My five-year-old son often gets skin rashes. I fear that this could be a symptom of some other disease. Could it be chicken pox rash?
— Seetha Balram, Chennai

Chicken pox rash tends to appear on the scalp, face, chest, and proximal limbs. Children suffering chicken pox also report high fever, often touching 103°F. The incidence of chicken pox is rare nowadays, because of widespread availability of the chicken pox (varicella) vaccine.
In hand, foot and mouth disease, small blisters manifest in the mouth, hands, feet, buttocks and genital areas within three-five days. The blisters scab over and disappear after five-seven days. This disease usually infects children in schools through shared toilets. With primary and pre-primary schools closed for over a year, the chances that your son having got it are slim.
Scabies skin infection appears in the mouth region. It’s very itchy, unlike hand, foot and mouth disease. Aphthous ulcers are common and appear singly, confined to the mouth area. There is no fever. Herpes simplex manifests as painful ulcers in the mouth — hands and feet are spared. Traumatic ulcers appear at the site of injury.
If your son’s rash doesn’t cause much discomfort and is getting better every day, it will most likely disappear.

With the Covid-19 pandemic showing no signs of abating, doctors are advising children to take other vaccines such as the rotavirus, pneumococcal and flu shots. What are the vaccines that can be safely taken? My son is two years of age.
— Shyamala Sunder, Hyderabad
Pneumococcus, which spreads through air and causes pneumonia, ear infection and meningitis, can be prevented by a vaccine. The rotavirus spreads through contaminated diapers, toys and doorknobs. It is the most common cause of infancy diarrhoea, which can be fatal in 35 percent of cases and often requires hospitalisation. Influenza causes fatigue, fever and cough. This vaccine is modified yearly depending on the prevalent viral strain (H1N1, Avian flu). Consult your doctor before deciding on the vaccine.

My 11-year-old son has bad breath. I make sure he brushes twice a day but it hasn’t helped. Please advise.
— Lipika Dar, Mumbai
To check if your son has bad breath, ask him to cup his palms, hold it over the mouth and nose, breathe out and then smell his breath. Everyone’s breath smells foul in the morning, but halitosis all day is abnormal.
It’s likely that your son has untreated dental cavities. Food often gets stuck in between teeth and bacteria feast on this residue, breaking it down and releasing gases. It’s also possible that plaque may have formed between the gums and teeth. This provides a crevice for bacteria to fester and causes foul smelling gum infection. The tongue also could have developed fissures and cracks. This also leads to bacterial growth which can ferment and produce foul smelling gases.
Ensure he brushes his teeth thoroughly twice a day. Also get him to rinse his mouth well after every meal.

(Dr. Gita Mathai is a well-known Vellore-based paediatrician and author of Staying Healthy in Modern India)