Back at school and already got the sniffles or other ailment? Here's a pediatrician's advice to battle back-to-school bugs

With school back in session, it probably won't be long before children are coming home with sniffles and sore throats. The average child gets six or more infections each year, reports Dr. Jacqueline Kaari, chair of the Department of Pediatrics at the University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, who also offers advice.

"Every parent has experienced it — the hectic morning maneuvering of getting the household fed, dressed and out the door is suddenly interrupted by an inconsolable child who has a sore throat, upset stomach, sniffles or something worse," she said. "When that happens, parents need to be able to quickly assess their child and determine if he or she is well enough to go to school or needs to stay home, or if it's time to call the pediatrician. Sometimes, parents will guess wrong, but if there's one rule of thumb, it should be to always err on the side of caution."

Kaari recommends the following guidelines for what do when it comes to:

Colds: Use child-strength, over-the-counter medicines and a cool mist humidifier to treat symptoms. Because they are caused by viruses, do not treat colds with antibiotics. Children can go to school if the symptoms won't impede them from participating in school activities.

Conjunctivitis (pinkeye): Go to the doctor for treatment, which is generally antibiotic eye drops. Children can usually go to school 24 to 48 hours after treatment starts.

Fever: Give acetaminophen (Tylenol) or ibuprofen (Advil) for low-grade fevers. Have the child drink lots of fluids and avoid fatty or fried foods, since fevers decrease stomach activity and make digestion more difficult. Keep children at home if the fever is above 100.4 degrees Fahrenheit. Call the doctor if a high fever lasts more than 24 hours or does not respond to medicine.

Flu: Have the child vaccinated. If he or she has not been vaccinated, keep the child home for several days and make sure he or she gets lots of rest and drinks lots of fluids.

Head lice: Kill with over-the-counter or prescription lotions and shampoos. Keep the child at home until all lice have been killed.

Ringworm: Look for small patches of skin that are scaly and red. They can also blister and ooze. Apply anti-fungal ointments or powders. Call the doctor if the infection is severe or does not go away.

Sore throat: If parents suspect strep throat, they should call the doctor. If drinking water relieves symptoms somewhat, the child likely has a viral infection that should go away in a few days.

Stomach ache: Children who have been vomiting should stay home from school. An hour after the child vomits, parents should start introducing small drinks of water. Clear liquids and bland food should be introduced throughout the day. If vomiting lasts more than 24 hours or if the child vomits blood or green or yellow bile, call the doctor.

Whooping cough (pertussis): Have the child vaccinated. If parents suspect whooping cough, characterized by a "whooping" sound when the child tries to breathe, call the doctor. (Read more)

With school back in session, it probably won't be long before children are coming home with sniffles and sore throats. The average child gets six or more infections each year, reports Dr. Jacqueline Kaari, chair of the Department of Pediatrics at the University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, who also offers advice.

"Every parent has experienced it — the hectic morning maneuvering of getting the household fed, dressed and out the door is suddenly interrupted by an inconsolable child who has a sore throat, upset stomach, sniffles or something worse," she said. "When that happens, parents need to be able to quickly assess their child and determine if he or she is well enough to go to school or needs to stay home, or if it's time to call the pediatrician. Sometimes, parents will guess wrong, but if there's one rule of thumb, it should be to always err on the side of caution."

Kaari recommends the following guidelines for what do when it comes to:

Colds: Use child-strength, over-the-counter medicines and a cool mist humidifier to treat symptoms. Because they are caused by viruses, do not treat colds with antibiotics. Children can go to school if the symptoms won't impede them from participating in school activities.

Conjunctivitis (pinkeye): Go to the doctor for treatment, which is generally antibiotic eye drops. Children can usually go to school 24 to 48 hours after treatment starts.

Fever: Give acetaminophen (Tylenol) or ibuprofen (Advil) for low-grade fevers. Have the child drink lots of fluids and avoid fatty or fried foods, since fevers decrease stomach activity and make digestion more difficult. Keep children at home if the fever is above 100.4 degrees Fahrenheit. Call the doctor if a high fever lasts more than 24 hours or does not respond to medicine.

Flu: Have the child vaccinated. If he or she has not been vaccinated, keep the child home for several days and make sure he or she gets lots of rest and drinks lots of fluids.

Head lice: Kill with over-the-counter or prescription lotions and shampoos. Keep the child at home until all lice have been killed.

Ringworm: Look for small patches of skin that are scaly and red. They can also blister and ooze. Apply anti-fungal ointments or powders. Call the doctor if the infection is severe or does not go away.

