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Childhood Illnesses – Are We Winning The Battle?

As with any illness, it is best to prevent than to treat.  Our progress in battling some devastating childhood illnesses over the years has centered on the introduction and efficiency of our existing vaccines and effective preventive medications.

One of the first notable vaccines was that produced to prevent paralytic polio.   Early on this was an oral vaccine and we (of a certain age) can remember the sugar cubes given out in school followed in rapid order by oral and then injectable types of the vaccine. These obviously were very effective in eliminating the most dreaded form of polio- that which produced paralysis in children and young adults.  Again, some of us remember trying to fall asleep at night thinking of that terrible disease and the pictures of “iron lungs” (a type of whole-body respirator) lined up in the hallways of hospitals.  There was no treatment and as of today there is still no treatment.  However the severe clinical outcome has been erased.  Polio virus is still around today and is not uncommon but is such a mild illness that affected people may not even realize they might have it. (Very similar to many of our common every day illnesses)

Many of us also remember smallpox vaccine that left a puckered, stippled scar on the top of our shoulders.  As it began disappearing from the US due also to better and newer isolation techniques, it was noticed that there were more bothersome reactions than actual cases of small pox in this country.   Also worldwide there were fewer and fewer outbreaks that became controllable with the above mentioned isolation techniques.  Smallpox vaccine was discontinued.

With the advent of improved TB testing and effective medicines, a vaccine became unnecessary although the disease still exists, it is controllable and treatable.

Measles, mumps and German measles used to take its toll on primitive peoples of the world until there were effective vaccines that prevented the illnesses and sometimes the birth defects that would arise in babies born to women who had had German measles during pregnancy.

Hemophilus influenza is a common bacterium causing some illnesses in this country and around the world but the most dreaded of these was a virulent kind of meningitis (infection of the covering of the brain and spinal cord, leading to some life-long neurologic deficits in children and even death).  While I was in my training to become a Pediatrician a vaccine was developed to eradicate this illness and within a very short time the incidence of hemophilus meningitis dropped severely – today it is a rarity.

More recently we have seen the development of effective and efficient vaccines to help prevent influenza, chickenpox, hepatitis, meningitis, rabies, and the list is constantly increasing (this is not a complete list).  Along with this ongoing effort is the continued development of medications to help treat the rare illnesses that still crop up occasionally.

The bottom line is that we have many weapons at our disposal to defeat our viral and bacterial contagious diseases in children and adults but those who ignore the value of immunizations at an early age are not only placing their own children at risk but the childhood and adult population of the entire country.  Many of these illnesses are highly contagious and infectious but we must all work together to control and hopefully eventually eradicate these deadly microscopic enemies.

Video: How Big a Concern is Fever and Vomiting in Children?

In this short video, Dr Rupal Shah explains how to tell if your child’s fever and vomiting are a sign of a serious illness requiring medical attention or the result of a common virus with no cause for alarm.

Editor’s Note: Video Highlights

  • Fever and vomiting are common symptoms in childhood and there are many possible causes
  • fever-and-vomiting-in-kidsThe most important thing to consider is how well your child appears to be….
    • For example, if they’re quite drowsy and floppy or if they’re not eating, then there’s a higher chance that they could be seriously ill with a nasty infection and you should see your doctor
    • If your child appears fairly well and is still eating and drinking, is still playing and interested in their environment, then it’s less likely they are suffering from a serious illness
  • Also, if your child isn’t managing to tolerate any fluids you should take them to the doctor, since children get dehydrated quite easily
  • Fever and vomiting can be caused by fairly common viral illness, like a rotavirus infection – or tummy bug – and generally the child is relatively well and cheerful despite throwing up at times
  • However, there are more serious causes of fever and vomiting – ranging from a bladder infection all the way to meningitis
  • If you’re worried that your child is less responsive, more floppy, not themselves – then it’s always worth seeking urgent medical help





How to Recognize and Treat Headaches in Kids and Teens

Prof Anne MacGregor gives tips for parents on how to recognise and treat headaches in children.

headaches in kidsMost children and teenagers get at least one headache a year. They’re often different from the headaches that adults get, so parents and healthcare professionals can fail to notice the problem.

Headaches, including migraines, tend to be much shorter in children, according to Prof MacGregor of the Centre for Neuroscience and Trauma at Barts and the London School of Medicine and Dentistry.

In children, headaches start suddenly, with the child quickly becoming pale and listless, and often feeling sick and vomiting.

Children also generally recover very quickly. “The headache can be over half an hour later, with the child feeling well and playing outside as if nothing’s happened,” Prof MacGregor says.

Children’s headaches can also affect their stomach, so tummy ache is a common complaint, she says.

Skipping Lunch Causes Headaches in Children

“In my experience, children very rarely fake headaches,” says Prof MacGregor. “Children with headaches often get them if, for example, they skip their packed lunch or they haven’t had anything to drink all day.

