Browsing Tag

Infectious Disease

Is Monsanto Behind Cases of Microcephaly in Brazil?

By February 17, 2016 12 Comments
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I am a medical doctor and professor of public health, and I am also the father of a beautiful daughter and uncle to the world’s best niece.  We also live in Rio de Janeiro, Brazil.  We are being inundated with information and misinformation about Zika and its correlation to microcephaly.  There is a lot of fear, which is the perfect environment for people to spread false information.

When I saw friends sharing an article based on fear and not facts, I knew I had to comment due to my background.  If you have not seen this article, you can read it here, but it claims the reported increase in microcephaly in Brazil is caused not by Zika or any other virus, but a larvicide called Pyriproxyfen.  Larvicides are used to kill mosquito larvae and since Zika is spread by mosquitoes this bit of misinformation could cost lives.

The article references a mysterious document purportedly written by “Argentine doctors.” The organization that undersigns it is the “Red Universitária de Ambiente Y Salud”, which is a loose affiliation of individuals dedicated to fighting the use of pesticides, agrotoxics and the like. Perhaps the biggest clue that the information in the document is not trustworthy is that the name of larvicide called into question is repeatedly spelled wrong throughout.

I will address the claims made in the executive summary of the document point by point.

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Categories: Ages + Stages, Chronic Illnesses + Conditions, Disability + Disability Advocacy, Infectious Disease + Vaccines, Newborns + Infants, Science 101 + Mythbusting

Planning A Pregnancy in the Time of Zika

By February 9, 2016 1 Comment
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Like a lot of couples, my wife and I have waited to start a family until the time was right for us, which just so happens to be now-ish.  Unfortunately the right time for us has coincided with the spread of the Zika virus in North America, a virus that shows an association between infection with it during pregnancy and an increased risk of microcephaly (reduced brain/head size) in newborns. The Zika virus is not a new virus from a historical perspective, however, the newly accepted correlation with microcephaly seems to have given the virus a significant amount of media attention.

For any expectant parent – or couples planning on getting pregnant, like my wife and me  – the possibility of a Zika infection is terrifying.  My wife and I are the kind of people who like to arm ourselves with information, so let’s dive into Zika virus infections and take a look at some facts and figures.

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Categories: Infectious Disease + Vaccines, Pregnancy, Birth + Family Planning

What is Microcephaly + What’s the Link to Zika?

By February 1, 2016 1 Comment
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With the increasing news coverage of Zika and it’s reported link to the birth defect microcephaly we’ve received a number of reader questions about microcephaly and what it actually means for children born with the condition.  We reached out to infectious disease specialist, Dr. Judy Stone, to answer some of your questions.

What does microcephaly actually mean (Is the brain small, does it stop growing at a certain stage, is part of the brain missing)?
Microcephaly literally means an abnormally small head. Both the skull and brain are abnormally small with microcephaly, and X-ray studies often show abnormal calcified areas in the brain and lack of normal development.

Is Zika the only way a baby can be born with microcephaly or are there other risk factors?
Microcephaly has been associated with many infections as well as genetic abnormalities, malnutrition, or exposure to certain toxins. It already happens very rarely in the U.S. due to the level of nutrition and prenatal care most women receive (although even with good nutrition and proper prenatal care, microcephaly can still occur due to certain genetic factors or infections). Even in Brazil, the “epidemic” of this birth defect is thought to be <1%. Some researchers think that some of the sudden apparent increase reflects changes in reporting rather than new illnesses. It’s also important to know that the link right now is just correlated with Zika, there hasn’t yet been a cause and effect relationship proven, but it’s enough to raise alarm bells.

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Categories: Ages + Stages, Chronic Illnesses + Conditions, Disability + Disability Advocacy, Infectious Disease + Vaccines, Newborns + Infants

Zika and Pregnancy: What You Need to Know

By January 19, 2016 2 Comments
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The Zika virus has been in the news a lot lately because it’s been linked to a cluster of cases of microcephaly in Brazil and Columbia. Microcephaly is a rare birth defect where the fetus’ brain does not develop fully in utero, and as a result, the baby is born with an abnormally small head and multiple neurological disorders.

Public health officials have been aware of Zika for decades, however, it was only believed to only cause mild flu-like symptoms with few, if any, lasting negative outcomes. The virus is spread by mosquitoes and recently cases as far north as Mexico, Hawaii and Puerto Rico have concerned public health officials in North America.

On January 15, the Centers for Disease Control and Prevention (CDC) issued a level-two travel alert for Latin America and the Caribbean, with a special note for pregnant women to avoid those areas. Since then we’ve been asked about Zika by a number of readers. We reached out to Dr. Waleed Al-Salem, a tropical medicine specialist and father based in Liverpool, England, to have him answer your questions.

