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001963/
Slide 18: As we conclude Part 2 of this course, let’s review the course objectives. We’ve
introduced common upper respiratory illnesses and rashes that are associated with childhood
and now have a general understanding of the reason behind these illnesses. In addition, you’ve
learned some best-practice techniques to treat these ailments to support the body and also
learned when to seek medical attention.
Slide 19: As stated previously, you’ve completed Part 2 of a three-part series. If you wish to
complete the three-part series, please return to the course database where you signed up for this
course and enroll in Part 3, Common Childhood Illnesses: Zoonotic and Other Illnesses.
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