Pediatric health blog by Dr. Nancy M. Silva. #WorkingMom, Small World Pediatrics #Doctor sharing my Best Pediatrician #parenting advice, #medical info, #affirmations, #quotes, #TampaBay, #Disney & other fun stuff too!
As of the end of December 2017, the flu season is officially moderately severe. The flu is widespread in 46 states. This is up from 36 states in the previous week. The U.S Centers for Disease Control and Prevention (CDC) research reveals that flu hospitalization is about 3 times higher than it was in the same time period in 2016. In addition, the flu season started earlier this year than it did in 2016. During the same time period in 2016, only 12 states had reported widespread activity, as compared to 46 states this flu season. This pretty much matches what I’ve been seeing in our office in Florida. About 3 weeks ago, we began to diagnose multiple children with the flu every day.
Why is this Flu Season Severe?
This season’s dominate flu strain is an Influenza A strain, H3N2, which is a particularly severe and causes more symptoms than other strains typically do.
What Are Flu Symptoms?
Flu symptoms typically include a fever and nasal congestion at a minimum. Other symptoms may include weakness, nausea, vomiting, diarrhea, headache, body aches, and more.
What To Do If I Think I Have the Flu?
If you are feeling sick with flu-like symptoms, you may want to consider going to see a doctor, especially within the first 48 hours of your illness. Your doctor may be able to prescribe an anti-viral medication against the flu, Tamiflu, which is effective in preventing worsening symptoms of the flu by stopping its replication. However, if you’ve been sick with the flu for more than 48 hours, Tamiflu is not effective.
I Have the Flu. Now What?
Follow your doctor’s instructions. Drink plenty of fluids. Rest. Stay home. Do not go to work, school, religious gatherings, or other community gatherings or events. By going out, you increase the risk of spreading the flu. In addition, as the flu weakens the immune system, if you go out, you place yourself at risk for contracting a secondary bacterial infection, such as pneumonia, sinusitis, or an ear infection.
The good news is that the CDC reports that this season’s flu vaccine strains are a good match to the live flu virus strains that are circulating (http://bit.ly/2CLWaCZ). That means the flu vaccine is providing good protection against the flu by preventing the flu so far.
The best course of action is to make sure you and your children get the flu vaccine. It’s not too late. No one knows exactly when the flu season ends. From the looks of it, it will probably continue for another few months. There is still time to protect yourself. Get the flu vaccine at your doctor’s office, health department, school, or pharmacy today.
Zika Virus | International Public Health Emergency
Zika Virus is a global health scare, especially for pregnant women. Due to the October 2015 cluster of 524 cases of newborns in Brazil diagnosed with microcephaly and other neurological disorders reported in Brazil, World Health Organization (WHO) has stated that it is as a Public Health Emergency of International Concern. (bit.ly/1PYrRKs)
What are the symptoms of the Zika Virus?
When humans become infected, they may develop symptoms which include fever, itchy rash, headache, red eyes, joint pain, muscle pain, and temporary paralysis. Typically, symptoms last for 2 to 7 days. Incubation period is unknown, but ranges from a few days to a week.
There has also been an increase in incidence of Guillain-Barré syndrome that has coincided with increased incidence of Zika Virus. (bit.ly/22Tg8mx)
Pregnant women infected with the virus have had newborns with microcephaly and brain damage. It is believed that the virus has spread from the infected mother to baby in utero and during delivery. Zika virus has been found in the brain tissue of these infected babies.
Where Did Zika Virus Start?
According to WHO, it was originally detected in a rhesus monkey in Zika Forest, Uganda in 1947 and in humans in Nigeria in 1954 (bit.ly/1QeAEcO). Before 2015, the virus was found in Africa, Southeast Asia, and the Pacific Islands. Currently, there are many countries around the world with local mosquito-borne Zika virus disease cases as noted on the CDC website at 1.usa.gov/1Mv4zhb Currently, countries affected by local transmission include Aruba, Barbados, Bolivia, Bonaire, Brazil, Colombia, Puerto Rico, Costa Rica, Cuba, Curacao, Dominica, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Nicaragua, Panama, Paraguay, Saint Martin, Saint Vincent and the Grenadines, Sint Maarten, Suriname, Trinidad & Tobago, U.S. Virgin Islands, and Venezuela).
Is Zika Virus in the United States?
Yes. However, only travel associated cases have been reported in the United States. However, "local mosquito-borne transmission of Zika virus has been reported in the Commonwealth of Puerto Rico, the US Virgin Islands, and America Samoa." (1.usa.gov/1RvWNAq) As of March 28, there have been 273 travel associated cases have been found in the U.S., including in Hawaii. There have been 258 locally acquired cases in Puerto Rico, 10 in the U.S. Virgin Islands & 14 cases in the American Samoas.
How is Zika Virus Transmitted?
It is most commonly transmitted by a mosquito bite. It can also be sexually transmitted and via blood transfusion. It is unknown how common sexual or blood transmission is among humans.
Can Zika Virus Be Sexually Transmitted?
Yes. The CDC recently reported on February 2, that this virus was sexually transmitted in Texas, USA (cnn.it/1WSuiRd). In addition, Florida confirmed on March 9 & California confirmed on March 25, that they too have had their first case of sexually transmitted Zika Virus. As a result of confirmed sexual transmission of the virus, the CDC now recommends that if you are a pregnant women whose "male sexual partner has traveled to or lives in an area with active Zika virus transmission, you should abstain from sex or use condoms the right way every time you have vaginal, anal, and oral sex for the duration of the pregnancy." The case in Texas did not involve pregnancy. However, keep in mind that this illness can infect anyone.