“The best way for parents to prevent their children getting these headaches is to make sure they have regular meals and drinks, and that they get enough sleep,” says Prof MacGregor. “Give children a good breakfast so that, even if they miss lunch, they’ve been set up for the day. It’s also helpful to put children to bed at a fixed time each evening.”

Read more about healthy eating, including five healthy breakfasts.

Find out how many hours sleep a night your child needs.

Read advice on how much children need to drink.

Sport is a Headache Trigger for Children

Sport can trigger children’s headaches, probably because of dehydration and the effect on blood sugar. “Drinking lots of water and sucking glucose tablets (available from pharmacies and supermarkets) before and during sport can help. So can a mid-morning and mid-afternoon snack, as well as meals,” says Prof MacGregor.

Headaches and Childhood Emotional Problems

Sometimes, headaches can be the result of emotional problems. “They can come on during times of stress, like being bullied at school or because of anxiety over parents splitting up,” says Prof MacGregor. “Parents often think their child is fine, that they’re adjusting to the divorce and that they like their parent’s new partner. Sometimes, however, the child is not fine and their unhappiness is expressing itself as headaches.”

Find out if your child is depressed.

Keep a Headache Diary

It can be helpful to keep a diary of your child’s headaches. If your child is old enough, they can keep their own diary. This is a good way of working out specific headache triggers.

Keep a record of when the headaches happen. Also record any event that’s different from the normal routine or that might be relevant. This could be a missed meal, sports activity or a late night, or an emotionally upsetting incident, such as a stressful exam or an argument with friends or parents.

After a few months, look through the diaries together with your child to see if there’s a pattern of triggers that could be causing the headaches.

Download a headache diary from The Migraine Trust

Once you’ve identified possible causes, get your child to avoid them one at a time over the next few months to see if this prevents the headaches.

Headache Self Help Tips for Kids

Often, simple steps will be enough to help your child through a headache or migraine attack:

  • Lie them down in a quiet, dark room.
  • Put a cool, moist cloth across their forehead or eyes.
  • Get them to breathe easily and deeply.
  • Encourage them to sleep, as this speeds recovery.
  • Encourage them to eat or drink something (but not drinks containing caffeine).

If you think your child needs painkillers, start the medicine as soon as possible after the headache has begun. Paracetamol (*acetaminophen/Tylenol) and ibuprofen are both safe and work well for children with headaches. The syrups are easier for children to take than tablets. Alternatively, try Migraleve, a pharmacy remedy that treats migraine and is suitable for children aged over 12 (*may not be available in all countries – not available in the USA).

When to See a Doctor for Your Child’s Headaches

As with adults, most headaches in children aren’t a serious health problem. They can be treated at home with pharmacy remedies and avoided by making sure children get enough food, drink and sleep.

But don’t delay consulting a doctor or pharmacist if you’re worried about your child’s headaches, says Prof MacGregor. “I’d advise parents to seek help if their child hasn’t been helped by painkillers or if the headaches are interfering with schoolwork. It’s important for these children to get the all-clear from a doctor.”

Here is information from The Brain Tumour Charity’s HeadSmart campaign on how to recognise the symptoms of brain tumours in children.

Read more about how to treat common conditions using your local pharmacy.

Editor’s Note: *clarification provided for our US readers.

 

 





Video: Kids and Cancer – What You Need to Know About ALL

Dr Victoria Grandage, Consultant Hematologist at the Children and Young People’s Cancer Service at University College London, describes the signs and symptoms of Acute Lymphoblastic Leukemia, also known as A.L.L. She and the mother of a young former patient, Josh, talk about the treatment and experience of ALL; a cancer that, thankfully, has a high cure rate in children. Click on the picture below to go to the NHS YouTube channel to watch the video.

Editor’s Note: Video Highlights

  • Acute lymphoblastic leukaemia or ALL is a form of cancer of the blood
  • For reasons we do not yet fully understand, immature cells in the bone marrow – lymphocytes or lymphoblasts – rapidly build up and crowd out the normal bone marrow cells
  • Some of the symptoms of ALL include:
    • Anemia: tiredness, shortness of breath, lethargy
    • Infections, high fevers, maybe mouth ulcers
    • Bleeding, bruising and rashes
    • Enlargement of some lymph nodes around the neck or in the groin
    • Enlargement of the liver and spleen
    • Bone pain (a prominent symptom)

“When Josh was about two and a half, he went back to crawling rather than walking. He’d say his legs were too sore to walk and he’d crawl around for the first half hour or so (after getting up) and then start walking after that.”                                    Josh’s Mom, Angela

  • child with cancerInitial treatment, before a diagnosis has been confirmed, is supportive to address the above symptoms and can include fluids for hydration, antibiotics, and possibly a blood transfusion
  • Treatment of the leukemia itself involves chemotherapy, a broad term for many different drugs that may be given in tablet form, as injections, or directly into the blood stream as IV infusions
    • Some ALL chemotherapy drugs are also given via a lumbar puncture
  • Side effects of the chemotherapy include nausea, tiredness, and hair loss
  • Treatment begins with acute therapy – for Josh this lasted 9 months – and is followed by maintenance treatment for a couple of years
    • Josh’s total treatment lasted three years
  • The majority of children with ALL go into remission – and 75%-80% of those are cured
  • Further intensified treatment, including a stem cell transplant, may be required for children who do not go into remission

 





Your Child’s Sick: Do You Know if They Need Antibiotics?

