Childhood Diseases

Also indexed as: Chicken Pox, Erythema infectiosum, Fifth Disease, German Measles, Roseola infantum, Rubella, Scarlet Fever

Some of the most common illnesses of childhood cause skin eruptions and are known as exanthems. The childhood exanthems include rubeola (measles), rubella (German measles), chicken pox, erythema infectiosum (fifth disease), and roseola infantum, all of which are viral infections, as well as scarlet fever, a bacterial infection. All of these infections affect the respiratory system and are highly contagious. Children with these illnesses usually recover fully even without treatment; however, all of these conditions carry the possibility of severe complications, such as pneumonia, heart and kidney damage, and encephalitis (inflammation of the brain). Vaccinations and other changes in modern lifestyle have rendered several of these previously common illnesses virtually nonexistent in the developed world, though they are widespread and remain a major cause of childhood deaths in other parts of the world.

Checklist for Childhood Diseases

Rating Nutritional Supplements Herbs
3Stars Vitamin A  
1Star Quercetin
Selenium
Vitamin C
Vitamin E
Zinc		  
3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

What are the symptoms of childhood diseases? Children with a childhood disease may have symptoms including muscle aches, fatigue, fever, coughing, sneezing, sore throat, runny nose, nausea, and vomiting. There may also be an itchy skin rash with red bumps that may look like blisters.

How is it treated? Children with an exanthem are commonly advised to rest and drink plenty of fluids. Doctors may also recommend limiting contact with other children to prevent transmission of the disease. Antiviral medicines such as acyclovir may be prescribed. Antibiotics may also be recommended in some people to prevent a bacterial infection. Aspirin-containing products are not given to children who have a fever and are under the age of 19, because their use in these circumstances has been linked to an increased risk of Reye’s syndrome, a potentially serious illness that can affect the liver and brain.

Dietary changes that may be helpful: Children who suffer from malnutrition have weakened immune systems and are more likely to acquire exanthemous infections and to experience more severe illness from them. Malnutrition contributes to half of all childhood deaths from infectious diseases worldwide.1 Measles, a common childhood viral infection, is more likely to result in permanent blindness and is more likely to be fatal in children with poor nutritional status.2 3 Measles vaccinations are less effective in children who are malnourished.4 5

Nutritional supplements that might be helpful: Preliminary research shows that supplemental vitamin A improves the likelihood that the measles vaccine will provide protection.6 Vitamin A has, since the 1920s, been the subject of much research into the prevention and treatment of childhood exanthems, particularly measles.7 This nutrient has a critical role in proper immune function, and there is evidence that supplementation with vitamin A reduces the incidence and severity of, and deaths from, childhood measles.8 9 The World Health Organization (WHO) has therefore recommended that children with signs of deficiency receive supplementation with vitamin A. The recommended amounts are 100,000 IU for children younger than one year and 200,000 IU for children older than one year, immediately upon diagnosis, and repeated once the next day and once in one to four weeks.10 A controlled trial of African children given vitamin A supplementation according to the WHO’s recommendations found that severity of measles and its long-term consequences were reduced by 82% on day eight, 61% in week six, and 85% six months after the onset.11

Another controlled trial found that giving approximately 200,000 IU of vitamin A once during measles illness was not adequate to provide any benefit in African children whose vitamin A status was unknown.12 In a controlled prevention study, Indian children treated with 2,500 mcg (8,333 IU) of vitamin A weekly had fewer measles complications and less than half of the rate of death as compared with children receiving placebo;13 but in another study, Indian children receiving 200,000 IU of vitamin A every six months did not have a different rate of total infectious illness nor rate of death as compared with children receiving placebo.14

An analysis of 20 controlled trials concluded that vitamin A supplementation reduced deaths from measles respiratory infection by 70%.15 While vitamin A deficiency is widespread in developing countries, it has also been reported in the United States and has been linked with more severe cases of measles.16 The American Academy of Pediatrics has recommended supplementation with vitamin A for children between the ages of six months and two years who are hospitalized with measles and its complications. The recommended amount is a single administration of 100,000 IU for children aged 6 to 12 months and 200,000 IU for children older than 1 year, followed by a second administration 24 hours later and a third after four weeks in children who are likely to have vitamin A deficiency.17

One trial showed that low levels of vitamin A are more prevalent in children with measles than in similar children without measles, with levels rising back to normal several days after the onset of the infection. This observation led the authors of the study to conclude that vitamin A deficiency is a consequence of infection with the measles virus and to recommend supplementation with vitamin A during measles infection even when prior deficiency is not suspected.18 Vitamin A stores have also been shown to be depleted during chicken pox infection,19 and some preliminary data supports its use in treatment of chicken pox. In a controlled trial, in which children without vitamin A deficiency were given either 200,000 IU of vitamin A or placebo one time during chicken pox, the children given vitamin A had shorter duration of illness and fewer severe complications. The researchers then treated the patients’ siblings with vitamin A before chicken pox became evident, and they had an even shorter length of illness.20

