Chickenpox

Chickenpox is a common illness among kids, particularly those under age 12. An itchy rash of spots that look like blisters can appear all over the body and may be accompanied by flu-like symptoms. Symptoms usually go away without treatment, but because the infection is very contagious, an infected child should stay home and rest until the symptoms are gone.

Chickenpox is caused by the varicella-zoster virus (VZV). Kids can be protected from VZV by getting the chickenpox (varicella) vaccine, usually between the ages of 12 to 15 months. In 2006, the Centers for Disease Control and Prevention (CDC) recommended a booster shot at 4 to 6 years old for further protection. The CDC also recommends that people 13 years of age and older who have never had chickenpox or received chickenpox vaccine get two doses of the vaccine at least 28 days apart.

A person usually has only one episode of chickenpox, but VZV can lie dormant within the body and cause a different type of skin eruption later in life called shingles (or herpes zoster). Getting the chickenpox vaccine significantly lowers your child's chances of getting chickenpox, but he or she may still develop shingles later.

Symptoms of Chickenpox

Chickenpox causes a red, itchy rash on the skin that usually appears first on the abdomen or back and face, and then spreads to almost everywhere else on the body, including the scalp, mouth, nose, ears, and genitals.

The rash begins as multiple small, red bumps that look like pimples or insect bites. They develop into thin-walled blisters filled with clear fluid, which becomes cloudy. The blister wall breaks, leaving open sores, which finally crust over to become dry, brown scabs.

Chickenpox blisters are usually less than a quarter of an inch wide, have a reddish base, and appear in bouts over 2 to 4 days. The rash may be more extensive or severe in kids who have skin disorders such as eczema.

Some kids have a fever, abdominal pain, sore throat, headache, or a vague sick feeling a day or 2 before the rash appears. These symptoms may last for a few days, and fever stays in the range of 100°–102° Fahrenheit (37.7°–38.8° Celsius), though in rare cases may be higher. Younger kids often have milder symptoms and fewer blisters than older children or adults.

Typically, chickenpox is a mild illness, but can affect some infants, teens, adults, and people with weak immune systems more severely. Some people can develop serious bacterial infections involving the skin, lungs, bones, joints, and the brain (encephalitis). Even kids with normal immune systems can occasionally develop complications, most commonly a skin infection near the blisters.

Anyone who has had chickenpox (or the chickenpox vaccine) as a child is at risk for developing shingles later in life, and up to 20% do. After an infection, VZV can remain inactive in nerve cells near the spinal cord and reactivate later as shingles, which can cause tingling, itching, or pain followed by a rash with red bumps and blisters. Shingles is sometimes treated with antiviral drugs, steroids, and pain medications, and in May 2006 the Food and Drug Administration (FDA) approved a vaccine to prevent shingles in people 60 and older.

Contagiousness

Chickenpox is contagious from about 2 days before the rash appears and lasts until all the blisters are crusted over. A child with chickenpox should be kept out of school until all blisters have dried, usually about 1 week. If you're unsure about whether your child is ready to return to school, ask your doctor.

Chickenpox is very contagious — most kids with a sibling who's been infected will get it as well, showing symptoms about 2 weeks after the first child does. To help keep the virus from spreading, make sure your kids wash their hands frequently, particularly before eating and after using the bathroom. And keep a child with chickenpox away from unvaccinated siblings as much as possible.

People who haven't had chickenpox also can catch it from someone with shingles, but they cannot catch shingles itself. That's because shingles can only develop from a reactivation of VZV in someone who has previously had chickenpox.

Chickenpox and Pregnancy

Pregnant women and anyone with immune system problems should not be near a person with chickenpox. If a pregnant woman who hasn't had chickenpox in the past contracts it (especially in the first 20 weeks of pregnancy), the fetus is at risk for birth defects and she is at risk for more health complications than if she'd been infected when she wasn't pregnant. If she develops chickenpox just before or after the child is born, the newborn is at risk for serious health complications. There is no risk to the developing baby if the woman develops shingles during the pregnancy.

If a pregnant woman has had chickenpox before the pregnancy, the baby will be protected from infection for the first few months of life, since the mother's immunity gets passed on to the baby through the placenta and breast milk.

