Back-to-school season brings not only a return to classes for children across Western Pennsylvania — but also a return of sicknesses that can spread like wildfire.
Dr. Raquel Zemtsov, assistant professor at the University of Pittsburgh’s School of Medicine and a practicing family medicine physician at UPMC Matilda Theiss Health Center in the Hill District, said these sicknesses, which can range from the common cold to severe cases of the flu, affect whole classrooms, teachers, parents and families.
Though there are many reasons why sicknesses surge in the back-to-school season, Zemtsov noted being in close quarters and the seasonality of viruses as leading factors.
“We usually think about influenza as coming in the wintertime, although we see that less and less with covid,” she said, adding that right now, she’s seen “a lot of people” sick with covid-19.
Another factor is people’s noses getting drier as the temperature drops outside, according to Zemtsov.
“Our noses are the first line of defense for viruses and illnesses,” she said, “and as it gets colder out and our nose gets drier, it gets worse at fighting off illnesses. When it’s cold out, wear a scarf over your nose. Obviously, masks are helpful, but also humidification at home can be really helpful.”
Sharing in sickness
As the new school year kicks off, “kids have a real tendency” to bring sicknesses home with them, according to Dr. Mike Dinger, a family medicine physician with Independence Health System’s Saltsburg Family Medicine.
“Kids are going to be kids — and they’re going to touch each other, their hands, wipe their nose, their face,” he said. “Mom, dad or grandpa could end up with it, too.”
Like clockwork, a few weeks into the school year, Dinger said upper respiratory infections will start to circulate. These can include symptoms like runny noses, coughing, sneezing and congestion, as well as some nausea, vomiting and diarrhea.
“It’s very easy for one kiddo, one teacher to pass it on to a majority of a class, and then you have all kinds of people staying home,” he said. “(It’s) sort of inevitable every year.”
Zemtsov said if a child is in school or in day care and needs to come home because they’re sick, “someone has to take care of them.”
For families who live in multigenerational households, the ripple effects of sicknesses brought home from school are even greater, according to Zemtsov.
“Not only are they risking getting their parents sick or their siblings sick, but if a grandparent gets sick, they may get sicker than a person who is younger and healthier might,” she said.
“I actually see that a lot, where a kid comes home with something terrible, the parents miss work, the kid feels better, goes back to school, but now the parent feels terrible and can’t go to work, so they’re essentially doubling the days that they’re out.”
The best way to stop the spread, Dinger said, is for people who are sick to stay home until they’re feeling better — and it’s especially important for those exhibiting any gastrointestinal symptoms.
Dinger recommended that children, parents and teachers practice good hand hygiene, cough and sneeze into their elbows instead of hands or without anything to cover it up, avoid sharing drinks and get flu and covid-19 shots.
The updated versions of covid and flu vaccines will be coming out soon for this season, according to Dinger.
“If you’re eligible for them, you should be getting them,” Dinger said of vaccines.
Getting immunizations can protect those who are immunocompromised, including older adults, according to Dinger.
“You also want to protect those around you … those who have more medical problems,” he said. “Flu or covid could be quite deadly for those folks.”
Despite Dinger’s advice on preventing illness, he said people “can do everything right, and you can still get sick.”
“The majority of them are viruses and bacteria,” he said of the sicknesses that go around. “They’ve survived this long by being pretty easy to transmit, so even with all of your best hand-washing … getting the flu shot doesn’t mean you won’t get the flu, but it’ll hopefully help some people from getting it worse.”
Focus on holistic health
Emotional well-being is just as important as physical well-being as the back-to-school season commences.
Dr. Joseph Aracri, chair of Allegheny Health Network’s Department of Pediatrics, said back-to-school season is the “perfect time” to reestablish healthy habits.
“A consistent sleep schedule is one of the most important things parents can do to support their child’s health — children who get enough high-quality sleep are able to better focus at school, regulate their emotions and maintain healthy relationships with friends,” he said.
Decreased sleep and stress both “lower immunity,” and school can sometimes offer added stressors, Zemtsov said.
“No one gets the amount of sleep they need once they’re in high school — at least that’s what it seems like,” she said. “Very few of my patients get the recommended amount.”
According to a new UC Davis Health study published in Psychological Medicine, sleep plays an integral role in adolescents’ success and mental health. Sleep was found to be the strongest factor associated with better grades and fewer social problems, the study said.
“It’s a foundational part of a healthy routine that makes a significant difference,” Aracri said.
Most children need a minimum of nine hours of sleep each night, according to AHN.
Zemtsov said teenagers need at least seven to eight hours of sleep, and toddlers can need 11 to 13 hours. Bedtime routines should be free from screen time.