Antibiotics are wonderful things. Since penicillin was first found and produced in the early twentieth century and used during the Second World War, it and related antibiotics have saved countless lives and cured many an illness quickly.

Antibiotics work by inhibiting certain growth factors and processes needed by bacteria to reproduce and flourish. As with many significant discoveries, penicillin was found purely by luck when an early twentieth century biochemist was trying to grow Staphylococcus (a type of bacteria). He opened the Petri dish to find that the growth of Staphylococcus seemed to be inhibited by a white substance growing next to it; that substance was studied and named “penicillin”, and indeed, did prevent growth of bacteria. The huge toll of injured and dying soldiers during the Second World War stimulated a renewed interest in the now decades old “antibiotic”, and it was pressed into service on battle fields around the world. Its successful wartime use spread to the private sector. Although initially used to help cure life threatening illnesses, it began to be used for even minor illnesses that would begin a trend that is still going on today.

The number of antibiotics in use today and their complexity is overwhelming and new ones are produced in ever increasing numbers. The primary reasons for producing a new antibiotic are to be able to treat an increasing number of bacteria known to be producing new diseases in people. Also the old antibiotics become outmoded when the existing bacteria develop very intricate mechanisms to shield themselves from the effects of the antibiotics (resistance).

Antibiotics are ineffective against viral infections, but many times well meaning health care professionals put them into use to possibly stop the advance of the viral illness (or secondary bacterial infections). Sometimes, antibiotics are dispensed at the insistent request of the parents who, in a misguided attempt to help “cure” their child of a viral illness, wish to use the latest antibiotic. At least in Pediatrics, an overwhelming majority of illness is due to viral infections and therefore speaks against the use of an antibiotic.

When antibiotics are used indiscriminately and in large amounts the following things can occur:

  1. More “allergic reactions” because of the widespread use of these drugs
  2. Increasing numbers of bacteria are developing resistances to these new and old drugs (leaving very few effective antibiotics for some very dangerous bacteria)

This is a trend that will probably continue unless health care professionals make this information available to the public. It is important to note, as new antibiotics are developed, the cost of delivering these to the portion of the population that really need them becomes prohibitive and adds tremendously to the cost of health care in this country. The process of getting a new medicine through the testing and the FDA is both very time consuming and expensive

Most of your child’s illnesses will be viral in origin and will not need an antibiotic. In addition, some routine illnesses that children get, such as ear infections, have been scrutinized carefully by researchers and their findings suggest that antibiotics may not be needed in mild ear infections. In fact, there are times that even severe ear infections can be followed carefully without the use of antibiotics as long as the pain is controlled. Every attempt is being made to limit the use of all antibiotics in general. There are certainly situations that require an antibiotic such as strep throat and certain types of pneumonia, but your doctor will discuss the options at the time of your visit.

Think both locally and globally when it comes to the use of antibiotics: it will help your child and children all over the world.

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Editor’s Note: with temperatures fluctuating wildly, (often by as much as 20 degrees on a day to day basis), it’s no wonder we’re seeing sniffles, sneezes and coughs that just won’t go away.  With the questions on every parent’s mind: “is this a cold? maybe the flu? should I take them to the doctor? do I need to keep them home from school an extra day”, it seemed the perfect time to re-share this Dr Joe classic from 2010 (Antibiotics…Not Always the Answer).  

Babies Should Get Peanuts Early to Cut Allergy Risk

New guidelines issued yesterday by experts from the US National Institutes of Health (NIH) recommend introducing peanut-containing foods to babies as early as possible as a way to lower their risk of developing a peanut allergy.

The recommendations reverse previous advice to add peanuts later, but are driven by new scientific research that showed early introduction of peanuts could cut allergy development by 81%. The guidelines are tailored for a child’s risk for peanut allergy, as follows:

  • babies should get peanuts earlyInfants at HIGH risk for peanut allergy (have severe eczema, egg allergy or both)
    • Add peanut-containing foods as early as 4 to 6 months
    • Consult with health care provider prior to adding peanuts – specialized testing may be needed
  • Infants with mild or moderate eczema
    • Add peanut-containing foods around 6 months
  • Infants without eczema or any food allergy
    • Add peanuts to infant diet as appropriate/desired
  • IN ALL CASES, start babies on other solids before adding peanut-containing foods

If you have specific questions or concerns about introducing your child to peanuts, speak to your pediatrician or family doctor.

 

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