Wondering whether you need to quarantine your child when she has a cold, an ear infection, pinkeye, or another common childhood illness? Read on to find out what precautions you should take and how long these conditions are contagious — if at all.
Cold (Upper Respiratory Infection)
According to the American Academy of Allergy, Asthma, and Immunology, the average young child between 1 and 3 years of age may get up to 12 colds a year. Telltale signs: a cough or a runny or stuffy nose.
Treatment Keep your child comfy until the cold runs its course. Give him nasal saline drops, run a cool-mist humidifier in his room, and suction his nostrils at least once a day. Because colds are caused by viruses, antibiotics are ineffective, and the American Academy of Pediatrics doesn’t advise administering cough and cold meds to children under the age of six.
Contagious factor When your child is feeling his worst (days three through five), he’s most contagious. But symptoms can last for up to two weeks, and he’s contagious as long as he’s sick. Of course, you can’t quarantine him for days. So wash your hands frequently after touching him, and keep him away from other kids during the cold’s peak. And if the snot is green versus yellow? It doesn’t matter. All colds are contagious regardless of mucus color.
Ear Infection
One of the most common childhood illnesses, it’s caused by bacteria settled behind the eardrum that cause a buildup of pressure in the middle ear canal. For your little one, this translates to pain! Other possible symptoms include fever, decreased appetite, fussiness, and sleep disturbance.
Treatment Many doctors take a minimalist approach, avoiding antibiotics and suggesting pain medicine — but this is appropriate only for kids who can verbally express their discomfort level. Otherwise, antibiotics are prescribed.
Contagious factor Good news: ear infections are not contagious, unlike the colds that can lead to or accompany them.
Vomiting and Diarrhea
Sometimes accompanied by fever, these icky conditions are most often caused by viruses invading the intestinal tract. Vomiting usually ends after 24 to 48 hours, but diarrhea can last a week or more.
Treatment Feed your child a bland diet (no spices or dairy foods) and lots of liquids. Pedialyte, which is full of important electrolytes, is a good choice in small and frequent servings.
Contagious factor Vomiting and diarrhea are spread by fecal bacteria, so wash your hands immediately after changing a diaper or cleaning vomit. If your child is throwing up, she is contagious from the first symptom until she feels completely better. With diarrhea or illnesses that involve both vomiting and diarrhea, contagiousness spans from the first symptom until stools are formed again. (If your baby wears a diaper, her stools should be firm enough so that they’re not leaking.)
If your child has blood in her stools and a fever above 102 degrees F., she may have a bacterial infection. In this case, your doctor will collect a stool sample. Keep your child home until you have the results (this takes up to 72 hours); contagiousness can last for several weeks, even if she doesn’t show any symptoms.
Pinkeye
An infection of the lining of the eye and eyelids, it’s characterized by redness, itching or pain, and eye drainage.
Treatment Pinkeye clears up fast. But getting antibiotic eyedrops into a toddler is not easy — and you’ll have to do this for an entire week.
Contagious factor It’s one of the only illnesses a child can infect himself with. That’s right! If your child has pinkeye in one eye, all it takes to spread it to the other is rubbing. But how did he get it in the first place? From direct contact with the germs that cause it, either by touching an infected person or an object handled by an infected person. At least contagiousness ends after just 24 hours treatment!
Fifth Disease
This viral infection infects immune cells, causing a rash and a low-grade fever. The classic description is a “slapped cheek” appearance with bright red cheeks and a lacy, non-raised rash on the body.
Treatment There’s really no specific treatment for fifth. It goes away on its own without antibiotics — the fever within a few days and the rash within a few weeks.
Contagious factor You can’t do anything to prevent spreading it or catching it. Kids who’ve been exposed may not show symptoms for up to two weeks, but they can be contagious for up to five days before showing symptoms. The most ironic part: by the time the red cheeks and rash appear, a child can no longer spread the infection.
More Conditions
Chickenpox
A viral infection that causes fever and a red, bumpy, itchy rash, chickenpox can lead to skin infections and potentially life-threatening cases of pneumonia, sepsis, or meningitis.
Treatment Rest, rest, and more rest! This is really the only cure. Acetaminophen can relieve discomfort (avoid aspirin, which can cause seizures, coma, and liver failure in babies), as can baths of colloidal oatmeal or applications of calamine lotion to lesions. In extreme cases, an antiviral medication is prescribed. (Always check with your doctor before administering OTC medicines to your child.)
Contagious factor Since babies younger than 12 months haven’t yet been vaccinated, they’re susceptible. And even after vaccination, children still have a slight risk of catching chickenpox. If you’ve never had the pox before, and your child does, you’ll need to avoid touching her until her lesions are crusted over (this is hard, we know!), especially since the older the patient, the more severe the symptoms and potential complications. How long is your child contagious? For up to five days once she shows symptoms and all lesions are crusted over.
Strep Throat
Symptoms of this bacterial infection include sore throat, fever, headache, decreased appetite, abdominal pain, and nausea. To confirm that your child has strep, he’ll need a throat swab; results take about five minutes. If the test comes up negative, you can get a backup culture (office tests are wrong up to 6 percent of the time), which takes 48 to 72 hours for results. This way, there’s little risk of your child’s developing serious complications caused by untreated strep.
Treatment A 10-day dose of antibiotics.
