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Health

Measles outbreak in central Ohio grows to more than 50 children, driven by ‘lack of vaccination’

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CNN
 — 

A measles outbreak in central Ohio is growing, sickening more than 50 children, with many of them needing hospitalization, according to data updated Tuesday by Columbus Public Health.

None of the children had been fully vaccinated against measles.

Since the start of the outbreak in November, at least 58 measles cases have been identified in Columbus and Franklin, Ross and Richland counties, and there have been 22 hospitalizations, according to Columbus Public Health.

Of those cases, 55 were in unvaccinated children. The other three were only partially vaccinated, meaning they received one dose of their MMR or measles, mumps and rubella vaccine when two are needed for a person to be considered fully vaccinated.

Experts recommend that children get the vaccine in two doses: the first between 12 months and 15 months of age, and a second between 4 and 6 years old. One dose is about 93% effective at preventing measles if you come into contact with the virus. Two doses are about 97% effective.

Nationwide, more than 90% of children in the US have been vaccinated against measles, mumps and rubella by age 2, according to the US Centers for Disease Control and Prevention.

“Measles can be very serious, especially for children under age 5,” Columbus Public Health spokesperson Kelli Newman wrote in an email Monday.

All of the Columbus cases have been in children: 12 in infants younger than 1, 28 in toddlers ages 1 to 2, 13 in children ages 3 to 5, and five in ages 6 to 17.

That corresponds to about 71% of cases being reported in 1- to 5-year-olds.

While the specifics of each hospitalized measles case can vary, “many children are hospitalized for dehydration,” Newman wrote. “Other serious complications also can include pneumonia and neurological conditions such as encephalitis. There’s no way of knowing which children will become so sick they have to be hospitalized. The safest way to protect children from measles is to make sure they are vaccinated with MMR.”

Some of the children visited a grocery store, a church and department stores in a mall while they were contagious, according to Columbus Public Health’s list of exposure sites.

Measles is a highly infectious disease that can spread through the air when an infected person coughs or sneezes or if someone comes into direct contact with or shares germs by touching contaminated objects or surfaces.

“Measles can be a severe illness and can commonly lead to complications which require hospitalization, especially in young children,” Dr. Matthew Washam, medical director of epidemiology and infection control at Nationwide Children’s in Columbus, wrote in an email Tuesday.

In the Ohio outbreak, the hospitalized children have been seen at Nationwide Children’s Hospital.

“Most children can usually recover at home with supportive care and can receive antibiotics for less severe complications, such as ear infections. Some children develop more severe complications, such as dehydration requiring intravenous fluids, pneumonia and/or croup which require respiratory support, or rarely more severe complications such as encephalitis,” Washam wrote.

“The mainstay of treatment for all children with measles is supportive care,” he added. “In the hospital, this can include intravenous fluids, antibiotics for secondary bacterial infections, and respiratory support amongst other supportive care measures. Some children with measles may also be treated with vitamin A given the association of lower vitamin A levels with more severe measles illness.”

The measles outbreak is “very concerning,” said Dr. Nora Colburn, an adult infectious diseases physician at The Ohio State University Wexner Medical Center in Columbus, who has been watching the outbreak closely along with her colleagues.

“What’s really driving this is unfortunately a lack of vaccination, which is just heartbreaking,” said Colburn, who also serves as the medical director of clinical epidemiology for the Richard M. Ross Heart Hospital at the OSU Wexner Medical Center.

“For measles, it is the most infectious disease we have,” she said. “And so it is very concerning as an infectious disease physician, as also a mother of a young child and as a community member.”

During the early days of the Covid-19 pandemic, while most people stayed home and some health-care facilities were closed, many children missed their routine immunizations, including the MMR vaccine – and they still may not have gotten all their recommended shots. That’s true around the world as well as in the US.

“The concern now is that we’ve had this global dip in vaccination coverage as a result of the pandemic, probably not actually from vaccine hesitancy or refusal but just there were a lot of kids that missed their checkups during the pandemic, and we really haven’t completely caught those kids up,” said Dr. Sean O’Leary, chair of the American Academy of Pediatrics’ Committee on Infectious Diseases and professor of pediatric infectious disease at the University of Colorado School of Medicine and Children’s Hospital Colorado.

“Measles is such a contagious disease that when you see those dips, we really worry about the potential for large outbreaks,” he said. “You need to really maintain a high vaccination coverage to keep measles from spreading.”

About 90% of unvaccinated people who are exposed to measles will become infected, according to Columbus Public Health, and about 1 in 5 people in the US who get measles will be hospitalized.

While the measles outbreak spreads across central Ohio, the United States has been battling a surge of respiratory illnesses, such as flu and RSV, or respiratory syncytial virus, and the ongoing Covid-19 pandemic.

Pediatric hospitals nationwide have been overwhelmed by this rise in respiratory infections and are bracing for the possibility of even more cases over the holiday season.

“I can’t even imagine if your hospital is already chock full and all of a sudden you’ve got to deal with measles, because measles is a really problematic infection-control situation, too. You need negative-pressure rooms, everyone has to wear N95 masks, and it’s incredibly contagious in a hospital,” O’Leary said.

“There’s a lot of risk particularly to immunocompromised patients that are also in children’s hospitals,” he said. “It’s a real problem.”

Nationwide Children’s Hospital confirmed to CNN in an email Tuesday that it has seen a surge in other respiratory illnesses, such as flu and RSV, but remains able to keep caring for patients.

“The current surge in respiratory illnesses such as the flu and RSV is being seen locally. While we are experiencing some visits and admissions related to measles, volumes are relatively low compared to flu and RSV. Measles poses a greater strain on resources related to public health efforts, including contact tracing, containment, education, and immunizations,” the hospital statement said. “While busy, our hospital remains able to continue to provide care for patients.”

With each of these respiratory illnesses, it sometimes can be difficult to determine which infection a person has as the symptoms – such as fever, cough, and runny nose – can be similar.

“To have RSV, influenza, Covid at the same time as the holidays, and then now we have measles on top of it, which can have overlapping symptoms of fever and cough and fatigue, it can be really challenging to kind of sort out which infection is what,” Colburn said, adding that it is important for anyone with symptoms to stay home and get tested.

Measles symptoms may include fever, cough, runny nose, watery eyes and a rash of red spots. In rare cases, it may lead to pneumonia, encephalitis or death.

“Wearing your mask, especially in crowded areas, is really important, especially for our immunocompromised patients. I really worry about measles in adult patients who cannot get the MMR vaccines,” she said. “We can’t give it to severely immunocompromised patients or pregnant women. So it’s really important that everybody else gets vaccinated to cocoon those very vulnerable people and decrease the circulation of measles in our community.”

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Health

RSV, flu and colds: How to tell when your child is too sick for school

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CNN
 — 

A sniffle, a sneeze or a cough can set off alarm bells these days for families with young children.

