Infectious diseases in children that are more common and are of public health importance are described in the slides.

1. PAEDIATR C
DSEASES

2. OVERVIEW OF INFECTIOUS
DISEASE IN CHILDREN
• Disease that occur in age group below 18 years.
• Infectious diseases are illnesses caused by germs
(microbes).
• Not all germs (bacteria, viruses, fungi, and parasites)
cause disease.
• Normal flora: a host of bacteria normally live on the skin,
eyelids, nose, and mouth and in the gut are considered
normal inhabitants.

3. • Carrier: person with the bacteria.
• It is not always clear why the same strains of bacteria
cause carriage in one child, mild illness in another, and
serious infection in others.
• Important factors in the child include age, immunity,
nutrition, genetic makeup, and general health.

4. TERMINOLOGIES
• Normal flora: Bacteria that live on or in a child
• Pathogen: A germ that can cause a disease
• Colonization: Presence of a germ in or on the child
without disease.
• Intoxication: Illness due to a toxin made by a germ
• latent infection: A germ (most often a virus) in a resting
state

5. • Incubation: Time between infection and symptoms
• Reactivation: The latent germ wakes up and reproduces
• Carrier: A child who is colonized but not sick
• Contagious: Able to spread the illness
• Carriage of the bacteria: bacteria present on a body
surface such as the nose or throat or in the bowels, but
there is no illness.

6. WHAT CAUSES INFECTIONS ?
• Prions: Infectious proteins. The smallest known infectious
agents
• Viruses: Very small. Viruses take over your cells to
reproduce themselves
• Bacteria: Two types: free-living, normal inhabitants (normal
flora); pathogens that produce disease
• Fungi: Molds and yeasts. Fungi colonize (live on or in a child)
and are pathogens
• Parasites: Forms range from single cells (amoeba, protozoa) to
worms

7. • New-borns are at risk because their protective systems
are not yet tested and are not always mature.
• Infants are at risk because they tend to put everything
into their mouths and rarely clean their hands.
• Older children are less at risk because their hygiene is
better and they have become immune through prior
infection or carriage of bacteria.
WHO ARE AT RISK ?

8. • Another important factor for a child is the use of medical
devices such as catheters and other tubes.
• These catheters and tubes provide a direct path for
bacteria and fungi to get into the blood, bladder, or lungs.
• Medicines such as corticosteroids (used in asthma and
many other conditions) and cancer chemotherapy can
interfere with a child’s ability to fight infection.
• Even antibacterials can be a factor by killing the normal
protective flora.

9. • Infections are a normal part of childhood.
• Most children will have at least 6 to 8 respiratory
(breathing tract) infections each year.
• These include colds, ear infections, sinus infections,
bronchitis, and pneumonia. Infections of the bowels also
are common.
• When children gather together in child care settings and
school, there is the opportunity for infections to spread
from one child to another.

10. • Not all infections are contagious (able to spread from
person to person).
• Ear and bladder infections are not spread from child to
child, while diarrhoea and colds are easily spread.
• Sometimes the incubation is short (e.g., a day or so for
the flu), while other times it is quite long (Eg, 2 weeks
for chickenpox and many years for HIV)
• Inflammation can be harmful to the child as well.
Inflammation can harm organs, cause pain, and interfere
with normal body functions.

11. • In some cases, a person is contagious during the
incubation period, while in others the person is not
contagious until the illness begins.
• The amount of time a child remains contagious depends
on the infection and the child.
• Young children are often contagious for longer than older
children.
• Infections are sometimes so mild that there are few or no
symptoms. Other infections cause more severe illness.

12. Common cold/Flu
• Symptoms:
• A congested or runny nose
• Nasal discharge that may be clear at first but then usually becomes
thicker and turns shades of yellow or green
• A low-grade fever of about 100.4 F (38 C)
• Sneezing
• Coughing
• Decreased appetite
• Irritability
• Difficulty sleeping
• Trouble nursing or taking a bottle due to nasal congestion
• Method of spread: Direct
• Incubation Period: 2 – 5 days
• Contagious period: Until the symptoms persist.

