Care4Kids

Pink-eye

Conjunctivitis (pink eye) is a common eye disorder among children. It is not a serious disease, and complications and vision problems associated with it are rare. Still, it irritates a child, and may be contagious to other children and adults.

CAUSE

Pink eye may have a number of different causes. Most mild cases of pink eye are caused by the same virus that causes the common cold, so it is no surprise when a child with a cold develops pink eye. The conjunctiva, or membrane of the eye, is basically the same kind of tissue as the moist lining of the nose, a magnet for cold-causing viruses.

Another common cause of pink eye is allergy. It may be caused by pollen, grass, topical medications, air pollutants, smoke or other allergens. Some kids develop a form of pink eye linked to warm weather.

Conjunctivitis is most common in the age groups in which children spend time together in close quarters, especially among those under age 5. This is because pink eye spreads just the way colds do, by contact from one child to another.

SYMPTOMS

Pink eye gets its name from the most common symptom: bloodshot or pink-tinged whites of the eyes. Many children have a sore throat and fever along with it and may suffer from runny eyes, itchiness and other infections throughout the body.

Pink eye may develop 24 to 72 hours after exposure. Some children notice sensitivity to light in their eyes, but pink eye generally doesn’t affect vision. It usually starts in one eye and quickly spreads to the other. Soon, there may be excessive tearing, redness in the white part of the eye or a stringy, green mucus in one or both eyes.

The course of the infection varies from child to child. One may have only slightly watery eyes and slightly pink conjunctiva for a few days before medication clears up the infection. Others may suffer itching, burning and lots of discharge for two to three weeks.

Moderate to severe cases of pink eye may have other symptoms than literally pink eyes. The presence of pus could mean the pink eye was caused by some bacterial organism that causes ear infections and pneumonia.

The form of pink eye that includes the sudden onset of pain, or the feeling that the child has something in his eye, may be caused by a fast-developing virus. This form may bring with it swollen eyelids, broken blood vessels and other symptoms. Often the lymph node in front of the ear is swollen.

Conjunctivitis can threaten the sight of newborn babies who are born to women who have the sexually-transmitted diseases gonorrhea or chlamydia. That is why erythromycin ophthalmic ointment is placed in the eyes of all newborns.

TREATMENT

It is important to consult your child’s physician if you suspect pink eye. Redness and irritation may simply be signs of a foreign object in the eye, not pink eye. Using special tests, the doctor can decide exactly what has caused the problem and what medications will rid him of it.

If the cause of your child’s pink eye is a form of bacteria, he may need special antibiotic eye drops or ointment. The type of pink eye caused by a virus resists medication, though in some cases antibiotic eye drops may prevent a secondary infection from developing. The allergic type of pink eye may be treated with eye drops, as well as cold compresses to relieve itching and, occasionally, oral antihistamines.

Do not use over-the-counter eye drops. Do not irrigate the eyes, or run water over them. Check with your health care provider to see if your child should temporarily stop wearing contacts while the condition clears. Cleanse the affected eye every two hours while awake with warm water and cotton balls or a clean cloth, wiping from the inner corner downward and outward. Wash your hands before and after to prevent the spread of infection.

HOW TO APPLY OINTMENT OR EYE DROPS

As typically prescribed, eye ointment or drops must be given three to four times a day. In more severe cases, the doses may be necessary every one or two hours. Follow your doctor’s instructions exactly.

If your child is prescribed antibiotics, it is important to treat for the entire seven days unless his doctor instructs otherwise. To administer medication to your child’s eyes:

While your child is infected, change her washcloths and towels after each use. Keep her toys and things separate from those of other children. Keep her eyes clean: Remove secretions by wiping downward and outward with a clean cloth. If her infection causes her eyes to be especially sensitive to light, have her wear a hat or sunglasses.

PREVENTION

As is true of many diseases, a key to preventing pink eye is good hygiene habits: frequent hand washing; proper use and disposal of tissues; keeping fingers away from the face; and covering the mouth during a sneeze.