Mother of two Vickie Leon said her kids, ages 4 and 2, can sometimes go a month or two without bringing anything back from day care. Then there are times when it seems the family in Aurora, Colorado, is sniffling with a virus every other week.

“Once that hits, we are just in it for a while,” she said.

Many kids have spent years socially distancing to protect against Covid-19, and now health care systems are being overloaded with cases of the respiratory virus RSV — which can cause a runny nose, decreased appetite, coughing, sneezing, fever and wheezing.

The viral infection has always been common. Almost all children catch RSV at some point before they turn 2, the US Centers for Disease Control and Prevention says. And immunity developed after an infection often wanes over time, leading people to have multiple infections in a lifetime, said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University School of Medicine in Nashville, Tennessee.

The public health challenge this year is that while many children were kept home to protect against Covid-19, they were also isolated from RSV, meaning more are having their first — and therefore most severe — infection now, said CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health.

An RSV infection is often mild but could be a cause for concern for young infants, children with underlying conditions and older adults, said Schaffner, who is also medical director of the National Foundation for Infectious Diseases.

That doesn’t mean it is time to panic, added Wen, who is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.” Catching RSV and other viral and bacterial infections is a part of children growing up and developing their immune system.

Here’s how to assess when to keep your child home from school and when to visit the pediatrician, according to experts.

Between colds, influenza, strep throat, RSV and lingering Covid-19, there are a lot of infections swirling about this winter — and they can often look a lot alike in terms of symptoms, Schaffner said. Even astute doctors may have trouble telling them apart when a patient is in the office, he added.

However, pediatricians are well practiced and equipped to treat upper respiratory infections, even if it isn’t possible to distinguish exactly which virus or bacteria is the cause, Wen said.

Whatever virus or bacteria is stirring up sniffles, headache or a sore throat in your household, the age, symptoms and health status of your child will likely make a difference in how you proceed, she said.

Ideally, public health professionals would like it if no child showing symptoms were sent to school or day care, where they could potentially spread infections Schaffner said. But — especially for single parents or caregivers who need to be at work — that is not always the most practical advice, he added.

At-home tests may signal if a child has a Covid-19 infection, he added. But for other viruses like a cold, there may not be a good way to know for sure.

Some symptoms that might really signal it is time to keep your child home from school or day care include high fever, vomiting, diarrhea, trouble eating, poor sleep or problems breathing, Wen said.

Donna Mazyck, a registered nurse and executive director of the National Association of School Nurses, breaks it down into two primary considerations: Does the child have a fever and are they too ill to engage with learning fully?

Families should also check their school’s guidelines, some of which can be detailed on when a child needs to be kept home from school, while others will rely more on parental judgment, she said.

“When in doubt, consult the school policies and have a plan with a pediatrician,” Wen said.

And for children at higher risk because of other medical conditions, consult with your pediatrician before your child gets sick so you know what to look for.

Again, here is where schools may have different policies and it becomes important to check with written information, a school administrator or school nurse, Wen said.

“Generally, the schools will ask that the child be fever free without the use of fever-reducing medications” before returning to the classroom, she said.

For children with asthma or allergies, it may not be reasonable to keep them out of school whenever they show any coughing or sniffling symptoms, Wen said. That could very well keep them out half the year.

And some symptoms, like a continued cough, may linger as an infection clears and a child recovers. In those cases, it may be appropriate to send a child back to school, Mazyck said, reiterating that it is important to check on the school’s guidelines.

Families are often good at bringing their children into the pediatrician when they seem unwell, Schaffner said. Still, with so many things going around, it is important to remind families that doctors would rather see kids who aren’t feeling well earlier than later, he added.

If they seem lethargic, stop eating or have difficulty breathing, parents and caregivers would also be justified in taking their kids to the pediatrician and seeking medical attention — especially if the symptoms worsen, Schaffner said.

“This is not something that they should hesitate about,” he said.

For younger babies and infants, it might be time to go to the emergency room if they are struggling to take in liquid or have dry diapers, flared nostrils, trouble breathing and a chest that contracts when it should expand, Wen added.

Families should seek emergency treatment for school-age kids who have trouble breathing and speaking in complete sentences, Wen said. Fortunately, most will not need emergency treatment — and those who do are usually back home and doing well in a couple days, Schaffner said.

“Parents should know that treating RSV and other respiratory infections is the bread and butter of pediatricians and emergency physicians,” Wen said. “This is what we do.”

To prevent these respiratory illnesses, teach your children to utilize the hygiene practices health care professionals were promoting long before the pandemic, like washing hands, using hand sanitizer when a sink isn’t available, coughing and sneezing into an elbow or tissue, and not sharing food or utensils with friends, Wen said.

There is not yet a vaccine for RSV approved by the US Food and Drug Administration, but there are effective ones available for influenza and Covid-19, Schaffner said.

If your child is not yet vaccinated, talk to their doctor about protecting them against these viruses, he added.

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Health

At 3 weeks old, she caught RSV, the virus that’s packing hospitals across the US

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CNN
 — 

As Abhishesh Pokharel carried his 3-week-old daughter into the emergency department, her fingers and toes were turning blue.

Other parts of her tiny body were yellow.

Something was very wrong.

The triage nurse at Greater Baltimore Medical Center knew it, too. She took one look at baby Ayra and gave her father an order:

Run!

Across the building he sped, his wife right behind him – to the pediatric emergency department.

By then, Ayra was sometimes not breathing at all, clinicians later told CNN.

The rapid response team went to work.

Still, “she was not responding to anything that they were doing,” Pokharel recalled.

“My mind just froze and thought I may not get her back.”

Ayra – born a preemie at just 36 weeks and 6 days – had already proved to be a fighter: Her first day on Earth was spent in the NICU because of fluid in her lungs.

Since then, she’d been healthy, her father said.

But now, her fragile body was caving to one of several respiratory illnesses spreading across the US: respiratory syncytial virus, or RSV, which often is most severe in young children and older adults.

While for most it causes a mild illness that can be managed at home, RSV – alongside flu, the coronavirus that causes Covid-19 and other common respiratory viruses – has driven an increase in hospitalizations nationwide. And pediatric hospitals are feeling the strain, with more than three-quarters of their hospital and ICU beds occupied for the past few months.

More than half of US states report high or very high respiratory illness activity, and US officials are begging people, including kids, to get the flu shot and Covid boosters ahead of Thanksgiving.

But for RSV, there is not yet a vaccine – nor an antiviral or specific treatment.

As baby Ayra’s blood oxygen level hit 55% – far from the 95% or better it should be – her parents could only watch, tears filling their eyes as they overheard clinicians say their newborn wasn’t responding.

