Health Info

West Nile Virus, Meningococcal Vaccine for Teens & Vision Screen for Infants

Dear El Camino Parents, We have an updates for you on the West Nile Virus concerns written by Dr. Levy. We also have some office updates on the new meningococcal virus vaccine for teens over 11 years of age and our new computerized screening test for children 6 months to 4 years.

West Nile Virus

There have been record amounts of rain in San Diego County this year and this will potentially cause an increase in the number of mosquitoes and rodents. This has the potential of increasing the prevalence of West Nile Virus disease (WNV). This is a viral infection similar to St. Louis encephalitis and Japanese encephalitis and is transmitted by the bite of infected Culex mosquitoes.

West Nile Virus disease is, thankfully, seldom serious in children. Most WNV infections are completely asymptomatic (there are no symptoms at all), but about 20% of infected people (and a lower percentage of children) will develop an acute fever accompanied by headache, fatigue, abdominal pain, and sometimes nausea and diarrhea. Less than 1% of all infected people and even fewer children develop the serious complications of meningitis, encephalitis or acute paralysis.

Children at most risk for more serious disease include those who are immunosuppressed. This is particularly true for children with leukemia and other blood malignancies, patients with advanced cancers and children on immunosuppressive drugs.

The best management of this illness is prevention. This means using common sense measures to avoid mosquito bites. Things that help include:

• wearing long sleeves and pants when possible
• avoiding being outside at dawn and dusk when mosquitoes are most active
• applying mosquito repellent.

The American Academy of Pediatrics recommends using formulations containing no more than 30% DEET on infants older than 2 months of age and children. DEET should not be used on infants younger than 2 months old.

The following are a list of recommendations regarding the use of DEET in children:

• Do not apply to infants under 2 months of age.
• Read and follow all directions and precautions on the product label.
• Do not apply over cuts, wounds or irritated skin.
• Do not apply to young children’s hands or near eyes or mouth.
• Do not allow young children to apply products themselves.
• Use just enough to cover the exposed skin and/or clothing.
• Do not use under clothing.
• Avoid over application.
• After returning indoors, wash treated skin with soap and water.
• Wash treated clothing before wearing again.
• Do not use spray solutions in enclosed areas or near food.
• For use on face, apply to adult hands and then rub on face. Do not spray face and avoid areas around eyes and mouth.

Parents should also be aware that the EPA withheld approval of products formulated with sunscreens, as well as products that used, or made any reference to, food-like odors or colors. Such products may be found in retail outlets for some months but should be avoided. While it is recommended that insect repellents be used sparingly and only up to a few times a day, a reminder that sunscreens should be reapplied every time a child returns from swimming, which could be many times a day.

Meningococcal Vaccine for Teens

Approved this summer is the new quadrivalent meningococcal vaccine for teens, also known as Menactra. The American Academy of Pediatrics guidelines call for the quadrivalent meningococcal vaccine for:

• Young adolescents (11-12 years of age)
• Adolescents at high school entry or 15 years of age (whichever comes first) for those who have not previously been vaccinated
• All college freshmen living in dormitories and military recruits
• Other groups at high risk such as those with underlying medical conditions, anyone without a spleen, immune system disorders, or travelers to areas with high rates of meningococcal disease

Meningococcal disease is the leading cause of bacterial meningitis (infection of fluid surrounding the brain and spinal cord) in children 2-18 years old in the United States. It also causes blood infections. This disease is dangerous because it progresses rapidly, and within hours of the onset of symptoms it may cause permanent disability or death. About one in every ten people who get the disease dies from it, and up to 20% more may lose an arm or leg, become deaf or mentally retarded.

Symptoms include high fever, headache, stiff neck, confusion, nausea, vomiting and exhaustion, and a rash may appear. Lifestyle factors thought to contribute to the disease include direct contact with an infected person, e.g., exchanging saliva; crowded living conditions, e.g., dormitories; and active or passive smoking. Vaccination is the best method of preventing meningococcal disease.

The Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) determined that establishing the target age at 11 years may give lasting immunity through college.

Side effects in about 50% of people can include redness and pain at the injection site. A small percentage may have a fever.

Computerized Vision Screening for Children

El Camino Pediatrics is pleased to offer a new vision screening test in our office known as DIOPSYS. This is a computerized vision test that is available for infants as young as 6 months of age and can be done up to 4 years of age. Generally at 5 years of age, children can cooperate with the standard vision testing. This new technology allows us to detect vision problems such as amblyopia ("lazy eye") and other vision acuity problems at a very early age. Please discuss the details of this test with your primary care physician.