Those at risk for severe disease or serious complications — such as newborns whose mothers had chickenpox at the time of delivery, patients with leukemia or immune deficiencies, and kids receiving drugs that suppress the immune system — may be given varicella zoster immune globulin after exposure to chickenpox to reduce its severity.

Preventing Chickenpox

Doctors recommend that kids receive the chickenpox vaccine when they are 12 to 15 months old and a booster shot at 4 to 6 years old. The vaccine is about 70% to 85% effective at preventing mild infection, and more than 95% effective in preventing moderate to severe forms of the infection. Although the vaccine works pretty well, some kids who are immunized still will get chickenpox. Those who do, though, will have much milder symptoms than those who haven't had the vaccine and become infected.

Healthy children who have had chickenpox do not need the vaccine — they usually have lifelong protection against the illness.

Treating Chickenpox

A virus causes chickenpox, so the doctor won't prescribe antibiotics. However, antibiotics may be required if the sores become infected by bacteria. This is pretty common among kids because they often scratch and pick at the blisters.

The antiviral medicine acyclovir may be prescribed for people with chickenpox who are at risk for complications. The drug, which can make the infection less severe, must be given within the first 24 hours after the rash appears. Acyclovir can have significant side effects, so it is only given when necessary. Your doctor can tell you if the medication is right for your child.

Dealing With the Discomfort of Chickenpox

You can help relieve the itchiness, fever, and discomfort of chickenpox by:

• Using cool wet compresses or giving baths in cool or lukewarm water every 3 to 4 hours for the first few days. Oatmeal baths, available at the supermarket or pharmacy, can help to relieve itching. (Baths do not spread chickenpox.)
• Patting (not rubbing) the body dry.
• Putting calamine lotion on itchy areas (but don't use it on the face, especially near the eyes).
• Giving your child foods that are cold, soft, and bland because chickenpox in the mouth may make drinking or eating difficult. Avoid feeding your child anything highly acidic or especially salty, like orange juice or pretzels.
• Asking your doctor or pharmacist about pain-relieving creams to apply to sores in the genital area.
• Giving your child acetaminophen regularly to help relieve pain if your child has mouth blisters.
• Asking the doctor about using over-the-counter medication for itching.

Never use aspirin to reduce pain or fever in children with chickenpox because aspirin has been associated with the serious disease Reye syndrome, which can lead to liver failure and even death.

As much as possible, discourage kids from scratching. This can be difficult for them, so consider putting mittens or socks on your child's hands to prevent scratching during sleep. In addition, trim fingernails and keep them clean to help lessen the effects of scratching, including broken blisters and infection.

Most chickenpox infections require no special medical treatment. But sometimes, there are problems. Call the doctor if your child:

• has fever that lasts for more than 4 days or rises above 102° Fahrenheit (38.8° Celsius)
• has a severe cough or trouble breathing
• has an area of rash that leaks pus (thick, discolored fluid) or becomes red, warm, swollen, or sore
• has a severe headache
• is unusually drowsy or has trouble waking up
• has trouble looking at bright lights
• has difficulty walking
• seems confused
• seems very ill or is vomiting
• has a stiff neck

Call your doctor if you think your child has chickenpox, if you have a question, or if you're concerned about a possible complication. The doctor can guide you in watching for complications and in choosing medication to relieve itching. When taking your child to the doctor, let the office know in advance that your child might have chickenpox. It's important to ensure that other kids in the office are not exposed — for some of them, a chickenpox infection could cause severe complications.

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Genital Herpes

Genital herpes is a sexually transmitted disease (STD) that's usually caused by the herpes simplex virus type 2 (HSV2), although it can also be caused by herpes simplex virus type 1 (HSV1), which normally causes cold sores around the mouth.

In some cases, genital herpes causes blisters and pain in the genital area, but in others, it doesn't cause any symptoms, so someone who is infected could unknowingly pass it on to others. Sometimes people who have genital herpes only have one outbreak. Others have many outbreaks, which are less painful and shorter than the first episode.

There's no cure for herpes. Once someone has been infected with the herpes virus, it stays in the body. Medications can alleviate the discomfort of outbreaks or limit their frequency. But it's better to prevent herpes infections. Anyone having sex (oral, anal, or vaginal) should take precautions against STDs and get screened for them regularly.

Symptoms

Symptoms of herpes outbreaks typically begin with pain, tenderness, or itching in the genital area and may also include fever and headache. Bumps and blisters may appear on the vagina, penis, scrotum, anus, thigh, or buttocks. Blisters soon open to form painful sores that can last up to 3 weeks.

