2012 Pediatrics Update
Updated March 05, 2015.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
More than 24,900 cases of pertussis have been reported to the CDC this year, with increases in 46 states, and 13 pertussis-related deaths. Although it still isn't clear why we're seeing these increases—which will soon reach the recent peak of 27,000 cases in 2010—the CDC states that "it's important that everyone get vaccinated. If it weren't for vaccines, we'd see many more cases of whooping cough."
In Washington alone, there have been 2,520 cases so far this year, a 1,300% increase over 2011 numbers.
Although a 'diminished duration of protection' from the DTaP vaccine, as compared to the older DTP vaccine, is getting part of the blame, it's important to note that "unvaccinated children have at least an eightfold greater risk for pertussis than children fully vaccinated with DTaP." And parents should also keep in mind that, "although vaccinated children can develop pertussis, they are less infectious, have milder symptoms and shorter illness duration, and are at reduced risk for severe outcomes, including hospitalization."
On a brighter note, there have been far fewer cases of measles so far this year than in 2011, when we had 222 cases—the most in 15 years. So far this year, there have only been 44 cases of measles. That's not surprising, considering that the number of outbreaks and reported cases in Europe have decreased as well, from more than 30,000 cases a year in 2010 and 2011, to just over 4,513 cases in 2012.
After years of worry about swine flu and seasonal flu, the West Nile virus outbreak has become the big story of 2012.
So far this year, there have been at least 1,590 cases of West Nile virus disease, and 65 deaths, in the United States, with most of the cases being reported in Texas, South Dakota, Mississippi, Oklahoma, Louisiana, and Michigan.
Experts predict that we may see as many cases as we saw in the West Nile virus epidemic years of 2002 and 2003, when there were about 3,000 cases, and 260 deaths.
Since there's no vaccine to prevent West Nile virus infections, and there's also no treatment, experts typically encourage people to use insect repellents when they go outdoors to protect themselves and their kids, and to take steps to get rid of mosquitoes around your home.
Keep in mind that West Nile virus infections are not very common in kids, though. Children and teens have the lowest incidence of infection.
Advice about circumcision keeps changing, which almost certainly adds to the confusion parents may have over deciding whether or not to have their children circumcised. Previously, the American Academy of Pediatrics concluded that "data are not sufficient to recommend routine neonatal circumcision' and that 'parents should determine what is in the best interest of the child."
The latest circumcision advice from the AAP is more clear. They state that "current evidence indicates that the health benefits of newborn male circumcision outweigh the risks, and that the procedure's benefits justify access to this procedure for families who choose it." They still state that the "health benefits are not great enough to recommend routine circumcision for all male newborns," though.
The HPV vaccine Gardasil was approved for use in males back in 2009. It wasn't until late 2011 that it was routinely recommended for all males aged 11 or 12 years, though, and older teens who haven't been vaccinated yet.
There have been some updates in the recommendations for use of pertussis vaccines as well. In light of the latest pertussis outbreaks, recommendations for the use of Tdap have expanded. The latest advice is that:
This is in addition to the advice that all kids get a dose of Tdap when they are 11 to 18 years old. These recommendations will hopefully improve immunity against pertussis and decrease the risk that newborns and infants who are too young to be fully protected aren't exposed to pertussis.
Although car seat guidelines seem to change every few years, it is important to note that it's usually the minimum recommendations for safety that seem to change.
For example, the last policy statement on child passenger safety from the AAP stated that infants and toddlers should ride in a rear-facing car seat (infant-only rear facing car seat or rear-facing convertible car seat) until they are two years old, or until they have reached the weight and height limits of their car seat. While surprising to some parents, this wasn't a big change for the many parents who already knew it was safer to ride rear-facing at that age.
Kids will hopefully also be a little safer with new warnings and proposed safety standards for high-powered magnet balls that continue to harm kids, often leading to the need for surgical removal of the magnets when they are ingested. Keep these magnets away from your kids—and entirely out of your home if you have kids—and watch out for them if you're visiting friends or family with your kids.
Parents often get used to the routine of a well child checkup: lots of questions about nutrition and safety, a physical exam, and a review of your child's growth and development, etc. There shouldn't be many changes from year to year, right?
While that is often the case, new recommendations about "Cardiovascular Health and Risk Reduction" will mean a new test for many kids: a non-fasting cholesterol test when they are 9 to 11 years old, even if they aren't overweight. Children at high-risk for heart disease should be tested even earlier, between 2 and 8 years.
Other stories that have been in the news a lot this year include:
Unfortunately, a lot of stories make the headlines and then are quickly forgotten. Be sure to think about these stories and learn from them to keep your kids safe and healthy.
Sources:
AAP. Circumcision Policy Statement. Pediatrics Vol. 130 No. 3 September 1, 2012pp. 585-586.
CDC. Telebriefing on West Nile Virus Update. Wednesday, August 29.
CDC. Pertussis Epidemic - Washington, 2012. MMWR. July 20, 2012 / 61(28);517-522.
CDC. Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males - Advisory Committee on Immunization Practices (ACIP), 2011. MMWR. December 23, 2011 / 60(50);1705-1708.
ECDC. Communicable Disease Threats Report. Week 35, 26 August - 1 September 2012.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Vaccine Preventable Diseases
More than 24,900 cases of pertussis have been reported to the CDC this year, with increases in 46 states, and 13 pertussis-related deaths. Although it still isn't clear why we're seeing these increases—which will soon reach the recent peak of 27,000 cases in 2010—the CDC states that "it's important that everyone get vaccinated. If it weren't for vaccines, we'd see many more cases of whooping cough."
In Washington alone, there have been 2,520 cases so far this year, a 1,300% increase over 2011 numbers.
