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Health and Wellness Tips

Catherine Cook School is committed to bringing our constituents the best, most applicable, and most up-to-date information we can on a variety of wellness issues. Please peruse the topics below to learn more tips on a variety of topics!

Fitness and Nutrition

Being fit is a way of saying a person eats well, gets a lot of physical activity (exercise), and has a healthy weight. If you're fit, your body works well, feels good, and can do all the things you want to do, like run around with your friends.

Some steps only parents can take — such as serving healthy meals or deciding to take the family on a nature hike. But kids can take charge, too, when it comes to health.

Here are five rules to live by, if you're a kid who wants to be fit. The trick is to follow these rules most of the time, knowing that some days (like your birthday) might call for cake and ice cream.

Eat a Variety of Foods, Especially Fruits and Vegetables

You may have a favorite food, but the best choice is to eat a variety. If you eat different foods, you're more likely to get the nutrients your body needs. Taste new foods and old ones you haven't tried for a while. Some foods, such as green veggies, are more pleasing the older you get. Shoot for at least five servings of fruits and vegetables a day — two fruits and three vegetables.

Looking for healthy snack suggestions for your child(ren)? Click here to download suggestions for healthy snack options, adapted with permission from the Healthy Schools Campaign. Thanks to Catherine Cook parent Melissa Graham for providing these materials.

Drink Water and Milk Most Often

When you're really thirsty, cold water is the No. 1 thirst-quencher. And there's a reason your school cafeteria offers cartons of milk. Kids need calcium to build strong bones, and milk is a great source of this mineral. How much do kids need? If you are younger than 9 years old, drink 2 cups of milk a day, or its equivalent. Aim for 3 cups of milk per day, or its equivalent. You can mix it up by having milk and some other calcium-rich dairy foods.

You probably will want something other than milk or water once in a while, so it's OK to have 100% juice, too. But try to limit sugary drinks, like sodas, juice cocktails, and fruit punches. They contain a lot of added sugar. Sugar just adds calories, not important nutrients.

Listen to Your Body

What does it feel like to be full? When you're eating, notice how your body feels and when your stomach feels comfortably full. Sometimes, people eat too much because they don't notice when they need to stop eating. Eating too much can make you feel uncomfortable and, over a period of time, can lead to unhealthy weight gain.

Limit Screen Time

What's screen time? It's the amount of time you spend watching TV or movies, playing video games (console systems or handheld games), and using the computer or mobile devices. The more time you spend on these sitting-down activities, the less time available for active stuff, like basketball, bike riding, and swimming. Try to spend no more than two hours per day on screen time, not counting computer use related to school.

Be Active

One job you have as a kid — and it's a fun one — is that you get to figure out which activities you like best. Not everyone loves baseball or soccer. Maybe your passion is karate, kickball, or dancing. Ask your parents to help you do your favorite activities regularly. Find ways to be active every day. You might even write down a list of fun stuff to do, so you can refer to it when your mom or dad says it's time to stop watching TV or playing computer games!

Speaking of parents, they can be a big help if you want to be a fit kid. For instance, they can stock the house with healthy foods and plan physical activities for the family. Tell your parents about these five steps you want to take and maybe you can teach them a thing or two. If you're a fit kid, why shouldn't you have a fit family?

Reference: www.kidshealth.org

Head Injuries and Concussions

All concussions are considered a serious brain injury. They can occur without loss of consciousness caused by a bump, blow, or jolt to the head causing the head and brain to move rapidly back and forth.

Know Your ABC’s:

Assess the situation, Be alert for signs and symptoms, Contact a health care professional

You can recognize a concussion by assessing for two things: a forceful blow to the head AND any change in someone’s behavior, thinking, or physical functioning. Students that experience one or more of the signs and symptoms listed below after a bump, blow, or jolt to the head or body should be referred to a health care professional experienced in evaluating for concussion, such as a medical doctor. It is important to monitor closely for 24 hours in addition to days after a head injury has occurred for the following symptoms:

Signs Observed: student appears dazed, stunned, or confused, answers questions slowly, repeats questions, loss of even brief consciousness, unable to recall events prior to or after incident.

Student Reports: feeling pressure or a headache, nausea or vomiting, balance problems, blurred vision, sensitivity to light or noise, feeling sluggish or groggy, irritable, sad, more emotional, drowsy, concentration or memory problems, confusion, or just not feeling right.

Danger Signs: In some cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. The student should be taken to the emergency department right away if any of the following are exhibited: one pupil larger than the other, is drowsy or cannot be awakened, has a headache that gets worse and does not go away, weakness or decreased coordination, repeated nausea or vomiting, slurred speech, convulsions, seizures, cannot recognize people or places, becomes increasingly confused, restless, or agitated, or experiences even a brief loss of consciousness.

What to do? Observe student for signs and symptoms of concussion for at least 30 minutes. Complete the checklist for symptoms (signs observed and student reports at time of incident) at intervals of initial assessment, 15 minutes, 30 minutes, and more if needed after the event. Also, fill out an accident report and notify parents/guardians of event and recommended monitoring.

