Thursday, September 25, 2014

What is Enterovirus D68?

Parents have been asking what is the Enterovirus D68--So here are a few questions and answers straight from the CDC that we hope will help.  Please call us if you have any questions.

 Q: What is enterovirus D68?

A: Enterovirus D68 (EV-D68) is one of many non-polio enteroviruses. This virus was first identified in California in 1962, but it has not been commonly reported in the United States.

Q: What are the symptoms of EV-D68 infection?

A: EV-D68 can cause mild to severe respiratory illness.
  • Mild symptoms may include fever, runny nose, sneezing, cough, and body and muscle aches.
  • Most of the children who got very ill with EV-D68 infection in Missouri and Illinois had difficulty breathing, and some had wheezing. Many of these children had asthma or a history of wheezing.                  

Q: How does the virus spread?

A: Since EV-D68 causes respiratory illness, the virus can be found in an infected person’s respiratory secretions, such as saliva, nasal mucus, or sputum. EV-D68 likely spreads from person to person when an infected person coughs, sneezes, or touches contaminated surfaces.

States with Lab-confirmed EV‑D68 Infections

States with Confirmed EV-D68 Infections From mid-August to September 24, 2014, a total of 220 people in 32 states have been confirmed to have respiratory illness caused by EV-D68. Learn more about states with confirmed cases.

Q: How common are EV-D68 infections in the United States?

A: EV-D68 infections are thought to occur less commonly than infections with other enteroviruses. However, CDC does not know how many infections and deaths from EV-D68 occur each year in the United States. Healthcare professionals are not required to report this information to health departments. Also, CDC does not have a surveillance system that specifically collects information on EV-D68 infections. Any data that CDC receives about EV-D68 infections or outbreaks are voluntarily provided by labs to CDC’s National Enterovirus Surveillance System (NESS). This system collects limited data, focusing on circulating types of enteroviruses and parechoviruses.

Q: What time of the year are people most likely to get infected?

A: In general, the spread of enteroviruses is often quite unpredictable, and different types of enteroviruses can be common in different years with no particular pattern. In the United States, people are more likely to get infected with enteroviruses in the summer and fall.
We’re currently in middle of the enterovirus season, and EV-D68 infections are likely to decline later in the fall.

Q: Who is at risk?

A: In general, infants, children, and teenagers are most likely to get infected with enteroviruses and become ill. That's because they do not yet have immunity (protection) from previous exposures to these viruses. We believe this is also true for EV-D68.
Among the EV-D68 cases in Missouri and Illinois, children with asthma seemed to have a higher risk for severe respiratory illness.

Q: How is it diagnosed?

A: EV-D68 can only be diagnosed by doing specific lab tests on specimens from a person’s nose and throat.
Many hospitals and some doctor’s offices can test ill patients to see if they have enterovirus infection. However, most cannot do specific testing to determine the type of enterovirus, like EV-D68. Some state health departments and CDC can do this sort of testing.
CDC recommends that clinicians only consider EV-D68 testing for patients with severe respiratory illness and when the cause is unclear.
Respiratory illnesses can be caused by many different viruses and have similar symptoms. Not all respiratory illnesses occurring now are due to EV-D68. Anyone with respiratory illness should contact their doctor if they are having difficulty breathing, or if their symptoms are getting worse.

Q: What are the treatments?

A: There is no specific treatment for people with respiratory illness caused by EV-D68.
For mild respiratory illness, you can help relieve symptoms by taking over-the-counter medications for pain and fever. Aspirin should not be given to children.
Some people with severe respiratory illness may need to be hospitalized.
There are no antiviral medications currently available for people who become infected with EV-D68.

Q: How can I protect myself?

A: You can help protect yourself from respiratory illnesses by following these steps:
  • Wash hands often with soap and water for 20 seconds, especially after changing diapers.
  • Avoid touching eyes, nose and mouth with unwashed hands.
  • Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick.
  • Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
Also, see an infographic that shows these prevention steps.
Since people with asthma are higher risk for respiratory illnesses, they should regularly take medicines and maintain control of their illness during this time. They should also take advantage of influenza vaccine since people with asthma have a difficult time with respiratory illnesses.

Q: What should people with asthma and children suffering from reactive airway disease do?