Other symptoms may include: pain or a burning sensation during urination; muscle aches; and tender, swollen glands in the groin area. After the first herpes infection, the virus can lie dormant without causing any symptoms. But the virus might reactivate later, leading to sores that usually don't last as long as those during the first outbreak. The virus tends to reactivate following some type of stress, like a cold, an infection, hormone changes, menstrual periods, or even before a big test at school.

After the herpes blisters disappear, a person may think the virus has gone away — but it's actually hiding in the body. Both HSV1 and HSV2 can stay hidden away in the body until the next herpes outbreak, when the virus reactivates itself and the sores return.

Contagiousness

Herpes is contagious and can be passed from person to person through any form of unprotected sex. This can occur even when there are no sores or blisters present. So people who are infected can unknowingly spread the infection to another person.

Treatment

To treat genital herpes, a doctor may prescribe an antiviral medicine in the form of an ointment or pills. These medications can't cure HSV2, but they can help make a person feel better and shorten the duration of outbreaks or prevent them.

If someone is being treated for herpes, any sexual partners should also be tested and, if necessary, treated, even if there are no symptoms. This will reduce their risk of developing serious complications of an undiagnosed infection or passing the infection to others. They should avoid sexual contact until they have completed the prescribed treatment.

Prevention

Because herpes is spread through sexual contact, the best way to prevent it is to abstain from having sex. Sexual contact with more than one partner or with someone who has more than one partner increases the risk of contracting any STD.

When properly and consistently used, condoms decrease the risk of STDs. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made of polyurethane, is also considered effective against STDs.

Using douche can actually increase a female's risk of contracting STDs because it can change the natural flora of the vagina and may flush bacteria higher into the genital tract.

A teen who is being treated for herpes also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it's important to encourage them to talk to a trusted adult who can provide the facts.

Because many STDs might not cause obvious symptoms, teens often don't know when they're infected. It's important for all teens who have had sex to get screened regularly for STDs so that they don't lead to other more serious health problems.

Getting Help

If your teen is thinking of becoming sexually active or already has started having sex, it's important to talk with him or her about it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don't have symptoms, so a partner might have an STD without knowing it.

It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It's also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual counseling centers in your local area also may be able to offer some guidance.

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Ascariasis

Ascariasis is an intestinal infection caused by a parasitic roundworm. While it is the most common human infection caused by worms in the world, ascariasis is not common in the United States. It occurs in varying prevalence worldwide, with far greater frequency in areas with poor sanitation or crowded living conditions.

Signs and Symptoms

Although no symptoms may occur, the greater the number of worms involved in the infestation, the more severe a child's symptoms are likely to be. Kids are more likely than adults to develop gastrointestinal symptoms because they have smaller intestines and are at greater risk of developing intestinal obstruction.

Symptoms seen with mild infestation include:

• worms in stool
• coughing up worms
• loss of appetite
• fever
• wheezing

More severe infestations can result in more serious signs and symptoms, including:

• vomiting
• shortness of breath
• abdominal distention (swelling of the abdomen)
• severe stomach or abdominal pain
• intestinal blockage
• biliary tract blockage (includes the liver and gallbladder)

Description

Ascariasis occurs when worm eggs of the parasite Ascaris lumbricoides commonly found in soil and human feces are ingested. The eggs can be transmitted from contaminated food, drink, or soil. The roundworms range in size from 5.9 to 9.8 inches for adult males and 9.8 to 13.8 inches for adult females. The worms can grow to be as thick as a pencil and can live for 1 to 2 years.

Ascariasis is frequently found in developing countries where sanitary conditions are poor or in areas where human feces are used as fertilizer. When the eggs are swallowed and passed into the intestine, they hatch into larvae. The larvae then begin to move through the body.

Once they get through the intestinal wall, the larvae travel from the liver to the lungs through the bloodstream. During this stage, pulmonary symptoms such as coughing (even coughing up worms) may occur. In the lungs, the larvae climb up through the bronchial tubes to the throat, where they are swallowed. The larvae then return to the small intestine where they grow, mature, mate, and lay eggs. The worms reach maturity about 2 months after an egg is ingested from the soil.