Selenium is a mineral known to have antioxidant properties and to be involved in healthy immune system activity. Recent animal and human research suggests that selenium deficiency increases the risk of viral infection and that supplementation prevents viral infection.21 22 23 24 25 In a controlled trial, children with a specific viral infection (respiratory syncytial virus) who received a single supplement of 1 mg (1,000 mcg) of sodium selenite (a form of selenium) recovered more quickly than children who did not receive selenium.26 While it is possible that childhood exanthemous viral infections might similarly be more severe in selenium-deficient children and helped through supplementation, none of the current research involves these specific viruses.

Zinc is another mineral antioxidant nutrient that the immune system requires. Zinc deficiency results in lowered immune defenses, and zinc supplementation increases immune activity in people with certain illnesses.27 As with vitamin A, zinc levels have been observed to fall during the early stages of measles infection and to return to normal several days later.28 There is evidence that zinc supplements are helpful in specific viral infections,29 30 31 but there are no data on the effect of zinc on childhood exanthemous infections.

Vitamin C has been demonstrated in test tube, animal, and human studies to have immune-enhancing and direct antiviral properties.32 Preliminary observations made on the effect of vitamin C on viral infections have involved both measles and chicken pox.33 An active immune system uses vitamin C rapidly, and blood levels fall in children with bacterial or viral infections.34 Reduced immune cell activity has been observed in people with measles, but in one preliminary study, supplementation with 250 mg daily of vitamin C in children 18 months to 3 years old had no impact on the course of the illness.35 The authors of this study admit that this amount of vitamin C may have been too low to bring about an observable increase in immune cell activity and thus an increase in speed of recovery.

Healthy immune function also requires adequate amounts of vitamin E. Vitamin E deficiency is associated with increased severity of viral infections in mice.36 37 38 Supplementation with vitamin E during viral infections has been shown to increase immune cell activity39 and reduce virus activity40 in mice. Research into the effects of vitamin E supplementation on childhood exanthems has not been done.

Flavonoids are a group of compounds found in some plant foods and medicinal herbs. An antiviral action of some flavonoids has been observed in a number of test tube experiments.41 42 43 44 45 Quercetin, one of the flavonoids, has shown particularly strong antiviral properties in the test tube;46 47 48 however, one study did not find quercetin to be of benefit to mice with a viral infection.49 It is not known whether flavonoids can be absorbed in amounts sufficient to exert an antiviral effect in humans, and therefore their possible role in the treatment of childhood exanthems remains unknown.

Are there any side effects or interactions? Refer to the individual supplement for information about any side effects or interactions.

References:

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12. Rosales FJ, Kjolhede C. A single 210-mumol oral dose of retinol does not enhance the immune response in children with measles. J Nutr 1994;124:1604–14.

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29. Mocchegiani E, Muzzioli M. Therapeutic application of zinc in human immunodeficiency virus against opportunistic infections. J Nutr 2000;130:1424S–31S.

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38. Beck MA, Levander OA. Dietary oxidative stress and the potentiation of viral infection. Annu Rev Nutr 1998;18:93–116.

39. Han SN, Wu D, Ha WK, et al. Vitamin E supplementation increases T helper 1 cytokine production in old mice infected with influenza virus. Immunology 2000;100:487–93.

40. Hayek MG, Taylor SF, Bender BS, et al. Vitamin E supplementation decreases lung virus titers in mice infected with influenza. J Infect Dis 1997;176:273–6.

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42. Debiaggi M, Tateo F, Pagani L, et al. Effects of propolis flavonoids on virus infectivity and replication. Microbiologica 1990;13:207–13.

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44. Amoros M, Simoes CM, Girre L, et al. Synergistic effect of flavones and flavonols against herpes simplex virus type 1 in cell culture. Comparison with the antiviral activity of propolis. J Nat Prod 1992;55:1732–40.

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46. Kaul TN, Middleton E Jr, Ogra PL. Antiviral effect of flavonoids on human viruses. J Med Virol 1985;15:71–9.

47. Mucsi I, Pragai BM. Inhibition of virus multiplication and alteration of cyclic AMP level in cell cultures by flavonoids. Experientia 1985;41:930–1.

48. Ohnishi E, Bannai H. Quercetin potentiates TNF-induced antiviral activity. Antiviral Res 1993;22:327–31.

49. Esanu V, Prahoveanu E, Crisan I, Cioca A. The effect of an aqueous propolis extract, of rutin and of a rutin-quercetin mixture on experimental influenza virus infection in mice. Virologie 1981;32:213–5.