News and Notes - Past

Update on Tomato-associated Salmonella outbreak
The nation is currently experiencing an outbreak of Salmonella due to apparent contamination of tomatoes. The outbreak, which was first noticed to affect Texas and New Mexico, has continued to expand and now involves more than 32 states and over 500 cases. The tomatoes affected are raw red tomatoes (specifically, red plum, red Roma, and round red tomatoes). Florida is one of the states affected, but so far only one case has been reported in our state. However, the investigation has traced the outbreak to potentially be linked to farms in Florida and/or Mexico.

The current CDC recommendation for consumers is:

• Refrigerate within 2 hours or discard cut, peeled, or cooked tomatoes.
• Avoid purchasing bruised or damaged tomatoes and discard any that appear spoiled.
  
• Thoroughly wash all tomatoes under running water.
  
• Keep tomatoes that will be consumed raw separate from raw meats, raw seafood, and raw produce items.
  
• Wash cutting boards, dishes, utensils, and counter tops with hot water and soap when switching between types of food products.

To see more information, go to CDC website

Professional Misconduct Charges for "MMR/Autism" Doc
A suggested link between the MMR vaccine and autism was first proposed in 1998 by a British physician named Andrew Wakefield. Numerous large scale studies since that initial report have repeatedly demonstrated no link between MMR and autism, and now Wakefield is facing charges of professional misconduct for issues related to the report. The 1998 article, despite the fact that it has been subsequently found to be unscientific and misleading, has had dramatic and devastating effects on immunization practices. In fact, measles cases in the U.K. have risen to their highest level in 20 years due to reduced utilization of the MMR vaccine related to parental fears. To see the BBC report discussing the issue, click here.

Merck recalls Hib vaccinations
Merck, one of the nation's leading vaccine manufacturers, announced yesterday that a recall has been issued on some of its vaccines because of concern over possible contamination. The vaccines affected were Hemophilus influenza vaccinations (commonly referred to as "Hib" and most often administered in the form of "Comvax").

According to the report, there is no concern whatsoever that the vaccines given are not effective; therefore, there is no need to repeat the vaccination. The concern is due to an inability to be certain that the vaccines are sterile. So, if the vaccines were contaminated (which Merck says is a relatively low possibility), a patient could have developed a local skin reaction or infection at the site of the injection. The vaccines affected have all been since April 2007. To see full report, click here.

Interlachen Pediatrics is currently in the process of reviewing our inventory, and any affected vaccines will be returned to the manufacturer. Additionally, we are trying to determine if any vaccines already given in our office were affected by the recall. Stay tuned to our website for further information.

There is no need to contact the office unless your child currently has symptoms of a possible reaction or infection on the skin where a vaccine was recently given.

News alert regarding Salmonella in peanut butter
To see more, click here.

Does weighing frequently help prevent unwanted weight gain?
Probably not, and perhaps the opposite. A study in the the Journal of Adolescent Health (December 2006 issue) found that frequent self-weighing in teenage females did not help with better weight management. In fact, those who weighed most frequently showed increased rates of binge eating and other unhealthy weight control behaviors. To see full article, click here.

Tip for Helping Your Child Learn to Swallow Pills
Getting your child to take medicine can be a frustrating and difficult adventure, but it is one that can be much easier once a child learns to swallow a pill. One suggestion to help your child learn this skill: "Have the child place one M & M mini candy on the side of her tongue. Then instruct her to drink her favorite beverage from a glass with a straw. The child will be amazed to discover that she has swallowed the candy along with the drink—and not felt a thing! Most children easily learn to swallow larger pills using the straw technique, then give up the straw altogether." (submitted to Contemporary Pediatrics by Anne C. Autry, MD, a pediatrician in Ohio)

Too Much Antibiotic use in Throat Infections
Most cases (~90%) of throat infection are NOT Strep throat and do NOT require antibiotics. This is as true, if not more so, in adults as compared to kids. A recent study looked at how well adult primary care providers adhere to treatment guidelines regarding throat infections in adults, and the results were not encouraging. Despite repeated studies showing the need for testing by throat swab to accurately diagnose Strep throat, many adult primary care providers continue to diagnose Strep throat simply by appearance of the throat (which is notoriously inaccurate) or, worse yet, over the phone. In this particular study, 30% of patients with a negative strep test still received antibiotics. There is obviously great concern with overprescribing of antibiotics and the subsequent development of bacteria that are resistant. Appropriate treatment of throat infections is an important step to help in this growing problem. To see the study, click here.

Does the diet of a breastfeeding mom affect colic in their infants?
A recent study tried to answer this question. 90 breastfed infants (average age - 6 weeks) who were deemed to have excessive fussiness due to colic were randomized into one of two groups. In one group, the mothers for one week eliminated from their diet all foods containing dairy products, soy, wheat, eggs, peanuts, tree nuts, and fish. In the second group, all of these foods were included in the mothers' diets for the week. The low-allergen maternal diet group (i.e. first group) had a significant improvement in fussy symptoms in the infants. To see the study, click here. Should breastfeeding moms, therefore, avoid these foods so that their babies won't be fussy? As you could imagine, adhering to a diet such as this is extremely difficult. Probably the primary usefulness of this study is understanding that the diet of a breastfeeding mother can affect symptoms of colic, a fact that has been suspected but not proven.

