Angela Di Paolo enjoyed good health during the maternity leave she took after giving birth to a daughter, who is now two.
But when the elementary school teacher went back to work last fall, the miasma of germs that hovers over young school-aged children quickly engulfed her.
In the first week of school she picked up hand, foot and mouth disease, which she unwittingly brought home to her two kids. A bout of bronchitis quickly followed.
Di Paolo, who teaches Grades 2 and 3 at a school in Scarborough, Ont., ended up missing about two weeks of work in September alone.
As parents and teachers of young children know, the annual resumption of classes is invariably followed by waves of illness. Coughs and colds. Stomach bugs. In some cases, parents have to deal with head lice or scabies, an infectious and itchy skin condition caused by minute mites.
"Every September is just the beginning of the cold and flu season for us. And it progresses from there," says Di Paolo, who capped that eventful fall term with a case of chickenpox just before Christmas. "It spreads through the school so quickly."
Where colds and flu normally hit adults in the dead of winter, the massing of children in early September turns schools into germ factories.
"Most childhood illnesses are caused by viral infections. And viruses are generally - so contagious, and they tend to be spread most easily if you have a whole lot of children in an enclosed space," says Dr. Jeremy Friedman, head of pediatric medicine at Toronto's Hospital for Sick Children.
"You're putting 20 or 25 children in very close proximity, indoors. And essentially anybody who might be harbouring a virus - which, you know, probably is happening all the time - if they're coughing, sneezing, touching things, that virus is obviously much more likely to spread to some of their classmates."
Some disease swapping is inevitable. Young children are still building the immunological armour they need to get through a lifetime of exposure to disease threats. Immunity is acquired by exposure to these foes, either through immunization or by contracting and fighting off illness-causing agents.
Friedman likens the spate of sicknesses that school-aged children experience to a rite of passage.
"That is what we tell parents, particularly of young children when they're starting daycare or kindergarten," he says. "That is how you build up your immune system. You have to be exposed to these viruses in order to develop some immunity to them."
The younger the child, the more pronounced the pattern, Friedman says.
There are steps parents can take in the waning days of summer to improve their kids' chances of making a healthy transition to school.
The start of the school year is a good time to take a look at a child's vaccination status, says Dr. Bob Bortolussi, a pediatric infectious diseases specialist at IWK Health Centre in Halifax, and a past chair of the Canadian Pediatric Society's infectious diseases and immunization committee.
"It's a good reminder," says Bortolussi. "Because ... if kids aren't immunized, all of those - measles, mumps, rubella - can be a problem."
All provinces and territories recommend that children have a booster shot of diphtheria, tetanus, pertussis and polio vaccine between the ages of four and six - so around the time they start kindergarten or Grade 1. Some children in that age group also need a booster of the measles, mumps, rubella and chickenpox shot.
All jurisdictions also recommend a booster shot for pertussis - whooping cough, which has been making an alarming comeback - for junior high school kids. It's recommended for Grade 9 students in B.C. (The Public Health Agency of Canada has a useful tool on its website at phacaspc.gc.ca/im/ iyc-vve/ schedule-calendrier-eng.php to help parents keep track of what shots their children need. Plug in your province and your child's grade level and it will tell you what shots he or she should have in the next few years.)
But to ward off the common cold, the best protection is still good hand hygiene - soap and water.
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