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Parenting

Mumps Reach 10 Year High; Hitting Colleges and Kids Hard

1:45

Mumps are making a comeback, particularly on college campuses and in daycare centers.

A recent U.S. Centers for Disease Control and Prevention report shows that mumps are at a 10-year high. As of November, 45 states and the District of Columbia had reported a total of 2,879 mumps infections — more than double the mumps cases reported in 2015.

Mumps is a contagious disease caused by a virus. Common symptoms can include swollen glands in front of and below the ear or under the jaw, pain with opening and closing the jaw, fever, fatigue and malaise, headache and earache.

Currently, college campuses are taking the brunt of the mumps outbreak.

Dr. Michael Grosso, medical director and CMO of Huntington Hospital/Northwell Health, said close quarters such as dormitory living, can make it easier to pick up the virus.

“It’s spread through respiratory secretions, coughing, sneezing, close contact and sharing the same cups and utensils,” Grosso told CBS News.

Some colleges, such as The University of Missouri’s Columbia, are asking students to restrict their social activities and to make sure they get immunized. Typically, two doses of vaccine are recommended by the American Academy of Pediatrics and the CDC, but the school is asking students to get a third measles-mumps-rubella (MMR) vaccine “based on discussions with public health officials and consistent with guidance from The Centers for Disease Control and Prevention.”

College students aren’t the only ones being hit hard by mumps; younger children are also experiencing a rise in reported cases. More parents have opted-out of getting their children the MMR vaccine - putting non-immunized children at a higher risk.

Daycare centers are similar to college dormitories in that they provide an environment where a virus can be easily spread.

While most mumps cases are mild, albeit, uncomfortable, others can be more serious.

“Most individuals recover uneventfully from mumps, however as many as 10 percent of males who get mumps will get an inflammation of the testes which can lead to permanent sterility,” Grosso said.

The brain can also be affected. About 1 percent of people who come down with the mumps get serious brain infections and can experience meningitis, encephalitis and deafness associated with a brain infection.

“That small risk was behind the original impetus to create a vaccine,” Grosso said.

 Physicians are urging students to get the immunizations and to practice good hygiene. Simple steps such as covering your cough or sneeze, washing your hands with soap and water or using an alcohol-based hand sanitizer, avoiding sharing food, drinks, cups or utensils can help prevent the spread of viruses.

Vaccines are still the most effective way to lower your risk of getting the mumps.  No vaccine is a 100 percent protective, Grosso notes, but it can help you avoid the risk of serious illness and lifelong health issues.

“Receiving two doses of mumps vaccines is said to confer about an 88 percent reduction in risk of getting mumps if you’re exposed,” said Grosso. A third dose may increase those odds.

The American Academy of Pediatrics recommends the first dose of MMR vaccine should be administered between 12 and 15 months of age, and the second dose between 4 to 6 years of age.

Grosso emphasizes that parents need to get their children vaccinated early.

“Being immunized late is better than not being immunized ever. But being immunized late is not nearly as good as being immunized on time,” Grosso said.

Story sources: Mary Brophy Marcus, http://www.cbsnews.com/news/mumps-cases-10-year-high-college-outbreaks-vaccination/

https://www.cdc.gov/mumps/

Daily Dose

Fight The Flu

1:30 to read

It is National Influenza Immunization Week, and I am hopeful that most everyone reading this has already had their flu vaccine….but if not, it is NOT too late! Just like the after Thanksgiving sales being extended…..your opportunity to be vaccinated has not passed!  Lucky for you, there are still vaccines available. If you act quickly there may be some places having a two for one sale, a coupon for shopping after getting vaccinate or even free vaccines…no excuses, everyone in the family ( over 6 months) may be vaccinated.

All kidding aside, this is an important time to remind people that it is not too late to get your flu vaccine and as of the first week of December there has not been a significant amount of flu in the country. But with that being said, influenza typically circulates December thru February but some years flu may even last into April or May.  But one thing is sure, flu is coming!!

