Common infections during the first five years of life

Abstract

Of the ordinary infections sustained by children during the first 5 years of life 56% were common colds, 16·5% other infections of the respiratory tract, 16% gastro-intestinal catarrhs, 6% infections of the skin and mucous membranes and 5·5% infectious diseases in a strict sense.Common colds were most frequent in the second year, namely, an average of 4·3 common colds per child per year. As the child grew older the number of colds decreased. Adults showed an average of two common colds per year.Of the ‘other infections of the respiratory tract’, 42% were undifferentiated respiratory tract infections, 23% febrile affections without definite localization, 17% otitis, 11% pharyngitis and 7% influenza. The frequency of these ‘other infections of the respiratory tract’ rose from 0·3 in the first to 1·8 in the fifth year of life. After the fifth year the frequency diminished to one infection every 2 years in adults.The frequency of gastro-intestinal catarrhs in the first year of life, namely, 0·6 per child per year, was doubled in the second year, and then remained constant for a few years. After the fifth year a decrease was observed in this figure too.Fifty-four per cent of the 116 index children sustained at least one suppurative skin affection during the first 5 years of their lives, 28% had more than one. Most pyodermias occurred in the first few months of life, a second maximum being observed in schoolchildren, 21% of the index children had stomatitis in the first 5 years, 42% conjunctivitis.By their fifth birthday, 49% of the 116 children had had measles, 46% chicken pox, 26% rubella, 24% exanthema subitum, 17% mumps, 3% whooping cough, while 2 of the 116 children had had scarlatina, 1 child hepatitis, 1 poliomyelitis and 1 bacterial meningitis.No difference in morbidity was found between boys and girls in respect of respiratory tract infections. The boys had skin infections distinctly more often than the girls, and infections of the mucous membranes and of the gastro-intestinal tract were also slightly more frequent in boys. Apart from infections of the skin and mucous membranes, which were more often observed in mainly bottle-fed children, ordinary infections were equally frequent in this latter category and in children mainly breast-fed.The index child with older brothers and sisters contracted the ordinary infectious diseases younger than the index child who was the eldest child in the family. On account of the presence of older children in the family, a child was ill not more often, but earlier. The infections of the respiratory tract showed a distinct preference for the winter months, and the frequency of gastrointestinal infections was also slightly higher in that season.Febrile affections without definite localization, as well as infections of the oral mucosa, occurred especially during the summer months.Going to the kindergarten did not lead to an increase of the frequency of common colds and gastro-intestinal catarrhs, but the number of infectious diseases in a strict sense became higher. The ‘other infections of the respiratory tract’ became more frequent under the influence of school only in those index children who were the eldest in the family. The index children from families with a low level of hygiene experienced more infections of the skin and mucous membranes than those from families with a high hygienic level.No difference between these two groups was demonstrable in regard to the other ordinary infections.There was a parallelism between the frequency of common colds and of gasto-intestinal catarrhs but not with the other minor infections.