European Tourist Diagnosed With Measles In New Orleans

 

By Adaora Uzodi, MD, MPH | April 10, 2018

 

A European tourist visiting New Orleans from the United Kingdom has been diagnosed with Measles. The Louisiana Department of Health in a newsletter released April 9, 2018 reports that laboratory testing of all samples confirmed the diagnosis.  The tourist reportedly arrived New Orleans late last week for an event and is currently hospitalized in a New Orleans hospital. Health Officials are conducting investigations into potentially-exposed persons.

 

 

Why is this a big deal?

Measles is one of the most contagious infections and is transmitted when a person with the infection coughs or sneezes. People with Measles are typically contagious from 4 days before the rash develops to 4 days after, so you may have been exposed without knowing it. If you are not protected by vaccination and are exposed, there is a 90% chance that you will develop Measles.

Measles is rare in the United States because of vaccination efforts and was declared eliminated in 2000. Louisiana State has not recorded a case in 10 years. When Measles occurs in the US, it is typically imported by a visitor from areas where Measles is still common. Unvaccinated persons in the US play an important role in propagating the spread.

Measles can cause serious complications such as pneumonia, bronchitis, diarrhea and rarely, inflammation of the brain ( encephalitis) with permanent brain damage.  Children below the age of 5 years  or children with weakened immunity from cancer or HIV can be severely ill or die from Measles.

 

What are the symptoms of Measles?

It takes an average of 8- 12 days after one is exposed to develop symptoms of Measles. It may take as long as 21 days. The infection first begins with fever, runny nose, cough and pink eyes.  These are followed by a distinctive rash that begins in the face and spreads downwards to the legs.

 

How is Measles treated?

There is no specific medication that effectively treats Measles. Treatment is aimed at relieving symptoms e.g rest, fluids, fever-reducing medications. An antiviral called ribavirin is sometimes prescribed for children who are very ill but it is not clear that it makes a difference. Vitamin A is also given because this helps with healing and recovery.

 

How is Measles prevented?

Measles is a great example for why vaccination saves lives. The MMR vaccine given to children before school entry works very well . When the recommended 2 doses are given, it offers up to 99% protection so a fully vaccinated child almost never gets Measles.

-Please have your child updated on his/her MMR vaccine unless there are medical reasons why he/she cannot receive it

-Wash your hands frequently and avoid sharing personal items

-When coughing or sneezing, cover your nose or mouth with tissue or your elbow

-Children who are unvaccinated and are exposed to a person with Measles should receive the MMR vaccine immediately as this can offer protection up to 72 hours after the exposure. If your child cannot receive the vaccine for medical reasons, discuss other options with your provider.

 

For updates on this story, please click here

 

 

 

image credit: CDC image library

 

 

E. coli Outbreak in New Jersey. Health Department Investigating Possible Link To Panera Bread

Adaora Uzodi, MD, MPH | April 9, 2018

 

 

The New Jersey Department of Health has confirmed that it is investigating 8 cases of E.coli reported from 4 counties namely: Hunterdon, Middlesex, Somerset and Warren. All 8 persons were hospitalized and 5 have been discharged. It is unclear how many of these are children versus adults.

 

News outlets are reporting that the outbreak is linked to the food chain Panera Bread. The NJ Department of Health is yet to confirm this and states that several food chains are being investigated. Interviews and laboratory testing are ongoing, with the help of the CDC and FDA.

 

There are different strains of E.coli which is a type of bacteria. The type of E. coli responsible for food-borne illnesses is transmitted through contaminated food or water; or by direct contact with an infected person. The type which commonly causes outbreaks is the Shiga-toxin E. coli O157: H7. Health officials are yet to comment on the type responsible for this outbreak.

 

When a person is infected with E.coli, they can develop symptoms in a few hours to a few days. The main symptoms are abdominal pain or cramps which can be severe, fever and diarrhea ( sometimes bloody). Most people recover in 5-7 days and all that is needed is fluids to stay hydrated. However, in 15% of patients infected with 0157:H7 strain, a life-threatening complication known as hemolytic-uremic syndrome (HUS) may occur. This complication manifests as anemia, bleeding, high blood pressure, seizures and acute kidney failure. Such patients will need blood transfusions and possibly dialysis.

