September 20, 2016

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Dr. Carol Baker, executive director of Texas Children’s Center for Vaccine Awareness and Research and Baylor College of Medicine professor of pediatrics, molecular virology & microbiology, presented the 2016 Jeryl Lynn Hilleman Endowed Lecture “Vaccines for Pregnant Women: A Long Time Coming” at the National Immunization Conference in Atlanta, GA on September 13.

This endowed lectureship, the first permanent endowment established at the CDC Foundation, was given by The Merck Company Foundation in celebration of the 50th anniversary of the Centers for Disease Control and Prevention (CDC) and the 25th anniversary of the first combination vaccine for measles, mumps and rubella, M-M-R and its successor M-M-R II, licensed by Merck. The lecture has become an important and popular component of the CDC’s annual National Immunization Conference.

June 24, 2014

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While thousands flock to Brazil for the World Cup games, many health care workers are worried about more than which team will take home the trophy. NTDs like Dengue and Chagas are plaguing the citizens of Brazil – putting a definite damper on the spirit of the games.

“The theme of the 2014 FIFA World Cup Brazil is ‘all in one rhythm.’ So far that rhythm could leave behind millions of Chagas disease sufferers in the Americas,” said Dr. Peter Hotez, Texas Children’s Hospital endowed chair in Tropical Pediatrics. Hotez’ recent article about Chagas disease, which is a leading cause of severe and life-threatening heart disease in the Americas, was published on HuffPost.com, and brings to light the fact that more than 1 million people in Brazil suffer from Chagas.

Also of great concern is the surge in cases of dengue fever in Brazil’s largest city, Sao Paulo. Certain strains of the disease, which is carried by female mosquitoes, can be fatal and there is currently no treatment or vaccine. Despite government efforts as of late to control mosquitos with powerful pesticides, the dengue epidemic is sweeping through Brazil, and many worry that international visitors could contract the disease and bring it back to their home countries.

“Several multinational pharmaceutical companies, even Brazil’s Instituto Butantan, are working to make a prototype dengue vaccine, but these will not be ready in time for the World Cup,” said Hotez. “In the meantime, measures aimed at mosquito control and personal protective measures against mosquitos are all that are available.”

Back here in Houston, fear of dengue spreading to the U.S. feels all too real, especially in light of evidence found by our own Dr. Kristy Murray, associate professor of pediatric tropical medicine at Baylor College of Medicine and Texas Children’s Hospital, which suggests that dengue has re-emerged in Houston. Murray and her team investigated the possibility that dengue might be in Houston because the area has the type of mosquitoes known to carry the virus and a dense population full of frequent travelers south of the border. But the study, published this past fall, found that most of the infections were transmitted in Houston.

“This study shows that Houston may be at risk of an outbreak, that people need to be on the lookout,” said Murray.

Beyond NTDs like dengue and Chagas, many in the health care field see Brazil’s hosting of the World Cup as a time to put the spotlight on the various diseases that impact (and often kill) children in Brazil and the Americas – some as simple as diarrhea and pneumonia, which can be prevented through vaccines.

The Global Alliance for Vaccines and Immunization (GAVI) launched a World Cup-themed report last month, designed to draw parallels between the shots, saves and goals made on the field and the shots (vaccines) needed to save lives and help achieve GAVI’s big goals. The report, “Going for Goal: Immunization and the Case for GAVI,” looks at each team playing in this summer’s World Cup (as well as a few others who didn’t make the cut), analyzing their countries’ contributions to global immunization efforts and offering up “pundit’s verdicts” for their future performance.

So while sports fans may be fired up whenever their team scores over the next few weeks, here at Texas Children’s, we’ll be cheering on organizations that are working to ensure children in Brazil, and everywhere, get the vaccines they need – a goal worth celebrating.

Those who are traveling to Brazil this summer, or want to know more about the diseases mentioned in this article, should visit the Travel Clinic at Texas Children’s.

May 27, 2014

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By Dr. Tiffany McKee-Garrett

When a baby is born, parents want nothing more than to love and protect their child. Part of that protection starts right after birth with the administration of a vitamin K injection. Babies are not born with sufficient vitamin K levels and cannot get adequate amounts of vitamin K from breast milk, so this injection, given within the first hour after birth, is crucial because it helps a baby’s blood to clot normally, which prevents vitamin K deficiency bleeding (VKDB) in newborns.\

A dangerous trend
A recent CDC report confirmed that there has been a nationwide increase in parents refusing the vitamin K shot for their newborns – and this dangerous trend, often based on inaccurate information found online and faulty science, is causing more babies to experience hemorrhaging that is preventable and may cause brain damage or even death in some cases.

In the United States, administration of intramuscular vitamin K at birth to prevent all forms of VKDB has been standard practice since first recommended by the American Academy of Pediatrics in 1961. Without the shot, the incidence of early and classical VKDB ranges from 0.25 percent to 1.7 percent of births and the incidence of late VKDB ranges from 4.4 to 7.2 per 100,000 infants. The relative risk for developing late VKDB has been estimated at 81 times greater among infants who do not receive intramuscular vitamin K than in infants who do receive it.

Early VKBD usually presents in previously healthy appearing infants as unexpected bleeding during the first two weeks of age, usually between the second and fifth day after birth. The bleeding can present as oozing from the umbilical cord area, bleeding from the circumcision site, persistent oozing from puncture sites, gastrointestinal hemorrhage, and/or bleeding into the brain, which can result in significant neurological complications that have a lifelong impact on a child.

Late VKDB is an indication of severe vitamin K deficiency and presents as unexpected bleeding, including brain bleeds in infants 2-12 weeks of age. Complications of late VKDB may be severe, including death. It classically presents in exclusively breastfed infants who received either no or inadequate neonatal vitamin K. It can also present in infants with intestinal malabosorption defects.

The myths
One myth about vitamin-k injections is that they are linked to leukemia, but studies show absolutely no relationship between getting vitamin K as a baby and an increased risk of leukemia. Another myth is that the vitamin K injection increases the risk of jaundice – which is inaccurate. Jaundice associated with vitamin K has been observed only in high risk babies (such as premature babies) in doses 30-60 times higher than the dose we give.

Some parents also argue that injections cause babies pain, but this pain is very brief and the benefits of the injection are very much worth a short period of discomfort. Parents are encouraged to mitigate this brief uncomfortable experience by holding baby skin to skin before and after the injection or allowing the baby to breastfeed before, during and/or after getting the injection.

In the not so distant past, infants and children had high rates of dying early in life. During the 20th century alone, the infant mortality rate declined greater than 90 percent and the maternal mortality rate declined 99 percent! Much of this is due to advancements in modern medicine. While it might seem nice to do things completely naturally, modern medicine has saved the lives of countless mothers and babies.