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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Training children to build immunity, fight germs

As children’s immune systems develop, ability to fight off germs will follow

During a hand-washing demonstration in Jenny Haley’s Hutton Elementary kindergarten class, Kadence Prosser, 5, (foreground) learns the proper way to wash her hands with classmate Phoebe Horne, 6. (Colin Mulvany)

Maybe your kindergartner, so eager and bright-eyed in the first week of school, got pink eye in the second.

Maybe your preschooler’s persistent sniffling has become her built-in beacon. Follow the trail of sodden tissues.

Maybe it’s come as a surprise – your child never got sick before. After starting school, or day care, she seems never to get healthy.

In the first weeks and months of school, kindergartners who hadn’t been to day care or preschool have it especially tough, said Laurie Moyer, health services coordinator for Spokane Public Schools. They seem to be just getting over one bout of sickness when they start another. It hits new teachers, too, she said, as their immune systems adapt to a new community of germs.

“It feels like an endless cycle,” Moyer said.

This too shall pass. The more pathogens – bacteria and viruses – a child encounters, the more equipped their immune system will be later to fight them off.

“The first year in day care is going to be your worst,” said Patti Buck, a school nurse for the Mead School District.

In the meantime, parents can help children keep their immune systems in shape and teach them habits that can help them avoid at least some of the pathogens. Yes, hand washing is key, school nurses say. But so are bike rides, soccer games and vegetables – and, even as families’ schedules grow busier, getting plenty of sleep.

Building immunity

It’s been confirmed by science: Schools are germy.

A study of bacteria and viruses in a Seattle-area elementary school found that water fountains and pencil sharpeners were the most bacterially contaminated, per square centimeter. Desktops and faucet handles were the most contaminated with viruses.

Influenza A virus was detected on as many of 50 percent of the surfaces, and norovirus was found on up to 22 percent of the surfaces throughout the day, according to the study, published in 2010 in the Journal of School Nursing.

But schools get kind of a bad rap, Moyer said. Adults play their own roles in exposing children to microbes.

“We think of schools as these breeding grounds (for germs), because the kids are in close contact with each other all the time,” she said. But adults encounter germs all day, too, when they go to work, push shopping carts, pump gas, eat in restaurants …

“We’re exposed to it all the time,” Moyer said.

Children need that exposure – and the resulting illnesses – to develop strong immune systems. Basically, people have two-part immune systems, said Phil Mixter, a clinical associate professor of molecular biosciences at Washington State University in Pullman.

We’re born with “innate” immunity that helps prevent infection. Skin is a part of it, helping to ward off invading organisms.

“Adaptive,” or “acquired,” immunity builds up over time as a child is exposed to more and more microbes. It’s based completely on the pathogens we’re exposed to, Mixter said.

When a child enters a play group or group day care or school for the first time, sharing microbes along with blocks and pencils, that process begins in earnest, Mixter said. The child encounters a new community of people “who’ve all brought their pathogens to the table for you to enjoy.”

Each illness, and each vaccine, teaches the immune system how to fight off a new pathogen. With each new pathogen a child encounters, Mixter said, their immune system gets more “experienced.”

Said Allison Cowart, another nurse for the Mead School District: “The more big-group exposure they have, the better it gets.”

Sleep, eat, wash, repeat

On the other hand, nobody wants to be sick all the time.

Even for older students, whose immune systems are stronger than first-timers’, the stress of a new grade, new teachers and new classes can leave them more susceptible to illness.

So can a shortage of sleep, suffered as they readjust to earlier wake-up calls, said Moyer, the health services coordinator for Spokane Public Schools.

“We all carry viruses and bacteria all the time,” Moyer said. Students get sick at “that point where the body is broken down enough when it can’t fight it enough.”

Some ways to help kids’ immune systems:

Make sure they get plenty of sleep. The role of sleep in a child’s immune system is “huge,” Cowart said. “If your child’s not getting enough sleep, they’re going to be more susceptible to illness.”

Citing connections between sufficient sleep and disease prevention, the Centers for Disease Prevention and Control recommends 12 to 14 hours for 1- to 3-year-olds; 11 to 13 hours for 3- to 5-year-olds; and 10 to 11 hours for children ages 5 to 10. Adolescents need more sleep than adults, the CDC says – 8.5 to 9.5 hours for 10- to 17-year-olds.

Give them a variety of healthy foods. Cowart advised lots of fruits and vegetables and grains and minimizing foods containing simple sugars.

It’s old advice that’s forgotten as families get busy and parents seek out easy – salty, sugary, fatty – offerings. “As humans we want what we can quickly and easily get,” she said.

Strive for at least 60 minutes of exercise a day. Kids need an hour of “rigorous” activity daily, Cowart said – “something to get their heart rate up, whether it’s soccer or going on a bike ride.”

“With increased blood flow, they’re increasing oxygen to the brain and other organs,” Cowart said. “It’s part of a good machine.”

Stress good hand washing. Perhaps you’ve heard it mentioned: Good hand washing is the best way to prevent the spread of illness. Health advocates mention it over and over because it’s been shown, over and over, to be the best way to prevent the spread of germs.

But a family in a hurry might rush to the dinner table, skipping the sink beforehand, Moyer said. Or parents try to enforce post-toilet hand-washing rules for their children, but fail to follow them themselves.

“Learning to properly wash your hands needs to start young, and it needs to start at home,” Moyer said.

Sneeze wisely. Teach children to do the “vampire cough” when they don’t have a tissue on hand – sneezing or coughing into the inside of their elbow to minimize germs sent airborne.

Teach children to be germ-aware. Encourage them to throw away their used tissues and avoid using other children’s cups.

Younger kids, especially, need help keeping their fingers away from their mouths and noses, Cowart said: “Those orifices are the germ playgrounds.”