Flu Can Kill Even Healthy Children, Study Finds

By Steven Reinberg
HealthDay Reporter

MONDAY, Oct. 28 (HealthDay News) -- Children, even those without severe medical conditions, can die from the flu in as little as three days after symptoms appear, U.S. health officials warn.

Between 2004 and 2012, flu complications killed 830 children in the United States, many of whom were otherwise healthy, according to the U.S. Centers for Disease Control and Prevention.

Most striking is that 35 percent of these children died before being hospitalized or within the first three days of developing symptoms, according to the report published online Oct. 28 in Pediatrics.

"We found these influenza-related deaths can occur in children with and without medical conditions and in children of all ages, and that very few of these children have been vaccinated," said lead author Dr. Karen Wong, a CDC medical epidemiologist.

Researchers who reviewed those deaths found that only 22 percent with a high-risk medical condition and just 9 percent without a significant medical condition had been vaccinated.

Wong doesn't know why so many children die so fast. "About a third of these children die within the first three days of their first reported symptoms," she said.

One expert wasn't surprised that many otherwise healthy children who died did so before being admitted to the hospital.

"First, parents don't realize that flu can be fatal," said Dr. Marcelo Laufer, a pediatric infectious diseases specialist at Miami Children's Hospital.

Second, parents of children with chronic diseases "know the system better, so they come earlier than healthy patients," he said.

Because flu can progress so quickly, prevention is really the best strategy, Wong said. "And that's why we recommend every child 6 months or older get vaccinated every year," she said.

Because an infant under 6 months of age can't be given flu vaccine, Wong said it is vital that pregnant women get a flu shot to help protect their newborn, and that everyone likely to be near the baby also be vaccinated so they can't pass flu to the infant.

Wong said children who get the flu need to be watched carefully. She recommends getting in touch with the child's doctor when symptoms start.

"That's especially true for kids with high-risk medical conditions and for very young children," she explained. "These children are at especially high risk for flu complications."

Laufer, however, said a phone call to the doctor isn't enough. "It's very difficult for a pediatrician on the other side of the phone to understand how sick the child really is," he said.

Parents should take their child to the doctor or emergency department if they're sicker than what one would expect with a common cold, he said.

"Parents should realize that influenza is much more than sniffles," Laufer added. "A kid with influenza is a kid who is very sick, is a kid who is lethargic, has decreased appetite, is not drinking as much and not urinating as much in addition to other flu symptoms," he said.

Wong added that early antiviral treatment is recommended for high-risk children who develop symptoms of influenza. "That's another thing they can talk to their health care provider about," Wong added.

Antiviral drugs include Tamiflu, Relenza, Symmetrel and Flumadine.

In the study, Wong's group found that of the 794 children whose medical history was known, 43 percent had no medical condition that put them at high risk of dying from flu.

As for children with high-risk medical conditions who died, 33 percent had neurological conditions such as cerebral palsy or seizure disorder, and 12 percent had a genetic condition that put them at risk for flu complications.

Asthma, lung disease, heart disease and cancer can also increase a child's odds of dying from flu, the researchers noted.

Each year in the United States, flu causes an estimated 54,000 to 430,000 hospitalizations and 3,000 to 49,000 deaths, with infection rates highest among children, according to the CDC.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Karen Wong, M.D., M.P.H., medical epidemiologist, U.S. Centers for Disease Control and Prevention; Marcelo Laufer, M.D., pediatric infectious diseases specialist, Miami Children's Hospital; November 2013, Pediatrics

View the original article here

Moms With Lupus More Likely to Have Children With Autism, Study Suggests

By Serena Gordon
HealthDay Reporter

SATURDAY, Oct. 26 (HealthDay News) -- Women with lupus are twice as likely to have a child with autism compared to mothers without the autoimmune disease, new, preliminary research finds.

However, the overall risk is still low and the findings won't change the management of women with lupus, said one expert.

"I wouldn't tell my lupus patients not to get pregnant," Dr. Yousaf Ali, acting chief of rheumatology at Mount Sinai Hospital in New York City.

The study was undertaken to follow up on earlier, small reports that found that women with systemic lupus erythematosus (SLE) -- the most common form of the disease -- may have an excess risk of having children with an autism spectrum disorder, said lead investigator Dr. Evelyne Vinet, an assistant professor in the rheumatology department at McGill University Health Center in Montreal.

"We identified all women with systemic lupus erythematosus in a Quebec database and matched them to women who didn't have SLE, and we were able to see how many of their children were diagnosed with an autism spectrum disorder," Vinet said.

