Travel in Good Health – Part 3 of 3

26 07 2014

Babies and small children are less able to fight off foodborne and waterborne infections. Little ones who are crawling or walking around and putting things in their mouths increase their exposure risk.

What comes from those infections? Yes, you knew we had to get there. We’re talking poo. The kind that makes you want to pay strangers good money to change an oozing diaper.

But, there are a few things we can do to help prevent the big D.

Breastfeeding helps eliminate foodborne and waterborne transmission to infants.

Use purified water for drinking, ice cubes, formula, brushing teeth, washing food if eating food raw, or just anytime you’d use water. Purify the water, unless you know the water source is safe.

Wash hands with soap and water frequently each day and certainly before eating anything and before preparing foods, after changing diapers, after going to the restroom, after coming in from outdoor activities (this includes shopping!), when you get up in the morning and before going to bed at night. Use soap and water if available and always when you can see any grime on the hands. Alcohol-based hand sanitizer can be used to help disinfect your hands.

Pacifiers and other items made to go into a baby’s mouth that you bring or buy on the trip need frequent cleaning.

Don’t eat food from street vendors. Make sure all your food is either cooked thoroughly or washed with purified water and, if applicable, peeled.

Dehydration due to diarrhea and vomiting

Infants and young children can easily become dehydrated due to diarrhea and vomiting. They need plenty of liquids each time they have a watery stool or vomit. If you’re unaware of the signs of dehydration, you should read up on it prior to departure. Prevention is the best thing, but just in case, there are commercial oral rehydration solutions, or you can make your own. Here are some suggestions from rehydration.org:

Make sure the rehydration drink has in it starches and/or sugars, a little sodium and some potassium. Breastmilk is great for those nursing, or watery cooked cereal, carrot soup, or rice water is fine as long as they’re made with purified water.

You can make a simple solution yourself by using salt and sugar (molasses, raw sugar or white sugar) and something like orange juice or mashed banana for potassium. Add one teaspoon of salt to eight teaspoons of sugar and stir into a liter of boiled and cooled water, stirring until everything is dissolved.

Fresh fruit juice, weak tea or even simply boiled and cooled water will help, if nothing else is available.

Parasites in the soil

There are parasites in sand and soil where children love to play. They should wear enclosed footwear and play on a tarp or covering. Don’t put clothing or towels on the ground to dry, and iron anything you hang out to dry before using. All of these precautions are dependent on your destination, of course.

Rabies

Children are more likely to be bitten by animals yet less likely to tell parents about the bite. Remind the children to stay away from animals and to report any wound immediately. If a child is bitten or wounded, wash the area with soap and water and take the child in for evaluation. If possible, bring the animal in as well.

Water and infectious agents

Children and adults can pick up illnesses or infections by swallowing or simply being in contact with contaminated water. If you don’t know the area, don’t swim in fresh, unchlorinated water and, depending on where you travel, be careful with washing in the bathtub.

Well, that’s about it. We’ve come to the end of our Travel in Good Health series. Hope you enjoyed it as much as we did and, hey, maybe we’ll meet you on the road somewhere and do some trading. Ten diapers for a barf bag?  Anybody?

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Travel in Good Health – Part 1 of 3

24 07 2014

[Editor’s note: We posted this a few years ago, but find the info timely, so what the heck, we’re running it again! Parts 2 and 3 run 25 and 26 July.]

Traveling with children, no matter their age, can be a joyful, tiring, exciting, and exhausting endeavor. Traveling with children who get sick on the trip is just plain exhausting and, sometimes, exciting in a way that we don’t want to experience.

Although dealing with illness in the midst of a family trip isn’t ideal, you can take steps to prevent illness before traveling and equip yourself with supplies to make the treatment of illness easier and more comforting.

Prevention is key, and no one does that better than the CDC. This article captures some tips for traveling families from CDC’s website, and a few other places.

If anyone in your travel group has an existing condition that may affect his or her health, it’s important to discuss travel health safety with a healthcare provider.

