Children's Health: Early contact with dogs linked to lower risk of asthma ♦ Pertussis infection in children associated with small increased risk of epilepsy

Early contact with dogs linked to lower risk of asthma Scientists have used national register information in more than one million children to study the association of early life contact with dogs and subsequent development of asthma. This question has been studied extensively previously, but conclusive findings have been lacking. The new study showed that children who grew up with dogs had about 15 percent less asthma than children without dogs.

Around a fifth of unvaccinated ethnic school girls in UK think they don't need Human Papilloma Virus because they feel they don't need to have it.

Kicking substance addiction in teens: Tobacco dependence should be treated with same urgency as other drugs, study says Substance abuse treatments that target main issues such as serious drug and alcohol addiction are not frequently being used to also wean adolescents from tobacco.

Pertussis infection in children associated with small increased risk of epilepsy Although the absolute risk was low, researchers found an increased risk of childhood-onset epilepsy among children in Denmark who had a hospital-diagnosed pertussis infection, compared with the general population.

Health Care Worker Who Worked While Ill with Pertussis

On September 5, 2014, the public health department of a Maryland hospital was notified of a case of Bordetella pertussis infection confirmed by polymerase chain reaction (PCR) in a staff health care worker (HCW). The HCW experienced onset of diarrhea and malaise (nonrespiratory symptoms atypical of the catarrhal phase of pertussis) on August 26. By September 2, paroxysms of coughing led the HCW to consult a colleague, who ordered the PCR test, prescribed a 5-day course of azithromycin, and advised avoidance of patient care until treatment completion.

Contrary to the hospital's infection control policy, neither the HCW nor the colleague reported the presumptive diagnosis of pertussis to the hospital's public health department. The HCW continued to work in the outpatient department until the positive PCR result was received on September 5, at which time the hospital's public health department was first notified.

The hospital barred the HCW from further work at the hospital while ill, and, in collaboration with local and state public health counterparts, began a contact investigation and stratified patient and HCW contacts by level of exposure.

The HCW had received tetanus, diphtheria, and acellular pertussis vaccine (Tdap) in 2010 and reported an ill family member who had been exposed at school during a widespread outbreak of pertussis affecting the surrounding community in August (1). In all, 47 persons were identified as being exposed to the HCW, including 31 patients ranging in age from 7 days to 12 years (six of whom were too young to receive diphtheria, tetanus, and acellular pertussis vaccine [DTaP]) and 15 HCWs. Of these exposed persons, 22 were considered high-risk contacts (seven patients and 15 HCWs) because they were aged <12 months, or contacts who themselves have close contact with infants under 12 months, pregnant women, or persons with preexisting health conditions at risk for severe illness or complications from pertussis.

All 22 high-risk contacts were assessed for symptoms and received postexposure prophylaxis according to established guidelines (2). Additionally, six HCW high-risk contacts (three staff physicians, two residents, and one nurse) reported symptoms suggestive of pertussis and were excluded from work until completion of a course of antibiotics. No patient contacts reported symptoms. Nasopharyngeal swabs obtained from all symptomatic high-risk contacts were negative for pertussis by PCR. The remaining low-risk contacts, or their identified parents or guardians, were screened for symptoms, informed of the low-risk nature of the exposure, and provided education on the signs and symptoms of pertussis. All 47 persons identified as exposed were contacted by public health investigators.

HCW presenteeism (i.e., working while sick) can jeopardize the well-being of patients and coworkers (3). Because of the need to investigate and limit exposures, clinical activities in a facility can be disrupted when staff members are potentially exposed to transmissible disease. HCWs should not work while ill with a potentially contagious condition.

Pertussis Cases Rise In South Dakota

 Recent reports of pertussis in the Black Hills area have the Department of Heath reminding parents to make sure their kids are appropriately immunized.

South Dakota had 67 cases of whooping cough, or pertussis, in 2013.  So far this year we have had 29 cases reported and several suspects and many close contacts.  A disproportionate number of cases have been in the Black Hills area.  

Pertussis is a highly contagious disease that is spread through the air by cough. Early symptoms resemble a common cold, including sneezing, runny nose, low-grade fever and a mild cough. Within two weeks, the cough becomes more severe and is characterized by episodes of numerous rapid coughs followed by a crowing or high pitched whoop. Thick, clear mucus may be discharged. Coughing episodes may recur for one to two months, and are more frequent at night.

While it can affect people of any age, it is most severe in babies under 6 months old, especially in preterm and unvaccinated infants. The elderly are also at risk.

The single most effective control measure is maintaining the highest possible level of immunization in the community. The vaccine is given in a series of doses at 2, 4, 6 and 15 months of age and between 4 and 6 years of age. Because immunity wanes over time, a booster dose is recommended for adolescents, 11-12 years of age, and for adults.

Treatment with antibiotics can shorten the contagious period. People who have been in contact with an infected person should see their physician, receive antibiotics, and be monitored for respiratory symptoms for 21 days after the last contact. People with pertussis or their symptomatic contacts may be isolated to prevent the spread of the disease.