Sore throat: If parents suspect strep throat, they should call the doctor. If drinking water relieves symptoms somewhat, the child likely has a viral infection that should go away in a few days.

Stomach ache: Children who have been vomiting should stay home from school. An hour after the child vomits, parents should start introducing small drinks of water. Clear liquids and bland food should be introduced throughout the day. If vomiting lasts more than 24 hours or if the child vomits blood or green or yellow bile, call the doctor.

Whooping cough (pertussis): Have the child vaccinated. If parents suspect whooping cough, characterized by a "whooping" sound when the child tries to breathe, call the doctor. (Read more)

Read More

Eliminating ringworm spores from the home

Winn grant W12-034
Decontamination of household textiles exposed to Microsporum canis spores
Investigator: Karen A. Moriello; University of Wisconsin-Madison

Ringworm is a superficial fungal skin disease that affects all animals, including cats. In cats, the most commonly isolated pathogen is Microsporum canis. This disease is important because it is highly contagious to cats and transmitted to people making it a public health concern. Ringworm can infect any cat, but the most commonly infected are the most adoptable (kittens and juveniles), old cats with other illnesses, and cats in animal shelters or rescue organizations. This skin disease is curable but treatment can be challenging because diseased cats shed large amounts of infective material (spores and infected hairs) into the environment. Effective cleaning is necessary to prevent spore contamination of the environment and prevent cats from becoming re-infected or “dust mop carriers”. Information on effective cleaning of hard surfaces (walls, counters, etc.) is available, but no evidence-based information is available for household textiles-fabric, clothing, carpeting, etc.

Microscopic view of M. canis

The purpose of this study is to determine the efficacy of decontamination options for household textiles (e.g., towels, fabric, and carpet) with a goal of identifying safe and effective practices. Common household textiles will be experimentally contaminated with naturally infective material and the following cleaning techniques tested: washing in cold or hot water with or without bleach pre-soaking, vacuuming rugs at different lengths of time, rental carpet cleaners, and high pressure/high temperature commercial cleaning of carpets. This study will determine which of these techniques are excellent, adequate, marginal or unsatisfactory for decontamination. Information will be immediately useful for people treating cats with ringworm.

This project is available for sponsorship. When you sponsor a project, your name will be added to the list of the project's supporters on our website and in any publications we produce about the project. You will receive exclusive pre-publication reports on the progress of your chosen project as they become available, and a final report at its conclusion.

More on cat health:
Winn Feline Foundation Library
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Read the Cat Health News Weekly
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Winn grant W12-034
Decontamination of household textiles exposed to Microsporum canis spores
Investigator: Karen A. Moriello; University of Wisconsin-Madison

Ringworm is a superficial fungal skin disease that affects all animals, including cats. In cats, the most commonly isolated pathogen is Microsporum canis. This disease is important because it is highly contagious to cats and transmitted to people making it a public health concern. Ringworm can infect any cat, but the most commonly infected are the most adoptable (kittens and juveniles), old cats with other illnesses, and cats in animal shelters or rescue organizations. This skin disease is curable but treatment can be challenging because diseased cats shed large amounts of infective material (spores and infected hairs) into the environment. Effective cleaning is necessary to prevent spore contamination of the environment and prevent cats from becoming re-infected or “dust mop carriers”. Information on effective cleaning of hard surfaces (walls, counters, etc.) is available, but no evidence-based information is available for household textiles-fabric, clothing, carpeting, etc.

Microscopic view of M. canis

The purpose of this study is to determine the efficacy of decontamination options for household textiles (e.g., towels, fabric, and carpet) with a goal of identifying safe and effective practices. Common household textiles will be experimentally contaminated with naturally infective material and the following cleaning techniques tested: washing in cold or hot water with or without bleach pre-soaking, vacuuming rugs at different lengths of time, rental carpet cleaners, and high pressure/high temperature commercial cleaning of carpets. This study will determine which of these techniques are excellent, adequate, marginal or unsatisfactory for decontamination. Information will be immediately useful for people treating cats with ringworm.

This project is available for sponsorship. When you sponsor a project, your name will be added to the list of the project's supporters on our website and in any publications we produce about the project. You will receive exclusive pre-publication reports on the progress of your chosen project as they become available, and a final report at its conclusion.

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Read the Cat Health News Weekly
Join us on Google+

Read More

Ringworm in a Cat Shelter

Carlotti, D.N., et al., Eradication of feline dermatophytosis in a shelter: a field study. Vet Dermatol, 2009. 21(3): p. 259-266.

