Since schools opened he’s constantly unwell
Is it normal for kids to get fevers every week?
There must be something you can give to boost her immunity?
He always has this cold,the cough hasn’t left him
We’re swimming high tides of cough, cold and fevers 1/n
Paediatricians across the country are running busiest of OPDs, juggling bed availability in wards and PICUs and even falling sick themselves more than ever before
Parents are at their wits end
Classrooms are half empty on some days 2/n
#RespiratoryViruses like #RSV, rhino, #influenza, parainfluenza,
human metapneumo, boca,coronavirus,adeno, enterovirus and #bacteria like strep pneumoniae, pertussis, haemophilus, mycoplasma etc were in constant low level circulation or saw seasonal outbreaks but now.. 3/n
#WeWereInAProtectiveBubble
Reduced human to human contact during lockdowns, school closures, masking and other covid protective measures (NPI - non pharmacological interventions) which crucially saved lives and tamed the pandemic had kept them out of circuit for a long time 4/n
Children’s immune systems have never met them up close and thus haven’t been schooled to ward them off
The floodgates opened up when we returned to ‘normalcy’ and went back to schools. The current surge is being seen as a #payoff time of this #ImmunityDebt 5/n
From New Zealand to Japan, from France to India there are reports of unusual or unseasonal surges of respiratory viral and bacterial infections in kids that are testing healthcare systems
The #hygienehypothesis is also at play may see increase in allergies and asthma too 6/n
What can be done?
1.Continue to follow precautions like masking and hand hygiene
2.Keep schools open, have kids return to classes as soon as they are able to
3.Schools need to plan for absences and bridge the gaps
4.Catch up on any missed out routine vaccines 7/n
5.Understand danger signs and seek medical attention 6.Weather it out, we are in unprecedented times. We are still understanding the changed dynamics and maybe wiser in months to come 8/n
Recurrent #Fever and frequent illness in children over last few months: There is nothing terribly wrong with your child, their immune system is having a crash course and will hopefully get out of that revolving door soon!
n/n
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#monkeypox 1. Simply put, a milder version of smallpox, caused by a virus of the same family 2. Was endemic (low level regular occurrence) in some African countries, we now have a global spread but no known epidemiological source 3. Self limiting illness with low CFR (3-6%)
4. Illness can last 2-4 wk, could be more severe in kids and rare complications include eye scarring, secondary infections & pneumonia 5. Although contagious, intimate & prolonged contact with infected person or contact with body fluids directly or from linen etc is needed
6. A person can be contagious 1-2 days prior to developing rashes until all skin rashes have scabbed off 7. Prodrome (0-5 day period leading up to rashes) of fever, swollen glands, chills, sweats, muscle aches, sore throat and severe fatigue is seen
#AntimicrobialResistance is a manmade disaster.
It is amongst the top 10 public health threats facing Humanity.
Available data analysed (for 2019)
4.95 M Deaths
189 M Years of Life lost thelancet.com/journals/lance…
1/n
Global burden of the disease due to AMR is huge, highest in Africa and South Asia 2/n
MRSA, Cephalosporin resistant E coli, Klebsiella are highly prevalent and Pan drug and XDR superbugs are fast emerging 3/n
What do we know from South Africa
-7% of infected kids needed hospitalisation
-18% of all hospital admissions were paediatric
-Paediatric admissions peaked prior to adult admissions
- 0 to 4 group needed most admissions
2/n South Africa (Contd)
- Short admission (mean of 3.2 days)
- 92% needed only ward care (NO HDU/ICU)
-25% needed some oxygen
- 6% needed ventilator care
Overall: early sharp increase in admissions especially 0-4 yo, but most needed short hospital stay and did well.
3/n UK data (so far)
- Positivity rate highest in Preschoolers (<6Y)
- 7% of <6Y infected
- <4 yo more admissions than any other paediatric age group (X3 other children)
- Slight increase in paediatric admissions compared to earlier wave (for every 100 now 107)
#ChildHealthMatters
Childhood #Asthma: not unusual to see some wishing it away. It’s stigmatised and poorly managed. Knowing triggers that can be avoided is the first step. Children need personalised Rx plan
Let us take up:
1.Can you prevent #Asthma? 2. Can you cure Asthma? 3. Will my child get 'addicted' to inhalers? 4. You have prescribed steroids!! 5. Can I try alternative medicine/no medicine?
1.Can you prevent #Asthma?
Primary (Preventing it all together)
Not much, but these help:
Breastfeeding - protective, regulates immune and allergic responses
Avoiding obesity/Overweight + wt loss/healthy wt in children with respiratory symptoms
Avoid exposure to/smoking
#ChildHealthMatters
Early Childhood Development (ECD) = critical period with consequences for lifetime. A thread:
The brain grows and develops in complexity at a phenomenal rate in first 2-3 years: forming new connections at an astounding rate of >1million per second!
The baby's brain comes with a blue print: genes, but needs critical components to achieve its potential: 1. Nutrition 2. Protection 3. Stimulation The first #1000Days and a bit beyond are crucial for Nature and Nurture to play their role
1. Nutrition: Mother's breast milk (and her nourishment) and wholesome age appropriate complementary food from 6 months is crucial