Pediatricians in metro Detroit share their medical outlook for school-aged children this fall

Detroit We asked local pediatricians to share what diseases they expect to see an increase in school-age children this fall, what diseases they care about most, and what advice they give parents.


The first set of answers come from, Marcos Degro, MD | Head of the Department of Pediatrics | Medical Director – Child Protection Team | Medical Director – Ambulatory Pediatrics | Ascension St John Children’s Hospital – Detroit

What diseases do you expect to occur in school-aged children in September and early October?

Well, we expect a return to relative normality with regard to children and typical diseases. That means a return to upper respiratory infections, typical colds such as rhinovirus and adenovirus, and the common everyday version of the old, regular coronavirus. Respiratory syncytial virus and influenza are also likely to be present, possibly earlier and more intensely functioning than in normal years (usually late fall through winter).

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Be prepared that children will get sick a little more than usual and each respiratory illness may be a little worse than usual. The average school-age child may suffer from 6-8 illnesses each year and this year may see a little more than this average. This is due to 2.5 years of isolation and separation, which has resulted in children with immune systems that have missed years of exposure and ‘training’ and therefore need some time to build ‘normal’ reactions to common illnesses.

Is there anything you see now that expects an increase in the number of school-age children as we approach the fall?

This summer has seen some increase in colds and respiratory illnesses. Now that children are back in person and around each other daily, we expect a rapid increase in typical school-related respiratory illnesses and infections such as bacteria, sore throats, colds, etc.

What diseases worry you the most about school age in the next couple of months?

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We worry about more serious illnesses like respiratory syncytial virus (RSV) and influenza acting in strange ways, such as causing illness sooner than usual (early fall rather than the usual winter after December, etc.) and possibly behaving in more dangerous ways in children.

It is important to note that in children, we are also more concerned about returning to school related to anxiety, depression, developmental delays, and exacerbation of learning losses caused by the last 2.5 years. We are grateful for the much-needed return to normalcy, but we anticipate that some children will really struggle to adjust to a full ‘normal’ school especially after they have experienced severe learning loss and delays in normal academic progress. Watch for signs of anxiety and depression and quickly seek help when indicated.

What advice would you give parents to reduce the risk of their children developing these diseases?

Regarding illness, just back to discussions about typical hygiene and disease avoidance. Make sure to wash your hands well, cover your mouth when coughing and sneezing, and avoid close contact with schoolmates who are obviously sick.

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Regarding mental health and school performance – open and honest discussions, good attention to a child’s mental health, concerted efforts to return to consistent sleep schedules, healthy eating and attention to self-care and mental health.


“For what we expect to see come in the fall, going back to school usually means an uptick in our visitation numbers, starting around now where some schools started last week,” said Marisa Lowe, MD, pediatric emergency physician at UM Health CS Mott Children’s Hospital. From viral infections such as the common cold, as well as some bacterial infections, such as strep throat.This is often a busy time for asthmatics caused by viral infections and changes with weather and pollen levels.One of the best ways families can avoid getting sick is to make sure their vaccinations are up to date. , including the COVID-19 vaccine that’s now approved for all but young children, and the seasonal flu vaccine that will be available next month.If families are late getting their regular vaccinations due to the pandemic, now is also the time to make sure they’re up to date. It can be treated with vaccines and can look like the common cold at first, but symptoms can last longer and be dangerous for those who are not yet fully immunized. It’s always difficult with young children, but we can continue to teach them to wash their hands well, use hand sanitizer, and cover coughs and sneezes. Children with a fever should stay home and not go to school or day care until the fever is gone for 24 hours.”

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The next set of answers comes from Stacey L. Leatherwood, MD/Pediatrician and Chief Medical Officer at Henry Ford Medical Center – New Center One/Wayne.

What diseases do you expect to occur in school-aged children in September and early October?

  • upper respiratory infection/common cold,

  • sore throat / viral pharyngitis (sore throat),

  • Gastroenteritis (vomiting, diarrhea).

  • Corona virus disease infection

  • conjunctivitis (pink eye),

  • Norovirus stomach flu

  • Child Care Centers – Young Children – Hand, Foot and Mouth Syndrome and Bronchiolitis – RSV

Is there anything you see now that expects an increase in the number of school-age children as we approach the fall?

  • Continuous increase in COVID infections.

  • Inflammation of the stomach and intestines

  • upper respiratory infections

  • Sore throat/viral pharyngitis (sore throat)

  • Fifth disease

What diseases worry you the most about school age in the next couple of months?

What advice would you give parents to reduce the risk of their children developing these diseases?

  • Wash hands well, teach your child how to cough or sneeze into his elbow.

  • Encourage healthy eating and exercise choices. Adequate sleep is also important.

  • Vaccination against influenza and COVID

  • Keep your child home if they are sick to reduce the spread of infection, have regular communication with the school regarding outbreaks at school, and wear masks.


