Disease of the Month: Childhood Diseases / Conditions

The term ‘childhood disease' is sometimes a subjective one, and does not refer to an accepted, categorical list. Adults can also contract nearly all the diseases that affect children, and all children can contract diseases not necessarily categorised as ‘childhood diseases.'

Bacteria and viruses are two distinct causes for infections in children. Doctors recommend breastfeeding because the natural antibodies found in breast milk protects babies against many of them, in addition to administering vaccines against some highly infectious diseases (such as measles, whooping cough and mumps, which are now much less prevalent among school aged children as a result).

It can be difficult for parents to distinguish between a common illness and a serious illness, with many parents inclined to overlook symptoms or worry that simple illnesses are worse than they are.

Ear infections

Ear infections are common in children because of the structure of the ear tubes. Bacteria enter the ear tubes because of a common cold, allergy or sinus infection. Symptoms may include earache, reduced hearing, tinnitus and fever.

Middle ear infections are most common in children aged six months to five years. Otitis media is a viral or bacterial middle ear infection and otitis externa is a viral or fungal infection of the external ear and ear canal, also known as swimmers ear that can reoccur. They are generally not serious.

Mumps

Mumps is a contagious viral infection that used to be common in children. It is most recognisable by the painful swellings at the side of the face under the ears (the parotid glands), giving a person with mumps a distinctive "hamster face" appearance.

Other symptoms include headache, joint pain and a high temperature, which may develop a few days before the swelling of the parotid glands. Both glands are usually affected by the swelling, although only one gland can be affected. The swelling can cause pain, tenderness and difficulty with swallowing.

Measles

Measles is a highly infectious viral illness that can be very unpleasant and can sometimes lead to serious complications. Fortunately, it is now uncommon in the UK because of the effectiveness of the MMR (Mumps, Measles and Rubella) vaccination.

After infection, the initial symptoms of measles develop around ten days and can include cold-like symptoms, red eyes and sensitivity to light, a high temperature, tiredness, a dry cough and tiny greyish-white spots (called Koplik's spots) in the mouth and throat.

The initial symptoms are then followed by a red-brown spotty rash that develops a few days later and lasts about a week.

Rubella

Rubella (also known as German measles) is a viral infection that used to be common in children. It is usually a mild condition that gets better without treatment in seven to ten days. A rash and swelling around the neck and head are common signs of the condition.

The rubella rash is typically a red-pink colour. The rash usually starts behind the ears, before spreading around the head and neck. It may then spread to the trunk, legs and arms.

In most cases, the rash will disappear by itself within three to five days. The lymph glands behind the ears, at the back of the head, and in the neck usually swell and can be painful.

Chickenpox

Chickenpox is a viral infection in which a person develops extremely itchy blisters all over the body. It used to be one of the classic childhood diseases. However, it has become much less common since the introduction of the chickenpox vaccine.

Chickenpox is caused by the varicella-zoster virus, a member of the herpes virus family. The same virus also causes herpes zoster (shingles) in adults. Most cases of chickenpox occur in children younger than ten.

The disease is usually mild, although serious complications sometimes occur. Adults and older children usually get sicker than younger children.

‘Fifth' disease (commonly known as ‘slapped cheek syndrome')

Fifth disease usually occurs in children aged two to twelve years and is more common during the spring. The condition is due to a viral infection and the child will sometimes initially develop mild flu-like symptoms, such as a sore throat, joint pains and headache, as well as one or two red cheeks, as if slapped. It can last for up to fourteen days.

Hand, foot and mouth disease

This condition can be due to a number of different enteroviruses (a group of viruses that include the poliovirus), causing the child to develop a large number of small spots and blisters, particularly in the mouth and on the feet and hands.

The disease can cause a fever that lasts for a few days. The disease is contagious as long as the blisters and spots are still present. Once the rash has disappeared, the child is able to return to school / childcare once they are considered well enough to do so.

Epilepsy

Epilepsy is a disease of the central nervous system in which electrical signals of the brain misfire. These disruptions cause temporary communication problems between the nerve cells, leading to seizures.