 

For updates on this outbreak, please visit the NJ Department of Health website 

 

 

 

 

image credit: dreamstime.com

 

 

 

Planning A Trip To Brazil? Protect Your Child From Yellow Fever

 

By Adaora Uzodi, MD, MPH | April 1, 2018

 

 

Brazil is in the news again. This time, it is for Yellow Fever. The South American country is currently experiencing an epidemic of the mosquito-borne infection. This outbreak began in early 2017 and over 1,000 people have been affected. Close to 300 people have died including travelers to Brazil.

 

What regions of Brazils are involved?

Espirito Santo State, São Paulo State, Rio de Janeiro State and some cities in Bahia State.

 


What is Yellow Fever?

Yellow Fever is an infection caused by the Yellow Fever virus. The virus is transmitted through mosquito bites. Symptoms of Yellow Fever include fever, chills, headaches, body aches and weakness. Many children recover in a a few days but occasionally, the infection progresses to a more severe phase. In this phase, the virus attacks the body organs especially the liver and kidneys leading to jaundice ( yellowness of the skin and eyes hence the name, Yellow Fever), kidney failure, bleeding and shock. Half of those who experience this severe phase will die within a week.

 

 

What is the treatment for Yellow Fever?

Theer is no specific drug available to treat Yellow Fever. Treatment is aimed at controlling the symptoms and complications e.g. intravenous fluids for shock, blood transfusions, oxygen, dialysis etc.

 

 

What precautions do I need to take to protect my child?

-If your child is 9 months or older, he/she should receive the Yellow Fever Vaccine if you plan to visit the affected areas of Brazil. This vaccine is very effective at preventing the infection. It can be obtained at a few designated travel clinics or immunization centers because of an ongoing shortage. To locate a Yellow Fever vaccination clinic near you, click here

 

-Your child should get vaccinated at least 10 days before your planned departure date

 

-Your child will not be eligible to receive the vaccine if he/she has certain medical conditions that weaken the immune system such as cancer or HIV or is allergic to eggs, chicken or gelatin

 

-If your child cannot receive the vaccine, is younger than 9 months or you do not wish to have your child vaccinated, avoid travel to the affected areas

 

-The vaccine is good for 10 years or more although for this outbreak, a booster dose may be received even if your child’s last vaccination was less than 10 years ago

 

-The virus is transmitted by mosquitoes, so measures to prevent mosquito bites are helpful. These include wearing light-colored, long-sleeved shirts and pants when outside, sleeping in rooms with mosquito nets and air-conditioning and applying insect repellents to exposed skin.

 

For information on insect repellents, please click here 

 

 

 

 

 

 

imagecredit: CDC

CDC Warning: Do not Eat These Packaged Coconut Brands

 

By Adaora Uzodi, MD, MPH | April 1, 2018

 

 

 

Thirteen people , including children, have become sick from Salmonella and health officials have traced this to packaged coconuts. Cases have been reported in eight states and three people have been hospitalized . Fortunately, there have been no deaths.

 

Investigations by the CDC and FDA showed that packaged coconut products from the following companies were contaminated with Salmonella:

Go Smile! Raw Coconut ( International Harvest, Inc. brand )

Go Smiles Dried Coconut ( International Harvest, Inc. brand )

Natural Grocers Coconut Smiles Organic

 

These coconut brands have been recalled and if you have purchased them, it is advised that you throw them away or return to the store for a refund.  Kitchen cabinets, refrigerators or other areas where the product (s) was stored should be sanitized.

 

Symptoms of Salmonella infection in children include fever, vomiting, stomach aches and diarrhea. Salmonella can sometimes get into the blood stream and cause more serious infections in bones ( osteomyelitis), the brain ( meningitis) or heart (endocarditis).

 

Children younger than five years, and children who have weak immune systems, sick cell disease or chronic intestinal tract problems can be severely ill from Salmonella.

 

For more information on this recall, click here   

 

 

 

Xofluza: The New Flu Drug That Could Change Everything

 

By Adaora Uzodi, MD, MPH |  April 1, 2018

 

 

As this deadly flu season winds down, there is hope on the horizon; a new medication for the treatment of Influenza. In mid-february, Japanese health officials announced the approval of a new antiviral for Influenza treatment.

 

The drug called xofluza ( generic name: baloxavir maboxir) is creating a lot of buzz because of its benefits over tamiflu which has been the go-to drug for years. Xofluza is given as a single dose in all ages unlike tamiflu which is taken for 5 days.

 

The manufacturers claim that xofluza kills the Influenza virus in 24 hours compared to tamiflu which takes up to 72 hours. Although the length of time it takes for a person to experience relief from the symptoms of Influenza is similar to tamiflu ( 3 days), xofluza has the potential to greatly limit the spread of the flu because of how fast it kills the virus.