Adult worms live and remain in the small intestine. A female worm can produce up to 240,000 eggs in a day, which are then discharged into the feces and incubate in the soil for weeks. Children are particularly susceptible to ascariasis because they tend to put things in their mouths, including dirt, and they often have poorer hygiene habits than adults.

Ascariasis is common in warmer or tropical climates, particularly in developing nations, where it can affect large segments of the population. Ascariasis is rare in the United States, due to strict sanitation rules and regulations.

Contagiousness

Ascariasis is not spread directly from one person to another. To become infected, an individual has to consume the worm's eggs.

Prevention

The most important measure of protection against ascariasis is the safe and sanitary disposal of human waste, which can transmit eggs. Areas of the world that use human feces as fertilizer must thoroughly cook all foods or clean them with a proper iodine solution (particularly fruits and vegetables).

Children who are adopted from developing nations are frequently screened for worms as a precautionary measure. Kids who live in underdeveloped areas of the world may be prescribed a preventive deworming medication.

These practices are recommended for all children:

• Try as much as possible to keep kids from putting things in their mouths.
• Teach kids to wash hands thoroughly and frequently, especially after using the bathroom and before eating.

Professional Treatment

The doctor will usually prescribe antiparasitic medication to be taken orally to kill the intestinal roundworms. Sometimes the stool will be re-examined about 3 weeks after treatment to check for eggs and worms. Symptoms usually disappear within 1 week of starting treatment.

Very rarely, surgical removal of the worms may be necessary (particularly in cases of intestinal or liver-related obstruction, or abdominal infection). A child who has ascariasis should be evaluated for other intestinal parasites, such as pinworm.

Home Treatment

If your child has ascariasis, the medication prescribed should be administered accordingly. To prevent reinfection:

• Ensure that your child washes his or her hands properly, particularly after using the bathroom and before eating.
• Have your pets checked for worms regularly.
• Keep your child's fingernails short and clean.
• Sterilize any contaminated clothing, pajamas, and bedding.
• Evaluate the source of the infection. Additional sanitation measures in or around your home may be necessary.

When to Call the Doctor

If your child has any of the symptoms of ascariasis, contact your doctor right away. Stool samples will be sent to a laboratory to check for eggs and worms and confirm the diagnosis.

Call the doctor if symptoms do not improve with treatment or if new symptoms occur.

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Bronchiolitis

Bronchiolitis is a common illness of the respiratory tract caused by an infection that affects the tiny airways, called the bronchioles, that lead to the lungs. As these airways become inflamed, they swell and fill with mucus, making breathing difficult.

Bronchiolitis:

• most often affects infants and young children because their small airways can become blocked more easily than those of older kids or adults
• typically occurs during the first 2 years of life, with peak occurrence at about 3 to 6 months of age
• is more common in males, children who have not been breastfed, and those who live in crowded conditions

Day-care attendance and exposure to cigarette smoke also can increase the likelihood that an infant will develop bronchiolitis.

Although it's often a mild illness, some infants are at risk for a more severe disease that requires hospitalization. Conditions that increase the risk of severe bronchiolitis include prematurity, prior chronic heart or lung disease, and a weakened immune system due to illness or medications.

Kids who have had bronchiolitis may be more likely to develop asthma later in life, but it's unclear whether the illness causes or triggers asthma, or whether children who eventually develop asthma were simply more prone to developing bronchiolitis as infants. Studies are being done to clarify the relationship between bronchiolitis and the later development of asthma.

Bronchiolitis is usually caused by a viral infection, most commonly respiratory syncytial virus (RSV). RSV infections are responsible for more than half of all cases of bronchiolitis and are most widespread in the winter and early spring. Other viruses associated with bronchiolitis include rhinovirus, influenza (flu), and human metapneumovirus.

Signs and Symptoms

The first symptoms of bronchiolitis are usually the same as those of a common cold:

• stuffiness
• runny nose
• mild cough
• mild fever

These symptoms last a day or two and are followed by worsening of the cough and the appearance of wheezes (high-pitched whistling noises when exhaling).

Sometimes more severe respiratory difficulties gradually develop, marked by:

• rapid, shallow breathing
• a rapid heartbeat
• drawing in of the neck and chest with each breath, known as retractions
• flaring of the nostrils
• irritability, with difficulty sleeping and signs of fatigue or lethargy

The child may also have a poor appetite and may vomit after coughing. Less commonly, babies, especially those born prematurely, may have episodes where they briefly stop breathing (this is called apnea) before developing other symptoms.