13. Nasal allergies
• Cause: dust mites, pet dander, mold, and pollen.
• Symptoms:
• Runny and itchy nose
• Congestion
• Frequent sneezing
• Chronic cough
• Red, watery eyes
• Allergic shiners -- dark rings under the eyes
• Mouth breathing, especially while asleep
• Exhaustion, because of poor sleep quality
• Symptoms that last longer than a couple of weeks

14. Acute bronchitis
• Swelling and irritation in your child's air passages.
• Acute bronchitis often starts because of another illness,
such as a cold or the flu.
• Bronchitis is often called a chest cold.
• Acute bronchitis lasts about 2 weeks and is usually not a
serious illness.
• Symptoms
• Constant cough
• Fever, body aches, and chills.
• Sore throat and a runny or stuffy nose
• Short of breath and wheezes
• More tired than usual.

15. Asthma
• A respiratory condition marked by attacks of spasm in
the bronchi of the lungs, causing difficulty in breathing.
• Symptoms:
• Frequent coughing spells, which may occur during play, at
night, or while laughing or crying
• A chronic cough (which may be the only symptom)
• Less energy during play
• Rapid breathing (intermittently)
• Complaint of chest tightness or chest "hurting"
• Whistling sound when breathing in or out -- called wheezing.
• See-saw motions in the chest from labored breathing. These
motions are called retractions.
• Shortness of breath, loss of breath
• Tightened neck and chest muscles
• Feelings of weakness or tiredness

16. Disease burden of Asthma:
• Asthma is the leading cause of chronic illness in children.
• It affects about 7 million children in the United States
and, for unknown reasons, is steadily increasing.
• Asthma can begin at any age (even in the very elderly),
but most children have their first symptoms by age 5.
• Risk Factors:
• Nasal allergies (hay fever) or eczema (allergic skin rash)
• A family history of asthma or allergies
• Frequent respiratory infections
• Low birth weight
• Exposure to tobacco smoke before or after birth
• Black or Puerto-Rican ethnicity
• Being raised in a low-income environment

17. Pneumonia
• Pneumonia is a general term for lung infections that can
be caused by a variety of germs (viruses, bacteria, fungi,
and parasites).
• Most cases, though, are caused by viruses, including
adenoviruses, rhinovirus, influenza virus (flu), human
metapneumovirus, and parainfluenza virus.
• Often, pneumonia begins after an upper respiratory
tract infection, with symptoms starting after 2 or 3 days
of a cold or sore throat. It then moves to the lungs.
• Fluid, white blood cells, and debris start to gather in the
air spaces of the lungs and block the smooth passage of
air, making it harder for the lungs to work well.

18. • Symptoms vary depending on a child's age and what
caused the pneumonia, but can include:
• Fever
• Shaking chills
• Cough
• Stuffy nose
• Very fast breathing (in some cases, this is the only symptom)
• Breathing with grunting or wheezing sounds
• Working hard to breathe; this can include flaring of the nostrils,
belly breathing, or movement of the muscles between the ribs
• Vomiting
• Chest pain
• Abdominal pain, which often happens because a child is
coughing and working hard to breathe
• Less activity
• Loss of appetite (in older kids) or poor feeding (in infants), which
may lead to dehydration
• In extreme cases, bluish or grey colour of the lips and fingernails

19. Urinary Tract Infection
• Symptoms:
• A fever not caused by the flu or another known illness.
• Urine that has a strange smell.
• Vomiting.
• The child not being hungry.
• The child acting fussy.
• Older children are more likely to have common symptoms,
such as:
• Pain or burning when they urinate.
• Needing to urinate often.
• Urinary incontinence.
• Red, pink, cloudy, or foul-smelling urine.
• Pain in the flank, which is felt just below the rib cage and above
the waist on one or both sides of the back.
• Lower belly pain.

20. Acute otitis media
• Acute otitis media means that fluid (usually pus) is in the
middle ear, causing pain, redness of the eardrum, and
possible fever.
• Symptoms
• The fluid in the middle ear may push on the eardrum, causing
ear pain. Older kids are able to complain of an earache, but a
younger child might just tug at the ear or simply act irritable
and cry more than usual.
• Lying down, chewing, and sucking also can cause painful
pressure changes in the middle ear, so a child may eat less
than normal or have trouble sleeping.
• If the pressure from the fluid build up gets high enough, it can
rupture the eardrum, causing fluid to drain from the ear. This
releases the pressure behind the eardrum, usually bringing
relief from the pain.

