Pediatric Inflammatory Multisystem Syndrome (PIMS): What Parents Should Know

Posted on May 13, 2020February 25, 2021 by Allied

We have been sheltering at home and following the recommendations of social distancing, handwashing and wearing a mask when we have to go out. The good news in our area is the dropping mortality and hospitalization rates of COVID patients. There is a new concern, however, for our children – Pediatric Multisystem Inflammatory Syndrome or PIMS.

PIMS is a very rare syndrome similar to Kawaski Disease and Toxic Shock syndrome, which most of you have never heard about. While extremely rare, about 100 children have been affected. The syndrome is thought to be a post-viral process, most likely related to COVID 19. The majority of patients with PIMS are COVID-antigen negative, but antibody positive or have a history of close contact with a COVID-positive patient.

Children with PIMS look sick. They have had a few days of fever greater than 101, and may have symptoms that include abdominal pain, vomiting, diarrhea, headache, rash, red eyes, swollen hands or red cracked lips. Younger children may not want to drink. Few patients actually have the respiratory symptoms we see in adults.

Our concern is the syndrome may affect heart function requiring hospitalization and ICU care. The majority of children do well with this syndrome but they need special attention and supportive care. Pediatric Multi-system Inflammatory Syndrome is new. We are watching this very carefully and scientists around the world are working hard to understand this syndrome and how best to treat it.

Until then, we want to reassure parents that most children are not affected by the coronavirus, and reports of children who become seriously ill remain rare and unusual cases. Many children have red eyes, or rash or diarrhea without fever or looking ill. These children do not have PIMS. What should parents do? If you are concerned, contact your Allied pediatrician. We can set up a telehealth visit and your pediatrician can evaluate your child and answer all your questions.

We are here for you and we will get through this together.

It’s Flu Season- AGAIN

Posted on September 26, 2018February 26, 2021 by Allied

By: Fatema Meah, MD (Peconic Pediatrics, Riverhead & Southold, NY)

Back to school time is the right time to think about getting this year’s flu vaccine. In general, flu season runs from October until April, and most cases are seen in the winter months. The peak of influenza disease in the Northeast is typically in February but varies every season. It is ideal to get your flu shot early in flu season.

Why should you get the flu vaccine? Influenza, or “the flu”, affects between 5 – 20% of our population. It is responsible for 200,000 hospital admissions and 36,000 deaths each year. Last year was especially severe with over 180 pediatric deaths and over 700,000 hospitalizations for flu-related illnesses. These are the highest numbers recorded since surveillance began. Influenza is the most common vaccine-preventable illness we see!

What is Influenza? Influenza is a respiratory illness caused by influenza viruses. There are two main types of virus: influenza A and influenza B. Each type includes many different strains, which tend to change each year. This is why flu shots must be given every year.

Influenza is extremely contagious and is easily transmitted through contact with droplets from the nose and throat of an infected person during coughing and sneezing. These viruses may also be spread when a person touches these droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.

If you have ever had “the flu” you know it is no fun. Symptoms may include high fever, body aches, headache, dry cough, sore throat, and extreme fatigue. Stomach symptoms like nausea, vomiting, and diarrhea can occur and are much more common in children than in adults.

Although anyone can get the flu, there are some groups that are at high risk for complications. The high-risk groups include:

Adults 50 and older, especially those 65 and older;
Children 6 months – 18 years;
People age 6 months and older with chronic medical conditions, including heart disease, pulmonary disorders (including asthma), diabetes, kidney disease, hemoglobinopathies, and compromised immune systems (HIV or immunosuppressive therapy);
People with certain conditions (such as neuromuscular disorders) that can cause breathing problems
Pregnant women
Residents of nursing homes and chronic-care facilities

Other individuals are at high risk of transmitting the flu. These include:

Health care workers involved in direct patient care;
Out-of-home caregivers and household contacts of children aged < 6 months.

There are 2 vaccines available to prevent influenza. The first is the “flu shot”— an inactivated vaccine containing a killed virus. The flu shot is approved for use in people older than 6 months, including healthy people, people with chronic medical conditions and pregnant women. The second is the nasal-spray flu vaccine— a vaccine made with live, weakened flu viruses. It is approved for use in healthy people 2-49 years of age.

This year there is some controversy about which vaccine is best. What is important is that you get one of them. If your child absolutely hates needles and will cause chaos for you getting “the shot” then opt for the nasal spray. What is most important overall is to be immunized and protected!

There are two common myths associated with the flu vaccine. The first is that the vaccine will give you the flu. It is not possible to get the flu from the flu vaccine! Side effects of the flu shot do include soreness, redness or swelling at the site of the injection, low-grade fever, and mild body aches. This is not the flu but your body’s response to the vaccine. Side effects of the nasal flu vaccine in children can include runny nose, cough, wheezing, headache, vomiting, muscle aches, and fever. In adults, side effects can include runny nose, headache, sore throat, and cough. The second myth is that the vaccine does not work. In years when the vaccine and circulating influenza viruses are well matched, the flu vaccine can be expected to reduce laboratory-confirmed influenza by 70 – 90%. In years when the viruses are not as well matched it will still lower incidence of disease as well as reduce severity in those who do get influenza. We must remember that not all flu-like illnesses are influenza, and the flu shot can only protect us against influenza viruses.

So is it time for your flu vaccine? Yes, the flu vaccine is now routinely recommended for everyone. That means babies over six months of age, children, and all adults including pregnant women. It takes about two weeks for your body to make a response to the vaccine. Call your doctor’s office to make an appointment today!

Meningitis: What Parents Need To Know

Posted on July 14, 2017March 3, 2021 by Allied

The Pennsylvania Department of Health confirmed a camper at an overnight camp passed away from a Neisseria Meningitidis infection.

The Health Department is directly involved and has contacted anyone who should receive prophylactic antibiotic due to increased risk from direct contact. The Health Department is very involved and we recommend following their recommendation.

The incubation period of meningitis is three to four days, with a range of two to 10 days. People spread meningococcal bacteria to other people by sharing respiratory and throat secretions (saliva or spit). Generally, it takes close (for example, coughing or kissing) or lengthy contact to spread these bacteria. Fortunately, they are not as contagious as germs that cause the common cold or the flu. The bacteria does not survive long outside the human body, and cannot be spread from touching contaminated surfaces. Symptoms include fever, headache, neck stiffness, vomiting, lethargy.

The best advice is to get vaccinated. Children are routinely vaccinated against Neisseria Meningitidis at 11 and 16 years of age with New York State requiring vaccination for children entering 7th or 12th grade. Sleepaway camp is not considered an indication for early vaccination, but early vaccination is allowed. Your pediatrician is a great source of vaccine information.

To understand more about the illness, please click on this link from the Center for Disease Control.

By: Dr. Eric Levene (Chester Pediatrics, Whiteplains, NY), Dr. Kerry Fierstein (Pediatrics Health Associates, Plainview, NY), Dr. Jennifer Shaer (Peconic Pediatrics, Riverhead & Southold, NY)