Why Are Social Distancing Kids Still Getting Sick?

Why are some kids still getting sick if they are have been our of school and stuck in the house for weeks because of COVID-19?

COVID-19 has kept most kids out of school for some time now. Many are also out of daycare. And few are out playing with friends.

So why are some still getting sick? What else is going on with kids stuck at home while we are all social distancing to flatten the curve.

Why Are Social Distancing Kids Still Getting Sick?

The first thought of some parents and pediatric providers upon reading this might be, wait, what, kids are still getting sick?

Flu activity is low in most of the United States.
Flu activity is low in most of the United States.

And that’s because it does seem that in addition to flattening the COVID-19 curve, staying home from school and daycare, washing hands, and general social distancing techniques has worked to keeps from getting sick with the flu and most other contagious diseases!

So while pediatric providers are available to do telemedicine appointments, it certainly isn’t business as usual, even as their days have gotten quite unusual.

Some kids are still getting sick though, and while we know what you are thinking, most probably don’t have COVID-19.

Why?

It might be because:

  1. they aren’t social distancing as well as they think they are, keeping in mind that with many diseases, people can be contagious for a few days before they show symptoms and you can sometimes catch germs from touching fomites, or objects that a sick person has recently touched. That still doesn’t mean that they have COVID-19 though. If they have contact with others, they could catch almost anything.
  2. they caught something from someone who had a disease a few weeks or months ago and is still shedding. For example, some infants can shed RSV for as long as 4 weeks after they get better. And they can shed the virus that causes hand, foot and mouth disease (HFMD) for almost two months! Human parainfluenza viruses (HPIV), a common cause of colds and croup (seal bark cough), can also shed for many months.
  3. they caught something from someone who had a viral disease that causes a lifelong latent infection with periodic reactivation and shedding. Wait, what? While herpes (cold sores) is the main disease you might think of as causing a lifelong latent infection, there are others. You may not realize this, but after getting roseola (causes a high fever for a few days, followed by a rash after the fever breaks), HHV-6 (human herpes virus-6) kind of does the same thing. The big difference is that while you shed HHV-6 in your saliva from time to time, you don’t have any symptoms. You can get other folks sick though, especially older infants, once they lose the passive immunity they got from maternal antibodies.
  4. they have a sore throat caused by a virus, allergies, or reflux, but have tonsil stones and a positive strep test because they are a strep carrier. Nearly 20% of kids are thought to be carriers of strep, which means that every time they get tested, they will be positive, whether or not they actually have strep throat. That means that you don’t have to worry about testing the dog to see if they are carrying strep…
  5. they were exposed to a disease with a long incubation period. While the incubation period (the time between getting exposed to something to when you get sick) is just a few days for many diseases, it can be several weeks or months for others. In fact, your child might not get sick until 30 to 50 days after being exposed to someone with mono!
  6. they had a virus a few weeks ago and now have Gianotti Crosti syndrome (GCS), a post-viral rash on a child’s legs, arms, and buttocks. Although GCS might linger for weeks or months, it eventually goes away on its own. Another rash, this one likely caused by reactivation of the virus that causes roseola, might have you thinking your child is covered in ringworm (how would they get that if they haven’t left the house??). Instead, they likely have pityriasis rosea.
  7. their symptoms are caused by a non-contagious infectious disease that is spread from an animal or insect and not from another person – think Lyme disease (ticks), Cat scratch disease (cats), and West Nile virus (mosquitoes), etc.
  8. they got sick (bacteria, virus, or parasite) from contaminated lake or well water, which can cause diarrhea – giardiasis, Crypto, shigellosis, norovirus,
  9. they got sick (bacteria, virus, or parasite) from eating raw or contaminated food – giardiasis, shigellosis, norovirus, E. coli, salmonellosis
  10. their symptoms are caused by a non-infectious disease, which could be anything from allergies and asthma to poison ivy or herpes zoster (shingles).

It is also possible that their symptoms are being caused by anxiety, fear, and stress, which is not unexpected as they see schools closed, people getting sick and wearing masks, and are likely unsure about what’s coming next.

Has your child been sick recently?

Do you have a pet turtle or chickens in your backyard? They could be a source for Salmonella…

Do you understand why now?

Now call your pediatric provider if you have questions and need help getting them well, especially if they seem anxious or have extra stress from being home all of the time and away from school and their friends.

You especially want to call if you think that they might actually have COVID-19. While most kids have mild symptoms or are asymptomatic, if your child has a fever, cough, and difficulty breathing, you should call your pediatric provider or seek medical attention.

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