21. www.gponline.com
Acute Otitis Media

22. Chickenpox (varicella-zoster virus)
• Symptoms: Sudden onset with slight fever. Blister-type
rash occurs in successive crops. Scabs form after the
blister stage. Spots or blisters usually appear first on the
body, face and scalp, then later spread to the limbs.
www.amcal.com.au

23. • Method of Spread: by sneezing and coughing. Direct
contact with Spread secretions from nose, throat and
mouth of infected people.
• Incubation: Usually 14 - 21 days from date of contact.
• Communicable Period : From 2 days before spots appear
to 5 days after the first crop of blisters.

24. • Control: Exclude from school when spots first appear
until 5 days after onset.
• Suggested treatment: Control fever with
acetaminophen. Aspirin contraindicated. Cut fingernails
short to prevent scratching. Calamine lotion, baking soda
paste or tepid baths with oatmeal or baking soda may
help to relieve itching, antihistamines may also reduce
itching.

25. Fifth Disease (Human Parvovirus)
• Symptoms: Raised, red, warm rash, first appearing on
cheeks (slapped cheek appearance). After 1 - 4 days, a lace-
like rash spreads to the rest of the body. Rash fades but
may recur for 1 – 3 weeks on exposure to sunlight.
www.skinsight.com

26. • Method of spread: Contact with infected respiratory
secretions; also from mother to foetus.
• Incubation: 4 - 20 days from date of contact.
• Communicable period: Greatest before onset of the rash
and probably not after Period the rash.
• Control: Careful hand-washing and disposal of articles
soiled with nose and throat secretions.

27. Hand / Foot / Mouth Disease
(Coxsackie virus)
• Symptoms: Sudden onset. Fever, sore throat, small
greyish blisters in mouth lasting 4 - 6 days. Blisters may
also appear on palms, fingers and soles for 7 - 10 days.
www.sarasota.k12.fl.us

28. • Method of Spread: by coughing and sneezing. Direct
contact with nose Spread and throat secretions and
faeces of infected persons.
• Incubation period: 3 - 5 days from date of contact.
• Communicable Period: While sick and sometimes longer.
• Control: Avoiding close contact. Careful disposal of
articles soiled with discharge. Careful hand-washing,
especially after toileting. Isolation of case and children
with fever, pending diagnosis.
• Treatment: Acetaminophen for fever.
• Prevention: Promote hand-washing and hygiene
measures in home and particularly in day-cares.

29. Herpes “cold sores” (virus)
• Symptoms: Superficial clear vesicles (blisters) with red
base, usually on face or lips, which crust and heal within
days.
www.activeforever.com

30. • Method of Spread: Direct contact with secretions from
throat and mouth of infected people.
• Incubation period: 2 - 12 days from date of contact.
• Communicable period: Up to 7 weeks after onset.
• Control Avoid direct contact with secretions or infectious
materials.
• Prevention Education to minimize transmission of
infectious material, avoiding contact with children with
eczema or burns and the immunocompromised.

31. Impetigo (staphylococcal or
streptococcal bacteria)
• Symptoms: A skin infection with moist, purulent, yellow
crusted sores surrounded by redness. Spreads forming
new sores. Usually found on the face.
doctorgrasshopper.wordpress.com

32. • Method of Spread: Direct contact with secretions from
open sores and nose. Can also be spread person-to-
person via hands.
• Incubation: Staphylococcal: 4 - 10 days from date of contact.
Streptococcal: 1 - 3 days from date of contact.
• Communicable Period: If untreated, as long as sores are present,
or 24 hours after antibiotic therapy has been started.
• Control: Avoid close contact with infants and debilitated people.
Keep out of school or day-care for 24 hours after start of
antibiotics. Wash clothes and linens. Provide separate towels and
soap.
• Prevention: Keep affected areas clean and covered, if wet.
Encourage children not to touch sores. Keep nails short and clean.
Wash hands frequently. Avoid sharing toilet articles.

