Friday, April 18, 2014
Inquirer Daily News

Infectious Diseases

POSTED: Thursday, April 3, 2014, 9:36 AM

Editor’s note: Last week, we took a more in-depth look at meningitis and local cases in the Philadelphia region. Here’s a look at how the disease affects those in the United Kingdom. Our regular contributor Gary Emmett, MD, recently traveled to London.

The world is too small. That was my first thought last week when an undergraduate at Drexel University died of meningococcal meningitis B. People are always surprised when this happens since many know that all children are supposed to get a meningococcal immunization at age 11 and then again before college.  

However, the "B" strain of this germ is still very rare in the United States and the U.S. shot (or "jab" as they say in Britain) contains four other strains:  A, C, W-135 and Y.  These strains accounted for over 90 percent of the approximately 1500 cases of meningococcal meningitis and meningococcal septicemia (blood infection) seen in the U.S. yearly and the most widely strain seen in Sub-Saharan Africa.

POSTED: Monday, March 24, 2014, 10:16 AM
Allen Smith, 21, from West Hollywood, Calif., gets a free vaccine against bacterial meningitis at the AIDS Healthcare Foundation in West Hollywood, Calif., Monday, April 15, 2013. (AP Photo/Damian Dovarganes)

Bacterial meningitis is a contagious and potentially lethal infection. Recent cases at Princeton and Drexel universities and the infection of an 8-year-old Collegeville elementary school student have raised concerns about the disease across the area. I hope to provide anxious parents with some understanding of the nature of this disease and its spread.

Historically, three species of bacteria accounted for the vast majority of cases of childhood bacterial meningitis: Hemophilus influenzae type b, Streptococcus pneumoniae, and Neisseria meningitides.  The advent of modern vaccines has eliminated the disease caused by the first two bacteria for the most part.  Neisseria meningitides remains as the most common cause of disease among healthy children and adolescents in the United States.

The disease is spread by respiratory secretions. While the disease is contagious, the attack rate is relatively low. Among household contacts of individuals with meningococcal disease, secondary cases appear at a rate of 2 to 4 in 1,000 household contacts. Children under 5, adolescents and young adults, and the elderly are the groups at highest risk for infection. Most cases occur as single instances, but outbreaks of the disease do occur, often on college campuses or in military barracks.

POSTED: Monday, September 30, 2013, 9:44 AM
(iStockphoto)

Vaccine refusal played a role in the large whooping cough outbreak of 2010 in California, found a study released today online from Pediatrics. That year, 9,120 cases of whooping cough were reported in California, the most since 1947.

In March, I wrote a blog about whooping cough, also known as pertussis.  The impetus for that blog was new data that had emerged regarding that California outbreak. Evidence available then suggested that waning immunity associated with the new acellular pertussis vaccine may have contributed to the outbreak.

Unlike many states, California requires only a parent’s signature on a form to permit a child to enter school without vaccinations.  The state keeps a record of these non-medical vaccination exemptions (NMEs). In California, pertussis is a disease that must be reported to the state health department. The authors of this study examined geographic clusters of NMEs and geographic clusters of pertussis cases to see if the clusters overlapped. The authors found that:

  • The average rate of NMEs per census tract in California averaged 2 percent between 2005 and 2010
  • 39 census tracts within the state had NME rates that were significantly higher than the rates seen in the remainder of the state
  • The odds of finding a cluster of pertussis cases within one of these census tracks with high rates of NMEs were 2.5 times higher than the odds of finding a cluster of cases in the remaining census tracts; this difference remained after the results were adjusted for a number of demographic factors.
About this blog
The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Christopher C. Chang, M.D., Ph.D Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Mario Cruz, M.D St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Lauren Falini Bariatric exercise physiologist, Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, RD Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Flaura Koplin Winston, MD, PhD Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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