If you grew up before the mumps vaccine became available, you might remember your experience with the disease, particularly the uncomfortable swelling on the side of one or both cheeks. These swollen salivary glands are the most characteristic sign of mumps, which is caused by a virus and usually spread through coughing. It occurs most often in children and teenagers 5 to 14 years old, but a vaccine has turned it into a very uncommon infection. There are now less than 500 reported cases in the United States each year.

Signs and Symptoms

Most often, mumps affects the parotid glands, which are located between the jaw and ear. In addition to swelling, the region can become painful when touched or while chewing, especially when consuming foods that stimulate the release of salivary juices or drinking orange juice or other juices that are acidic. Other symptoms may include

  • Fever lasting 3 to 5 days
  • Headache
  • Nausea
  • Occasional vomiting
  • Weakness
  • A decrease in appetite
  • Swelling and pain in the joints (and in boys, of the testes)

A child with mumps will become contagious beginning a day or two before the swelling begins, and the contagious period will continue for about 5 days after the swelling has started. (It’s interesting to note that approximately one third of those infected with mumps do not show obvious swelling.) As a general guideline, keep your child with mumps away from school and child care for 9 days after the gland swelling has begun.

What You Can Do

Here are some home care steps to keep in mind for a child with mumps.

  • Make sure she gets plenty of rest.
  • Feed her soft, non-citrus foods that can be easily chewed and swallowed.
  • Encourage her to drink extra fluids to prevent dehydration

When to Call the Pediatrician

Notify your doctor if your child’s condition becomes worse, especially if she develops abdominal pain, shows an unusual lack of energy, or (for boys) his testicles become painful.

Last Updated 11/21/2015

Meningococcal Infections

Meningococcal Infections

Neisseria meningitidis is a type of bacteria that can cause serious, life threatening infections such as meningococcemia and meningitis.

These infections are often spread through:

  • Sneezing
  • Coughing
  • Sharing glasses or utensils
  • Close physical contact
  • Touching an unwashed hand

Signs and Symptoms

The signs and symptoms of meningococcemia are fever, aches, loss of appetite, and development of a rash. The rash starts as small red dots and progresses to large bruises. Within hours, a child can be overcome by the infections and develop shock and organ failure.

Signs and symptoms of meningococcal meningitis are similar to meningitis caused by other bacteria. They include:

  • Fever
  • Decreased appetite
  • Irritability
  • Excessive sleepiness
  • Vomiting
  • Headache
  • Stiff neck
  • Back pain

When to Call Your Pediatrician

Because timely treatment is important for meningococcal infections, contact your pediatrician immediately if you notice that your child has any of the symptoms that have been described.

Last Updated 11/21/2015




Measles was once a common disease among preschool and school-aged children and almost an expected part of growing up. This is no longer true. Measles has not been completely eliminated as a childhood illness in the United States, but most cases now occur in children who were infected in other parts of the world or were infected by contact with these travelers. Measles remains a usual childhood infection in most parts of the world so this disease is just a plane ride away.

Children and adults still get the infection, although in much smaller numbers than in the past. Since the measles vaccine became available in 1963, there has been a more than 99% decline in the number of measles cases in the United States.

Measles is caused by the measles virus which is spread easily through the air when an infected person sneezes or coughs and someone nearby inhales the infected droplets. It can also be transmitted by direct contact with fluids from the nose or mouth of an infected person.

Signs and Symptoms

Prior to the approval of the measles vaccine, measles epidemics usually took place during the late winter and spring. The most recognizable symptom of measles is an extensive red or brownish blotchy rash, although this is not the only symptom.

Once a child is exposed to and infected with the measles virus, his first symptoms will not appear for 8 to 12 days (the incubation period). Infected children tend to be contagious for 1 to 2 days before symptoms finally emerge and 3 to 5 days before the rash breaks out. This contagious period continues for 4 days after the rash appears.

Prior to the appearance of the rash, children with measles develop cold-like symptoms, including a cough, runny nose, fever, and inflamed eyes, often called pinkeye (conjunctivitis). These symptoms tend to get worse during the first 1 to 3 days of the illness. In some children, the infection causes pneumonia and in a few, encephalitis (infection of the brain).

