Is it Measles? One Mom’s Story

Gracelyn Spruell

Gracelyn Spruell

One recent Wednesday afternoon, Katie Spruell’s daughter came home from daycare with a red rash on her neck.

Katie, a Medical Assistant at Swope Health Services, examined her three-year-old daughter carefully. She found red bumps at her hairline, on her face and cheeks, down her neck and throughout the trunk of her body.

Little Gracelyn had a fever, too.

That’s when Katie began wondering if this was a case of measles.

An outbreak of measles had been reported in the Kansas City area, reaching 16 confirmed cases as of mid-April.  Most of the people who came down with measles had not been vaccinated.

Measles is highly contagious disease, producing a fever, cough, runny nose and red eyes, followed by a rash of tiny red spots. The rash typically starts at the head and spreads down the body. The disease is dangerous, especially in children, if it leads to pneumonia or swelling of the brain, according to the Centers for Disease Control and Prevention (CDC).

Measles infographicKatie brought her daughter to SHS the next morning, where the Pediatric team ordered initial tests for strep throat and bacterial infection. Those rapid tests came back negative, Katie said, but that didn’t answer the specific question: was it measles?

“We had Gracelyn come back three days later for a blood draw to determine if it was an atypical case of measles,” said Dr. Kenneth Thomas, SHS Pediatrician and Chief Medical Officer. He explained the test should be performed three days after of the outbreak of the rash in order to get an accurate result.

Meanwhile, during those three days, Gracelyn stayed home to prevent any spread of her illness. She was irritated, whiny and still feverish, Katie reported. Katie was worried, too, because Gracelyn had only received one vaccination against measles.

The CDC, the American Pediatric Association and most physicians recommend defending children against the disease with a combination vaccine that provides protection against measles, mumps and rubella. The vaccine takes two doses: the first at 12 to 15 months old, and the second before the child starts school, usually between age 4 and 6.

After the blood tests, the SHS providers were able to identify the cause of Gracelyn’s rash: it was a case of scarlet fever, related to strep throat.

“I was so relieved,” said Katie, noting that Gracelyn is now better.

“This illustrates how important it is for every parent to make sure your children are vaccinated,” said Dr. Thomas. “People get complacent and think it isn’t a risk anymore. But it is – the world is a much smaller place these days.”

Most outbreaks of measles are traced to unvaccinated people or those who have traveled abroad where measles is still common. The same is true of other diseases, such as polio and the flu, he noted, which is why vaccinations are necessary.

“It’s important to protect yourself and your kids from disease,” he said. “The measles vaccine is effective and safe. We would much rather prevent the disease than treat it.”

Measles spreads quickly, typically through coughing and sneezing. If you think you have been exposed to measles and have the symptoms, it’s time to see a doctor. Bring immunization records with you, and be sure to explain the reason for your visit before you arrive. This will help us protect other patients and caregivers from risk.

“If you’re not protected from measles, this is a good time to fix that,” said Dr. Thomas. “Come talk with us. Help prevent more cases of measles, and more importantly, keep your kids safe and healthy.”

Call 816-923-5800 for an appointment at SHS Pediatrics Clinic.  

Additional resources:

 

A Dialog on the Safety of Vaccines

By Kenneth Thomas, MD, Chief Medical Officer, Pediatrician

I received some critical feedback from someone on my recent blogs on immunization addressing myths vs truths, frequently asked questions, and  schedules. I appreciate the time this reader took to write, and I want to share both the comment and my response with you.

First the comment:

This is a disappointing example of how “experts” in medicine will say a lot while saying nothing at all. You promised to address parents’ objections to vaccines, yet really provided nothing in particular to assuage those concerns parents might have after witnessing friends or family members deal with the reality of a vaccine-damaged child. What would you say to the request of a parent for any long term studies to support the efficacy or safety of any vaccine combinations administered to infants and up today? The sad reality is that there really are not any studies done like this while the vaccine inserts themselves list the many reasons parents would be objectionable to their infant being injected with vaccines.