If you’re traveling outside the United States and you love detail, download a copy of CDC’s Yellow Book . It’s written for healthcare providers, but many people find it useful. Wherever you’re traveling, these suggestions may help you and yours avoid infectious diseases on the road.

There are steps you can take prior to departure that will protect you and your kids, and many things you can do while traveling. First, the pre-departure list:

Time Zones and Rest

If you’re changing time zones, spend a few days just before travel adjusting your sleep/wake periods to match the destination’s time zones. When you arrive, get out during the sunny periods so that you body realizes it’s time to be awake. Good sleep is critical to good health. Make sure everyone gets lots of rest a few days before and then during the trip.

Vaccinations

You and your kids should be up-to-date on currently recommended vaccines in the U.S.

If you’re traveling outside the United States, you need to check the destination country for recommended vaccines for you and your children, and if you have special health concerns, you need to determine which vaccines to get and which you should not have. Not all vaccines recommended for international travel are licensed for children.

Health Notices

If you’re traveling outside the U.S., read the CDC’s Health Notices first to get the latest updates on infectious diseases in various areas of the world. What you learn may affect your travel plans.

First Aid Kits

Prepare a first aid kit for the trip or purchase one from a commercial vendor. This is a sample list, as not all destinations require the same things.

  • 1% hydrocortisone cream
  • Ace wrap
  • Acetaminophen, aspirin, ibuprofen, or other medication for pain or fever
  • Address and phone numbers of area hospitals or clinics
  • Adhesive bandages
  • Aloe gel for sunburns
  • Antacid
  • Anti-anxiety medication
  • Antibacterial hand wipes (including child-safe) or alcohol-based hand sanitizer containing at least 60% alcohol
  • Antibacterial soap
  • Antibiotic for general use or travelers’ diarrhea (azithromycin, cefixime)
  • Antidiarrheal medication (e.g., bismuth subsalicylate, loperamide)
  • Antifungal and antibacterial ointments or creams
  • Antihistamine (such as Benadryl)
  • Antimalarial medications, if applicable
  • Anti-motion sickness medication
  • Commercial suture/syringe kits (to be used by local health-care provider with a letter from your prescribing physician on letterhead stationery)
  • Cotton-tipped applicators (such as Q-tips)
  • Cough suppressant/expectorant
  • Decongestant, alone or in combination with antihistamine
  • Diaper rash ointment
  • Digital thermometer
  • Epinephrine auto-injector (e.g., EpiPen), especially if anyone has a history of severe allergic reaction. Also available in smaller-dose package for children.
  • First aid quick reference card
  • Gauze
  • Ground sheet (water- and insect-proof)
  • High-altitude preventive medication
  • Insect repellent containing DEET (up to 50%)
  • Latex condoms
  • Laxative (mild)
  • Lice treatment (topical)
  • Lubricating eye drops
  • Malaria prophylaxis and standby treatment, as required by itinerary
  • Medications that the child has used in the past year
  • Moleskin for blisters
  • Mosquito netting, if applicable
  • Oral rehydration solution (ORS) packets
  • Personal prescription medications in their original containers (carry copies of all prescriptions, including the generic names for medications, and a note from the prescribing physician on letterhead stationery for controlled substances and injectable medications)
  • Safe water
  • Scabies topical ointment
  • Sedative (mild) or other sleep aid
  • Snacks
  • Sunscreen (preferably SPF 15 or greater)
  • Throat lozenges
  • Tweezers
  • Water purification tablets

Discuss with your family’s pediatrician any special needs your children might have that require you to prepare beyond this basic list. Also, your pediatrician may be able to give you sample sizes of antibiotics and other meds that may be useful for your kit.

Health Insurance

Before traveling, check your health insurance policy to see what it pays for. It will probable reimburse you for most of the cost of emergency medical care abroad, excluding any deductible or co-payment. For non-emergency care overseas, you may be covered, but check with your health plan about this before you leave home. Failure to get authorization may mean denial of reimbursement.