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Categories: Ages + Stages, Chronic Illnesses + Conditions, Disability + Disability Advocacy, Infectious Disease + Vaccines, Newborns + Infants

When NOT Washing your Hands Is a Crime: What We Can Learn From The Chipotle Sanitation Nightmare

By January 18, 2016 2 Comments
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Chipotle touts organic and fresh ingredients, making it a fan favorite for many parents, but perhaps not anymore, given the terrible year that the fast-food chain is struggling to recover from. 2015 ended poorly for Chipotle, with at least five viral or bacterial outbreaks in various branches of their restaurant chain between July and December. Three of those five outbreaks were associated with naturally occurring bacteria in food (Salmonella and E.coli) and possible food mishandling; the other two outbreaks were directly linked to sick employees (who had the norovirus) who spread their illness through improper hand-washing. These type of issues are both a public health and a parenting nightmare, since the spread of those three contagions are enough to make anyone violently ill, and for children, dangerously so. And soon, it seems, spreading the latter through poor hand hygiene in the workplace could be considered a crime. 

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Categories: Food, Nutrition, + Infant Feeding, Infectious Disease + Vaccines

Passive Immunity 101: Will Breast Milk Protect My Baby From Getting Sick?

By January 10, 2016 14 Comments
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As a neonatal nurse specialist, mothers often ask me about the antibodies found in breast milk and how they can work to protect their babies. To explain it to them, and to you, I have to delve into immunology, and those conversations are usually too technical for most readers and mothers I meet in the NICU. Unfortunately, the information that is readily available to mothers that isn’t highly technical is a large body of conflicting information. So I’m here to talk more about this very important topic in a way that makes it straightforward! My goal is to answer very common reader questions like these:

“Why does my infant need any vaccines at all since she’s getting all the antibodies she needs from my breast milk?” and,

“Why does my seven-month old son need to get a flu shot if I received it during my pregnancy?”

Both, excellent questions! Parents, take note – there are 2 ways babies acquire immunity: through passive transfer, and active transfer (also known as acquired immunity).

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Categories: Ages + Stages, Food, Nutrition, + Infant Feeding, Infectious Disease + Vaccines, Newborns + Infants

Your ‘Stomach Flu’ Isn’t a Real Thing, You’ve Caught Something Much Grosser

By December 16, 2015 2 Comments
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The stomach flu isn’t a real diagnosis – there’s no such thing.  I remember finding that out as a kid and being confused; after all, everyone around me had had it at one point or another. How could everyone be wrong? We’ve all used this term at some point to describe an illness that’s forced us to pray to (or sit with) the porcelain gods. However, it turns out it’s one of those generational quirks of language that’s been passed down, and it’s not founded in science.

The viruses or bacteria that we attribute to “the stomach flu” are very real, however, as I can tell you from personal experience.  There’s just no such thing in epidemiology as a family of viruses or bacteria called “the stomach flu.”

Let’s start off by defining what the flu is. “Flu” is short for influenza, which is a viral infection that affects your respiratory system, namely your nose, throat, and lungs. Symptoms include coughing, congestion, fever, and muscle aches. According to the CDC, there are 3 types of influenza viruses: A, B, and C. The seasonal flu is typically an A or a B type, and it runs in cycles that are heavily skewed to wintertime in the United States. The C type is considered milder, and isn’t seasonally dependent or the type that’s a cause for epidemic concern. All three types are spread through contact with an infected person’s respiratory secretions, meaning contagious droplets of water that you inhale or get in your eyes, nose, mouth, when an infected person talks, coughs, or sneezes around you. Ewwwww.

The stomach flu, on the other hand is what we colloquially call a variety of digestive-related illnesses that involve distressing gastrointestinal symptoms (i.e. vomiting, diarrhea, stomach cramps, etc.) combined with malaise, and a low-grade fever, when in reality it’s a form of gastroenteritis (“gas-tro-enter-EYE-tis”). Gastroenteritis is caused by viruses and bacteria (and rarely, parasites) that infect the digestive tract, none of which are members of the influenza family.

I repeat: the “stomach flu” is a virus or bacteria that has much grosser consequences, and is not at all related to influenza.

Viral gastroenteritis is the most likely culprit when it comes to most of the so-called “stomach flus,” and it’s typically the result of one of two groups of viruses: Noroviruses or Rotaviruses.  And, ick alert: you typically catch it from direct exposure to an infected person, exposure to infected fecal bacteria (poop), or exposure to things cross-contaminated by fecal bacteria like food that’s been handled by contaminated hands, since it’s so hard to completely sanitize against, as any Celebrity Cruise worker can tell you.

Grossed out yet?Norovirus flu FINAL

A read-through of this horrifying in-depth article from
National Geographic on

the science of the Norovirus
describes how it causes your body to become a walking germ factory; how hard it is to kill it on surfaces including your own skin, and how easy it is to infect those around you as you’re purging liquid from your intestinal tract cells at a rapid rate, and loading up each gram of your diarrhea with five billion Noroviruses. You read that right. Five billion. As for the infectiousness of your vomit? I’ll just leave this article on a the Norovirus Vomit Machine here. I can’t even.