The documentary VaXXed chronicles the CDC’s own use of fraud and abuse of its power to perpetuate the idea that vaccines do not cause autism, when in its own MMR study it dramatically increased the rates of autism in African-American patients.

I would ask Dr. Thomas to take the time to read the vaccine inserts before imposing on others the idea that vaccines are safe, they simply are not safe for everyone. They never have been proven, in today’s schedule, to be safe or effective in preventing the illnesses they are purported to prevent.

When 1 in every 2 children is overweight, obese or struggles from some sort of learning disability I would say that everything being done in the name of keeping our children healthy is on the table for reconsideration and vaccines, because of all the toxic and foreign ingredients from heavy metals to adjuvants to foreign DNA, are a primary choice for elimination until proven, by sound science and not political theater, to be absolutely safe and effective.

immunizations (1)I’ll address each point:

If a parent asked me for long-term studies to support the safety or efficacy of vaccine combinations, I’d offer this website: http://www.immunize.org/journalarticles/conc_multi.asp.

It contains a list of long-term studies, specifically addressing multiple injections. This site is produced by the Immunization Action Coalition and provides solid scientific reference materials for parents and physicians.

One of the most compelling research studies (an analysis of 96,000 children) was published by the Journal of the American Medical Association. The study specifically debunks any link between vaccines and autism.

You are correct about vaccine inserts containing information that many parents might find scary or objectionable. There’s a law (the National Childhood Vaccine Injury Act) that specifies that all vaccines have Vaccine Information Statements that detail possible side effects and risks. All FDA-approved medicines are required to inform users of possible negative outcomes from taking the medication.

I am quite familiar with the Vaccine Information Statements and regularly give them to my patients.

While I have not seen the film “VaXXed,” I know it is a work of propaganda, not journalism or unbiased reporting. (For example, even the IMDb movie site labels the film a “fantasy, thriller,” not a documentary.) It represents the point of view of the director, who is the same author who initially instigated the now-debunked concept linking vaccines and autism and lost his medical license as a result of ethical violations and deliberately manipulating data – in other words, committing fraud in his research.

I stand by my position and I stand with the scientific data that demonstrates the efficacy, safety and benefits of childhood vaccinations. I stand with a majority of physicians, scientists and researchers united in support of the positive health benefits of vaccinations.

I also stand with you and share your concerns for keeping our children healthy, including addressing the factors that cause obesity and learning disorders. I’ll take that on in a follow-up post.

Meanwhile, thank you for your concerns. I look forward to continued engagement and working together to keep our children healthy.

Questions and comments are always welcome. Use the box below to respond, or call us for an appointment for your child at 816-923-5800.

Here’s Our Recommended Routine Vaccination Schedule for Children

immunizations (1)By Kenneth Thomas, MD – Chief Medical Officer, Pediatrician

Scheduling children for vaccinations can be challenging. The recommended schedule shows a list of diseases and dates for immunizations — six sets from 2 -18 months of age.

Plus more at age 4 years, to start school, and again at starting at age 11, all together providing protection against more than a dozen diseases.

Yes, it’s complicated. And important.

Let me explain. In a previous post, I answered some common questions about vaccines.

Vaccines work by stimulating the body to create defenses against disease-bearing bacteria or viruses. A vaccine contains a weakened version of the germ (or toxin they produce), or subunits (parts) of the germ to “imitate” an infection – just enough to prompt the body’s immune system to get to busy fighting off the infection. Once the body fights off this imitation infection, it can “remember” and fight off a real infection if it occurs.

Decades of research have developed the detailed schedules of recommended vaccines throughout a lifetime — the process assures that appropriate vaccines are given to children at the right ages, in the right sequence, and at the right intervals.

You see, the vaccines are carefully timed for maximum effectiveness. Some vaccines require multiple doses to achieve immunity or booster doses to maintain protection.