Reference: U.S. Department of Health and Human Services and Centers for Disease Control and Prevention, May 2010

Communicable Illnesses

Here you will find information on childhood communicable illnesses. Click the drop-down links below for more information.


Adenoviruses are a family of viruses that can infect people of all ages. These infections most often affect the upper respiratory tract. They are slightly more common in the late winter, spring, and early summer months, but can develop at other times of the year as well. Different adenoviruses cause illness at different areas in the body. Some strains cause infection of the eyelids, breathing passages, and lungs, while others affect the bowel or bladder.

The adenoviruses are spread by person-to-person contact, including through secretions that are sneezed or coughed into the air or onto hands and faces. Some adenoviruses are present in the bowels and stools. A person who gets the virus on his hands while bathing or using the bathroom can spread these viruses. The virus can go from one set of hands to the next and then into the mouth or nose or onto the eyes. The viruses also are spread in daycare centers, schools, or summer camps. On occasion, children may get the infection through contaminated swimming pool water or by sharing towels.

Signs and Symptoms

The signs and symptoms of adenovirus infections are similar to those of the common cold. Sick children may develop a stuffy or runny nose as well as a sore throat (pharyngitis), eyelid inflammation (conjunctivitis), infection of the small breathing tubes in the lungs (bronchiolitis), pneumonia, a middle ear infection, or a fever. Some youth may have a harsh cough similar to that of whooping cough. Sometimes there is bleeding into the covering of the swollen eyes. This virus may cause eyes to look very sick, but vision is not affected. Children infected with some strains of adenovirus develop inflammation of the stomach and intestinal tract, which can cause diarrhea and abdominal cramps (gastroenteritis). This virus can also infect the bladder and cause blood in the urine and pain while urinating. Occasionally, the virus causes infection in or around the brain (meningitis or encephalitis). In children with an organ transplant or other conditions in which the immune system is weakened, adenovirus infection can be quite severe and result in an overwhelming infection and death.

Once a child is exposed to the virus, there is an incubation period of 2 to 14 days before he or she has symptoms. The incubation period for gastroenteritis can range from 3 to 10 days.

What You Can Do

Make sure your child gets extra rest and drinks plenty of fluids. If he is uncomfortable, you can consider giving him acetaminophen to reduce his fever or ease the pain of a sore throat.

When to Call Your Pediatrician

If your school-aged child has a sore throat and fever, contact your pediatrician to be sure the illness is not caused by group A streptococcus bacteria (strep throat). Call if your child has symptoms that last more than a few days, he has difficulty breathing, or he appears to be getting worse. Also, let your pediatrician know if your child shows signs of dehydration, such as a decreased output of urine or crying without tears.

How Is the Diagnosis Made?

Most times your pediatrician will examine your child and make the diagnosis based on the signs and symptoms. If your child’s throat is inflamed, the pediatrician may check for strep. There are special tests for virus detection, but because there is no specific medicine to fight these viruses, it is usually not worth the pain of getting the specimen or the cost of the tests. If your child is very ill or has an underlying problem, your pediatrician can take a sample of secretions from the throat, eyes, and other body regions for laboratory testing to identify the presence of adenoviruses. Tests can also be conducted on stool, blood, or urine samples.


As of 2005, there is no specific treatment for adenoviruses. Your pediatrician will suggest supportive care that helps ease your child’s symptoms and makes him or her more comfortable.

What Is the Prognosis?

Most children with adenovirus infections tend to get better in a few days, although coughs and eye infections often last longer. Complications occasionally develop, particularly in young infants and children with weakened immune systems. Rarely, these may include severe pneumonia leading to respiratory failure or an systemic body infection leading to failure of multiple organs.


Frequent hand washing can help reduce the chances of spreading adenovirus infections. Toys and other objects handled by children should be kept clean and disinfected. Your child should swim only in swimming pools that have been adequately chlorinated.

Last Updated 5/26/2011
Immunizations & Infectious Diseases: An Informed Parent's Guide
(Copyright © 2006 American Academy of Pediatrics)

Chicken Pox (Varicella)

Chickenpox is a highly contagious disease caused by a virus called varicella zoster.

Signs and Symptoms

Most children with chickenpox have relatively mild symptoms. They commonly develop a very itchy, blister-like rash that appears 10 to 21 days after exposure and infection with the virus. The blisters usually appear first on the torso and scalp, often surrounded by a reddened area. They may spread to other parts of the body, including the face, arms, and legs. In time, the blisters become crusty before finally healing. Most children develop a mild fever during the course of the infection.

What You Can Do

If your child has chickenpox and is feverish or uncomfortable, you may choose to give him appropriate doses of acetaminophen (keep in mind, however, that a fever helps the body fight off an infection). Never give aspirin to a child with a fever.

Try to prevent your child from scratching the rash, or the rash itself could become infected with bacteria and may leave small scars. Keep fingernails trimmed. Bathe him or her with soap and water or, if you choose, oatmeal baths sold in pharmacies. An antihistamine is useful to decrease itch.

Keep your child away from other children who have never had chickenpox or the chickenpox vaccine, especially children with weakened immune systems. The contagious period begins 1 to 2 days prior to the first appearance of the rash and continues for another 5 to 7 days (or 24 hours after the last new blister develops). Children with chickenpox should be kept home from school until the rash has crusted over.

