DETROIT – We asked local pediatricians to share the illnesses they’re expecting to see increase in school-age children this fall, which ones they’re most concerned about, and what advice they have for parents.
The first set of answers come from, Marcus DeGraw, MD | Chairman, Department of Pediatrics | Medical Director - Child Protection Team | Medical Director - Ambulatory Pediatrics | Ascension St. John Children’s Hospital - Detroit
What illnesses do you expect to see going around in school-age kids in September and early October?
Well, we expect a return to relative normalcy in terms of children and typical illnesses. That means a return to upper respiratory infections and colds typical like rhinovirus, adenovirus and the common, everyday version of plain old coronavirus. RSV and influenza are also likely to be around, and possibly be around earlier and acting more intensely than normal years (typically very late fall and into winter).
Be prepared for children to be sick a bit more often than typical and possibly each respiratory illness to be a bit worse than normal. The average school-age child may experience 6-8 illnesses per year and this year may see a bit more than that average. This is due to 2.5 years now of seclusion and separation which has led to children having immune systems that have missed out on years of exposure and “training” and thus needing some time to build back up “normal” reactions to common illnesses.
Is there anything you’re seeing now that you expect to increase in school-age kids as we head into fall?
This summer saw some increase in typical colds and respiratory illnesses. Now that kids are back in-person and around each other daily, we expect a quick increase in respiratory illnesses and typical school-related infections like strep, sore throats, colds, etc.
What illnesses are you most concerned about in school-age kids in the next two months?
We are worried about more serious illnesses like RSV and influenza acting out in weird ways, like causing illness sooner than typical (early fall rather than typical winter after December, etc) and possibly acting in more severe ways in children.
Important to note that in CHILDREN, we are also more worried about return to school related anxiety, depression, developmental delays and exacerbation of learning losses experienced due to the last 2.5 years. We are grateful for a much-needed return to normalcy but we expect some kids to really struggle to adjust back to full “normal” school especially having suffered from severe learning loss and delays in normal academic progression. Watch for signs of anxiety and depression and seek help quickly when indicated.
What advice would you give parents to reduce their child’s risk of catching these illnesses?
In terms of illness, just a return to discussions on typical hygiene and illness avoidance. Stress good hand washing, covering mouth with coughs and sneezes, and avoiding close contact with obviously ill schoolmates.
In terms of mental health and school functioning - open and honest discussions, good attention to the child’s mental health, and a concerted effort to a return to consistent sleep schedules, healthy eating and attention to self care and mental health.
Marisa Louie, M.D., pediatric emergency physician at U-M Health C.S. Mott Children’s Hospital said, “As for what we expect to see come fall, return to school usually means a bump in our visit numbers, starting about now as some schools started last week. Most of the increases come from viral infections like colds, as well as some bacterial infections, such as strep throat. This is often a busy time for asthmatics who are triggered by both viral infections and the changes with weather and pollen levels. One of best ways for families to avoid illness is to make sure immunizations are up to date, including the COVID-19 vaccine which is now approved for all but the very youngest babies, and the seasonal influenza vaccine which should be available next month. If families have fallen behind on the usual vaccines because of the pandemic, it is also a good time to make sure those are up to date. Pertussis is vaccine-preventable and can look like a common cold at first, but the symptoms can last much longer and be dangerous to those who cannot yet be fully immunized. Hygiene will always be challenging with young kids, but we can continue to teach them to wash their hands well, use hand sanitizer and cover their coughs and sneezes. Kids with fevers should stay home from school or daycare until the fever has been gone for 24 hours.”
The next set of answers come from Stacy L. Leatherwood, M.D./Pediatrician and Senior Staff Attending Physician at Henry Ford Medical Center-New Center One/Wayne.
What illnesses do you expect to see going around in school-age kids in September and early October?
- Upper respiratory infection/colds,
- Strep throat/viral pharyngitis (sore throat),
- Gastroenteritis (vomiting and diarrhea),
- COVID infection
- Conjunctivitis (pink eye),
- Norovirus-stomach flu
- Childcare centers- Younger children- hand, foot, mouth syndrome, bronchiolitis- RSV
Is there anything you’re seeing now that you expect to increase in school-age kids as we head into fall?
- A continued increase in COVID infections.
- Gastroenteritis
- Upper respiratory infections
- Strep throat/viral pharyngitis (sore throats)
- Fifth’s disease
What illnesses are you most concerned about in school-age kids in the next two months?
- Influenza
- COVID
What advice would you give parents to reduce their child’s risk of catching these illnesses?
- Good handwashing, teach your child how to cough or sneeze into their elbow.
- Encourage healthy choices for eating and exercise. Adequate sleep is also important.
- Vaccinate against Influenza and COVID
- Keep your child home if they’re sick to reduce spread of infection, regular communication with school concerning outbreaks in the school, mask wearing.
