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Germs That Can Send Your Kid to the Hospital

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How to Avoid Them

Some of these infections are making a comeback in kids. Here’s how to protect your children.

Nowadays it’s much rarer for young children to be hospitalized for severe infections than it was even a decade ago. Still, almost 2.4 million children are admitted to the hospital each year due to infections, and if children up to age 5 are included, the number of infection-caused hospitalizations soars to 4.5 million annually, according to a report in the journal Clinical Infectious Diseases.

Thankfully, most serious infections are preventable, experts say. Vaccines have helped dramatically reduce the numbers. Simpler measures, such as soap and water, are also effective at removing even scary bugs like methicillin-resistant Staphylococcus aureus, or MRSA. Allison Aiello, a professor of epidemiology at the Gillings School of Global Public Health for the University of North Carolina at Chapel Hill, says parents should also ask day care providers about their hand hygiene guidelines for staff and how they encourage children to wash their hands.

To protect your child from a surprise hospital stay, watch out for the pathogens most often responsible for pediatric admissions:

Norovirus

When people talk about the “cruise ship virus” or “stomach flu” they are likely referring to noroviruses, says Aditya Gaur, director of clinical research for the Department of Infectious Diseases at St. Jude Children’s Research Hospital. The illness, however is not associated with viruses specific only to cruise ships, nor is it related to the influenza virus, he says. In fact, a recent Centers for Disease Control and Prevention report found that the virus was spread primarily in restaurants or at catering events. Cruise ships accounted for only 1 percent of reported outbreaks, according to the report. Norovirus is the leading cause of acute gastroenteritis among children under 5, according to a 2013 study in the New England Journal of Medicine. Researchers estimated that the virus caused 14,000 pediatric hospitalizations and 281,000 emergency room visits. Children develop intense vomiting and severe diarrhea, and they’re highly contagious. Other than through person-to-person contact, the virus can spread through contaminated food, water and hard surfaces, according to the CDC.

Streptococcus pneumonia

This bug, which can lead to life-threatening meningitis and deafness, is the most common bacterial cause of pneumonia. But pneumococcal infections have become a lesser danger among children in the U.S. since 2000, when vaccination with the Prevnar or PCV7 vaccine became routine. After its introduction, severe pneumococcal diseases in children younger than 5 fell by 80 percent, according to the CDC. The vaccine protects against seven types of S. pneumoniae, while more than 90 so-called serotypes exist.

In February 2010, the ACIP recommended the use of a new vaccine, named Prevnar 13, that children under age 2 should receive in four doses. PCV13 protects against an antibiotic-resistant form of the bacteria as well as 12 other serotypes. If a child has a fever, cough and noisy, labored or rapid breathing, pneumonia – an infection of the lung – may be the culprit.

Influenza (seasonal flu)

Children are in greater danger of getting the flu than adults because their immune systems are not fully developed. The flu caused about 20,000 hospitalizations for children under 5 and killed 165 children during the 2012-13 season, according to the latest government data. Symptoms include fever, cough, vomiting and runny nose. Children who have conditions such as asthma, heart disease, diabetes or cerebral palsy are particularly susceptible to developing serious complications, including pneumonia.

Experts have recommended that children older than 6 months, as well as their parents or caregivers, get vaccinated ahead of each flu season, which begins in the fall and peaks each year around January or February. A flu vaccine protects children against both the seasonal flu and H1N1, or what is more commonly known as “swine flu.” Though the swine flu became less of a threat during the last flu season, each year the predominant infecting strain of flu changes, Gaur says.  A child who gets vaccinated and still gets the flu can be treated through antiviral medications, like Tamiflu, according to the government’s flu.gov website.

RSV

Nearly all infants and toddlers will be exposed to respiratory syncytial virus, or RSV, and can even catch the bug from a parent, who may mistake their own RSV infection for a common cold. The risk of RSV infection is smaller in young, healthy children, but in infants and premature newborns, RSV may lead to pneumonia. The virus is responsible for killing as many as 200,000 children worldwide, and hospitalizing anywhere between 75,000 and 125,000 children in the U.S. annually, according to the CDC. No RSV vaccine exists. As a preventive measure, infants are typically given an antibody shot.

MRSA (staph infections)

Methicillin-resistant Staphylococcus aureus infection is the cause of 21 in 1,000 child hospitalizations, according to a 2010 study that involved 25 children’s hospitals. The so-called “superbug,” which causes pneumonia and bone and joint infections, is being acquired in the community, not in the hospital as it has in years past. The study showed that the infection had increased 10-fold in a decade, to 30,000 infections total. The bacteria often spread among children playing contact sports – as they lurk on their sweaty gym socks, jerseys and other workout gear that may be shared – or can come from cuts and scrapes while playing.

MRSA, which survives on surfaces as well as on hands, is genetically different from hospital-acquired MRSA and can cause severe, even lethal skin infections in otherwise healthy children. The majority of MRSA skin infections – unsightly, pus-filled red bumps or boils – can be treated, however, without hospitalization, which would otherwise involve surgical draining. Doctors may recommend a warm compress or provide oral antibiotics. In June, the Food and Drug Administration approved a new drug called Dalvance to treat infections in adults.

Neisseria meningitidis

While Neisseria meningitidis is more rare than other infections on this list, it is extremely harmful, leading kids quickly downhill before doctors have time to administer antibiotics. The bacteria, which can cause meningitis, bloodstream infections or death, can live in the nose and mouth and spread among people living in close quarters. A vaccine that protects against four types of N. meningitides is recommended for children ages 11 and older before they go off to college. A type that isn’t protected by the vaccine is dangerous in children younger than 2. Beware of the telltale splotchy purple rash, especially if it darkens or spreads rapidly, a signal to see a pediatrician right away.

Pertussis

Whooping cough, or pertussis, is a bacterial infection that causes a very distinctive cough and cold-like symptoms. A vaccine for pertussis has long held it in check. During the last 30 years, however, U.S. pertussis cases have been increasing. The infection is usually mild in adults and children, but in infants, pertussis may be fatal. Pneumonia, seizures and brain damage are additional dangers. DTaP, a combination vaccine that also shields against tetanus and diphtheria, is given to children in five doses: once at ages 2, 4 and 6 months; once between 12 and 18 months; and once between 4 and 6 years old. Because the vaccine’s benefits wane over time – and because infants under 2 months are not protected – adults and health care workers who are in regular contact with infants are advised to get a whooping cough booster, the Tdap, to avoid spreading the infection.

Written By: Kimberly Leonard

She is a health care reporter for the News division at U.S. News. Previously she worked in Health Rankings as a multimedia producer and reporter. You can follow her on Twitter, connect with her on LinkedIn, circle her on Google+ or email her at kleonard@usnews.com

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