No one is immune from the flu and the best protection is to get a flu vaccine!!  I hear people tell me, “they have never had the flu before so why should I get a vaccine?”, or “ I got sick after I had the flu vaccine, so I am not getting it again”.   Both of those are myths and are just a few of the anecdotes that I hear from patients and their families.

It is recommended that everyone over the age of 6 months receive a flu vaccine as it is the best protection against getting sick from the flu, and by vaccinating everyone we are also protecting those infants under 6 months that cannot yet get a flu vaccine.  Infants have a higher incidence of complications from the flu ( as do children with asthma and other underlying health issues ), and those precious babies born during the late summer and into the winter depend on the community to help keep them healthy. This is especially important for infants and children in day care, as influenza is a respiratory virus that is spread when someone in close proximity has coughed or sneezed. So, check to make sure that everyone in your daycare center is vaccinated, including the parents.

Statistics show that flu vaccination activity drops off after the end of November, but it is never too late to get the vaccine.  Remember,  it does take about two weeks to develop immunity after being vaccinated.  People also tell me, “I think I have already had the flu this year”, but even if you have, you have not had all of the strains of influenza that are in the vaccine and yes…you could get sick again. This years flu vaccine is available as a trivalent vaccine (which contains 2 type A, flu and 1flu B) and a quadrivalent vaccine ( with 2 type A and 2 B strains), and either vaccine is fine….get whatever your doctor, health department, pharmacy, grocery store, or employer has.  Most children over the age of 2 years may also take the live attenuated intranasal flu vaccine ( because how many kids want a shot -right?) and it is a quadrivalent vaccine.

So now is the time to run…not walk to get your flu vaccine!!  Don’t delay, put it on the top of the holiday “to do list”.

Daily Dose

Rotarix Vaccine Temporarily Suspended

The FDA suspends Glaxo Rotarix vaccine I received the CDC Health Alert yesterday afternoon notifying physicians to “temporarily suspend the usage of GlaxoSmithKline (GSK) Rotarix (rotavirus) vaccine. Rotarix was licensed for use in 2008 to prevent rotavirus disease, which typically causes fever, vomiting and diarrhea in infants and young children.

Prior to this Merck’s vaccine RotaTeq had been licensed for us in 2006. Both of these vaccines are given orally. Both RotaTeq and Rotarix were found to prevent serious rotavirus illness and hospitalizations for dehydration. The GSK product, Rotarix, which is a “live attenuated” vaccine, has been found to contain DNA from porcine circovirus type 1 (PCV 1). PCV 1 virus is not known to multiply in human cells or to cause illness.  According to the FDA, “all available evidence indicates that there had been no increased risk to patients who have received this vaccine”.  The GSK vaccine, Rotarix, is made in a different manner than the Merck vaccine RotaTeq.  Preliminary studies by the FDA on RotaTeq vaccine have not shown the presence of PCV 1 DNA. Preliminary data reported to the FDA  by GSK related to PCV 1 being in the vaccine seems to suggest that it has been present since the early stages of the vaccine’s development.  Studies on Rotarix, both before and after the approval of the vaccine, have shown it to be extremely safe and no unusual adverse events have been reported.  At the same time, the vaccines that have been given are presumed to be effective. In the interim, while futher studies are being completed, it is recommended that children continue to receive RotaTeq vaccine.  The FDA plans to convene an advisory committee to look into how the DNA components came to be present in this vaccine. They are also going to look into the use of new techniques for identifying viruses in vaccines.  After this meeting, the FDA will make further recommendations about the use of rotavirus vaccines in the United States. This recall was limited to the United States, and children in other areas or the world are continuing to receive Rotarix, as the available evidence suggests that the benefits of the vaccine outweigh the risks, especially in areas where rotavirus disease causes severe disease and even deaths. I would not be alarmed if my baby had received this vaccine as it does not cause disease in animals or humans.  I would also complete my child’s vaccine series with the Merck product which is available.  We will all have to stay tuned for further details,  but this should also make parents aware that the safety of vaccines continues to be monitored, even after they have been approved. That's your daily dose for today.  We'll chat again tomorrow! Send Dr. Sue your question now!