“We are seeing significant behavioral and mental health concerns among children of all ages that appear to be closely linked to social media use,” Aracri said. “When possible, parents should significantly limit social media use or eliminate it altogether.
“We have seen increases in low self-confidence, social anxiety and body image concerns, and we believe social media is playing a major role in those trends.”
Parents should pay attention to potential signs that their child is struggling emotionally during the school year, according to AHN pediatricians. Signs could include persistent changes in mood, sleep, appetite or social engagement.
Outside of sleep and reduced social media and screen time, pediatricians at Allegheny Health Network also recommended keeping vaccines up to date, focusing on healthy nutrition and balanced meals that include fruits, vegetables, whole grains, lean proteins and healthy fats; and encouraging children to make social connections, such as spending time with their friends and participating in physical activities like sports and clubs, to build confidence and strengthen important life skills.
Zemtsov said vaccination rates have declined nationally, a trend that she said can be fatal.
“Because of that, we’re starting to see cases of diseases we never used to see, like measles, and that’s a really concerning one — not just because it can make kids very, very sick, but people who can’t be immunized, like infants,” she said. “Also, if a pregnant woman were to get it, that can impact the development of the fetus.”
Healthy habits like a good diet can be interrupted during the school year, according to Zemtsov, and “gut (heath) plays a big role in our immunity.”
“I want to make sure kids are getting enough fiber, fruits and vegetables, things that have probiotics naturally, like yogurt,” she said. “Other things that tend to change in the fall is kids are now indoors a lot, and so that can decrease the amount of vitamin D they’re getting naturally from the sun. We know that vitamin D deficiency makes immunity worse, and so I do encourage families to make sure that their kids are spending enough time outside.”
If there’s a deficiency in vitamin D, Zemtsov encourages the use of supplements.
On average, children get six to eight colds a year — “even if you’re doing absolutely everything right,” according to Zemtsov. “It’s more if you’re in day care or you’re around a lot of sick kids or you have issues with your immunity.”
Do supplements work?
Taking various supplement options can be hit-or-miss in terms of staying healthy and preventing sickness, doctors said.
“My take on that is for the majority of those, there is not any significant data that says that they prevent or help treat any type of illnesses,” said Dr. Mike Dinger, a family medicine physician with Independence Health System’s Saltsburg Family Medicine.
However, he said there’s some evidence that elderberry can shorten the duration of illness and upper respiratory infections in adults if it’s taken correctly. But that evidence is not conclusive yet.
Dr. Raquel Zemtsov, assistant professor at the University of Pittsburgh’s School of Medicine and a practicing family medicine physician, encouraged taking vitamin C before people become sick; once people are sick, it doesn’t really help.
“I think echinacea potentially might help you get sick less, but again, it was really hard to tell. The studies weren’t super great, but we know that taking zinc at the onset of an illness can help shorten it by a couple of days,” she said. “What’s a little different about zinc is that taking it in a lozenge form, where you’re sucking on it and it’s coating the back of your throat, has some better efficacy because it’s actually hitting where the virus is stuck onto cells.”
But supplements can also cause various side effects, according to Zemtsov. For example, zinc can cause stomach problems.
For children, Dinger said supplements shouldn’t be used without first speaking to their doctor.
“None of those should be used in lieu of certainly an antibiotic or whatever the doctor has prescribed,” he said. “Some people swear on vitamin C, it makes them feel better quicker — I don’t argue with them.
“If that’s what they feel, then that’s totally fine.”
Taking vitamin C or zinc won’t hurt people, but Dinger believes how much they will actually help is “pretty debatable.”
He said people can rely on throat drops, Tylenol and Robitussin.
“Always stay well-hydrated,” Dinger said. “Everyone seems to have their individual things that work.”
Zemtsov said it’s important to know where and how to get safe supplements.
“We can fall culprit to good marketing … I think is really important is remembering that supplements don’t have to go through the FDA for approval,” she said. “A lot of companies and third-party testing have shown that oftentimes, we don’t know what is in a supplement or how much of something is in a supplement.”
For this reason, she recommended looking at and using the verified supplements listed on two third-party testing sites: NSF International and U.S. Pharmacopeia. Products listed have been tested by those third-party sites, she said.
“You can search for the type of supplement that you want to use, and it will tell you what companies have been tested — and what’s in it is what’s truly in it,” Zemtsov said. “Or you can search for just which companies in general are third-party tested, and so I do recommend that for all my patients.”
In general, though, she said supplements are safe.
“They’re not going to hurt you — they just may not be super helpful,” Zemtsov said.