 

Xofluza may be available to the Japanese public as soon as May 2018 but will not be approved for use in the United States until at least 2019.

 

 

 

The Flu Vaccine Gets An Upgrade

 

By Adaora Uzodi, MD, MPH | April 1, 2018

 

 

Despite the bad flu season encountered this year, vaccination remains the most reliable way of preventing Influenza.

 

For the 2018/2019 Influenza season, the WHO has recommended the replacement of two of the four components of the flu vaccine with different strains that have been shown in the past to be more effective. In addition, FluMist, the nasal spray flu vaccine will make a comeback this year in a new form that is believed will be more effective.

 

The National Institute of Health (NIH) has also ramped up efforts to develop a universal flu vaccine. Flu vaccines used in recent years are 10-60 % effective and if the virus changes significantly, the vaccine is completely ineffective. The goal of a universal vaccine is one that is more effective to the tune of 75 % and offers protection for a longer period such that yearly flu vaccines are no longer necessary.

 

 

 

 

image credit: thinkstock

Flu Facts

By Adaora Uzodi, MD, MPH .

 

Although Influenza is common, you may have some questions about the infection. Maybe you are lucky to have never dealt with the flu. Or you recently immigrated from a region where Influenza is uncommon.

 

Here is a quick video to help you and your child learn the basics about Influenza.

 

 

 

Influenza FAQs

 

 

How long after my child is exposed to Influenza will he/she develop symptoms?

 

Children typically develop symptoms an average of 2 days after they are exposed to the virus. However, symptoms may develop as quickly as a day later and as late as 4 days.

 

 

My child did not receive the flu vaccine this year and has been exposed to someone with Influenza? What can be done to prevent him/her from getting sick with the flu?

 

Vaccination is the most reliable way to prevent Influenza. In this scenario, we recommend that your child get vaccinated as soon as possible. Because the vaccine takes about 2 weeks to begin to protect your child, he/she may not be protected from the current exposure. Although tamiflu can offer protection if given after an exposure, it is generally not recommended for healthy children because the infection may have already set in and the lower dose given for prevention may be partially treating your child. A good approach is to observe your child closely for symptoms of Influenza such as fever , body aches, cough etc so that early treatment with tamiflu can be offered.

 

 

My child has been diagnosed with Influenza, what symptoms should alert me to take him/her to the hospital?

 

If you child begins to breathe fast or hard, this may be a sign that pneumonia has developed. Other red flags that should prompt a hospital visit are seizures, severe weakness, severe muscle cramps, paleness or bluish discoloration to his/her skin or lips, chest pain, not peeing enough  or not responding  appropriately to your calls or interactions.

 

 

How long can I expect my child to be sick from the flu?

 

Unless complications set in, most previously healthy children begin to recover from the flu within 3 days to a week. They may have a lingering cough and tiredness for a few weeks afterwards.

 

 

Is my child too young to take tamiflu?

 

Tamiflu has been licensed by the FDA for children as young as 2 weeks old. Because the benefits of treating Influenza outweigh the risks in children below 2 years who can experience severe Influenza,  the American Academy of Pediatrics permits the use of tamiflu to treat children of all ages with Influenza who need treatment.

 

 

Can my child get Influenza from the flu vaccine?

 

No. This is a common myth. The injectable flu vaccine contains a killed virus and the nasal spray , a live but weakened virus so your child cannot get Influenza from the vaccine. If your child develops flu-like symptoms or the flu after receiving the vaccine, the possibilities are:

-he/she is experiencing common reactions that can happen with any vaccine  e.g fever, achiness etc

-he/she had already been exposed to influenza before the vaccine was given

-he/she has another “cold” virus that causes symptoms that are similar to the flu

5 Things You Need to Know About This Flu Season

By Adaora Uzodi, MD, MPH |  April 1, 2018

 

 

 

1.The high number of Influenza cases this year is not caused by a new strain of the Influenza virus. The most common strain is the H3N2 strain which has been in existence but is known to cause severe illness.

 

2. The number of cases is finally on the decline but remains high. The season is not over.

 

3. This year’s flu vaccine is estimated to be only 36% effective.

 

4. However, it performed better in children below the age of 8 years in whom it is  estimated to be 50% effective.

 

5. It appears that the flu vaccine was appropriately chosen as the circulating strains are same as those the vaccine was intended to protect against. Research is ongoing to determine why it did not work as expected.