“This fall, I think we are going to have a lot of the typical fall-winter viral illnesses like influenza that have not been so prevalent over the past couple of years due to mask-wearing,” said Jordan Cridler, MD/Pediatrician at Henry Ford Medical Center-Royal Oak/Auckland. I also feel that COVID has not gone away and I will likely see more cases of COVID as well. Influenza and COVID will be the cases I will be most concerned about increasing as we go into the fall and winter months. In terms of things that parents can do, I recommend parents to educate and help their children Using good hand hygiene techniques. Giving their children hand sanitizer to take with them to school and things like teaching them how to cough into their elbow and always covering their mouths when sneezing or coughing.”

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The next set of answers come from Jacqueline Metz, DO, FAACP/Pediatrician at Henry Ford Medical Center – Ford Road/Wayne.

What diseases do you expect to occur in school-aged children in September and early October?

Expect to see many upper respiratory infections once children start school. Many upper respiratory infections at this time of year are caused by viruses such as rhinoviruses and enteroviruses.

This year we saw an early rise in cases of RSV, the respiratory syncytial virus, which causes a cold-like illness in healthy older children, but can cause more serious illnesses in children younger than two years old. It is the most common reason for hospitalization in this age group. RSV usually rises beginning in November in Michigan. This year we saw a slight rise in cases in July and August. This early increase may continue into the school year.

Other illnesses that are most common at this time of year include strep throat and viral gastroenteritis. We also see many children whose seasonal allergies worsen as the season changes.

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Is there anything you see now that expects an increase in school-age children as we approach the fall?

Recently I have seen many children with streptococcal pharyngitis. I expect the number of children with this disease to increase, especially in the first few weeks of school.

What diseases worry you the most about school age in the next couple of months?

I am very concerned about COVID in school-age children. With many schools dropping mask requirements, a sudden increase can be expected. Many school-aged children are still not immune to the coronavirus. While it is true that the majority of children recover from COVID without problems, there are still many who have moderate to severe infections. Some had several days of high fever, others had severe headaches, difficulty breathing, or had prolonged COVID-19. Of course, our biggest concern about the consequences of COVID is MIS-C. This is a life-threatening syndrome that usually develops 2-3 weeks after infection with the COVID virus, and fortunately it is generally rare.

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What advice would you give parents to reduce the risk of their children developing these diseases?

Parents should keep their children at home when they are sick to prevent the spread of disease. Children should be taught not to drink from other people’s cups or share things like Chapstick. Of course, good hand washing should be encouraged. Families should also consider sending their children to school wearing masks, especially if they are not immunized or medically at risk.


The next set of answers come from Abdul-Khaleq Al-Ajmi, DO, Physicians of Promedica Monroe Pediatrics.

What diseases do you expect to occur in school-aged children in September and early October?

There are a few common things to look for. Rhinoviruses, the most common cause of the common cold, usually reach their peak in September. Strep throat can be common as children return to the classroom with symptoms of sore throat, fatigue, and possibly a fever. COVID-19 is also on our list this back to school season.

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Is there anything you see now that expects an increase in the number of school-age children as we approach the fall?

RSV (respiratory syncytial virus) has been a very common cause of cold-like symptoms in infants and young children in the winter months. However, over the past two years of the COVID-19 pandemic, we have seen a shift in the number of RSV infections toward the summer and fall months. Historically, I would expect RSV to increase in the fall and winter.

What diseases worry you the most about school age in the next couple of months?

COVID-19 is still at the top of my list, especially with the prevalence of newer sub-variables in our societies. There are now approved COVID-19 vaccines for children under 6 months of age to receive to help protect them from COVID-19. I encourage all of my family to learn more about the COVID-19 vaccine at all of my appointments.

What advice would you give parents to reduce the risk of their children developing these diseases?

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Kids will be kids! As our children grow and develop, illness is a normal part of going to school whether it’s in class or playing outside in recess. For example, proper hand washing is an easy and effective way we can teach to promote awareness in our children. If your child is sick, contact the medical provider and the school and determine whether or not your child should go to school that day. Oftentimes, staying home after an evaluation by a medical provider can help reduce the spread of common illnesses in our communities.


The next set of answers comes from Emily Jarrett, NP, a family medicine nurse from McLaren Health Care.

What diseases do you expect to occur in school-aged children in September and early October?

  • RSV

  • flu

  • Catch cold

  • COVID-19

  • Sore throat

  • Hand, foot and mouth disease.

Is there anything you see now that expects an increase in school-age children as we approach the fall?

What diseases worry you the most about school age in the next couple of months?

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What advice would you give parents to reduce the risk of their children developing these diseases?

  • Teach children to wash hands properly and frequently

  • Teach children to avoid touching their faces or putting their hands in their mouths

  • Teach kids not to share things like ChapStick or water bottles

  • Quarantine when you are sick according to CDC guidelines

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