Summer officially began in Brazil on December 21st. Higher temperatures, combined with school holidays, mean that children spend more time outside enjoying beaches, public parks and various outdoor activities. This is the time of year when the number of cases of seasonal illnesses, including the flu, skyrockets. As we are still in a pandemic period, in which symptoms of COVID-19 can be confused with flu-like symptoms, Ruy Medeiros, a pediatrician at the Santos Dumont Institute (ISD), teaches how to identify common illnesses among children during the summer.

“Among the infections that can occur in children, the main ones during this time of year are the most prevalent in childhood in general. These are upper respiratory tract infections, colds and flu; and gastrointestinal infections, which are diarrhea and vomiting. This happens due to the seasonality of the diseases and the coexistence between children, as they are on vacation,” emphasizes the pediatrician. As a preventive measure for these diseases, Ruy Medeiros highlights that the most common ones, so widespread during the pandemic, are the most effective.

Children aged five and older should be encouraged to wear masks and keep their hands clean. Food should be washed and stored properly to prevent gastrointestinal infections. “Another measure is to avoid crowds, confined spaces and places with lots of people. These places are ideal for spreading diseases. Choose more airy environments such as parks, beaches and playgrounds, which are more open spaces,” says Ruy Medeiros. According to the pediatrician, viral diseases that are common at this time of year are self-limiting. In other words, children have some symptoms for consecutive days, which vary in intensity. If the case progresses to a more serious condition, with fever, for example, a pediatrician should be consulted.

An outbreak of influenza that began in Rio de Janeiro has spread rapidly throughout Brazil, with the presence of a new strain, H2N3. The symptoms of the flu syndromes common in the Brazilian summer are now confused with those of infection by the new coronavirus. The only way to differentiate them is through laboratory tests.

“Even today, it is difficult to make a reasonable distinction between these diseases. The symptoms are very similar, and in children, COVID-19 is very similar to the flu. From a clinical point of view, it becomes difficult to identify. In children with more intense symptoms, such as coughing, we end up doing a swab test to differentiate. This test is the means we have to differentiate COVID-19 from the common flu. In practice, we also observe the epidemiology. If there is someone in the family with COVID-19, for example. This procedure is recommended by the Brazilian Society of Pediatrics. But I suggest that, with any of the symptoms, you seek a qualified professional. They will be able to monitor the patient and identify whether or not the test (swab) is necessary,” says Ruy Medeiros.

The Rio Grande do Norte State Department of Public Health (Sesap/RN) reinforces the need for immunization with the Covid-19 and Influenza vaccines, which are available in all municipalities. The state distributed 200,000 doses of the Influenza vaccine last week to reinforce the immunization work of the people of Rio Grande do Norte. To date, 93 cases of Influenza A and 37 cases of H2N3 have been identified, investigated by the Central Laboratory (LACEN). In addition, the first case of co-infection between Influenza and Covid-19 was detected.

Dehydration

Because they spend more time exposed to the sun, swimming in the sea or pool, and playing with friends, children are more prone to dehydration during the hottest months of the year. In Natal and in cities in the Seridó and Oeste regions of Rio Grande do Norte, temperatures are reaching over 30º. According to the pediatrician at ISD, dehydration can occur for a number of reasons, and parents and guardians need to be aware of the symptoms so that the correct treatment can be administered in a timely manner.

“At first, the child becomes more limp. Dehydration can occur for several reasons. The most common is the amount of time spent in the sun. Some children have diarrhea, vomiting, and gastrointestinal symptoms. We need to identify these factors to understand what happened. As clinical parameters, we need to know if the child is not urinating, if he or she is crying without tears… these are signs that the child is dehydrated. It is important to prevent this from happening. It is not advisable to expose very young children to the sun for a long time. We do not have sunscreens for children under six months of age. Ideally, parents should wait until these children can go to the beach and pool, but always use sunscreen and pay attention to the time, always avoiding the sun between 10 am and 3 pm,” says Ruy Medeiros.

In addition to the sun itself, external factors need to be identified as potential causes of sunstroke and skin burns. Plastic umbrellas, for example, are a risk. “Children who spend a lot of time under umbrellas and plastic tents think they are protected. But these tents can often create a greenhouse effect. This can cause sunstroke. Always choose roof coverings or straw. This helps protect the child. And, of course, always hydrate with water or juice, according to the child's preference and within the recommended age range. Children who breastfeed should breastfeed more,” emphasizes Ruy Medeiros.

Heat rash and diaper rash

According to the specialist, prickly heat is a skin reaction and is very common in children due to heat and allergic exposures. Diaper rash is more common in areas with folds and areas that are in greater contact with the diaper, for example. The heat and friction of the diaper material with the skin can cause diaper rash.

“We ask that these lesions be monitored and that children be kept in well-ventilated environments. And in order to protect children by always wearing plenty of clothing, lighter clothing should be preferred in the summer. In children who wear diapers, the use of preventive ointments is recommended to avoid diaper rash in the future. In some cases, parents confuse diaper rash with more serious lesions that require clinical monitoring. It is necessary to keep the child's pediatrician informed so that appropriate treatment can be provided,” warns the medical preceptor.