Vaccine slashes diarrheal illness in kids

Date: 10/25/2008 2:05 PM

By MARILYNN MARCHIONE
AP Medical Writer


WASHINGTON (AP) _ A vaccine against rotavirus, the leading cause of diarrhea in infants, has led to a dramatic drop in hospitalization and emergency room visits since it came on the market two years ago, doctors reported Saturday.

A bonus: the vaccine seems to be preventing illness even in unvaccinated children by cutting the number of infections in the community that kids can pick up and spread.

"We're a little surprised by the degree of impact given the coverage we've achieved," said Jane Seward of the federal Centers for Disease Control and Prevention. Only about half of young children had received the vaccine and very few had received all three doses when the studies were done.

Results were reported Saturday at an infectious diseases conference in Washington.

Before the vaccine, more than 200,000 U.S. children were taken to emergency rooms and more than 55,000 were hospitalized each year with rotavirus, which causes vomiting and diarrhea, mostly from January through May. Worldwide, the virus kills 1,600 young children each day.

Since Merck & Co.'s Rotateq came out in 2006, hospital visits and stays due to the virus have dropped 80 percent to 100 percent, studies by the CDC and several other groups show.

Last winter, rotavirus cases started and peaked two to three months later and were much less extensive than in previous years, CDC scientists report. Hospitals in a network that tracks these cases for the CDC saw more than an 80 percent drop in admissions from them, one study showed.

Another study, by Merck, found a 100 percent drop in hospitalizations and ER visits during the 2007 and 2008 rotavirus seasons compared to previous ones. The study was based on a review of health insurance claims for about 61,000 infants and diagnoses by doctors in routine clinical practice.

Rotateq is an oral vaccine given at two, four and six months of age. In June, a second rotavirus vaccine came on the market — GlaxoSmithKline's Rotarix. It requires only two doses, completed by four months of age.

Also at the conference, scientists reported that a new version of Wyeth's Prevnar vaccine seems to better protect kids against germs that cause pneumonia, meningitis and ear infections, but whether it makes it onto the market before dangerous strains become a big problem remains to be seen.

Scientists have been retooling Prevnar, which came on the market in 2000 and is advised for children under age 2. It protects against the seven strains of Strep bacteria that were causing the most serious infections at the time. Since then, new strains have become more of a threat and increasingly are resistant to common antibiotics.

The experimental new vaccine adds six of these to the original seven. Scientists from Wyeth and from Johannes Gutenberg University in Mainz, Germany, compared immune responses to the new vaccine, given to 293 babies, versus those of an equal number of babies given the old one.

The new vaccine did about as well as the old one on the original strains and well on five of the six new ones.

The company has said it plans to seek federal approval for it in early 2009, and review can take a year or more. British-based GlaxoSmithKline has a similar vaccine in final-phase testing that targets 10 strains common in Europe and other regions.

In the meantime, parents should continue to have their toddlers get the existing Prevnar, and to use antibiotics only when needed because they don't work against the common cold and overuse worsens the bacteria resistance problem, said Dr. Cynthia Whitney, a pneumonia expert at the CDC.

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On the Net:

Infectious disease meeting: http://www.icaacidsa2008.org/

CDC: http://www.cdc.gov/vaccines/.

Copyright 2008 The Associated Press.

Food allergies increasing in US kids, study says

Date: 10/22/2008 8:04 AM

By MIKE STOBBE
AP Medical Writer

ATLANTA (AP) _ Food allergies in American children seem to be on the rise, now affecting about 3 million kids, according to the first federal study of the problem.

But experts said that might be because parents are more aware and quicker to have their kids checked out by a doctor.

About 1 in 26 children had food allergies last year, the Centers for Disease Control and Prevention reported Wednesday. That's up from 1 in 29 kids in 1997.

The 18 percent increase is significant enough to be considered more than a statistical blip, said Amy Branum of the CDC, the study's lead author.

Nobody knows for sure what's driving the increase. A doubling in peanut allergies — noted in earlier studies — is one factor, some experts said. Also, children seems to be taking longer to outgrow milk and egg allergies than they did in decades past.

But also figuring into the equation are parents and doctors who are more likely to consider food as the trigger for symptoms like vomiting, skin rashes and breathing problems.

"A couple of decades ago, it was not uncommon to have kids sick all the time and we just said 'They have a weak stomach' or 'They're sickly,'" said Anne Munoz-Furlong, chief executive of the Food Allergy & Anaphylaxis Network, a Virginia-based advocacy organization.

Parents today are quicker to take their kids to specialists to check out the possibility of food allergies, said Munoz-Furlong, who founded the nonprofit in 1991.

The CDC results came from an in-person, door-to-door survey in 2007 of the households of 9,500 U.S. children under age 18.

When asked if a child in the house had any kind of food allergy in the previous 12 months, about 4 percent said yes. The parents were not asked if a doctor had made the diagnosis, and no medical records were checked. Some parents may not know the difference between immune system-based food allergies and digestive disorders like lactose intolerance, so it's possible the study's findings are a bit off, Branum said.

However, the study's results mirror older national estimates that were extrapolated from smaller, more intensive studies, said Dr. Hugh Sampson, a food allergy researcher at the Mount Sinai School of medicine.

"This tells us those earlier extrapolations were fairly close," Sampson said.

The CDC study did not give a breakdown of which foods were to blame for the allergies. Other research suggests that about 1 in 40 Americans will have a milk allergy at some point in their lives, and 1 in 50 percent will be allergic to eggs. Most people outgrow these allergies in childhood.

About 1 in 50 are allergic to shellfish and nearly 1 in 100 react to peanuts, allergies that generally persist for a lifetime, according to Sampson.

Some people have more than one food allergy, he said, explaining why the overall food allergy prevalence is about 4 percent.

Children with food allergies also were more likely to have asthma, eczema and respiratory problems than kids without food allergies, the CDC study found, confirming previous research.

The study also found that the number of children hospitalized for food allergies was up. The number of hospital discharges jumped from about 2,600 a year in the late 1990s to more than 9,500 annually in recent years, the CDC results showed.

Also, Hispanic children had lower rates of food allergies than white or black children — the first such racial/ethnic breakdown in a national study.

The reason for that last finding may not be genetics, said Munoz-Furlong. She is Hispanic and said people in her own family have been unwilling to consider food allergies as the reason for children's illnesses. "It's a question of awareness," she said.

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On the Net:

The CDC report: http://www.cdc.gov/nchs

Copyright 2008 The Associated Press.