Other countries, confirmed that they too have had their first case of sexually transmitted Zika Virus. France confirmed this occurred on February 27. Chile confirmed firmed this on March 27. Be aware that more cases and countries are confirming sexual transmission of the virus.
What Can I Do to Prevent Zika Virus?
Use insect repellent, especially when outdoors. Avoid travel to areas with active Zika Virus transmission. If you cannot avoid travel to an area with active transmission, then practice abstinence or use birth control while traveling in that area. Abstain from sex if your partner has traveled to an area with active transmission.
What Insect Repellent is Best to Zika Virus Infection?
The CDC recommends the use of insect repellents with active ingredients registered with the U.S. Environmental Protection Agency (EPA) for use to be applied to skin and clothing. EPA registered insect repellents contain DEET, picaridin, IR3535, and some oil of lemon eucalyptus and para-menthane-diol. Insect repellents with these active ingredients products offer longer-lasting protection. Insect repellents containing oil of lemon eucalyptus should not to be used on children under the age of three years. Insect repellents can be used by pregnant and nursing women. The CDC has many details about use, efficacy, and safety of insect repellents available at 1.usa.gov/25rRxr1.
I'm Worried Myself or My Child Might Have Zika Virus. What Should I Do?
First, know the symptoms. Typically, at a minimum, an infected person may have a low grade fever which is frequently accompanied by and a rash. Next, contact your doctor. If your doctor is concerned that you or your child might be infected with Zika Virus, they will advise you to schedule an appointment for a more detailed evaluation. Lastly, if your doctor thinks that you may need to be tested for Zika Virus, then your doctor will refer you to your local health department. Currently, only local health departments have testing for the Zika Virus.
Is There a Travel Advisory Due to Zika Virus?
Yes. There is a Alert Level 2, Practice Enhanced Precautions in areas with active transmission (1.usa.gov/1MMaER1). There is not yet a Warning Level 3, Avoid Nonessential Travel for areas with active transmission.
I'm Not Pregnant & Plan to Travel to an Area with Zika Virus. Is There Anything I Should Do?
It is advised to not travel to areas with the Zika Virus. However, if you do travel to an area where Zika Virus is present, then use insect repellent at all times, especially when outdoors. It is also recommended that if you are a women that is not currently pregnant, that you take birth control as it is estimated that 50% of all pregnancies are estimated to be unplanned.
I'm Pregnant and I've Traveled to an Area with Zika Virus. What Should I Do?
Talk to your OB/GYN doctor before any travel, especially if you are traveling to an area with active Zika Virus transmission. Follow up with a phone call with your doctor immediately upon return. Depending upon your experience or exposure, they may have additional recommendations for you and your unborn baby.
Is a Vaccine for Zika Virus Available?
Not yet. However, there is work on a vaccine. As of February, the National Institutes for Health (NIH) has stated that Zika Virus Vaccine trials will begin this summer (wapo.st/1pTCPZO). They have built upon research on similar viruses, Dengue and West Nile. They are likely to be able to do a small scale trial of about 20 to 30 people in Summer 2016 with large scale trials likely to occur in 2017. Until a Zika Virus Vaccine is available, use insect repellent, travel with caution, if pregnant prevent exposure in your travel and with your sexual partner.
In the July 7, 2014 issue of People magazine, there was an article called, "6-Year-Old Football Players, Too Young to Tackle?" The article discusses the Tri-County Titans, a competitive tackle football team in the Texas Youth Football Association. What makes the Tri-County Titans so unique? They are a team comprised of 6 year olds. They were highlighted on Friday Night Tykes, a TV show on Esquire Network. There's been a lot of controversy regarding these elementary kids playing football. So what's wrong with 6 year olds playing football? Nothing, except, these young kids are playing tackle football. While the article discusses the potentially negative impact of competitive football among elementary school kids, I would like to focus on an important issue, concussions in football and children.
Concussions & Concussion Symptoms
A concussion is a type of traumatic brain injury that typically occurs when there is a sudden movement of the brain due to an injury such as a blow to the head, a jarring of the head, or a fall. Concussion symptoms can be various and linger. Symptoms may include disordered thinking, memory loss, dizziness, headaches, blurred vision, tiredness, nausea, vomiting, difficulty sleeping, and more. There are new guidelines for returning to sports after a concussion. These serve to promote brain healing and prevent additional injury.
Concussions in Children
Concussions and other injuries are more likely to occur with tackle football than flag football. Concussions have a huge impact for children. The reality is that once someone has had a concussion, they are more likely to have additional concussions. Repeated concussions are repeated brain injuries. What does that mean for the brain? It increases the likelihood of chronic lifelong brain damage. What does that mean to our youth? The younger the child has a concussion, the more likely they are to have more concussions in their sports lifetime. The growing brain in the child with repeated concussions is uniquely susceptible to brain damage with prolonged effects, especially if the family and child are planning a life with many years of football or high-impact sports participation.
If your child suffers a sports related injury, make sure to go to his or her doctor. Also, make sure your child receives an extra exam that clears him or her to return to their sport. More importantly,even before a potential injury occurs, make sure you know the facts about concussions. Make sure your children's school and coaches know the facts as well. The CDC has many concussion education resources available, such as "Concussion Fact Sheet for Teachers, Counselors, and School Professionals." They've even created an "Heads Up" app to help parents identify concussion or traumatic brain injury symptoms. For more support and resources about concussions, concussion symptoms, and treatment, please refer to the CDC concussion support website.