Dermatophytosis is a superficial fungal skin infection affecting many animals, as well as humans. In otherwise healthy cats, it is self-curing, resolving in several months. Treatment, however, shortens the course and prevents spread, including to humans. This is particularly important in a shelter situation where infection can impede adoptions, and is a risk for staff and visitors. This report describes a successful eradication of fungal infection from a shelter in the UK. The authors used a three-area method in the existing facility. One area was used to isolate cats with lesions and positive skin culture; cats with no lesions, but positive by fungal culture were placed in a separate area; and healthy, fungus-free cats were kept in a third area. Cats in the first two groups were treated topically (enilconazole) and systemically (itraconazole). In addition, the environments were sampled every three weeks using a dust-catching cloth. Sequential use of detergent (cleaning) and 1% sodium hypochlorite (disinfection) were used on premises and materials. Cats were not moved into group C (fungal-free) until two negative culture results (done every two weeks). The protocol described did have a significant cost but proved successful in eradicating fungal infections from the shelter housing approximately 140 cats. In addition, by isolating incoming animals initially and assessing for infection, maintenance of fungal-free population was possible. [MK]

Related articles:
Newbury, S., et al., Use of lime sulphur and itraconazole to treat shelter cats naturally infected with Microsporum canis in an annex facility: an open field trial. Vet Dermatol, 2007. 18(5): p. 324-31.

More on cat health: Winn Feline Foundation Library
Join us on Facebook
Follow us on Twitter

Carlotti, D.N., et al., Eradication of feline dermatophytosis in a shelter: a field study. Vet Dermatol, 2009. 21(3): p. 259-266.

Dermatophytosis is a superficial fungal skin infection affecting many animals, as well as humans. In otherwise healthy cats, it is self-curing, resolving in several months. Treatment, however, shortens the course and prevents spread, including to humans. This is particularly important in a shelter situation where infection can impede adoptions, and is a risk for staff and visitors. This report describes a successful eradication of fungal infection from a shelter in the UK. The authors used a three-area method in the existing facility. One area was used to isolate cats with lesions and positive skin culture; cats with no lesions, but positive by fungal culture were placed in a separate area; and healthy, fungus-free cats were kept in a third area. Cats in the first two groups were treated topically (enilconazole) and systemically (itraconazole). In addition, the environments were sampled every three weeks using a dust-catching cloth. Sequential use of detergent (cleaning) and 1% sodium hypochlorite (disinfection) were used on premises and materials. Cats were not moved into group C (fungal-free) until two negative culture results (done every two weeks). The protocol described did have a significant cost but proved successful in eradicating fungal infections from the shelter housing approximately 140 cats. In addition, by isolating incoming animals initially and assessing for infection, maintenance of fungal-free population was possible. [MK]

Related articles:
Newbury, S., et al., Use of lime sulphur and itraconazole to treat shelter cats naturally infected with Microsporum canis in an annex facility: an open field trial. Vet Dermatol, 2007. 18(5): p. 324-31.

More on cat health: Winn Feline Foundation Library
Join us on Facebook
Follow us on Twitter

Read More

Treatment of Ringworm in Cats

Mancianti, F., S. Dabizzi, et al. (2009). "A lufenuron pre-treatment may enhance the effects of enilconazole or griseofulvin in feline dermatophytosis?" Journal of Feline Medicine & Surgery 11(2): 91-95.

In this study performed at the University of Pisa, Italy, the effect of pre-treatment with lufenuron on the effectiveness of enilconazole or griseofulvin for the treatment of feline ringworm was studied. Ringworm in cats is most commonly caused by the fungal agent, Microsoporum canis. A variety of treatment options have been recommended over the years, including both topical and systemic drugs. Lufenuron is a drug that interferes with chitin synthesis and is most commonly used to prevent flea infestations. It has also been proposed as an alternative treatment for ringworm, but with highly variable results when used as a sole agent. Lufenuron was given at 100 mg/kg biweekly for 8 weeks to 38 M. canis infected cats. Group A cats (13) were only treated with lufenuron. In Group B, 11 cats were pre-treated with lufenuron, and then treated with four weekly rinses of enilconazole (0.2% solution). In Group C, 14 cats were pre-treated with lufenuron, and then treated with oral griseofulvin at 50 mg/kg twice daily for 40 days. Twelve cats were used as controls in that they were given griseofulvin (7 cats) or enilconazole (5 cats), but not lufenuron. All cats except one given lufenuron alone were still infected at day 60. The authors conclude that lufenuron alone was found to be ineffective, but may have an immunomodulatory effect as a pre-treatment combined with other drugs. [SL]
>> PubMed Abstract

Related articles:
Nuttall, T. J., A. J. German, et al. (2008). "Successful resolution of dermatophyte mycetoma following terbinafine treatment in two cats." Veterinary Dermatology 19(6): 405-410.
>> PubMed Abstract

Sharma, R., S. de Hoog, et al. (2007). "A virulent genotype of Microsporum canis is responsible for the majority of human infections." J Med Microbiol 56(10): 1377-85.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library
Join us on Facebook

Mancianti, F., S. Dabizzi, et al. (2009). "A lufenuron pre-treatment may enhance the effects of enilconazole or griseofulvin in feline dermatophytosis?" Journal of Feline Medicine & Surgery 11(2): 91-95.