A seizure can be thought of as an ‘electrical storm' that causes the brain to do things that the person having the seizure does not intend. Anyone can suffer epilepsy at any age, but the majority of new diagnoses are in children.

About two-thirds of all children with epilepsy outgrow the seizures that accompany the disease by the time they are in their teens.

• Underwriting considerations (in adulthood) will include the period since the onset of the disease, the type of epilepsy (e.g. petit mal or grand mal), the date of the last seizure, any underlying cause, frequency of seizures and how well seizures are controlled with medication.
Scarlet fever

Scarlet fever is a bacterial illness that causes a distinctive pink-red rash. Other symptoms include a high temperature, a flushed face and a red, swollen tongue. Although this is a highly contagious bacterial infection, it is now uncommon in the UK and is usually mild.

Children between the ages of four and eight years are more usually affected. Once they have reached the age of ten, most children have developed a natural immunity to the toxins.

Meningitis

Meningitis is an infection of the meninges (protective membranes) that surround the brain and spinal cord. Although anyone of any age can get meningitis, babies and young children are often affected.

Bacterial meningitis is the more serious form of the condition and has a number of early warning signs that include pain in the muscles, joints or limbs, such as in the legs or hands, unusually cold hands and feet, or shivering and pale or blotchy skin and blue lips. The presence of a high temperature (fever) with any of the above symptoms should be taken seriously.

• Underwriting considerations (in adulthood) will include the period that has elapsed since full recovery and whether there are any residual complications. Terms can usually be offered for both Life and Critical Illness covers.

Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis (JIA), also known as juvenile rheumatoid arthritis, is the most common form of arthritis in children and adolescents. JIA is the umbrella term under which several forms of chronic arthritis in children are categorised. The cause(s) are not well understood.

The disease commonly occurs in children from the ages of seven to twelve, but it may occur in adolescents as old as fifteen years of age, as well as in infants. Both environmental and genetic influences are felt to contribute to the development of signs and symptoms of JIA.

Paediatric rheumatologists can help to limit the possibility of complications of juvenile idiopathic arthritis including leg-length discrepancy, joint contractures and blindness due to inflammation of the eye (iritis).

• Underwriting considerations (in adulthood) will include whether the disease is currently active or inactive, the period that has elapsed since recovery, the period for which the disease has been dormant, any joint damage, any limitation of function and any treatment, and current blood profile.

Rheumatic fever

Rheumatic fever and rheumatic heart disease continue to be a major health hazard in most developing countries as well as sporadically in developed economies. Rheumatic fever particularly affects children, and less often young adults. It is an inflammatory disease that can involve the heart, joints, skin, and brain.

The illness typically develops two to three weeks after a streptococcal infection. Acute rheumatic fever commonly appears in children between the ages of six and fifteen.

The most serious effect of rheumatic fever is the permanent damage it can do to the heart, usually consisting of endocarditis.

• Underwriting considerations (in adulthood) will be for any complications arising out of the disease such as damage to the mitral valve (prolapse), the age of the applicant at the time of application, the extent to which the valve has been damaged and whether the valve has been surgically repaired or replaced.

Leukaemia

Although approximately ten times more adults than children have leukaemia, it is the most common cancer among children, with acute lymphoblastic leukaemia (ALL) accounting for approximately seventy five percent of all childhood leukaemias.

ALL is an acute form of leukaemia, characterised by the overproduction of cancerous white blood cells known as lymphoblasts. In ALL, lymphoblasts are overproduced in the bone marrow and continuously multiply, causing damage and death by inhibiting the production of normal cells, such as red and white blood cells and platelets in the bone marrow and by spreading (infiltrating) to other organs.

ALL is most common in childhood with a peak incidence at two - five years of age, and another peak in old age.

• Underwriting considerations (in adulthood) include the age at onset of the disease, the period that has elapsed since recovery (remission), treatment (e.g. chemotherapy, successful bone marrow transplant), confirmation of regular follow-ups with the results of investigations to check for recurrence or complications and current blood profile.

In most cases, terms will not be offered for Critical Illness Cover, although some insurers may offer Critical Illness with a cancers benefit exclusion.

David Jones is strategic claims manager at VitalityLife (formerly PruProtect)