“I was lost,” recalled Ayra’s mom, Menuka KC. “It was a nightmare.”

The staff at the pediatric ER in Towson, Maryland, was already overwhelmed by a crush of respiratory illnesses so severe it had for weeks claimed virtually every pediatric ICU bed in the state.

But as Ayra lay before them, they knew they had to act.

Fast.

Knowing Ayra could have gone into respiratory arrest right there in the waiting room “sent heart palpitations through all of us,” said Dr. Theresa Nguyen, the center’s interim chair of pediatrics.

The infant was lethargic, breathing quickly – sometimes not breathing at all. Thick mucus filled her nose and went down as far as her lungs, Nguyen said.

Her prematurity “increased her risk of how her body would react to the RSV virus,” the doctor explained.

It had been just 10 days since the older Pokharel daughter, 4-year-old Aavya, had gotten sick with a fever and runny nose that her pediatrician diagnosed as viral and ear infections, their dad said.

Five days later, on October 13, the couple noticed Ayra started having a runny nose and mucus that they had to remove with a suction ball, Pokharel said. They took her to her doctor for a scheduled check-up and were told she had a viral infection, though her lungs were clear and she had no fever.

But monitor her, they were told.

Three days after that, they took Ayra back because she had a bad cough, and the couple could barely hear her cry.

Two days later, here they were in the pediatric emergency department, with doctors now telling them intubation was Ayra’s best bet.

Inserting a tube into Ayra’s airway and attaching a breathing machine would give the infant the oxygen she needed, the doctors explained.

Ayra was on the brink of death.

She needed to be intubated immediately, the doctors said, before she stopped breathing.

Her parents waited just outside the room and prayed for God to save her and bring her back to them as the medical team carefully and swiftly intubated Ayra.

Immediately, her blood oxygen bounced back to a safer level.

But more hurdles lay ahead.

Greater Baltimore Medical Center could not keep Ayra – or any intubated child who needs to be on a ventilator – because that level of care requires a pediatric ICU, Nguyen explained.

The discussion quickly turned to where to send her for more care.

Hospital staff took to the phones.

Sending patients to other facilities for treatment is common during the height of flu and RSV seasons, Nguyen said.

But this year, the need had started rising much earlier.

RSV symptoms

  • RSV is a common virus, but it can cause serious illness, especially in younger infants and older adults. Symptoms may appear in stages and not all at once, according to the US Centers for Disease Control and Prevention.
  • Symptoms include:
  • Runny nose
  • Decrease in appetite
  • Coughing and sneezing
  • Fever
  • Wheezing
  • “In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties,” according to the CDC.

    • Greater Baltimore Medical Center last month had to transfer twice as many pediatric patients as it did last October, hospital data show. And October transfers were double what they were in September, with respiratory transfers accounting for 80%.

    “My doctors are seeing patients in the hallways every day,” Nguyen said, adding some have waited up to 16 hours to be seen.

    And this was far from the only facility squeezed by the surge in child respiratory illnesses.

    “There haven’t been pediatric ICU beds available in the state of Maryland since mid-September,” Nguyen said. “We’ve had to send children out of state.”

    Searching out a landing spot for Ayra, they dialed hospitals in Washington, DC, and Virginia and Delaware, Pokharel said.

    “‘Worse comes to worst, we have to airlift her and take her to another state,’” he remembered a clinician telling him as they called facilities as far away as Georgia and Florida.

    It didn’t dawn on Pokharel to even think about how his family would get to wherever Ayra was sent.

    She needed care, and it didn’t matter where.

    An hour passed.

    Then, a single phone call changed everything.

    “There was one bed available,” Pokharel said, “at Children’s National Hospital in DC.”

    Ayra was transferred in an ambulance, her father seated beside the driver. Pokharel stayed the night with his ailing daughter.

    The next morning, KC was ferried 90 minutes from Perry Hall, Maryland, to the hospital by Pokharel’s brother, who also cared for Aavya while the girls’ parents focused on her sick sibling.

    In the pediatric ICU, Ayra lay on a tiny, heated hospital bed. She was connected to blue and white ventilator tubes, her miniscule feet and wrists restrained so she wouldn’t pull at anything. Doctors pulled fluid out of her lungs and gave her an antibiotic, her dad said.

    On each of the next two days, Pokharel’s brother chauffeured his sister-in-law home, then back to her vigil at Ayra’s bed.

    All the while, their tiny fighter battled for every breath.

    Her parents didn’t know how long they’d have to wait.

    Then, on the third day: a breakthrough.

    Less mucus filled Ayra’s lungs, and she was getting only minimal support from the ventilator, Pokharel said. So, the doctors extubated her.

    She still needed a CPAP machine – the kind adults sometimes use to deal with sleep apnea – to get enough oxygen, her father said. And she later would require a nasal cannula – the tube outfitted with prongs going into the nostrils – to help administer lower amounts of oxygen.

    But Ayra was pulling through.

    Even as the doctors started talking about discharging her, KC grew nervous and started checking and rechecking to make sure her daughter was breathing.

    Soon, though, Ayra’s fever broke and she began drinking again from a bottle.

    On the fourth day, a friend drove KC to see Ayra – and the whole family went home together.

    Being back home has been an adjustment.

    The family of four is isolating until Ayra is at least 2 months old, said Pokharel, who works a hybrid schedule and goes out for errands.

    “We haven’t allowed any visitors to come home,” he said. “My wife hasn’t left home since then. She doesn’t want to go anywhere.”

    They also pulled Aavya out of day care, hoping to keep the germs at bay – and posing an extra challenge for everyone.

    “We have a baby who is sick, just came out of the hospital. We are giving 100% focus on the little one,” Pokharel said. “And on another side, I have a 4-year-old who needs my attention, like, 24/7.”

    Pokharel, while working some days from home, gives Aavya pre-K workbooks so she can draw, trace or paint, he said. When he’s off work, they go for a walk or a bike ride.

    KC spends her days caring for Ayra. Sleep, she said, comes in two- or three-hour stints.

    Back at Greater Baltimore Medical Center, the throngs of children with serious respiratory symptoms keep coming, Nguyen said. “Our staff, our physicians, advance practitioners and nursing staff are, for a lack of a better word, they’re overwhelmed.”

    “They’re burnt out because this has been ongoing for two months,” the doctor said. “And there’s no end in the near future because … you start seeing RSV and then you see the flu,” which can stick around until April.

    “This is really the children’s version of the Covid crisis in adults,” Nguyen said. “I don’t think it’s gotten as much attention as it needs because it’s kids, they’re little. It’s the pediatricians who advocate for them, but we’re actually really, really busy taking care of the kids.”

    As Ayra’s parents keep vigil at home over their tiny fighter, their want other families to know: With this virus still surging, be ready for anything.

