News : Meningitis can cause cerebral palsy or epilepsy

Excerpt from STAR ONLINE

A shot for protection

DON’T say children don’t know how to share. Why, they share all sorts of things! Sometimes it’s their toys, their food, but most often, they share the microscopic organisms that live on and inside them.

Lice, for instance. You know how it is – one child has kutu and all the other kids in the class go home scratching.

Or the common cold virus, which is why your child sometimes develops a sniffle after coming home from kindergarten.

Daycare centres, kindergartens and schools are hotbeds for infectious diseases like cold, sore throat, chickenpox and hand-foot-and-mouth (HFM) disease because children are in such close contact all day long.

There is now a conjugate vaccine that can prevent pneumococcal bacterial infection in infants and children up to nine years old.And unlike adults, a child’s immune system is more vulnerable to being invaded by disease-causing bacteria and viruses.

Most of the time, the illnesses that spread are harmless. Plus, you can rest assured that if your child has been vaccinated following the National Immunisation Schedule, he is already protected against many common infectious childhood diseases like rubella, mumps, measles and whooping cough.

Unfortunately, emergencies can happen when you least expect it, as in the case of seven-year-old Thomas Lee. What started out as a normal fever one day turned into a full-blown emergency case of pneumococcal pneumonia.

It was two weeks of agony for little Thomas and his parents who had to watch helplessly as their son succumbed to a frightening disease that did not respond to antibiotics.
Seen under a microscope, the pneumococcus or Streptococcus pneumoniae bacterium looks deceptively pretty, like a strand of pearls, or a string of beads. But don’t be fooled, it’s nastier than it looks.

Pneumococcus causes a group of illnesses called pneumococcal disease, with the scariest ones being the invasive infections. These include bacteremia (infection of the blood), meningitis (infection of the membranes covering the brain or spinal cord), sepsis (an infection in the blood associated with shock and organ failure) and pneumonia (infection of the lungs).
Pneumococcus is the most common cause of meningitis in Malaysia, replacing Haemophilus influenzae type b (Hib), for which children are now vaccinated against.

Meningitis is dangerous because the lining of the brain becomes inflamed, and this can cause death or, for those who survive, multiple neurological problems like mental retardation, cerebral palsy, blindness, deafness or epilepsy.

Pneumonia can be near fatal as well. In our country, it is one of the common illnesses that causes childhood hospitalisation and death.

Pneumococcus also causes non-invasive diseases, including otitis media (middle-ear infection) and sinusitis.

These diseases are dangerous, too; a child with middle-ear infection may develop complications like hearing loss, learning disabilities and delays in speech development.
The impact of the pneumococcus bacterium is devastating: each year, more than one million children throughout the world die as a result of pneumococcal disease.
If antibiotics are the marvel that scientific discovery produced to fight bacteria, why didn’t it cure Thomas’ pneumonia?

Many years ago, it might have. But Thomas was probably infected by a strain of pneumococcus that has recently become resistant to penicillin and other antibiotics. This is happening in many countries around the world, including Malaysia, due to the overuse and misuse of antibiotics
Children infected with antibiotic-resistant strains of the bacteria may have prolonged illness because they do not respond to formerly effective drugs. Their disease may spread more rapidly, unless treated with expensive alternative antibiotics.
Clearly, antibiotics are not the answer.

So how do you protect your child from something that spreads through a simple cough, a sneeze, or by the touch of a hand?

Through vaccination, that’s how. And fortunately for parents in Malaysia, there is now a conjugate vaccine that can prevent pneumococcal bacterial infection in infants and children up to nine years old.

The vaccine provides protection against 60%-80% of pneumococcal infections. It is safe, but may sometimes cause some mild reactions like local irritation and fever. Some children may experience other temporary side effects like irritability, drowsiness, restless sleep, decreased appetite, vomiting and diarrhoea.

Although Thomas did not receive the vaccination, he recovered from the infection with no ill effects.

His mother, having gone through the trying ordeal, now advises parents to have their children, especially the very young ones, vaccinated against pneumococcal infection.

“A child cannot live in isolation, and you never know when the infection will strike, and whether you will be as lucky as Thomas to survive unscathed,” she says.

– Article courtesy of the Malaysian Paediatric Association

[tags : seic epilepsy seizures children pediatric neurology]

News : Vital protection for children

Excerpt from STAR ONLINE

Vital protection for children

With the introduction of the Haemophilus influenzae type b (Hib) vaccine in 2002, S. pneumoniae has replaced Hib as the most common cause of meningitis in children in Malaysia. And now, there’s a vaccine for it, too.

ON 7 OCTOBER 1996, parents around the world went about their daily routine, oblivious to the fact that two scientists they did not know, and would never meet, had discovered something that would impact their lives directly.

