02/09/16

Tuesday, February 9, 2016

Email: Bacteria worries influenced Flint corrosion decision

City's former public works director was concerned anti-corrosive chemicals could be "food" for bacteria if added to water from Flint River

From: http://www.cbsnews.com/news/flint-water-crisis-email-bacteria-worries-influenced-corrosion-decision/

The 7 things you need to know about the Zika virus

It's spreading fast; watch this to protect yourself

From: http://www.cbsnews.com/videos/the-7-things-you-need-to-know-about-the-zika-virus/

Can Stress Cause Weight Gain?

Can stress cause you to gain weight? WebMD shares the answer and explains what you should do with it.

From: http://www.webmd.com/diet/stress-weight-gain?src=RSS_PUBLIC

Involuntary manslaughter charges possible in Flint water crisis

A special counsel appointed to investigate the lead contamination of Flint's water says criminal charges are possible

From: http://www.cbsnews.com/news/flint-water-crisis-involuntary-manslaughter-charges-possible/

Homemade "Dewshine" can be deadly, experts warn

Several teens have died from drinking toxic brew made with racing fuel

From: http://www.cbsnews.com/news/homemade-dewshine-can-be-deadly-experts-warn/

What to Eat When You Have HIV

A nutritious diet is key when you have HIV. WebMD explains what you should eat to improve your energy and strength, and avoid complications.

From: http://www.webmd.com/hiv-aids/features/hiv-what-to-eat?src=RSS_PUBLIC

Eye Defects in Some Babies With Zika Microcephaly

Doctors should check these infants with abnormally small heads for vision problems, researchers say

From: http://www.webmd.com/children/news/20160209/eye-defects-seen-in-some-babies-born-with-zika-linked-microcephaly?src=RSS_PUBLIC

Statement from Agriculture Secretary Vilsack on Farm Income Forecasts for 2016

WASHINGTON, Feb. 9, 2016 – Agriculture Secretary Tom Vilsack issued the following statement today on the Farm Income and Financial Forecasts for 2015 and 2016, released by USDA’s Economic Research Service.

From: http://www.usda.gov/wps/portal/usda/usdahome?contentid=2016/02/0036.xml&contentidonly=true

Access PPR with ADA member login

Beginning in March, ADA Professional Product Review, an online-only publication that provides members with reliable product evaluations, expert panel discussions, interviews with key opinion leaders and more, will be available exclusively to ADA members in the members-only section of ADA.org.

From: http://www.ada.org/en/publications/ada-news/2016-archive/february/access-ppr-with-ada-member-login

Three things that keep Americans from living longer

Adults in the U.S. have shorter life expectancy than other developed nations, and new research sheds light on the reasons why

From: http://www.cbsnews.com/news/the-three-things-that-keep-americans-from-living-longer/

Mayo Clinic Minute: Should Women of High Risk of Cancer Have Surgery?

From: Mayo Clinic http://www.youtube.com/watch?v=ADp6G1859Gs

Η βιταμίνη C στις τροφές και τα οφέλη της στην υγεία

Tροφές πλούσιες σε βιταμίνη c και τα οφέλη της στην υγεία Η βιταμίνη C, γνωστή επίσης και ως ασκορβικό οξύ, είναι μία υδατοδιαλυτή βιταμίνη και ένα θρεπτικό συστατικό το οποίο ο ανθρώπινος οργανισμός αδυνατεί να συνθέσει. Η βιταμίνη C ουσιαστικά δεν αποθηκεύεται στον οργανισμό και οι πλεονάζουσες ποσότητες της αποβάλλονται από το σώμα κι έτσι η καθημερινή της πρόσληψη μέσω της διατροφής είναι απαραίτητη.

Η βιταμίνη λειτουργεί ως συμπαράγοντας αρκετών ενζύμων και είναι ένα φυσικό ισχυρό αντιοξειδωτικό, με αποτέλεσμα τελικά να συμμετέχει σε πολλές διεργασίες απαραίτητες για τη διατήρηση της υγείας του οργανισμού, μερικές από τις οποίες αναφέρονται παρακάτω.