    “I didn’t think RSV would go to this extent,” her dad said. “I never thought I would see a baby intubated – and not my baby intubated.”

    “I’m glad she’s doing OK and she’s feeding and sleeping well,” added her mother. “Thank you to all those doctors and the nurses who saved her life.”

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    Health

    As measles outbreak sickens children in Ohio, local health officials seek help from CDC

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    CNN
     — 

    A growing measles outbreak in Columbus, Ohio, has sickened dozens of unvaccinated children and hospitalized nine of them, and local public health officials are seeking assistance from the US Centers for Disease Control and Prevention.

    “We asked the CDC for assistance and they will be sending two epidemiologists at the end of the month to assist with our local investigation,” Kelli Newman, a spokesperson for Columbus Public Health, told CNN in an email Thursday.

    The CDC confirmed Thursday that it is aware of the cases and is “deploying a small team to Ohio to assist on the ground with the investigation.”

    “State and local health authorities are in the process of notifying potentially exposed residents, making sure they are vaccinated, and helping any community members who may have been exposed understand the signs and symptoms of measles infection,” CDC spokesperson Kristen Nordlund said in an email to CNN. “Anyone who may have been exposed should follow up with their healthcare provider.”

    When the measles outbreak was first reported last week, only four confirmed cases had been identified in one child-care facility, which temporarily closed – but the number of cases and facilities involved has grown.

    “As of today, we are investigating 24 cases of measles at nine day cares and two schools,” Newman said. “All cases are in unvaccinated children, and all but one are less than 4 years old. One child is 6 years old.”

    Health officials with Columbus Public Health and Franklin County Public Health have been investigating these cases and tracing any contacts who may have been exposed to the measles virus.

    Officials at Columbus Public Health are encouraging parents to make sure their children are up to date on their immunizations, including the measles, mumps and rubella vaccine, known as the MMR vaccine.

    Experts recommend that children receive the vaccine in two doses: first between 12 months and 15 months of age and a second between 4 and 6 years old. One dose is about 93% effective at preventing measles if you come into contact with the virus. Two doses are about 97% effective.

    “We are working diligently with the cases to identify any potential exposures and to notify people who were exposed,” Columbus Public Health Commissioner Dr. Mysheika Roberts said in a news release last week. “The most important thing you can do to protect against measles is to get vaccinated with the measles-mumps-rubella (MMR) vaccine, which is safe and highly effective.”

    About 90% of unvaccinated people who are exposed to measles will become infected, according to Columbus Public Health, and about 1 in 5 people in the US who get measles will be hospitalized.

    However, the CDC says that more than 90% of children in the US have been vaccinated against measles, mumps and rubella by age 2.

    Measles is a highly contagious disease that can spread through the air when an infected person coughs or sneezes or if someone comes into direct contact with or shares germs by touching the same objects or surfaces. Measles symptoms may include fever, cough, runny nose, watery eyes and a rash of red spots. In rare cases, it may lead to pneumonia, encephalitis or death.

    The measles outbreak in Columbus is a “fairly typical scenario” of an infectious virus finding its way into one environment and spreading among unvaccinated people, said Dr. David Freedman, professor emeritus of infectious diseases at the University of Alabama at Birmingham and founding director of the Travelers’ Health Clinic.

    Freedman said that during the early days of the Covid-19 pandemic, while many people stayed home and some health-care facilities were closed, many children missed their routine immunizations – and they still may not have gotten their MMR shots.

    “There are a lot of children nationwide that are behind on their routine vaccinations. So I think the message is still, if your child is 1 year of age or older, they need to be vaccinated,” said Freedman, a spokesperson for the Infectious Diseases Society of America.

    “Measles is not particularly a wintertime disease. It is not as likely to be affected by travel because it usually is in young, not immune children. Most adults are vaccinated,” he said. However, he added, “measles is highly contagious. Measles is probably the most contagious disease we know. It’s probably 10 times as contagious as Covid is.”

    In 1912, measles became a nationally notifiable disease in the United States, meaning health care providers and laboratories were required to report diagnosed cases. In the decade afterward, an average of about 6,000 measles-related deaths were reported annually.

    In the 1950s, researchers isolated the measles virus in a patient’s blood, and in the 1960s, they were able to transform that virus into a vaccine. The vaccine was licensed and then used as part of a vaccination program.

    Before the measles vaccination program was introduced in the United States in 1963, an estimated 3 million to 4 million people got the disease each year nationwide, according to the CDC. Afterward, cases and deaths from measles in the United States and other developed countries plummeted. There were 963 cases reported in the United States in 1994 and 508 in 1996.

    The last major measles outbreak reported in the US was in 2019. It was the largest since the disease was declared eliminated in 2000 and involved more than a thousand confirmed cases in 31 states – the highest number of cases reported in the US since 1992.

    Overall, the number of measles infections reported in the United States each year remains low because of the widespread use of vaccines, said Dr. Martin Hirsch, professor of medicine at Harvard University and Massachusetts General Hospital, who also serves as editor of the Journal of Infectious Diseases.

    As of October 28, a total of 33 measles cases have been reported this year in five jurisdictions across the United States, according to the CDC.

    “Over 90% of people in the United States have been vaccinated against measles, and even though it’s a highly transmissible virus, I wouldn’t expect to see the rates, for example, that we’re seeing with RSV now because we don’t have an RSV vaccine,” Hirsch said, referring to a surge of respiratory syncytial virus infections across the country, mostly among children.

    “Most of the cases of measles that we do see in the United States result from people who are coming to this country from other countries where the immunization rates are much less, followed by transmission to US residents who are not vaccinated,” said Hirsch, a spokesperson for the Infectious Diseases Society of America. “So the possibility that someone carrying measles virus coming into the country could spread into an unvaccinated population is always there.”

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    World

    Ukrainian women on the front line struggle to find uniforms that fit. One couple aims to fix that

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    Kyiv, Ukraine
    CNN
     — 

    Andrii Kolesnyk and Kseniia Drahanyuk both beam with excitement as they crouch over a box.

    They are about to unpack Ukraine’s first ever military uniform for pregnant women, which they recently commissioned after a pregnant sniper got in touch.

    The young couple, both TV journalists before the war started, are now fully dedicated to their independent NGO, “Zemlyachki,” or “Compatriots,” which procures vital items for women in the armed forces.

    The initiative started when Andrii’s sister was sent to the front on February 24, the day Russia invaded Ukraine.

    “She received men’s uniform, men’s underwear,” he says. “Everything that [was] designed for men.”

    It soon became clear that servicewomen needed a lot more than uniforms. Everything from smaller boots to lighter plates for bulletproof vests to hygiene products is in demand.

    So, the couple turned to private company donations, charity funds and crowdfunding to purchase goods independently of the military. Some customized gear such as women’s fatigues is produced under their own brand by a factory in Kharkiv in the country’s east – including the new pregnancy uniform.