Travel Regulations

Check travel regulations and carry what you can onboard the plane, particularly prescription medication. Put the rest in your checked baggage. Put your first aid kit in a fanny pack or backpack that you take with you everywhere you go. There’s no sense bringing the kit if you don’t have it when you need it.

Now that you’ve done your pre-departure prep, stay tuned for Part 2 for some tips on problems you may encounter on the road.

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Standard Precautions for Your Family

19 12 2011

At PKIDs, we talk a lot about disease prevention and the three steps you and your family can take to stay as healthy as possible. Today I’m going to share some of our information about one of those steps, but I can’t resist mentioning the other two.

First, keep your hands clean and don’t touch your eyes, nose or mouth. Those are prime areas for germs to enter your body.

Second, check with your provider to see what vaccines you and your family need and then get vaccinated on schedule.

Third, practice standard precautions in daily living. This means that you assume that everyone’s blood and body fluids are infectious for HIV, hepatitis B or C, or other bloodborne pathogens and you act accordingly.

People of all colors, rich and poor, fat and thin, old and young are chronically infected with HCV, HBV, HIV, and other diseases. Forty to 90 percent of these folks don’t know they’re infected.

It’s impossible to identify those living with an infectious disease. The only way to try and keep yourself and your kids reasonably healthy is to learn a practical approach to standard precautions. At first, you’ll be paranoid of everyone and everything, but as the precautions become habits, they’ll be a natural part of your life—like turning the lock on a door, or stepping on the brake at a red light. They will become normal, daily precautions.

The primary thing to remember with standard precautions is to always have a barrier between your skin and mucous membrane (around the eyeballs, gums, and inside the nose), and the (potentially) infectious substance. Go to a medical supply store and buy some latex gloves. Keep them in your house and car. If you don’t happen to have gloves and you need to deal with someone’s body fluid, put sandwich baggies or trash can liners over your hands. Use a sanitary napkin or thick, rolled-up towel to collect the fluid or staunch the flow of blood.

Sometimes blood and body fluids can become airborne. If you wear glasses, keep them on. If you don’t wear glasses, put on your sunglasses to protect your eyes. If you have one, tie a scarf around your face like the masked bandits used to do.

Use a one-part bleach to ten-part water solution or another disinfectant for cleaning up substances, including your own! As soon as you have dealt with the situation, throw away the disposable protective items (your gloves, etc.) and wash your hands thoroughly.

As soon as possible, cover your hands again and remove any non-disposable items you’re wearing and wash them appropriately. Common sense will guide you in this. Just don’t go through all of the precautions only to bare-hand your dress which is covered in someone else’s body fluid.

Make sure you keep all of your cuts and abrasions covered with a waterproof bandage. Be careful with badly chapped skin. It can crack and allow fluids to enter and exit. These precautions are a two-way street. You may be one of the millions unaware that you’re living with an infectious disease.

Only you know if your child is old enough to understand these precautions. Practicing them with your kids would be useful for the whole family. If your kids are too young to understand what we’ve outlined, there are a few things you can try to help the younger members of the family participate in standard precautions.

It would help if you set aside a non-work day to role play this with your kids. Call it: Family Safety Day. This would also be a good day to practice evacuating the house in case of fire and all those other safety rules we seldom rehearse.

To help the kids understand how invisible germs can pass from one person to the next, put glitter on your child’s hands and let him/her go to the bathroom, play with family members, and pick up a cracker (without actually eating it). Go back to the beginning of the journey and walk him/her around the house, following the trail of glitter. This will help demonstrate how we can pass germs (and other things) to each other without knowing it. To press home the point, you might put glitter on your hands, too.

Have one member of the family be “bleeding” ketchup. You be a young child and run for an adult when you see the blood. Have your young child go through the same scenario several times. Then pretend there’s no adult around and show your child how to use a coat or towel as a barrier between them and the blood.