When to Call Your Pediatrician

Most children with chickenpox do not need to be seen by a pediatrician. However, contact your pediatrician if your child has a high fever (temperature greater than 102°F or 38.9°C) or if the fever lasts for more than 4 days.

Also, notify your pediatrician if your child has any signs of a bacterial infection, such as part of the rash becoming extremely red, tender, and warm, or if your child’s symptoms seem much worse.


Your pediatrician can prescribe an antiviral medication called acyclovir that can reduce the symptoms of chickenpox. However, to be most effective, it must be given within 24 hours after the disease begins. This medicine is most often prescribed for teenagers and for children with asthma or a skin condition called eczema rather than otherwise healthy young children.

What Is the Prognosis?

As uncomfortable as chickenpox may be, the disease clears up completely without complications in most children. Bacterial infections do occur in some children. These are usually mild skin infections, but at times the infection can be more severe and involve the tissues under the skin and the muscles. In these cases, antibiotics and surgery are needed to control the bacteria.

A few children will have a more severe disease affecting the brain during the rash or a few weeks after the rash. Although most of these children recover, some will be left with damage to the brain.


The American Academy of Pediatrics recommends a first dose of the chickenpox vaccine at 12 to 15 months of age for all healthy children who have never had the disease. A second dose should be given at 4-6 years of age (but may be given earlier, if at least 3 months after the first dose). Until your child reaches his first birthday, the best way to protect him from chickenpox is to keep him away from children with the active disease. Keep in mind that an infant will have immunity during the first few months of life if his mother has had chickenpox or the chickenpox vaccine at some point in her life.


Immunizations & Infectious Diseases: An Informed Parent's Guide
(Copyright © 2006 American Academy of Pediatrics)

Fifth Disease (Parvovirus B19)

Fifth Disease (Parvovirus B19) is a contagious virus. Its most notable symptom is a bright red patch or rash on your child’s cheeks. It can be spread from one person to another through droplets or secretions (eg, saliva, sputum). It can also be passed from a pregnant woman to her fetus. The virus can cause serious illness in a fetus or any child who has a certain type of anemia (low red blood cell count).

Outbreaks of parvovirus B19 infections occur from time to time in elementary and middle schools during the late winter and early spring months.

Signs and Symptoms

In the initial stages of fifth disease, your child may develop mild cold-like symptoms including a stuffy or runny nose, sore throat, mild fever, muscle soreness, itching, fatigue, and headaches. Less commonly, your child may experience aches in the knees or wrists.

After 7 to 10 days of these first symptoms, the distinctive rash of fifth disease may appear. It typically starts on the face, giving the child a “slapped cheek” appearance. A slightly raised rash in a lacelike pattern may develop on the torso and then spread to the arms, buttocks, and thighs. Five to 10 days later, the rash will tend to fade. It may reappear briefly weeks or months later, especially when your child becomes hot while exercising, bathing, or sunbathing.

The incubation period from exposure to the virus to the beginning of symptoms usually ranges from 4 to 14 days. The rash appears 2 to 3 weeks after your child becomes infected. Once the rash is present, your child will no longer be contagious.

When To Call Your Pediatrician

If your child’s symptoms seem to get worse with time or if he/she develops joint swelling, contact your pediatrician. If your child has sickle cell disease, contact your doctor whenever your child gets a fever or seems especially pale.

How Is The Diagnosis Made?

Your pediatrician will diagnose fifth disease by examining the rash, which has a distinctive look. In some cases, your doctor will conduct a blood test that can detect antibodies to parvovirus B19.


Most children with fifth disease are treated only with symptomatic care to make them feel more comfortable. If a fever is present, your pediatrician may recommend acetaminophen to lower the temperature as well as to reduce the intensity of any aches and pains that are part of the illness. Your pediatrician also may advise using antihistamines to relieve any itching associated with the rash.

What Is The Prognosis?

Most children infected with parvovirus B19 have only a mild illness that goes away on its own. However, children with blood disorders such as sickle cell anemia or a weakened immune system can become seriously ill if they develop fifth disease and should be seen by a doctor immediately. The infection can also be serious if it is contracted by pregnant women. Fifth disease can result in serious complications such as damage to the fetus, miscarriages, or stillbirths.


To reduce the risk of spreading fifth disease, good hygiene is important, including frequent hand washing.

Children who have fifth disease rash are no longer contagious and may attend child care or school. However, during the early stages of the virus when he/she may have a fever, keep him/her away from other children until the fever subsides.


Immunizations & Infectious Diseases: An Informed Parent's Guide (American Academy of Pediatrics) www.healthychildren.org

Hand, Foot & Mouth Disease

Hand, Foot & Mouth Disease is a viral infection that causes mouth ulcers and tiny blisters on the hands and feet


  • Small, painful ulcers in the mouth, especially on tongue and sides of mouth (in all children)
  • Small, thick-walled water blisters (like chickenpox) or red spots located on the palms, soles, and webs between the fingers and toes (70%)
  • 1 to 5 water blisters per hand or foot
  • Small blisters or red spots on the buttocks (30%)
  • Low-grade fever less than 102° F (39° C)
  • Mainly occurs in children age 6 months to 4 years


  • Coxsackie A-16 virus
  • Not related to animal disease

Return to School

  • Can return to child care or school after the fever is gone (usually 2 to 3 days). The rash is not contagious.


