TB Today

24 03 2014

Tuberculosis. Sounds old-timey to me, a disease not of this century.

My 87-year-old uncle had TB when he was a teenager. He was sent to a sanatorium and came back about a year later, more or less healthy.

In those days, TB was the leading cause of death for teens and young adults. He was lucky to survive it.

Today, TB hasn’t dropped down the list much. It’s still a killer, and holds the number two spot in the world for leading cause of death from infectious disease.

One million kids get sick from TB each year. The World Health Organization says that in 2012, about 8.6 million people developed TB and 1.3 million died from the disease.

We talked about the details of TB on this blog last June. Today, let’s watch a story unfold. This is Chapter One of EXPOSED – four short films by Aeras TB.

 

 

 

By Trish Parnell

 





A Brother’s Love

14 03 2014

My older brother, Evan, and I were 12 1/2 months apart.  We were the “twins” who weren’t really twins, but who shared a bond so close, that I still can’t believe he is gone.

I never needed to worry about having friends around, because I always had Evan.  We both loved sports, and I have the greatest memories of growing up playing baseball, soccer, and basketball together.  It was a great family time, and one I hope to impart to my children.

Evan wanted to be a pitcher on a college baseball team, and my dad took him around to different colleges in Georgia.  After tryouts at Georgia Southwestern University, Evan was asked to join the team as a walk-on player.

Me and Evan

Me and Evan

He was at a small university, but he loved it and loved his team.  I was attending the University of Georgia, and I was so proud of my brother for following his dream.  Both of us had plans to become orthopedic sports physicians and practice medicine together.  We would get married, our children would not only be cousins but best friends—everything was planned out, everything was in motion.

Then, Evan came down with a violent migraine, so we thought.

The ER physicians diagnosed him as having a “little virus,” but it wasn’t a “little virus.”  It was bacterial meningitis, or more specifically, “meningococcal disease.” My parents were told he had a 5% chance of survival.

I can only imagine, now that I am a parent myself, what horror they must have felt hearing that their son might die.  I was on spring break with some friends in Florida, and my parents couldn’t reach me until much later that night.  I immediately left to drive to the hospital where Evan was being treated.

In a spirit of youthful optimism, I felt that if Evan knew I was by his bedside, he would rally, just as each of us could always get the other one to rally.

But this horrible disease was stronger than all of the prayers and love being sent to Evan.  My parents and I watched the disease ravage Evan’s body,  as gangrene set in on his arms and legs.  We watched the machines monitoring Evan, willing the numbers to be stable, for some sign of improvement.

As Evan was transferred to a third hospital, a burn unit, we were told that Evan had a 1% chance of survival.  I remember asking my mom about life after death.  I didn’t understand how my brother could be so sick.  Evan went in for surgery to try to save his life, and both arms and legs were amputated.

That still wasn’t enough.

I watched my brother, in a medically induced coma, lie in bed with stumps, his face and body bloated from kidney failure.  I cried, I prayed, I begged.  I would go listen to music in my car, to try to escape from the reality of what was happening.

Then, Evan suffered 10 hours of grand mal seizures, and that caused irreversible brain swelling, and a herniated brain stem.

My brother, who I loved so much, was brain dead.

We all watched as Evan was disconnected from life support, flat-lined, and carried away in a body bag.  Those are my last images of my brother.

I missed that quarter of school, because Evan had been in the hospital almost a month.  When I went back, it was with a renewed determination to be a doctor.  I did get admitted to medical school, and when I graduated, I fist-pumped my arm, and said to myself, “Evan, I did this for both of us.”

I still talk to Evan, I still miss him so much, and I carry his memory with me everywhere.  My daughter’s middle name is Evan. When I got married, I did not have a best man, because that spot was reserved for Evan.

When my parents and I found out that Evan’s death could have been prevented with a vaccine, that was being routinely used in the military, it just made no sense.  Why hadn’t any of us been told about the vaccine?

Needless to say, I am a staunch vaccine advocate, and as a primary care physician, I make sure that all of my patients are up-to-date on all CDC-recommended vaccinations.

It really is your choice, and your life. Take control and protect yourself against infections by getting immunized.

by Ryan Bozof





Baby Armor

6 03 2014

And now, a timely reminder from CDC:PSA-superbaby

It’s easy for parents to think of vaccine-preventable diseases like measles or whooping cough as issues of the past, but we know that most of these diseases still persist around the world.

Just last year a higher than normal number of measles cases were reported in the U.S., including an outbreak of 58 cases in New York City that was the largest reported outbreak of measles in the U.S. since 1996.