After a child has been ill for about 2 to 3 days, the rash will finally become visible, first as tiny red bumps that form larger patches of red. The rash usually begins on the face and neck and then spreads to the torso, arms, and legs. It lasts for 5 to 8 days before it begins to go away. Young children with measles may develop other symptoms, including an ear infection, croup, and diarrhea.

What You Can Do

If your child has contracted the measles, keep him home from school or child care. In particular, be sure he stays away from others who may not have been immunized against the disease. As part of your home care, give your child plenty of liquids to drink. Some pediatricians recommend that you treat him with over-the-counter acetaminophen if a fever is making him uncomfortable.

When To Call Your Pediatrician

If your child develops symptoms commonly associated with measles, contact your pediatrician right away. The doctor will want to examine your youngster to diagnose the illness. Discuss with your pediatrician the best way to keep your child from infecting other children and adults that he may encounter in your doctor’s waiting room or elsewhere. If your pediatrician diagnoses measles, your pediatrician will call the local health department, which will take steps to prevent the spread of measles in the community.

Last Updated 11/21/2015

The Flu

The Flu

Flu is the short term for influenza. It is an illness caused by a respiratory virus. The infection can spread rapidly through communities as the virus is passed from person to person. When someone with the flu coughs or sneezes, the influenza virus gets into the air, and people nearby, including children, can inhale it. The virus also can be spread when your child touches a contaminated hard surface, such as a door handle, and then places his hand or fingers in his nose/mouth or rubs his eye.

Flu Season

The flu season usually starts in the fall and ends in the spring. When there is an outbreak or epidemic, usually during the winter months, the illness tends to be most pronounced in preschool or school-aged children. Adult caregivers are easily exposed and can contract the disease. The virus usually is transmitted in the first several days of the illness.

Flu Symptoms

All flu viruses cause a respiratory illness that can last a week or more. Flu symptoms include:

  • A sudden fever (usually above 100.4°F or 38°C)
  • Chills and body shakes
  • Headache, body aches, and being a lot more tired than usual
  • Sore throat
  • Dry, hacking cough
  • Stuffy, runny nose

Some children may throw up (vomit) and have loose stools (diarrhea).

After the first few days of these symptoms, a sore throat, stuffy nose, and continuing cough become most evident. The flu can last a week or even longer. A child with a common cold usually has a lower fever, a runny nose, and only a small amount of coughing. Children with the flu—or adults, for that matter—usually feel much sicker, achier, and more miserable.

Healthy people, especially children, get over the flu in about a week or two, without any lingering problems. However, you might suspect a complication if your child says that his ear hurts or that he feels pressure in his face and head or if his cough and fever persist beyond 2 weeks. Talk with your child’s doctor if your child has ear pain, a cough that won’t go away, or a fever that won’t go away.

Children with chronic health conditions

Children who appear to have the greatest risk of complications from the flu are those with an underlying chronic medical condition, such as heart, lung, or kidney disease, an immune system problem, diabetes mellitus, some blood diseases, or malignancy. As these children may have more severe disease or complications, they should, when possible, be kept away from children with the flu or flu-like symptoms. Their pediatrician may suggest additional precautions that should be taken. If your child has flu-like symptoms along with any difficulty breathing, seek medical attention right away. There can be serious complications, even death, from the flu, but thanks to the flu vaccine these are uncommon.

Flu Treatment

For all children with the flu who don’t feel well, lots of tender loving care is in order. Children may benefit from extra bed rest, and extra fluids.

If your child is uncomfortable because of a fever, ace taminophen or ibuprofen in doses recommended by your pediatrician for his age and weight will help him feel better. Ibuprofen is approved for use in children six months of age and older; however, it should never be given to children who are dehydrated or who are vomiting continuously.

It is extremely important never to give aspirin to a child who has the flu or is suspected of having the flu. Aspirin during bouts of influenza is associated with an increased risk of developing Reye syndrome.