Your Baby

Infant Ear Infections Declining

2:00

Ear infections in infants are very common and can be quite unsettling for parents. The good news is that ear infections among U.S. babies are declining according to a new study.

Researchers found that 46 percent of babies followed between 2008 and 2014 had a middle ear infection by the time they were 1 year old. While that percentage may seem high, it was lower when compared against U.S. studies from the 1980s and '90s, the researchers added. Back then, around 60 percent of babies had suffered an ear infection by their first birthday, the study authors said.

The decline is not surprising, according to lead researcher Dr. Tasnee Chonmaitree, a professor of pediatrics at the University of Texas Medical Branch, in Galveston.

"This is what we anticipated," she said.

That's in large part because of a vaccine that's been available in recent years: the pneumococcal conjugate vaccine, Chonmaitree said. The pneumococcal conjugate vaccine protects against several strains of pneumococcal bacteria, which can cause serious diseases like pneumonia, meningitis and bloodstream infections.

Those bacteria are also one of the major causes of children's middle ear infections, Chonmaitree said.

She added that flu shots, which are now recommended for children starting at 6 months, could be helping as well. Many times an ear infection will follow a viral infection such as the flu or a cold.

Vaccinations "could very well be one of the drivers" behind the decline in infant ear infections, agreed Dr. Joseph Bernstein, a pediatric otolaryngologist who wasn't involved in the study.

Other factors could be having a positive impact as well, such as rising rates of breast-feeding and a decrease in babies’ exposure to secondhand smoke.

"The data really do suggest that breast-feeding -- particularly exclusive breast-feeding in the first six months of life -- helps lower the risk of ear infections," said Bernstein, who is director of pediatric otolaryngology at the New York Eye and Ear Infirmary of Mount Sinai, in New York City.

There's also the fact that breast-fed babies are less likely to spend time drinking from a bottle while lying down, Bernstein noted. That position can make some infants more vulnerable to ear infections, he said.

The study findings were based on 367 babies followed during their first year of life. By the age of 3 months, 6 percent had been diagnosed with a middle ear infection; by the age of 12 months, that had risen 46 percent, researchers found.

Breast-fed babies had a lower ear infection risk, however. Those who'd been exclusively breast-fed for at least three months were 60 percent less likely to develop an ear infection in their first six months, the study showed.

But whether babies are breast-fed or not, they will benefit from routine vaccinations, Chonmaitree said. "Parents should make sure they're on schedule with the recommended vaccines," she said.

Parents can have a difficult time recognizing an ear infection in an infant or a child to young to tell them that their ear hurts.

Some symptoms to watch for are:

·      Tugging at the ear

·      Fever

·      Crying more than usual

·      Irritability

·      Child becomes more upset when lying down

·      Difficulty sleeping

·      Diminished appetite

·      Vomiting

·      Diarrhea

·      Pus or fluid draining from ear

Treatment for ear infections rarely requires medication, such as antibiotics, except when an infection is severe or in infants. 

According to the American Academy of Pediatrics (AAP), most children with middle ear infections get better without antibiotics, and doctors often recommend pain relievers -- like acetaminophen -- to start. But with babies, Bernstein said, antibiotics are often used right away.

The AAP recommends antibiotics for infants who are 6 months old or younger, and for older babies and toddlers who have moderate to severe ear pain.

The study was published online in the March edition of the journal Pediatrics.

