Tag Archives: reuters-health

Vaccine exemptions rising, tied to whooping cough

The number of New York parents who had their child skip at least one required vaccine due to religious reasons increased over the past decade, according to a new study. What's more, researchers found counties with high religious exemption rates also had more whooping cough cases - even among children that had been fully vaccinated. States set their own requirements on which vaccines a child must have received to enter school. All allow exemptions for medical reasons, and most, including New York, also permit parents with a religious objection to forgo vaccination. Less than half of states permit exemptions due to personal or philosophical beliefs. But those also can get counted under religious views in places with less strict exemption policies. “Particularly in New York State, I do believe that parents are using religious exemptions for their personal beliefs,” said Dr. Jana Shaw, who worked on the study at SUNY Upstate Medical University in Syracuse. “There's a lot of vaccine hesitancy.” Studies have shown cases of whooping cough, also known as pertussis, have been on the rise across the U.S. Researchers suspect that's due to the use of a new type of pertussis vaccine - which is safer, but less effective over the long run - and to more children missing or delaying vaccination. For their study, Shaw and her colleagues tracked data from the New York State Department of Health on both religious exemptions and new whooping cough cases. Children were reported as having a religious exemption if they had been allowed to skip at least one required vaccine for non-medical reasons. Between 2000 and 2011, the proportion of religiously exempt kids increased from 23 in 10,000 to 45 in 10,000, the study team reported Monday in Pediatrics. The number of counties where at least 1 percent of children had a religious exemption also increased, from four to 13. Most of those counties were in western or northern New York. Higher religious exemption rates were tied to more reported cases of whooping cough. In counties with at least 1 percent exemption, 33 out of every 100,000 children developed pertussis each year, compared to 20 per 100,000 in counties with fewer religious exemptions. 'Overwhelming evidence' on safety Children who had been fully vaccinated were also more likely to get sick in places with high exemption rates. No vaccine is 100 percent perfect, so infectious disease prevention relies on “herd immunity” - when enough kids are vaccinated that the infection can't spread. “If you have enough exempted children in your schools and neighborhood, they will put even vaccinated children at risk,” Shaw told Reuters Health. Saad Omer, a researcher at the Emory Vaccine Center in Atlanta, said the pattern of increasing non-medical exemptions has been seen in other states as well, including Michigan and California. Because of the general success of vaccination, “there is less disease to go around and there's less individual and collective experience. You don't hear about the disease that often,” he told Reuters Health. “When that happens, successive cohorts of parents start evaluating the real or perceived risk of vaccines more than the risk of disease.” But those perceived risks - such as a link between vaccines and autism - have not panned out. “If you look at the risk-benefit ratio between side effects of vaccines and the benefits they render, it's not even a close call. It's hugely, heavily in favor of vaccines,” said Omer, who wasn't involved in the new research. Shaw agreed. “Vaccines are extremely safe, in spite of what the Internet and other sources have argued,” she said. “We have overwhelming evidence that vaccines are safe.” Both Omer and Shaw said they don't think states and schools should pass judgment on parents' religious beliefs, but that it shouldn't be easy to get a vaccine exemption for convenience or personal preference. And, Omer added, “those who don't get (their kids) vaccinated should remember that it's not a benign choice. There are real disease risks.”source : http://www.foxnews.com/health/2013/06/03/vaccine-exemptions-rising-tied-to-whooping-cough/