Contagious factor Strep is spread by sneezes, coughs, and sharing sippy cups. But knowing this likely won’t prevent your child from getting sick: The infection is contagious before symptoms appear. There is a way to prevent him from getting sick again, though. Strep likes to hang out on toothbrushes, so get him a new one 24 hours after he’s been on antibiotics — when he’s no longer contagious — so he won’t reinfect himself.
Impetigo
Caused by strep or staph, this bacterial skin infection usually starts around the opening of the nostrils, but it can pop up on any skin surface and looks like an oozing honey-colored crust. The staph that causes impetigo isn’t dangerous or life threatening and is different from MRSA, which is resistant to most antibiotics.
Treatment Antibiotics for seven to 10 days.
Contagious factor It’s spread by direct contact with the bacteria — a child’s rubbing an infected area and then touching a playmate or a toy that another kid might play with. The bacteria must enter the skin to cause an infection, so if your child has a cut or scrape, keep it clean and covered until it heals. Contagiousness lasts for 24 hours from the first sight of lesions
Roseola
This common childhood virus causes high fever for three to five days. As the fever breaks, a child will develop a red rash on her body that may last for another day or two.
Treatment Because roseola is caused by a virus, antibiotics won’t treat it. Instead, check with your pediatrician to see if giving your child a fever-reducing medicine might be a safe option.
Contagious factor Wait until the fever is gone before letting your child play with other kids. Studies show that kids are almost noncontagious, if not completely, by the time the rash appears.
Pneumonia
In the winter, viral pneumonias are frequent and can cause wheezing and asthma-like symptoms that can last for a few weeks but often aren’t severe. Bacterial pneumonia is less common but typically causes kids to be much sicker, with high fever, lethargy, and cough.
Treatment Rest often works best, but if children have significant wheezing or difficulty breathing, medicine may be prescribed to open up the airways. For bacterial pneumonia, a 10-day course of antibiotics should do the trick.
Contagious factor Both kinds of pneumonia are spread by coughing and sneezing. With the viral type, children are contagious for as long as they have symptoms. But as with colds, they’re most contagious during the peak of the illness, between days three and five. With bacterial pneumonia, contagiousness lasts from the first respiratory symptom until 48 hours after starting antibiotics.
More Conditions
Croup
Its name comes from the barking-dog or seal-like cough it causes. Croup is spread by a virus that attaches to the throat’s lining and causes the upper airway to swell. Fever usually accompanies it, and symptoms last for five to seven days.
Treatment For severe cases, liquid prednisone (a steroid that calms inflammation) is sometimes prescribed. For routine, mild cases, your doctor may suggest anti-fever medications if fever is present. At home, you can help your child by exposing her to alternating hot and cold air: steam up your bathroom like a homemade sauna, and have your child sit in it for five minutes, then follow with a blast of cold air, either from outside or in front of an open freezer door. This helps to decrease airway swelling and makes breathing easier.
Contagious factor It’s contagious as long as fever and cough are present. While prednisone is helpful in decreasing symptoms’ severity, it doesn’t prevent your child from spreading the illness as long as he has symptoms. So keep him home until the “barking” subsides.
Fever
No matter the illness, keep your child home if she has a fever. It may seem harmless enough, but assume any fever is a symptom of a contagious condition. Viruses that cause fevers are contagious as long as the fever is above a 100.4 degrees F. reading rectally. For these, ask your pediatrician if acetaminophen or ibuprofen are safe for your child, and encourage your little one to drink lots of cool fluids. Many parents take their sick child to daycare or birthday parties, but this isn’t wise because other kids can get sick. The next time your child has a fever, regardless of the cause, keep her home until it dissipates.
Why Can’t My Child Have an Antibiotic?
Unfortunately, pediatricians get requests for them every day from parents of children with viral infections, which only time can heal. By refusing to comply, doctors are trying to prevent antibiotic resistance and to protect children from unnecessary side effects from these medicines, like dizziness, nausea, and diarrhea.
Special Considerations
When it comes to contagious illnesses, some people are more susceptible than others to severe cases and complications. This includes pregnant women and children with underlying medical conditions.
Pregnant Women
Fifth disease The virus that causes this relatively mild illness in children can be harmful to unborn fetuses, particularly during the first trimester. It attacks their red blood cells, causing severe anemia and sometimes miscarriage. If your child is diagnosed with this condition and you’re pregnant or know of any pregnant women your child may have had contact with, it’s important to alert your doctor and the other pregnant women.
Chickenpox It’s dangerous only if you’ve never had it or a vaccine. The risk is greatest during the first 10 weeks of pregnancy and can lead to a range of congenital abnormalities. Susceptible pregnant women should also avoid exposure from five days before to two days after delivery because chickenpox can be fatal for newborns.
Children
Colds and pneumonia Respiratory illnesses take on special meaning for certain kids, namely those with asthma or congenital heart disease. These children are more susceptible to respiratory illnesses and are more likely than the average kid to become sicker from them. So if your child has one of these conditions and he attends group childcare, it’s important to let the director know so she can alert you when a classmate shows respiratory symptoms.
Impetigo For kids with compromised immunity, and even for kids with skin conditions like eczema, impetigo can lead to dangerous infections. The best way to protect your child: clean any cuts or scrapes, apply antibacterial ointment, and keep the wound covered until it’s completely healed.
Originally published in the October 2008 issue of American Baby magazine.
Updated February 2010
All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.
By Sara DuMond, MD | AMERICAN BABY