Making sure children get all of their vaccines is the most important thing parents can do to protect them from 14 serious childhood diseases before their second birthday. And CDC has created a series of print PSAs encouraging just that (including an adorable  super baby version).

CDC also has immunization schedules available for all ages and a handy scheduling tool that allows you to enter your child’s birth date and print out a custom copy of his or her personal immunization schedule.

As winter begins to fade and a new spring season starts creeping up, don’t forget to schedule your pediatrician’s visits and discuss vaccinations with your doctor. Let’s give our little super heroes the best protection we can.





Rotavirus, Vaccination, and Intussusception

15 01 2014

Rotavirus is a nasty little germ that targets our stomach and intestines, making them swollen, red, and sore.

The intestines help digest the food and liquid we take in, and they make poop out of what doesn’t get absorbed into our bodies.

When the rotavirus attacks, it can cause our poop to turn into watery diarrhea. Fever, vomiting, and pain are often part of the disease.

In younger kids and babies, the diarrhea and vomiting can be nonstop, causing a serious loss of body fluids (dehydration).

The CDC says that “Rotavirus is the leading cause of severe diarrhea in infants and young children worldwide. Globally, it causes more than a half a million deaths each year in children younger than 5 years of age.”

We have effective vaccines—hospitalization rates have dropped 96 percent in the US since the vaccines became available, and the overall number of infections has plummeted.

There’s something that can happen that’s a rare side effect of the rotavirus vaccine. It’s called intussusception. The important thing to know is that intussusception happens anyway in the infant population, but with the vaccine, there appears to be a tiny increase in numbers of those affected.

Intussusception is when one part of the intestine slides into another, similar to a telescope closing. This causes a blockage in the intestines which requires hospitalization and sometimes surgery.

In the US, there are about 34 intussusception-related hospitalizations per 100,000 babies in the first year of life.

These cases happen whether a baby has been vaccinated against rotavirus or not. It’s called the “background” rate.

There has been a slight uptick in cases of intussusception with vaccination against rotavirus. For those babies vaccinated, the increase in rates of intussusception appears to be 1 to 5 cases per 100,000 babies.

We’re talking about this because a couple of studies have been done and these are the findings. It’s important to know all that we can when making health decisions for our children.

We parents don’t want to expose our babies to anything that might harm them. In the case of rotavirus disease and vaccination, it’s clear that the greater risk by far is the disease.

Talk to your baby’s healthcare provider and make the informed decision to protect your young one against rotavirus. It can be a deadly disease.





I’m Immunized! (Pass it on!)

12 11 2013

At PKIDs, we have seen the awful reality of children affected by preventable disease: horrible illnesses, hospitalizations, chronic infections, and sometimes death. C

We share our stories with the hope that others will learn from them and get their families fully vaccinated to protect themselves and the ones they love.

In the same way that we are intimately familiar with the harm that comes from not vaccinating, we are also joyously aware of what happens when a family is fully vaccinated.

We want families to understand that getting vaccinated isn’t just about avoiding the horrors of disease. It’s also about experiencing the happiness of health.

Our I’m Immunized! campaign is a visual depiction of immunized people living happy, energetic lives.

We invite you, as immunization advocates, to share these images through your social media platforms, and to use them in your organizations’ educational outreach.

Immunization advocates at PKIDs share their families’ personal stories of illness and loss with the hope that those who hear the stories will be motivated to protect themselves and their loved ones through vaccination.

We humans are certainly motivated by empathy for others and a feeling of vulnerability for ourselves and those we love.

We are also motivated by positive messages that make us aspire to attain positive goals.

Both approaches may be effective, as noted by Angela Y. Lee and Jennifer L. Aaker in Journal of Personality and Social Psychology: “A positive frame that promotes something desirable is more effective than a negative frame that laments the absence of something desirable. At the same time, a negative frame that threatens the onset of something undesirable is more effective than a positive frame that promises the absence of something undesirable—a concept known as ‘regulatory fit’.”

RRAs parents, we at PKIDs share the realities of vaccine preventable infections with those who question the need for protection by immunization. We also propose to share the benefits of a vaccinated life.

Staying healthy is good. When you’re healthy, you can play and party and easily tackle life’s challenges. Vaccinating is a beneficial choice because it makes one’s life healthier and therefore happier. Adding that messaging through the I’m Immunized! campaign to our current communications mix is just what we all need to help spotlight the positive aspects of vaccination.

We encourage you to send us pictures (pkids@pkids.org) of family members of various ages who have been immunized. We’re looking for good, impactful photography. We will format them and add them to the growing library of images depicting the positive that comes through immunization.