33. Influenza (virus)
• Symptoms: Fever, headache, muscular aches and pains,
exhaustion, running nose, sore throat. Sometimes
nausea, vomiting, diarrhoea, but this is more common in
children.
• Method of Spread: Spread by sneezing and coughing,
particularly in crowded conditions, and by direct contact
with nose and throat secretions.
• Incubation period: Usually 1 - 3 days from date of
contact.
• Communicable period: Probably 3 - 5 days in adults, up
to 7 days for young children.

34. Measles “red measles” (Rubeola
virus)
• Symptoms: Fever, inflamed eyes, dry cough, runny nose,
dusky red blotchy rash 3 - 7 days later spreading
downwards from face, white spots in mouth.
www.reddit.com

35. • Method of Spread: Spread by sneezing or coughing, or by
direct contact with nose and throat secretions. Highly
contagious.
• Incubation: 7 - 18 days from exposure to onset of fever,
usually 14 days until rash appears.
• Communicable Period: From just before the symptoms start
to 4 days after the rash appears.
• Control: Excluding from school and non-family contacts until 4
days after rash appears. Immunizing susceptible contacts.
Immune globulin available for infants under 1 year, immuno-
compromised people, and those who can not have the vaccine
due to medical reasons.
• Prevention: 2 doses of measles vaccine (age 12 months and 18
months)

36. Meningitis
• Meningitis is an inflammation of the membranes that
surround the brain and spinal cord.
• Meningitis can be caused by a bacteria or a virus.
• Bacteria that cause meningitis include:
• Haemophilus Influenzae type B (Hib)
• Meningococcal Meningitis
• Streptococcus pneumoniae
• Group B Streptococcus
• About 90% of cases of viral meningitis are caused by
members of a group of viruses known as enteroviruses, such
as coxsackieviruses and echoviruses.
• Polioviruses, mumps virus, and herpes simplex virus can also
cause meningitis.

37. Meningococcal Meningitis
(bacteria)
• Symptoms: Sudden onset with fever, intense headache,
nausea, vomiting, stiff neck, and often a pinpoint rash.
• Confirmed with: test of blood and cerebral spinal fluid
(CSF).
mumcentral.com.au

38. • Method of Spread: Spread by direct contact with nose
and throat secretions.
• Incubation: 2 - 10 days from exposure to onset of fever,
usually 14 days until rash appears.
• Communicable Period: Until 24 hours after start of
appropriate antibiotic therapy.
• Prevention: Immunization during outbreaks

39. Haemophilus Influenzae type B (Hib)
• Hib was the most common cause of bacterial meningitis in
children aged 2months to 5 years of age before the
introduction of Hib vaccine in 1988.
• The majority of cases in children now occur in unimmunized
children or in children who are too young to have received
their primary series of vaccines at 2, 4, and 6 months of age.
• Signs and symptoms of Hib meningitis:
• Fever
• Vomiting
• Tiredness
• Bulging fontanelle (soft spot) in infants
• Stiff back and neck in older children

40. • How is it spread?
Through contact with secretions from the nose and throat of an
infected person.
• Breathing in air contaminated with the bacteria after an
infected person has coughed or sneezed
• Close face to face contact
• Kissing
• Sharing food, utensils, drinks, soothers, bottles, or toys used by
other children.
• Incubation period: 2 – 4 days
• Communicable period:
• As long as the organism is present, which may be a long period
if individual is not treated with antibiotics.
• no longer contagious after receiving 24 – 48 hours of
antibiotics.

41. Diarrhoeal Diseases
• Diarrhoeal disease is the second leading cause of death in
children under five years old. It is both preventable and
treatable.
• Each year diarrhoea kills around 760 000 children under
five.
• A significant proportion of diarrhoeal disease can be
prevented through safe drinking-water and adequate
sanitation and hygiene.
• Globally, there are nearly 1.7 billion cases of diarrhoeal
disease every year.
• Diarrhoea is a leading cause of malnutrition in children
under five years old.