About 1.4 percent of children born to women with lupus were diagnosed with an autism spectrum disorder, compared to 0.6 percent of children born to women without lupus, the study found. It's important to note that while this study found an association between lupus in women and autism in their children, it wasn't designed to prove that the mother's lupus caused the autism.

Vinet is scheduled to present the findings Saturday at the American College of Rheumatology annual meeting in San Diego.

In lupus, as with other autoimmune disorders, the body's own immune system mistakenly attacks and destroys healthy cells, damaging the skin, joints and other organs. In some cases, the brain and nervous system are affected.

Autism spectrum disorders include a group of neurodevelopmental disabilities that can range from mild, as in Asperger's syndrome, to full-blown autism. Children with autism display social problems, communication difficulties and restricted, repetitive patterns of behavior.

Vinet said research done in mice has suggested that the rogue immune system cells that account for a mother's lupus may react with cells in the brains of her offspring.

The new study included 509 women with lupus who had 719 children and, for comparison, a group of nearly 5,900 women without lupus who had about 8,500 children.

In addition to finding that the incidence of autism disorders was doubled for children of women with lupus, the researchers also found that the autism diagnosis occurred earlier in children whose mothers had lupus. The average age was 3.8 years for children of women with lupus compared to 5.7 years for children of women without lupus.

Vinet said it's not clear why children of women with lupus would be diagnosed sooner. But the researchers hypothesize that the autism in these children may be more severe, or it may simply be that women with lupus are more vigilant about any changes in their children's health.

The researchers also controlled the data to see if pregnancy complications, such as preterm birth, gestational diabetes or being born small for gestational age, would affect the rate of autism in the children. After controlling for these factors, they found the risk of autism was slightly more than twofold for the children of women with lupus.

Ali said it would be important for these findings to be replicated in another study.

The findings shouldn't alarm women with lupus who want to become mothers, he noted.

"Lupus is a disease of young women of childbearing age, and the absolute risk of having children with an autism spectrum disorder is very small," Ali said.

Women who want to start a family should see their doctors ahead of time so they can switch medications before pregnancy if necessary (some aren't considered safe for pregnancy), Ali and Vinet said. They should also wait until their disease has been quiet for at least six months before conceiving, the doctors said.

Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Evelyne Vinet, M.D., assistant professor, McGill University Health Centre, Montreal; Yousaf Ali, M.D., acting chief, rheumatology, Mount Sinai Hospital, New York City; Oct. 26, 2013, presentation, American College of Rheumatology annual meeting, San Diego

View the original article here

Helping Your Children Grow into Healthy Teens

Toddlers become teenagers way too fast, and many parents worry about what their adorable child will become. Most teens do very well, especially when supported by parents who play an important role in helping their children mature. Research shows that teens thrive when they have strong relationships with supportive adults.

Healthy relationships develop over years and their foundation is effective communication. Here, Richard Chung, MD, an expert in adolescent medicine at Duke, explains how you can open the lines of communication, and foster that strong relationship with your child now and as they become teenagers.

•       Kids don’t talk to strangers: The more involved you are with your child’s lives, the more impact you conversations with your child will have. Being involved should start early on. Make it a habit to spend one-on-one time with your child on a regular basis. If you’re child is already a teen, find ways to spend time together. Go to the movies, play golf, or go shopping. The latter offer spontaneous ways to start conversations.

•       Teens need parents, not referees: Make it a habit early on to actively praise your child whenever it’s appropriate. It’s okay to offer constructive feedback, but balance it with a healthy dose of praise. A single positive comment can go a long way toward building their confidence and self esteem.

•       I learned it by watching you:  If you aren’t able to share information about your life with your children, they are unlikely to do so with you. Parents are role models who should lead by example. Share stories about your childhood and what’s going on in your world currently. Establish a sense of openness that invites them to respond in kind.

•       Open 24/7: As your child grows and strikes up conversation with you less and less frequently, it will become more important to drop what you’re doing when they actually want to talk, even when it’s inconvenient. It inevitably will be late at night or when you’re walking out the door, but it will be well worth it if they are truly ready to engage.

•       Sigh…“What do you want now!?!”: Make sure communication doesn’t just happen when something has gone wrong or needs to be done. If it’s always negative or stressful, teens will tune out. Touch base daily in a meaningful way. The value of sincere conversation with no motives other than to engage your teen cannot be overstated.

•       Meet them (well beyond) half way: It is undeniably challenging to get teens to converse. However, most parents know of at least a few things that reliably get their teen talking excitedly, whether it’s their new video game, their favorite celebrity, or something silly their friend did at school. If that’s their communication comfort zone is, then that’s where you should be.

To make an appointment with Dr. Chung, or another adolescent medicine specialist at Duke, call 1-888-ASK-DUKE.

View the original article here