Story source: Amy Norton, http://www.webmd.com/children/news/20160328/infant-ear-infections-becoming-less-common

Your Teen

Study: 1 in 4 Girls Received HPV Vaccine

A new government study shows that one in four teenage girls have received the new HPV vaccine. The vaccine protects against strains of the virus that cause about 70 percent of cervical cancers. The study done by the Centers for Disease Control and Prevention covered children ages 13 to 17 years old. The recommended age that girls get the shots is 11 to 12 if possible, before they become sexually active. The vaccine is a three-shot series that costs about $375, although many health insurers now cover it.

Merck, the maker of the Gardasil vaccine, said they were pleased with the vaccination rate.

Daily Dose

Deciding to Vaccinate Your Child

1.15 to read

I was recently doing a 4 year old well-child check up. This little girl was the youngest in a family of 4 girls with the oldest daughter being 18.

Through the many years of taking care of this family of girls, I have come upon new issues and changes that have occurred in pediatrics.  There have also been and will continue to be, different parental concerns. 

When this child was born, there was still a lot of discussion about immunization safety and parental concerns surrounding vaccines and autism. Although all of her older siblings had been immunized on schedule, without any issues at all, when the “baby” was born her mother and I had many discussions about giving this little girl her vaccines. 

The mother told me that she was now “hanging out with younger parents and they had made her concerned about vaccines, specifically as they related to autism.”  

Well, after much discussion and hand wringing on the mother’s part, the little girl was vaccinated on schedule just as her siblings had been. In fact, the father brought the daughter for her 1 year old vaccines (which include the MMR) just because the mother was anxious.  The dad and I had a bit of a chuckle about this, but nevertheless the child received her MMR without problems. 

So, fast forward to the 4 year old check up. This little girl is quite precocious and worldly as well, being the youngest in the family. She has always been exceptionally verbal, and doesn’t mind telling you exactly what she has on her mind. (sometimes with words she may have picked up from her older siblings!). Birth order, a daily dose for a later date! 

At the end of the check up, as it became time to discuss vaccines, I turned to the mother and said, “ Sally, is going to get her immunizations today including her MMR”.  Are you still concerned about giving her vaccines as surely you don’t think that Sally is autistic?” 

As the mother was getting ready to speak, little Sally quickly interrupted in her usual loud voice and said, “ Dr. Sue I am to artistic, I drew those pictures for you!” 

Enough said, ice broken, subject over and vaccines all given on time and without a problem. 

Daily Dose

Latest Flu News

Dr. SUe discusses the latest news about seasonal flu and H1N1It seems like a while since I have discussed one of the favorite topics this fall, swine flu (novel H1N1).  Now that there is less swine flu in the U.S., actually less than 14 states are reporting widespread flu (the latest update will be released today), there is less hysteria and at the same time less concern for prevention.  