Although a 'diminished duration of protection' from the DTaP vaccine, as compared to the older DTP vaccine, is getting part of the blame, it's important to note that "unvaccinated children have at least an eightfold greater risk for pertussis than children fully vaccinated with DTaP." And parents should also keep in mind that, "although vaccinated children can develop pertussis, they are less infectious, have milder symptoms and shorter illness duration, and are at reduced risk for severe outcomes, including hospitalization."
On a brighter note, there have been far fewer cases of measles so far this year than in 2011, when we had 222 cases—the most in 15 years. So far this year, there have only been 44 cases of measles. That's not surprising, considering that the number of outbreaks and reported cases in Europe have decreased as well, from more than 30,000 cases a year in 2010 and 2011, to just over 4,513 cases in 2012.
Other Infections
After years of worry about swine flu and seasonal flu, the West Nile virus outbreak has become the big story of 2012.
So far this year, there have been at least 1,590 cases of West Nile virus disease, and 65 deaths, in the United States, with most of the cases being reported in Texas, South Dakota, Mississippi, Oklahoma, Louisiana, and Michigan.
Experts predict that we may see as many cases as we saw in the West Nile virus epidemic years of 2002 and 2003, when there were about 3,000 cases, and 260 deaths.
Since there's no vaccine to prevent West Nile virus infections, and there's also no treatment, experts typically encourage people to use insect repellents when they go outdoors to protect themselves and their kids, and to take steps to get rid of mosquitoes around your home.
Keep in mind that West Nile virus infections are not very common in kids, though. Children and teens have the lowest incidence of infection.
Circumcision Advice
Advice about circumcision keeps changing, which almost certainly adds to the confusion parents may have over deciding whether or not to have their children circumcised. Previously, the American Academy of Pediatrics concluded that "data are not sufficient to recommend routine neonatal circumcision' and that 'parents should determine what is in the best interest of the child."
The latest circumcision advice from the AAP is more clear. They state that "current evidence indicates that the health benefits of newborn male circumcision outweigh the risks, and that the procedure's benefits justify access to this procedure for families who choose it." They still state that the "health benefits are not great enough to recommend routine circumcision for all male newborns," though.
Vaccines
The HPV vaccine Gardasil was approved for use in males back in 2009. It wasn't until late 2011 that it was routinely recommended for all males aged 11 or 12 years, though, and older teens who haven't been vaccinated yet.
There have been some updates in the recommendations for use of pertussis vaccines as well. In light of the latest pertussis outbreaks, recommendations for the use of Tdap have expanded. The latest advice is that:
- all adults get a single dose of Tdap if they haven't yet had a dose
- all adults aged 65 years and older should get vaccinated with Tdap
This is in addition to the advice that all kids get a dose of Tdap when they are 11 to 18 years old. These recommendations will hopefully improve immunity against pertussis and decrease the risk that newborns and infants who are too young to be fully protected aren't exposed to pertussis.
Safety
Although car seat guidelines seem to change every few years, it is important to note that it's usually the minimum recommendations for safety that seem to change.
For example, the last policy statement on child passenger safety from the AAP stated that infants and toddlers should ride in a rear-facing car seat (infant-only rear facing car seat or rear-facing convertible car seat) until they are two years old, or until they have reached the weight and height limits of their car seat. While surprising to some parents, this wasn't a big change for the many parents who already knew it was safer to ride rear-facing at that age.
Kids will hopefully also be a little safer with new warnings and proposed safety standards for high-powered magnet balls that continue to harm kids, often leading to the need for surgical removal of the magnets when they are ingested. Keep these magnets away from your kids—and entirely out of your home if you have kids—and watch out for them if you're visiting friends or family with your kids.
Well Child Care
Parents often get used to the routine of a well child checkup: lots of questions about nutrition and safety, a physical exam, and a review of your child's growth and development, etc. There shouldn't be many changes from year to year, right?
While that is often the case, new recommendations about "Cardiovascular Health and Risk Reduction" will mean a new test for many kids: a non-fasting cholesterol test when they are 9 to 11 years old, even if they aren't overweight. Children at high-risk for heart disease should be tested even earlier, between 2 and 8 years.
Other Pediatric News and Updates
Other stories that have been in the news a lot this year include:
- food recalls - there were several recalls this year because of Salmonella and E. coli contamination
- LeRoy, NY - teens in a small NY town develop mysterious symptoms. Mass hysteria or chemical contamination of town?
- autism rates - the CDC is now reporting that one in 88 children may have autism
- raw milk - several outbreaks linked to drinking raw milk.
- Bully - the movie Bully makes it to the big screen.
- pink slime - we learned a little bit more about the food we are eating this year.
- synthetic marijuana - another scary story - kids are trying fake weed and it isn't as safe as they think it is.
- brain-eating amoebas - another rare infection that scares a lot of people each year was in the news again this summer, as a 9-year-old boy died of the infection in Minnesota and a 30-year-old man died of Naegleria fowleri, likely contracting the infection while teaching his daughter how to swim.
Unfortunately, a lot of stories make the headlines and then are quickly forgotten. Be sure to think about these stories and learn from them to keep your kids safe and healthy.
Sources:
AAP. Circumcision Policy Statement. Pediatrics Vol. 130 No. 3 September 1, 2012pp. 585-586.
CDC. Telebriefing on West Nile Virus Update. Wednesday, August 29.
CDC. Pertussis Epidemic - Washington, 2012. MMWR. July 20, 2012 / 61(28);517-522.
CDC. Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males - Advisory Committee on Immunization Practices (ACIP), 2011. MMWR. December 23, 2011 / 60(50);1705-1708.
ECDC. Communicable Disease Threats Report. Week 35, 26 August - 1 September 2012.