In this study performed at the University of Pisa, Italy, the effect of pre-treatment with lufenuron on the effectiveness of enilconazole or griseofulvin for the treatment of feline ringworm was studied. Ringworm in cats is most commonly caused by the fungal agent, Microsoporum canis. A variety of treatment options have been recommended over the years, including both topical and systemic drugs. Lufenuron is a drug that interferes with chitin synthesis and is most commonly used to prevent flea infestations. It has also been proposed as an alternative treatment for ringworm, but with highly variable results when used as a sole agent. Lufenuron was given at 100 mg/kg biweekly for 8 weeks to 38 M. canis infected cats. Group A cats (13) were only treated with lufenuron. In Group B, 11 cats were pre-treated with lufenuron, and then treated with four weekly rinses of enilconazole (0.2% solution). In Group C, 14 cats were pre-treated with lufenuron, and then treated with oral griseofulvin at 50 mg/kg twice daily for 40 days. Twelve cats were used as controls in that they were given griseofulvin (7 cats) or enilconazole (5 cats), but not lufenuron. All cats except one given lufenuron alone were still infected at day 60. The authors conclude that lufenuron alone was found to be ineffective, but may have an immunomodulatory effect as a pre-treatment combined with other drugs. [SL]
>> PubMed Abstract

Related articles:
Nuttall, T. J., A. J. German, et al. (2008). "Successful resolution of dermatophyte mycetoma following terbinafine treatment in two cats." Veterinary Dermatology 19(6): 405-410.
>> PubMed Abstract

Sharma, R., S. de Hoog, et al. (2007). "A virulent genotype of Microsporum canis is responsible for the majority of human infections." J Med Microbiol 56(10): 1377-85.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library
Join us on Facebook

Read More

Terbinafine for Feline Ringworm

Foust, A. L., R. Marsella, et al. (2007). "Evaluation of persistence of terbinafine in the hair of normal cats after 14 days of daily therapy." Vet Dermatol 18(4): 246-51.

Microsoporum canis is the dermatophyte most commonly associated with ringworm in cats. Several drugs have been used for treatment of M. canis in cats, including itraconazole, griseofulvin, and terbinafine. Terbinafine (Lamisil, Novartis) is of interest because in other species, it shows good penetration into affected tissues, efficacy with short durations of treatment, and is well tolerated. Few studies have been conducted on the use of terbinafine in cats. In this study, the residual concentration of terbinafine in cat hair was determined after 14 days of oral treatment. Ten normal cats were administered terbinafine at a daily dose of 34-45 mg/kg for 14 days. Hair samples were analyzed at day 0, and weekly for 8 weeks after the last dose of terbinafine. With a 99% confidence interval, the concentration of terbinafine remained above the minimal inhibitory concentration (MIC) for 5 weeks. Four cats experienced vomiting during treatment, and two of these cats experienced intense facial pruritus 7 to 14 days after the end of treatment. The researchers concluded that terbinafine persists in cat hair at concentrations above the MIC for several weeks after the end of therapy, even when treated for only 14 days. Pulse therapy using terbinafine is worth further investigation for the treatment of feline ringworm.
>> PubMed abstract

Related articles:
Mancianti, F., F. Pedonese, et al. (1999). "Efficacy of oral terbinafine in feline dermatophytosis due to Microsporum canis." J Fel Med Surg 1(1): 37.
>> PubMed abstract

Kotnik, T. (2002). "Drug efficacy of terbinafine hydrochloride (Lamisil) during oral treatment of cats, experimentally infected with Microsporum canis." J Vet Med B Infect Dis Vet Public Health 49(3): 120-122.
>> PubMed abstract

More on cat health: Winn Feline Foundation Library

Foust, A. L., R. Marsella, et al. (2007). "Evaluation of persistence of terbinafine in the hair of normal cats after 14 days of daily therapy." Vet Dermatol 18(4): 246-51.

