Salmonella From Turtles
Small pet turtles were linked to four cases of salmonella in children in 2004, according to the Centers for Disease Control and Prevention and the public health departments of Wisconsin and Wyoming (MMWR 2005;54:223-6). A 4-year-old girl from Kansas developed diarrhea and a 4-day fever shortly after vacationing in Wisconsin and purchasing a small turtle at a souvenir store. The girl was treated with trimethoprim/sulfamethoxazole for 3 days and had recovered after 5 days. A 2-year-old boy and a 10-year-old boy in Wisconsin developed similar symptoms, including diarrhea and fever, which were traced to pet turtles purchased from different souvenir shops in Wisconsin. In addition, a 6-year-old boy in Wyoming presented with nausea, diarrhea, vomiting, and a persistent fever. A stool sample yielded S. typhimurium, which was traced to the boy's two pet turtles. Although salmonella infections generally resolve after mild gastroenteritis, they can develop into serious illnesses. Despite an FDA ban on the sale of turtles with a carapace less than 4 inches, local health and environmental officials must consider the potential for infections transmitted by turtles that are sold illegally.
Oseltamivir Eases Asthma During Flu
Treatment with oseltamivir (Tamiflu) within 24 hours of the onset of flu symptoms reduced exacerbations of asthma in children aged 6-12 years, wrote Sebastian L. Johnston, M.D., of Imperial College, London, and his associates (Pediatr. Infect. Dis. J. 2005;24:225-32). In a randomized, double-blind, placebo-controlled 4-week study, the asthmatic children received either 2 mg/kg of oseltamivir or a placebo twice daily as an oral syrup (6 mg/mL). The primary end point—median time to freedom from flu illness—was not significantly different within the intent-to-treat infected population of 179 children; the median was 124 hours in the treatment group, compared with 134 hours in the placebo group. A greater difference appeared in the per protocol population, in which 170 children who took oseltamivir had a 17% reduction in the median length of illness (24 hours). However, children treated with oseltamivir within 24 hours of symptom onset experienced rapid improvement in asthma exacerbation, whereas those in the placebo group initially showed worse symptoms, then improved gradually. Children who presented later than 24 hours after symptom onset recovered steadily regardless of randomization, although the treated children had a higher rate of improvement of asthma. Although oseltamivir generally was well tolerated, approximately half of all the children reported at least one adverse event. Gastrointestinal problems were the most common problem, reported by 16% on oseltamivir and 11% on placebo. In addition, improvement in pulmonary function (FEV1) was significantly greater among the oseltamivir group, compared with the placebo group, after 6 days of treatment (10% vs. 5%).
Bacterial Infections Rare With Flu
Serious bacterial illness occurred in only 16 of 163 (9.8%) children with influenza, compared with 153 of 542 (28.2%) children without flu in a retrospective study of 705 infants aged 0-36 months, according to Hannah F. Smitherman, M.D., and her colleagues at Baylor College of Medicine in Houston. The evaluation of febrile children consumes much office time, and the relatively low prevalence of serious bacterial infections suggests that febrile children with the flu may not need to have blood drawn for cultures, the investigators wrote (Pediatrics 2005;115:710-8). The study included four flu seasons, and children who presented with fever underwent viral testing and blood cultures. Bacteremia was 86% less likely among the children with the flu, compared with those who did not have the flu. In addition, of the 110 children with the flu who underwent urine cultures, only 2 (1.8%) tested positive for urinary tract infections.
Teens Unaware of Hepatitis Risk
Adolescents showed a significant lack of understanding of the risk of hepatitis B from contaminated piercing and tattoo tools, as well as from infected needles and risky sexual behaviors, wrote Amy B. Slonim, Ph.D., of the Michigan Public Health Institute in Okemos, and her associates. In a survey of 17,063 adolescents and young adults aged 13-21 years, 47% could not provide any correct information about hepatitis B vaccination, including 27% who gave no information and 20% who gave incorrect information. Nearly half of those who gave incorrect information thought a vaccination was “something bad.” Clinic staff members who conducted the surveys suggested a strategy for educating teens about hepatitis including examples of how it is contracted, emphasis of the possible severity of the illness (liver cirrhosis) and the safety and effectiveness of the vaccine (J. Adolesc. Health 2005;36:178-86).