Immunizations & Infectious Diseases: An Informed Parent's Guide (American Academy of Pediatrics) www.healthychildren.org

Head Lice


Any student with live lice or nits should not be sent to school and will be sent home early from school if found by a teacher or the school nurse. Head lice is easily transmitted. If one member of the household is diagnosed with head lice or nits, please check any students in the household and confirm they are lice- and nit-free before sending them to school.

Parents are expected to treat head lice promptly by shampooing the infected child’s head with anti-lice shampoo. Effective treatment of head lice requires the removal of both lice and nits from the hair, as lice shampoos alone do not remove nits. The nits must be combed out or manually removed. In some cases, over-the-counter products fail to kill live lice. If this occurs, please contact your health care provider, as they may be able to order a prescription medication for treatment. Upon returning to school, it is advised that students with long hair wear it up and tight to the head for two to three weeks until it is confirmed that no additional lice or nits are found. Continuous checking may be required for all types and lengths of hair for up to three weeks to avoid re-infestation.

Regular checks are a good way to spot head lice before they have time to multiply and infest your child's head. It is strongly recommended that every parent check their child’s hair by using a "wet technique" once a week to check for lice or nits.

Personal hygiene or cleanliness in the home or school has nothing to do with getting head lice. Lice is spread most commonly through hair-to-hair contact. It can also be transferred by sharing hats, combs and brushes, and other hair accessories.

Please read below for further instructions.

Diagnosing and Treating Head Lice at Home
For weekly checks, or if you are concerned that someone has head lice, you can usually diagnose this at home. You will need 2 common items:

    • Bright light
    • Fine-tooth comb or lice comb

How to check your child:

    1. Wet the hair of the adult or child. This may help to visualize nits or lice.
    2. Sit the person under a bright light.
    3. Separate hair into sections. Beginning at the scalp, slowly comb outward through the hair section by section.
    4. Wipe the comb on a paper towel after each comb through to remove any nits or lice.
    5. Do not confuse dandruff or other hair debris with nits or lice.

Tips to Rid Your Home and Car of Lice:

    1. Wash all linens and clothing your child has been in contact with in hot water and dry on high heat (if possible).
    2. Items that cannot be washed or vacuumed (e.g. stuffed animals, special pillows, etc.) can be placed in a tightly closed plastic bag for 48 hours.
    3. Vacuum the house, mattress, furniture, car upholstery, and child car seats.
    4. Lice and nits generally do not survive off of their hosts beyond 48 hours.

For more information on lice, please see these websites:



Impetigo is a contagious bacterial skin infection that often appears around the nose, mouth, and ears. More than 90 percent of impetigo cases are caused by staphyloccus or “staph” bacteria, while the rest are caused by streptococcus bacteria (which also are responsible for “strep” throat and scarlet fever). If staph bacteria are to blame, the infection may cause blisters filled with clear fluid. These can break easily, leaving a raw, glistening area that soon forms a scab with a honey colored crust. By contrast, infections with strep bacteria usually are not associated with blisters, but they do cause crusts over larger sores and ulcers.


Impetigo needs to be treated with antibiotics, either topically or by mouth, and your pediatrician may order a culture in the lab to determine which bacteria are causing the rash. Make sure your child takes the medication for the full prescribed course, or the impetigo could return.

One other important point to keep in mind: Impetigo is contagious until the rash clears, or until at least two days of antibiotics have been given and there is evidence of improvement. Your child should avoid close contact with other children during this period, and you should avoid touching the rash. If you or other family members do come in contact with it, wash your hands and the exposed site thoroughly with soap and water. Also, keep the infected child’s washcloths and towels separate from those of other family members.


The bacteria that cause impetigo thrive in breaks in the skin. The best ways to prevent this rash are to keep your child’s fingernails clipped and clean and to teach him not to scratch minor skin irritations. When he does have a scrape, cleanse it with soap and water, and apply an antibiotic cream or ointment. Be careful not to use washcloths or towels that have been used by someone else who has an active skin infection.

When certain types of strep bacteria cause impetigo, a rare but serious complication called glomerulonephritis can develop. This disease injures the kidneys and may cause high blood pressure and blood to pass in the urine. Therefore, if you notice any blood or dark brown color in your child’s urine, let your pediatrician know so he/she can evaluate it and order further tests if needed.


Immunizations & Infectious Diseases: An Informed Parent's Guide (American Academy of Pediatrics)



Almost every child has influenza from time to time. Commonly called the flu, the high fever and muscle aches caused by influenza are hard to ignore, often forcing the most active child into bed for a few days of rest and recovery.

Influenza is a respiratory illness caused by a virus. Flu infections are highly contagious. They spread easily in schools, households, child care settings, the workplace, and any other places where groups of people are together. Your child can catch the flu if someone around him/her has the infection and sneezes or coughs, sending viral droplets into the air where they can be breathed in by others. He/she can also get the disease by touching a toy that has been contaminated by someone with the infection and then putting her hand or fingers into her mouth or nose. Children are most contagious during the 24 hours before symptoms begin and the period when their symptoms are at their worst.

