Archive for the ‘Infectious Disease and Immunology’ Category

Sharing knowledge: National Women and Girls HIV/AIDS Awareness Day

Sunday, March 10th, 2013

Today is National Women and Girls HIV/AIDS Awareness Day. Women and girls now make up almost a quarter of people living with HIV in Minnesota, and over 70 percent of these are women and girls of color, according to the Minnesota Department of Health.  Women of color have been especially hard hit, accounting for the majority of new infections occurring among women in the United States.

The United States has made great strides in efforts to eliminate the spread of HIV from mother to child, and the number of children perinatally (around birth) infected with HIV in the United States has declined over 90 percent since the epidemic began. We’ve also seen a significant – 21 percent – decrease in new infections among women in recent years. But, the fight is not over.

As the largest provider of care to HIV-infected infants, children, and youth in Minnesota, Children’s Hospitals and Clinics of Minnesota provides medical care to about 75 to 80 children, adolescents and youth infected with HIV and their families annually. Children come to us from all over Minnesota and surrounding states (North and South Dakota, Iowa, Michigan, and others), and all over the world. Many of the children in our care have been adopted from countries in Asia, Africa, Eastern Europe, and the Caribbean.  Many more are first or second generation refugees and immigrants.

In addition to specialized medical care, families can access specialized support services, including education and family case management funded through the federal Ryan White CARE Act program and referrals to additional programs and services throughout the state.

With modern advances in HIV care, women and girls are living longer, healthier lives, and many men and women affected by and infected with HIV are choosing to start to add to their families.

Without medical intervention, about one in four children born to HIV-positive mothers will become infected, but by following current treatment and prevention guidelines, women can reduce their risk of transmission to 1 to 2 percent. Despite this success, however, the prevention of perinatal HIV infection remains complex and requires access to specialized, competent medical care and prevention support services.

Children’s houses the Minnesota Perinatal HIV Program, which exists to eliminate the transmission of HIV from mother to child in Minnesota and ensure men and women living with HIV can give birth to healthy babies, born free of HIV. Our specialized services are open to HIV-infected pregnant women and HIV-negative pregnant partners of HIV-infected men at-risk of acquiring HIV infection.

We provide nursing care coordination, case management, and education services to women, their partners, and their providers during pregnancy and up to six months following birth. In partnership with community providers, we also offer preconception counseling and guidance for couples wishing to conceive safely and prevent HIV transmission. During 2003 to 2012, the program provided services to more than 390 women, 75 percent of whom came from racial and ethnic minority populations and almost 40 percent were African-born.

Women and girls are EMPOWERED by knowledge and actions to change the course of HIV.

Prevention tips:

1. Get tested, know your status! HIV testing is recommended as a routine part of medical care.  Talk to your provider about testing.

2. Educate yourself about your risks! Learn how to prevent HIV infection and how to keep yourself safe.

3. Get connected, get support! If you are living with HIV, find out about the programs and services offered in your area to help you stay healthy and support you and your family in dealing with your disease.

Posted in Infectious Disease and Immunology | No Comments »

Has the flu reached your home? Here’s the 411.

Wednesday, January 23rd, 2013

By Patsy Stinchfield

Patsy Stinchfield

Flu season arrived early this year and with more severity than in recent years. According to the U.S. Centers for Disease Control and Prevention (CDC), 48 states had reported influenza during the week of Jan. 6-12. There were nine influenza-related pediatric deaths during that week, bringing the total to 29.

We have seen a record number of influenza cases at Children’s Hospitals and Clinics of Minnesota. We’re seeing lab-confirmed influenza cases at rates higher than our highest week during H1N1. We’ve taken steps here to help prevent spreading the flu, including updating our visitor guidelines.

The No. 1 way to prevent the flu is to get vaccinated. And it’s not too late for that. We have more tips on preventing the flu here. In case the flu has reached your family, here are some helpful tips for taking care of your child.

What’s the difference between the cold and the flu and how can I tell?