It’s important that they learn not to reach out and touch another person’s blood or body fluid. One way to help them understand (and this is kind of gross) is to ask them if they would touch someone else’s poop or nose gunk. Most kids, no matter how young, will say no. You can then explain that blood is really personal, like poop and nose gunk, and they don’t want to touch anyone else’s blood.

This approach is necessary only for a few years. Once they get to be five or six, you can start explaining more.

A few general rules for everyone to remember would be: don’t share razors, toothbrushes, manicure tools, nail clippers, hypodermic needles, cocaine straws, body piercing equipment, tattooing equipment, or anything that can puncture or is a personal grooming item.

Standard precautions as practiced by healthcare professionals cover a wide range of topics, including sharps disposal, ventilation devices (mouth pieces for resuscitation), specimen handling, and other opportunities for the spread of infection which you are unlikely to come across in daily living.

We wanted to give you some practical, basic precautions to help you live a normal, safe life. Let us know if you have any ideas for teaching little ones precautions.

You might want to check on your daycare or preschool or kindergarten’s awareness of standard precautions. Most of them will say they’ve had AIDS training. If they are receptive to suggestions, feel free to share some of these ideas with them.

We know of a preschool which keeps a chart for cleaning the bathrooms, gloves are always worn when necessary, and they really work hard to do everything right. But, several of the preschoolers never get to use soap on their hands because the sink is too wide for them to reach across to the soap dispenser, and the side access is blocked from a large storage cabinet which is pushed against the sink. The best of intentions can’t overcome reality.

Following these steps won’t guarantee you a disease-free life, but it’ll cut down on the number of infections you have.

By PKIDs staff

Image courtesy of skidmore.edu





Vaccine Education Center

28 04 2011

Dr. Paul Offit, Director, VEC

The science of vaccines can be . . . daunting. The lists of ingredients and potential side effects make us want to second guess ourselves and our children’s providers. We need to be sure we’re making safe choices.

And the complicated schedules! They’re enough to make sane people pound their heads.

The folks at the Vaccine Education Center (VEC) at Children’s Hospital of Philadelphia have a gift for presenting the complexities of vaccines and attending issues in a way that’s easy to understand yet comprehensive in scope.

The VEC website has a special section for parents and adults of all ages.  While there, you can sign up for the Parents PACK newsletter to get monthly immunization updates.  In the March issue, there’s a timely post on measles and the dangers of rubella parties.

You’ll also find age-specific information on vaccines and the diseases they prevent. There are FAQs, but if you can’t find your question, you can send it in via a form provided on the site.

The VEC has created a library of educational materials on specific vaccines and commonly asked questions. These resources range from information sheets to more consumer-friendly bookmarks and brochures.

They also maintain essential tools, including vaccine schedules, facts about vaccine preventable diseases, and the latest in vaccine science.

To keep information fresh, the VEC pens a monthly “Ask the VEC” on a myriad of topics.

Starting in 2011, the VEC will present three or four webinars a year addressing evolving issues, recent ACIP meetings, new science and media reports.

There are layers and layers of information available on the website, for those of us who feel more is better.  And what parent doesn’t?

The VEC staff constantly works at sifting vaccine fact from fiction and explaining the difference in ways we can all understand.  If you have questions, they’re worth checking out.





Sand, Surf, and What?!

25 04 2011

Kids love to dig in the sand and build castles. They’ll work for hours, crafting structures of dizzying heights, sculpting the turrets and drawbridges just so with their hands.

Oh, and getting buried in the sand? Even better.

Turns out, all that digging and getting buried can expose kids to lots of germs.  Researchers found “… evidence of gastrointestinal illnesses, upper respiratory illnesses, rash, eye ailments, earache and infected cuts. Diarrhea and other gastrointestinal illnesses were more common in about 13 percent of people who reported digging in sand, and in about 23 percent of those who reported being buried in sand.”

Just makes your skin crawl, doesn’t it?  Before you give up on the beach, know that there are things we can do to combat the germs.