Η βιταμίνη C είναι απαραίτητη για τη βιοσύνθεση του κολλαγόνου, που αποτελεί την κύρια πρωτεΐνη του δέρματος, των οστών, των δοντιών και των συνδετικών ιστών. Eίναι σημαντική για το σχηματισμό και τη διατήρηση γερών οστών και δοντιών, την επούλωση πληγών, τη διατήρηση της ελαστικότητας του δέρματος, την ενδυνάμωση των τοιχωμάτων των αιμοφόρων τριχοειδών αγγείων. Επίσης είναι απαραίτητη για την καλή λειτουργία του ανοσοποιητικού συστήματος και συμβάλει στην παραγωγή λεμφοκυττάρων. Εμπλέκεται στη σύνθεση της καρνιτίνης (παραγωγή ενέργειας από τα λιπαρά οξέα), στο μεταβολισμό αμινοξέων και τη σύνθεση ορισμένων ορμονών, στο μεταβολισμό της χοληστερόλης, αυξάνει την απορρόφηση του μη-αιμικού σιδήρου (της μορφής σιδήρου που συναντούμε σε προϊόντα φυτικής προέλευσης) και φαίνεται να προστατεύει άλλες ουσίες από οξείδωση, όπως τη βιταμίνη Ε.

Η σχέση της αυξημένης πρόσληψης της βιταμίνης με την πρόληψη του κοινού κρυολογήματος είναι εδώ και χρόνια αμφιλεγόμενη. Από τα μέχρι τώρα ερευνητικά δεδομένα προκύπτει ότι η συμπληρωματική χορήγηση της βιταμίνης δε σχετίζεται με την πρόληψη του κοινού κρυολογήματος. Θετικά αποτελέσματα όμως, φάνηκαν στις περιπτώσεις ατόμων με έντονη φυσική δραστηριότητα για σύντομα χρονικά διαστήματα, όπως οι αθλητές (μαραθωνίου). Επίσης, η τακτική πρόσληψη επαρκών ποσοτήτων βιταμίνης μπορεί να συμβάλει στη μείωση της διάρκειας και της έντασης των συμπτωμάτων. Έτσι άτομα που γενικά παρουσιάζουν επάρκεια στην πρόσληψη της βιταμίνης, είναι πιθανό να εμφανίζουν πιο ήπια συμπτώματα κρυολογήματος.

Ιδιαίτερα ερευνάται κατά πόσο η βιταμίνη C, μέσω της αντιοξειδωτικής της δράσης και, ως εκ τούτου, του περιορισμού των επιζήμιων για την υγεία επιδράσεων των δραστικών μορφών οξυγόνου, μπορεί να συμβάλλει στην πρόληψη ή την καθυστέρηση της ανάπτυξης κάποιων μορφών καρκίνου, καρδιαγγειακής νόσου και άλλων καταστάσεων των οποίων η ανάπτυξη ευνοείται από την παρουσία οξειδωτικού στρες.

Συνέπειες της ανεπάρκειας βιταμίνης C

Ανεπάρκεια της βιταμίνης δεν παρατηρείται συχνά σε περιοχές όπου υπάρχει επάρκεια τροφής. Κάποια άτομα βέβαια έχουν αυξημένες πιθανότητες να παρουσιάσουν έλλειψη, όπως είναι οι καπνιστές και άτομα που εκτίθενται παθητικά στον καπνό, αφού το κάπνισμα αυξάνει τις ανάγκες σε βιταμίνη C.

Σε περιπτώσεις εξαιρετικά χαμηλής πρόσληψης, μπορεί να παρουσιαστεί το σκορβούτο, μία ασθένεια της οποίας τα συμπτώματα είναι αίσθημα κόπωσης και αδυναμίας, πόνος στους συνδέσμους, αργή επούλωση τραυμάτων, ούλα που ματώνουν, χαλαρά δόντια, πετέχιες, εκχυμώσεις, αναιμία, καταθλιπτική διάθεση.