Flu Prevention

Everyone should get the flu vaccine each year to update their protection. It is the best way to prevent getting the flu. Safe vaccines are made each year and the best time to get the flu vaccine is the late summer/early fall or as soon as it is on hand in your community.

Vaccination is especially important for:

  • Children, including infants born preterm, who are 6 months to 5 years of age,
  • Children of any age with chronic medical conditions that increase the risk of complications from the flu
  • Children of American Indian/Alaskan Native heritage
  • All contacts and care providers of children with high risk conditions and children younger than 5 years (especially newborns and infants younger than 6 months because these young infants are not able to receive their own vaccination)
  • All health care personnel
  • All women who are pregnant, are considering pregnancy, have recently delivered, or are breastfeeding during the flu season

The flu virus spreads easily through the air with coughing and sneezing, and through touching things like doorknobs or toys and then touching your eyes, nose, or mouth.

Click here for some tips that will help protect your family from getting sick.

Flu Vaccine

Only the Inactivated (killed) vaccine, also called the “flu sh ot”, given by injection into the muscle, should be used for influenza vaccination this season.

There are two types of inactivated flu vaccine based on the number of flu virus strains it contains: A trivalent (two A and one B viruses) influenza vaccine and a quadrivalent (two A and two B viruses) influenza vaccine. There is no preference for the use of either of these formulations. Any of these vaccines should be given as available in your area.

The American Academy of Pediatrics recommends that an influenza vaccine be given annually to all children starting at six months of age. Children 6 month through 8 years old may need two doses of the vaccine given at least four weeks apart. Children 9 years of age and older only need one dose.

Flu vaccines are especially important for children at high risk for complications from the flu such as those with a chronic disease such as asthma, heart disease, decreased immune system function due to a primary condition or from medications such as steroids, renal disease, or diabetes mellitus.

All eligible children may receive the inactivated flu shot. All adults should receive the flu vaccine yearly; this is especially important for adults who live in the same household as someone who has a high risk for flu complications or who care for children under the age of five.

Side effects

The flu vaccine has few side effects, the most common side effects of the flu shot are redness, soreness or swelling at the injection site, and fever.

Although flu vaccines are produced using eggs, influenza vaccines have been shown to have minimal egg protein so that virtually all children with presumed or confirmed egg allergy may still safely receive the flu vaccine.  Talk to your doctor if you have any questions.


Antiviral medications to treat an influenza infection are available by prescription. Your pediatrician may be able to treat the flu with an antiviral medicine. Antiviral medications work best if started within the first 1 to 2 days of showing signs of the flu. However, in some children with increased risk for influenza complications, treatment could be started later.

Call your pediatrician within 24 hours of the first flu symptom to ask about antiviral medications if your child

  • Has an underlying health problem like asthma, diabetes, sickle cell disease, or cerebral palsy
  • Is younger than 6 month old.
  • Is younger than 5 years old, especially if less than 2 years old
Last Updated 9/9/2015

Human Papillomavirus (HPV)

Human Papillomavirus (HPV)

According to the Centers for Disease Control and Prevention, there is an epidemic of human papillomavirus (HPV) in the United States. HPV is the most common sexually transmitted infection. It is most common in men and women in their late teens and early 20s. Because so many types of HPV have no symptoms, it is easily spread between sex partners.

There are about 40 different types of HPV that can cause genital infection. Most are not serious and do not even cause any symptoms. Most come to an end in 1 to 2 years. However, some types of HPV can cause serious health problems, including:

  • Cervical cancer in women. In the United States, about 12,000 women get cervical or other genital cancers from HPV each year.
  • Head and neck and anal cancers in men. In the United States, about 7,000 men get head and neck and anal cancers from HPV each year.
  • Genital warts in women and men.
  • Rarely, warts in the airways of infants and children.

Read on for more information from the American Academy of Pediatrics about HPV and how to prevent it.

How to Prevent HPV:

There are 3 types of HPV vaccine: Cervarix, Gardasil, and Gardasil-9. See the table below for a quick comparison.

