Child health news round-up (9-19 March 2010)

* Peanut allergy linked to worse asthma in kids

* U.S. children turn to inhaling to get high: study

* Drugmakers agree landmark vaccines deal for poor

* Birth control pill poses no added health risk

* Supplement may slow overweight kids’ fat gain

* Infection warning on child deaths

Peanut allergy linked to worse asthma in kids

Amy Norton

Thu Mar 11, 2010

SOURCE: Journal of Pediatrics, online February 15, 2010.

NEW YORK (Reuters Health) – Among children and teenagers with asthma, those who also have peanut allergies may have more or more-severe asthma attacks, a new study suggests.

HEALTH

Researchers found that among 160 5- to 18-year-olds with asthma seen at their center, the 46 with peanut allergies generally had more hospitalizations for asthma exacerbations than children without the food allergy. They also had a higher rate of treatment with oral corticosteroids — anti-inflammatory drugs given for a short period to control severe asthma symptoms.

Of children and teens with peanut allergy, 23 percent had ever been hospitalized for asthma after the age of 3. That compared with 16 percent of those without peanut allergy.

When it came oral steroids, only 28 percent of kids with peanut allergy had never needed treatment after age 3. That figure was 37 percent among those without the food allergy, according to lead researcher Dr. Alyson Simpson, of Alfred I. duPont Hospital for Children in Wilmington, Delaware.

When she and her colleagues accounted for other factors — like family history of asthma and any other allergies the children had — peanut allergy remained linked to higher risks of hospitalizations and oral steroid use.

The goal in children’s asthma care is to avoid hospitalizations and oral steroids whenever possible, Simpson noted in an interview with Reuters Health, so any increase in those rates is concerning.

She said that parents of children with both asthma and peanut allergy should be particularly sure to work with their child’s doctor to keep the asthma well-controlled. That typically means minimizing kids’ exposure to their particular asthma triggers, helping them maintain a healthy weight and, often, giving them medications that prevent asthma attacks.

Simpson and her colleagues report the findings in the Journal of Pediatrics.

Asthma symptoms arise when the airways become inflamed; that inflammation is most commonly triggered by exposure to allergens, such as pollen, mold or animal dander. Food allergies can also spur asthma symptoms.

It is not clear, however, why study patients with peanut allergy tended to have more problems with asthma control, according to Simpson. Her team’s findings point to an association between peanut allergy and more asthma exacerbations, but do not prove that the food allergy is the cause.

“The exact link is still being studied,” Simpson said.

Understanding the connection is important, she and her colleagues note, as recent studies suggest that both peanut allergy and asthma are on the rise among children — for reasons that are unclear.

It’s estimated that just over 1 percent of U.S. children have peanut allergy, while roughly 9 percent have asthma, according to the American Academy of Asthma, Allergy & Immunology.

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U.S. children turn to inhaling to get high: study

By JoAnne Allen – Thu Mar 11, 2:33 pm ET

(Editing by David Storey)

WASHINGTON (Reuters) – More 12-year-olds in the United States admit to using potentially deadly inhalants to get high than have used marijuana, cocaine and hallucinogens combined, U.S. health officials said on Thursday.

Among this age group, alcohol was the only intoxicating substance used more than inhalants, according to data from 2006-2008 surveys on drug use and health compiled by the U.S. Department of Health and Human Services.

Sniffing common household products, such as gasoline, nail polish, bleach, paint solvents and cleaning spray is like taking poison and many people do not understand the risks or consequences, the health officials said.

Inhaling vapors to get high, or “huffing,” can cause cardiac arrest. It can lead to brain, heart, liver and kidney damage and can be addictive.

“It’s frustrating because the danger comes from a variety of very common household products that are legal, they’re easy to get, they’re laying around the home and it’s easy for kids to buy them,” Pamela Hyde, of the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) said.

“Kids and parents don’t think of these things as dangerous because they were never meant to be used to be intoxicating,” Hyde told a news conference to discuss the data.

About 7 percent of 12-year-olds have used an inhalant to get high, compared with about 5 percent who have taken prescription drugs for nonmedical use, the surveys showed. About 1.4 percent of 12-year-olds have used marijuana and fewer than one percent have used cocaine or hallucinogens.

The rate of inhalant use of that age has remained steady over the past few years, but officials are concerned that young people increasingly do not see abusing inhalants as risky.

“Unfortunately between the years 2001 and 2009, 8th graders’ perception that inhalants are great risk decreased from about 75 percent to about 58 percent, “Dr. Timothy Condon of the National Institute on Drug Abuse said, calling it a dangerous trend.

“We know, historically, that when the perception of risk declines we often almost always see an increase in use,” Condon added.

Adults abuse inhalants too, but health officials are targeting youngsters and parents in a new public information campaign because they say children are more vulnerable.

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EXCLUSIVE-Drugmakers agree landmark vaccines deal for poor

11 Mar 2010 16:02:26 GMT

Source: Reuters

By Kate Kelland and Ben Hirschler

(Editing by Elaine Hardcastle)

LONDON, March 11 (Reuters) – Several drug firms have agreed a landmark deal to supply up to 200 million doses a year of cut-price pneumococcal vaccines to developing nations, according to the global immunisation alliance that is overseeing the deal.