Η συνιστώμενη ημερήσια πρόσληψη της βιταμίνης από τους ενήλικες είναι 90 mg για τους άνδρες και 75 mg για τις γυναίκες. Η συνιστώμενη πρόσληψη για καπνιστές ανέρχεται στα 125 mg και 110 mg, αντίστοιχα. Για τις εγκύους συνιστάται η πρόσληψη 85 mg βιταμίνης / ημέρα και για τις γυναίκες που θηλάζουν 120 mg / ημέρα. Οι ποσότητες αυτές μπορούν να καλυφθούν μέσα από μία ισορροπημένη διατροφή, η οποία περιέχει φρούτα και λαχανικά.

Τα συμπληρώματα βιταμίνης C είναι από τα πιο ευρέως χρησιμοποιούμενα, λόγω του σχετικά χαμηλού κόστους, της γενικότερης αντίληψης ότι προστατεύει τον οργανισμό από λοιμώξεις και κρυολόγημα, αλλά και του γεγονότος ότι η λήψη της σε μεγαλύτερες δόσεις από τη συνιστώμενη δε φαίνεται να παρουσιάζει συχνά παρενέργειες, καθώς η περίσσεια της απεκκρίνεται μέσω των ούρων. Αν και παρουσιάζει χαμηλή τοξικότητα, ωστόσο συστήνεται προσοχή σε ότι αφορά τις πολύ υψηλές προσλήψεις και προτείνεται, για τους ενήλικες, να μην υπερβαίνει κανείς τα 2000 mg/ημέρα, καθώς μπορούν να εμφανιστούν ανεπιθύμητες ενέργειες (στομαχικές διαταραχές, διάρροια, αλλά και άλλες πιθανές ανεπιθύμητες ενέργειες, όχι απαραίτητα στο γαστρεντερικό). Όπως και τα υπόλοιπα συμπληρώματα διατροφής, τα συμπληρώματα βιταμίνης C πρέπει να λαμβάνονται μετά από συζήτηση με το γιατρό ή το διαιτολόγο, καθώς και η επιλογή συγκεκριμένου σκευάσματος.

Επίσης, καλό είναι να επισημάνουμε ότι η λήψη επαρκούς ποσότητας της βιταμίνης μέσω των τροφών είναι περισσότερο επωφελής και αποτελεσματική σε σχέση με αυτήν που προέρχεται από συμπληρώματα. Η βιταμίνη C στις τροφές και τα οφέλη της στην υγεία

Φυσικές πηγές βιταμίνης C

Σημαντικές πηγές βιταμίνης C είναι αρκετά τρόφιμα, κυρίως φρούτα και λαχανικά. Τέτοια είναι τα εσπεριδοειδή (πορτοκάλι, λεμόνι, μανταρίνι, γκρέϊπφρουτ) , το ακτινίδιο, η φράουλα, η παπάγια, οι κόκκινες και πράσινες πιπεριές, τα σκούρα πράσινα φυλλώδη λαχανικά, το μπρόκολο, το κουνουπίδι, τα λαχανάκια Βρυξελλών, η ντομάτα, ο μαϊντανός, το σχοινόπρασο και άλλα.

Μέσω της καθημερινής διατροφής, η πλειονότητα της βιταμίνης C λαμβάνεται μέσω φρέσκων φρούτων και λαχανικών και φρέσκων χυμών αυτών. Αυτό συμβαίνει επειδή η βιταμίνη αυτή είναι ιδιαίτερα ευαίσθητη και καταστρέφεται σχετικά εύκολα από την έκθεση στο ατμοσφαιρικό οξυγόνο, στην υψηλή θερμοκρασία, στο φως και από τη χρήση σόδας στο μαγείρεμα, ενώ ως διαλυτή στο νερό, μεγάλο ποσοστό της χάνεται στο νερό που χρησιμοποιείται για το μαγείρεμα κάποιων τροφών και που στη συνέχεια απορρίπτεται.

