Pediahealth

Gazette Parents:

Peak PediaHealth Your guide to pediatric care SUNDAY, OCTOBER 19, 2014

• Enterovirus 68 • Children’s heart health • Knowing your family history

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HealthTip:

IF YOUR CHILD’S GRADES ARE DROPPING MAKE SURE A PHYSICAL PROBLEM ISN’T THE CAUSE Diana Kohnle, HealthDay

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If your child is suddenly struggling with school performance, the cause may be a physical health problem.

The American Academy of Pediatrics says problems that may contribute to a drop in school performance include: • Having a sleep disorder, anemia or a thyroid condition.

• Contracting infectious mononucleosis.

• Having hearing or vision problems.

• Having a learning or developmental disability, such as attention-deficit hyperactivity disorder (ADHD), dyslexia or a central auditory processing disorder.

• Having a substance abuse problem. ✚

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Melissa Lewis, of Denver, helps her son, Jayden Broadway, 9, as he coughs in his bed at the Children’s Hospital Colorado in Aurora, Colo.He was treated for the enterovirus 68 and released, but his asthma made the illness more difficult to fight. A wave of severe respiratory illnesses has swept the country in the last two months, propelled by enterovirus 68. The virus has caused serious breathing problems in many children, and now is being eyed as possible factor in at least four deaths, and muscle weakness and paralysis in children in Colorado and perhaps other states. AP Photo/The Denver Post, Cyrus McCrimmon

Enterovirus 68: THINGS TO KNOW ABOUT RESPIRATORY DISEASE PLAGUING KIDS NATIONWIDE Mike Stobbe, The Associated Press

A

wave of severe respiratory illnesses has swept the country in the last two months, propelled by what was long considered an uncommon germ.

The enterovirus 68 has caused serious breathing problems in many children, and now is being eyed as possible factor in at least four deaths, and muscle weakness and paralysis in children in Colorado and perhaps other states.

The Centers for Disease Control and Prevention on Oct. 3 released a report on the Colorado cluster. The investigation continues and many questions remain unresolved.

CONTINUED ON PAGE 4

SUNDAY, OCT 19, 2014 I THE GAZETTE I G 3

Enterovirus 68: CONTINUED FROM PAGE 3

Some questions and answers about the germ: Q: IS THIS VIRUS NEW? A: No. It was first identified in the U.S. in 1962, and small numbers of cases have been regularly reported since 1987.

Because it’s not routinely tested for, it may have spread widely in previous years without being identified in people who just seemed to have a cold. It’s one of a group of viruses that contribute to an uptick in cold-like illnesses every year around the start of school.

In August, the virus got more attention when hospitals in Kansas City, Missouri and Chicago had many children with trouble breathing. Some needed oxygen or more extreme care such as a breathing machine. Tests found enterovirus 68.

Q: HOW MANY PEOPLE HAVE BEEN SEVERELY SICKENED BY THE VIRUS? A: Lab tests by the CDC have confirmed illness caused by the germ in 538 people in 43 states and the District of Columbia.

Almost all are children. Testing is limited and has been focused on very sick children, so it’s likely that many, many more people — including adults — have been infected.

Q: WHY ARE MOST OF THE SEVERE CASES IN CHILDREN? A: They generally have not been exposed to enteroviruses as often as adults are, and are less likely to have developed immunity to them. Some children are especially vulnerable because of pre-existing conditions — for example, many hospitalized children were kids who had asthma.

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Q: WHY ARE MORE SEVERE ILLNESSES FROM ENTEROVIRUS 68 BEING REPORTED THIS YEAR? A: That’s a mystery. Health officials have not found a recent mutation or other change in the virus that would cause it to become more dangerous. Clusters have been reported in other countries, including some Asia nations and the Netherlands, in recent years.

Q: WHAT ABOUT THE REPORTS OF DEATHS? A: This week the CDC said four people who were infected with enterovirus 68 died last month, but what role the virus played in the deaths is unclear. Investigators are trying to sort out if the viral infection was coincidental, a contributing factor or a main cause. One case was a 10-year-old Rhode Island girl who died last week after infections of bacteria and enterovirus 68.

Rhode Island health officials suggested the bacteria — Staphylococcus aureus — and the virus may have formed a rare and deadly combination, but the investigation continues.