Leading manufacturers of such vaccines include GlaxoSmithKline <GSK.L> and Pfizer <PFE.N>.

The agreement is the first under a new scheme called an Advance Market Commitment (AMC), which provides a guaranteed market for vaccines supplied to poor nations but sets a maximum price that drugmakers can expect to receive.

It is likely to pave the way for future deals on recently introduced vaccines against rotavirus, which causes severe diarrhoea, and an experimental one against malaria, which combined kill millions in poor countries each year.

The GAVI Alliance (Global Alliance on Vaccines and Immunisation) said details of the pneumococcal deal would be announced in the coming weeks.

“Decisions have been made and we are hoping for an announcement very shortly — in the next couple of weeks,” GAVI’s deputy chief executive officer Helen Evans told Reuters in an interview on Thursday.

“It’s very exciting news because they are going to make long-term commitments.”

Pneumococcal disease is one of the world’s biggest killers of children, claiming up to 1.6 million lives each year. Africa and Asia together account for 95 percent of all deaths from pneumococcal disease, which causes serious illnesses such as pneumonia and meningitis.

Glaxo’s pneumococcal vaccine, called Synflorix, protects against 10 strains of the streptococcus pneumoniae bacteria which cause the disease. It was approved late last year by the World Health Organisation for use in developing countries.

Pfizer’s Prevnar 13 shot protects against 13 strains and won the approval of U.S. regulators earlier this month.

Under the terms of the AMC tender, drugmakers were required to make a 10-year commitment to supply a share of the total forecast demand of 200 million doses a year.

Evans said each manufacturer would have a minimum volume order guaranteed in return for a price of $7 per dose for the first 20 percent supplied, dropping to $3.50 dollars for the remaining 80 percent.

The higher price is only paid for the first tranche of doses so as to ensure the drug firm’s research and development costs are covered. Beyond that, $3.50 is the maximum price GAVI and countries will pay for the vaccine.

By comparison, Glaxo charges around 40 euros ($54) per shot for Synflorix in Europe.

The AMC scheme was devised to try to encourage drug companies to make and supply medicines and vaccines to boost health in poorer countries, which are generally unable to afford the high prices paid in Western markets. GAVI and its partners say they plan to introduce pneumococcal vaccines in 42 developing countries by 2015.

Officials at both Glaxo and Pfizer confirmed they had been working with GAVI on the supply agreement.

“We remain committed to participating in this initiative and hope to be one of the first companies to supply its vaccine,” Glaxo spokeswoman Claire Brough said in an emailed statement.

The pneumococcal deal will be partly funded by Britain, Italy, Canada, Russia, Norway and the Bill & Melinda Gates Foundation, who agreed in June last year to invest a total of $1.5 billion in the project.

If it proves successful, existing and new donors have said they would be interested in supporting more AMC schemes, including one for malaria.

Glaxo struck another long-term deal for its pneumococcal vaccine worth 1.5 billion euros with Brazil last September, guaranteeing sales for 10 years.

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Birth control pill poses no added health risk

LONDON

Thu Mar 11, 2010

(Reporting by Kate Kelland; Editing by Jon Hemming)

(Reuters) – One of the world’s largest studies of the contraceptive pill has found that women who have taken it can expect longer lives and are less likely to die from any cause, including cancer and heart disease.

British researchers said their study, which should reassure many millions of women across the world who have taken oral birth control pills, found no link between the drugs and an increased long-term risk of dying sooner.

“The results of this study are enormously reassuring and suggest that in the longer term the health benefits of the contraceptive pill outweigh any risks,” said Richard Anderson of Edinburgh University and the Medical Research Council human reproductive sciences unit, who was not involved in the study.

The research, published in the British Medical Journal on Friday, followed 46,000 women for nearly 40 years, creating “more than a million woman-years” of observation, according to Philip Hannaford from Aberdeen University, who led the study.

The results showed that in the longer term, women who used oral contraception had a significantly lower rate of death from any cause, including heart disease and all cancers, compared with women who had never taken it.

But the scientists said their findings may only be true for women who have taken older-style pills rather than those on more modern types of drugs, since their study began in 1968.

“Many women, especially those who used the first generation of oral contraceptives many years ago, are likely to be reassured by our results,” Hannaford and colleagues wrote.

Around 12 million women in the United States and some 3 million women in Britain take the contraceptive pill.

Earlier reports from the same study — known as the Royal College of General Practitioners’ Oral Contraception Study and one of the world’s largest ongoing investigations into the health effects of oral contraceptives — suggested the drugs may increase the risk of dying sooner, particularly in older women or those who smoked.

While the newest data also showed a slightly higher risk in women under 45 who are current or recent users of the pill, the researchers said the effects in younger women disappear after about 10 years and the benefits in older women outweigh the risks in younger women.

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Supplement may slow overweight kids’ fat gain

Thu Mar 18, 2010

SOURCE: American Journal of Clinical Nutrition, online March 3, 2010.

