Together, three types of bacteria account for over 90 percent of bacterial meningitis: H. influenza type b, meningococcus, and pneumococcus.
These bacteria are transmitted by person-to-person contact through respiratory secretions. Many people carry these bacteria with no serious consequence. (Pneumococcus, for instance, is the most common cause of ear infections.) A few people get very sick. Pneumococcus causes meningitis in about 3 per 100,000 people. (Textbook of Pediatric Infectious Disease, Saunders 1998)
Sudden onset meningitis features shock, internal bleeding, purple spots, and reduced consciousness at the very outset, with a rapidly progressive course often resulting in death within 24 hours.
More commonly, meningitis begins with several days of upper respiratory symptoms or gastrointestinal symptoms. Most children have high fevers, severe headaches, and poor feeding. They may also have muscle aches, nasal congestion, vomiting, neck stiffness, and seizures.
Children with meningitis become increasingly irritable and/or lethargic. The presence of petechiae (purple spots that indicate internal bleeding) is a sign that the infection may be raging out of control.
Pneumococcal meningitis is a devastating disease. Of all causes of meningitis, it is the most likely to have a negative outcome (Pediatric Infectious Disease Journal, May 1993). The overuse of antibiotics is resulting in increasingly resistant strains of pneumococcus every month.
In 1991, a vaccine against the H. influenzae Type b (HIB) bacteria was incorporated into the routine immunization schedule beginning at 2 months of age. The amount of meningitis plummeted. Arkansas Children's Hospital had about 27 cases of HIB meningitis per year in the 1980's before the vaccine was used. By 1993, the number had dropped to only 1.7 per year (Southern Medical Journal, Jan 1994). During the same period the number of cases dropped by 95 percent in the United States as a whole (Textbook of Pediatric Infectious Diseases, Saunders 1998).
The new pneumococcal vaccine for infants is now FDA approved and recommended by the American Academy of Pediatrics for all children less than 2 years of age. Vaccination of children between 2 and 5 years of age may also be considered on an individual basis. In large clinical studies, the vaccine has been shown to decrease the risk of invasive pneumococcal infection (i.e. meningitis and blood infections) by more than 93%. It has also been shown to decrease the risk of pneumonia and otitis media (ear infections). More information about the vaccine can be found at www.cdc.gov/.
When I meet with parents before their baby is born, I like to take a moment to reflect with them about this momentous time. I often ask them to consider what habits they now have that they wish they had avoided. What would they change in their lives if they had known earlier what they know now?
The answers I hear often mirror the topics you see on magazine covers in supermarket check-out lines. People wish they ate better, weighed less, exercised more, and managed their finances more wisely. Given a fresh start, some would go out for football or learn to play the piano or speak Spanish. Some focus on credit cards and how easy it is to get in too deep. Others' greatest wish is that they had learned how to have mutually satisfying relationships without so many painful missteps.
Having a child is one of life's great fresh starts. It can give smokers the extra umph they need to stop and spenders the extra thought for the future they need to start investing for their children.
This is a powerful time for parents; it can also make a huge difference for children. They are masters of observation and imitation--even before they are born. They will learn about how their parents really live (not what they say they believe, but what they believe in practice). If you want to teach your baby about things you are not yet doing, this is a great time to start doing them! Even the attempt will teach her that these things matter to you.
For instance, parents often identify overspending as a problem they would like their children to avoid. How might they address this? Children have a legitimate need for new experiences. In order for play to be fun, it has to involve some degree of novelty. Kids can satisfy this deep thirst for newness by always getting new stuff, but this can lead to costly habits down the road (financially and emotionally). It can lead to the oft-repeated refrain, "I'm bored!" However, kids can also satisfy this strong drive by learning to discover new ways to enjoy the things they already have. This can lead to growing creativity and imagination, as well as fun that satisfies more deeply, relationships that last, and credit card balances that can be paid off. We'll talk about how parents and kids can learn this fun skill together, by both curtailing overspending and enjoying the adventure of creative alternatives, in a later chapter.
Once parents have identified one or two things they would most like to change, I like to talk with them about strategies for teaching these things to their kids. I'd be happy to brainstorm ideas for your specific areas with you at www.DrGreene.com during my chats.
Teaching your children is a core part of parenting. This will get increasingly multidimensional as pregnancy progresses and even more so as your child grows after birth. For now, teaching starts with what you eat.
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Most of the treatments for poison ivy, oak and sumac are aimed at reducing the itching, until the self-limited rash runs its course, which takes about two weeks. Click here for Dr. Greene’s tips on treating these allergic reactions.
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