Περιεχόμενο βιταμίνης C σε μερικά τρόφιμα

Τρόφιμο - Ποσότητα	Βιταμίνη C (mg)
Πορτοκάλι, 1 φλυτζάνι	95,8
Χυμός πορτοκαλιού φρέσκος, 1 φλυτζάνι	124
Ακτινίδιο, 1 φλυτζάνι	166,9
Χυμός λεμονιού φρέσκος, 1 φλυτζάνι	94,4
Φράουλες, 1 φλυτζάνι	89,4
Παπάγια, 1 φλυτζάνι	88,3
Κόκκινες πιπεριές ωμές, 1 φλυτζάνι	190,3
Πράσινες πιπεριές ωμές, 1 φλυτζάνι	119,8
Μπρόκολο βρασμένο, μισό φλυτζάνι	50,6
Λαχανάκια Βρυξελλών ωμά, 1 φλυτζάνι	74,8
Λάχανο ωμό, 1 φλυτζάνι	32,6
Κουνουπίδι βρασμένο, μισό φλυτζάνι	27,5
Σπανάκι βρασμένο, 1 φλυτζάνι	17,6
Μαϊντανός φρέσκος, 1 φλυτζάνι	79,8

Πίνακας με τροφές που περιέχουν βιταμίνη C σε σημαντική ποσότητα. Πηγή: USDA National Nutrient Database for Standard Reference, Release 28

Μερικοί τρόποι με τους οποίους μπορούμε να εμπλουτίσουμε τη διατροφή μας σε βιταμίνη C:

Καταναλώνουμε καθημερινά περίπου 3 μερίδες φρούτων και φροντίζουμε να τρώμε σαλάτα λαχανικών μαζί με τα κυρίως γεύματα. 1 μερίδα φρούτων αντιστοιχεί ενδεικτικά σε 1 μέτριου μεγέθους φρούτο, 2 μικρά (πχ μανταρίνια), 1 φέτα καρπούζι ή πεπόνι, 1-2 κ.σ. σταφίδες, 4 κομμάτια αποξηραμένου φρούτου, 7-8 φράουλες, περίπου 15 κεράσια, ½ ποτήρι φυσικό χυμό.
Προσθέτουμε φρέσκα λαχανικά στα σάντουιτς που φτιάχνουμε, όπως ντομάτα, μαρούλι, τριμμένο λάχανο, κομματάκια μπρόκολο.
Όταν θέλουμε ένα γρήγορο και εύκολο σνακ, μπορούμε να επιλέξουμε μερικά αποξηραμένα φρούτα, που μπορούν να συνδυαστούν και με ωμούς ξηρούς καρπούς.
Όταν χρειάζεται, μαγειρεύουμε τα λαχανικά σε μικρή ποσότητα νερού ή στον ατμό.
Ετοιμάζουμε τις φρέσκιες σαλάτες αμέσως πριν ξεκινήσουμε το γεύμα και αποφεύγουμε να αφήνουμε τα κομμένα λαχανικά εκτεθειμένα για πολλή ώρα.
Δεν αφήνουμε εκτεθειμένα για ώρα τα κομμάτια φρούτων και τους χυμούς που έχουμε ετοιμάσει, αλλά τα καταναλώνουμε μέσα σε σύντομο χρονικό διάστημα.

Βιβλιογραφία:

Office of Dietary Supplements, National Institutes of Health, Vitamin C Fact Sheet, Reviewed : June 05, 2013.
Hemila H., Chalker E. 2013. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev 2013.
Scientific Opinion on Dietary Reference Values for Vitamin C. EFSA Journal 2013; 11(11):3418.
Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium and Carotenoids (2000). National Academy of Sciences. Institute of Medicine. Food and Nutrition Board.
USDA National Nutrient Database for Standard Reference, Release 28 (2015).

Το άρθρο Η βιταμίνη C στις τροφές και τα οφέλη της στην υγεία εμφανίστηκε για πρώτη φορά στο Άρθρα και συμβουλές για υγιεινή διατροφή • Nutripedia και το έγραψε ο/η Ευαγγελία Τόττη.

From: Ευαγγελία Τόττη http://www.nutripedia.gr/vitamini-c-trofes-ofeli/

Pediatric practice opens its doors for GKAS

The day was Give Kids A Smile but the goal was to create an experience to last a lifetime. And that's just what Mt. Airy Children's Dental Associates did.