    Other items, including body armor plates, helmets and boots, come from companies as far afield as Sweden, Macedonia and Turkey. But Kolesnyk and Drahanyuk say they are struggling with the procurement of winter items like sleeping bags and thermal clothing that will be important for comfort as winter sets in.

    Kolesnyk says they have distributed equipment worth $1 million so far and helped at least 3,000 women. If they’re on the front-line shooting rockets they might as well do it “in minimum comfort,” he tells CNN.

    There are currently about 38,000 women in the armed forces, according to the country’s Ministry of Defense.

    “We are doing this to help our government,” Kolesnyk says, not to compete with it. Their hub is overflowing with cardboard boxes full of kit, all paid for from crowdfunding and grants.

    A physical disability prevents Kolesnyk from joining his sister, father and brother-in-law on the front lines, a fact that saddens him.

    “For a man, it’s hard to understand that you can’t go there, and your sister is there. So, I’m trying to do my best here to help not only my family, but the whole army,” he says.

    Twenty-one-year-old Roksolana, who gave only her first name for security reasons, walks in to pick up a uniform and other gear before heading out on her next assignment. An art school graduate, she joined the army in March and is now part of an intelligence unit.

    “It’s so valuable to have these people who understand that we are tired of wearing clothes that are three sizes too big,” she says. “We had no helmets, we had old flak jackets, wore tracksuits and sneakers. Now we feel that we are humans.”

    She giggles as she laces up her new boots with impeccable long fingernails. Before they hug goodbye, Drahanyuk hands Roksolana a copy of “The Choice,” the best-selling memoir by Holocaust survivor and psychologist Edith Eger. The aim is that this can be a tool to help process trauma. Zemlyachki has also formed partnerships with military psychologists to whom women in combat can reach out.

    Other women, such as 25-year-old Alina Panina, are receiving psychological support through the Ukrainian military. A border guard with a canine unit, Panina spent five months in captivity at the infamous Olenivka prison in the Russian-controlled Donetsk region after leaving the besieged Azovstal steel plant in Mariupol.

    She was finally released on October 17 as part of an all-female prisoner exchange with Russia and went into mandatory rehabilitation at a military hospital, under whose care she remains.

    Ukraine recently demanded that the International Committee of the Red Cross send a delegation to the Russian prisoner of war camp.

    “I was not prepared [for captivity], and we discussed this a lot with other women prisoners that life hasn’t prepared us for such [an] ordeal,” Panina says at a pizza bar run by veterans in downtown Kyiv.

    She says prison guards “were unpredictable people” who sometimes abused prisoners verbally, but that she was spared any physical harm.

    Now her partner’s fate is up in the air. He is also a border guard who is still in captivity. “I know he is alive but don’t know in which prison he is,” Panina says sadly as she scrolls through pictures of him.

    When asked what gives her hope, she simply says, “our men, our people.”

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    Health

    RSV responsible for 1 in 50 child deaths under age 5, study estimates

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    CNN
     — 

    A new study estimates that 1 in 50 deaths of otherwise healthy children under age 5 around the world is due to a common virus that’s currently surging in the US: respiratory syncytial virus, or RSV. And in high-income countries, 1 in 56 babies who are born on time and are healthy will be hospitalized with RSV in the first year of life, according to the researchers’ estimates.

    The virus is known to be especially dangerous for premature and medically fragile babies, but it causes a “substantial burden of disease in infants worldwide,” wrote the authors of the study, published Thursday in the journal Lancet Respiratory Medicine.

    Other research has examined the number of children with pre-existing conditions who are hospitalized with RSV, but the new study is one of the first to look at the numbers in otherwise healthy kids.

    “This is the lowest-risk baby who is being hospitalized for this, so really, numbers are really much higher than I think some people would have guessed,” said study co-author Dr. Louis Bont, a professor of pediatric infectious diseases at Wilhelmina Children’s Hospital at University Medical Center Utrecht in the Netherlands. Bont is also the founding chairman of the ReSViNET foundation, a nonprofit dedicated to reducing the global burden of RSV infection.

    The estimates are based on a study that looked at the number of RSV cases in 9,154 infants born between July 2017 and April 2020 who were followed for the first year of life. The babies received care at health centers across Europe.

    About 1 in 1,000 children in the study were put in an intensive care unit to get help breathing from a mechanical ventilator. This care is vital: In parts of the world where there is a lack of hospital care, the risk of death is significant.

    “The vast majority of deaths with RSV occur in developing countries,” Bont said. “In the developed world, mortality is really rare, and if it happens, it’s virtually only in those who have severe comorbidities. But in most places in the world, there is no intensive care unit.”

    Globally, RSV is the second leading cause of death during the first year of a child’s life, after malaria. Between 100,000 and 200,000 babies die from the virus every year, Bont said.

    There are fewer RSV deaths in high-income countries, but the virus still causes substantial morbidity, and even hospitalization can have serious effects, said Dr. Kristina Deeter, chair of pediatrics at the University of Nevada, Reno and a specialty medical officer for pediatric critical care at Pediatrix Medical Group.

    “Whether that is just traumatic psychosocial, emotional issues after hospitalization or even having more vulnerable lungs – you can develop asthma later on, for instance, if you’ve had a really severe infection at a young age – it can damage your lungs permanently,” said Deeter, who was not involved in the new study. “It’s still an important virus in our world and something that we really focus on. It’s kind of the bread and butter of a pediatric ICU.”

    Health-care providers know that November through March is the traditional “viral season,” and they must plan accordingly for RSV and other respiratory problems.

    Dr. Nicholas Holmes, senior vice president and chief operating officer at Rady Children’s Hospital in San Diego, said officials there are always sure to have enough respiratory therapists and physicians to manage the influx of cases.

    Even then, at the largest pediatric hospital on the West Coast, officials have had to get creative to keep up with the patient load, Holmes said.

    “One thing that we just recently implemented to help is that we have many clinicians who are licensed nurses or therapists, or physicians like myself, who are in nonclinical roles in the organization. So we are engaging those licensed staff back in to help support and bridging that gap to support our nurses, physicians who are in direct line of patient care,” Holmes said.

    On Wednesday, Holmes said, through the hospital’s Helping Hands program, he spent an hour and a half in the emergency department rather than doing his usual work. He checked on families and patients, handing out blankets and fruit pops. It gave him a chance to watch for problems and alert nurses if a child was getting sicker and needed medical attention right away.

    “This allows the nursing team in the triage area to really focus on the sickest of the sick kids,” Holmes said.

    Although there is no specific treatment for RSV in healthy babies, recent developments around vaccines and therapies mean help could be on the way for busy hospitals.

    There is only one monoclonal antibody treatment for patients who have pre-existing conditions or who were born prematurely. It’s been available since 1998 and has made a significant difference, Deeter said.

