Infections

Evidence  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901347/ 

Laura Steiner, Susanne C. Diesner and Peter Voitl 

Preterm infants are at a significantly increased risk of suffering serious infections that require hospitalisation and treatment. The entities responsible for the increased risk of infection in preterm infants are neonatal sepsis and respiratory infections, with respiratory tract infections caused by respiratory syncytial virus (RSV) in particular. 

Education 

Infections can be a concern during the early years of a child's life, especially if your child was born premature or sick. Babies and young children have developing immune systems, which can make them more susceptible to infections.  

Infections during this time may include: 

Respiratory syncytial virus (RSV) 

Respiratory syncytial virus, or RSV, is a virus that causes respiratory infections. It mostly affects young children and babies, but it can occur in adults. Almost all children will have been infected by the age of 3 years. 

If your premature baby has bronchopulmonary dysplasia (BPD), congenital heart disease or a problem with their immune system, they are more likely to get a more serious form of RSV. This can lead to chest and ear infections. 

Children at greatest risk for severe illness from RSV include the following: 

• Premature infants 

• Infants up to 12 months, especially those 6 months and younger 

• Children younger than 2 years with chronic lung disease or congenital (present from birth) heart disease 

• Children with weakened immune systems 

• Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions. 

Like other respiratory viruses, it is highly infectious and can spread through the air by coughing and sneezing, as well as by hands, cups and other objects that have been in contact with an infected person's mouth or nose. 

Symptoms of RSV are similar to other respiratory viruses such as a cold with runny nose, sneezing, sore throat, fever and headache and also cough, wheezing and difficulty breathing. A person is usually infectious for 3 - 8 days after symptoms begin but this may be longer in someone who has a weakened immune system. 

RSV usually causes mild infection, but some babies need to go to hospital if they develop difficulty breathing. 

If you are concerned about your child’s breathing, please call 000. 

For more information on RSV visit: https://www.miraclebabies.org.au/content/respiratory-syncytial-virus-rsv/gmfcyg 

Conjunctivitis 

Conjunctivitis is a common eye condition where the outer surface of the eye becomes inflamed. This is often caused by an infection (virus or bacteria) and is usually highly contagious. Conjunctivitis is spread by direct contact with discharge from the eyes, nose or throat of someone with the infection, or by contact with contaminated fingers or objects. 

Children should stay at home until the discharge from their eyes has stopped. 

Ear Infections 

There are 2 common types of ear infection: 

• middle ear infections, also called otitis media, which occur on the inner side of the ear drum. 

• outer ear infections, which occur in the ear canal outside the eardrum. 

Ear infections are common in babies and young children, especially between the ages of 6 and 18 months. Often the infection clears up by itself within a few days. You child’s ears might be painful for 2 or 3 days. Pain relief medication can help. 

An ear infection that lasts a while can affect your child’s hearing. If your child has painful ears, you should see a doctor. 

Gastroenteritis 

Gastroenteritis (or gastro for short) is a bowel infection that causes diarrhoea and sometimes vomiting. Diarrhoea is runny, watery bowel motions. Bouts of gastro can cause dehydration, which can be dangerous for very young babies and young children. Gastro is spread by contact with the vomit or faeces of an infected person, either directly or by contact with objects, food or drink that have come in contact with vomit or diarrhoea. 

Children should stay at home until there has not been a loose bowel motion and no vomiting for 48 hours.  

Glandular Fever 

Glandular fever (also known as infectious mononucleosis) is a common viral infection that can cause fever, a sore throat with exudate (deposits of fluid) around the tonsils and throat and enlarged lymph nodes (or ‘glands’). 

The symptoms usually develop four to six weeks after infection with the virus. In young children, glandular fever usually causes mild or no symptoms. 

Glandular fever spreads through close, personal contact and is transmitted by saliva. Young children can become infected by saliva on toys, shared cups or the hands of carers. Children do not need to be excluded from Nurture Group, Playgroups or Daycare unless they are sick. 

Hand, foot and mouth disease 

Hand, foot and mouth disease is a common viral infection. It is not related to the disease in cattle with a similar name (foot-and-mouth disease). 

