Childhood Communicable Diseases

Measles (Rubella)

  • Caused by direct contact with respiratory secretions; airborne transmission.

  • Incubation Period: 7-12 days.

  • Contagious Period: 4 days before rash develops to 5 days after.

Timeline of Disease Progression

  • Prodromal Phase: Begins post-exposure, symptom onset includes cough, cold symptoms, conjunctivitis, low-grade fever.

  • Rash Development: Rash appears approximately 4 days after symptoms, starting on the face and nape of neck, spreading downward.

  • Convalescence Period: Rash resolves completely after spreading, fever ceases.

Symptoms

  • Fever & Malaise: General discomfort, cough, inflamed mucous membranes.

  • Rash: Starts on the face, spreads downwards; may have gastrointestinal symptoms occasionally.

Prevention & Treatment

  • Prevention: MMR vaccine, administered at 15 months and again at 4-6 years.

  • Treatment: Antipyretics for fever, hydration, bed rest, gamma globulin for exposed unvaccinated children.

Rubella (German Measles)

  • Included in MMR vaccine, eliminated in the U.S. as of 2004, primarily seen in travelers.

  • Transmission: Direct contact with secretions or fomites (inanimate objects).

  • Incubation Period: 14-21 days.

  • Contagious Period: 7 days before rash to 5 days after.

Symptoms

  • Generally milder than measles: lymphadenopathy, fever, sore throat, rash starts on face, fades in reverse order.

Prevention & Treatment

  • Prevention: MMR vaccine, same schedule as measles.

  • Treatment: Supportive care including antibiotics for secondary infections, plenty of fluids, rest, airborne precautions.

Roseola

  • Caused by Human Herpes Virus Type 6, affects children ages 6-24 months.

  • Symptoms: Sudden high fever followed by a rash lasting 1-2 days.

Erythema Infectiosum (Fifth Disease)

  • Caused by Human Parvovirus B19, transmitted through respiratory secretions or blood.

  • Incubation Period: Up to 20 days.

Symptoms

  • Prodromal stage includes fever, headache, malaise, pharyngitis.

  • Rash Characteristics: "Slap cheek" appearance, lace-like rash on extremities lasting about a week.

Treatment

  • Supportive care: Tylenol for fever, isolation with droplet precautions if hospitalized, good handwashing practices.

Scarlet Fever

  • Caused by respiratory secretions.

  • Incubation Period: 1-7 days; contagious for up to 10 days.

Symptoms

  • Abrupt high fever, vomiting, abdominal pain, and a fine sandpaper-like rash.

  • Tongue Appearance: Strawberry tongue, swollen tonsils with exudate.

Treatment

  • Antibiotics (penicillin or erythromycin if allergic), supportive care: analgesics, bed rest, fluids, droplet precautions.

Diphtheria

  • Transmitted through respiratory secretions.

  • Clinical Manifestations: Thick throat covering causing breathing difficulties, nasal discharge.

Treatment

  • Antibiotics (penicillin or erythromycin), possible tracheostomy if airway is compromised.

Mumps

  • Caused by respiratory secretions.

  • Symptoms: Parotid gland swelling (enlarged cheeks), fever, malaise, headache.

Treatment

  • MMR vaccine, supportive treatment: acetaminophen for pain, IV fluids if needed, ice/heating pad for jaw pain, rest, droplet precautions.

Pertussis (Whooping Cough)

  • Transmitted through direct contact or droplet transmission.

  • Incubation Period: 7-20 days.

Symptoms

  • Distinctive cough, difficulty breathing, complications like pneumonia and seizures.

Treatment

  • DTaP and Tdap vaccines, monitor for airway obstruction, supportive care, anti-seizure treatment if necessary.

Polio

  • Largely eradicated due to vaccination.

  • Symptoms: Flu-like signs (fever, headache, fatigue, vomiting, muscle weakness).

Hand, Foot, and Mouth Disease

  • Presents with blisters around mouth, hands, feet, often without fever.

  • Treatment: Supportive care: fluids, Tylenol for fever, good hygiene practices.

Mononucleosis (Mono)

  • Caused by Epstein-Barr virus; often asymptomatic.

  • Symptoms: Sore throat, swollen lymph nodes, fever, fatigue; concern for spleen enlargement.

Management

  • Avoid contact sports to prevent spleen rupture, monitor for abdominal pain, general supportive care.