Flu Shot Safe for Children
No evidence of serious adverse events within 2 weeks of vaccination appeared in a population-based study of 251,600 children, mean age 10 years, who received the trivalent inactivated influenza vaccine, said Eric K. France, M.D., of Kaiser Permanente Colorado, Denver, and his colleagues. The study spanned four flu seasons and two half-seasons between 1993 and 1999 (Arch. Pediatr. Adolesc. Med. 2004;158:1031–6). In a primary analysis, only one case of uncomplicated diabetes mellitus was positively associated with vaccination. Subanalysis revealed one case each of impetigo, atopic dermatitis, and a renal and ureteral disorder not otherwise specified. Overall, vaccinated children were significantly less likely to visit a doctor for an illness during the postvaccination period, compared with a control period. Reasons for this may include the fact that children are more likely to be vaccinated when they are healthy and that children are less likely to visit a doctor for low-grade fever, limb soreness, and irritability during the postvaccination period, because parents expect these symptoms after vaccination.
Hepatitis B Incidence Declines
Incidence of acute hepatitis B declined by 89% among U.S. children aged 19 years and younger between 1990 and 2002, according to data collected by the Centers for Disease Control and Prevention (MMWR 2004;53:1015–8). A total of 13,829 cases were reported during this period. Overall, incidence per 100,000 children declined by 92% among Asian/Pacific Islanders, 88% among whites, 88% among blacks, and 84% among American Indians/Native Alaskans. The greatest declines coincided with greater hepatitis B vaccination rates in children aged 19–35 months, which increased from 16% in 1992 to 90% in 2002, and in adolescents aged 13–15 years, which increased from almost 0% in 1992 to 67% in 2002.
Iron Deficiency's Role in ADHD
Children with attention-deficit hyperactivity disorder had significantly lower levels of iron, compared with controls in a study of 53 children aged 4–14 years, said Eric Konofal, M.D., of Hôpitaux de Paris, and his colleagues.
The mean serum iron level was 23 ng/mL in the children with ADHD, compared with 44 ng/mL in the controls. In addition, 42 (84%) of the ADHD children had iron levels considered abnormally low—below 30 ng/mL—compared with 5 (18%) of the 27 controls (Arch. Pediatr. Adolesc. Med. 2004;158:1113–5). Low levels of iron may hamper the development of the central nervous system and consequently contribute to the likelihood of behavioral disorders, so children with ADHD might benefit from iron supplements.
Neighborhoods and Violent Girls
Adolescent girls who mature early and live in economically disadvantaged neighborhoods committed three times as many violent acts as early maturers in less disadvantaged neighborhoods, said Dawn Obeidallah, Ph.D., of Harvard Medical School, Boston, and her colleagues.
The investigators used census data to characterize neighborhoods in the Chicago area and interviewed 501 adolescent girls and their families twice during a 3-year period (J. Am. Acad. Child Adolesc. Psychiatry 2004;43:1460–8).
Overall, 121 girls had engaged in violent behavior at the time of the second interview: 18% of the early maturers, 48% of on-time maturers, and 33% of late maturers. Approximately 50% of the girls were Hispanic, 36% were black, and 14% were white, and 20% of early maturing black girls, 14% of early maturing Hispanic girls, and 7% of early maturing white girls had engaged in violence at the time of the second interview.
Infant Hypoglycemia
Significant risk factors for prolonged hypoglycemia in infants include gestational age, 1-minute Apgar scores, male sex, and weight in the lowest quartile.
Prolonged hypoglycemia was present in 55 of 594 (9%) small-for-gestational-age infants, Dr. Eugenia K. Pallotto said in a poster presented at the annual meeting of the Society for Perinatal and Pediatric Epidemiologic Research in Salt Lake City.
The infants were born between 1998 and 2001 and were in the 10th percentile or below for gestational age. Prolonged hypoglycemia was defined as blood sugar of 40 mg/dL or less occurring beyond 72 hours of life.
One-minute Apgar scores of less than 5, male gender, young gestational age, and birth weight in the lowest quartile of the study group were significantly associated with prolonged hypoglycemia, said Dr. Pallotto of the University of Missouri-Kansas City. Hypoglycemic episodes were longer among premature infants, compared with those born at term. Prospective monitoring of high-risk infants may improve glucose control and reduce unrecognized hypoglycemic episodes, she said.