Although there are 3 influenza viruses—types A, B, and C—most flu outbreaks are caused by A or B. Epidemics of influenza usually occur during the winter months, often lasting through March.

Signs and Symptoms

When your child gets the flu, he/she will probably develop a fever (temperature greater than 100°F), usually quite rapidly, often accompanied by the chills, headaches, lack of energy, a dry cough, and muscle aches and pain. As the illness progresses, other symptoms such as a sore throat and runny or stuffy nose may develop and worsen. Some children also have abdominal pain, nausea, and vomiting.

Particularly in infants, influenza can cause ear infections, croup, bronchiolitis (an infection of the lungs’ small breathing tubes), or pneumonia.

What You Can Do

You’re probably familiar with many of the home treatments for the flu. They’ve been used by generations of parents, although they are not as useful in getting rid of the virus as some parents think. Your child may benefit from getting plenty of rest, and he/she should drink liquids to prevent dehydration.

To help make your feverish child more comfortable and reduce fever, some pediatricians recommend giving him/her acetaminophen (although there’s evidence that a fever is the body’s way of fighting off the invading infection). However, do not give aspirin to any child or teenager who has a temperature. The use of aspirin in such circumstances has been associated with a rare but very serious illness called Reye syndrome. Be sure to read the labels on any medicine you plan to give to your child because some medicines contain aspirin (acetylsalicylic acid) as part of their ingredients.

When to Call Your Pediatrician

Contact your pediatrician early if your child has flu symptoms—some antiviral medicines work best if given within the first 48 hours after symptoms begin. In particular, let your doctor know if a fever continues, your child complains of an earache, or he/she has a cough that does not go away.

Some of the common signs of complications associated with the flu include an ear infection, a sinus infection, or pneumonia. Complications are more likely to occur in a child who has an underlying health problem, including heart disease, lung disease, a weakened immune system, or a malignancy.


Immunizations & Infectious Diseases: An Informed Parent's Guide
(Copyright © 2006 American Academy of Pediatrics)


Mononucleosis is also known as Epstein-Barr virus. This virus is spread from one person to another in saliva, blood, and other body fluids.

Signs and Symptoms

Many children infected with Epstein-Barr virus (EBV) have no symptoms or only very mild ones. When there are signs and symptoms of mononucleosis, they usually include the following:

  • Fever
  • Sore throat, including white patches in the back of the throat
  • Swollen lymph glands in the back of the neck, groin, and armpit
  • Fatigue

In addition to these classic symptoms, some children may also have one or more of the following signs and symptoms:

  • Chills
  • Headache
  • Decreased appetite
  • Puffy eyelids
  • Enlargement of the liver and spleen
  • Oversensitivity to light
  • Anemia

When to Call Your Pediatrician

Contact your pediatrician if your child has the major symptoms described above, especially a fever, sore throat, fatigue, and enlarged glands.

How Is the Diagnosis Made?

The diagnosis of infectious mononucleosis is usually made through a medical history, physical examination, and blood tests. These tests may include a complete blood count to check for unusual looking white blood cells (atypical lymphocytes). Blood tests can also detect increases in antibodies against EBV.


Much of the treatment for mononucleosis is aimed at making your child more comfortable until the infection goes away on its own. For example

  • Some pediatricians may recommend giving your child acetaminophen to reduce the fever and ease pain.
  • Sore throats can be treated by gargling with warm water and salt.
  • Bed rest can be important for a child feeling fatigued.

What Is the Prognosis?

Most cases of infectious mononucleosis clear up in 1 to 3 weeks (although symptoms, particularly fatigue, can last for several additional weeks in some children). Patients with abnormal immune systems can have a more severe infection that further weakens the immune system, resulting in cancers or death caused by liver failure and bacterial infections.


It is difficult to prevent the spread of this virus because people who have been infected can spread the virus for the rest of their lives. Your child should avoid infected saliva by not sharing drinking glasses, water bottles, or eating utensils.


Immunizations & Infectious Diseases: An Informed Parent's Guide (American Academy of Pediatrics) www.healthychildren.org


Meningitis is an inflammation of the tissues that cover the brain and spinal cord. The inflammation sometimes affects the brain itself. With early diagnosis and proper treatment, a child with meningitis has a good chance of getting well without any complications.

Thanks to vaccines that protect against serious forms of bacterial meningitis, most cases of meningitis are caused by viruses. The viral form usually is not very serious, except in infants less than three months of age. Once meningitis is diagnosed as being caused by a virus, there is no need for antibiotics and recovery should be complete. Bacterial meningitis (several types of bacteria are involved) is a very serious disease.

It occurs very rarely (because of the success of vaccines), but when it does occur, children under the age of two are at greatest risk.

The bacteria that cause meningitis often can be found in the mouths and throats of healthy children. But this does not necessarily mean that these children will get the disease. That doesn’t happen unless the bacteria get into the bloodstream.

