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Fast Fact
More than 100 different types of Group A Beta Strep have been identified.
Common sites of infection include the upper respiratory tract; scarlet fever, which includes skin involvement and can be very mild or extremely serious; strep pneumonia (which can also be quite serious); strep skin infections (such as impetigo); strep vaginitis in pre-pubertal girls; and strep bacteremia (or strep in the bloodstream), which can then lead to meningitis, brain abscess, bone infections, joint infections, or even endocarditis (an infection of the valves of the heart).
Strep pharyngitis (commonly known as “strep throat “) is one of the most common strep infections. Strep throat is contagious until antibiotic therapy has been in place for at least 24 hours. It is spread by close contact, both via respiratory droplets and by touch.
The diagnosis of a systemic strep infection should at least be entertained when there is vomiting lasting longer than 24 hours, a high fever, and an elevated white blood count in an ill-appearing child.
The presence of strep infection can be confirmed by performing a culture of the suspected site. Depending on a child’s symptoms, a throat culture, wound culture, blood culture, and/or a blood test may be obtained to evaluate for strep infection.
In the case of strep throat, rapid strep tests can give almost immediate results in the doctor’s office but may miss 10 to 20% of infections. Throat cultures may take 1 to 2 days, but are able to detect infection 95% of the time.
My daughter is allergic to nuts. What can we do to prepare for a possible allergic reaction?
Learn CPR. Now.
Your child will need an Epipen Jr. kit – make that two Epipen Jr. kits. These contain easily injectable epinephrine, the one drug that can stop this reaction in its tracks. There should always be an Epipen nearby, wherever your child is. You and your spouse should each carry an Epipen with you at all times, 24 hours a day. It is important that each of you is comfortable using it.
Signs of an allergic reaction include facial or neck swelling, breathing difficulties, lightheadedness, nausea, vomiting, rash or flushing associated with a nut ingestion. If you think there has been any nut ingestion, and your child exhibits any signs of an allergic reaction, USE IT! Don't wait and see. Use the Epipen and take your child to the emergency room immediately or call 911.
Once you have educated yourself on emergency care, it is vital that you educate any other adult who will be caring for your child. These adults should know CPR and should have an Epipen. In a chilling study from Johns Hopkins University, thirteen children with life-threatening nut allergies were followed -- six of them died. All six of these children had ingested nuts while at their various schools. They immediately went to their school nurses who told them to lie down and see if they felt better. Each of them did feel better and went back to class -- and died. Speak with your child's teachers, principal, and school nurse – in person. Any adult taking care of your child should be given a written note that indicates your son has a life-threatening allergy to nuts and peanuts in all forms. Consider purchasing a medical alert bracelet—an identification bracelet that has your child’s name and allergy engraved on it.
Don't go down this road alone. You can definitely benefit from links to other families going through the same thing. Food allergy support groups are available in many locations. Whether or not you contact a local support group, I would definitely contact, and join, The Food Allergy and Anaphylaxis Network (FAAN). It costs about $20 per year and provides outstanding information, literature, videos, and the kinds of practical information and support you will need. Their phone number is 800.929.4040. Their address is 11781 Lee Jackson Hwy., Suite 160, Fairfax, VA 22033-3309. Contact them right away. They also have programs for schools and camps.
Some of the research being done right now in life-threatening food allergies is very exciting. Companies are working on products to block this type of allergic response at the cellular and molecular level. This research is quite promising, but still only investigational.
Life-threatening food allergies are not rare. Fortunately, as deadly and as common as they are, very few children actually die from them. With this combination of avoidance, preparation, and education, your child can look forward to a long and healthy life.
For most children, it takes many more hours of cumulative trauma than it does for an adult to cause aches or tingling (this can happen, though -- it's amazing how long a kid can stay glued to a computer game without a break). Click here for more of Dr. Greene’s Tips For Avoiding Repetitive Stress Injuries.
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