Cervarix Gardasil 
3-dose series 3-dose series
Females only Females and males
Females: 11 or 12 years of age. This age group has the best response to the vaccine, and the vaccine must be given before sexual activity begins. HPV vaccine can be started at 9 years. It is also recommended for females aged 13 through 26 years who have not been vaccinated or did not finish the 3-shot series. Females and males: 11 or 12 years of age. This age group has the best response to the vaccine, and the vaccine must be given before sexual activity begins. HPV vaccine can be started at 9 years. It is also recommended for females aged 13 through 26 years who have not been vaccinated or did not finish the 3-shot series. It is recommended for males aged 13 through 21 years who have not been vaccinated or did not finish the 3-shot series. It may be given to males aged 22 through 26 years and should be given to high-risk males aged 9 through 26 years.
  • Prevents most cases of cervical and anal cancer in females if the vaccine is given before a person is exposed to HPV.
  • Prevents most cases of cervical and anal cancer in females if the vaccine is given before a person is exposed to HPV.
  • Prevents most cases of anal cancer and should protect against head and neck cancer caused by HPV in males.
  • Prevents genital warts from strains included in the vaccine in females and males.

Mild to moderate reactions to both vaccines may include pain or swelling where the shot was given, fever, headache, and fainting immediately following the shot. Call the doctor right away for severe allergic reactions that may include rash; swelling of the hands and feet, face, or lips; and trouble breathing.

Other Ways to Prevent HPV:


The only sure way to prevent HPV and other sexually transmitted infections is to abstain from all sexual activity, including vaginal, anal, and oral sex. This is a good policy for teens and young adults. Adults can reduce their risk of HPV by limiting the number of partners they have.


A condom should always be used because it lowers the risk of genital warts and cancer as well as other sexually transmitted infections. However, condoms do not completely prevent HPV because there is still some genital contact even when condoms are used.


Circumcision does not completely prevent HPV but reduces the risk of HPV infection. There are many other considerations when deciding about circumcision.

Other Ways to Prevent Cervical Cancer:

Regular Pap tests

Regular Pap tests (also called Pap smears) are still an important way to prevent cervical cancer, including for females who have had the HPV vaccine. A Pap test is a simple test done in the doctor’s office in which small amounts of cells are swabbed from the cervix and tested in a lab. Pap tests can detect cell changes in the cervix caused by HPV before they turn into cancer. Pap tests cannot be done at other sites on the body.

Last Updated 11/21/2015

Hepatitis B

Hepatitis B

Hepatitis B is a liver disease caused by a virus. It is spread via infected blood and body fluids, although there is also an extremely small risk of contracting it through blood transfusions. Sexually active teenagers may be at particular risk for the disease, as are users of non-sterilized needles and syringes.

Signs and Symptoms

Hepatitis B is caused by a virus. Some people who are infected with the hepatitis B virus never feel sick. Others have symptoms that might last for several weeks. Those symptoms can include:

  • loss of appetite and tiredness
  • pains in muscles, joints or stomach
  • diarrhea or vomiting
  • yellow skin or eyes (jaundice)

This is called “acute” hepatitis B.

It can also cause long-term (chronic) illness that leads to:

  • liver damage (cirrhosis)
  • liver cancer
  • death

What You Can Do

You can protect children from hepatitis B by getting them vaccinated with three doses of hepatitis B vaccine.

Last Updated 11/21/2015



For parents of an earlier era, polio was one of the most feared infectious diseases. Many were worried about letting their children swim in public swimming pools or get together at neighborhood movie theaters because they were afraid that their youngsters might become the next victims of polio. After the polio vaccine became widely available in the mid-1950s, the world saw a dramatic decline in this disease.

Polio is caused by a virus that affects infants and young children more often than other age groups. It is spread through close person-to-person contact and can produce paralysis of the muscles. Some cases are mild, but others are much more severe, leaving people physically impaired for the rest of their lives. Thanks to the polio vaccine, the wild poliovirus has been virtually eliminated from the United States and much of the rest of the world.