Jordan Kridler, M.D./Pediatrician at Henry Ford Medical Center-Royal Oak/Oakland said, “This fall I am guessing we are going to see a lot more of the typical fall winter viral illnesses such as the flu that have not been as prevalent these past two years because of mask-wearing. I also feel that COVID hasn’t gone away and will probably see more COVID cases as well. Flu and COVID would also be the cases that I would be most concerned about increasing as we going to the fall and winter months. In terms of things that parents can do, I recommend parents teaching and helping their kids with good hand hygiene techniques. Giving their kids hand sanitizers to take with them to school and things like teaching them to cough in their elbow and always cover their mouth when they sneeze or cough.”
The next set of answers come from Jacqueline Metz, DO, FAACP/Pediatrician at Henry Ford Medical Center-Ford Road/Wayne.
What illnesses do you expect to see going around in school age kids in September and early October?
We are expecting to see many upper respiratory infections once kids start school. Many upper respiratory infections this time of year are caused by viruses such as rhinovirus and enterovirus.
This year, we have seen an early spike in cases of RSV, respiratory syncytial virus, which causes a cold-like illness in healthy older children, but can cause more serious illness in children younger than 2 years of age. It is the most common cause of hospitalization in this age group. RSV usually spikes starting in November in Michigan. This year we saw an uptick in cases in July and August. This early surge may continue into the school year.
Other more commonly seen illnesses this time of year include strep pharyngitis and viral gastroenteritis. We also see many children whose season allergies flare with the change in season.
Is there anything you’re seeing now that you expect to increase in school age kids as we head into fall?
Recently, I have seen many children with strep pharyngitis. I expect that, especially in the first few weeks of school, the number of children with this illness will increase.
What illnesses are you most concerned about in school-age kids in the next two months?
I am most concerned about COVID in school age children. With many schools dropping mask requirements, a surge can be expected. Many school age children are still unvaccinated against COVID. While it is true that the majority of children recover from COVID without issue, there are still many who suffer from moderate to severe infections. Some have had several days of very high fevers, others have had severe headaches, difficulty in breathing, or have developed long COVID. Of course, the COVID consequence we worry about the most is MIS-C. This is a life threatening syndrome that typically develops 2-3 weeks after COVID infection, and thankfully it is rare overall.
What advice would you give parents to reduce their child’s risk of catching these illnesses?
Parents should keep their children home when they are sick to stop the spread of illness. Children should be taught not to drink from others’ cups or share items like Chapstick. Of course, good hand washing should be promoted. Families should also consider sending their children to school wearing masks, especially if they are unvaccinated or medically vulnerable.
The next set of answers come from Abdelkhalek Elagamy, DO, ProMedica Physicians Monroe Pediatrics.
What illnesses do you expect to see going around in school-age kids in September and early October?
There are a few common ones to look out for. Rhinovirus, which is the most common cause of the common cold, usually peaks in September. Strep throat can be common as kids return to classrooms with symptoms of sore throat, fatigue, and possibly fever. COVID-19 is also on our list this back-to-school season.
Is there anything you’re seeing now that you expect to increase in school-age kids as we head into fall?
RSV (respiratory syncytial virus) was a very common cause of cold-like symptoms in infants and young children in the winter months. However, during the past couple of years of the COVID-19 pandemic we have seen a shift in a good number of RSV infections towards the summer and fall months. Historically, I would expect RSV to increase in the fall and winter months.
What illnesses are you most concerned about in school age kids in the next two months?
COVID-19 remains high on my list, especially with the newer subvariants spreading in our communities. There are now approved COVID-19 vaccines for children as young as 6 months old to receive to help protect them against COVID-19. I encourage all my families to learn more about the COVID-19 vaccine at all of my appointments.
What advice would you give parents to reduce their child’s risk of catching these illnesses?
Kids will be kids! As our children grow and develop, becoming sick is a natural part of going to school whether it is in the classroom or playing outside at recess. For example, proper hand washing is an easy and effective way that we can teach to promote awareness in our children. If your child is sick, call your medical provider and school and determine if your child should attend school that day or not. Oftentimes, staying home after being evaluated by a medical provider can help decrease the spread of common illnesses in our communities.
The next set of answers come from Emily Jarrett, NP, family medicine nurse practitioner from McLaren Health Care.
What illnesses do you expect to see going around in school-age kids in September and early October?
- RSV
- Influenza
- Common cold
- COVID-19
- Strep throat
- Hand foot and mouth disease.
Is there anything you’re seeing now that you expect to increase in school age kids as we head into fall?
- Common cold
What illnesses are you most concerned about in school age kids in the next two months?
- Influenza, COVID-19
What advice would you give parents to reduce their child’s risk of catching these illnesses?
- Teach children proper and frequent handwashing
- Teach children to avoid touching their faces or putting their hands in their mouths
- Teach children not to share items such as ChapStick or water bottles
- Quarantine when you are sick per CDC guidelines