(Sept. 2) -- Ear infection is getting more and more common in kids, a new study suggests.
Ear infections increased throughout the 1980s. That trend continued through 1994, report University of Rochester researcher Peggy Auinger and colleagues in the September issue of Pediatrics.
By 1994, nearly half of all kids got ear infections during their first year of life. And more than 40% of kids got them over and over again by age 6.
More Kids With More Infections
Auinger's team looked at surveys given to parents of more than 8,200 children. The families were representative of the U.S. as a whole. The percentage of kids who had ear infections before age 12 months increased from 41% to 46%. This suggests that across the U.S., 561,000 more kids got early-onset ear infections in 1991-1994 than in 1988-1991.
The percentage of kids who got three or more infections by age 6 years increased from 35% to 41%. This suggests that across the U.S., 720,000 more kids got repeated ear infections in 1991-1994 than in 1988-1991.
Are Vaccines Helping?
The Auinger study looks at data only up to 1994. In the decade since then, there's been more use of vaccines that prevent major causes of ear infections. Have they worked? The jury's still out. The bug thought to cause most ear infections is called Streptococcus pneumoniae. That's the target of the pneumococcal vaccine given to infants. And lots of kids get ear infections when they get the flu bug. More and more kids are getting annual flu vaccines, too. The number of ear infections is likely to change following widespread immunization of children with these vaccines, Auinger and colleagues suggest.
SOURCES: Auinger, P. Pediatrics, September 2003; vol 112: pp 514-520.
© 2003 WebMD Inc. All rights reserved.
Effectiveness of Inactivated Influenza Vaccine in Preventing Acute Otitis Media in Young Children
A Randomized Controlled Trial
Alejandro Hoberman, MD; David P. Greenberg, MD; Jack L. Paradise, MD; Howard E. Rockette, PhD; Judith R. Lave, PhD; Diana H. Kearney, RN; D. Kathleen Colborn, BS; Marcia Kurs-Lasky, MS; Mary Ann Haralam, CRNP; Carol J. Byers, CRNP; Lisa M. Zoffel, CRNP; Irene A. Fabian, CRNP; Beverly S. Bernard, CRNP; Jill D. Kerr, RN
Context Acute otitis media (AOM) frequently complicates influenza infection. Previous studies have found influenza vaccine effective in reducing the occurrence of AOM in children mainly older than 2 years.
Objective To evaluate the effectiveness of inactivated influenza vaccine in preventing AOM in children aged 6 to 24 months.
Design, Setting, and Patients Randomized, double-blind, placebo-controlled trial of 786 children aged 6 to 24 months enrolled at Children's Hospital of Pittsburgh before the 1999-2000 (411 children) and 2000-2001 (375 children) respiratory seasons (defined as December 1 through March 31 of the respective following year). Children received influenza vaccine or placebo in a 2:1 ratio. The first cohort was observed for 1 year and the second cohort until the end of the ensuing respiratory season.
Intervention Two doses (0.25 mL each) of inactivated trivalent subvirion influenza vaccine or placebo were administered intramuscularly approximately 4 weeks apart. Main Outcome Measures Proportion of children who developed AOM, monthly occurrence rate of AOM, estimated proportion of time with middle ear effusion, and utilization of selected health care and related resources.
Results Of the 66 children in the vaccine group from whom serum samples were collected, seroconversion against strains in the vaccine formulations developed in 88.6% to 96.8%, depending on the specific strain. The efficacy of the vaccine against culture-confirmed influenza was 66% (95% confidence interval [CI], 34%-82%) in 1999-2000 and -7% (95% CI, -247% to 67%) in 2000-2001; however, influenza attack rates differed between these 2 periods (in the placebo group, 15.9% and 3.3%, respectively). Compared with placebo, influenza vaccine did not reduce the proportion of children who had at least 1 episode of AOM during the respiratory season (in the first cohort: vaccine, 49.2% vs placebo, 52.2%; P = .56 ]; in the second cohort: vaccine, 55.8% vs placebo, 48.3%; P = .17). The vaccine also did not reduce the monthly rate of AOM; the estimated proportion of time with middle ear effusion; or the utilization of selected health care and related resources. There were also no differences between the vaccine and placebo groups regarding any of these outcomes during peak influenza periods. The vaccines administered to both cohorts of children were well tolerated.