Signs and Symptoms

For most people, polio may cause no symptoms at all. At times, however, it can impair and paralyze the arms and legs. It causes death in some people, most often when the muscles involved in breathing become paralyzed. When symptoms occur, they may begin with a low-grade fever and a sore throat, beginning about 6 to 20 days after exposure to the poliovirus. Some children may also have pain or stiffness in the back, neck, and legs, although these symptoms may not last long.When polio results in paralysis, the muscle pain can be severe.

The most contagious period for polio is 7 to 10 days before the appearance of symptoms. It can continue for another 7 to 10 days after symptoms surface.

No treatment is available for polio.

Some children fully recover from polio, but others are disabled for a lifetime or may die from the disease.

To protect your child from polio, make sure that he is properly immunized against the disease.

Last Updated 11/21/2015

Pneumococcal Infections

Pneumococcal Infections

Pneumococcus (Streptococcus pneumoniae) is a type of bacteria that can cause infections, some serious, in many parts of the body. Pneumococcus is responsible for many cases of

  • Brain and spinal cord infection (meningitis)
  • Lung infection (pneumonia)
  • Infection of the bloodstream (bacteremia)
  • Joint infection (arthritis)
  • Ear infection (otitis media)
  • Infection of the sinus membranes (sinusitis)
  • Eye infection (conjunctivitis)

These infections are often spread through sneezing, coughing, or touching an unwashed hand.

Signs and Symptoms

The signs and symptoms of pneumococcal infections depend on the site of the infection. Typical signs and symptoms for meningitis are fever, headache, lethargy, vomiting, seizures, and stiff neck; for pneumonia, fever, cough, and difficulty breathing; for bacteremia, fever and less energy; for ear infections, fever and ear pain; and for sinustitis, fever and pain in the face.

Your pediatrician will prescribe antibacterials for treating pneumococcal infections.

Pneumococcal infections can be serious and may pose greater health risks in very young children whose immune systems are still developing. Some of these diseases are life threatening in normal children as well as children who have other illnesses or health conditions such as HIV infection, certain cancers (eg, leukemia, lymphoma), sickle cell disease, diabetes, and chronic heart, lung, or kidney disease.

Last Updated 11/21/2015

Whooping Cough

Whooping Cough

What is whooping cough?

Pertussis, or whooping cough, is less common in young children than it used to be, as the pertussis vaccine has made most children immune. Before this vaccine was developed, there were several hundred thousand cases of whooping cough each year in the United States. Now there are approximately 1 million cases a year in the US, but these are mostly in adults and adolescents.

This illness is caused by pertussis bacteria, which attack the lining of the breathing passages (bronchi and bronchioles), producing severe inflammation and narrowing of the airways. Severe coughing is a prominent symptom. If not recognized properly, the bacteria may spread to those in close contact with the infected person, through her respiratory secretions.

Who is at risk?

Infants under one year of age are at greatest risk of developing severe breathing problems and life- threatening illness from whooping cough. Because the child is short of breath, she inhales deeply and quickly between coughs. These breaths (particularly in older infants) frequently make a “whooping” sound—which is how this illness got its common name. The intense coughing scatters the pertussis bacteria into the air, spreading the disease to other susceptible persons.


Pertussis often acts like a common cold for a week or two. Then the cough gets worse, and the older child may start to have the characteristic “whoop”s. During this phase (which can last two weeks or more), the child often is short of breath and can look bluish around the mouth. She also may tear, drool, and vomit.

Infants with pertussis become exhausted and develop complications such as susceptibility to other infections, pneumonia, and seizures. Pertussis can be fatal in some infants, but the usual course is for recovery to begin after two to four more weeks. The cough may not disappear for months, and may return with subsequent respiratory infections.

When to call the doctor

Pertussis infection starts out acting like a cold. You should consider the possibility of whooping cough if the following conditions are present.

  • The child is a very young infant who has not been fully immunized and/or has had exposure to someone with a chronic cough or the disease.
  • The child’s cough becomes more severe and frequent, or her lips and fingertips become dark or blue.
  • She becomes exhausted after coughing episodes, eats poorly, vomits after coughing, and/or looks “sick.”