    “Once premature babies started to receive that, the numbers drastically dropped,” she said. “It is incredibly rare at this point for us to put a baby on a ventilator for RSV. This tiny, fragile group is so well-protected by those injections; however, we still have thousands of babies coming in who didn’t receive those injections who still need supportive care, and often, they’re managed without a respiratory support system.”

    There are things parents of infants can do to prevent RSV, said Dr. Priya Soni, an assistant professor of pediatric infectious diseases at Cedars Sinai Medical Center. They’re the simple behaviors everyone is familiar with from the Covid-19 pandemic: Thoroughly wash your hands, stay home if you’re sick, and keep surfaces clean.

    “The virus is a little more hardy on hard surfaces, so really cleaning those surfaces and hand-washing goes a long way with RSV, as well as limiting the child’s exposure to infected respiratory secretions and droplets overall,” said Soni, who wasn’t involved in the new research.

    The study’s findings about the number of children who get RSV in the first months of life show how important it will be to have an immunization strategy for pregnant women, she said.

    “Whatever we could do to close that gap for those young infants that are within the first six months of life, that may be really really prone to that RSV infection, will help,” Soni said.

    In the US, four RSV vaccines may be nearing review by the FDA. Globally, more than a dozen are going through trials. A preventive treatment for lower respiratory tract infections caused by RSV got the go-ahead from the European Commission last week.

    These developments can be game-changers, experts say.

    “Every pediatrician that I know has always been working very, very hard during Christmastime. We are always swamped with RSV patients every year,” Bont said. “This or next year could be the last time that we actually see that, because it could really prevent the bulk of severe infection.”

    Read original article here

    Health

    Respiratory illness: When to go to the ER

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    CNN
     — 

    Respiratory viruses including flu and RSV are circulating across the United States at high levels, overwhelming children’s hospitals and prompting concern among parents of young children. Most kids who get sick this season will recover quickly with home care, but some will need medical attention. What should parents watch for, and how might they know it’s time to call their pediatrician or go to the ER?

    CNN spoke with Dr. Edith Bracho-Sanchez, director of pediatric telemedicine at Columbia University Irving Medical Center, about warning signs of serious illness and the steps parents and children can take to help protect themselves from germs. The following is an edited version of that conversation.

    CNN: How quickly can a baby or a small child go from being totally fine to needing urgent medical care?

    Dr. Edith Bracho-Sanchez: Every child is different in terms of when they’re going to show signs that it’s time to go into the emergency room or to the pediatrician’s office. I worry the most about the very small babies, the babies under 6 months of age, because their airways are so small. For kids of different ages, they might get worse at different points in any illness.

    Kids who are less than 6 months of age can really turn the corner really quickly and get worse at home, really out of nowhere, so it’s so important that parents learn the signs and know when to look for help. Older kids tend to get sick more gradually. It is important in that case as well to know when to look for help.

    CNN: As a pediatrician, what warning signs do you look for when it comes to these respiratory viruses that mean it might be time for someone to go to the hospital?

    Bracho-Sanchez: Any time a child is starting to have trouble breathing – by that I mean they’re getting tired, they look like it’s effort that they have to put in with breathing, it’s time to come into the emergency room. Any time a child is getting dehydrated or any time a fever is not coming down at home or has been there for more than three days, it’s time to come in and see us.

    CNN: We hear people talk about signs of “respiratory distress,” but what does that look like?

    Bracho-Sanchez: Signs of trouble include starting to use muscles that they don’t usually use to breathe – by that I mean using the muscles of the nostrils and then using muscles in between their ribs. Any time you’re noticing that a child is starting to use those additional muscles to breathe or is starting to breathe fast, that means they’re really having a hard time breathing, and it’s time to go to the emergency room.

    CNN: Is there any point in trying to treat these things at home? Or is it already time to get in the car?

    Bracho-Sanchez: If you’re starting to see signs of respiratory distress at home, call your pediatrician. If you know that it’s going to take several hours or a couple of days to reach your pediatrician, go to the emergency room. Your child needs to be seen more and more urgently at that point.

    CNN: Once you start to notice that something is wrong, how do you make the decision on where to go for help?

    Bracho-Sanchez: First and foremost, when you’re deciding where to take your child, I think it’s important to listen to your own gut and intuition as a parent. If you feel that your child needs medical attention right now, go to the emergency room, no questions asked. We’re always so glad to help you.

    If you think your child has been getting worse gradually or your child is not improving, you may be able to call the pediatrician first.

    If your child gets sick on weekends or at a time when you cannot reach your pediatrician, that might be a good place to go to urgent care instead of going to the emergency room first.

    CNN: Many children’s hospitals across the country are operating at capacity. If I look online and see that the hospital wait times are just outrageous, what is my best bet as a parent?

    Bracho-Sanchez: If your child is showing signs of respiratory distress and you feel that it’s time to go to the emergency room, go to the emergency room.

    I think it’s important for parents to know that when you come in to see us, we do what’s called triaging. Kids who need urgent, immediate medical attention are seen first. So that is slightly unfortunate for parents who might be there for a broken bone or because their kids might have fallen. I think those parents are unfortunately going to have a longer wait. But if your child is having respiratory distress, we are not going to make you wait. We’re going to help your child right away.

    CNN: A lot of children get sick. Not all of them need this kind of care. How many kids are going to be able to be treated at home?

    Bracho-Sanchez: It’s important to note that almost all kids are going to catch a cold or some sort of respiratory illness this season. Most kids are going to recover at home and are going to be totally, totally fine with a little bit of rest and extra fluids and a parent who’s watching them at home. It is a very small minority of children who are going to get enough complications or respiratory distress that it is going to need medical attention.

    CNN: In addition to a thermometer, are there any devices that might be helpful for parents to have at home, such as a pulse oximeter?

    Bracho-Sanchez: The best device you can have at home as a parent is your own educated intuition. Any time that you are noticing signs of respiratory distress, I don’t think you should waste time trying to get a blood oxygen measurement or trying to do an additional maneuvers at home. When you are spotting those signs, it is time to come in and see us – at least, at a minimum, give us a call if you know that you’re going to be able to get a hold of us right away. But please don’t delay getting your child’s medical attention.

    CNN: There are vaccines for flu and Covid-19 but not for RSV. How can you protect yourself from all of these things?

    Bracho-Sanchez: During respiratory season, there are so many things that we as parents cannot control, but there are some ways to protect our kids from severe respiratory illnesses and the complications of those severe respiratory illnesses. That includes getting a flu shot and getting the Covid vaccine, including all of the boosters they’re eligible for.

    Kids adapt and learn so many things as long as we adults set the example for them. So this respiratory season, it’s so important that we teach them to wash their hands frequently, to cough into their elbows, to cover their coughs and sneezes with tissues when appropriate and to stay home if they’re not feeling well.

