Summer is over and children are back in school, picking up all sorts of germs, eating junk food (after school!) and playing football. Nowadays, there are a host of concerns for parents on how to keep their kids safe.

Dr. Kimberly Uyeda, a pediatrician and director of student medical services for the Los Angeles Unified School District, has some advice for parents and students for a safe school year. And chief among her recommendations: teach students to wash their hands.

General hygiene, including stopping the spread of colds and flus in the fall and winter, tops Uyeda’s list of things to watch out for.

“When you have a lot of students and children, and even staff, in a small space … there’s a greater chance of passing along viruses,” she said. “We just generally have a lot of kids coming down with illness when they come back from summer.”

Get immunizations and get the flu vaccine when it’s available. Keep your children home when they’re sick. And encourage regular hand-washing.

What’s new, what’s out

Some concerns have gone away or diminished since vaccines have been developed, such as chickenpox and ear infections.

But “some things just persist,” Uyeda said. “We still have lice. We still have the cough and cold and the pinkeye, the things that most people would remember from their elementary years.”

There are also new concerns. Take football and head injuries for example. For insight into that topic, the Southern California News Group asked the district’s coordinator of the interscholastic athletics department, Trenton Cornelius, to weigh in.

Football players, parents and coaches are educated about the seriousness of head injuries, Cornelius said. That includes techniques to avoid head injuries and how to recognize the symptoms of injuries and get medical help.

“I believe our students are more protected today than ever before,” he said.

Another health concern that’s gotten more attention in recent years is mental health, Uyeda said.

More people are feeling free to talk about the stress and pressure of everyday life, she said.

“There’s an openness to acknowledge that a student that’s suffering from perhaps depression or anxiety or trauma in general is not going to learn,” she said.

The district addresses mental health with a variety of means, including mental health clinics throughout the school district, psychiatric social workers and counselors at schools and even individual counseling if needed, she said.

Immunizations

Immunizations are always a hot topic when school starts. What do parents need to know?

To attend L.A. Unified schools, children must have immunizations, and parents or guardians have to provide documentation of those shots for their children to go to school. The list of required immunizations, include those for polio, Hepatitis B and chickenpox, for example, and the timeline for them can be found at the state’s ShotsforSchool website.

“The biggest things that have changed are around the waivers and around the personal belief exemption,” Uyeda said. “The law is that in California there are no personal belief exemptions that any school district, public or private, can accept at this point.”

Only medical exemptions are allowed.

Parents can no longer exempt their children and sign them up for school simply with a form stating that immunizations are against their personal beliefs or religion. That’s thanks to a law signed by Gov. Jerry Brown in 2015.

But if there is a medical reason to skip an immunization — a medical condition that could be worsened with a vaccine, such as an allergic reaction or ongoing cancer treatment — parents might be able to use a medical exemption, Uyeda said. That requires an examination and a detailed form from a medical provider describing the child’s medical condition, how long it will last and when it might end so the child can be immunized. The district accepts that exemption.

Why are vaccines for polio still required when the disease has been eradicated in the United States? Because we can’t let our guard down, Uyeda said.

“If we didn’t require the polio vaccine, there are still, in very small corners of the globe — and we’re a very global society right now — a small possibility that the wild type of polio could come back. And if we decrease our defenses by having fewer than anywhere from 95 percent to 100 percent of our children vaccinated, there is a small — and real — possibility of having polio come back.”

For homeless students and immigrant students who might come to the district partway through the year, LAUSD has special services to help them, Uyeda said. For homeless youth, for example, the district allows them to enroll in school without proof of immunizations but then helps them schedule vaccines or find their records, she said. “That’s to acknowledge that it’s very difficult to keep records and to get your life organized when you’re out of a house, when you’re just trying to survive.”

Good news — sort of

Childhood obesity rates were on the upswing for many years but more recently they’ve been leveling off a bit.

“On the obesity front, we’ve actually made some good headway,” Uyeda said.

She pointed to a study published in February from Los Angeles County Department of Public Health researchers who looked at obesity rates from 2001 to 2013 among L.A. Unified fifth-grade students, the age group with the highest prevalence of obesity reported among children and adolescents in Los Angeles County.

From 2001 to 2005, the rate of obesity was on the upswing, from 27.5 percent in 2001 to 31.6 percent in 2005. But then it started a gradual decline to 28.5 percent in 2013, according to the study.

That’s still higher than the national rate for this age group (17.5 percent for 6- to 11-year-old children from 2011 through 2014, according to the study), and higher in 2013 than it was 12 years earlier. Still, it’s progress, Uyeda said.

“Before, in the early 2000s, it was a pretty steep rise in students that were unable to pass their physical fitness testing,” she said.

Now, “that’s leveling out, so I think that that’s very hopeful,” Uyeda said.