Lesson Plan on Prevention and Control of Common Diseases in Children

For the prevention and control of common diseases for child care providers and parents of children aged 0-6, as long as the three core actions of "early identification of signs, hierarchical intervention, and cutting off cross-transmission" are mastered, the prevention and control needs of more than 80% of children's common respiratory, digestive tract, and infectious diseases can be covered without relying on special drugs or high-end protective equipment. The quarterly prevalence of children can be reduced by more than 30%, and the incidence of severe illness can be reduced by more than 90%.

I have been working as a front-line prevention and control officer in a community child care department for 6 years. I have given training to no less than 50 child care institutions. I have seen too many extreme situations: some kindergartens spray hypochlorous acid spray on children every day, and even schoolbags have to be sterilized. As a result, the children often develop allergic rhinitis.； Some parents are so arrogant that they send their children to kindergarten if they have herpes on their hands, and half the class ends up with hand, foot and mouth disease. In fact, it really doesn’t have to be so extreme. Most problems can be solved by focusing on the key points.

Let’s talk about the most easily overlooked “early identification” first. You really don’t need to memorize a thick symptom comparison list. The core is to look at one signal: the child is different from usual. For example, a child who usually loves to run and jump suddenly becomes clingy and lacks energy today. He usually eats two bowls of rice and doesn’t want to touch a bite today. Even if the temperature is normal, you have to pay more attention to it. This signal is much more accurate than measuring the temperature. I once encountered a particularly impressive case. When a child in a small class came in the morning, the teacher felt that he was lethargic. When he asked his parents, he asked his parents and said that he was fine because he played too late the day before and did not sleep well. As a result, his fever reached 39 degrees at noon and he was diagnosed with influenza A. Fortunately, the teacher moved him to an isolation seat in the corner of the classroom early. In the end, he was the only one who got sick and the disease did not spread.

When it comes to whether to intervene in advance after identification, the opinions of two schools of thought in the industry are quite interesting: Most Western medicine pediatricians recommend that as long as the child is in good spirits and the body temperature does not reach 38.5°C, there is no need to take medicine, just drink more water and rest. After all, the common cold is a self-limiting disease, and it takes a week to take or not take medicine. Taking medicine in advance will increase the metabolic burden on the liver and kidneys.； In the field of pediatric massage in traditional Chinese medicine, it is believed that if you have symptoms of wind and cold such as runny nose and cold hands and feet, you can drink some green onion and ginger water and massage the Sanguan acupoint for 10 minutes, which can indeed relieve the symptoms and shorten the course of the disease. My own experience is that you can try both, as long as you don't blindly give antibiotics to your child - there was a parent who gave cephalosporin to his baby as soon as he saw a runny nose. After taking it for half a year, the baby's immunity was so weak that he would catch a cold whenever he blew the wind. It was completely a good intention and a bad thing.

Let’s talk about the most troublesome cross-transmission issue in day care institutions. When I was coaching the No. 3 Kindergarten in the district, their absenteeism rate in winter has been stable at more than 20%. Later, I changed three small details that cost little: First, during the morning check-up, instead of just touching the forehead, I also added a touch of the back of the neck. Many children wear too much, and the forehead is cold but the back of the neck is already hot. It is especially easy to miss the diagnosis.； Second, children are not allowed to share cups or sweat towels. Even plasticine is divided into small groups. After playing with one group, wipe it with disinfectant wipes before giving it to the next group. ； The third is to open the windows for ventilation at least three times a day, for 20 minutes each time, and open a small crack even if it is cold in winter. With these three actions, their absenteeism rate dropped directly to 6% after two months. The principal was shocked and said that the ultraviolet disinfection equipment he bought worth thousands of yuan was not used. Oh, by the way, I would like to mention the no-rinse disinfectant gel that everyone asks about the most. Don’t let your children use it seven or eight times a day. Use it at most once before meals and after going to the toilet. Frequent use will damage the skin barrier and make it easier for viruses to take advantage of it.

There has never been any controversy over whether to take Class II vaccines: Class I vaccines are definitely mandatory and there is no controversy about this.； Some parents think that it is possible to get the second-class vaccines such as influenza, hand, foot and mouth, and rotavirus, so there is no need to spend the money. Some parents think that it is better to prevent them. My suggestion is that if your child is usually weak and catches more than 5 colds a year, it is best to get vaccinated. After all, even if he is infected, the symptoms will be much milder. Last year, I met a child who received the flu vaccine. After the infection, the fever went away in one day. The classmate who did not receive the vaccine had a fever for 4 days and was hospitalized for a week because of pneumonia. The difference is quite obvious.

There are a few pitfalls that parents are particularly likely to fall into. I must mention: Don’t give your kids isatis root to prevent colds when the season changes. Isatis root is used to treat wind, heat and colds. Drinking it when you are not sick can damage the spleen and stomach. I have seen several children who drank half-month-old isatis root. They lost their appetite for food and were more likely to get sick.； Don't wrap yourself up in a thick quilt to cover your baby's sweat whenever you see a fever. Children's temperature regulation center is not fully developed. Covering your baby too tightly can easily lead to fever-masking syndrome. In severe cases, it can also damage the nervous system. There was one such case in our jurisdiction last year, and parents didn't even have time to regret it. By the way, if there is an outbreak of norovirus or hand, foot and mouth in a kindergarten, don’t hide it, report it to the disease control department in time, and suspend classes as required. Don’t force it. There was a private kindergarten that concealed the hand, foot and mouth epidemic before. In the end, half of the children in the kindergarten got sick, and the principal was punished. This is the bottom line that cannot be touched.

In fact, when it comes to the prevention and control of common childhood diseases, there is really no 100-point standard answer. Some babies are born with good physical constitution and will be fine even if they freeze. Some babies are allergic and sneeze when exposed to pollen. Don’t always follow the online strategies. Observe your own baby’s condition more than anything else. If you are really unsure, go to the hospital and see a doctor. Don’t give your baby medicine blindly. Most common diseases can be cured smoothly as long as the care is in place.