Because pink eye tends to spread quickly in groups of children, don’t return your child to a child-care or school setting until she has received medical treatment for at least 24 hours.

DISEASETRANSMISSIONINCUBATION PERIODCONTAGIOUS PERIOD
Bronchiolitis Spread via respiratory droplets through sneezing or coughing  2 to 10 days  Onset of cough until 7 to 10 days 
Chickenpox (Varicella) Airborne or via skin contact with lesions  10 to 21 days  2 days before rash appears until all sores have crusted 
Colds Spread via respiratory droplets or direct contact with infected person or object  2 to 4 days  Onset of runny nose until fever is gone

 
Croup (viral) Spread via respiratory droplets or contact with infected person or object  2 to 6 days  Onset of cough until fever is gone
 
Diarrhea Contact with feces  Depends on causative agent (bacterial 1 to 7 days; viral 1 to 4 days)  Depends on causative agent; usually until stools are formed. (See specific agents)
 
Fifth Disease (Parvo virus) Spread via respiratory droplets  Usually 4 to 14 days, but can be as long as 21 days  7 days before rash until rash begins 
Hand-foot-mouth (Coxsackie) Spread via respiratory droplets, fecal/oral contact or fluid from blisters  3 to 6 days  Onset of mouth ulcers until fever is gone (respiratory tract shedding usually 1 week; fecal can be several weeks)
 
Hepatitis A Fecal contact  15 to 50 days  1 to 2 weeks before jaundice begins until 1 week after onset of jaundice
 
Hepatitis B Contact with infected blood/body fluids  45 to 160 days  Indefinite period. If Hepatitis e antigen is positive, at risk for transmission 
Herpes Simplex Oral/genital skin contact  2 days to 2 weeks  Initial infection: 1 week to several weeks (oral/genital). Recurrent infection: 3 to 4 days
 
Impetigo Direct skin contact with lesion and contact with infected objects  7 to 10 days  Onset of sores until 1 day on antibiotics
 
Influenza Spread via respiratory droplets or contact with infected person or object  1 to 4 days  24 hours before onset of symptoms until fever is gone, about 7 days
 
Lice Spread via contact with skin or hair  10 to 14 days  Onset of itch until 24 hours after first treatment
 
Meningococcus Spread via respiratory droplets  1 to 10 days  7 days before symptoms to 24 hours after treatment begins
 
Mononucleosis Contact with infected saliva  30 to 50 days  Undetermined, but usually 6 weeks
 
MRSA Spread via contact with infected person, person who is a carrier of the disease, or contaminated surface.  One to 10 days  Varies depending on whether infection is active and if person is seeking treatment 
Pertussis (whooping cough) Spread via respiratory droplets  Five to 21 days  Two weeks after onset of cough or until five days on antibiotics
 
Pink-eye or Conjunctivitis (bacterial) Spread via contact with eye drainage
 
2 to 7 days  Onset of pus until symptoms have resolved
 
Rotavirus Direct or indirect contact with infected people  2 to 4 days  Before onset of diarrhea until 10 to 12 days after onset
 
Salmonella, Shigella, Campylobacter Fecal contact  Salmonella - 12 to 36 hours
Shigella & Campylobacter - 1 to 7 days 
Contagious until diarrhea is resolved; sometimes with prolonged excretions with salmonella
 
Scabies Contact with clothing, bedding or skin of infected animal or person  4 to 6 weeks (previous exposure 1 to 4 days)  Onset of itch until one treatment completed
 
Scarlet fever Spread via airborne respiratory droplets and direct contact  1 to 2 days  Onset of fever or rash until 1 day on antibiotics
 
Sore throat (viral) Spread via respiratory droplets  2 to 5 days  Onset of sore throat until fever is gone 
Strep throat Spread via respiratory droplets  2 to 5 days  Onset of sore throat until 1 day on antibiotics 

2006 Red Book, Report of the Committee on Infectious Disease, American Academy of Pediatrics

Airborne - droplets nuclei that remain suspended in the air for long periods
Respiratory droplets - droplets propelled for a short distance, such as talking, sneezing, coughing, etc.


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