Sometimes it’s hard to know whether a child has a cold or the flu because she may cough, have a runny nose, sore throat and fatigue with both. With the flu, a child tends to have a high fever. It comes on more suddenly with more severe fatigue and body aches.  Colds come on more gradually, and many kids may feel well enough to keep playing and going to school. Clinics use a rapid nose swab test to determine if someone has influenza.

What should I do if I suspect influenza?

Most cases of influenza are mild and can be managed at home with rest, plenty of fluids, and fever-reducing medicines.  Tender-loving care is good medicine, too. Most over-the-counter “cough and cold” medicines do not help a sick child get better faster and won’t have much effect on influenza. Sometimes, the flu can make a child very ill and a visit to the clinic or emergency room is necessary.

When should I take my child to the Emergency Department?

Take your child to be checked if there is difficulty breathing (fast, grunt-sounding, noisy breathing or small breaths), the color looks bad (pale or bluish), they aren’t drinking fluids often or urinating at least once every eight hours or just aren’t themselves and you’re worried.  Signs of dehydration are dry lips, sunken eyes, sleepiness or crankiness.  Children who seem like they’re getting better and then suddenly get worse should be taken to the Emergency Department immediately.  This could mean they have another infection in addition to the flu.

What are the best ways to get my child’s fever down when she has the flu?

Fever is one of the tools our immune system uses to kill germs.  However, children with high fever can feel quite miserable, get crabby, have trouble waking up and may drink less fluids causing dehydration. If you can’t keep the fever down with a fever-reducing medicine such as Tylenol or Ibuprofen, then the child should be taken to the clinic or Emergency Department.

Is there anything else I can do to help make my child more comfortable?

You can keep your child home from day care, school, sports or other activities and have them rest early in their illness and until they show signs of getting back to “their normal.” If your child doesn’t want to eat regular meals, don’t insist, but do make sure they drink small amounts of fluids every hour to prevent dehydration.

Is there anything I can do to help my child recover more quickly?

There is an anti-viral medicine called Tamiflu that can be given to children as young as 2 weeks of age. This is used if the child has moderate or severe influenza and works best if given in the first two days of illness.  Tamiflu usually cuts the severity and number of days of illness in half.

How long will my child be contagious?

Influenza is most contagious the day before symptoms present through about day five of illness. Your child should stay home from school during this time. After viral illnesses, kids can have lingering muscle or body aches and really do need time to rest and recover before rushing back to school. Depending on the severity of the flu, this may be a few days to a few weeks.  Most kids recover within a week. Most schools require that your child be fever-free (without the help of medicines) for two days before returning to school or day care. For more information, visit the CDC.

Patsy Stinchfield is a nurse practitioner and the director of the Infectious Disease Division at Children’s. Follow her on Twitter and watch her videos on Clear.MD.

 

Posted in Infectious Disease and Immunology, Influenza Prevention | No Comments »

Four reminders to prevent the flu

Tuesday, October 16th, 2012

Flu season. It’s that time of year when we duck for cover in Minnesota. We all know someone who has battled the flu.

The flu is a serious respiratory illness, and the symptoms can be downright nasty – sudden onset of fever, cough, congestion, sore throat, achy muscles, fatigue, occasionally pneumonia, and, in extreme cases, death.

Each year, an average of 20,000 kids under 5 are hospitalized because of flu-related complications, according to the Centers for Disease Control and Prevention. Influenza causes more hospitalizations among young children than any other vaccine-preventable illness.

“Don’t think of influenza as ‘just the flu.’  For infants and children especially, it can be a scary, very severe disease.  Prevent it,” said Patsy Stinchfield, nurse practitioner and director of infectious disease at Children’s Hospitals and Clinics of Minnesota.

