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Back-to-school bugs and how to deal with them

September 22, 2023
Back-to-school bugs and how to deal with them
September 22, 2023

Why is it that as soon as your kids go back to school, they seem to come down with something? Whether it’s with a case of nits, a bad cold or something else, it’s not surprising, says ZoomDoc Chief Medical Officer and GP, Dr Kenny Livingstone.


‘Children spend all summer outdoors and away from hot and crowded classrooms. When they go back it’s a breeding ground for germs to spread, especially as the weather gets colder and they spend less time outdoors,’ he says. Fortunately, some of the most common back-to-school bugs won’t need time off school and even if they do need a few days at home, it’s unlikely they’ll need a trip to the doctor. (Although always go with your gut and get your child checked out if you’re concerned.)


Here are some of the most likely conditions to affect your child this term – and how to treat them.


Need a GP referral today? Get a same-day referral from ZoomDoc.


Head lice and nits 


Head lice and nits are very common in young children and their families. They are picked up by head-to-head contact.


Not had a letter sent home yet about head lice or nits outbreaks yet? If your child’s at primary school it probably won’t be too long before you get one. But to properly get rid of them and stop them continuing to do the rounds takes more than one wet combing session or treatment.


Start by wet combing using a nit comb or fine-toothed comb to go through small sections of the hair. This will take around 30 minutes for long or curly hair.


This then needs to be repeated, says NHS treatment advice, which recommends: ‘wet combing on days 1, 5, 9 and 13 to catch any newly hatched head lice. Check again that everyone’s hair is free of lice on day 17.’


If you prefer or need to use a medicated lotion or spray, you’ll probably need to repeat this after 7-10 days to catch any newly-hatched lice.  If your child hasn’t been affected by the latest head lice outbreak in their class is it worth treating their hair anyway?


‘No, head lice remedies don’t work to prevent head lice appearing and they could irritate the scalp. Just keep any eye on their hair and scalp so that you can treat any that may appear, as soon as you spot them,’ says Dr Kenny.




Threadworms, also known as pinworms, are tiny parasitic worms that infect the large intestine of humans.


Threadworms – or pinworms – are common in children and can spread easily if they’re not washing their hands well with soap, particularly after using the toilet and before eating. Tell-tale signs, aside from seeing tiny white worms around their bottom, can be an itchy bottom that gets worse at night and disrupts their sleep.


‘Threadworms may sound unpleasant but you don’t need a doctor to treat them,’ says Dr Kenny.


See your pharmacist for a medicine called Mebendazole as this will kill the actual worms. To kill the eggs you’ll need to make sure everyone washes hands well, regularly, has regular baths or showers and wash all clothes and bedding on a hot wash.


Stomach bugs


Young children are more likely to pick up tummy bugs as their immune systems aren’t yet fully developed and they often forget to wash their hands after going to the toilet.


Unfortunately a stomach bug, such as norovirus that involves sickness, vomiting or diarrhoea will require time off school. 


Read more about when sick kids need to stay at home.


NHS guidance is to keep them off for 48 hours after their last bout of either sickness or diarrhoea. ‘Although the symptoms are unpleasant, most children will recover after a few days,’ says Dr Kenny.


However, if you’re worried about your child, follow NHS advice, which says to see a doctor or call 111 if you’re concerned about any of the following symptoms during a suspected bout of norovirus:


  • your child shows signs of dehydration after using oral rehydration sachets
  • your child keeps being sick and cannot keep fluid down
  • your child has bloody diarrhoea or bleeding from the bottom
  • your child has diarrhoea for more than 7 days or vomiting for more than 2 days.


Struggling to get an appointment at a time that suits you? Download our app and speak to a ZoomDoc GP from just £35. We can offer peace of mind, prescriptions or help with referrals, if required.


COVID, coughs and colds


If your child has mild symptoms such as a runny nose, sore throat or mild cough, and they feel well enough, they can go to school or childcare.


Coughs and colds are already doing the rounds at schools and with no need to take time off school with them, it’s no surprise they spread quickly around pupils. It’s also no bad thing, explains Dr Kenny.


‘Kids need to get coughs and colds to help build up their immune system and help them to fight off infections as they get older. So although they can make healthy kids feel a bit under the weather, it’s actually good for them,’ he says.


But what about COVID? We all remember the days when a cough or fever meant keeping kids and even their siblings off for up to 10 days. Fast forward a few years and we’re now living restriction free. In fact, there’s no need to test for the virus anymore, unless you want to. 


Recovered from COVID? Get a same-day COVID recovery certificate today.


If your child does test positive for COVID – or you suspect they have it – and they have a fever or seem unwell with it, it’s a good idea to keep them off school until their fever goes. However, if they have flu-like symptoms but seem well enough to go to school, let them.


Read more about the latest COVID strain and vaccines.


How long do you have to be off school with a bug?


If you are experiencing a stomach bug with symptoms such as diarrhoea, vomiting, or a high temperature then you should not allow your child to go to school. If these symptoms appear to have cleared your child should still avoid school for another 2 days whilst the body clears itself of infection, attendance at school before this 2 day period could pose a risk of spreading the bug to classmates or teachers.


Can school ask for proof of illness?


Schools requiring proof of illness is often down to their own discretion, particularly if the authenticity of a child’s illness is in doubt. For the most part, schools will not request proof of illness in the first few days or even week of absence, as most illnesses will not be evidenced by a medical visit or GP confirmation in this time.

If an absence has gone on for a considerable amount of time then a school may require proof of your child’s illness. If your school has requested proof of illness you can obtain a same day proof of illness certificate from ZoomDoc, we also offer GP referrals online if you are struggling to get an appointment for your child.


Top tips for keeping kids well this winter


Teaching your child how to wash their hands properly with soap, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell.


Here are Dr Kenny’s tips for keeping your child as healthy as possible this term, and beyond:


  1. Get them into good handwashing techniques – make sure they always wash well after they go to the toilet and before they eat, ideally. Use soap and wash for about 20 seconds before drying on a clean towel.


  1. Take up the flu nasal spray when offered  – schools will administer this quickly and painlessly on a school day so do consent when you receive your flu vaccine letter over the next few weeks. Find out more here.


  1. Give them a healthy diet and lifestyle – fill their lunch boxes with colourful fruit and vegetables, which will help support their immune systems. And try to get as much fresh air and daylight as you can, whether a kickaround at the park after school or a weekend bike ride, keeping them active will help keep them healthy.

Want to know more?

Our team of Doctors are available via the ZoomDoc App for any medical questions or queries.