Horrors of science aside, viral gastroenteritis is rotten because in addition to the symptoms listed in our handy-dandy graphic in this article, it’s completely exhausting and there’s nothing you can do other than rest, stick with eating what you can hold down, which may or may not include the once-heavily recommended B.R.A.T. diet (Bananas, Rice, Applesauce, and Toast) to coax your stomach into digestion,  and to stay as hydrated as possible. Dehydration is the danger zone of these type of illnesses, which is where gastroenteritis can turn from miserable to deadly. It’s essential to replace liquids lost from loose stools and vomiting. For parents of kids who have had this, I’m sure you’ve had the hard task of trying to pressure these foods and liquids into your child who is exploding from both ends, and feeling like it’s all a waste because it’s coming back out as quickly as its going in. I’m sorry. You’re doing the right thing, though, since nutrients and liquids are critically important to maintain during these illnesses.

Norovirus

The Norovirus: Courtesy of the CDC

In my recent experience, I went to my local emergency room five days after my symptoms began, but only after I started to have heart palpitations and an unbearable case of heartburn. I managed to stay hydrated as I’d choked down an entire Pedialtye (ack!), but I was wrecked. The doctor attributed my illness to a nasty case of Norovirus, which is circulating in the San Diego area again, but he said those extra symptoms were actually from exhaustion and hunger – I needed more nutrients and rest. How could I get more nutrients if nothing was sticking in my stomach? I asked him. He said to keep eating anyway, since “your body has to finish shedding the diseased lining of your intestines for all of the purging to stop.” Fabulous, right?

Here’s the problem with waiting it out, however. You shouldn’t make the call to simply rest and switch to a BRAT-like diet on your own for you or your children and wait for the symptoms to pass for more than a day or two. Rest, hydrate, and bland diet, yes. However, viral gastroenteritis and bacterial infections (i.e. c.diff., salmonella and e.coli) that affect the digestive tract can initially look the same, be acquired through the same channels (contaminated food, etc.), but can’t be treated the same way.

You must treat the bacterial infections because they don’t just “run their course” without having massive impacts on you or your child’s system – and you likely need medical intervention like antibiotics to make them stop in a timely manner. Below are threshold recommendations per the Mayo Clinic, but your family physicians may have other guidelines so we urge you to contact them first:

Seek immediate medical care if in addition to the previously mentioned symptoms of malaise, stomach cramps, vomiting and diarrhea, you or your child havethe following symptoms:

Adults:

  • You’re not able to keep liquids down for 24 hours
  • You’ve been vomiting for more than two days
  • You’re vomiting blood
  • You’re dehydrated — signs of dehydration include excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness
  • You notice blood in your bowel movements
  • You have a fever above 104 F (40 C)

For kids, seek medical care if they:

  • Have a fever of 102 F (38.9 C) or higher
  • Seem lethargic or very irritable
  • Are in a lot of discomfort or pain
  • Have bloody diarrhea
  • Seem dehydrated — watch for signs of dehydration in sick infants and children by comparing how much they drink and urinate with how much is normal for them

For babies seek medical care if they:

  • Have vomiting that lasts more than several hours
  • Haven’t had a wet diaper in six hours
  • Have bloody stools or severe diarrhea
  • Have a sunken soft spot (fontanel) on the top of his or her head
  • Have a dry mouth or cry without tears
  • Are unusually sleepy, drowsy or unresponsive

As always, self-diagnosis is not the way to go when you’re dealing with an illness, particularly one that’s this high-impact – consult your physician or child’s pediatrician for an exam and testing if you have any of the above symptoms and have a concern about you or your child’s well-being. And remember, until you do, hydrate, eat, and rest as much as you can!

For illness spreading and prevention tips, see this helpful guide.

 

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Categories: Infectious Disease + Vaccines, Science 101 + Mythbusting

Confessions of a Toddler School Drop-Out

By December 14, 2015 No Comments
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This post originally appeared on the Graham’s Foundation blog on December 3, 2015

Three weeks ago, my toddler dropped out of school. My husband and I didn’t anticipate it. We started in September just like everyone else…with adorable “first day of school!” pictures on our front porch and excitement for everything my son would learn, and the new friends he would make.

It was a leap of faith for us to try out a group childcare setting in his second winter of life. My son, now 21 months old, was born at 31 weeks and 6 days in January of 2014. When he was discharged from the NICU in late February of that year, we- like all preemie parents- feared colds, flu, and RSV. We limited visitors, bought stock in hand sanitizer, and checked proof of TDAP and flu vaccinations at the front door.

With a thriving toddler interested in learning and socializing, we decided to graduate from the parent-nanny caregiver model and enroll him in a Montessori program four mornings per week. We took careful note of the advice from fellow parents about sickness in the first year of school or daycare.

“He will definitely get sick, but then his immune system will be unstoppable for the rest of his educational career,” they promised.

We thought we’d see a few bad illnesses this year, but for the most part he’d just have a chronic runny nose.

Boy – were we wrong.  

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Categories: Ages + Stages, Infectious Disease + Vaccines, Toddlers + Preschoolers