Here are some easy reminders to keep your family and you healthy during flu season:

  1. Get vaccinated against the flu. All people 6 months of age and over need an annual flu vaccine.  While flu vaccines are not perfect (100 percent effective), not getting one provides zero protection.
  2. Wash your hands with soap and water. At Children’s, we wash ‘em proud. You should wash your hands before and after eating, after using the restroom, after blowing your nose and sneezing.
  3. Cover your cough and sneeze. If you’re visiting Children’s, we ask that you wear a mask if you have a cough. We ask staff and visitors to stay home if they are ill and if they have a cough to wear a mask to prevent the spread of such things as influenza and other infections to our vulnerable patients.
  4. Sick? Please, stay home from work or school. If your child is sick, keep him/her home from school and daycare, too.
Visit our flu prevention website for more information.

Kohl’s Cares and Children’s Flu Prevention Tips from Children's of Minnesota on Vimeo.

Posted in Infectious Disease and Immunology, Influenza Prevention, Uncategorized | No Comments »

West Nile virus cases are up; you can take precautions

Wednesday, September 12th, 2012

Empty water-holding containers like rain barrels, flowerpots and buckets.

The number of West Nile virus cases is quickly rising in the United States. There’s a record-setting number of  cases up to this point in the year since the virus was first detected here in 1999, according to the Centers for Disease Control and Prevention.

As of Sept. 4, 48 states had reported West Nile virus infections in people, birds or mosquitoes. The CDC received reports of 1,993 cases of the viral disease in people, including 87 deaths.

While more than 70 percent of the cases have been reported in Texas, South Dakota, Mississippi, Oklahoma, Louisiana and Michigan, there have been cases in Minnesota, too.

“Most people — adults and children — who are infected by West Nile virus, show no symptoms at all.  The disease can present like many other viral illnesses with fever, headache, and body aches. Sometimes a rash on the trunk or swollen lymph nodes are seen,” said Dr. William Pomputius, medical director of Infectious Disease and Immunology at Children’s Hospitals and Clinics of Minnesota. “In general, 1 in 150 people may develop severe disease with high fever, stiff neck, and nervous system symptoms, but children are much less likely than adults to have this complication. Parents concerned about their child’s health should see their health care provider.”

The latest report from the CDC serves as a reminder that we should take precautions to avoid the mosquito-borne illness.

The No. 1 way to prevent getting West Nile is to avoid a mosquito bite. We know that’s easier said than done. So, we compiled some tips from the CDC and the Minnesota Department of Health to help:

  • Eliminate water-holding containers from your property. Get rid of mosquito breeding sites by emptying standing water from flowerpots, buckets and barrels. Change the water in pet dishes and replace the water in birdbaths weekly. Drill holes in tire swings so water drains out. Keep children’s wading pools empty and on their sides when they aren’t being used.
  • Use mosquito repellent that contains up to 30 percent DEET (10 percent for children)
  • Wear long sleeve shirts and pants
  • Avoid outdoor activity during dusk and dawn, when mosquito activity is highest.

 

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Staying healthy at the Minnesota State Fair

Thursday, August 23rd, 2012

Today kicks of 12 days of jam-packed fun, food and more at Minnesota’s Great Get-Together.

We’ll be at the Minnesota State Fair every day at our Making Safe Simple booth, located at Randall Avenue and Cosgrove Street, across from the Fine Arts building.

We love the Minnesota State Fair and so do our kids.  As always, taking a few safety steps can ensure a fun time while keeping children healthy.  With a higher than usual number of cases of pig to human influenza this year (without pig to human to human transmission) taking basic precautions in the pig barns is wise.  We balance risks and benefits of the things we do every day including preventing infections.  So take a minute to think it through for your family.

You might have heard from the Minnesota Department of Health that the state recorded its first confirmed and a second probable case of a new influenza strain that people acquire through contact with pigs. The cases were reported in a pre-school-age child and an older sibling. MDH officials believe they were likely exposed to the new strain from pigs while they were at an animal market (not at a fair).

Before we eat our first Pronto Pup, we asked our infectious disease and infection prevention guru and Nurse Practitioner Patsy Stinchfield for a few tips so we stay healthy while we’re at the fair.

