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Infectious diseases: what you should know

By Dr. Tamara W. Harper

The saying “There is nothing new under the sun” also pertains to childhood diseases and infections. Through time, we have seen many illnesses eradicated. Others are harder to eliminate, but physicians, and the healthcare industry in general, have been effective at decreasing the cases that can cause serious damage. They also have made improvements in identifying and managing symptoms. Some illnesses that remain very prevalent and can have very serious complications, or even cause death in the younger population, are:

MEASLES

Some people think of measles as a simple rash with runny nose, red eyes and a fever — symptoms that often mirror other illnesses. It is not a simple childhood illness that will clear up on its own in a few days. Measles can cause serious complications, even death, especially in children younger than 5. There is no way to tell in advance the severity of the symptoms your child may experience, and we see it as being very serious because there is no treatment.

One in four people in the U.S. will require hospitalization. One out of every 1,000 will develop brain swelling, which could lead to brain damage. Two out of every 1,000 with measles will die, even with the best medical care.

As of this writing, the total number of measles cases in the United States for 2019 has surpassed the total for any year since the disease was considered effectively eliminated from the country in 2000, thanks to a highly effective vaccination program. All pediatric populations are at risk, with patients age 19 or younger accounting for 77 percent of cases so far.

Measles is very contagious and re- mains common, with large outbreaks still occurring in many parts of the world. An infected person can spread measles to others before knowing he/ she has the disease, from four days before developing symptoms to four days afterward. Thus, measles is just a plane ride away — or even closer now with the recent outbreak in the U.S.

Outbreaks are linked to travelers who are exposed to measles abroad and then bring it home. The disease then may spread, especially in communities with high rates of unvaccinated people, as measles is very contagious and can live for up to two hours on surfaces infected patients may have touched or in the air where they may have coughed or sneezed. A significant factor contributing to the decline in the rate of vaccination has been miscommunication about the safety of the measles/mumps/rubella (MMR) vaccine.

Measles can be prevented with measles-containing vaccine, which is administered as the combination measles – mumps – rubella (MMR) vaccine. It is recommended that all children receive the MMR vaccine at age 12-15 months, and against at 4-6 years. Additionally, it is recommended that children ages 6-12 months receive a dose of the vaccine if traveling abroad.

PERTUSSIS / WHOOPING COUGH

Pertussis, also known as whooping cough, is a highly contagious respiratory disease caused by the bacterium Bordetella Pertussis. Pertussis is known to cause uncontrollable violent coughing spells that make it hard to breathe. After coughing fits, someone with pertussis often must take deep breaths, resulting in a “whooping” sound. Pertussis can affect people of all ages and be very serious, even deadly for babies less than 1 year old. Half of babies that age who get pertussis need care in the hospital. Of those hospitalized:

One in four get pneumonia. One in 100 will have convulsions or seizures. One in 300 will have swelling or disease of the brain (encephalopathy). One in 100 will die.

Pertussis spreads from person to person. People usually spread the disease by coughing or sneezing, or when spending a lot of time near one another where breathing space is shared. Many babies who get pertussis are infected by older siblings, parents or caregivers who might not know they have the disease. Infected people are most contagious up to about two weeks after the cough begins.

The best way to prevent pertussis is to get vaccinated. Keep babies, who are too young to be well protected by pertussis vaccines, and others at high risk for pertussis complications away from infected people. All mothers are advised to get the vaccine in the third trimester of each pregnancy. In addition, encourage those who will be in close contact with your baby to be up to date with pertussis vaccination. It is recommended that infants start the series on time, at 2 months of age.

INFLUENZA

Influenza, or flu, is a very contagious respiratory illness from which most people will recover in a few days. However, some, especially younger children, may develop complications that can be life threatening, or even fatal. The CDC estimates for the 2018-19 flu season:

Over 520,000 hospitalizations secondary to flu complications Over 40,000 flu-related deaths
Anyone can get sick with flu (even healthy people), and serious problems related to flu can happen at any age. However, some people are at high risk of developing serious flu-related complications if they get sick. This includes people of any age with certain chronic medical conditions, like asthma, diabetes, or heart disease, pregnant women and children younger than
5 — especially those younger than 2.

Flu virus infection of the respiratory tract can trigger an extreme inflammatory response in the body and lead to a sepsis, the body’s life-threatening response to infection. Flu also can make chronic medical problems worse. For example, people with asthma may experience asthma attacks while they have flu or develop secondary pneumonia. Those with congenital heart disease may experience a worsening of this condition triggered by flu.

The best way to prevent serious complications from seasonal flu is to get vaccinated each year. It is recommended that everyone age 6 months and older get a flu vaccine every season.

Dr. Tamara W. Harper is board certified by the American Academy of Pediatrics and affiliated with the Garden Park Physician Group. Contact the Pediatric Center at (228) 328-1401.

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