A: CDC recommends:
  • discuss and update your asthma action plan with your primary care provider.
  • take your prescribed asthma medications as directed, especially long term control medication(s).
  • be sure to keep your reliever medication with you.
  • if you develop new or worsening asthma symptoms, follow the steps of your asthma action plan. If your symptoms do not go away, call your doctor right away.
  • parents should make sure the child’s caregiver and/or teacher is aware of his/her condition, and that they know how to help if the child experiences any symptoms related to asthma.

Q: Is there a vaccine?

A: No. There are no vaccines for preventing EV-D68 infections.

**All Info from

Tuesday, September 23, 2014

Parent Teacher Conference Tips

Parent Teacher Conference are right around the corner! Dr Jopling found a great article that address how to be prepared with the best questions for your time with the teacher.

LA Johnson/NPR So you finally get the chance to meet one on one with your child's teacher — now what?
Like a good Boy Scout, be prepared: Educators agree that doing your homework before a parent-teacher conference can make a big difference.
The Harvard Family Research Project's Tip Sheet for Parents suggests reviewing your child's work, grades and past teacher feedback. Ask your child about his experience at school and make a list of questions ahead of time to ask during the conference. A good parent-teacher conference, experts say, should cover three major topics: the child, the classroom and the future.
The Child
Most experts suggest telling the teacher about your child: Describe what they're like at home, what interests and excites them, and explain any issues at home that may be affecting your child at school.
"Often times we don't have any understanding of what happens when a child leaves school," says Amanda Wirene, a reading specialist at the Montessori School of Englewood in Chicago. "Often parents are our only way to know what's going on at home."
Be thorough, but do be aware of the time.
"You always get that one parent who wants to stay forever and tells you in great detail all about their child," says Colleen Holmes, assistant principal at Lincoln Elementary School in Erie, Pa. Share information, she says, and if you need to talk more, schedule another time.
The Classroom
Ask about what's happening in the classroom — both academically and socially.
"Parents have more access to student information than ever before," says Scot Graden, superintendent of Saline Area Schools in Saline, Mich. "Chances are, anything that's going to come up at parent-teacher conferences, the student will already know about it."
By talking to your child in advance, you can ask more specific questions about grades or behaviors, says Graden.
Don't be afraid to ask the teacher to clarify what assessment or grades actually mean.
"Teachers can sometimes use educational jargon that may seem alien to you," Karen Mira writes in The Asian Parent, a parenting magazine in Singapore. "Don't be shy to ask your child's teacher to explain what a certain educational word means."
If teachers bring up areas for improvement, don't get defensive, says Holmes, the elementary school assistant principal.
And don't let the meetings be a dumping ground for pent-up concerns or frustrations.
"We don't want parents to load up on things they've wanted to discuss and are looking to have a sort of 'gotcha' moment," says Graden.
The same holds true for teachers: Lindsay Rollin, a second-grade teacher at Teachers College Community School in New York, says conferences should never be the first time parents are hearing about problems their child is having.
"I am not dropping bombs on anybody," she says.
Before the meeting is over, you should be sure you're clear on the teacher's expectations for your child.
"It's important for everyone to understand what the goal is at the end of the year," says Graden, the school superintendent. "That way you all have a stake in that success."
The Future
Spin the conversation forward and ask what you can do to help.
Parent-teacher conferences are no longer a once-a-year check-in; they can provide useful insight for immediate and clear next steps.
"Conferences are now a progress report timed so parents can actually do something about what they learn from teachers," says Heather Bastow Weiss, founder and director of the Harvard Family Research Project.
To get the most out of the conversation, she says, both the teacher and the parent should know what comes next. Brainstorm with the teacher to come up with ways to solve challenges your child faces. Ask for concrete examples of things you can do at home to help.
"Go in looking for an opportunity to get involved with supporting your child," advises Holmes, who taught for 16 years before becoming an administrator. Parents should leave knowing the resources that are available to them, says Holmes, such as teacher or school websites and assignment calendars.
Ask if the teachers can recommend resources outside of school.
"There are many out-of-school programs that can help kids improve their success in school," says Weiss. "The nonschool learning experience should be part of the conversation at conferences."
Concrete next steps are essential, says Graden. If parents feel as though they didn't get answers to all of their questions, he recommends trying to connect with the teacher again within a week.
"We want both the teacher and the parent to have a positive experience," he says. "When parents and teachers work together, the results are always better."

