Everyone gets sick from time to time. And while it’s normal for children to get their fair share of colds, it’s common for parents to be concerned when they feel their child is “sick all the time” or having too many infections.  When are these infections normal or a sign that a person’s immune system is not working like it should? How many infections are too many infections?

 It is normal for children to have

∙6 to 8 colds per year in the first 10 years of life

∙Up to 6 episodes of ear infections per year in the first 2-3 years of life

∙3 episodes of gastroenteritis (“stomach flu”) per year in the first 2-3 years of life

(These numbers may be even higher if the child attends a large daycare defined as more than 8 children per room).

When infections are severe, caused by unusual organisms or recurrent in nature, then parents and physicians should be concerned that there may be an underlying immune deficiency that needs to be addressed.   A primary immune deficiency is one where the immune system has not developed or matured normally; it does not include HIV or AIDS, which is an acquired immune deficiency.


10 Warning Signs that may indicate an immune deficiency according to the Jeffrey Modell Foundation are:

∙4 or more new ear infections in one year after age 2-3.

∙2 or more serious sinus infections in one year.

∙2 or more months on antibiotics with little effect.

∙2 or more pneumonias in one year.

∙Failure of an infant to gain weight or grow normally.

∙Recurrent deep skin or organ abscesses.

∙Persistent thrush in the mouth or persistent fungal infection on the skin.

∙Need for intravenous antibiotics to clear infections.

∙2 or more deep-seated infections including septicemia (blood stream infection).

∙A family history of primary immune deficiency.


How are frequent infections diagnosed? 

The most common forms of immunodeficiency are caused by defects in the patient’s ability to produce blood proteins called antibodies. Antibodies are proteins that attach to germs and help the body eliminate them. Simple blood tests can measure the number of antibodies a patient is producing. To more fully evaluate your antibody health, it may be important to measure a specific antibody response by giving you diphtheria, tetanus and pneumococcal (pneumonia) vaccines and performing a blood test before immunization and three to four weeks afterward. Skin tests or more specialized blood tests can diagnose other forms of immunodeficiency. Allergy skin tests are commonly done because allergies often contribute to infection susceptibility, and many patients with immunodeficiency also suffer from allergies.


Did You Know?
∙ The first lines of defense against infection are your skin and the membranes lining the respiratory and digestive system.

∙ If you have year-round allergies to dust mites, pollen and mold, you may have some damage to your mucus membranes which can increase your chances of infection.

To the Point
People with immunodeficiency get the same kinds of infections other people get like ear infections, sinusitis and pneumonia. The difference is their infections occur more frequently, are often more severe, and have a greater risk of complications. Early diagnosis and treatment are key, and Allergy Partners physicians specialize in the diagnosis and treatment of immune deficiencies. If you are concerned that you or your child may have immune deficiency,  consult your trusted Allergy Partners physician.


Sherif Taha FAAAAI

Allergy Partners of Eastern Carolina, Greenville NC.