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Down The Hatch

By Dr. Scott Hamilton
May 27, 2021
Hamilton Blog Headshot Updated 12.21.21

This week's guest columnist is Dr. Tasia Bradley, a Family Practice resident at the University Hospital and Clinics here in Lafayette.

Remember "Show and Tell" from grade school? In fourth grade, I had a classmate bring in his pet soft-shell turtle, named Eric. He took Eric out of his aquarium to crawl on the table. Then he flipped Eric on his back. That seemed mean, but then we learned that soft-shell turtles can stretch their neck out far enough to push on the ground and flip themselves over. Flip!- back went Eric onto his feet.

Another thing we learned about turtles, Eric's owner in particular, is that they carry a bacteria called Salmonella. Salmonella contaminates many foods, like eggs and raw chicken; besides pets like turtles and snakes. Salmonella causes gastroenteritis, a.k.a. "stomach bug," with vomiting and diarrhea. Usually the symptoms only last a few days, but diarrhea from salmonella can sometimes go for 10 days. Though it's a bacteria, antibiotics are seldom necessary- it's usually gone before you can get a prescription filled, much less by the time tests on your kid's poop come back to show it's salmonella.

Though salmonella is a risk when chicken or eggs are under-cooked, children can get it from mud puddles, petting zoos, and show-and-tells like above. Kids touch contaminated raw egg, unwashed cutting boards, mud puddles, or turtles; a little while later put their fingers in their mouths, and bingo!  8 to 72 hours later, they're running for the toilet. We haven't seen salmonella for the past year or so, given our COVID precautions. Kids have had cleaner hands and mask-covered mouths to prevent picking up and transmitting salmonella. However, now that we're all relaxing some, we're bound to start seeing it again.

Make sure your kids are still practicing good hand hygiene, especially if they encounter Eric the Turtle!

Did this 8 year-old have leprosy?  The school sure acted like it! Mom thought her 6 year-old boy just had a runny, crusty nose from a cold virus.  But when the crust involved his upper lip, chin, and cheeks, mom got a stern call about sending her son to school like that. To hear them tell it, he should have acted like a biblical leper, wearing torn clothes and shouting "unclean" to other passersby on the road to Jerusalem. But the boy did have more than just a runny nose. The lesions on his face were red, with a honey-colored crust on them. Diagnosis: Impetigo, a.k.a  Indian Fire. Impetigo is a bacterial skin infection. If a child's face gets the bacteria on it and the skin has a break in it, like with a scratch or mosquito bite, the bacteria invades the defect and spreads.

Like with salmonella above, kids catch impetigo by putting contaminated hands on their faces and in their mouths and noses. While they pick up salmonella from turtles and raw eggs and chicken, they pick up impetigo bacteria from other kids. The school therefore wasn't entirely wrong to suggest mom get the kid seen- impetigo just isn't a community-threatening scourge like ancient leprosy. Treatment is easy: we prescribe an antibiotic cream which kills the bacteria and keeps children from spreading it to other parts of their bodies, or to other kids. Prevention is even easier- make sure kids wash their hands or use hand sanitizer frequently, and not touch each other (good luck on that one!). As you might guess, we've seen about zero impetigo during COVID, but as everyone is now relaxing their hand hygiene, we're seeing it again. Unclean!