When her 18-month-old son caught the chicken pox from a friend at his nursery two years ago, Debbie Donahoo knew what was coming next.
Sure enough, two weeks later she'd contracted the itchy rash.
Then her hus- band, Scott, came down with the bug -- a surprise since he had thought he'd already had the disease. Both parents ended up scratching and sweating for nearly a fortnight.
"I'm laughing about it now, but believe me, I cried when it was all going on," said Mrs. Donahoo, of Pikesville, now 34 and a mother of three. "My in-laws had to come up from Ocean City to take care of [my son]."
With the majority of small children lack- ing immunities to common diseases, frequent illness is a fact of life for most youngsters -- and often for their parents, as well. And the situation tends to worsen each fall, when many children first come into contact with large numbers of their peers -- and large numbers of new germs -- at school.
In fact, according to Dr. John A. Boscia, assistant chair- man of pediat- rics at the Greater Baltimore Medical Center, it's not uncommon for a child to get sick more than a dozen times during his first year of school. Most of these illnesses are upper respiratory infections and stomach viruses.
"Any time a child is exposed to a greater social structure, they're going to pick up infections," said Dr. Boscia. "It's normal, and it's something to expect."
By having your children immunized against measles, mumps, rubella, polio, diphtheria, tetanus and whooping cough, as nearly all schools require, you can protect them from more serious diseases. But little can be done to prevent children from catching the various colds, flus and stomach viruses circulating schools or day-care centers.
"My philosophy is that the child has got to get [these illnesses] some time because his body has to build up an immunity to them," said Dr. Pat Fosarelli, director of the pediatric outpatient department at Saint Agnes Hospital and an assistant professor of pediatrics at Johns Hopkins University School of Medicine.
Still, certain steps may minimize the number of diseases children pick up. One move is to encourage children to pay attention to personal hygiene. Remind children to wash their hands after playing outside or using the toilet, and before putting anything in their mouths. Also, tell children to avoid sharing food with other children, since that's an easy way to catch viral infections.
Discourage your child from using classmates' combs or trying on hats to protect against catching head lice, a recurring problem among schoolchildren, according to Dr. John Santelli, director of School and Adolescent Health Services for Baltimore City's Health Department. Signs of lice are the presence of eggs -- small white dots resembling dandruff -- that stick to the hair and tiny black bugs clinging to the scalp. The condition is treated with a prescription anti-louse shampoo.
Scabies also prey on children, but unlike lice, these insects burrow under the skin, causing "probably the most intense itching human beings experience," said Dr. Fosarelli. "Kids will dig at themselves so hard they'll bleed." If you see your child digging at his skin in that manner, call your doctor; if it's scabies, it can be treated by a cream or lotion.
Both scabies and ringworm -- a fungal infection that shows up as a round lesion about the size of a dime or quarter -- usually are contracted by direct contact with an affected area. Ringworm is treated with an oral medication.
Still another common illness passed among children is chicken pox. Highly contagious, it is transmitted through the air. Consult your doctor if your child comes down with chicken pox and avoid giving your child aspirin; aspirin use during chicken pox has been associated with an increased risk of Reye's syndrome, a form of encephalitis (brain inflammation). Instead, use a pain reliever prescribed by your doctor.
Careful hygiene will not only help keep your child healthy at school, it also may reduce the chances of your child's illness spreading to other family members. If you have an infant in the house, you may want to send a sick sibling to his grandparents' house until the bug clears up, since infants can develop serious problems stemming from viruses, according to Dr. Boscia of GBMC.
Still, parents should recognize that it's often impossible to prevent other family members from falling ill when one child gets sick.
"For me, the healthiest attitude is keeping it all in stride," said Marla Newmark, 43, of Baltimore. A lactation specialist at GBMC and the mother of 11 children ranging from two months to 21 years, she has weathered many a sniffle.
"The bottom line is, there's only so much you can do," said Ms. Newmark. "If they're going to get it, they're going to get it, whether I worry about it or not."
Although a laissez-faire policy might be acceptable at home, it's still best to take precautions against the possibility of your child infecting his classmates.
Recent reports indicate that more and more parents are sending their sick children to school, rather than keeping them at home to rest. While it might be OK to let a child attend school with a minor cold, never send him with a fever, rash, vomiting or diarrhea, said Dr. John Krager, Baltimore County's deputy health officer and the director of school health services.
"Those symptoms really need to be cleared up before you send your child to school," said Dr. Krager. "You're putting his health at risk, and that of his classmates."