Q&A: Your queries on toddler coughs and colds answered

Junior magazine’s Dr Philippa Kaye answers common questions on toddler seasonal sniffles

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Q. My five-year-old daughter suffers the occasional cold and high temperature. How can I tell if it is just a bad cold or whether she actually has the flu?

A. Colds can affect the nose, throat and often the ears, and are caused by a large number of different viruses. Flu is generally caused by one of the three types of influenza virus. These change slightly each year which is why if you do need to be vaccinated against the flu, for example, if you have asthma, you will need to be revaccinated each year.

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If your daughter has a cold, she will get a runny or blocked nose, and may be sneezing. She may also have a sore throat and a cough or earache and may have a mild fever. The illness generally lasts a few days to about a week. If she has the flu, however, she generally would not get a runny or blocked nose, though she may have a sore throat and a cough. The flu leads to a higher fever and often patients describe the chills. She might also complain of a headache and of feeling aches and pains in the muscles of her arms and legs.

In the UK, flu season is generally between November and February. Both conditions are treated the same way, with rest, plenty of fluids and, if necessary, medication for the fever and aches and pains. Antibiotics are not helpful for either colds or the flu as they are not effective against viruses. If you are still concerned, seek further advice from your doctor.

Q. Every time my seven-year-old son gets a cold or sore throat his Gran worries it’s scarlet fever. What is this and should I worry about it?

A. Scarlet fever is an infection caused by group A streptococcus bacteria, which also causes throat infections (strep throat). The rate of scarlet fever has fallen dramatically over the last 50 years due to the use of antibiotics and better immunity against the infection as a result of improved diets. The chances of your son having scarlet fever are quite low. It’s estimated that between five and 25 per cent of sore throats are caused by strep bacteria, but not all strep bacteria produce the toxin, which causes the rash of scarlet fever. Also, not all children are sensitive to the toxin; this means they may still get the sore throat and fever but none of the other symptoms or long-term complications.

Typically, scarlet fever starts with a sore throat and a high temperature followed by a rash of small red spots on the neck and chest, which go white when you press them; these may then spread to the rest of the body. Commonly, the cheeks go bright red (hence the name scarlet fever), while the area around the mouth remains pale. The tongue also turns pale with red spots before going very red. The rash usually lasts about six days. As it improves, the skin on the hands and feet may peel off.  

If your son has these symptoms, see your doctor who can prescribe a ten-day course of antibiotics to prevent complications from scarlet fever (which can affect the heart and kidneys). If your son has a fever, give him junior paracetamol, plenty of liquids and keep him cool. Even if he starts to feel better, ensure he finishes the whole course of antibiotics. Scarlet fever is infectious, and is passed on by coughing and sneezing, so keep your son off school for five days after starting the antibiotics.

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Dr Philippa Kaye who works in general practice and is author of The Fertility Handbook is Junior magazine’s resident doctor.

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