From: http://www.ada.org/en/publications/ada-news/2016-archive/february/pediatric-practice-opens-its-doors-for-gkas

Teen girls' transitions into adulthood "Untangled"

Psychologist says girls' erratic behavior during adolescence is "normal" and walks parents through important developmental stages in her new book

From: http://www.cbsnews.com/news/lisa-damour-untangled-guiding-teenage-girls-through-the-seven-transitions-into-adulthood/

Home Treatments for Scalp Psoriasis

From vegetable oil to apple cider vinegar to tar, there are lots of good do-it-yourself remedies for the itchiness of scalp psoriasis. WebMD tells you more.

From: http://www.webmd.com/skin-problems-and-treatments/psoriasis/features/home-treatments-scalp-psoriasis?src=RSS_PUBLIC

New Lyme Disease Bacteria Discovered: CDC

Infection may trigger nausea, vomiting and a more widespread rash, officials say

From: http://www.webmd.com/arthritis/news/20160209/new-lyme-disease-bacteria-discovered-in-upper-midwest-cdc?src=RSS_PUBLIC

“Something Just Isn’t Right”: Reflections on Our Daughter’s Type 1 Diagnosis

Cassidy about one week before she was diagnosed.

My daughter Cassidy was 16 months old and still in diapers when we started to suspect that something wasn’t quite right. My husband and I didn’t know what to do or think, but we knew something was wrong.

Cassidy was an early talker, and each morning we found her standing up in her crib telling us “Cassidy thirsty.” She kept drinking and drinking—and she was very hungry, too. She kept wetting through her diapers, clothes and bed sheets.

Deeply concerned, we took her into the pediatrician three weeks in a row. Our regular doctor happened to be on medical leave during this time, so we saw other doctors who weren’t as familiar with her history. At one appointment, she was diagnosed with an ear infection. At others, we came home without any diagnosis. No one asked specifically about her symptoms of increased urine and thirst, and while we thought we were communicating effectively, perhaps we weren’t. As first-time parents with no experience in the medical field, we were quick to chalk it up to our own inexperience.

“Something just isn’t right.”

Things escalated on an airline trip with Cassidy. We lived in California at the time and were flying home to Los Angeles. During our trip, she had been extremely hungry and thirsty, and on the two-hour flight, she wet through her diaper, clothing and the cover of her car seat. She was very fussy as well. As we landed at LAX, I turned to my husband and said: “This can’t be normal. Something just isn’t right.”

My mother turned out to be the first person to “diagnose” Cassidy. An attorney, she has made a long career of defending school systems. She is very familiar with Section 504, the federal civil rights law that prohibits discrimination on the basis of disability, and the rights of students with diabetes.

I called my mom to tell her about Cassidy’s health problems. “Sounds like diabetes,” she said, urging us to visit the doctor again right away.

Diabetes?

At the time, type 1 diabetes just wasn’t on my radar. There was a very short section about it in my dog-eared copy of “What to Expect the First Year” that I looked up after my talking with my mother.

Cassidy’s symptoms worsened. By the time of our appointment, she was stumbling, vomiting and having trouble breathing. At check-in, we told the clerk we thought she might have diabetes. She replied that Cassidy was probably “too young.” They sent us down to the lab for bloodwork, but she was so dehydrated they were having trouble finding a vein.

Then, almost out of nowhere, appeared a doctor whom we had met briefly upstairs and who knew what was wrong. He came running over, grabbed Cassidy and told us to follow him. “She’s really sick. Do you want to go to the intensive care unit by helicopter or ambulance?”

Four Days in the Hospital

I still didn’t know what this type 1 diagnosis meant or what we were facing. In the ICU, we were told that Cassidy’s blood glucose was so high that she was experiencing diabetic ketoacidosis (DKA), a condition that can lead to diabetic coma or even death. The nursing staff allowed us to stay at her bedside, and although she had IVs in both arms held in place by splints, we managed to take turns holding her through the night.

