You expect your child to come back from school with stories about his day, a few worksheets, and maybe a nice art project. But he might also tote in something far less appealing, like a cough, a fever, or a head full of lice. "When kids are in close contact, it's inevitable that they'll infect one another," says Kathryn Edwards, M.D., professor of pediatrics at Vanderbilt University, in Nashville.
Vaccines can help fend off the heavy hitters, like chicken pox and the measles. As for the rest: Sending your kid to class wearing surgical gloves and a mask may sound tempting, but it's not exactly practical. Instead, learn to spot the most common home invaders -- listed on the following pages in order of prevalence -- and teach your child some simple, preventive hygiene tricks. These won't guarantee he'll stay 100 percent germ-free, but they'll go surprisingly far toward limiting those lying-on-the-couch sick days.
Everyone's familiar with the telltale signs: runny nose, sneezing, coughing. Colds are the most common illness among kids -- nearly 22 million school days are lost to them each year, according the Centers for Disease Control and Prevention.
How they spread Germs go flying in tiny droplets when a sick child sneezes or coughs. They can also be passed along when she wipes her nose and then grabs a toy or a pencil -- and another kid picks it up.
Keep it away Tell your child to avoid touching her face or rubbing her eyes or nose (key routes for cold viruses to enter the body), and teach her to wash her hands thoroughly with soap. One way to do it: Sprinkle cinnamon on her fingers so she can see how much scrubbing it takes to remove the spice, suggests Linda Davis-Alldritt, R.N., president of the National Association of School Nurses. Also, ask about the school's hygiene policy: Kids should wash their hands after gym and recess and before lunch and snacktime. (Studies show repeated hand-washing can reduce the chance of catching a cold.) If she's getting sick, teach her the "vampire" move: "Tell her to cough or sneeze into her elbow, like Dracula with his cloak," says Davis-Alldritt.
Knock it out Unfortunately, there's still no cure for the common cold. But you can ease your child's discomfort. Have her drink plenty of water and clear fluids to stay hydrated, and relieve her congestion by giving her saline nose drops or using a humidifier. Cold meds aren't safe for children under age 6; consult with your doctor before giving one to your older child.
The flu is a debilitating respiratory illness that will keep your child out of school -- and in bed -- for a few days to a week. He'll likely have chills, a fever, extreme fatigue, body aches, and possibly a stuffy nose or a cough.
How it spreads Flu viruses are especially contagious and can be transmitted both through the air and by touch. A child can be infectious for a full day before he shows signs of illness.
Keep it away Getting a flu shot or nasal vaccine is by far the best weapon. They're not 100 percent effective, so it's possible your child will still get sick, but his symptoms will be less severe and he'll be less likely to suffer from complications, such as pneumonia, than if he wasn't vaccinated.
Knock it out If your child has had symptoms for less than 48 hours, his doctor may prescribe Tamiflu, an antiviral medication that can speed recovery. Otherwise, he needs plenty of rest and liquids.
This inflammation of the membranes lining the eyelids -- conjunctivitis, as it is officially called -- can cause itching, redness, eye pain, and blurred vision. Typically, you will first notice crust around your child's eyelids and eyelashes or a white, yellow, or green discharge from one or both of her eyes when she wakes up. In other cases, the white part of your child's eyes may appear pink or red. She also could be infected if she can't stop rubbing her eyes or complains that they're burning.
How it spreads Though some forms of pinkeye are caused by allergies or irritants, most are either viral or bacterial -- and highly contagious. Conjunctivitis tends to peak during cold season. Your kid can catch it if an infected child rubs his eyes and then touches her, or if they share a towel to dry their hands or face.
Keep it away Remind your child to wash her hands frequently and avoid rubbing her eyes. Make sure she doesn't share blankets or pillows during rest time, says Dr. Edwards.
Knock it out Your pediatrician will probably prescribe antibiotic eyedrops, and your child won't be able to go back to school until she's been on them for 24 hours. Keep her hands clean, because pinkeye can easily spread from one eye to the other or to other people, or return after treatment is done. And be sure to keep her towel separate from everyone else's at home.
While a cold or the flu may cause a sore throat, strep's hallmark is severe throat pain, especially on swallowing. Caused by streptococcus bacteria, it usually doesn't trigger a stuffy nose, sneezing, or coughing. Your child may have white or yellowish spots on his tonsils or swollen lymph nodes on his neck, and a fever that suddenly spikes above 101?F.
How it spreads Strep is passed from kid to kid by sneezing or coughing. The bacteria can also live for a short time on surfaces such as doorknobs and faucet handles, says Dr. Edwards.
Keep it away Teach your child to be smart around sick pals. He should keep his distance from anyone who complains of a sore throat.
Knock it out If a throat culture confirms strep as a diagnosis, your pediatrician will prescribe your child antibiotics. He may start feeling better quickly, but it's important that he finish the entire course of treatment. Remember, too, that he won't be able to go back to school until he's been on antibiotics for at least 24 hours.
When your child says her head tickles or she starts scratching, take a close look at her scalp. Lice may be living there: Up to 12 million kids in child care, preschool, and elementary school are infested by these little buggers each year. You may be able to see the nits attached to the hair shaft about one-quarter of an inch up from the scalp (they're sometimes mistaken for dandruff). Or, because they're most active at night, your child may have trouble sleeping or be unusually irritable in the morning.
How they spread Since they can't hop or fly, these pinhead-size parasites get passed around when kids are in close contact -- crowded together on a rug or huddled over a group project -- or when their coats and hats are piled together, says Davis-Alldritt.
Keep them away Lice can cling to almost anything, so tell your child she shouldn't try on her friend's scarf, hat, or scrunchie, even quickly, just for fun. If the school sends home a note saying that a classmate has lice, do an inspection of her head, pronto. Girls with long hair should wear a braid or a ponytail to minimize the odds of accidental contact. It also can't hurt to run any recently worn clothing or hats through the washing machine at a temperature of 130?F or higher.
Knock them out Check with your doctor about whether to try one of several prescription lice treatments that have come on the market, such as the topical lotion Sklice. Otherwise, you can apply an over-the-counter delouser, such as a shampoo or a cream rinse, and then carefully run a fine-tooth comb through her hair to remove every nit you see. It often takes at least two treatments before she'll be lice- and nit-free. Make sure you launder any bedding and clothing she's been using. Adult lice can survive for a couple of days, and nits can survive for a week away from the ideal conditions on your child's head, so some experts suggest that any material that can't be washed should be placed in a sealed plastic bag for two weeks, just to be safe.
When to Keep Kids Home
You hate for your child to miss school unless it's absolutely necessary. But you also don't want her to be responsible for infecting the whole class. If your child has a dry cough or a runny nose (or has been treated for lice), it's probably okay to send her in. But hold on to her if she:
--is vomiting or has diarrhea.
--has had a fever above 100.1?F within the past 24 hours.
--has an unexplained rash, which could be a sign of chicken pox, a virus, or another infection, and you haven't seen a doctor yet.
--has a severe cough, which could be a sign of whooping cough.
Originally published in the September 2012 issue of Parents magazine.