NEW YORK (Reuters Health) – Supplements containing the dietary fat conjugated linoleic acid (CLA) may help overweight kids curb the amount of fat they gain over time, a small study suggests.

HEALTH

Researchers found that overweight and obese children who took the CLA supplement for seven months showed less fat accumulation than a comparison group of children given a placebo.

However, children on the supplement also showed a dip in their blood levels of “good” HDL cholesterol and a lesser gain in bone mass over time.

The findings suggest that while CLA might help slow body fat gain, its overall safety and effectiveness for children needs to be studied further, the researchers note in the American Journal of Clinical Nutrition.

CLA is an unsaturated fatty acid found in beef, lamb and dairy products; the CLA in supplements is generally derived from vegetable oils that are rich in linoleic acids.

Animal research has found that CLA can help melt away body fat, and some studies have suggested the same may hold true in humans. One recent study, for example, found that obese women with diabetes shed a couple pounds of body fat, on average, after taking CLA for four months.

Lab research on the fatty acid has suggested that it may be particularly effective at preventing fat accumulation in young animals. But the effects on overweight children have been largely unknown.

For the current study, researchers led by Natalie M. Racine of the University of Wisconsin-Madison recruited 62 overweight or obese children between the ages of 6 and 10. They randomly assigned the children to take either a CLA or placebo mixture — both chocolate- flavored and added to milk — once a day for seven months.

The CLA supplement, marketed as Clarinol, was provided by Netherlands-based manufacturer Lipid Nutrition BV, which also partially funded the study.

After seven months, the researchers found, children on the CLA supplement showed a small dip, on average, in the percentage of their total body weight that was fat — as measured by X-ray. Children in the placebo group showed a gain, of 1.3 percent versus a decline of 0.5 percent in the CLA group.

When it came to overall body mass index (BMI) — a measure of weight in relation to height — children on CLA had a smaller gain than those on the placebo. However, the gains in both groups were still higher than what would be expected for the typical child in the same age group, the researchers note.

Children on the CLA supplement also showed a reduction in heart-healthy HDL cholesterol — by five points, on average — and a smaller rate of bone mass accumulation.

The effects on HDL are similar to what’s been seen in some studies of adults, Racine and her colleagues write, but the bone mass findings are “surprising” and have not been seen before.

They recommend that any future studies of CLA in children monitor bone density changes, as well as the overall safety of the supplement.

Two co-researchers on the study are employees of Lipid Nutrition, and another was named on a use patent application the company submitted for CLA.

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Infection warning on child deaths

Emma Wilkinson

Health reporter, BBC News

Story from BBC NEWS:

http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/8564921.stm

Published: 2010/03/19

One in five deaths in children in England and Wales is due to potentially preventable infections, a study suggests.

Half of the 1,300 infection-related deaths in a two-year period were in children with other health problems.

Health Protection Agency researchers said greater vigilance by doctors could significantly reduce child mortality.

Childhood vaccines have a key role in cutting unnecessary deaths, they said.

The study, which analysed data from 2003 to 2005, is the first to look at the burden of deaths from specific infections in children.

“ We have very good vaccination programmes in place – but we also need to make sure we are up to date with the latest vaccines out there ”

Dr Shamez Ladhani

Looking at death certificates in children aged 28 days to 14 years old, they found 20% of a total 6,987 deaths were related to an infection.

Underlying health problems in children dying from infectious disease included prematurity, cerebral palsy and cancer.

In deaths where a specific type of infection was recorded, 59% were bacterial, 31% viral and 8% fungal.

One finding which particularly worried the researchers was a high rate of deaths from some intestinal infections in children with underlying medical problems, as these are infections which would not normally be a problem in healthy children but can often be resistant to treatment.

Prevention

As this is the first time such analysis has been done, the researchers had no data to compare the findings with.

But they said the results backed a recent report on the care of critically ill children in the UK which called for better recognition of serious illness in children and more aggressive treatment.

A study published last year warned that more needed to be done to prevent children with cancer dying from potentially preventable infections.

Writing in the Pediatric Infectious Disease Journal, they said that adding in more vaccines to the routine childhood programme would be one way to cut the number of deaths.

Influenza, hepatitis B, rotavirus, and chicken pox vaccines are among those that are currently available but not included in the schedule.

Dr Shamez Ladhani, study leader and consultant in paediatric infectious disease, said ensuring good uptake of currently used vaccinations would also have an impact on deaths.

“We have very good vaccination programmes in place – but we also need to make sure we are up to date with the latest vaccines out there.”

He added that doctors needed to be more vigilant for infection in seriously ill children to ensure they get treatment quickly enough.

“We also need to look at surveillance and keep an eye out for antibiotic resistance.”

Dr David Vickers, a registrar at the Royal College of Paediatrics and Child Health, said: “We support the need to research whether new vaccinations should be added to the routine childhood immunisation programme.

“Earlier recognition of ill children and more systematic management through the use of clinical protocols both offer the potential to reduce mortality from infection.”