Symptoms of hand, foot and mouth disease include tiny blisters on various parts of the body, including in the mouth and on the fingers, palms of hands, buttocks, nappy area, soles of the feet, upper arms or upper legs. The blisters last a little longer than a week. Some children may also have a fever, sore throat, runny nose or cough. The most troublesome symptom is often the blisters in the mouth, which make it difficult for the child to eat or drink. The virus is in the fluid of the blisters and can be spread by becoming airborne during coughing and talking. It’s also found in the child’s faeces. Symptoms usually start three to five days after the child is exposed. Careful hand washing especially after wiping nose, using the toilet and changing nappies helps prevent spread. 

Children need to stay at home and be excluded from Nurture Group, play groups and Daycare until all blisters have dried up. 

Influenza 

Influenza (‘the flu’) is a viral infection that starts in the throat but can cause fever, cough, chills, headache and muscle aches and pains. The infected person usually recovers in two to seven days. 

Flu is very infectious as it can spread through the air by coughing and sneezing, as well as by hands, cups and other objects that have been in contact with an infected person’s mouth or nose. Symptoms usually start one to three days after being exposed. 

Teaching children about covering their coughs and sneezes (including with their elbow if they don’t have a tissue) and washing their hands regularly are important ways to prevent the spread of flu and many other diseases. 

Children should stay at home until they are well again. 

Chickenpox (Varicella) 

Chickenpox is usually a mild childhood illness that causes a rash of red, itchy spots that turn into fluid-filled blisters. They then crust over to form scabs, which eventually drop off. Most Children recover without complications, but sometimes the infection can lead to serious complications, such as pneumonia and inflammation of the brain. 

Early in the illness, the virus is spread by coughing. Later, it is spread by direct contact with the fluid in the blisters. 

Children with chickenpox should avoid others by staying at home, cover their coughs and sneezes with a tissue and wash their hands regularly. Children with chickenpox shouldn’t share toys, utensils, food or drinking cups. 

The exclusion period for Nurture Group, Playgroups or Daycare is usually at least 5 days after the rash first appears and when all the blisters have dried.  

Meningitis 

Meningitis is a serious infection that can affect young children, especially infants and toddlers. It occurs when the membranes covering the brain and spinal cord become inflamed due to a viral or bacterial infection. Bacterial meningitis is particularly concerning because it can progress rapidly and cause severe complications. 

Symptoms of meningitis in babies and young children can include: 

• High fever 

• Irritability or fussiness 

• Poor feeding or lack of appetite 

• Vomiting 

• Excessive sleepiness or difficulty waking up 

• Stiff neck or body 

• Seizures 

• Rash (especially in bacterial meningitis) 

If you suspect your child has meningitis, it's essential to seek immediate medical attention. Bacterial meningitis requires prompt treatment with antibiotics to prevent serious complications like brain damage or death. 

Early recognition and treatment of meningitis are critical for a positive outcome. Trust your instincts and seek medical care if you suspect your child may have symptoms of meningitis. For more information on Meningitis visit https://meningitis.com.au/  

Sepsis 

Sepsis is when your child’s body has an extreme response to an infection. It is a life- threatening condition and your child will need immediate medical attention.  

Sepsis always starts with an infection. Infections which may cause sepsis can be anywhere in the body, such as chest, abdominal (for example after kidney or gall stones) and urinary infections. 

Not all infections lead to sepsis. However, if you have already seen your doctor and have been told your child has an infection and you are worried that your child is getting worse, then go back for another review and ask, ‘could it be sepsis?’ 

Immediately call Triple Zero (000) or go to a hospital emergency department if your baby or young child have any of these serious symptoms of sepsis: 

• you feel like your child is very sick or feel that something is seriously wrong with your child - you know your child best 

• getting very sick, very quickly 

• not needing to urinate (wee) all day or less wet nappies (less wee) than usual 

• being quieter or sleepier than normal or difficult to wake 

• irritable and can’t comfort them 

• a new concerning rash or a rash that does not fade when you roll a glass over it 

• blue, grey, pale or blotchy skin 

• difficulty breathing (you may notice grunting noises or their lower chest getting sucked in as they breath) or breathing very quickly 

• fever in a child less than 3 months old 

• low temperature or cold skin in babies less than 1 month old 

• feels floppy when you pick them up 

• convulsions or seizures 

• a weak or high-pitched cry that's not the same as their normal cry.