When your child needs hospital care

The majority of infants with whooping cough who are less than six months old, and slightly less than one-half of older babies with the disease, initially are treated in the hospital. This more intensive care can decrease the chances of complications. These complications can include pneumonia, which occurs in slightly less than one fourth of children under one year old who have whooping cough. (If your child is older, she is more likely to be treated only at home.)

While in the hospital, your child may need to have the thick respiratory secretions suctioned. His breathing will be monitored, and he may need to have oxygen administered. For several days, your youngster will be isolated from other patients to keep the infection from spreading to them.


Whooping cough is treated with antibiotics, usually for two weeks. These medications are most effective when they are given in the first stage of the illness before coughing spells begin. Although antibiotics can stop the spread of the whooping cough infection, they cannot prevent or treat the cough itself. Because cough medicines do not relieve the coughing spells, your pediatrician probably will recommend other forms of home treatment to help manage the cough.

Let your child rest in bed and use a cool-mist vaporizer to help soothe his irritated lungs and breathing passages. A vaporizer also will help loosen secretions in the respiratory tract. Ask your pediatrician for instructions on the best position for your child to help drain those secretions and improve breathing. Also ask your doctor whether antibiotics or vaccine boosters need to be given to others in your household to prevent them from developing the disease.


The best way to protect your child against pertussis is with DTaP vaccination (immunizations at two months, four months, and six months of age, and booster shots at twelve to eighteen months and at four or five years of age). See Recommended Immunization Schedules.

Tdap also protects against pertussis. A single dose of Tdap vaccine should be administered to children 7 through 10 years of age who were underimmunized with DTaP or who have an incomplete vaccine history.

The American Academy of Pediatrics (AAP) continues to recommend vaccination of adolescents, including pregnant adolescents. Pregnant women should also receive the vaccine. A single dose should be given to adults who have contact with infants, even if they are older than 65, and for health care workers of any age.

Last Updated 11/21/2015

Hepatitis A

Hepatitis A

Hepatitis means “inflammation of the liver.” This inflammation can be caused by a wide variety of toxins, drugs, and metabolic diseases, as well as infection. There are at least 5 hepatitis viruses.

Hepatitis A is contracted when a child eats food or drinks water that is contaminated with the virus or has close contact with a person who is infected with the virus. Hepatitis A is present in the stool as early as 1 to 2 weeks before a person develops the illness.

The infection can be spread in child care settings when caregivers do not wash their hands after changing the diaper of an infected baby or from infant to infant because most very young infants do not wash their hands or have their hands washed for them. This virus also can be spread during male homosexual activity. The incubation period is 2 to 6 weeks.

Signs and Symptoms

Hepatitis symptoms tend to be similar from one virus type to another. Many of these symptoms are flu like, such as fever, nausea, vomiting, loss of appetite, and tiredness, sometimes with pain or tenderness of the liver in the right upper abdomen. A hepatitis infection is also associated with jaundice, a yellow discoloration of the skin and a yellowish color to the whites of the eyes. This is caused by inflammation and swelling of the liver with blockage and backup of bile (bilirubin) into the blood. This backup also usually causes the urine to turn dark orange and stools light yellow or clay colored.

However, many children infected with the hepatitis virus have few if any symptoms, meaning you might not even know that your child is sick. In fact, the younger the child, the more likely she is to be symptom free. For example, among children infected with hepatitis A, only about 30% younger than 6 years have symptoms, and most of them are mild. Symptoms are more common in older children with hepatitis A, and they tend to last for several weeks.

When to Call Your Pediatrician

If your youngster has developed any of the symptoms associated with hepatitis, including jaundice, or if she has had contact with someone who has hepatitis (eg, in a child care center), call your pediatrician.

What You Can Do

In most cases, no specific therapy is given for acute hepatitis. The child’s own immune system will fight and overcome the infecting virus. Your pediatrician will recommend supportive care for your child, which can include rest, a well-balanced diet, and lots of fluids.

Do not give your child acetaminophen without talking to your pediatrician first—there is a risk of toxicity because her liver may not be fully functioning. Your pediatrician may also want to reevaluate the dosages of any other medicines your child is taking. They may have to be adjusted because of changes in the liver’s ability to manage the current dosages.

Last Updated 11/21/2015