In severe cases, symptoms may worsen quickly. A child with severe bronchiolitis may tire from the work of breathing and have poor air movement in and out of the lungs due to the clogging of the small airways. The skin can turn blue (called cyanosis), which is especially noticeable in the lips and fingernails. The child also can become dehydrated from working harder to breathe, vomiting, and taking in less during feedings.

Contagiousness

The infections that cause bronchiolitis are contagious. The germs can spread in tiny drops of fluid from an infected person's nose and mouth, which may become airborne via sneezes, coughs, or laughs, and also can end up on things the person has touched, such as used tissues or toys.

Infants in child-care centers have a higher risk of contracting an infection that may lead to bronchiolitis because they're in close contact with lots of other young children.

Prevention

The best way to prevent the spread of viruses that can cause bronchiolitis is frequent hand washing. It may help to keep infants away from others who have colds or coughs. Babies who are exposed to cigarette smoke are more likely to develop more severe bronchiolitis compared with those from smoke-free homes. Therefore, it's important to avoid exposing children to cigarette smoke.

Although a vaccine for bronchiolitis has not yet been developed, a medication can be given to lessen the severity of the disease. It contains antibodies to RSV and is injected monthly during peak RSV season. The medication is recommended only for infants at high risk of severe disease, such as those born very prematurely or those with chronic lung disease.

Incubation

The incubation period (the time between infection and the onset of symptoms) ranges from several days to a week, depending on the infection causing the bronchiolitis.

Duration

Cases of bronchiolitis typically last about 12 days, but kids with severe cases can cough for weeks. The illness generally peaks on about the second to third day after the child starts coughing and having difficulty breathing and then gradually resolves.

Professional Treatment

Fortunately, most cases of bronchiolitis are mild and require no specific professional treatment. Antibiotics aren't useful because bronchiolitis is caused by a viral infection, and antibiotics are only effective against bacterial infections. Medication may sometimes be given to help open a child's airways.

Infants who have trouble breathing, are dehydrated, or appear fatigued should always be evaluated by a doctor. Those who are moderately or severely ill may need to be hospitalized, watched closely, and given fluids and humidified oxygen. Rarely, in very severe cases, some babies are placed on respirators to help them breathe until they start to get better.

Home Treatment

The best treatment for most kids is time to recover and plenty of fluids. Making sure a child drinks enough fluids can be a tricky task, however, because infants with bronchiolitis may not feel like drinking. They should be offered fluids in small amounts at more frequent intervals than usual.

Indoor air, especially during winter, can dry out airways and make the mucus stickier. Some parents use a cool-mist vaporizer or humidifier in the child's room to help loosen mucus in the airway and relieve cough and congestion. If you use one, clean it daily with household bleach to prevent mold from building up. Avoid hot-water and steam humidifiers, which can be hazardous and can cause scalding.

To clear nasal congestion, try a bulb syringe and saline (saltwater) nose drops. This can be especially helpful just before feeding and sleeping. Sometimes, keeping the child in a slight upright position may help improve labored breathing. Give acetaminophen to reduce fever and make the child more comfortable.

When to Call the Doctor

Call your doctor if your child:

• is breathing quickly, especially if this is accompanied by retractions or wheezing
• might be dehydrated due to poor appetite or vomiting
• is sleepier than usual
• has a high fever
• has a worsening cough
• appears fatigued or lethargic

Seek immediate help if you feel your child is having difficulty breathing and the cough, retractions, or wheezing are getting worse, or if his or her lips or fingernails appear blue.

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Tinea (Ringworm, Jock Itch, Athlete's Foot)

If your kids are active, locker-room showers and heaps of sweaty clothes probably are part of their everyday lives — and so is the risk of getting fungal skin infections.

Jock itch, athlete's foot, and ringworm are all types of fungal skin infections known collectively as tinea. They're caused by fungi called dermatophytes that live on skin, hair, and nails and thrive in warm, moist areas.

Symptoms of these infections can vary depending on where they appear on the body. The source of the fungus might be soil, an animal (most often a cat, dog, or rodent), or in most cases, another person. Minor trauma to the skin (such as scratches) and poor skin hygiene increase the potential for infection.