  • Wash ‘em proud!  Clean hands are still the No. 1 way to prevent the spread of germs. Wash your hands after exposure to animals or animal barns and before touching your eyes, nose or mouth in any way.
  • People who are high risk for influenza complications should skip the pig barns this year.  This includes infants and pre-schoolers, the elderly, pregnant women, the immunocompromised and anyone with a neurological or difficulty managing their own saliva.
  • If you do go to the pig barns (we know we will), don’t kiss the animals.  We agree – they’re cute – but don’t smooch them (in fact, looking at the pigs from 6 feet away or more is safest).
  • Wash bottles and pacifiers in hot soapy water after they’ve been in an animal exhibit area.
  • Oh, and, pork chops on a stick do not cause influenza so enjoy!

The MDH and fair officials have also discouraged fairgoers or exhibitors from eating, drinking or placing anything in their mouths while in the animal exhibit areas.

We hope to see you at the fair!  Stop by our Making Safe Simple booth and say hi.

Posted in Infectious Disease and Immunology, Influenza Prevention, Ways to Stay Healthy | No Comments »

Pertussis: High number of cases cause for concern

Friday, July 27th, 2012

Pertussis. It sounds foreign, doesn’t it?

But Pertussis, also known as “whooping cough,” is a highly contagious respiratory disease that can strike infants to the elderly. And there’s currently an epidemic underway in Minnesota.

There were 1,758 Pertussis cases reported in Minnesota as of June 30, according to the Minnesota Department of Health. More than 400 cases have been reported so far in July alone. Nationally, the number of cases could reach its highest level in 50 years, according to the Centers for Disease Control and Prevention.

Children’s Hospitals and Clinics of Minnesota saw nine Pertussis cases just this past week and 41 in the month of July, said Patsy Stinchfield, director of Infectious Disease/Immunology and Infection Prevention. The hospital typically sees 32 cases over the course of a year.

The numbers are concerning.

“Everyone should be on their toes thinking about and testing for Pertussis for people with a cough lasting more than a week,” Stinchfield said.

Pertussis can be a serious illness in infants, children and adults and can be life-threatening, especially for infants. A person with Pertussis develops a severe cough that usually lasts four to six weeks or longer, even up to 100 days. It can make it hard to breathe or cause vomiting. The “whooping” sound isn’t always present.

It’s unknown what has caused the spike in cases. While Pertussis occurs in all age groups, the average age is 14 and outbreaks have occurred in middle schools, according to the Minnesota Department of Health.

“Teens are like a perfect storm of infection,” Stinchfield said.

They may not have gotten their Tdap booster yet, and they tend to continue socializing when they’re sick, spreading their infection to others in their social groups and communities, she explained.

The good news is that Pertussis is preventable. Stinchfield offered the following tips to protect your children and yourself:

  • Children need their primary series of DTaP vaccinations
  • All adolescents and adults need a Tdap booster—one dose for anyone 10 and older
  • Women who are 20 or more weeks pregnant, adults who have significant contact with children and elderly need to make sure they get a Tdap booster
  • Thoroughly wash hands and avoid touching eyes, nose or mouth
  • Those who have Pertussis should not leave home until they have completed their entire antibiotic treatment which is generally five days.  If no antibiotics are taken, Pertussis can spread during the first 21 days of the cough.  Avoiding social contact (stay home from work, school and daycare) until five days of antibiotics are completed is essential
  • It’s called “The 100 day Cough” for a reason—the antibiotics reduce spread to others, but it does not repair damage in the airways which can cause the person to have a harsh cough for many weeks and even a few months
  • Babies too young to be immunized are the ones most likely to die from Pertussis and usually get it from their mom, dad or grandparent.  Vaccinating anyone in contact with a newborn helps prevent needless tragedy

Patsy Stinchfield talks more about Pertussis by video. To watch the series, click here.

For more information or to contact a provider, please visit www.childrensmn.org.

 

 

Posted in Infectious Disease and Immunology, Vaccinations, Ways to Stay Healthy | No Comments »