Here is our recommended routine vaccination schedule:

At Age …Receive a Vaccination to Prevent
Two months

(Primary Series)

•       Diphtheria, Tetanus, Pertussis / Hepatitis B / Polio (Dose1)

•       Pneumococcal disease (Dose 1)

•       Haemophilus Influenza Type B (Dose 1 – we typically use a 3 dose series)

•       Rotavirus (Dose 1 – we typically use a 2 dose series)

Four months

(Primary Series)

•       Diphtheria, Tetanus, Pertussis / Hepatitis B / Polio (Dose 2)

•       Pneumococcal disease (Dose 2)

•       Haemophilus Influenza Type B (Dose 2)

•       Rotavirus (Dose 2)

Six months

(Primary Series)

•       Diphtheria, Tetanus, Pertussis / Hepatitis B / Polio (Dose 3)

•       Pneumococcal disease (Dose 3)

Nine months Catch up any as needed
12 months •       Measles, mumps, rubella (Dose 1)

•       Varicella (chickenpox) (Dose 1)

•       Hepatitis A (Dose 1)

Note: other vaccines may be given at this point to catch up or if an accelerated schedule is needed.

15 months

(Boosters)

•       Diphtheria, Tetanus, Pertussis (Dose 4)

•       Pneumococcal disease (Dose 4)

•       Haemophilus Influenza Type B (Dose 3)

18 months •       Hepatitis A (Dose 2)
4 years

(Boosters)

•       Diphtheria, Tetanus, Pertussis (Dose 5)

•       Polio (Dose 4)

•       Measles, mumps, rubella and varicella (Dose 2)

11 years •       Tetanus, diphtheria, pertussis

•       Meningococcal disease (Dose 1 of 2)

•       Human Papilloma Virus (starting 3 dose series)

16 years •       Meningococcal disease (Dose 2)

Our recommended schedule complies with state immunization requirements for public schools and aligns with the latest guidance from the medical profession and the U.S. Centers for Disease Control and Prevention. (You can learn more from the CDC website.)

Vaccines will help keep your children safe and healthy. Please bring your children for regular physical and Well-Child exams. Call 816-923-5800 to schedule an appointment.

Have other questions about vaccines? Leave your question in the comment box below or come visit the SHS pediatric clinic.

Vaccination Q&A: You’ve Got Questions. We’ve Got Answers.

immunizations (3)By Kenneth Thomas, MD – Chief Medical Officer, Pediatrician

In my experience in pediatrics, I know parents often have questions about childhood vaccinations. In this post, I will answer some of the most common questions I hear.

  • How do vaccines work? Vaccines greatly reduce the risk of infection by working with the body’s natural defenses to safely develop immunity to disease. Vaccines work by stimulating the body to create defenses against disease-bearing bacteria or viruses. A vaccine contains a weakened version of the germ (or the toxin they produce), or parts of the germ, to “imitate” an infection — just enough to prompt the body’s immune system to get busy learning how to recognize and fight off the infection.

This type of infection does not cause illness, but it does cause the immune system to produce T-lymphocytes (White Blood Cells) and antibodies to respond to the infection. Sometimes, after getting a vaccine, the imitation infection can cause minor symptoms, such as fever. This is normal and expected as the body builds immunity. Once the imitation infection goes away, the body is left with a supply of “memory” T-lymphocytes, as well as B-lymphocytes that will remember how to fight that disease in the future.