We still don’t understand exactly why some children get meningitis and others don’t, but we do know that certain groups of children are more likely to get the illness. These include the following:

  • Babies, especially those under two months of age (Because their immune systems are not well developed, the bacteria can get into the bloodstream more easily.)
  • Children with recurrent sinus infections
  • Children with recent serious head injuries and skull fractures
  • Children who have just had brain surgery

With prompt diagnosis and treatment, 7 out of 10 children who get bacterial meningitis recover without any complications. However, bear in mind that meningitis is a potentially fatal disease, and in about 2 out of 10 cases, it can lead to serious nervous system problems, deafness, seizures, the loss of arms or legs, or difficulties at school.

Because meningitis progresses quickly, it must be detected early and treated aggressively. This is why it’s so important for you to notify your pediatrician immediately if your child displays any of the following warning signs:

  • If your child is less than two months old: A fever, decreased appetite, listlessness, or increased crying or irritability warrants a call to your doctor. At this age, the signs of meningitis can be very subtle and difficult to detect. It's better to call early and be wrong than to call too late.
  • If your child is two months to two years old: This is the most common age for meningitis. Look for symptoms such as fever, vomiting, decreased appetite, excessive crankiness, or excessive sleepiness. (His cranky periods might be extreme and his sleepy periods might make it impossible to arouse him.) Seizures along with a fever may be the first signs of meningitis, although most brief, generalized (so-called tonic-clonic) convulsions turn out to be simple febrile seizures, not meningitis. A rash also may be a symptom of this condition.
  • If your child is two to five years old: In addition to the above symptoms, a child of this age with meningitis may complain of a headache, pain in his/her back, or a stiff neck. He/she also may object to looking at bright lights.


If, after an examination, your pediatrician is concerned that your child may have meningitis, she will conduct a blood test to check for a bacterial infection and also will obtain some spinal fluid by performing a spinal tap, or lumbar puncture (LP).

This simple procedure involves inserting a special needle into your child’s lower back to draw out spinal fluid. This is a very safe technique in which fluid is sampled from the bottom of the sac surrounding the spinal cord, so there is no risk of injury to the cord itself. Any signs of infection in this fluid will confirm that your child has bacterial meningitis. In that case he/she will need to be admitted to the hospital for intravenous antibiotics and fluids and for careful observation for complications.

During the first days of treatment, your child may not be able to eat or drink, so intravenous fluids will provide the medicine and nutrition needed. For certain types of meningitis, this may be necessary for seven to twenty-one days, depending on the age of the child and the bacteria identified.


Some types of bacterial meningitis can be prevented with vaccines. Ask your pediatrician about the following:

  • HiB (Haemophilus Influenzae Type B) Vaccine: This vaccine will decrease the chance of children becoming infected with Haemophilus influenzae type b (Hib) bacteria, which was the leading cause of bacterial meningitis among young children before this immunization became available. The vaccine is given by injection to children at two months, four months, and six months, and then again between twelve and fifteen months of age (some combined vaccines may allow your doctor to omit the last injection).
  • Pneumococcal Vaccine: This vaccine is effective in preventing many serious infections caused by the pneumococcus bacteria, including meningitis, bacteremia (an infection of the bloodstream), and pneumonia. It is recommended starting at two months of age, with additional doses at four, six, and between twelve and fifteen months of age. Some children who have an increased susceptibility to serious infections (including those with abnormally-functioning immune systems, sickle cell disease, certain kidney problems, and other chronic conditions) may receive an additional pneumococcal vaccine between ages two and five years.
  • Meningococcal Vaccine: There are two kinds of meningococcal vaccines available in the U.S., but the preferred vaccine for children is called the meningococcal conjugate vaccine (MCV4). Although it can prevent four types of meningococcal disease, it is not recommended for very young children, but rather for young adolescents (eleven to twelve years of age) or teenagers at the time they start high school (or at fifteen years old).


Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)


MRSA (methicillin-resistant Staphylococcus aureus) is the name of a “staph” bacterium that can cause infections not only on the surface of the skin, but also into the soft tissue where a boil or abscess can form. In recent years, MRSA has become a major public-health problem because this bacterium has become resistant to antibiotics called beta-lactams, which include methicillin and other commonly prescribed antibiotics (such as penicillin and amoxicillin). This resistance has made treating these infections more difficult. While MRSA was once limited to hospitals and nursing homes, it has spread into the community in schools, households, and child care centers, among other places. It can be transmitted from person to person through skin-to-skin contact, particularly through cuts and abrasions.

If your child has a wound that appears to be infected—specifically, if it is red, swollen, hot, and draining pus—have it checked by your pediatrician. He may drain the infection and prescribe antibiotics. The most serious MRSA infections may cause pneumonia and bloodstream infections. Even though MRSA infections are resistant to some antibiotics, they are treatable with other medications.

