Heat Illnesses

by Sarah Givner, MD, MPH

The summer sun in all its glory gives rise to hot, hot weather and consequently, heat-related illnesses. Heat illnesses are those conditions brought about by prolonged exposure to heat and humidity without adequate hydration to cool the body down. They include heat cramps, heat exhaustion and heat stroke. Children and adolescents adjust to environmental changes more slowly than do adults and tend to bear the brunt of these illnesses.

Heat Cramps

Heat cramps are the mildest form of the heat-related illnesses. They are painful spasms and cramps that occur after exercise in high heat conditions. Skin is typically flushed and moist when they occur.

If your child is suffering from heat cramps, stop activity participation, move to a cool, shaded place and rest. Remove excess clothing, fan skin and place cool compresses on the body. Drink chilled sports drinks containing a mixture of salt and sugar (Pedialyte, Gatorade, Powerade) and stretch out the affected muscles gently and slowly.

Heat Exhaustion

Heat exhaustion is more severe than heat cramps and results when the body is unable to cool itself properly. It results from water and salt loss in conditions of extreme heatand excess sweating without adequate fluid and electrolyte re-hydration.

Symptoms include muscle cramps, pale (as opposed to flushed) and moist skin, fever over 100.4 F, nausea, vomiting, diarrhea, headache, fatigue, weakness, anxiety and feeling faint.

If your child is suffering from heat exhaustion, again, stop activity participation, move to a cool, shaded place and rest. Remove excess clothing, fan skin and place cool compresses on the body. Drink chilled sports drinks containing a mixture of salt and sugar. If this is insufficient, or your child is unable to keep fluids down, go to the emergency room immediately. IV fluids may be required.

Heat Stroke

Heat stroke is the most severe of the heat illnesses and occurs when the body’s thermoregulation system is overwhelmed by the extreme heat. It is a life-threatening medical emergency and requires immediate attention.

Symptoms include warm, pale and dry (as opposed to moist) skin, high fever (>104 F), rapid heart rate, loss of appetite, nausea, vomiting, headache, fatigue, confusion, agitation, lethargy, stupor and seizures.

If you believe your child is suffering from heat stroke, call 911 or your local emergency medical services IMMEDIATELY. In the interim, remove excess clothing, DRENCH skin with cool water and fan skin. Place ice bags under armpits and in the groin. Offer chilled fluids, if your child is alert and able to drink.

Ways to Avoid Heat Illnesses (or as they say, an ounce of prevention is worth a pound of cure)

  • Drink plenty of fluids during both strenuous and non-strenuous (such as sunbathing!) outdoor activities on hot days. Drink water and sports drinks (again with a mix of salts and sugars). Avoid alcoholic and caffeinated beverages (tea, coffee, soda) as they can be dehydrating.
  • Dress in light-colored, lightweight and loose-fitting clothes on hot, humid days
  • Schedule vigorous outdoor activities outside peak sun hours – go in the morning, late afternoon or evening
  • Take shaded (and frequent!) rest brakes
  • Wear sunscreen (at least SPF 15), a hat and sunglasses
  • Have kids mist themselves, go swimming, or play in splash pads during the day

Lastly, enjoy the heat! And be safe!


Fight the Flu

This winter started with a wimper. We didn’t see many cases of the flu, colds or other ailments compared to years past. However, since the end of January, flu has made its presence known. We went from a trickle of flu patients to a flood – with some staff members even calling out sick.

In this season, it’s important to protect you and your loved ones from the flu. Flu is a serious contagious disease that can lead to hospitalization and death. The 2017-2018 flu season provides a grisly reminder with the Center for Disease Control reporting an estimated 49 million people affected, 960,000 hospitalizations and 79,000 deaths with 185 confirmed pediatric deaths.

Below are some strategies to help you and your family navigate flu season safely.

1) Get immunized!

The CDC strongly encourages everyone above 6 months to get their flu vaccine. While there are many different strains of flu, the flu vaccine protects against those strains research suggests will be most prevalent in the community.

Immunization is critical in preventing the flu and in mitigating its severity. The CDC reported that of the 185 pediatric deaths for the 2017-2018 season, 80% occurred in those who had not received a flu vaccine.

Many people express anxiety about getting the flu vaccine since they believe it can cause the flu. Rest assured, it cannot. There are three main types of flu vaccines all of which were designed with safety in mind: 2 needle-based vaccines (inactivated influenza vaccines [IIV] and recombinant influenza vaccines [RIV]) and the nasal mist spray (live attenuated influeza vaccine [LAIV]).

The inactivated influenza vaccine (IIV) uses flu viruses that have been killed (inactivated) and are not infectious. The recombinant influenza vaccine (RIV) uses only a single gene from the flu virus (as opposed to the whole virus) in order to mount an immune response without causing an infection. The flu mist, or the live attenuated influenza vaccine (LAIV), contains live flu viruses, but these viruses are weakened so that they cannot cause flu illness. In addition, the LAIV, is cold-adapted, meaning that it can only replicate in the nose, but cannot affect the lungs or other warmer parts of the body.

The CDC recommends use of any of these vaccines this season. So for those who are shot-averse, feel free to use the Flu Mist yet again!

While the flu vaccine cannot cause the flu, it can cause some mild side effects. The most common side effects from the flu shots (IIV and RIV) are redness, soreness and tenderness at the injection site. Other potential side effects may include low-grade fever, headache and muscle aches typically within 1-2 days of the shot. Side effects from the nasal spray flu vaccine (LAIV) include runny nose, vomiting, headache, wheezing, muscle aches, sore throat, cough and fever. Usually, these side effects occur soon after vaccination and are short-lived. All flu vaccine associated side effects are significantly less severe compared to symptoms caused by the actual flu virus.

2) Avoid sick contacts!

Although it probably goes without saying, try to stay away from people who are sick with cold and flu symptoms. Avoiding others will help you avoid catching germs.

3) Stay home when sick! 

If you are feeling unwell, please be kind to others and stay home! If you are sick with flu symptoms or fever, the CDC recommends that you stay home for at least 24 hours after your fever is gone. However, you may step out to seek medical care or pick up other necessities.

No one wants to be near a sick co-worker or classmate this time of year.

4) Cover your nose and mouth! 

Please try to cover your mouth and nose while coughing and/or sneezing. This helps prevent the spread of germs (including flu, RSV and whooping cough) out in the community.

5) Wash your hands! 

Routine hand washing with soap and water, or, if not available, alcohol-based hand rubs, will help protect you from germs.

6) Avoid touching your eyes, nose or mouth!

Germs are easily spread when touching a contaminated surface and then touching your eyes, nose and mouth. Touching these body parts enables germs to get into your body.

7) Personal and Household Hygiene! 

Clean and disinfect household, work or school surfaces frequently and regularly – especially when a close contact is sick. Also, make sure to get plenty of sleep and fluids, to manage your stress, and eat nutritious foods. All of this will help protect you from illness.

Good luck staying healthy this flu season! For further information, please check out the CDC’s website.



Written by Dr. Sarah Givner