Even though some childhood diseases have become rarer thanks to vaccinations, they are by no means extinct. In addition, there is not a vaccine against all pathogens. Here is an overview of the most important diseases.
The classic childhood diseases are a group of diseases that occur preferentially in childhood and are usually characterized by the combination of fever and a skin rash (exanthem).
Three-day fever (exanthema subitum, roseola infantum)
Three-day fever is often the first of the classic childhood diseases that children come into contact with. Affected are mainly children aged six months to three years. The disease almost always begins with a high fever of up to 40 oC over three to four days without further signs of illness. After that, the fever drops rapidly. A rash with fine red spots appears especially on the abdomen and back, and disappears after a day (Fig. 1). Once a child has had three-day fever, he or she is protected for life. Transmission is by droplet infection, the time between infection and illness is about 5 to 15 days.
Due to the rapidly rising high fever, febrile convulsions may occur but leave no sequelae. Therapeutically, antipyretics are usually sufficient. There is no vaccination against the three-day fever.
Measles
Measles is an infectious disease caused by the measles virus that occurs worldwide and primarily affects young children and schoolchildren. Measles can be contracted only once. Complications such as middle ear and lung infections occur in about one in seven children, but encephalitis may also occur in rare cases. Measles is not harmless: According to WHO estimates, approx. one million people die as a result of measles disease.
It takes 8 to 14 days from infection to the onset of the disease.At the beginning there are rhinitis, irritable cough, swollen light-sensitive and red eyes and rising fever. Two to three days later, white spots called "Koplik's" can be seen on the oral mucosa opposite the molars spots that are characteristic of measles (Fig. 2). The rash begins with dark red, large, irregularly circumscribed spots behind the ears, then spreads over the face and neck to the body (Fig. 3). Fever begins to drop on about the fourth day of the rash. The rash disappears relatively quickly, sometimes brownish spots remain on the skin for one to two weeks, but they are no cause for alarm. The skin scales.
Therapeutically, fever-reducing measures and plenty of fluids help. The measles-mumps-rubella vaccination is very effective and well tolerated and should definitely be given.
Mumps (parotitis epidemica)
Children under 15 years of age most frequently contract mumps. The disease is a viral infection that particularly affects the parotid glands. Mumps is contagious from four days before to seven days after the onset of the disease. Anyone who has once contracted mumps has lifelong protection. Possible complications are the involvement of other organs (e.g., the parotid glands). B. pancreas and testicles).
Two to three weeks after infection, there is a brief preliminary stage with a rise in fever, headache and aching limbs, and finally swelling behind the ears that is pasty-soft to the touch and painful. Typical is the protruding earlobe, first on one side, after one or two days on the other side. One-sided courses are possible (ca. 20 %). Swelling goes down after five to ten days. The fever can rise up to 40 oC – however, some children remain completely fever-free.
Therapeutically, chewing gum helps to promote saliva drainage. If necessary, antipyretic measures are applied.
Rubella (rubeola)
Rubella is a worldwide spread infectious disease caused by viruses. In addition to general symptoms of the disease, there is a rash. Swelling of the lymph nodes, especially in the neck. Complications are rare in children. Rubella infections are dangerous in early pregnancy, as they can damage the embryo. Therefore, all girls between the age of 11. and 15. People who have had rubella as a child or who have already been vaccinated must be vaccinated before the age of 18. You can only get rubella once.
The incubation period is 14 to 16 days. Symptoms in the early stages without a rash include painful lymph nodes, headache, and low-grade fever. Later, bright red spots develop on the face that are lighter and smaller than in measles, rarely larger than a lens (Fig. 4). They do not fuse and are often surrounded by a lighter halo; lymph nodes on the neck and throat are often swollen. Fever usually does not rise above 38 0C, larger children and adults occasionally have joint pain. Rubella is present as early as seven days before the onset of the rash. The first days after that contagious.
Antipyretics and local heat in the area of the aching lymph nodes are the most important therapeutic measures.
Scarlet fever
Scarlet fever is a bacterial infection (streptococcus) that often affects preschool and school children, especially during the winter months. It starts suddenly with high fever and sore throat, typical is a velvety skin rash and after subsiding a skin desquamation on hands and feet. Only a subgroup of streptococci produces the toxins that can trigger the full-blown scarlet fever. The susceptibility to scarlet fever is different in different people. The duration from infection to the onset of the disease is short and is about two to four days.
Scarlet fever begins with fever, sore throat and difficulty swallowing. The adenoids are swollen. Dark red in color with later purulent plaques (Fig. 5). The lymph nodes on the neck are swollen. The tongue initially has a whitish coating, but by the third to fourth day of illness it is reddened with small nodules (raspberry tongue).