It was the day that Peter Doherty and Rolf Zinkernagel were awarded the 1996 Nobel Prize in Physiology or Medicine for their discoveries concerning “the specificity of the cell mediated immune defence”.

Their discovery of how the immune system recognises virus-infected cells “laid a foundation for an understanding of general mechanisms used by the cellular immune system to recognise both foreign microorganisms and self molecules.”

Dr Musa Mohd Nordin and Dr Theodore Tsai agree that the way ahead to prevent invasive pneumococcal diseases in infants and young children is with vaccination.In other words, their work has paved a better platform for the construction of new vaccines, among them the pneumococcal saccharide conjugate vaccine.

This is the first licensed vaccine to protect children under the age of two from invasive pneumococcal disease caused by several of the most common types of the pneumococcal bacteria.

Nasty pathogen
Pneumococcus, formally known as Streptococcus pneumoniae, is a gram-positive bacteria discovered way back in 1881 by French microbiologist Louis Pasteur.
“Pneumococcus contains a sugar capsule (polysaccharide) that encapsulates the bacteria. It is this capsule that makes this germ very infectious,” says Dr Musa Mohd Nordin, consultant paediatrician and neonatologist.

This germ is very easily transmitted via inhalation of aerosols or direct physical contact, for example through a cough or a sneeze.
Once it has landed in your nose, the germ parks itself in there, ready to cause troublesome infections like sinusitis and otitis media (infection of the middle ear).
However, it doesn’t stop there.

S treptococcus pneumoniaeis a nasty pathogen that is the number one cause of sinusitis, otitis media, bacteraemia, pneumonia and meningitis.“(Pneumococcus) breaches the barrier lining of the nose and the pharynx, and enters the blood. When it has invaded the bloodstream, it causes bacteraemia, or blood poisoning,” Dr Musa explains.
The Health Ministry has estimated that the incidence of pneumococcal bacteraemia is about 30 per 100,000 in Malaysian children under five years old, with at least 750 cases and 20 deaths per year.

“And if it goes across the blood-brain barrier into the cerebrospinal fluid, it causes meningitis,” he adds.

Meningitis, where the meninges or the lining of the brain becomes inflamed, is every parent’s worst nightmare. Without prompt diagnosis and treatment, a child with meningitis may die. Even those who survive may have multiple neurological deficits, such as mental retardation, cerebral palsy, blindness, deafness or epilepsy.

“It’s a very tragic survival,” Dr Musa stresses.
Previously, pneumococcus has been overshadowed by the Haemophilus influenzae type b (Hib) bacteria, which was the number one cause for meningitis. However, after the Health Ministry introduced the Hib vaccine in 2002, the rates of Hib meningitis have declined tremendously.
“Now, S. pneumoniae has replaced Hib as the most common cause of meningitis in Malaysia,” Dr Musa points out.

Pneumococcus can also infect segments of the lungs, causing pneumonia. The relentless little germ is actually the number one cause of acute respiratory infections in Malaysia, which is, in turn, the leading cause of childhood illnesses, according to the National Health and Morbidity Survey 1996.

“There are at least 90 different types of pneumococci. But only about eight to 10 of the different pneumococci are responsible for the majority of invasive pneumococcal disease,” says Dr Musa.
His favourite phrase, “pneumococcus is number one” is justified. WHO reports that one million children in the world below the age of five die every year from invasive pneumococcal disease.

Antibiotics not the answer
Gone are the days when antibiotics could be deployed to battle attacks by any bacteria.
Today, bacteria and other microorganisms that cause infections have developed ways to survive drugs meant to kill or weaken them, leading to an emerging public health problem known as “antibiotic resistance”.

“In the 1940s, when penicillin was discovered, it was thought that this was the magic bullet that would eradicate all forms of bacteria. This would be the end of the pneumococcus,” relates Dr Musa.

Instead, the bacteria has managed to clone itself to be resistant to common antibiotics like penicillin and macrolides.

In a study carried out by the Asian Network for the Surveillance of Resistant Pathogens (ANSORP) between 1999 and 2001 in 12 Asian countries, the group concluded that there is a worrying increase in the prevalence of penicillin- and macrolide-resistant pneumococcus.
Antibiotic resistance is believed to arise from the abuse, overuse and misuse of antibiotics. As a result, pneumococcal infections, and many other diseases like tuberculosis, malaria and cholera, are not responding to formerly effective drugs and are spreading rapidly.
In the same study, the ANSORP group recommended that there should be continuous surveillance of pneumococci, while doctors should be more circumspect about the use of antibiotics.

ANSORP also concluded that pneumococcal vaccination is urgently required in Asia, a point that Dr Musa fervently agrees with.

“Antibiotics are not the solution to the pneumococcal problem. The way ahead is to prevent these invasive diseases with vaccination,” he says.

[tags : seic epilepsy seizures children pediatric neurology]