Advising on illness and minor ailments
Preventing illness1
1. Keep up to date with vaccinations – the NHS offers a comprehensive immunisation programme for children. Appointments may have been missed due to COVID-19 restrictions, so encourage parents and caregivers to check that their child is up to date with their vaccinations. Visit www.nhs.uk/conditions/vaccinations/nhs-vaccinations-and-when-to-have-them/ for the full schedule. There are some vaccinations that are not routinely given on the NHS, such as the chickenpox vaccination. Parents and caregivers who are concerned can be signposted to private vaccination services for more information.
2. Practice good hand hygiene – handwashing is key to preventing the spread of colds, flu and other viruses. Children should be encouraged to wash their hands after using the bathroom, blowing their nose, touching animals and prior to touching food; this will help eliminate germs. Hands should be washed using soap and water for at least 20 seconds. Hand sanitisers can be used if handwashing facilities are not available.
3. Support the immune system – a healthy immune system can help fight off germs before they cause illness. The immune system can be supported by eating a healthy and well-balanced diet, including lots of fruit and vegetables, keeping hydrated and getting enough exercise and sleep. If parents or caregivers are concerned that their child is not getting sufficient nutrients from their diet, you could advise them on appropriate food supplements.
Did you know?
A normal temperature in babies and children is about 36.4C, but this can vary. A high temperature is 38C or more.2
Advising on minor ailments
There are a number of common minor ailments that affect children and concerned parents or caregivers may come into the pharmacy asking for advice or treatment options.
Many common childhood ailments can be treated using OTC medicines. Customers can be encouraged to use the pharmacy as the first port of call rather than making a GP appointment. When recommending products for children, always remember to check suitability and dosage instructions.
Warts and verrucas3
Warts and verrucas are caused by a virus and can be spread to other people from contaminated surfaces or through close skin contact. Warts and verrucas are more likely to spread if the skin is wet or damaged, so a return to swimming lessons may cause an increase in cases.
Warts and verrucas can be treated using products containing salicylic acid, which breaks down the skin cells, or products that use freezing to destroy the wart or verruca (cryotherapy). Always check the age limit on the product and advise parents or caregivers to follow the instructions carefully.
Additional advice you can give to parents and caregivers of children with warts and verrucas includes
- Wash hands after touching a wart or verruca
- Cover warts and verrucas with a plaster when they are swimming, if appropriate
- Do not share towels, flannels, socks or shoes
- Avoid biting nails or sucking fingers with warts on
- Wear socks and shoes as much as possible – do not walk barefoot in public places with a verruca
- Do not scratch or pick warts or verrucas.
Molluscum contagiosum4
This is a self-limiting viral infection that affects the skin. It most commonly affects children, although it can occur at any age. Most cases will clear up without treatment in around six to 18 months.
The main symptom is small spots on the skin. These are usually firm and dome-shaped, with a small dimple in the middle. They are typically pink or red and may have a tiny white or yellow head in the centre. If broken, the spot will release a thick yellowy-white substance, which is highly infectious. You should refer someone who is presenting with these symptoms to the pharmacist.
Treatment is usually only recommended for people with weakened immune systems or for older children and adults when the spots are particularly unsightly and affect quality of life.
Headlice
Head lice have been around for over 100,000 years5 and whilst COVID-19 has reduced the prevalence of the condition due to less social contact, it has not gone away. It is likely that once social distancing is removed, cases may increase.
Parents and caregivers should be advised to treat head lice as soon as they spot them. Everyone in the house should be checked for head lice and everyone who has them should be treated on the same day. There is no requirement to keep children home from school.
Head lice can be removed by wet combing with a detection comb after washing hair and applying conditioner. This needs to be done on days 1, 5, 9 and 13 with a final check on day 17.6
If wet combing doesn’t work you can recommend medicated lotions and sprays. These usually kill lice within a day, but may need to be repeated after a week to kill any newly hatched lice.6 Remember to check the pack for suitability and usage instructions.
Threadworms7
Threadworms are tiny parasites that can infect the large intestine of humans. They are sometimes known as pinworms, and are white in colour, resembling small pieces of thread.
Not everyone gets symptoms, but those who do usually notice itchiness around the bottom, particularly at night. The worms may be visible on the skin around the area, in stools, and on clothing or bedding. Untreated cases may cause a loss of appetite, weight loss, bedwetting, and skin infections.
Mebendazole is the main treatment used and should be taken by all members of the household at the same time. It kills the worms, but not the eggs, so strict hygiene measures must be followed by everyone in the household for two weeks to reduce the chance of reinfection:
- When someone is diagnosed, wash all sleepwear, bedding, towels and soft toys (without shaking them beforehand to prevent eggs being transferred to other surfaces)
- Thoroughly damp-dust and vacuum the whole house, particularly any bedrooms, and repeat regularly
- Keep fingernails short and discourage nail biting and thumb sucking
- Wash hands before eating, after going to the toilet, and before and after nappy changes, taking care to scrub under the nails
- Wear underwear at night and change it in the morning
- Bathe or shower in the morning, paying special care to the area around the bottom
- Don’t share towels and rinse toothbrushes before use
- Notify schools or other childcare settings.
A second tablet is highly recommended after two weeks, if re-infection is suspected. Hygiene measures without treatment should be followed for six weeks. Pregnant or breastfeeding women, children under two years old, and persistent or recurrent cases should be referred to the pharmacist.
Vitamin D – children over four years oldVitamin D is vital for maintaining healthy bones, teeth and muscles. It also contributes to the normal functioning of the immune system.8 During autumn and winter, the sun is not strong enough for the body to make vitamin D and so it must come from the diet. It is, however, difficult to get enough vitamin D from food alone, so adults and children over four years should consider taking a daily supplement containing 10 mcg of vitamin D during autumn and winter.Between late March/early April to the end of September, most people can make all the vitamin D they need through sunlight on their skin and from a balanced diet. Therefore, parents may choose not to supplement during these months.9 |