42. • There are three clinical types of diarrhoea:
• Acute watery diarrhoea – lasts several hours or days, and includes
cholera;
• Acute bloody diarrhoea – also called dysentery; and
• Persistent diarrhoea – lasts 14 days or longer.
• Diarrhoea is a symptom of infections caused by a host of
bacterial, viral and parasitic organisms, Rotavirus
and Escherichia coli are the two most common etiological
agents of diarrhoea in developing countries.
• Prevention and treatment
• access to safe drinking-water;
• use of improved sanitation;
• hand washing with soap;
• exclusive breastfeeding for the first six months of life;
• good personal and food hygiene;
• health education about how infections spread; and
• rotavirus vaccination.

43. Dehydration
• The most severe threat posed by diarrhoea is dehydration.
• During a diarrhoeal episode, water and electrolytes (sodium,
chloride, potassium and bicarbonate) are lost through liquid
stools, vomit, sweat, urine and breathing. Dehydration occurs
when these losses are not replaced.
• The degree of dehydration is rated on a scale of three.
• Early dehydration – no signs or symptoms.
• Moderate dehydration:
• Thirst
• Restless or irritable behaviour
• Decreased skin elasticity
• Sunken eyes
• Severe dehydration:
• Symptoms become more severe
• Shock, with diminished consciousness, lack of urine output, cool, moist
extremities, a rapid and feeble pulse, low or undetectable blood pressure,
and pale skin.

44. E. Coli: Diarrhea Illness and
Haemolytic Uremic Syndrome
Signs and symptoms of E. coli infection may include:
• Loose, watery diarrhoea that may change to bloody diarrhoea
• Mild to severe abdominal cramps
• Vomiting
• Fever (usually less than 38.5°C)
HUS is an acute disease characterized by haemolytic
anaemia, acute renal failure (uraemia), and a low platelet
count.
• Symptoms of HUS may include:
• Decreased urine output
• Irritation
• Fatigue
• Pale skin

45. Mode of spread:
E. coli is spread when a person gets tiny (usually
invisible) amounts of human or animal faeces in their
mouth:
• Eating raw or undercooked beef, especially hamburger
• Eating raw fruits and vegetables that have not been
washed or peeled
• Drinking unpasteurized milk or juice
• Touching surfaces accidentally contaminated with
stool from an infected person (e.g., toys, bathroom
fixtures such as taps and light switches, changing
tables, or diaper pails)

46. • Incubation period: Usually 3 – 4 days (range is 2 – 10
days)
• Communicable period: Usually for the duration of
diarrhoea (1 week or less). Young children may continue
to shed the bacteria in their stool for up to 3 weeks.
• Prevention: Exclude child from school and child care until
diarrhoea has stopped.
• Exclude any individual with symptoms from food handling and
child care.
• In a child care setting, advise ill child or care provider to get a
medical assessment before returning to the child care facility.

47. Rotavirus
• Rotavirus is the most common cause of severe
diarrhoea among young children.
• It usually affects children between the ages of 6 months
and 2 years.
• Signs and symptoms:
• Fever (may be as high as 40°C)
• Vomiting
• About 12 – 24 hours later, child starts to pass large amounts
of watery diarrhoea
• Abdominal pain
• The illness usually lasts 3 – 7 days.

48. Mode of Spread:
• Through direct contact:
• changing an infected child’s diaper or assisting a child with
toileting
• Through indirect contact:
• touching an object (e.g., toy, faucet, doorknob) that was
contaminated with rotavirus. The virus is able to survive for
long periods on hard surfaces, in contaminated water, and on
hands.
• Incubation period: Usually 1 – 3 days
• Contamination period: During the acute stage of illness
and until diarrhoea stops

49. Head Lice (Pediculosis)
Head lice are tiny insects that live on the scalp. Lice have 3
stages in their life cycle:
• Nits (eggs)
• Nymphs are young lice.
• Adult lice
comberskc.com

50. • Signs and symptoms:
• Itchy scalp (may be worse at night)
• Scratching marks or small red lesions like a rash
• Child may have head lice and not have any symptoms
• Method of spread: Direct hair contact & Indirect
contact
• Incubation period: Period from laying of eggs to
emerging adult lice is 10 – 20 days.

