Summer Time Illness and Physicals

The summer time is vacation time for our school aged patients and that reduces the frequency of illness because the kids are not cooped up indoors and most of the infections that they catch are respiratory (colds, flu, bronchiolitis, pneumonia, ear infections, sinus infections, etc.). But illness still occurs often enough and it is almost always caused by Enteroviruses.

Dr. Casey and I wrote one of our first articles together on the topic of Enterovirus infections, published in Contemporary Pediatrics June 2001. The key points of our article I share here with you:

  1. Enteroviruses cause a broad spectrum of illnesses such as hand-foot-mouth disease, herpangina, sore throat, croup, conjunctivitis (pink eye), fever with or without a rash, gastroenteritis (vomiting and diarrhea), muscle aches and fatigue, and even pleurisy.
  2. Enterovirus infections are often confused with bacterial infections because fevers can run as high as 104F and treated unnecessarily with antibiotics in many practices. At Legacy Pediatrics we avoid this unnecessary antibiotic use by using our in office laboratory to take a Complete Blood Count (CBC) with a finger prick and drop of blood with results ready in a few minutes. The CBC can be interpreted to support the possibility of a virus (the count is usually low for white blood cells during a virus illness). Or the count can be normal and reassuring. Or the count can be high and put us on alert for the possibility of a bacterial infection.
  3. In a study of summer Enterovirus infections in our practice we found that 39% of our patients who came in due to illness in the summer had an Enterovirus.
  4. 50% of exposed siblings and day care attendees caught the Enterovirus, so it is quite contagious.
  5. 50% of the mothers caught the same strain of Enterovirus from their children; very few fathers caught the virus because mostly it was the mother who was the primary care taker of the kids.
  6. When a sibling, day care mate, or parent caught an Enterovirus from a child in our practice only about one-half of time did the sibling, day care mate, or parent display the same symptoms. That is, the child seen first might have hand-foot-mouth but the sibling would come in with only a fever and the mother might only have a sore throat. The different symptoms from the same virus in the same family were a surprise.
Summer Flowers

Photo by Ove Overmyer

Summer time is also the time for physicals!

Annual check ups are recommended for all children beginning at age 2 years old. When children are in their first 2 years of life we check them every 2 – 3 months to make sure all is OK. The annual check up often is considered a summer time ritual by most parents. The kids are out of school and the weather is nicer. At Legacy Pediatrics we do our best to have every patient seen for a physical that is requested during the time frame of the request. But, in fact, it is impossible for any pediatric practice to accommodate all of the physical requests during the summer months. We take vacation too! So we do our best to have you see your physician, but after all the available appointments are taken, then we offer other choices: 1. See the other physician at Legacy if your physician is already full on the dates you seek; 2. See one of our physician assistants who also know your child well; or 3. Schedule in the Fall when many appointments are available.

We strongly believe in “The Medical Home”, as advocated by the American Academy of Pediatrics. This means Legacy Pediatrics is your Medical Home. Getting a sports physical at school or going to an Urgent Care center for a physical is contrary to the recommendations of a Medical Home for your children. Especially as they get older and we only see them once a year we want to do their physical check up. There is a lot to review and examine and give counseling about – the Legacy Pediatrics way! And of course there are the vaccinations to be given as needed and all your records with our practice updated so when those school and sports forms come around we have all the information we need to correctly complete them so your child can get back in school and participate in sports.

Have a nice summer!