By the next day, she had stabilized and was soon moved out onto the hospital floor. It was during this time that we embarked on our diabetes education, meeting with doctors, nurses and dietitians to learn about the disease and how to manage it with injections and a fixed meal plan. Within six months, we had learned to count carbohydrates and Cassidy started using an insulin pump, which was a better fit for a toddler’s lifestyle.

Though we have adapted to life with diabetes—it will be 14 years in April 2016—I will never forget how scary that experience was. It’s not something you ever want to go through as a parent. I so wish that Cassidy’s type 1 had been picked up sooner.

Cassidy in action on the volleyball court.

Our Family Today

Now Cassidy is a happy 15-year-old. She has never been back to the hospital for diabetes care—even when she came down with rotavirus a few months after developing type 1 (now there is a vaccine for it). She uses an insulin pump and CGM (continuous glucose monitor) most of the time, but sometimes she prefers injections. She is very independent with her diabetes management and not at all shy or embarrassed about her diabetes. Perhaps her openness has allowed her friends and their families to be involved and supportive. We have learned that with the right support, you can manage diabetes, even with its inevitable ups and downs.

Cassidy is an excellent student and an active teenager who plays volleyball, and is involved in theater and dance. She loves diabetes camp and we attend the Children with Diabetes Friends for Life conference every summer in Orlando. I’d say she is a very good everyday champion for this disease—she just lives her normal life, and diabetes comes along for the ride.

This Shouldn’t Have to Happen

A diabetes diagnosis will always be a serious event, but it doesn’t have to be the bad start that ours was, or worse. With a very heavy heart, I acknowledge that some families have not been so fortunate. I channeled the trauma of almost losing Cassidy at diagnosis into raising awareness about diabetes while simultaneously raising money for diabetes research.

Then, on a typical drive to school one day in 2007, Cassidy innocently asked: “Mommy, what are you doing to cure diabetes?” After sitting lost in thought in the parking lot, I resolved to dedicate my professional life to type 1 diabetes care, research and advocacy. I am proud to have volunteered with the American Diabetes Association® in many capacities over years—and now to help them raise awareness of this very important issue.

I have learned that there are many reasons why hyperglycemia, or very high blood glucose, can be missed in children. There are many other health problems it can be mistaken for—the flu, for example. But this doesn’t have to be the case.

What I Want You to Know

Type 1 diabetes onset is acute, and the signs and symptoms can be dramatic. Parents, teachers, daycare providers, camp counselors—anyone who cares for children, both young and old—should know the basics.

The same goes for all health care providers, especially in the primary care and emergency care settings, who should take a full health history of the present illness. Considering cases of type 1 diabetes have increased dramatically in the last 20 years, it should be on their list of possible diagnoses in patients who have even one of the symptoms. Providers also shouldn’t assume that parents will know to volunteer this information.

To all the parents out there: Be aware and speak up for your child. When you know something is just not right, trust your gut. If your child isn’t acting normally, suddenly wetting the bed, showing signs of the flu—take him or her in to see the doctor. Report everything that you’re seeing at home, so they have the full picture. Be a partner in your child’s health. Maybe it’s serious, maybe it’s not, but you need to find out.

We need to get to the bottom of these cases faster, so we can avoid the progression to life-threatening DKA. The sooner type 1 is diagnosed, the better.

Anastasia Albanese-O’Neill, PhD, ARNP, CDE, is an assistant professor of nursing at the University of Florida in Gainesville, as well as a nurse practitioner and diabetes researcher. A longtime volunteer for the American Diabetes Association, she currently serves as co-chair of the Safe at School Workgroup and also sits on the Association’s National Advocacy Committee, Legislative and Regulatory Subcommittee and Volunteer Engagement Workgroup. She and her family live in Gainesville, Florida.

From: American Diabetes Association http://diabetesstopshere.org/2016/02/09/reflections-on-daughters-type-1-diagnosis/

U.S. Officials: Zika Focus Is on Pregnant Women

Efforts against the Zika virus in the U.S. are focused on protecting and diagnosing pregnant women and controlling the aggressive mosquito that spreads the virus, two top U.S. health officials said in a White House press briefing Monday.