Another way to reduce the risk of SIDS -- give your baby a pacifier!
A group of authors reviewed all the articles published on pacifier use and SIDS, and these authors concluded that their is good evidence that pacifier use does significantly reduce the risk of SIDS (to see the study, click here). Use of pacifiers should be encouraged during the first year of life, especially during times of sleep. (FYI: in babies who are breastfed, it is recommended to avoid pacifier use until breastfeeding is well established, usually 2 weeks)

New Study links sleeping difficulties in toddlers to TV
Sleeping problems in toddlers are common, and a recent study suggests that television viewing may be contributing. The children in the study who spent the most time watching television tended to have the most irregular nap schedules and more frequent nighttime awakenings. To see the article, click here.

The American Academy of Pediatrics recommends that children under the age of 2 not watch television, and that children over 2 watch less than 2 hours a day. Many other studies have shown other harmful associations with TV viewing including obesity, attention problems, and behavior problems.

Don't forget to request HRS forms
Many schools require updated HRS forms from your pediatrician's office before the upcoming school year. These are the forms with an updated vaccination record ("the blue form") and an updated physical exam form ("the yellow form"). If you need these forms for your child before next school year, contact our office either by requesting the forms online or by calling the office.

New Study suggest sunscreen may be inadequate in preventing melanoma
Melanoma is one of the fastest growing cancers in the United States. A recent study looked at the development of melanocytic nevi ("moles") in children and found the more clothing a child wore, the fewer moles the child developed. No such effect was seen with sunscreen. Number of melanocytic nevi is a risk factor for the development of melanoma.

Much controversy exists whether sunscreen provides any protection at all against the development of melanoma (conversely, the risk for nonmelanoma forms of skin cancer such as basal cell and squamous cell carcinoma is thought to be reduced by sunscreen). Two of the theories as to why sunscreen is not as helpful as some think are 1) most people do not use adequate amounts and 2) the false sense of security results in people spending more time in the sun than they would otherwise.

Another Polio Outbreak
Indonesia is yet another country where polio was thought to be eliminated but is now experiencing an outbreak. The country had not had a case of polio in 10 years yet is now experiencing an epidemic of the paralyzing disease that so far has resulted in 110 cases. To read more, click here.

Just a couple of years ago we were talking about the coming worldwide eradication of Polio. Then came the news that some areas of Africa had refused Polio vaccination because they thought the free vaccine being offered them was actually an anti-fertility agent, all part of an American plot to depopulate the developing world. As a result of this lag in immunization coverage, some areas of Africa and surrounding countries began experiencing a re-emergence of Polio. For instance, Yemen is one of these countries and expects that at least 200 children will end up crippled before the outbreak is controlled. Prior to this outbreak, Yemen had not seen a case of polio since 1996! Other areas of Africa that are currently not experiencing the disease now are thought to be vulnerable due to current low immunization rates. In 2003, there were less than 800 cases of polio worldwide; last year there were almost 1300! Before the widespread use of the polio vaccine (only 50 years ago), polio would affect up to 50,000 people (mostly children) a year. To read more about the remarkable history of polio and the vaccine, click here.

STROLLER RECALL on Graco Duotandem and Metrolite!
To read more, click here.

No link between MMR and Autism - another study
A recent study in Lancet compared MMR immunization rates among ~1300 children with Pervasive Developmental Disorder (considered part of the spectrum of Autism) and ~4500 children without the diagnosis. No association was found between MMR immunization and PDD (in fact, there was a 14% reduced risk of developing PDD in children who had received MMR vaccination; this was likely simply a random statistical variation but does further support that there was no association between the vaccine and autism). To read more, click here

New Study supports what was suspected - Allergies are on the rise!
A recent study examined the allergic responses in almost 700 adult patients with asthma and then compared the results with ~800 of the patients' children. The researchers found that signficantly more of the children demonstrated allergic sensitivity to cat dander, dust mites, and Alternaria (a mold). Additionally, of those with sensitivity, the allergic responses were signficantly greater than the average responses in the parents. The greatest increase was seen with dust mites, and this study supports the thought that allergic disease (including Asthma) is increasing and is perhaps doing so because of allergy to dust mites. To read more about the study, click here. Also, to read about ways to reduce your child's potential exposure to dust mites, click here.

First West Nile Virus case of 2005 diagnosed in Kansas
The CDC reported that the first human case of West Nile virus for 2005 was diagnosed in Kansas earlier this week. The virus, which is transmitted from infected mosquitos, had already been detected from animals (birds, horses, etc.) in 14 states this year, but this was the first human case of the year. West Nile virus infection causes no symptoms most of the time, but in a small minority of people (~1 out of 150 who get infected) will cause a severe, potentially life-threatening infection. The primary means of prevention is avoiding mosquito bites, mainly through the use of insect repellents. To learn more about proper use of insect repellents containing DEET, click here. To read more on West Nile virus, click here. The CDC recently announced that insect repellents containing "DEET-alternatives" (such as Picaridin and oil of lemon eucalyptus) are effective as well.