51. Hepatitis A
Hepatitis A is an infection of the liver caused by the
Hepatitis A virus. It is usually mild and rarely causes
permanent liver damage. Hepatitis A is usually more serious
in adults than children.
Signs and symptoms:
• Fever
• Fatigue
• Loss of appetite, nausea, and vomiting
• Abdominal pain
• Jaundice (yellowing of the skin and eyes)
Incubation period: Usually 25 – 30 days (range is 15 – 50
days)

52. • Method of spread:
• Direct contact with the stool of an infected person
• Direct contact with the hands of an infected person
• Direct contact with an object contaminated with the virus
• Eating food prepared by an infected person
• Drinking contaminated water
• Communicable period: From about 14 days before onset of
symptoms until about 7 days after onset of jaundice.
Infants and children may continue to shed virus in their
stool for up to 6 months.
• Prevention: Excluding child from school or child care facility
for 14 days from the onset of illness or 7 days from the
onset of jaundice.

53. Mononucleosis (“Mono”)
Mono is caused by the Epstein-Barr virus (EBV). It is most
common in older children and adolescents.
• Signs and symptoms:
• Fever
• Sore throat
• Swollen lymph glands
• Lethargy (exhaustion)
• Enlarged liver and spleen
• Jaundice (yellowing of the skin and eyes) occurs occasionally
• Incubation period: 4 – 6 weeks

54. Method of spread:
• Through direct and indirect contact with the nose and
throat secretions of an infected child:
• Kissing
• Sharing anything that children put in their mouths (e.g., toys,
Sippy cups, food, drinks, soothers)
• Touching something contaminated with an infected person’s
saliva

55. Mumps
• Caused by the mumps virus.
• Signs and symptoms:
• Fever
• Headache
• Swollen and painful salivary glands (found in front of and below
the ear or under the jaw)
• Complications of mumps disease include:
• Meningitis in 20% of people infected
• Orchitis in 20-30% of post-pubertal males
• Oophoritis in 5% of post-pubertal females
• Deafness and infertility occur occasionally
• Incubation period: Usually 16 – 18 days from contact with
an infected person but can range from 14 – 25 days

56. Method of spread:
• Through direct or indirect contact with nose and throat
secretions of an infected person
• Breathing air contaminated with the virus when an infected
person has coughed or sneezed
• Touching the nose and throat secretions of an infected person
• Kissing
• Sharing anything that is put in the mouth (e.g., cups, toys)
Communicable Period: From 7 days before to 9 days after
the onset of swelling
• Child is most contagious 2 days before to 4 days after the onset
of illness.

57. Pertussis (Whooping Cough)
• Caused by the bacteria Bordetella pertussis.
• Infants under one year of age are at highest risk.
• If a pregnant woman has pertussis 2-3 weeks before labour,
the infant is at high risk of pertussis disease.
• Signs and symptoms:
• Runny nose, low grade fever, and mild cough
• After 1 – 2 weeks, the cough worsens
• Child will cough violently and rapidly, over and over, until no air is
left in their lungs. Child will then inhale with characteristic
“whooping” sound
• Child will sometimes vomit after coughing
• Coughing will last for several weeks

58. Method of spread:
• Through direct contact with the respiratory secretions of
an infected person
• Breathing in air contaminated with pertussis when an infected
person has coughed or sneezed
• Sharing anything that is put in the mouth (e.g., cup, toys)
• Kissing
• Touching the nose and throat secretions of an infected person
or touching articles freshly soiled by an infected person.
• Infected adults or adolescents with mild illness or no symptoms
may infect infants.
• Incubation period :Usually 7 – 10 days (range is 5 – 21
days)

59. Communicable period: Usually from the time when first
symptoms develop (1 – 2 weeks before severe coughing
starts) until about 3 weeks after cough starts
• A child who is started on antibiotics is not infectious after 5 days
of antibiotic therapy.