From: http://www.webmd.com/news/20160209/us-officials-zika-focus-pregnant-women?src=RSS_PUBLIC

Healthier Diets May Be Cutting Teens' Health Risks

But obesity still rose and physical activity remained the same, study showed

From: http://www.webmd.com/children/news/20160209/healthier-diets-may-be-cutting-heart-diabetes-risks-in-us-teens?src=RSS_PUBLIC

Protection from the TdaP vaccine doesn’t last very long

Follow me at @drClaire

When my patients come in for their 11-year check-up, I give them the TdaP vaccine. I explain to them that a big part of the reason we give it is to protect them against pertussis, or whooping cough. I talk about outbreaks that are happening all the time, how it can be especially dangerous for little babies, and how this vaccine can help stop them from catching pertussis and spreading it to others.

It turns out that’s only true for about 2 to 3 years after getting the vaccine, according to a study just published in the journal Pediatrics.

Before the early 1990s, we used a different kind of pertussis vaccine, a “whole-cell” vaccine. It worked quite well, and rates of pertussis were quite low among vaccinated people. But the vaccine had side effects. Fever, swelling, and pain at the injection site, as well as sleepiness or irritability, were common. Rarely, it led to seizures or similar episodes, and even more rarely it caused acute encephalopathy, a more serious but temporary effect on the brain.

Because of all this, we changed the vaccine to the “acellular” kind, which has fewer side effects. We went from DTP to DTaP. And when we did, we stopped protecting children as well as before. Recent studies show that protection against pertussis goes down 42% each year after the fifth vaccine dose, which is given at 4-6 years. This means that by the time kids get to be 10 or 11, they have hardly any protection at all.

In 2010, when the first group of kids who had only gotten DTaP, not DTP, got to be about 10, there was an epidemic of pertussis in California. It was clear that we needed to boost protection. California made TdaP (the version of DTaP we give to older children and adults) mandatory in middle school, which helped for a while, but there was another epidemic in 2014.

Because by 2014, those who got it in 2010 or 2011 didn’t have protection anymore.

Researchers looked really closely at all of these data, and from them were able to figure out that in the first year after TdaP, its effectiveness is about 70%. By four years out, that protection is less than 10%. Given that the most common source of infection for infants is siblings, this is a real problem.

Clearly, we need to do something differently, if the point of vaccination is to protect against illness.

We have two choices. The first, and best, would be to make a better vaccine. We might need to consider going back to the whole-cell pertussis vaccine, and finding ways to prevent or deal with the side effects. But it would be better, obviously, if we could make a whole-cell vaccine that didn’t have as many side effects. Researchers are working on this, but we likely won’t see it for years.

The other choice would be to use the TdaP vaccine more wisely. Instead of vaccinating everyone at 11 or 12, a better approach might be to use it in response to known or possible outbreaks. Just like we now vaccinate pregnant women during each pregnancy, which is very effective in protecting infants, we might want to use the vaccine in certain people and circumstances rather than giving it to everyone.

Which is harder to organize and carry out. It would require being on top of every outbreak or exposure. It would require lots of public education and outreach, and it would mean that families would need to take responsibility and bring their child in for vaccination when needed, instead of getting things done at routine check-ups. But if that’s what it takes to protect newborns and other vulnerable people from pertussis, it’s what we’ll have to do.

After all, vaccination has always been about protecting not just your child, but everyone around you.

The post Protection from the TdaP vaccine doesn’t last very long appeared first on Harvard Health Blog.

From: Claire McCarthy, MD http://www.health.harvard.edu/blog/protection-from-the-tdap-vaccine-doesnt-last-very-long-201602099202

White House seeks $1.1 billion to combat opioid abuse, increase access to treatment

The White House announced Feb. 2 that it is seeking more than a billion dollars in federal funds to help reduce the rates of addiction, overdoses and deaths associated with prescription opioid abuse.

From: http://www.ada.org/en/publications/ada-news/2016-archive/february/white-house-seeks-1-1-billion-to-combat-opioid-abuse-increase-access-to-treatment