Q: AND WHAT ABOUT THE REPORTS OF WEAKNESS? A: Last week, the CDC sent doctors an alert about nine children at a Denver-area hospital who suffered muscle weakness or paralysis in the neck, back or limbs about a week after they had a fever and respiratory illness. The number since has grown to 10.

Four of the children tested positive for enterovirus 68. But health officials don’t know whether the virus caused any of the children’s arm and leg weaknesses or whether it’s just a germ they coincidentally picked up.

The CDC asked doctors to report patients 21 or younger who developed limb weakness since August 1 and who have had an MRI exam that showed abnormalities in the nerve tissue in the spinal cord. Since putting out the call, several reports have come in, but the CDC is still evaluating which should be counted as similar cases.

Q: WHAT CAN I DO TO PROTECT MY CHILD? A: The CDC recommends making sure children and their parents are up to date on all vaccinations, including those against respiratory diseases like flu, measles and whooping cough. The other advice has to do with basic hygiene — wash hands frequently with soap and water, stay away from sick people and disinfect objects that a sick person has touched. See a doctor right away if your child starts having severe problems breathing, develops difficulty moving their limbs or walking or standing. ✚

ON THE MOVE:

AN HOUR OF PHYSICAL ACTIVIT Y A DAY HELPS KIDS THINK BETTER, STUDY SAYS Deborah Netburn, Los Angeles Times

Here’s another reason to get your kids off the couch and make them run around instead: It will help them think better.

In a paper published in Pediatrics, researchers report that kids 7 to 9 years old who attended a daily, after-school fitness program showed an increased ability to pay attention, avoid distraction and switch between tasks at the end of a nine-month period, compared with a control group that did not attend the program.

“Our study shows that brain activation was different in the ‘FIT Kids’ group compared to a control group,” said Charles Hillman, a professor of kinesiology and community health at the University of Illinois at ChampaignUrbana and lead author of the paper.

The study involved a total of 222

elementary-school-aged children. Half of them were accepted to a free fitness program called “FIT Kids” (for “Fitness Improves Thinking”) that met daily after school on the campus of the University of Illinois. The other half were put on a wait list for the program, and were used as a control group.

The kids enrolled in FIT Kids were bused to a facility after their school day ended. After arriving, they were given some quick fitness tasks — jumping jacks or push-ups, just to get them moving.

Then there was a snack and a quick lesson on healthy living — for example, they might learn about soccer, or what types of foods are healthiest to eat. Then they would put on heat rate monitors and pedometers and play physical games.

On average, the kids’ rate monitors

indicated that activity was moderate to vigorous, and they averaged about 4,500 steps over the course of the two-hour program.

All the kids in the study, both those enrolled in FIT Kids and those on the wait list, went through a series of tests that measured aerobic fitness and cognitive functions at the beginning and end of the nine months. When the kids were tested for cognitive function, they also wore an EEG cap that measured their brain activity.

At the end of the nine months, the physical fitness of the kids in the after-school program had improved by 6 percent, compared to just 1 percent improvement in the control group.

The researchers also found that the kids in the program had a 10 percent

increase in accuracy on a series of cognitive tests, while the control group saw an increase of just 5 percent.

The researchers report that the EEG measured more activity in the brains of the kids who participated in FIT Kids than their wait-listed peers.

It also seems that the number of FIT Kids classes a child attended had an effect on how well he or she performed on the cognitive tests: Kids who showed up to more classes performed better.

In the conclusion of the paper, the researchers lament the “rapid decline in physical activity opportunities for children at school,” and say policies that reduce or replace these opportunities in an effort to increase academic achievement may have “unintended consequences.” ✚

SUNDAY, OCT 19, 2014 I THE GAZETTE I G 5

Family history is critical piece of children’s health Leslie Massey, Gazette Parents

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While many of us endeavor to reduce our risk of illness by eating healthy, exercising, not drinking too much alcohol and not smoking, family health history may be one of the strongest influences in the risk for developing many diseases such as Alzheimer’s, stroke, heart disease, diabetes or cancer.

Along with genetics, lifestyle and environmental factors also play a part in developing disease, but the importance of any one factor varies for each person. While we can’t change our genetics, knowing your family history can actually help reduce you and your children’s risk of developing health related problems.