Conclusion Administration of inactivated trivalent influenza vaccine to children aged 6 to 24 months did not reduce their burden of AOM or their utilization of selected health care and related resources.
Author Affiliations: Department of Pediatrics (Drs Hoberman, Greenberg, and Paradise), School of Medicine, and Departments of Biostatistics (Dr Rockette and Ms Kurs-Lasky) and Health Services Administration (Dr Lave), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pa; and Children's Hospital of Pittsburgh (Mss Kearney, Colborn, Haralam, Byers, Zoffel, Fabian, Bernard, and Kerr).
I would scream and cry, and mom would tell me, "Drink your milk. It's good for you." Parents cannot see earaches. Sometimes, they think the child pretends. Kids know when parents doubt their honesty. That's when it begins. The two-way distrust, caused by dairy cows. Some parents bring their kids to the doctor for surgery, thinking they know best for the child.
"Milk allergies are very common in children...They are the leading cause of the chronic ear infections that plague up to 40% of all children under the age of six."
Julian Whitaker, M.D., "Health & Healing," October, 1998, Volume 8, No. 10
"If a bottlefed baby has an ear infection, eliminate milk and dairy products from the child's diet for thirty days to see if any benefits result...a cause of frequent ear infections in children is food allergies."
James Balch, MD, "Prescription for Nutritional Healing" ISBN 0-89529-727-2
"Concerning ear infections, You just don't see this painful condition among infants and children who aren't getting cow's milk into their systems."
William Northrup, M.D., Natural Health July, 94
"Improve hearing," is the promising title of a thread on the HSI Forum this week. But improving on hearing that has been reduced with age is easier said than done. An HSI member named Robert starts the thread with this question: "Can hearing be improved without the application of hearing aids when the probable cause of the hearing loss was exposure to high intensity noise?"
A member who goes by the initials DGH knows what Robert is talking about. He says, "I grew up listening to loud music, as I know many of you probably did, so it will be interesting to see if we all end up with hearing aids. I thought hearing loss was usually caused by 'noise vibrations' that shear off the little ear hairs that are responsible for our hearing. Once gone, I thought you were just out of luck."
A member named Don has hearing impairment from the noise of guns being fired. He says, "It seems to me that it comes down to whether or not some hair cells within the ear are destroyed or
merely injured – thus with the potential for recovery." There are actually several ways that hearing can be damaged. Some people are simply genetically predisposed to suffer presbycusis; the medical term for age-related hearing loss. Ear infections, free-radical damage and reduced blood flow to the ear can impair hearing, as can the use of some antibiotics (streptomycin, neomycin and kanamycin) and chemotherapy.
A member named Patty has had an unfortunate experience with a popular diuretic drug. Patty writes: "Lasix causes hearing loss, big time! I have been taking Lasix for some years now because of a heart condition. I am now almost deaf because of it. A couple nurses told me that they know for sure that Lasix causes hearing loss. The pill book says so too, but does not tell how bad it can be."
Other diuretic agents may cause problems as well, according to a member named Ambar who believes that taking a high dose of the diuretic herb astragalus may have caused hearing problems. Ambar adds, "A physician told me that a vitamin B1 deficiency could have contributed to it as well. So I would wonder whether anyone taking Lasix should be taking B-complex. By the way, vitamin B-6
is a diuretic."
There are several natural treatments that may stop or even reverse hearing loss. The free-radical problem can be addressed with antioxidants such as zinc. And because reduced blood flow can affect every part of the body during aging, boosting the circulation of blood to the ears' auditory mechanisms may restore hearing. Some people have had good results using vinpocetine; a semi-
synthetic vasodilator (it increases circulation), derived from the periwinkle plant, and widely used to enhance both hearing and mental processes.
A member named Jerry offers this suggestion to improve hearing: "Apple Cider Vinegar is an excellent therapy. ACV should be taken as 1 tsp or so in a glass of water 3 times daily. Adding a tsp
of honey would be a plus."
A more artistic suggestion comes from a member named Gerry, who writes: "Hearing can be improved by listening to high frequency sounds. It seems that our ears are dulled by low frequency sounds, particularly if they're loud. Naturally rich in high frequencies are music with a lot of stringed instruments (Mozart music is famous for this, though baroque ear music from Handel, Vivaldi, and Bach are also in this category)."