  • Can someone who’s been vaccinated still get the disease? It typically takes time for the immune system to develop an adequate level of protection after vaccination. So it is possible that a person who was infected with a disease just before or after vaccination could develop symptoms and catch the disease, because the vaccine has not had enough time to provide protection. No vaccine is 100 percent effective, but most come pretty close, and the vaccine may prevent the most severe complications of the disease such as hospitalizations or death.
  • Is the “natural” way better? This is a belief that it’s better to catch the real disease and let your body deal with it. This is a dangerous belief, as the fact is children can suffer from serious consequences or die from measles, chicken pox, whooping cough and other preventable diseases. Vaccines save lives.
  • Why are there so many childhood vaccinations? Decades of research have developed the detailed schedules of recommended vaccines throughout a lifetime. The vaccines are carefully timed for maximum effectiveness. Some vaccines require multiple doses to achieve immunity or booster doses to maintain protection. (I’ll talk more about this in my next post.).
  • Why do babies and young children need vaccines? In general, vaccines are recommended for members of the youngest age group at risk for experiencing the specific disease, for which efficacy and safety have been demonstrated. We try to protect children before they are likely to encounter the disease.
  • Are vaccines toxic? Unsafe? Untested? In the United States, vaccines are regulated and required to meet standards for safety and effectiveness before they are approved for use. This includes careful testing and controls in their development and production. The vaccines are safe and only a tiny fraction of people ever have a serious reaction to them. Take a look at The Journey of Your Child’s Vaccine, an explanation of the vaccine development process, for more information.
  • Are these the same vaccines offered at big hospitals and specialty health centers? SHS vaccines are those approved and recommended by medical experts and the government. There is no differentiation in vaccines based on income, race, religion, gender or any other attribute.

Here at SHS, we know vaccines are safe. Vaccines are important protections against disease. It is our desire that the children of this community are as safe and healthy as possible. If you have other questions, let’s talk.

Let’s get our entire community healthy. Please bring your children for regular physical and Well-Child exams. Call 816-923-5800 to schedule an appointment.

Have other questions about vaccines? Leave your question in the comment box below or come visit the SHS pediatric clinic.

The Truth About Vaccines: What You Need to Know

immunizations (2)By Kenneth Thomas, MD – Chief Medical Officer, Pediatrician

Pediatricians often encounter parents who object to immunizations – often based on anecdotal information that vaccines are unsafe or fears that they will cause other health problems.

I want to address those objections with facts, confirm that the vaccines we offer have been tested extensively, and express our confidence in the practice of providing routine vaccinations.

There is always a risk of side effects after vaccination (as with any medication). The most common side effects are tenderness at the injection site and low-grade fever – these are considered a positive sign that the body is reacting to the vaccine. Severe reactions are possible but very rare.

Every Child by Two (ECBT), a non-profit organization that advocates for immunizations, expresses our confidence:

ECBT is confident in the safety of vaccines because of the elaborate systems in place to license safe vaccines and continually monitor their safety post-licensure. As vaccines are given to otherwise healthy people, they are held to the highest safety standards, requiring more rigorous testing than most medications. It can take 15 or more years and an average of $800 million dollars to thoroughly test a new vaccine before it is licensed by the U.S. Food & Drug Administration (FDA) and made available to the public.”

Want to learn more about the process of developing, licensing and monitoring vaccines? Here is a link to an infographic created by the Centers for Disease Control and Prevention (CDC), called The Journey of Your Child’s Vaccine.

There are many excellent websites that have information about vaccine safety – here are some I share with patients:

During the past 50 years, immunization has saved more than a billion lives and prevented countless illnesses and disabilities in the United States. Vaccine-preventable diseases, such as measles, mumps, and whooping cough, are still a threat. They continue to infect U.S. children, resulting in hospitalizations and deaths every year.

Here at SHS, we know vaccines are safe and important protections against disease. It is our desire that the children of this community are as safe and healthy as possible. If you have other questions, let’s talk.

Please bring your children for regular physical and Well-Child exams. Call 816-923-5800 to schedule an appointment.

Have other questions about vaccines? Leave your question in the comment box below or come visit the SHS pediatric clinic.

Healthy Start Initiative Helps New and Expecting Mothers

KCHSI logoJohnea was about eight months pregnant with her second child when she learned about the Kansas City Healthy Start Initiative program at Swope Health Services.

Now, after seven months in the program, she feels like she has been adopted and embraced.

“It’s like I have an extended family,” she said. “The doors are always open. They are so caring and their arms are so wide!”

Healthy Start is a federal program, offered by the Health Resources and Services Administration department of the Maternal and Child Health Bureau, to support healthy pregnancy and early childhood. The Kansas City Healthy Start Initiative operates at SHS and at Samuel Rodgers Health Center through the Mother & Child Health Coalition.