Influenza, and particularly swine flu, is always difficult to predict when and where it will occur, but one thing that seems certain, there will be more flu in the U.S. in the New Year, as flu typically lasts in some parts of the country until May.  Many infectious disease experts worry that swine flu (novel H1N1) will peak again as it has in some parts of the southern hemisphere.  If this turns out to be the case, there are many more people who will become ill. If the current statistics are correct, and 1 out of 6 Americans has already had swine flu, that still leaves MILLIONS more who are at risk of becoming ill. Unfortunately, with illness we will also see deaths, and the swine flu seems to be infecting a younger population and therefore there are more pediatric deaths being reported. All of this is important, as the only way to try and prevent disease is through vaccination.  When novel H1N1 vaccine was first shipped to my pediatric office in October, we could not keep up with the phone calls or provide enough vaccine for those that wanted it.  Remember it is recommended for all children from 6 months – 24 years of age.  That is really my entire practice. It is also recommended for parents and caregivers who have infants under 6 months of age, as these young babies cannot be vaccinated against flu.  But, what I have seen happening, is that now that novel H1N1 is not rampant in our area, the desire for vaccine is also waning.  Human nature is quite interesting, we want what we cannot have, and once the “Frenzy” passes, the desire also wanes. I know this right now from my own Christmas shopping,  as I am desperate to find a “marshmallow gun”.  I am sure that once the “game” of locating one is over, or Christmas arrives, I too will not feel like I “need” a marshmallow gun. There will be something else to replace the gun. This should not be the case with flu vaccines. Do not be complacent and forget to get your swine flu vaccine (or your seasonal flu for that matter).  The swine flu vaccine is safe, and post marketing surveillance continues and has not shown any problems with the vaccine in terms of safety. The latest recall was not due to safety, but rather to concern that the lots of vaccine that were recalled may provide less immunity than expected. In other words, it wont’ hurt you, but it may not provide as much protection as a good vaccine should. Those lots have already been pulled and those infants will be getting a second dose of swine flu vaccine any way, and that should boost their antibody level. Give your children a Christmas present and get their flu vaccines. We may not know which flu is coming, but just like Santa comes each year, we know that flu will too. Who wants to be home sick for a week, hospitalized, or even worse, have someone in your own family become a statistic.   Just because you have been lucky enough never to have had the flu before, does not mean that you are immune.  Don’t test it, get the vaccine and remember children under 10 years need to get a second dose of vaccine to provide optimum immunity and protection. That's your daily dose.  Heave a wonderful weekend!

Daily Dose

Changes in Flu Immunizations for Children

Flu season is fast approaching and that means it is time to get your flu vaccine. Recently the Centers for Disease Control and Prevention and the American Academy of Pediatrics expanded the recommendation for flu vaccination to include all children ages six months to 18 years.

The previous recommended age group was 6 months to 5 years. "Children under nine years of age who have never received a flu vaccine need to have two doses of vaccine separated by at least four weeks, and all other children receive a single dose," says pediatrician Dr. Sue Hubbard. That means the time is now for you to call and schedule a flu shot with your doctor and your child's pediatrician. Many offices block off certain times during the day in which they have "flu shot clinics." According to Dr. William Schaffner, president-elect of the National Foundation for Infectious Diseases there is an ample supply of the flu vaccine this year. He encourages people to start taking it now as there is no reason to wait. "There are two options for children older than two: the injectable flu vaccine or the live attenuated flumist intranasal vaccine. There are some restrictions to intranasal vaccine (children with asthma, immuno-suppressed children) but for many children the idea of sniffing a vaccine is far better than a SHOT. The upside of the nasal vaccine is also that it seems to be more effective," says Dr. Hubbard. "Either way, start thinking about getting on your doctors schedule to get vaccinated before the winter and influenza hits." Dr. Hubbard also recommends that you teach your child to practice good hand and cough hygiene to help prevent the spread of germs. More Information: The American Academy of Pediatrics More Information: Centers for Disease Control and Prevention

Daily Dose

First Day of Fall

This is the time of year to think about winter and flu, and to begin annual flu vaccinations.This time of year is so invigorating and the weather everywhere is becoming picture perfect. It all makes for a great time to enjoy the outdoors, whether having family dinners on the porch, picnics on the weekend, spending time playing outside and getting exercise as a family.

But for a pediatrician it is also the time of year to think about winter and flu, and to begin annual flu vaccinations. This year it is recommended that all children six months to 18 years receive a flu vaccine. Children under nine years of age who have never received a flu vaccine need to have two doses of vaccine separated by at least four weeks, and all other children receive a single dose. There are two options for children older than two: the injectable flu vaccine or the live attenuated flumist intranasal vaccine. There are some restrictions to intranasal vaccine (children with asthma, immuno-suppressed children) but for many children the idea of sniffing a vaccine is far better than a SHOT. The upside of the nasal vaccine is also that it seems to be more effective. Either way, start thinking about getting on your doctors schedule to get vaccinated before the winter and influenza hits. In the meantime, enjoy fall! That's your daily dose, we'll chat tomorrow!

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