    Read original article here

    Health

    Who should get the flu vaccine and why? Our medical analyst explains

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    CNN
     — 

    Welcome to this year’s flu season.

    This year’s flu strain has already begun spreading across the United States, according to new data from the US Centers for Disease Control and Prevention. There have been at least 880,000 cases of influenza, nearly 7,000 hospitalizations and, tragically, 360 deaths from the flu this fall, including one pediatric death. Not since 2009, during the height of the H1N1 swine flu pandemic, have there been this many cases of influenza so early in the season.

    Despite these numbers, many people wonder if the flu is really that serious of an illness. What’s the benefit of the vaccine, especially if some people may still get the flu despite being vaccinated? Could you get the flu from the vaccine? If you get the Covid vaccine, do you still need the flu vaccine?

    To guide us through these questions and more, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician, public health expert and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.”

    CNN: Is the flu a serious illness? What symptoms do people experience?

    Dr. Leana Wen: It certainly can be serious. The CDC estimates that flu resulted between 9 million and 41 million illnesses, 140,000 to 710,000 hospitalizations, and 12,000 to 52,000 deaths annually across the US between 2010 and 2020.

    Symptoms of the flu include fever, muscle aches, headaches, fatigue, coughing and a runny nose. A lot of people recover within several days, but some may still be feeling unwell as long as 10 days to two weeks after the onset of their symptoms. Some will develop complications, including sinus and ear infections, pneumonia, and inflammation of the brain. The flu can also exacerbate underlying medical conditions — for example, people with chronic lung and heart diseases can see their conditions worsen due to the flu.

    Even generally healthy people can become very ill due to the flu. However, those particularly susceptible to severe outcomes include those 65 and older, young children under 2, pregnant people and people with underlying medical conditions.

    CNN: What’s the benefit of the vaccine, especially if some people may get the flu despite being vaccinated?

    Wen: The flu vaccine does two things. First and most importantly, it reduces your chance of severe illness — that is, of being hospitalized or dying. Second, it can also reduce your likelihood of getting sick from the flu at all.

    In a sense, this is not too different from the Covid-19 vaccine. The most important reason to get vaccinated against both the flu and the coronavirus is to prevent severe illness. New data released in the CDC’s latest morbidity and mortality report shows this year’s flu vaccine reduces the risk of hospitalization by about 50%. A 2018 study found that people vaccinated against the flu were 59% less likely to be admitted to the ICU due to influenza when compared with those who were unvaccinated.

    The vaccine’s effectiveness can vary depending on how well matched the vaccine is to circulating influenza strains. The CDC cites vaccine effectiveness against “medically attended illness” anywhere from 23% to 61% depending on the year and vaccine-to-strain match. It’s true, then, that you could get the flu vaccine and still contract the flu. But the vaccine does reduce your chance thereof — and, crucially, it reduces the likelihood that you could end up very ill.

    Another thing to consider is that there are a lot of other viruses that can cause flu-like symptoms. The flu vaccine helps protect against viral infections caused by influenza, but there are a lot of other causes of viral syndromes, including adenovirus, rhinovirus, parainfluenza and others. These other viruses spread easily, too, and there aren’t vaccines against them. I often hear patients say they once got the flu the same year they had a flu vaccine, and that’s why they don’t want to get vaccinated again. But when I ask them whether they were actually diagnosed with the flu or just had flu-like symptoms, they would say the latter.

    CNN: Should children and pregnant people also get the flu vaccine?

    Wen: Absolutely. These are groups particularly vulnerable to severe outcomes, so it’s very important they receive the flu vaccine.

    One study found the flu vaccine reduces children’s risk of severe life-threatening influenza by 75%. Another found it reduced flu-related emergency department visits in children by half.

    Similar results are found in people who are pregnant. Not only does the flu vaccine protect the pregnant person, if the vaccine is given during pregnancy it also helps protect their baby from the flu for the first few months of its life. That’s important, because the flu vaccine is not available to babies until they are 6 months or older.

    CNN: Could you get the flu from the vaccine?

    Wen: No. The flu vaccine is an inactivated vaccine, which means it does not contain the live virus and therefore cannot cause the flu. It is also a very well-tolerated vaccine, with the most common side effect being discomfort at the injection site that is gone after a day.

    CNN: If you got the Covid-19 vaccine, do you still need the flu vaccine?

    Wen: Yes. Different vaccines target different viruses. The Covid vaccine helps to protect against Covid, but does not protect against the flu, and vice versa. You can receive the Covid vaccine (or bivalent booster) at the same time as you receive the flu vaccine, just in a different injection site.

    CNN: Some people have been waiting until later in the flu season to get the flu vaccine. Is this a good idea?

    Wen: At this point, no, because it’s now clear this flu season is starting earlier than usual. Cases are already high, and it takes about two weeks to reach optimal immune protection after vaccination. I’d encourage people who have not yet received the flu vaccine to get it now.

    CNN: What should people know about treatments for the flu?

    Wen: Most cases of the flu can be treated symptomatically, meaning patients get rest, hydration and treatment for symptoms that come up — such as fever-reducing medicines like acetaminophen or ibuprofen. There are also antiviral treatments available. These are really important for people at high risk for severe influenza complications and/or who are very ill. The earlier such treatments are started, the better. An oral medication, oseltamivir (Tamiflu), can also be given to non-high-risk patients, too, within 48 hours of the start of their illness.

    I’d encourage everyone to have an influenza plan, the same way they should have a Covid plan. Ask your doctor in advance if you should receive Tamiflu or another antiviral treatment. Know how you can get testing and where you can access treatment, including after hours and on weekends.

    CNN: How can people prevent catching the flu?

    Wen: The flu is primarily spread through droplets — if an infected person coughs or sneezes, these droplets can land on someone else nearby. It’s also possible that the droplets land on a surface, from which someone gets infected after touching it and then touching their nose, mouth or eyes.

    We can help to reduce flu transmission by staying away from others while symptomatic. We should all cough or sneeze into our elbow or a tissue, and wash our hands frequently, including after touching high-contact surfaces. Individuals particularly vulnerable to severe outcomes should consider wearing a mask to reduce their chance of contracting viral illnesses like the flu. And, of course, get vaccinated!

    Read original article here

    Health

    Drinking caffeine while pregnant impacts child’s height: Study

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    Editor’s Note: Sign up for CNN’s Eat, But Better: Mediterranean Style. Our eight-part guide shows you a delicious expert-backed eating lifestyle that will boost your health for life.



    CNN
     — 

    Starting the day with a hot cup of caffeinated coffee or tea may sound divine to some, but it could have negative impacts for the children of people who are pregnant, according to a new study.