Kansas City Healthy Start supports eligible women from zip codes in Jackson (MO) and Wyandotte (KS) counties where infant mortality rates are higher than average. The free program helps pregnant women and women with children under the age of 2 get information and services they need to have a healthy pregnancy, raise a healthy family, and keep themselves healthy and strong.

In the program, each woman is assigned a community health worker, said Ahkeya Howard, SHS Lead Community Health Worker and a licensed clinical social worker.

HealthyStartStaff

The SHS Healthy Start team, from left, Community Health Workers Angela Hawkins, Ahkeya Howard, Tameka White and Treva Smith.

Each case worker provides a broad range of services to help the individual mother with her immediate needs, for example, attending medical appointments, signing up for health insurance, obtaining food, housing assistance or job training referrals.

To help strengthen family resilience, referral and resource information is also provided for the father of the baby and/or male significant other.

“Our goal when they get here is to make sure they are getting the best care possible and utilizing what is available to them,” said Ahkeya. “We take time to find the right resources.”

The support is also personal, Ahkeya notes. Regular discussions include topics like managing stress or depression, safe sleep practices, child development, breastfeeding, building strong relationships, and setting positive goals.

Says program participant, Johnea, “They always say ‘Let’s put you first — how are you today?’ It all starts with a strong foundation for me, the mother, both mentally and physically.”

Johnea and children

A participant in the Kansas City Healthy Start Initiative, Johnea holds Nevaeh, 2, and Jeremy, 6 mo., at a recent visit to SHS.

That means caring conversations about what’s going on at home, how the children are feeling, and what help might be needed. Johnea described the case workers and program team as mentors and coaches, mothers themselves who understand her feelings and always give support.

“We get a lot of hugs,” Johnea said.

Johnea received information on topics from breastfeeding to job openings. The program provides HappyBottoms diapers for her children, and has given her the opportunity to meet other women through events like a holiday dinner and story-time readings for children.

As a result of the program, Johnea hopes to return to school to finish her nursing degree and find a good job in health care. She’s also working on potty training her two-year-old daughter.

“I would recommend it to any woman. It is a family-oriented program that is beneficial all the way around,” Johnea said. “I love it.”

RESOURCES: Kansas City Healthy Start Initiative

 

Would you like more information about the Kansas City Healthy Start Initiative? Call SHS at 816-599-5790 and come visit with our Healthy Start team.

Read Across America Celebration at SHS!

Dr. SeussOn Wednesday, March 2, Swope Health Services joined thousands of organizations in celebrating Read Across America Day.

Volunteers Ann Goodrich and Pam Bickel spent the morning in Pediatrics and WIC departments at SHS Central.

They sat one-on-one with children and quietly explored books, and at other times they read out loud to groups of kids. Children who participated selected stickers and took home a bag of books, donated via the Barnes & Noble holiday book drive.

Reading 1Sponsored by the National Education Association (NEA), this annual celebration of reading also marks the birthday of Theodor Seuss Geisel, better known as Dr. Seuss. That’s why our volunteers wore “Cat in the Hat” costumes and frequently used favorite Dr. Seuss books for read-alongs.

Goodrich, who has been a Reach Out and Read volunteer for more than two years, said she knows from personal experience as a Kindergarten teacher how important it is to read to children.

Children need a vocabulary of about 5,000 words by the time they start Kindergarten, she said. Those without will feel left behind, and she noted it can be difficult to catch up.

“I always tell parents to share their words with their kids,” she said. “You have 80,000 to 100,000 words — just give some to your child.”

Goodrich says it doesn’t even matter what you read — it’s OK to read your Facebook feed or text messages.

“They need to hear your voice,” she said. “They need to hear words and sounds to learn.”

According to the NEA, children who are read to and who read for pleasure are significantly more successful in school than children who do not.

Reading 3Goodrich agrees, and frequently takes time with parents to coach them with reading tips. You can make reading interactive by pointing out what’s happening on the page and asking your child questions about the story. Help build your child’s vocabulary by talking about interesting words and objects.

