Chickenpox
On the first day a rash appears as small red patches about 3-4mm across. Within a few hours, small blisters appear in the centre of these patches. During the next three or four days further patches will appear and the earlier ones will turn ‘crusty’ and fall off.

• Calamine lotion may be applied to soothe the often severe itching
• Cool baths may also help
• The most infectious period is from two or three days before the rash appears and up to five days after this date. Children may return to school as soon as the last ‘crusts’ have dropped off

German Measles (Rubella)
The rash appears during the first day and usually covers the body, arms and legs in small pink patches about 2-4mm across and doesn’t itch. No other symptoms are usually present apart from occasional aching joints.

• It is infectious from two days before the rash appears, until the rash disappears in about four or five days from that date
• The only danger is to unborn babies and, therefore, it is important that all contacts are informed in order that anyone who may be pregnant can contact their doctor
• Immunisation can prevent this disease

Measles
The rash is blotchy and red and appears on the face and body around the fourth day of illness. It is at its most infectious from two or three days before the rash appears until eight to ten days after that date.

• Immunisation can prevent this disease

Meningitis
This is a rare illness that is most common in babies, children under four years and teenagers, and requires urgent attention. It is important to be aware of the symptoms which we have listed below.

Signs and symptoms in babies and very young children are:

• Difficulty waking
• A high pitched cry that is different from a normal cry
• Repeated vomiting
• Refusing feeds
• Pale or blotchy skin, especially with red or blue/black bruises that don’t go white when you press on them
• Tight or bulging soft spot on the top of your baby's head
  If you are in any doubt contact your doctor immediately.

Signs and symptoms in older children and adults are:

• A high temperature
• A constant headache
• Vomiting
• Drowsiness or confusion
• Dislike of bright lights
• Stiffness of the neck (moving their chin to the chest will be particularly painful)
• A rash of red/blue spots or bruises that don’t go white when pressed with a tumbler

If you are in any doubt contact your doctor immediately.

Mumps
Symptoms are: Swelling of the gland in front of one ear often followed, after a couple of days by swelling in front of the other ear.

• It is infectious from two or three days before the swelling appears until eight to ten days after that date
• If the pain is severe you should consult your doctor
• Immunisation can prevent this disease

How to look after a child with a temperature
A child will develop a fever because of an infection. Usually the child will get over such an infection without the need for antibiotics. Most childhood infections are caused by viruses and these do not respond to antibiotics. The following advice will help to bring your child's temperature down and make them feel better.

1  Always keep a supply of paracetamol syrup (Calpol, Disprol) at home. If you wait until you need it, there will be none close at hand.

2  If your child feels hot or appears unwell -

a) Give the maximum dose of paracetamol stated for a child of that age.

b) Dress your child in cool clothes. A lot of heat is lost through a child's head, so leave it uncovered. Cool down the room by opening doors and windows.

c) Give your child plenty of cool drinks as fluid is lost with a fever. If they are reluctant to drink, encourage small amounts from a favourite cup.

d) Sponging your child down with a tepid flannel will make them feel better as well as bringing their temperature down. Using tepid water is more effective than using cold water.

e) Repeat the dose of paracetamol every four hours as necessary, up to the maximum daily dose stated.

f) A child with a fever is likely to be restless at night. Offer cool drinks and sponge them down if they wake.

g) If your child does not improve after giving paracetamol and sponging, or appears particularly ill, call the doctor.

3  Very rarely, a child under five years will have a convulsion with a high temperature. They will shake all over and become very still. It usually subsides in less than five minutes. Lie the child on their side and stay with them while it lasts. If there is another adult in the house, ask them to phone a doctor. If not, call when the convulsion has passed.