Family history doesn’t guarantee that you or your children will develop a disease, but just like traits that run in families like curly hair, freckles, blue eyes, or dimples, family members share risks for diseases too. Some of the chief aspects of family health history that increase risk are: • Disease that occur at an earlier age than expected (ten to 20 years before most people develop the disease) • Disease in more than one close relative • Disease that does not usually affect a certain gender (such as breast cancer in a male) • Certain combinations of diseases

within a family (for example heart disease and diabetes) Recognizing your family health history is an important step to supporting better health for your children. Such activities as smoking, poor eating habits, and inactivity can increase the risk of acquiring diseases that are shared within a family.

Screening tests (mammograms, colonoscopies,) can detect diseases at an early stage. Screenings can also detect risk factors, (blood pressure, cholesterol) which can be treated to reduce the likelihood of getting disease. Many diseases are more treatable when they are caught in the early stages.

To better understand the risks for you or your children, collect information about your family’s health history including grandparents, parents, aunts, uncles and nieces and nephews. Find out about major medical conditions and causes of death, age of disease onset and age of death.

If you and your doctor notice a pattern within your family, it could be a form of disease passed down from generation to generation. Sometimes genetic testing may also help determine your level of risk. Even with hereditary types of diseases, steps can be taken to reduce the risk for your kids. ✚

Pediatric cardiomyopathy:

WHAT EVERY PARENT NEEDS TO KNOW ABOUT CHILDREN’S HEART HEALTH StatePoint Media

W

hen thinking of heart disease, older adults typically come to mind, but children also can have heart disease, often with more devastating outcomes. Pediatric cardiomyopathy is a potentially lifethreatening disease and the leading cause of sudden cardiac arrest (SCA) in children.

Cardiomyopathy is a chronic disease of the heart muscle that affects the heart’s ability to pump blood. Some children who have the disease can be symptomfree and are unknowingly at risk for SCA. Approximately 2,000 people under 25 die of SCA every year according to the Centers for Disease Control and Prevention, but there are preventative measures.

“In many cases, if cardiomyopathy is detected early and managed properly, sudden cardiac death can be prevented,” says Lisa Yue, a parent who lost two children to cardiomyopathy and founder of the Children’s Cardiomyopathy Foundation (CCF). The Foundation is working to call attention to the disease. “Knowing the symptoms and risk factors for cardiomyopathy can help save lives.”

KNOW THE SYMPTOMS Currently there is no formal cardiac screening process for children. While

pediatricians can respond to more obvious symptoms, identifying pediatric cardiomyopathy can be challenging because some affected children are symptom-free. It is not uncommon for cardiomyopathy to be missed or misdiagnosed as a cold, flu or asthma.

Symptoms include shortness of breath, rapid breathing, fainting, chest pain, dizziness, heart palpitations and fatigue.

Infants may experience poor weight gain, difficulty breathing, excessive sweating or lethargy. It is important for parents to communicate concerns to the pediatrician.

exhibit symptoms such as chest pain, discomfort upon exertion, fatigue, fainting or high blood pressure should be evaluated by a cardiologist.

PROTECTING AT-RISK YOUNG ATHLETES Adolescents with an underlying heart condition like cardiomyopathy are at a higher risk for SCA due to increased physical activity and certain body changes.

SCA is the top cause of death on school property, and according to the American Heart Association these deaths occur most

commonly in high-intensity sports.

To help keep young athletes safe, Senator Robert Menendez, Representatives Lois Capps and Bill Pascrell, Children’s Cardiomyopathy Foundation and the National Athletic Trainers’ Association introduced the Supporting Athletes, Families, and Educators to Protect the Lives of Athletic Youth (SAFE PLAY) Act, with provisions to protect student athletes from SCA. For more information about cardiomyopathy, visit www. childrenscardiomyopathy.org. ✚

KNOW THE RISK FACTORS

“Cardiomyopathy can occur in any child and be inherited or acquired through a viral THE WILLIAM STORMS ALLERGY CLINIC infection or from cancer chemotherapy,” explains Steven Lipshultz, M.D., pediatrician-in-chief of Children’s Hospital Board Certified in Allergy and Clinical Immunology of Michigan and chair of CCF’s medical Treating Adults and Children advisory board.

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