Check young kids for motor delays, pediatricians suggest

Doctors should regularly screen babies and young children for delays in motor skill development - including trouble sitting, standing and speaking - at well-child visits, pediatricians said today. In a clinical report, an American Academy of Pediatrics (AAP) panel said diagnosing and treating those problems early on may ultimately improve kids' outlook and help families gain additional support. “Identifying children with delays and motor abnormalities, theoretically or hopefully would set them on a better trajectory,” said Meghann Lloyd, who studies motor development at the University of Ontario Institute of Technology in Oshawa, Canada. Lloyd, who was not involved in the new report, called it “a really big step forward for the field.” Dr. Garey Noritz and colleagues on the AAP's neuromotor screening expert panel lay out the skills that a child should have developed by office visits at ages 9, 18, 30 and 48 months. For example, a 9-month-old baby should be able to roll to both sides, sit well without support and grasp objects. At 18 months, that child should be able to walk, sit and stand on its own. Pediatricians should also ask parents open-ended questions about their child's development and watch the child play for signs of delays or loss of motor skills at well-child visits, the panel said. On a general exam, it recommended that doctors measure head size and look at children's muscle tone, reflexes and eye movements. The U.S. Preventive Services Task Force, a government-backed expert panel, said in 2006 there wasn't enough evidence to recommend for or against screening instruments designed to detect speech and language delays in young kids. The task force does not have screening recommendations for motor delays in general. “The AAP… recognized that we as a profession weren't necessarily doing a good job screening for motor problems,” Noritz, from Nationwide Children's Hospital in Columbus, Ohio, told Reuters Health. Cerebral palsy and muscular dystrophy are two of the most common motor-related diseases and could both be picked up and treated earlier than they typically are now, according to Noritz. He said families often refer to the “diagnostic odyssey” involved in getting a definitive diagnosis for a sick child. “We're hoping that people can get to a specialist more quickly and thus get diagnosed more quickly, but that primary care clinicians at the same time as they're looking for a diagnosis, will refer (kids) to therapy,” he said. Promoting movement There is normal variation in how kids develop, Lloyd said - so if a child is a couple of months late to walk, for example, parents shouldn't be overly concerned. But longer delays, or combinations of multiple motor problems, are a good reason for a visit to the pediatrician, she told Reuters Health. “Other types of movements that don't seem right, like a tremor or a rigidity or some sort of repetitive motor movement would be another red flag for me,” Lloyd added. Typical motor delays that aren't a result of more serious underlying conditions are treated with physical or occupational therapy. Parents can bring their children to an early movement program such as Kindergym to promote development of motor skills, Lloyd said, regardless of other treatments and whether or not they are delayed. Having poor motor skills in general “sets you on a trajectory for low levels of physical activity, which of course is related to obesity,” she said. “The prevention of these delays or the promotion of motor ability can actually impact your health for your lifespan.”source : http://www.foxnews.com/health/2013/05/28/check-young-kids-for-motor-delays-pediatricians-suggest/

Sugar water injections may help ease knee pain

Knee pain appears to decrease up to one year after “prolotherapy,” a series of sugar water injections at the site of the pain, according to a new study. Previous research on the therapy that suggested positive effects was plagued by flaws, but the new report may be more reliable, according to Dr. John D. Loeser, a pain specialist and professor emeritus at the University of Washington in Seattle. “This is a well-performed clinical trial that deals with many of the issues that have clouded prior reports of prolotherapy,” Loeser, who was not involved in the study and has spoken out against the practice in the past, told Reuters Health in an email. Knee osteoarthritis is common, especially among people over 65, but no single therapy has proven particularly beneficial. In prolotherapy, which costs $200 to $1000 per session and is not covered by Medicare, small amounts of solution are injected at multiple painful ligament and tendon locations in the knee over several sessions. The hope is that a new minor irritation will stimulate the body to repair both old damage and new. “The idea is to stimulate a local healing reaction,” lead author Dr. David Rabago, assistant professor at the University of Wisconsin in Madison, told Reuters Health. Rabago and his colleagues divided 90 people with knee osteoarthritis and between ages 40 and 76 years old into three groups: one got sugar-water prolotherapy injections, another got salt-water placebo injections, and the third was instructed in at-home exercise and received no injections. The first two groups got injections at least three times, sometimes more if they asked for it, over 17 weeks, and were followed for one year. The sugar water group reported better knee function, improving 16 points on a 100-point scale of osteoarthritis severity, compared to 5 points for saline and 7 points for the exercise group. The sugar water group also reported less frequent and less severe pain, improving 14 points on the same scale, at one year, while the salt water and exercise groups improved 7 points and 9 points, respectively. The study was small but not too small and included the right type of subjects: typical sufferers of knee osteoarthritis, researchers said. One of the things that has held back previous studies of prolotherapy is the difficulty of mimicking the injections for a placebo group without actually injecting them with something - that makes it difficult to tell what's causing the improvements, the sugar water itself or the needle stick, bleeding or stretching the tissue, which can all have effects. “The best one can do is ‘control' for those effects by testing an agent against a similar treatment and varying only one thing, which is what we did,” Rabago said. But since the salt water group and the exercise-only groups had similar results, the benefit was probably not a placebo response, Loeser said. “This study yields results that are more favorable than other carefully controlled studies of prolotherapy in other regions,” Loeser said. But there are a lot of questions to answer before this becomes widely adopted, he cautioned. “Certainly, additional studies are needed before one accepts prolotherapy as standard treatment for knee OA,” Loeser said. Researchers don't yet know how long the pain benefit will persist after one year. But Rabago said, “These results support its use as routine care for knee OA in patients who have not improved with more conservative measures.” Though he doesn't yet know how prolotherapy works, he added that he would recommend the treatment for a member of his own family.source : http://www.foxnews.com/health/2013/05/24/sugar-water-injections-may-help-ease-knee-pain/