In a series of postings between Gerry and other members, he offers details about a high frequency generator that can be downloaded from the Internet. In addition to improved hearing, there may be another bonus to using high frequency therapy. Gerry writes: "High frequency sounds 'tone' the brain and thus, reduce the amount of sleep needed by someone. And for me, it does reduce my need for sleep."
Trouble in the air
First it was smoking, now US cities are banning artificial fragrances in public places. But, as Kate Hilpern discovers, our love of perfumes really could be making us sick
09 November 2004
Perfume is the new tobacco. The effects of fragrance chemicals have become the focus of a new health scare, with campaigns against "passive smelling" becoming increasingly common. For some people, second-hand scent is more serious than second-hand smoke, says to Lindsay McManus of Allergy UK. The onset of symptoms are quicker and can be debilitating, she explains. "Whilst some people might get a mild headache from getting a whiff of perfume from someone walking down the
street, others may be very ill for several days."
She reports that a growing number of helpline calls are from sufferers of "fragrance sensitivity", with symptoms including dizziness, fatigue, rashes, hives, watery eyes, sore throat and chest tightness. Fragrance sensitivity has even been blamed for learning disabilities and depression. "Normally the blood expels anything toxic," explains McManus. "With fragrance-sensitive people this may not happen and it can affect the nervous system."
Like many sufferers, Josh Devonshire, 32, believes his condition becomes worse with continued exposure. "I used to enjoy wearing aftershave in my early 20s," he says, "but now I can't even tolerate others around me wearing perfumes, colognes or soap. It's particularly bad in the winter, when the cold weather dries out my nasal membranes and the chemicals seem to get into my system even quicker."
Department stores, theatres and even aeroplanes have become no-go areas, he explains. "At work, I've asked everyone to make my desk a scent-free zone, but that hasn't worked and, on a few occasions, I've had to go home because my chest feels so tight and I can't concentrate," he says. Medications aiming to deal with allergies don't work, he claims.
The US, as well as Canada, takes the problem far more seriously than Britain does. In Halifax, Nova Scotia, a policy of "no scents makes good sense" discourages the wearing of cosmetic fragrances in municipal offices, libraries, schools, hospitals, courts and public transport. Santa Cruz in California has banned fragrances from public meetings, whilst neighbouring Marin County boasts a growing number of restaurants with fragrance-free sections.
Throughout America, the fragrance-free office has become prevalent. In the past three years, a growing number of fragrant-sensitive employees have claimed protection under the Americans with Disabilities Act. It's not just your sexy new eau de toilette that you may find being blamed for causing fragrance sensitivity. Some experts say the condition can be brought on by other products with manufactured scents, ranging from laundry aids through to household cleaners. More than 5,000 different fragrances are in products that are used on a daily basis and they can enter the body through the nose, mouth or skin.
Last month, research found that mothers and their babies are being made ill by products including air fresheners, polish, deodorants and hair sprays. Dr Alex Farrow of Brunel University, who led a study of 10,000 women, found that frequent use appeared to increase the risk of diarrhoea, earache and other symptoms in infants, as well as headaches and even depression in mothers. "What the study doesn't tell us is why and how the fragrances of these products cause these symptoms," she says. "But what it does suggest is that there is an effect. Since more than 40 per cent of families use air fresheners regularly, this is a significant finding."
Betty Bridges, who runs the Fragranced Products Information Network, says the problem has become worse than ever. "Historically, fragrance has been for luxury and special-occasion use," she explains. "But since the 1970s, it has become a part of daily life. The use of fragrance has increased tenfold since the 1950s."
A further reason for the increase in cases, she says, is indoor air quality. "Homes are much tighter when it comes to insulation and we use many more synthetic fragranced products than we used to." She believes many people suffer the effects of fragrances but haven't yet made the link. Helen Lynn, the health co-ordinator at the Women's Environmental Network (WEN) agrees. "People see a bottle with nice pictures of flowers or ferns on the front," she says, "but what they are actually getting is a bottle of chemicals - some of which may be toxic."