Thursday, September 11, 2014

Flu shots are here!

It is that time again to get your annual flu shot or flu mist. Flu shots for all children ages 6 months and up, as well as FluMist for all children ages 2 years and up!  All of our doctor's do recommend getting an annual flu vaccination.
Flu vaccines will be by appointment only; Tuesday from 9-5, Wednesday 2pm-6pm, Thursday 2-7 pm. We will add another morning as the need increases. We will not be doing walk-in flu vaccines this year.  At this time we do NOT have any VFC flu shots or mist. Please call us with any questions.
Please contact your insurance company prior to your appointment to find out if they cover the flu vaccine and if they require a copay.  Most insurance companies do require a copay anytime a fee is generated.  If you choose not to pay your copay at the time of service, there is an additional $5 fee to bill you for your copay.

Monday, September 8, 2014

Family dinners may help kids cope with cyberbullying

Dr Jopling found a great article! Another great suggestion in helping our kids!

NEW YORK (Reuters Health) – Like victims of face-to-face bullying, kids who experience internet bullying are vulnerable to mental health and substance use problems – but spending more time communicating with their parents may help protect them from these harmful consequences, a new study suggests.
For example, the researchers found, regular family dinners seemed to help kids cope with online bullying. But they say talk time with parents in cars or other settings can also help protect against the effects of cyberbullying.
“In a way, cyberbullying is more insidious because it’s so hard to detect,” said lead author Frank J. Elgar of the Institute for Health and Social Policy at McGill University in Montreal.
“It’s hard for teachers and parents to pick up on,” Elgar told Reuters Health by phone.
He and his team used voluntary, anonymous survey data from more than 18,000 teens at 49 schools in Wisconsin.
About one in five students said they’d been bullied on the Internet or by text messaging at least once over the past year.
“The good news is that most of the kids in this sample from Wisconsin had not been cyberbullied,” Elgar said.
Cyberbullying was more common for girls than for boys, for kids who’d been victims of face-to-face bullying, and for those who themselves had bullied other kids in person. Cyberbullying tended to increase as students got older.
Youngsters who’d been cyberbullied were more likely to also report mental health problems like anxiety, self-harm, thoughts of suicide, fighting, vandalism and substance use problems, according to results in JAMA Pediatrics September 1.
Almost 20 percent of the kids reported an episode of depression, while around five percent reported suicide attempts or misuse of over the counter or prescription drugs.
Teens who were often cyberbullied were more than twice as likely to have been drunk, fought, vandalized property, or had suicidal thoughts, and were more than four times as likely to have misused drugs than those who were never cyberbullied.
One survey question asked how many times each week the teen ate the evening meal with his or her family.
As the number of weekly family dinners increased, the differences in mental health issues for kids who were or were not cyberbullied decreased.
“It’s hard for parents to know where kids are spending time online on their smartphone, laptop or other device,” said Catherine P. Bradshaw of the Johns Hopkins Bloomberg School of Public Health in Baltimore.
“It’s more challenging for parents to be able to monitor,” she said.
Bradshaw wrote a commentary that was published in the same issue of the journal, along with the researchers’ paper.
“We don’t know exactly what those parents were talking about at dinner, but we do know they were spending more time together face to face,” she told Reuters Health by phone.
Family discourse can happen in many settings, including at dinner or while driving around in the car, she noted.
“If parents want to try to figure out how many nights a week should I turn off the TV and spend time with my kids, it’s nice to see data on this,” she said.
Parents who have an opportunity to talk to their kids about bullying problems should emphasize that it wasn’t the victim’s fault and that you shouldn’t hit back or retaliate, Bradshaw said.
“The more contact and communication you have with young people, the more opportunities they have to express problems they have and discuss coping strategies,” Elgar said. “Essentially the relationships between victimization and all other mental health outcomes were lessened with more frequent family dinners.”
Family dinners are a proxy indicative of a range of other contextual factors that affect kids relating to family contact open communication, he said. Many families aren’t able to have family dinners together, but that doesn’t mean the kids are out of luck or that communication can’t happen, he said.
“It would be wrong to focus solely on family dinners as the active ingredient in all this,” Elgar said.
“The message that comes through for us is to talk to your kids,” he said. “Unless you take time to check in, a lot goes undetected.”

SOURCE: and JAMA Pediatrics 2014.