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Concern re child welfare
Dear Forum,
I am a professional health advisor. However paediatric health is not a speciality so I would welcome views of others.
Recently, whilst minding my young niece, I noticed she has perianal lesions. I arranged to have her seen by a GP, her father was present during the consult. The GP confirmed that it was Molluscum Contagiosum and advised that it should be left alone as methods of treatment may be extremely uncomfortable and painful for the child. She said that it was common enough amongst children and a cause of infection may be swimming pools, schools etc. She did advise re : highly infectious nature of the condition and stated it may take up to 2 years to resolve or that it may get worse spreading across genital area to thighs etc.    
I asked whether there was any other way the child could have contracted the infection as it seemed unusual to me that she has lesions only in her perianal region if she had caught it in swimming pool or by poor handwashing in school etc. The GP said she did not understand what I meant and appeared to become very dismissive. Essentially, I
need to know if I should be concerned. The visit to the GP didn't reassure me at all. Having researched the topic it says that it can be transmitted through sexual contact and an indicator of this may be the absence of lesions elsewhere on the body. Am I being an overly anxious auntie ? My niece is 6 years od and lives with her mother in her family home as parents are separated.  I wondered why her mother did not take her to the GP 2 months ago when they first appeared as she said she had noticed them also. All help greatly appreciated.  
          
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Your looking for an answer to see if this child was abused. We can not give you that answer.
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No, I am asking if anyone in this forum has any similar experiences to share so that I can determine whether I should pursue the matter. If, for instance another parent had a child who contracted this infection from swimming pool, school etc. Just trying to get a balanced viewpoint. Thanks anyway.    
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101028 tn?1419606604
Most of the time molluscum in children isn't sexually transmitted.  I completely understand your concern though as far as it being in the genital area and the mother seeming unconcerned.  

Any way you can spend time alone with your niece again to ask her if anyone has been touching her inappropriately?  She's been taught stranger danger somewhat in school by now I"m sure and there are very tasteful ways to approach the question.  I'm sure with your training, even though it's not pediatric, you can tell if she's trying to hide something or not if you just bring it up perhaps like - so honey how is your rash doing?  and go from there.  Another option is to talk to other family members about your concerns and see if any of them think anything could be going on that shouldn't be with new partners of her parents or anything like that.  

It's a tough call in these situations and I think you know that already.  You'd kick yourself for not being more concerned if in the future you found out that something was going on.   I would not automatically assume though that she's been molested just because it's in the genital area. It can get on the hands and then be spread by wiping after using the toilet.  

grace
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101028 tn?1419606604
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Hello Grace,
Thanks for your feedback. I have found it most useful. I have asked the mother if she would consider bringing the child back for a second opinion with another GP. As you can imagine, I am not the most popular auntie around but I can live with that.
Her mother says she will consider it so hopefully she will agree.
As you say, it's just as probable she has contracted this from poor toilet hygiene etc. However, at this stage and pending further investigation, I cannot in all conscience, dismiss it out of turn.        
Thanks again & have a nice weekend.
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