“You should read to children from Day One,” she said. “Take 20 minutes a day and hold the child on your lap. It’s a confidence you are putting into your child.”

If you missed our Read Across America celebration, you can still learn about reading to your children. You can find a Reach Out and Read volunteer in the WIC department, typically every Thursday morning, reading to kids and meeting with parents.

Call to make an appointment, even for a same-day visit, at 816-923-5800. Do you have suggestions for reading with kids? Leave us a comment about your favorite books or ways you make reading fun.

Reading 2

SHS Provides Car Seats for $25 to Keep Kids Safe!

Swope Health Services is now offering qualified pediatric patients a new car seat for just $25, part of an ongoing effort to help keep kids safe and healthy while riding in vehicles.

“This could be the most important purchase you’ll ever make,” said Kristina Duran, LMSW, SHS Pediatric Support Specialist. “This can save lives.”

car seat pic

Lakeisha Davis, left, with Kristina Duran, show off one of the new car seats now available through the SHS Car Seat and Booster Program.

She knows. Duran and Lakeisha Davis, WIC Coordinator, completed a comprehensive car seat safety training program from the National Highway Traffic Safety Administration in 2015. Some of the facts:

  • Car seats, according to the CDC, can reduce the risk of injury by up to 71 percent for infants and 54 percent for toddlers.

Car seats and booster seats have been demonstrated to help keep children safe. That’s why all 50 states require the use of car seats for children.

Choosing the right car seat, however, can be confusing. That’s where Duran and Davis, each with National Child Passenger Safety Certification, come in. They help parents find the right car seat and make sure they understand the importance of car seat safety.

The two car seat safety technicians are happy to examine any car seat for safety. They check to make sure it hasn’t expired or been recalled and they examine it for damage from an accident or misuse. Car seats that have been in an accident should be replaced.

“Parents might not know that a car seat can be damaged with wear and tear, or that seats come with expiration dates,” Davis said. “We can check them out and help them get new seats.”

With a new car seat, the two also make sure it’s installed properly. Davis and Duran use guidelines from the specific car seat manual and the vehicle’s owner’s manual. They teach parents how to correctly position the child in the seat, and help register the new seat with the manufacturer in case there are recalls or changes required.

To qualify for the SHS car seat and booster program, an infant or child must be a registered SHS pediatric patient, and the parent or guardian must have their own vehicle.  Then, after the $25 payment, the technicians schedule an appointment to install the new seat and make sure parents – and kids – are comfortable with it. 

Said Duran: “We want our kids to leave safer than when they arrived.”

Questions? Leave a comment below. You can call 816-923-5800 to make an appointment in pediatrics.

Car Seat Program

Come Join The Fun at the Back-to-School Health Fair on July 25th!

Face paintingMark your calendars and plan on joining us at our second annual Back-to-School Health Fair. Festivities run from at 9 a.m. to 1 p.m. on Saturday, July 25, at central campus located at 3801 Blue Parkway in Kansas City, Mo.

The health fair will provide information for parents and children, with resource tables featuring staff from SHS and other community organizations. Among those scheduled to join us are:

  • YMCA
  • United Services
  • Women, Infants and Children (WIC)
  • Women & Minority Health Program
  • Reach Out and Read
  • Children’s Community Psychiatric Health programs
  • SHS Pediatrics and Behavioral Health programs
  • Brain Injury Association

Pediatrics Health Fair (2)Visitors to the health fair will receive a “passport” to help them navigate through the fair. Once they receive six stamps at the information tables, the passport can be entered into a drawing for prizes, including backpacks and school supplies, refurbished bikes and new bike helmets (all while supplies last).

Children may also enjoy face painting and balloon animals. A hot dog lunch will also be provided while supplies last.

The SHS Back-to-School Health Fair is sponsored in part by Aetna. Additional support comes from Hot 103 Jamz, the Brain Injury Association of Kansas and Greater KC and the Bike Shop by RevolveKC.

We look forward to seeing you there!

Ped Health Fair