On the second day, the rash appears, starting in the armpits and groins and on the inner thighs, spreading over the whole body. The spots are slightly raised and velvety, intensely reddened, about the size of a pinhead. The region of the face around the mouth is typically left out of the rash. After about a week, the signs of the disease subside. At the end of the disease, scaling of the skin appears on the hands and feet. Classical scarlet fever is rarely observed nowadays, as it is usually treated early with antibiotics.
Diagnosis can be confirmed with a rapid test in the doctor's office. Antibiotic therapy should be administered to prevent subsequent damage. In addition, sufficient fluid intake is important, as well as fever-reducing measures.
Chickenpox (Varicella)
Around three quarters of all children under the age of 15 contract chickenpox. The virus is transmitted by droplets and is highly contagious. In chickenpox, in addition to general symptoms, there is a typical vesicular and itchy rash. Chickenpox can be contracted only once, but the virus can cause shingles as a secondary disease years later.
The disease begins with fever, then small, pale red spots appear, which quickly develop into thin-walled, matchstick-head-sized blisters (Fig. 6). They are surrounded by a narrow, red yard and burst even with slight prere. The rash develops in episodes: The individual stages of development – spots, blisters and dried crusts – follow closely one after the other. The vesicles can also spread to the mucous membranes in the mouth and genitals, where they cause painful, ulcerated areas. The symptoms last approx. ten days, the crusts are no longer infectious. The incubation period is 14 to 21 days. Rarely, complications can occur: Pneumonia or meningitis.
If infection occurs during pregnancy, it may occur between the 8. and 21. Week of pregnancy in approx. 1 % of cases can lead to malformations of the unborn child. A few days before and after birth, an illness of the mother can lead to a severe course of the disease in the newborn child.
Treatment is with itch-relieving lotions. Fingernails should be cut short. Cotton clothing is beneficial. For severe courses with high fever, a drug (aciclovir) is also available against the virus, which prevents the multiplication of the viruses, but does not kill the existing ones.
Aspirin® and other drugs containing the active ingredient acetylsalicylic acid should not be used to reduce fever in chickenpox.
Ringworm (Erythema infectiosum)
Ringworm is a viral disease transmitted by droplet infection, mainly to young children and schoolchildren. In addition to general symptoms of the disease, there is a garland-shaped rash. Complications are rare, but infection at all stages of pregnancy leads to illness of the unborn child in 20% of cases. This dropsy must be treated with a blood exchange transfusion, but malformations do not occur.
You can get ringworm only once. From the time of infection to the onset of the disease it takes ca. a week, the rash appears after ca. 14 to 18 days. With the fading of the rash, there is no longer a risk of infection.
Initially, the virus multiplies over a period of approx. In some children, this can manifest itself as a mild cough or cold, nausea or muscle pain, but this phase is usually asymptomatic. It is followed by a slight fever. The typical skin rash. Starting in the face, there is redness of the cheeks and root of the nose, the child looks "like slapped". After one day, it spreads from the face to the extensor side of the arms and legs and to the buttocks (Fig. 7).
Garland-shaped figures appear, which are seen for about one to seven weeks, and both the strength and the extent vary constantly. Furthermore, joint pain and swelling of the lymph nodes often occur.
In pregnant women with ringworm infection, ultrasound examinations and a blood sample are performed to detect a risk to the child.
In rare cases (patients with anemia) there can be a serious disturbance of red blood cell formation.
Ringworm generally requires no treatment, antibiotics are ineffective. In case of infection of the unborn child during pregnancy, the blood of the child can be exchanged by puncturing the umbilical cord vessels through the mother's abdominal wall.
Hand Foot and Mouth Disease
This children's disease is also caused by viruses, epidemics occur worldwide. Transmission occurs through both droplet infection and smear infection (unwashed hands). These infections occur more frequently in the summer and autumn months.
The disease begins after a short incubation period of one to five days with general signs of illness, but can also be very asymptomatic. Later, reddish spots, small nodules or blisters are seen on the hands and feet, which can also appear on the oral mucosa. There you can see small, painful ulcers (aphthae). In older children, the symptoms are usually mild, the disease may even pass unnoticed. It passes after eight to twelve days. Very rare complications would be myocarditis, pneumonia or meningitis.
An analgesic gel for the blisters in the mouth is recommended. Various herbal remedies (chamomile, lemon balm, thyme) can also help. There is no effective drug against the virus itself, nor is there a vaccine.