Tell the kids they can play in the sand, but not to touch their faces with sandy hands, and make sure they clean their hands with soap or sanitizer when they’re done playing.  Also, send them to scrub down in a shower as soon as possible after play.  There’s no guarantee they’ll avoid an infection, but it’ll help.

Kids (and adults) love to swim in pools, lakes, and oceans. We’re usually swimming in urine,  garbage, or who knows what contaminants.  Due to the reality of raw sewage runoff, we could come down with all sorts of infections, including E. coli, after practicing the backstroke.

Blech, but hey, everything carries a risk. There’s no guarantee we’ll get sick or we won’t get sick from swimming.

So go. Swim. Enjoy and shower when you’re done.

Life is too short not to have fun on vaca!

(Photo from dMap Travel Guide)





April: STD Awareness Month

21 04 2011

There are an estimated 19 million new cases of STDs each year in the United States.  That’s too many.  We can significantly cut that number down.

April, the STD Awareness Month, is a time to shine a light on sex and disease.

STDs know no age limits, they can be visible or invisible and, yes, they can even affect our own sons and daughters. STDs also have a serious economic impact, with direct medical costs estimated at $17.0 billion annually  in this country alone.

The majority of STDs are preventable. Just by having a frank discussion with our partners, and using the appropriate protection, we can prevent most sexually transmitted diseases.

These are practical resources to help individuals and parents learn more about STDs and how to deal with current or potential infections:

There is never anything embarrassing about protecting our health. So wrap it up, protect yourself and keep STDs at bay!

(Photo courtesy of Andy54321)





Celebrating Prevention! NIIW 2011

18 04 2011

Protecting babies from infectious diseases is a big deal around here, as evidenced by disease prevention taking up a chunk of space in our mission statement.

National Infant Immunization Week (NIIW), observed April 23-30 this year, is part of a larger global vaccine education initiative with WHO. For the past 17 years in the U.S., the CDC, health departments, and immunization organizations across the country have marked the week as a time to showcase immunization achievements and raise awareness of the need for continued vaccination of babies.

We asked our child immunization friends to share their planned activities, and we did some research of our own to find novel programs to share. To learn about activities in your area, visit the CDC’s NIIW site for details. Here’s a sampling of events coming up for NIIW:

  • Arizona – The Cochise County Health Department is giving free diapers to parents who bring in up-to-date immunization records. Children who need vaccines will also be vaccinated at the event and parents will receive free diapers. Scientific Technologies Corporation is doing a blog series during NIIW and promoting the week on their homepage.
  • Connecticut – The New Britain Immunization Program has collaborated with the New Britain Rock Cats Minor League Baseball Team to give free tickets to stadium visitors who have their children’s immunization records reviewed. The Southwestern Area Health Education Center will honor WIC moms and dads at a Mother’s Day Social where attendees will get education and play CIRTS (Connecticut Immunization Registry and Tracking System) BINGO.
  • Illinois – The Chicago Area Immunization Campaign has partnered with Jewel Osco, a local pharmacy chain, to distribute 15,000 immunization information cards with people’s prescriptions.
  • Nevada – The Northern Nevada Immunization Coalition will host “Give Kids a Boost: Sun Valley Health and Safety Fair” (GKAB Fair) to alleviate the barriers of health care access and transportation.
  • Rhode Island – The Rhode Island Department of Health has partnered with birthing hospitals and childcare centers to have area children to draw pictures inspired by the story “The Flu and You,” by Geri Rhoda, RN. The pictures will be used on placemats designed for use in the maternity wards and will include the infant immunization schedule and information about the importance of vaccinating caregivers with Tdap.
  • Texas – The Hidalgo County Health & Human Services Department will host an event with speakers from Mexico and Texas educating promotoras (health educators in Latino communities) on vaccine preventable diseases, the importance of vaccines, and the Mexico/US immunization schedule. The Immunize Kids! Dallas Area Partnership is reaching out to Hispanic families and women’s centers with education packets and presentations.

Do you have great activities planned for NIIW? Post a comment and tell us about it!

(photo courtesy snorp on Flickr)