60. Pink Eye (Conjunctivitis)
• Pink eye is an infection of the covering of the eyeball and
the inside of the eyelid.
• It is usually caused by a virus, but may be caused by
bacteria or other irritant.
• Children under 5 years of age are most often affected.
newshealth.net

61. • Signs and symptoms:
• Teary, red, itchy, painful eye(s)
• Eyelid(s) may be swollen
• Pus or thick discharge (yellow or yellowish-green colour) can
make eyelids sticky, especially during sleep
• Fever
• Eye(s) may be sensitive to sunlight
• Mode of Spread: both direct & indirect
• Incubation period: Usually 1 – 3 days from contact with
an infected person
• Contamination Period: During active infection when the
child has symptoms

62. Ringworm
Signs and symptoms of a ringworm infection may include:
• Ring shaped rash that is reddish and may be itchy
• Rash may be dry and scaly or wet and crusty
• If ringworm infection is on the scalp, there may be patches of
hair loss or hair thinning
www.nhs.uk

63. • Mode of spread:
• Through direct contact with an area of ringworm infection.
• Contact with infected articles
• It is possible to become infected by contact with infected
animals such as dogs, cats, and farm animals.
• Incubation period: Usually 4 – 14 days
• Communicable period: As long as lesions are present.

64. Rubella (German Measles)
Signs and symptoms:
• Low-grade fever
• Malaise, tiredness
• Raised, red, pinpoint rash that starts on the face and spreads
downwards
• Rash lasts 3 – 5 days
• 50% of adolescents and adults with rubella develop muscle and
joint pain
womanjournal.org

65. • Rubella infection during pregnancy can cause severe birth
defects, miscarriage, or stillbirth.
• 85% of foetuses who are infected with rubella in the first
10 weeks of pregnancy will develop Congenital Rubella
Syndrome(CRS).
• CRS may include deafness, eye problems, heart defects,
liver, spleen, and brain damage.
• Incubation period: Usually 14 – 21 days from contact
with an infected person
• Contamination period: 1 week before and at least 4 days
after onset of rash. A child with rubella is most infectious
when the rash is erupting.

66. Scabies
• Signs and symptoms of scabies may include:
• Intense itching, especially at night
• A pimple – like rash may be present
• Itching and rash may be all over the body but the most common
sites are between the fingers, wrists, elbows, armpits, groin area,
nipples, waist, buttocks, and shoulder blades.
• Tiny burrows that look like greyish-white or skin-coloured lines on
the skin may be seen.
healthool.com

67. • Mode of transmission: Both direct & indirect
• Incubation period: Usually 2 – 6 weeks in people who
have not had scabies before
• Contamination Period: Until mites and eggs are
destroyed by treatment

68. Streptococcal Infections: Scarlet Fever
and
Strep Throat
• Scarlet fever and strep throat are both caused by
streptococcal bacteria.
www.webmd.com
Scarlet Fever

69. Signs and symptoms of scarlet fever:
• Red rash that looks like sunburn and feels like rough sandpaper
• Rash most often begins on chest and stomach and then spreads
to rest of body
• Rash usually lasts 2 – 7 days
• When rash fades, skin on hands and feet may start to peel
• Fever
• Nausea and vomiting
• Sore throat
• Red, swollen lips, strawberry – like tongue
• Flushed cheeks and pale area around mouth
Signs and symptoms of strep throat:
• Fever
• Very sore throat
• Swollen lymph glands
• Swollen tonsils
• Loss of appetite

70. • Mode of spread: both direct & indirect
• Incubation period: Usually 1 – 3 days from contact with
an infected person
• Contamination period: In untreated cases, 10 – 21 days.
Untreated cases of strep throat may carry the organism
for weeks or months.

71. REFERENCES
• Healthychildren.org
• American Academy of Pediatrics. (2006). Red Book:
Report of the Committee of Infectious Diseases (27th
ed.) Elk Grove, IL: American Academy of Pediatrics.
• Frankowski, B. et al (2002). American Academy of
Paediatrics Clinical Report: Head Lice. Paediatrics. Vol
110:3.
• Heymann, D. (2004). Control of Communicable Diseases
Manual (18th ed.). Washington, DC
• BCCDC Laboratory Services (2003)
• http://www.caringforkids.cps.ca/index.htm
• http://www.chop.edu/consumer/your_child/index.jsp