    Children who were exposed to small amounts of caffeine before birth were found on average to be shorter than the children of people who did not consume caffeine while pregnant, according to the study published Monday in JAMA Network Open.

    Children of parents who consumed caffeine while they were in the womb were shown to be shorter in stature at age 4 than those whose parents did not — and the gap widened each year through age 8, according to lead author Dr. Jessica Gleason, a perinatal epidemiologist.

    “To be clear, these are not huge differences in height, but there are these small differences in height among the children of people who consumed caffeine during pregnancy,” said Gleason, who is a research fellow at Eunice Kennedy Shriver National Institute of Child Health and Human Development.

    The American College of Obstetricians and Gynecologists currently recommends limiting caffeine consumption to less than 200 milligrams per day while pregnant.

    For context, a mug of caffeinated tea typically has about 75 milligrams of caffeine, a mug of instant coffee has about 100 milligrams and a mug of filtered coffee has about 140 milligrams, according to the Cleveland Clinic. And even chocolate has about 31 milligrams of caffeine.

    But the differences found in the most recent study were found even in the children of parents who drank less than half a cup of coffee per day while pregnant — well below the current guidelines, Gleason said.

    It’s not clear whether this study effectively shows causation between maternal caffeine consumption and child height, according to Dr. Gavin Pereira, a professor of epidemiology and biostatistics at Curtin University in Australia. Pereira was not involved in the study.

    “The correlation observed in this study can be explained by the existence of a common cause of both caffeine consumption and growth restriction e.g., poverty, stress, and dietary factors,” said Pereira in a statement to the Science Media Centre.

    If shorter height in early childhood were to persist into adulthood, there would be a chance those children could face the risk of poor cardiometabolic outcomes, such as heart disease and diabetes, which are associated with smaller stature.

    But there is still no way to know if the difference would persist into adulthood, and studies like this that focus on population outcomes are no reason for individual families to panic, Gleason said.

    These population-level trends should instead be taken together with other research for organizations to reassess their recommendations, Gleason said.

    In the past, there were inconsistent studies regarding whether consuming caffeine during pregnancy impacted the fetus, but the evidence has come together in recent years, Gleason said.

    A 2015 meta-analysis that reviewed all of the existing research found there is a dose response association between consumption of caffeine and smaller birth size. And a 2020 study revealed there is no safe level of caffeine for a developing fetus.

    Even without the panic that Gleason cautioned against, some people might want to cut back on caffeine — and then find that it’s easier said than done.

    Remember, caffeine is found in coffee, tea, soft drinks, energy drinks and shots, as well as cocoa and chocolate. It’s also present in fortified snack foods, some energy bars and even some pain medications. (For a more extensive list of caffeine content from various sources, check the chart from the Center for Science in the Public Interest.)

    A 2016 Johns Hopkins University study found that it was helpful when individuals identified situations or moods in which they are most likely to crave caffeine so they could avoid situations that trigger cravings, especially during the first few weeks of modifying caffeine use. Caffeine drinkers could also have a plan for when cravings occur, like taking a five-minute relaxation break involving deep-breathing exercises.

    Remember to always discuss any major lifestyle or dietary changes with your health care provider first, as changes may affect your mood or medical conditions.

    Read original article here

    Health

    Drinking caffeine while pregnant impacts child’s height: Study

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    Editor’s Note: Sign up for CNN’s Eat, But Better: Mediterranean Style. Our eight-part guide shows you a delicious expert-backed eating lifestyle that will boost your health for life.



    CNN
     — 

    Starting the day with a hot cup of caffeinated coffee or tea may sound divine to some, but it could have negative impacts for the children of people who are pregnant, according to a new study.

    Children who were exposed to small amounts of caffeine before birth were found on average to be shorter than the children of people who did not consume caffeine while pregnant, according to the study published Monday in JAMA Network Open.

    Children of parents who consumed caffeine while they were in the womb were shown to be shorter in stature at age 4 than those whose parents did not — and the gap widened each year through age 8, according to lead author Dr. Jessica Gleason, a perinatal epidemiologist.

    “To be clear, these are not huge differences in height, but there are these small differences in height among the children of people who consumed caffeine during pregnancy,” said Gleason, who is a research fellow at Eunice Kennedy Shriver National Institute of Child Health and Human Development.

    The American College of Obstetricians and Gynecologists currently recommends limiting caffeine consumption to less than 200 milligrams per day while pregnant.

    For context, a mug of caffeinated tea typically has about 75 milligrams of caffeine, a mug of instant coffee has about 100 milligrams and a mug of filtered coffee has about 140 milligrams, according to the Cleveland Clinic. And even chocolate has about 31 milligrams of caffeine.

    But the differences found in the most recent study were found even in the children of parents who drank less than half a cup of coffee per day while pregnant — well below the current guidelines, Gleason said.

    It’s not clear whether this study effectively shows causation between maternal caffeine consumption and child height, according to Dr. Gavin Pereira, a professor of epidemiology and biostatistics at Curtin University in Australia. Pereira was not involved in the study.

    “The correlation observed in this study can be explained by the existence of a common cause of both caffeine consumption and growth restriction e.g., poverty, stress, and dietary factors,” said Pereira in a statement to the Science Media Centre.

    If shorter height in early childhood were to persist into adulthood, there would be a chance those children could face the risk of poor cardiometabolic outcomes, such as heart disease and diabetes, which are associated with smaller stature.

    But there is still no way to know if the difference would persist into adulthood, and studies like this that focus on population outcomes are no reason for individual families to panic, Gleason said.

    These population-level trends should instead be taken together with other research for organizations to reassess their recommendations, Gleason said.

    In the past, there were inconsistent studies regarding whether consuming caffeine during pregnancy impacted the fetus, but the evidence has come together in recent years, Gleason said.

    A 2015 meta-analysis that reviewed all of the existing research found there is a dose response association between consumption of caffeine and smaller birth size. And a 2020 study revealed there is no safe level of caffeine for a developing fetus.

    Even without the panic that Gleason cautioned against, some people might want to cut back on caffeine — and then find that it’s easier said than done.

    Remember, caffeine is found in coffee, tea, soft drinks, energy drinks and shots, as well as cocoa and chocolate. It’s also present in fortified snack foods, some energy bars and even some pain medications. (For a more extensive list of caffeine content from various sources, check the chart from the Center for Science in the Public Interest.)

    A 2016 Johns Hopkins University study found that it was helpful when individuals identified situations or moods in which they are most likely to crave caffeine so they could avoid situations that trigger cravings, especially during the first few weeks of modifying caffeine use. Caffeine drinkers could also have a plan for when cravings occur, like taking a five-minute relaxation break involving deep-breathing exercises.

    Remember to always discuss any major lifestyle or dietary changes with your health care provider first, as changes may affect your mood or medical conditions.

    Read original article here