Or, upload your pictures to your social media platform of choice (Google+, Instagram, Facebook, Twitter, etc) and use the hashtag #I’mImmunized! or, #We’reImmunized! if there’s more than one of you in the photo.

We’d love to hear or see how you’re using these images to promote immunization. Share with us directly at pkids@pkids.org, or in the comment section below.

Thanks!





Stay Healthy This Winter!

30 09 2013

Stay Healthy This Winter

Click here for larger image!





Your Student Athlete

27 08 2013

Kids are back in school and signing up for sports.

Some parents wonder about their infected children playing sports and possibly infecting others in the process.  Parents also wonder how concerned they should be about their children becoming infected from other players living with undiagnosed or undisclosed infections.

Playing sports can be risky in many ways and part of that risk is the potential to become infected with all sorts of germs.

Parents of children living with diagnosed infectious diseases worry that they may be responsible for infecting another child.  They wonder if they should inform the coach or the school.  They worry that the adults in charge don’t really follow standard precautions, thereby increasing the risk of infections.  They want their kids to enjoy life and they want to do the right thing.

The American Academy of Pediatrics issued a policy statement on this dilemma in December, 1999: HIV and Other Blood-Borne Viral Pathogens in the Athletic Setting. In it, the Academy made clear, “Because of the low probability of transmission of their infection to other athletes, athletes infected with HIV, hepatitis B or hepatitis C should be allowed to participate in all sports.”

The AAP’s Redbook still supports this policy.

Participation, however, assumes all athletes and coaches will follow standard precautions to prevent and minimize exposure to bloodborne viruses.

There is no reason to exclude any student from sports if they’re infected with HIV, HBV or HCV.  Nor is there a reason to disclose the infection.  There are many people living with undiagnosed infections, so it is more prudent to ensure everyone is practicing standard precautions rather than simply excluding those with known infections and not properly protecting all athletes from undiagnosed infections.

Dr. Steven J. Anderson, a pediatrics professor at the University of Washington and a team doctor for many high school athletic teams, ballet companies and the U.S. Olympic Diving Team, suggests children should have access to any sport, except boxing, which the Academy opposes for all youths because of its physical risks.

Pediatricians can avoid reporting a student’s infection, the Academy noted, by making it clear on any participation forms that they support the Academy’s position that all students can participate in all sports and that pediatricians must respect an athlete’s right to confidentiality.

But strict compliance with standard precautions is critical for this open embrace of all athletes, regardless of their infectious status.  Dr. Anderson notes that, as a parent, he would make sure that there is a plan in place to handle blood spills, including latex gloves, occlusive dressings, appropriate sterilizing solutions, disposal bags and even a printed protocol for coaches, athletes and officials.

Dr. Anderson does feel that students with infectious hepatitis A (spread through close physical contact with contaminated food, water or skin) or with liver or spleen enlargement should be restricted from contact or collision sports until the liver or spleen has returned to normal size, and the person is no longer contagious.

An article that ran in 2004 in the British Journal of Sports Medicine talked about possible methods of transmission in sports and reported incidents of transmission:

Bleeding or oozing injuries could, in theory, transmit the virus through the mucous membrane or injured skin of other athletes.  This risk is considered extremely low.  However, contact and collision sports like wrestling or boxing increase that risk.  The risk goes down a bit for those playing basketball or soccer, and those playing sports with little physical contact, such as tennis or baseball, are at the lowest risk.

It has been suggested that bloodborne infections may be transmitted through sharing a water container, because bleeding around the mouth is common in contact sport.  Therefore it is recommended that water containers should be available individually for each player in contact sports. Athletes should use squeeze water bottles which they do not put in their mouth.

Bloodborne infections can be transmitted through blood doping. There is also a risk from sharing needles which may be associated with drug abuse in sport. Injectable drugs used in sports include steroids, hormones, and vitamins.

Three separate cases of HIV infection associated with sharing needles among bodybuilders have been reported, two in the United States and one in France.  It has also been reported that three soccer players from one amateur club were infected with HCV as a result of sharing a syringe to inject intravenous vitamin complexes. Syringes have often been shared by athletes who inject vitamins minutes before a game.

A 1993 study estimated that, in the United States, there were one million people who were either current or past users of anabolic androgenic steroids. Of these, 50% were intramuscular drug users, and about 25% had shared needles. Therefore it seems that the risk of transmission in this way may be considerable among athletes, especially bodybuilders.

So, if your family is getting involved in sports, it would be worth your time to:

  • Get caught up on all vaccinations
  • Practice standard precautions
  • Wash your hands a lot or, if hands aren’t visibly soiled, use alcohol handrubs
  • Don’t share needles with anyone for any purpose