Microsoporum canis is the dermatophyte most commonly associated with ringworm in cats. Several drugs have been used for treatment of M. canis in cats, including itraconazole, griseofulvin, and terbinafine. Terbinafine (Lamisil, Novartis) is of interest because in other species, it shows good penetration into affected tissues, efficacy with short durations of treatment, and is well tolerated. Few studies have been conducted on the use of terbinafine in cats. In this study, the residual concentration of terbinafine in cat hair was determined after 14 days of oral treatment. Ten normal cats were administered terbinafine at a daily dose of 34-45 mg/kg for 14 days. Hair samples were analyzed at day 0, and weekly for 8 weeks after the last dose of terbinafine. With a 99% confidence interval, the concentration of terbinafine remained above the minimal inhibitory concentration (MIC) for 5 weeks. Four cats experienced vomiting during treatment, and two of these cats experienced intense facial pruritus 7 to 14 days after the end of treatment. The researchers concluded that terbinafine persists in cat hair at concentrations above the MIC for several weeks after the end of therapy, even when treated for only 14 days. Pulse therapy using terbinafine is worth further investigation for the treatment of feline ringworm.
>> PubMed abstract

Related articles:
Mancianti, F., F. Pedonese, et al. (1999). "Efficacy of oral terbinafine in feline dermatophytosis due to Microsporum canis." J Fel Med Surg 1(1): 37.
>> PubMed abstract

Kotnik, T. (2002). "Drug efficacy of terbinafine hydrochloride (Lamisil) during oral treatment of cats, experimentally infected with Microsporum canis." J Vet Med B Infect Dis Vet Public Health 49(3): 120-122.
>> PubMed abstract

More on cat health: Winn Feline Foundation Library

Read More

Treatment of Ringworm in Shelter Cats

Newbury, S., K. Moriello, et al. (2007). "Use of lime sulphur and itraconazole to treat shelter cats naturally infected with Microsporum canis in an annex facility: an open field trial." Vet Dermatol 18(5): 324-31.

Dermatophytosis is the most common contagious skin disease of cats. It is often a concern in shelter situations since it is zoonotic and highly contagious. It is important to find an effective and rapid treatment protocol for cats with ringworm in shelters to expedite cure and adoption. This open clinical trial in a shelter enrolled 58 cats with confirmed Microsporum canis infection and 32 uninfected bonded pairs. The cats were treated with 21 days of oral itraconazole at 10 mg/kg and twice weekly lime sulphur rinses until cured. No hair coat clipping was performed. Fungal cultures were performed once weekly on all cats. Cats were considered cured with two consecutive negative cultures. No cats developed oral ulcerations as a result of grooming after lime sulphur treatment. No uninfected cats living in contact with infected cats developed dermatophytosis. The mean number of days of treatment required for cure was 18.4 (range 10-49 days). In this shelter, a combination of oral itraconazole and topical lime sulphur treatment was effective and safe.
>> PubMed abstract

Related articles:
Moriello, K. A. and M. Verbrugge (2007). "Use of isolated infected spores to determine the sporocidal efficacy of two commercial antifungal rinses against Microsporum canis." Vet Dermatol 18(1): 55-8.
>> PubMed abstract

More on cat health: Winn Feline Foundation Library

Newbury, S., K. Moriello, et al. (2007). "Use of lime sulphur and itraconazole to treat shelter cats naturally infected with Microsporum canis in an annex facility: an open field trial." Vet Dermatol 18(5): 324-31.

Dermatophytosis is the most common contagious skin disease of cats. It is often a concern in shelter situations since it is zoonotic and highly contagious. It is important to find an effective and rapid treatment protocol for cats with ringworm in shelters to expedite cure and adoption. This open clinical trial in a shelter enrolled 58 cats with confirmed Microsporum canis infection and 32 uninfected bonded pairs. The cats were treated with 21 days of oral itraconazole at 10 mg/kg and twice weekly lime sulphur rinses until cured. No hair coat clipping was performed. Fungal cultures were performed once weekly on all cats. Cats were considered cured with two consecutive negative cultures. No cats developed oral ulcerations as a result of grooming after lime sulphur treatment. No uninfected cats living in contact with infected cats developed dermatophytosis. The mean number of days of treatment required for cure was 18.4 (range 10-49 days). In this shelter, a combination of oral itraconazole and topical lime sulphur treatment was effective and safe.
>> PubMed abstract

Related articles:
Moriello, K. A. and M. Verbrugge (2007). "Use of isolated infected spores to determine the sporocidal efficacy of two commercial antifungal rinses against Microsporum canis." Vet Dermatol 18(1): 55-8.
>> PubMed abstract

More on cat health: Winn Feline Foundation Library

Read More