WAYS TO TELL SARS FROM INFLUENZA IN CHILDREN
Chang LY, Huang FY, Wu YC, et al. Childhood severe acute respiratory syndrome in Taiwan and how to differentiate it from childhood influenza infection. Arch Pediatr Adolesc Med. 2004;158:1037-1042.
Severe acute respiratory syndrome (SARS) emerged in 2003. Since this disease is similar in its symptoms to other upper respiratory infections, this retrospective study undertaken in Taiwan focused on differentiating children with SARS from those who were having influenza.
The study consisted of 15 children younger than 20 years who had been positively diagnosed with SARS-associated coronavirus via laboratory cultures and assays. All of these children also had had contact with SARS via:
1. Prior contact with a person with SARS.
2. Visited facilities where SARS was present.
3. Traveled to a place where SARS occurred.
The children also had the classic symptom of SARS-temperature greater than 38.5[degrees]C. In addition, most had standard respiratory symptoms of cough, sore throat, and difficulty breathing. Fourteen of the 15 children had lung infiltrates that were found on their chest x-rays. Approximately one third of the children also had leukopenia, lymphopenia, and monocytopenia.
The chart information from the 15 children with SARS were then compared to the chart information from 15 children diagnosed with either influenza B or influenza A. Both sets of children had similar fevers and coughs; however, the SARS group had less runny noses and less sore throats. In addition, there were no signs of monocytopenia in the children with influenza.
The researcher proposed that the best way to differentiate children with SARS or influenza is to check for rhinorrhea and monocytopenia. Should a SARS outbreak appear again, the researchers recommend further research to help identify cases of SARS and ways to differentiate it quickly from other upper respiratory diseases in children.
HEAD INJURIES IN DISABLED CHILDREN IN SCHOOLS
Limbos ANP, Ramirez M, Park LS, Peek-Asa C, Kraus JF. Injuries to the head among children enrolled in special education. Arch Pediatr Adolesc Med. 2004;158:1057-1061.
There are almost 6 million disabled children in the United States who attend the schools. That comes to approximately 20% of the total population of school-aged children. It has been proposed that children with disabilities have more incidences of injury than children who are not disabled. This study investigated the rates of head injury in the disabled children in Los Angeles using a review of the school records for the years 1994 to 1998.
All 6769 children who were disabled and who attended 17 of 18 special education schools in the Los Angeles, Calif, school district had their records reviewed for injuries. Children were noted as disabled if they are in one of the following categories:
* Developmentally disabled
* Cognitively disabled
* Physically disabled
* Had multiple disabilities
* Had other disabilities
These injuries were routinely reported on the Pupil Accident Reports. In addition, data on the sex and age of the children were gathered.
Analysis of the data showed that there were 697 physical injuries during that period for a rate of 4.7 per 100 student-years and rates of 1.3 per 100 student-years for head injuries. More than half (60%) of the head injuries were either in children with cognitive disabilities or with multiple disabilities. In addition, those children with other injuries were again more likely to be cognitively disabled. The overall highest rates of head injury were in the multiply disabled children. Most head injuries were either due to falls, unstructured play activities, or occurred on playgrounds. When data were compared to children who were not disabled, it was found that the rates of injury were similar and that sex and age had no bearing on the rates of injury.
The researchers recommend that head injuries could be lessened in the disabled if the classrooms were altered to be safer. This could be done by padding the classrooms and restrooms where a great deal of the injuries occur and by providing more staffing to increase supervision of the disabled children.