Experts urge caution as seasonal shift sparks cough, fever among children

DIMAPUR — As temperatures rise and seasons shift in Nagaland, a surge in common childhood ailments such as fever, cough, cold, and stomach flu has become evident, particularly impacting children under eight years old with developing immune systems.

With high-grade fever and flu among children in Nagaland on the rise, especially in Dimapur, one mother shared her experience with her three-year-old daughter, Aka, who battled a persistent cough for two months.

According to the mother, despite medical attention and precautions, Aka’s cough and runny nose only subsided after about two months. This led to Aka missing play school for an extended period, as her mother was worried about spreading the cough to her classmates.

Dr. Akumtoshi, Head of the Department of Pediatrics and Neonatology at Zion Hospital in Dimapur, explained that a child’s immune system typically takes around eight years to fully mature, making younger children more susceptible to infections.

He also highlighted additional factors contributing to this vulnerability, including insufficient physical activity, which hinders immune system development, and exposure to unhealthy food and snacks that can negatively impact a child’s growing body.

On the current seasonal ailments among children, he noted that while viral infections are the most common culprits behind childhood illnesses, bacterial and other infections can also occur. However, it is not possible to entirely avoid viral infections in this group of population because of several factors, he added.

Dr. R WonashiTsanglao, Consultant Pediatric Intensivist at the Christian Institute of Health Sciences and Research (CIHSR), shed light on the common cold, which is frequently caused by hundreds of different viruses and can lead children to experience up to eight colds per year.

He said that the best methods for preventing transmission of the common cold is to frequently wash hands and avoid touching one’s mouth, nose and eyes. Children with colds should be encouraged to cough into a tissue or the crook of their elbow rather than their hands, he added.

Describing the typical early signs of a common cold, Dr. Tsanglao said that children usually have low-grade fever lasting up to four days, accompanied by a runny nose and cough.

The children usually remain active between feversand while mild symptoms may persist beyond ten days in some cases, he reassured that complications are rare.

However, he cautioned that ear infections, sinusitis, and pneumonia can develop in a small percentage of children (5-10%). Parents should remain vigilant for worsening symptoms such as high fever, difficulty swallowing or breathing, inactivity between fevers, or persistent cough and nasal discharge beyond ten days.

Addressing the practice of some schools requiring doctor’s notes for sick students to return to class, Dr. Tsanglao suggested that children can attend school if they are fever-free and feeling well enough, as transmission often occurs before symptoms even appear.

In this connection, Ajung, a teacher at a private school in Dimapur, confirmed that their school only restricts students with conjunctivitis or food and mouth diseases due to their contagious nature. She also explained that sick leave is granted for other illnesses, and missed lessons are covered through one-on-one sessions to ensure students stay on track.

Misuse of antibiotics

Meanwhile, Dr. Tsanglao raised concerns about the misuse of antibiotics for common colds, observing that parents often resort to over-the-counter antibiotics from pharmacies before seeking medical advice.

He went on to explain that by the time a child is brought for check-up, ‘the parents usually would have started an antibiotic, most of the time taken as an over the counter drug from a nearby pharmacy.’

Stating that the strength or composition of the medicine and dosage would, in most cases, be always improper, he informed that antibiotics are ineffective against viral infections like the common cold.

‘The need for an antibiotic should be decided after consultation and examination by a pediatrician,’ he asserted, emphasising the need to avoid irrational use of antibiotics to avoid spreading antibiotic resistance.

Dr. Akumtoshi identified other prevalent contagious infections among children in the state, including mumps, enteritis, croup, pneumonia, various viral rashes, and chicken pox, and urged for more awareness and precautions to prevent further spread.

Parents can do certain things to prevent recurrent infection in their children

1. Eat healthy: Healthy and balanced diet helps children develop good immunity against Infections. Avoid eating from unhygienic outlets.

2. Hygiene: Make sure the hands are always clean. Utensils, food preparation and storage should be clean. The environment should also be clean and hygienic.

3. Physical activity: Physical activity is important for the optimum functioning of the immune system.

4. Stay away from people who are sick.

5. Proper sleep is important for the body and immune cells to function properly.

6. Vaccinate against all vaccine preventable diseases.

7. Teach children how to use handkerchiefs or tissues when they cough and discard them properly. Encourage them to cover when they cough or sneeze.

8. Keep them at home if they are unwell and can spread infection in the classroom.

9. Encourage use of mask in crowded places and high risk areas.

Dos and don’ts for schools

1. Ensure all the children and teachers are protected against the common vaccine preventable diseases.

2. Face mask can be used during an outbreak in the school or classroom.

3. Enough clean water should be made available for cleaning and personal hygiene.

4. Hygienic and healthy food should be provided in the school.

5. Toilets should be clean and it should be children friendly.

6. Avoid overcrowding in the classroom and maintain cross ventilation.

(Dr. Akumtoshi)