General symptoms 

If you are unsure or if your baby or young child has any of these general symptoms of infection that may lead to sepsis, call your doctor or healthdirect on 1800 022 222 (a 24-hour service): 

• fevers in children older than 3 months 

• not behaving or acting like they normally do or not interested in eating, feeding or normal activities 

• vomiting or diarrhoea 

• swelling or pain around a cut or wound.

For more information on Sepsis visit https://www.australiansepsisnetwork.net.au/ 

Whooping cough (pertussis)  

Whooping cough (pertussis) is a highly infectious disease caused by infection of the throat with the pertussis bacteria. It affects infants, children and adults. The disease usually starts like a cold, with a runny nose, tiredness and sometimes a mild fever. A cough then develops, usually in short bouts followed by a deep gasp (or ‘whoop’). Young infants may stop breathing and sometimes turn blue. Adolescents and adults may just have a persistent cough. One in four children will also develop pneumonia; some have fits (convulsions); and some may develop inflammation of the brain (encephalitis).  

Whooping cough is particularly serious in children under 12 months of age, and hospitalisation is often necessary. Whooping cough spreads by airborne droplets. It can also spread through contact with surfaces that have been contaminated by infectious airborne droplets (e.g. hands, tissues, toys, eating utensils). Symptoms usually start nine to 10 days after exposure.  

Specific antibiotics are used to treat whooping cough and may be recommended for some people that have been in close contact to help prevent infection. Children should be excluded for 21 days from the start of their symptoms, or until they have taken an appropriate antibiotic for at least 5 days. 

Urinary tract infections (UTIs)  

Urinary tract infections (UTIs) are very common infections that happen in the urinary system. The parts of the urinary system that are commonly infected are: 

• the kidneys – the organs that filter waste from the blood, turning it into urine (wee) 

• the bladder – where urine is stored. 

• the urethra – the tube that takes urine out of the body. 

UTIs are caused when germs enter the urinary system through the urethra and grow. Females are at higher risk of developing UTIs because their urethra is shorter and sits closer to the anus. 

UTIs are very common in babies and children, but if left untreated can develop into bigger infections that cause serious illness. Spotting a UTI in your child will depend on how old they are, and what symptoms they are showing. 

Because babies and toddlers are unable to communicate how they are feeling, and often wear nappies, symptoms of a UTI may look like: 

• irritability 

• loss of appetite 

• vomiting

• drowsiness 

• poor weight gain 

• fever 

• blood in the nappy. 

Take your child to your local doctor as soon as possible if they show signs of a UTI. 

Present to your nearest emergency department if your child becomes very lethargic, develops pain in their back and has a persistent fever as this can be a sign of a more serious infection.

Empowerment 

It's important for parents to watch for signs of infection, such as fever, cough, runny nose, diarrhea or vomiting. Seek medical advice if you suspect your child has an infection, especially if they are very young or show signs of dehydration or difficulty breathing. 

To reduce the risk of infections, practicing good hygiene is crucial. This includes regular handwashing, keeping shared spaces clean and avoiding close contact with sick individuals.  

If your child does get sick, providing them with plenty of rest, fluids, and appropriate medical care can help them recover more quickly. Always consult a healthcare professional if you have concerns about your child's health or symptoms of infection. 

Useful Links 

NSW Health 

https://www.health.nsw.gov.au/Infectious/factsheets/Pages/childhood.aspx 

Pregnancy, Birth and Baby 

https://www.pregnancybirthbaby.org.au/how-your-babys-immune-system-develops 

NHMRC - National Health and Medical Research Council 

https://www.nhmrc.gov.au/about-us/publications/staying-healthy-preventing-infectious-diseases-early-childhood-education-and-care-services 

Health Direct -24/7 health advice from registered nurses. 

https://www.healthdirect.gov.au 

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