Infectious Diseases

Among children, rotavirus remains a leading cause of gastroenteritis and, globally, of death. Here's the latest on treatment and prevention, including vaccines in the offing.

Among children, rotavirus remains a leading cause of gastroenteritis and, globally, of death. Here's the latest on treatment and prevention, including vaccines in the offing.

"There is some drama associated with influenza every year," said George Kent, MD, associate director of the Center for Education in Family and Community Medicine at the Stanford University School of Medicine. "In 2004, it was the surprise vaccine shortage and the surge in demand, followed by a very ordinary year in terms of disease. This year, we appear to have plenty of vaccine, except for avian influenza, for which we have no vaccine at all."

ABSTRACT: Hypothermia is not limited to the northern states: people also die of hypothermia in other areas with milder climates. Infants, young adolescent boys, and inadequately dressed teens who abuse alcohol or illicit drugs are at highest risk for death secondary to hypothermia. The mildly hypothermic patient may appear fatigued and display persistent shivering, ataxia, clumsiness, confusion, tachypnea, and tachycardia. The child with moderate hypothermia will not be shivering; declining mental status may cause the freezing patient to remove clothing. An irregular heartbeat is likely at this stage. Severe hypothermia is marked by apnea, stupor, and coma. In a frostbitten patient, rapid rewarming of the affected area in warm water for 15 to 30 minutes is the first step. Potent analgesia is often necessary. After thawing, the frostbitten part is kept dry, warm, and loosely covered. With an adequate dose of common sense, the vast majority of deaths from cold injury can be prevented.

In the aftermath of Hurricane Katrina's devastation in the Gulf Coast region, it is important for physicians in the United States to consider the infectious disease risks for children who have been displaced or who are still living in affected areas. These risks include infections acquired through ingestion of waterborne organisms; wound infections; lack of immunization continuity; and overcrowding, which increases the risk of respiratory or GI infections. In addition, problems will arise from disruption of therapy for select populations of children, such as those who are HIV-infected; those receiving immunosuppressive treatment; and those in need of continuous antibiotic prophylaxis, such as those who have sickle cell disease.

For 2 days, a 4-year-old girl had complained of discomfort and a yellow discharge from the left eye. The left conjunctiva was hyperemic, but there was no preauricular lymphadenopathy.

I have a 4-year-old female patient whose mother is concerned about obsessive-compulsive behavior.

"Kids Need Flu Vaccine, Too!," a toolkit developed by the National Foundation for Infectious Diseases, now includes new material—available online—to help educate parents about influenza and the importance of annual flu vaccinations for infants and children.

Pneumonia is one of the most common conditions encountered by primary care providers. Certain organisms cause pneumonia in particular age groups. For example, group B streptococci, Gram-negative bacilli Escherichia coli in particular) and, rarely, Listeria monocytogenes cause pneumonia in neonates. In infants younger than 3 months, group B streptococci and organisms encountered by older children occasionally cause pneumonia, as does Chlamydia trachomatis. Older infants and preschoolers are at risk for infection with Streptococcus pneumoniae and Haemophilus influenzae. In children older than 5 years, S pneumoniae and Mycoplasma pneumoniae are the key pathogens. Let the patient's age, history, clinical presentation, and radiographic findings guide your choice of therapy. Even though most patients with uncomplicated pneumonia can be treated as outpatients, close follow-up is important. Hospitalize patients younger than 6 months and those with complications.

The Centers for Disease Control and Prevention (CDC) announced that approximately 81% of the nation's toddlers are receiving all the vaccinations in the recommended series."These results are terrific news," said Dr. Julie Gerberding, director of the CDC. "They illustrate the tremendous progress we've made in preventing what were once common childhood diseases. Most importantly, these results show that parents have high levels of confidence in our vaccination recommendations. It's encouraging to see that parents recognize the importance of protecting their children against diseases that while relatively uncommon, can cause serious harm."

The incidence of community-based methicillin-resistant Staphylococcus aureus (MRSA) infection in healthy children is increasing. This review discusses possible reasons for that rise, reviews antibiotic susceptibility patterns, and presents management guidelines.

Over the past 5 years, methicillin-resistant Staphylococcus aureus (MRSA) isolates have become widespread throughout the United States as well as the world.1 In some regions, including our own Gulf Coast, MRSA accounts for the majority of S aureus isolates recovered from patients with community-acquired infections.

With the recent licensing of conjugated, quadrivalent meningococcal vaccine (MCV4) and likely approval of other "childhood" vaccines to prevent disease during adolescence and adulthood, the national immunization program ventures onto new ground.

ORT is an effective yet underused treatment for acute gastroenteritis. Here's a look at the specifics and benefits of this "low-tech" approach.