Travel with children are rewarding, but the responsibility for observing signs and symptoms and providing treatment without medical advice are bigger.
It is rewarding to travel with children. It easier to get into contact with the local population and in general children tolerates well a warm and humid climate. Children are exposed to the same diseases as adults, but small children cannot complain of specific signs and symptoms. Children at school age often get local friends easily, and may therefore be exposed to other environments than their parents.
Medical assistance In areas, where there is no rapid and easy access to qualified medical care the parents have more responsibility than at home for observing and perhaps diagnosing and treating their sick child. Most of us know well when our children are ill. A tired child who looks miserable, do not have the usual appetite or cries more than usual may be signs that the child is not well. The child may feel hot, cough or sneeze symptoms most parents recognise.
Fever It is not possible to give an exhaustive list of diseases, which may cause fever. The important thing is to keep observing the febrile child, does it drink (if it does it also urinate) and can we communicate i.e. is the child awake. Any type of rash should always be observed. In hot and humid climates, it may be difficult to feel if the child has fever or is just generally hot because of the weather. It is therefore important to be able to take a body temperature and a thermometer is a must in the household with children. The digital thermometers which measure the temperature in the ear, mouth or arm pit are all well suited and dependable and do not frighten the child as much as the conventional rectal thermometer.
Treatment of uncomplicated fever Most febrile illnesses are virus infections, which usually pass over in a few days without specific treatment. The most important treatment is sufficient fluid, and the best way to measure this is to ensure that the child is urinating regularly. Fluid deficit will make the child even more tired and difficult to contact. Febrile seizures Seizures due to fever are not unusual and are not normally dangerous, however, it is an unpleasant experience. febrile seizures are seen in the age group 1 to 4 years and the treatment is:
Cooling for instance by covering the child with a towel soaked in cold water.
Ensuring sufficient ventilation in the room for instance by using an electric fan.
If the seizures do not stop within a few minutes under this treatment, it is necessary to seek medical advice.
Malaria We are used to think about a number of diseases when our children get fever, but malaria is not one of them. In areas with malaria, it is an infection, which we need to keep in mind every time our children get sick. It is difficult to get children to take malaria drugs, and the efficacy is reduced if the child do not get every dose or if half the dose is not swallowed. Fever is the only symptom in the beginning and small children cannot complain of headache and muscle pain. If there is not other obvious explanation for the fever, examination of a thick and thin blood film is necessary and should be done at most not more than 2 days after the fever started so not to miss an infection. If the first microscopy is negative and the fever continues, three blood films should be examined with not more than 24 hours in between before the diagnosis is disregarded. Concomitant intake of malaria drugs may blur the diagnosis and should be kept in mind when interpreting the results of the microscopy.