To prevent your child from getting MRSA at school or other public places, the following strategies can be helpful:

  • Follow good hygiene practices. Your child should wash his hands frequently with soap and warm water, or use alcohol-based hand sanitizers.
  • Use a clean dry bandage to cover any cuts, scrapes, or breaks in your child’s skin. These bandages should be changed at least daily.
  • Don’t let your child share towels, washcloths, or other personal items (including clothing) with anyone else.
  • Frequently clean surfaces that your child touches.
Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)

Pink Eye

The American Academy of Pediatrics states that pink eye results in redness, irritation, purulent yellow drainage, or inflammation of the conjunctiva. The conjunctiva is a clear membrane covering the white of the eye and the eyelids. The conjunctiva usually reacts to bacteria, viruses, allergy causing agents, irritants, or diseases of other parts of the body. Viruses that spread from other different ailments like colds, sore throats, respiratory infections, and others usually cause viral conjunctivitis or contagious pink eye. Certain types of bacteria that have made their way to the eye cause bacterial Conjunctivitis. Common bacteria include staphylococci and streptococci. Allergic reactions to different substances such as fumes, cosmetics, medication, and many others cause allergic Conjunctivitis.

A good rule of thumb is that if a child wakes up in the morning with crusty yellow drainage sticking to their eyelashes, wash it off with a warm washcloth and if it re-appears within the hour it is considered pink eye requiring anti-biotic eye drops from your pediatrician.


Immunizations & Infectious Diseases: An Informed Parent's Guide (American Academy of Pediatrics) www.healthychildren.org


Pneumonia means “infection of the lung.” While such infections were extremely dangerous in past generations, most children today can recover from them easily if they receive proper medical attention.

Most cases of pneumonia follow a viral upper respiratory tract infection. Typically, the viruses that cause these infections (respiratory syncytial virus [RSV], influenza, parainfluenza, adenovirus) spread to the chest and produce pneumonia there. Pneumonia also can be caused by bacterial infections.

Some of these are spread from person to person by coughing or by direct contact with the infected person’s saliva or mucus. Also, if a viral infection has weakened a child’s immune system, bacteria may begin to grow in the lung, adding a second infection to the original one.

Children whose immune defenses or lungs are weakened by other illnesses, such as cystic fibrosis, asthma, or cancer (as well as by the chemotherapy used to treat cancer), are more likely to develop pneumonia. Children whose airways or lungs are abnormal in any other way also have a higher risk.

Because most forms of pneumonia are linked to viral or bacterial infections that spread from person to person, they’re most common during the fall, winter, and early spring, when children spend more time indoors in close contact with others. The chance that a child will develop pneumonia is not affected by how she is dressed or by air temperature.

Signs and Symptoms

Like many infections, pneumonia usually produces a fever, which in turn may cause sweating, chills, flushed skin, and general discomfort. The child also may lose her appetite and seem less energetic than normal. Babies and toddlers may seem pale and limp, and cry more than usual.

Because pneumonia can cause breathing difficulties, you may also notice these other, more specific symptoms:

  • Cough
  • Fast, labored breathing
  • Increased activity of the breathing muscles below and between the ribs and above the collarbone
  • Flaring (widening) of the nostrils
  • Pain in the chest, particularly with coughing or deep breathing
  • Wheezing
  • Bluish tint to the lips or nails, caused by decreased oxygen in the bloodstream

Although the diagnosis of pneumonia usually can be made on the basis of the signs and symptoms, a chest X-ray sometimes is necessary to make certain and to determine the extent of lung involvement.


When pneumonia is caused by a virus, usually there is no specific treatment other than rest and the usual measures for fever control. Cough suppressants containing codeine or dextromethorphan should not be used, because coughing is necessary to clear the excessive secretions caused by the infection. Viral pneumonia usually improves after a few days, although the cough may linger for several weeks. Ordinarily, no medication is necessary.

Because it is often difficult to tell whether the pneumonia is caused by a virus or by bacteria, your pediatrician may prescribe an antibiotic. All antibiotics should be taken for the full prescribed course and at the specific dosage recommended. You may be tempted to discontinue them early, but you should not do so. Your child will feel better after just a few days, but some bacteria may remain and the infection might return unless the entire course is completed.

Your child should be checked by the pediatrician as soon as you suspect pneumonia. Check back with the doctor if your child shows any of the following warning signs that the infection is worsening or spreading.

  • Fever lasting more than a few days despite using antibiotics
  • Breathing difficulties
  • Evidence of an infection elsewhere in the body: red, swollen joints, bone pain, neck stiffness, vomiting, or other new symptoms or signs


Your child can be vaccinated against pneumococcal infections, a bacterial cause of pneumonia. The American Academy of Pediatrics recommends that all children younger than two years old receive this immunization (called pneumococcal conjugate or PCV7). A series of doses needs to be given at two, four, six, and twelve to fifteen months of age, at the same time that children receive other childhood vaccines.

Another pneumococcal vaccine (pneumococcal polysaccharide or PPV23) also is recommended for older children (twenty-four to fifty-nine months of age) who have a high risk of developing an invasive pneumococcal infection. These include children with sickle cell anemia, heart disease, lung disease, kidney failure, damaged or no spleen, organ transplant, and HIV (human immunodeficiency virus) infection. It’s also recommended for children taking medications or who have diseases that weaken their immune system.


Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)

Scarlet Fever

When your child has strep throat, there’s a chance that he/she will get a rash known as scarlet fever or scarlatina. The symptoms of scarlet fever begin with a sore throat, a fever of 101-104°F (38.2–40°C), and headache. This is followed within twenty-four hours by a red rash covering the trunk, arms, and legs. The rash is slightly raised, which makes the skin feel like fine sandpaper. Your child’s face may turn red, too, with a pale area around the mouth. This redness will disappear in three to five days, leaving peeling skin in the areas where the rash was most intense (neck, underarms, groin, fingers, and toes). He/she may also have a white coated, then reddened, tongue and mild abdominal pain.


Call your pediatrician whenever your child complains of a sore throat, especially when a rash or fever also is present. The doctor will examine him and swab his throat to check for strep bacteria. If strep throat is found, an antibiotic (usually penicillin or amoxicillin) will be given. If your child takes the antibiotic by mouth, it’s extremely important to complete the entire course because shorter treatment sometimes results in a return of the disease.

Most children with strep infections respond very quickly to antibiotics. The fever, sore throat, and headache usually are gone within 24 hours. The rash, however, will remain for about three to five days.

If your child’s condition does not seem to improve with treatment, notify your pediatrician. If other family members develop a fever or sore throat at this time—with or without a rash—they, too, should be examined and tested for strep throat.

If not treated, scarlet fever (like strep throat) can lead to ear and sinus infections, swollen neck glands, and pus around the tonsils. The most serious complication of untreated strep throat is rheumatic fever, which results in joint pain and swelling and sometimes heart damage. Very rarely, the strep bacteria in the throat can lead to glomerulonephritis, or inflammation of the kidneys, causing blood to appear in the urine and sometimes high blood pressure.


Immunizations & Infectious Diseases: An Informed Parent's Guide (American Academy of Pediatrics) www.healthychildren.org

Strep Throat

The most common infection caused by group A streptococci is a sore throat known as strep throat. Streptococcal sore throats (pharyngitis) are especially common among school-aged children and teenagers..

Signs and Symptoms

When group A streptococcus infects a child younger than 3 years, the symptoms tend to be milder than in older children. Infants with a streptococcal infection may have a low fever and thickened nasal discharge. Toddlers may have a fever, irritability, decreased appetite, and swollen glands in the neck.

When a child is older than 3 years, he may have more serious streptococcal-related symptoms such as a red and very painful sore throat, a high fever (greater than 102°F or 38.9°C), white patches of pus on the tonsils (but not always), swollen glands in the neck, and stomach ache.

An infected child will become ill two to five days after being exposed to streptococcal bacteria.

What You Can Do

Home remedies such as gargling with warm salt water may relieve some of your child’s throat pain. Acetaminophen or ibuprofen can help lower body temperature and lessen the pain.

When to Call Your Pediatrician

If your child has a sore throat, especially with pus on the tonsils or swollen glands, contact your pediatrician.

How Is the Diagnosis Made?

Your doctor will swab your child’s throat and tonsils to test whether he has a GAS (Group A Strep) infection. Most pediatricians’ offices have quick-result streptococcal tests that can help diagnose streptococcal infection in several minutes. A culture may be sent out to determine the most effective antibiotics to treat the infection with. This result will not be for 48 hours.


The primary treatment is penicillin taken orally, such as: ampicillin, amoxicillin, or oral cephalosporins. If your child is allergic to penicillin, oral erythromycin is usually chosen.


Group A streptococcal infections are very contagious. Throat infections, for example, are passed through the air by sneezing, coughing, or touching an infected child.


Immunizations & Infectious Diseases: An Informed Parent's Guide (American Academy of Pediatrics) www.healthychildren.org

Hearing and Vision Screenings

Students in various grades will have hearing and vision screenings completed at Catherine Cook annually. This is mandated by the State of Illinois through the Illinois Department of Public Health and Illinois State Board of Education for students in private or public schools to help identify children who may have a visual or hearing impairment. A qualified technician certified by the State of Illinois will be hired to screen these mandated students free of charge. If you are strongly against your child participating in this screening, please email the school nurse promptly at nurse@ccookschool.org.

You will only be contacted (mailed letter with results) if your child has any abnormal results from these screenings. This will occur within one week of the screening. Please read below if this applies to your child.

Who will receive a vision screening?

  • Preschool, Junior Kindergarten, 2nd, and 8th Grades (SK must receive an annual eye exam this year completed by their doctor)
  • Transfer students
  • Any student that a teacher feels should be screened (you will be contacted previous to the screening if this applies to your child)

Hearing screenings

  • Preschool, Junior Kindergarten, Senior Kindergarten, 1st, 2nd, and 3rd Grades
  • Transfer students
  • Any student that a teacher feels should be screened (you will be contacted previous to the screening if this applies to your child)

The purpose of hearing and vision screening is to identify children who may have a visual or a hearing impairment. Impairment in either of these areas may prevent a child from obtaining full benefit from their educational opportunities. Vision and hearing problems often go unnoticed because the defects are difficult to notice. Without specific screening tests, a problem may not be found until your child develops significant educational or medical problems. Hearing and vision screening enables us to detect unrecognized conditions as early as possible in order to obtain prompt treatment and resolution to any problems.

If you have any questions or concerns, please contact nurse@ccookschool.org.