The outbreak originating at Disneyland has proven to be a valuable case study on Measles. Since Disneyland attracts many people from around the world, it is well suited as an incubator for some transmissible diseases. Experts from the CDC have been involved in analyzing the outbreak. It is believed that unvaccinated individuals who had traveled to the Philippines and contracted measles then visited Disneyland. That led to an outbreak involving over 100 people in 14 states.
"The index patient or patients could easily have spread the extremely infectious measles virus via sneezing and coughing. The people around him then inhaled or touched a surface where the droplets landed." Not only can measles survive up to 2 hours on a surface or in the air, and it also takes less of it to cause disease than any other infectious agent. "If you were in a room that a patient with Ebola was in 2 hours ago, you'd have to actually touch the patient's bodily secretions to get infected - the Ebola virus is not airborne." However, after a patient with measles coughs or sneezes, "the virus is still at high enough concentration 2 hours later that the next person who hasn't had measles or been vaccinated has a 90% chance of catching it."
Measles was eradicated in the US in 2000, but 19 states in the US allow parents to opt out of vaccination for personal beliefs. Old beliefs about measles vaccine being linked to autism cited a European study that has been discredited. Investigators reexamined the children involved in the study, and found that the purported link to autism was a lie; the doctor was discredited and lost his medical license, though people still talk about measles and a possible link to autism.
In 2014, there were 644 cases of measles in the US. We have already had more than 100 in 2015. Measles can cause pneumonia, encephalitis (inflammation and infection of the brain), eye problems, and ear infections that can cause permanent hearing loss. Encephalitis, though rare, is devastating.
The MMR vaccine (Measles Mumps Rubella) has been proven in study after study to be extremely safe. Independent bodies including the CDC, the Institute of Medicine and European experts have used databases going back into the 1980s, and have analyzed millions of vaccine records. They have found no hint of serious adverse events.
MMR vaccine is recommended at 1 year old, with a booster at age 4-6 years. The first shot confers around 90% protection, and the second dose raises it to 99%.
Wednesday, March 18, 2015
Wednesday, March 4, 2015
Caffeinated Kids - How Much is Too Much?
We've all seen the news articles on the harmful effects of high doses of caffeine in teenagers and college students. Energy drinks are marketed for teenagers, and I see many teenagers in my practice who drink them.
A recent study looking at the caffeine content of popular beverages (and foods) yielded some startling results. The results indicate that children, who are especially vulnerable due to their lower weight and body mass, can easily consume enough caffeine to leave them jittery and anxious, or cause physical symptoms like abdominal pain and headaches.
The common culprits - dark-colored sodas and energy drinks, as well as Mountain Dew (well known on college campuses everywhere) and Sunkist orange soda. Listed with mg of Caffeine per 8 oz. serving:
Red Fusion - 38 mg
Mountain Dew - 37
Pepsi - 27
Coca-Cola classic - 24
Sunkist orange soda - 23
Vanilla Coke - 21
Barq's Root Beer - 15
Some sodas that are caffeine free include: Minute Maid Orange, Slice, Sprite, 7-Up, Mug Root Beer.
In comparison, coffee drinks and other beverages:
Starbucks Coffee Frappuccino - 83 mg
AMP Energy drink - 77
Red Bull Energy drink - 70
Elements Atomic Jacked Apple Juice - 33
Sobe Energy Citrus - 25
Glaceau Vitaminwater Energy Tropical - 21
Snapple Lemon Ice Tea - 10
Most energy drinks (and some fortified waters) also include guarana, a caffeine-containing herb, and ginsing, which may intensify the effects of caffeine.
Some other surprising sources of caffeine:
Dannon Natural Flavors Low Fat Coffee yogurt - 36 mg
Starbucks Coffee Java chip ice cream, 1/2 cup - 28 mg
Haagen-Dazs Coffee ice cream, 1/2 cup - 24
Caffeine seems to have the same effects on kids and teens as it does on adults. "At low doses, it produces an increase in wakefulness, alertness, feelings of energy and sociability", according to Roland Griffiths, a professor at Johns Hopkins University. "As you increase the dose, you get into anxiety, insomnia, and tension. Raise it further and you get things like nausea and upset stomach."
Some experts suggest "upper limits" for kids - no more than 45 mg per day for 4-6 year olds, 62.5 mg per day for 7-9 year olds, and 85 mg per day for 10-12 year olds. However, there are a lack of studies on "safe" caffeine intake for any children, and no warning labels exist on many common caffeinated beverages.
It is far safer to avoid caffeine in children altogether, especially if you child seems sensitive to caffeine side effects. In addition, as I have covered in my blog previously, there are serious concerns about soda in general (secondary to artificial coloring, sugar and non-sugar sweeteners) - enough concern, I think, to avoid giving your children soda in general.
A recent study looking at the caffeine content of popular beverages (and foods) yielded some startling results. The results indicate that children, who are especially vulnerable due to their lower weight and body mass, can easily consume enough caffeine to leave them jittery and anxious, or cause physical symptoms like abdominal pain and headaches.
The common culprits - dark-colored sodas and energy drinks, as well as Mountain Dew (well known on college campuses everywhere) and Sunkist orange soda. Listed with mg of Caffeine per 8 oz. serving:
Red Fusion - 38 mg
Mountain Dew - 37
Pepsi - 27
Coca-Cola classic - 24
Sunkist orange soda - 23
Vanilla Coke - 21
Barq's Root Beer - 15
Some sodas that are caffeine free include: Minute Maid Orange, Slice, Sprite, 7-Up, Mug Root Beer.
In comparison, coffee drinks and other beverages:
Starbucks Coffee Frappuccino - 83 mg
AMP Energy drink - 77
Red Bull Energy drink - 70
Elements Atomic Jacked Apple Juice - 33
Sobe Energy Citrus - 25
Glaceau Vitaminwater Energy Tropical - 21
Snapple Lemon Ice Tea - 10
Most energy drinks (and some fortified waters) also include guarana, a caffeine-containing herb, and ginsing, which may intensify the effects of caffeine.
Some other surprising sources of caffeine:
Dannon Natural Flavors Low Fat Coffee yogurt - 36 mg
Starbucks Coffee Java chip ice cream, 1/2 cup - 28 mg
Haagen-Dazs Coffee ice cream, 1/2 cup - 24
Caffeine seems to have the same effects on kids and teens as it does on adults. "At low doses, it produces an increase in wakefulness, alertness, feelings of energy and sociability", according to Roland Griffiths, a professor at Johns Hopkins University. "As you increase the dose, you get into anxiety, insomnia, and tension. Raise it further and you get things like nausea and upset stomach."
Some experts suggest "upper limits" for kids - no more than 45 mg per day for 4-6 year olds, 62.5 mg per day for 7-9 year olds, and 85 mg per day for 10-12 year olds. However, there are a lack of studies on "safe" caffeine intake for any children, and no warning labels exist on many common caffeinated beverages.
It is far safer to avoid caffeine in children altogether, especially if you child seems sensitive to caffeine side effects. In addition, as I have covered in my blog previously, there are serious concerns about soda in general (secondary to artificial coloring, sugar and non-sugar sweeteners) - enough concern, I think, to avoid giving your children soda in general.
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