News & Trends

SEPTEMBER 21, 2011
Nicole Leonard

Pharmacists can keep up-to-date on a new requirement in California to provide proof of a Tdap booster for middle and high school students, as well as new studies on the obesity epidemic, asthma care, teen vaccination rates, autism research, and teen prgnancy.

Survey Says Tdap Tops List of Vaccines Required by Schools

A growing number of states are now requiring that children get the Tetanus, Diphtheria, and Pertussis (Tdap) vaccine before setting foot in schools.

According to the Centers for Disease Control and Prevention (CDC), 27,550 cases of pertussis were reported in 2010. Pertussis, a common disease resulting in frequent outbreaks and periodic epidemics, can affect children of all ages and become dangerous if left untreated.

The CDC reports that there were 9143 cases of pertussis in California alone last year, including 10 infant deaths. On September 30, 2010, as part of an effort to control outbreaks, the California Department of Public Health issued a law requiring students to receive a booster shot against pertussis before the start of the school year. Beginning July 1, 2011, all students in the state entering grades 7 through 12 were required to provide proof of a Tdap booster shot before starting the 2011-2012 academic year.

The bill mirrors CDC recommendations that children nationwide should get 1 dose of the Tdap vaccine on or after their 10th birthday. Adults are advised to get the booster shot to protect themselves, their families, and their communities.

Busy EDs Can Mean Inferior Care for Children with Asthma

Children being treated for acute asthma at a crowded emergency department (ED) are less likely to receive timely and effective care than when the ED is less crowded, according to research published in the March 2011 issue of the Annals of Emergency Medicine, which found that the care received is not influenced by factors such as insurance status or having a primary care provider.

Studies of adult patients have shown that ED crowding is widespread and can negatively impact quality of care for heart attacks and hospitalized cases of pneumonia— conditions that are less common among children. In this study, Marion R. Sills, MD, MPH, and colleagues from the University of Colorado School of Medicine analyzed data from acute asthma-related visits at a children’s hospital pediatric ED from November 2007 through October 2008.

The researchers found that patients were 52% to 74% less likely to receive timely care—and were 9% to 14% less likely to receive effective care—when the pediatric ED was at the 75th percentile of the crowding measure than when it was at the 25th percentile.

Experts Call for Worldwide Effort to Target Obesity Epidemic

Long-term efforts to curb the obesity epidemic have been less than satisfactory, according to researchers at Harvard School of Public Health. In a new report, Steven Gortmaker, PhD, and colleagues call for a collaborative effort from governments around the world to take steps to monitor, prevent, and control obesity.

“By imposing tax on sugar-sweetened beverages and limiting marketing of unhealthy foods to children, governments can lead in making it easier for children to make healthy choices,” the authors wrote. The team hopes to draw on the success that taxation has had in discouraging smoking to reduce the consumption of unhealthy foods.

In the report, which is published in the August 27, 2011, edition of The Lancet, Dr. Gortmaker and colleagues urged organizations like the United Nations, the World Health Organization, and others to parti– cipate with the public and private sectors to target obesity in children and adolescents through initiatives including school education, nutrition and physical activity programs, and weight loss interventions.

Breast-fed Babies at Lower Risk for Asthma

A study by researchers at the Erasmus Medical Center in The Netherlands found that infants who were breastfed up to the age of 6 months were less likely to develop asthma-related symptoms in early childhood.

For the study, which was published online July 20, 2011, in the European Respiratory Journal, researchers used questionnaires to determine breastfeeding duration and exclusiveness during the first 12 months using data from 5368 children. Further questionnaires were completed when the children reached the ages of 1, 2, 3, and 4 years to check for the presence of asthma-related symptoms.

The results showed that children who had never received breast milk in their first 6 months were more likely to experience asthma-related symptoms at age 4. Children who had never been breast-fed were 1.4 times more likely to develop wheezing and 1.5 more likely to experience persistent phlegm.

“These results support current health policy strategies that promote exclusive breast-feeding for 6 months in industrialized countries,” said lead author Agnes Sonnenschein-van der Voort, MSc. “Further studies are needed to explore the protective effect of breast feeding on the various types of asthma in later life.”