Since WEN implemented its fragrance-free office-policy a year ago, she says, staff have reported an absence of headaches, streaming eyes and tightness of the chest, as well as having a clearer head.
But not everyone believes fragrance sensitivity is a problem. In fact, it is not accepted as a medical condition by the NHS and many allergists doubt its existence. Dr Adrian Morris, an allergist from the Surrey Allergy Clinic, explains: "You can generally only have a 'type one' allergic reaction to something which contains a protein component, such as house dust, peanuts or pollen. A fragrance chemical doesn't contain protein and can, therefore, only cause an irritant reaction."
Andrew Wardlaw, the president of the British Society for Allergy and Clinical Immunology, isn't quite so dismissive. "Fragrances can... cause irritation in someone who has an underlying allergy," he says. "Someone with asthma could have an attack triggered by a fragrance."
June Harris, a 47-year-old asthmatic, says the fumes of some products - notably air fresheners and perfumes - are enough to make her start wheezing and, in a handful of cases, have brought on an attack. "I wish we could follow in America's footsteps by taking this issue seriously," she says.
Many believe this will soon be the case. Anja Leetz of the European Environmental Bureau explains that much of the scepticism around fragrance sensitivity in UK medical circles is down to lack of public information about fragrance chemicals and their effects - something that is set to change with forthcoming European legislation.
Fragrance formulas are considered trade secrets, she explains. Manufacturers only have to print "fragrance" or "parfum" on the label - a term that can hide up to 200 different chemicals. "For 86 per cent of these chemicals, there isn't sufficient data," says Ms Leetz. "Without this, we can't do safety assessments and suggest how the chemical industry should be controlled. The new legislation will change this."
The chemical and fragrance industries claim their products are safe, she says, "but at the moment they don't provide proof. Now they will have to". The problem is that it will be at least two years until the legislation comes in and a further 11 years before all the data is provided, Ms Leetz claims. "In the meantime, we advise people to limit exposure by opening a window instead of using an air freshener and think about what fragranced products are really necessary in their lives."
Betty Bridges seconds this advice. "Economics is a lot quicker than legislation," she says. "If people start demanding products that don't contain fragrances, this will be a far more effective and faster solution than waiting for new laws to come in."
But be wary of products that are labelled "fragrance-free" or "unscented", as these may still contain fragrance chemicals. They may contain a fragrance that is used to cover up the odour of ingredients. The safest bet is to go for the label "without perfume".
NOT TO BE SNIFFED AT
These are some common allergy-causing fragrances used in perfumes and cosmetics. If its label says "parfum", a product could contain any of these
Hyacinth fragrance found in natural fragrances such as hyacinth oil, cinnamon leaves and balsam of Peru.
Used in: perfumes, cosmetics, deodorants, laundry products, soap, toothpastes and mouthwashes, and also colas, vermouths and bitters.
Spicy clove odour founds in oils of clove and cinnamon leaf and also in roses, carnations, hyacinths and violets, with antiseptic and fungicidal properties.
Used in: perfumes, cosmetics, hair products, toothpastes and pharmaceutical creams.
Rose fragrance present in more than 250 essential oils, including rose oil and lavender oil.
Used in: the most widely used fragrance in perfumes and make-up.
Alpha amyl cinnamic alcohol
Synthetic essential oil with intense jasmine odour.
Used in: perfumes, soaps, cosmetics, toothpaste.
Synthetic fragrance of lily of the valley.
Used in: perfumes, aftershaves, soaps, cosmetics and eye creams.
Earthy, woody odour, an essential oil made from tree lichen.
Used in: very common, inexpensive ingredient in perfumes and aftershaves.
11 November 2004 20:49
Anyone see any hypocrisy here?
PEDIATRICS Vol. 108 No. 1 July 2001, pp. 197-205
Direct quotes from an document published by the American Academy of Pediatrics:
"Thimerosal used to irrigate the external auditory canals in a child with tympanostomy tubes has caused severe mercury poisoning."
"Mercury in all of its forms is toxic to the fetus and children"
"Inorganic and elemental mercury should not be present in the home or other environments of children"
"It would seem prudent for the FDA to carefully examine all uses of mercury in pharmaceuticals, particularly pharmaceuticals that are used by infants and pregnant women."