It's important to teach kids to take precautions to prevent fungal skin infections, which can be itchy and uncomfortable. If they do get one, most can be treated with over-the-counter medication, though some might require treatment by a doctor.

Ringworm

Ringworm isn't a worm, but a fungal infection of the scalp or skin that got its name from the ring or series of rings that it can produce.

Symptoms of Ringworm

Ringworm of the scalp may start as a small sore that resembles a pimple before becoming patchy, flaky, or scaly. These flakes may be confused with dandruff. It can cause some hair to fall out or break into stubbles. It can also cause the scalp to become swollen, tender, and red.

Sometimes, there may be a swollen, inflamed mass known as a kerion, which oozes fluid. These symptoms can be confused with impetigo or cellulitis. The distinctive features of ringworm are itching, redness on the skin, and a circular patchy lesion that spreads along its borders and clears at the center.

Ringworm of the nails may affect one or more nails on the hands or feet. The nails may become thick, white or yellowish, and brittle.

If you suspect that your child has ringworm, call your doctor.

Treating Ringworm

Ringworm is fairly easy to diagnose and treat. Most of the time, the doctor can diagnose it by looking at it or by scraping off a small sample of the flaky infected skin to test for the fungus. The doctor may recommend an antifungal ointment for ringworm of the skin or an oral medication for ringworm of the scalp and nails.

Preventing Ringworm

A child usually gets ringworm from another infected person, so it's important to encourage kids to avoid sharing combs, brushes, pillows, and hats with others.

Jock Itch

Jock itch, an infection of the groin and upper thighs, got its name because cases are commonly seen in active kids who sweat a lot while playing sports. But the fungus that causes the jock itch infection can thrive on the skin of any kids who spend time in hot and humid weather, wear tight clothing like bathing suits that cause friction, share towels and clothing, and don't completely dry off their skin. It can last for weeks or months if it goes untreated.

Symptoms of Jock Itch

Symptoms of jock itch may include:

• itching, chafing, or burning in the groin, thigh, or anal area
• skin redness in the groin, thigh, or anal area
• flaking, peeling, or cracking skin

Treating Jock Itch

Jock itch can usually be treated with over-the-counter antifungal creams and sprays. When using one of these, kids should:

• Wash and then dry the area with a clean towel.
• Apply the antifungal cream, powder, or spray as directed on the label.
• Change clothing, especially the underwear, every day.
• Continue this treatment for 2 weeks, even if symptoms disappear, to prevent the infection from recurring.

If the ointment or spray is not effective, call your doctor, who can prescribe other treatment.

Preventing Jock Itch

Jock itch can be prevented by keeping the groin area clean and dry, particularly after showering, swimming, and sweaty activities.

Athlete's Foot

Athlete's foot typically affects the soles of the feet, the areas between the toes, and sometimes the toenails. It can also spread to the palms of the hands, the groin, or the underarms if your child touches the affected foot and then touches another body part. It got its name because it affects people whose feet tend to be damp and sweaty, which is often the case with athletes.

Symptoms of Athlete's Foot

The symptoms of athlete's foot may include itching, burning, redness, and stinging on the soles of the feet. The skin may flake, peel, blister, or crack.

Treating Athlete's Foot

A doctor can often diagnose athlete's foot simply by examining the foot or by taking a small scraping of the affected skin to detect the presence of the fungus that causes athlete's foot.

Over-the-counter antifungal creams and sprays may effectively treat mild cases of athlete's foot within a few weeks. Athlete's foot can recur or be more serious. If that's the case, ask your doctor about trying a stronger treatment.

Preventing Athlete's Foot

Because the fungus that causes athlete's foot thrives in warm, moist areas, infections can be prevented by keeping feet and the space between the toes clean and dry.

Athlete's foot is contagious and can be spread in damp areas, such as public showers or pool areas, so it's wise to take extra precautions. Encourage kids to:

• wear waterproof shoes or flip-flops in public showers, like those in locker rooms
• alternate shoes or sneakers to prevent moisture buildup and fungus growth
• avoid socks that trap moisture or make the feet sweat and instead choose cotton or wool socks or socks made of fabric that wicks away the moisture
• choose sneakers that are well ventilated with small holes to keep the feet dry

By taking the proper precautions and teaching them to your kids, you can prevent these uncomfortable skin infections from putting a crimp in your family's lifestyle.

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