Fast Fact: Migraine headache is the most common headache seen by the pediatric neurologist. Nicole Leonard

Teens Don’t Complete HPV Vaccine Series

Vaccination rates for human papillomavirus (HPV) are lagging behind. According to a recent study by the CDC, the rate at which teens and preteens complete the 3-part HPV vaccination pales in comparison with the increasing rates for other immunizations such as Tdap, and MenACWY, which protects against meningococcal meningitis.

Findings from the study, which drew on data from the 2010 National Immunization Survey-Teen, were as follows:

• Just 49% of teens received the HPV vaccine, compared with 63% for MenACWY and 69% for Tdap.

• For girls who received the recommended 3 doses of HPV vaccine, coverage increased over the previous year.

• Hispanics had higher coverage for 1 dose of MenACWY and HPV, but Hispanics, African Americans, and girls living in poverty were less likely to complete the third dose of HPV due to poor coverage.

• Coverage increases for HPV were less than half of the increases seen for Tdap and MenACWY.

According to the CDC, 6 million individuals are infected with HPV each year, and approximately 12,000 women are diagnosed with cervical cancer. To help protect against the types of HPV that cause cervical cancer, the CDC recommends the HPV vaccine for 11- or 12-year-old girls and urges teenage girls who have not yet been vaccinated to complete the vaccination series.

“If we don’t make major changes, far too many girls in this generation will remain vulnerable to cervical cancer later in life,” said Anne Schuchat, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases. “Now that we have the tools to prevent most cervical cancers, it is critical that we use them.”

Autism Recurrence in Siblings More Common than Believed

New research indicates that in families with an autistic child, there is a 1 in 5 chance that a second child will develop autism. The risk of having a second child with autism is even higher if the child is a boy, according to a study published in the September 2011 issue of Pediatrics.

A team of researchers led by Sally Ozonoff, PhD, of MIND Institute at the University of California-Davis, tracked the development of 644 infants from 12 consortium sites. At age 3 years, subjects were tested for autism using the Autism Diagnostic Observation Schedule, an autism diagnostic tool, and the Mullen Scales of Early Learning, which measures nonverbal cognitive, language, and motor skills.

A total of 132 infants met the criteria for an autism spectrum disorder; of those, 54 were diagnosed with autistic disorder and 78 were diagnosed with a pervasive developmental delay not otherwise specified. The overall rate of autism among all study participants was 18.7%; in families with an older child with autism, the rate of incidence was 20.1%. In families with more than one sibling with autism, the rate of incidence was 32.3%.

Although previous research has suggested that genetic factors play a critical role in vulnerability for developing autism, this study was the first to identify such a high risk of recurrence, according to Dr. Ozonoff. “The rate is much higher than previous estimates. This points to the important need for closely monitoring and screening siblings so that they can be offered intervention as early as possible,” she said.

Pregnancy and Binge Drinking Down in Teens

A new report from the Federal Interagency Forum on Child and Family Statistics indicates that pregnancy and binge drinking are becoming less common in young people.

Data showed that teen birth rates have dropped from 21.7 per 1000 girls in 2008 to 20.1 per 1000 girls in 2009, and that premature births dropped slightly from 2008 to 2009. Rates of heavy drinking in teens fell from 13% in 1997 to 7% in 2010 in 8th grade students, from 24% in 2000 to 16% in 2010 in 10th graders, and from 32% in 1998 to 23% in 2010 for 12th grade students.

Drug abuse, however, has become more prevalent. According to the report, the percentage of 8th grade students who took illicit drugs in the past 30 days increased from 8% in 2009 to 10% in 2010. Nineteen percent of 10th grade students and 24% of 12th graders reported illicit drug use in the past 30 days in 2010.

Although the rise in drug use is alarming, “It is reassuring to see continued declines in the preterm birth rate and adolescent birth rate,” said Alan E. Guttmacher, MD, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Fast Fact: According to the CDC, approximately 6.8% of US children under the age of 18 years have a diagnosed eye and vision condition. Vision disability is one of the most prevalent disabling conditions among children.

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