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KidsDoc Newsletter from AllForKids

August & September-2010, Vol-1, Issue-25

By Dr. M.Vijayalakshmi M.D(Peds), M.D(USA), FAAP, DAA

Content Sources:

Centers for Disease Prevention and Control(CDC), American Academy of Pediatrics

Latest from AllForKids

AllForKids will be conducting a free spirometry camp third Saturday of every month, Please call 0484-645 2772 to register. Annual Influenza Vaccination (Flu Shot) for 2009-10 is now available at AllForKids. Please call ahead for appointments.


Conjunctivitis is a common eye condition worldwide. It causes inflammation (swelling) of the conjunctiva—the thin layer that lines the inside of the eyelid and covers the white part of the eye. Conjunctivitis is often called "red eye" because it can cause the white of the eye to take on a pink or red color.

We have been seeing a Conjunctivitis epidemic in Kochi and surrounding areas recently. The following information should be useful to you to understand the disease and to prevent its spread.

The most common causes of conjunctivitis are viruses, bacteria, and allergens. The conjunctiva can also become irritated by foreign bodies in the eye and by indoor and outdoor air pollution caused, for example, by chemical vapors, fumes, smoke, or dust.

Viral Conjunctivitis

Viral conjunctivitis is caused by infection of the eye with a virus. Viral conjunctivitis

  • Can be caused by a number of different viruses, many of which are associated with an upper respiratory tract infection, cold, or sore throat.
  • Usually begins in one eye and may progress to the second eye within days.
  • Spreads easily and rapidly between people and can result in epidemics.
  • Is typically mild, with symptoms being the worst on days 3–5 of infection. The condition usually clears up in 7-14 days without treatment and resolves without any long-term effects. In some cases, it can take 2-3 weeks or more for viral conjunctivitis to completely clear up, depending on whether complications develop.

Bacterial Conjunctivitis

Bacterial conjunctivitis is caused by infection of the eye with certain bacteria. Bacterial conjunctivitis

  • Usually begins in one eye and may sometimes progress to the second eye.
  • Is a leading cause of children being absent from day care or school (Patel, 2007).
  • Cases are typically mild and can last as few as 2-3 days or up to 2-3 weeks. Many cases improve in 2-5 days without treatment However, topical antibiotics are often prescribed to treat the infection.

Symptoms of Conjunctivitis

Symptoms of conjunctivitis can include

  • Pink or red color in the white of the eye(s) (often one eye for bacterial and often both eyes for viral or allergic conjunctivitis)
  • Swelling of the conjunctiva (the thin layer that lines the white part of the eye and the inside of the eyelid) and/or eyelids
  • Increased tearing
  • Discharge of pus, especially yellow-green (more common in bacterial conjunctivitis)
  • Itching, irritation, and/or burning
  • Feeling like a foreign body is in the eye(s) or an urge to rub the eye(s)
  • Crusting of eyelids or lashes sometimes occurs, especially in the morning
  • Symptoms of a cold, flu, or other respiratory infection may also be present
  • Sensitivity to bright light sometimes occurs
  • Enlargement and/or tenderness, in some cases, of the lymph node in front of the ear. This enlargement may feel like a small lump when touched. (Lymph nodes act as filters in the body, collecting and destroying viruses and bacteria.)
  • Symptoms of allergy, such as an itchy nose, sneezing, a scratchy throat, or asthma may be present in cases of allergic conjunctivitis

Preventing the Spread of Conjunctivitis

Conjunctivitis caused by allergens is not contagious; however, viral and bacterial conjunctivitis can be easily spread from person to person and can cause epidemics. You can greatly reduce the risk of getting conjunctivitis or of passing it on to someone else by following some simple good hygiene steps.

If you have infectious (viral or bacterial) conjunctivitis, you can help limit its spread to other people by following these steps:

  • Wash your hands often with soap and warm water. If soap and water are not available, use an alcohol swab.
  • Avoid touching or rubbing your eyes.
  • Wash any discharge from around the eyes several times a day. Hands should be washed first and then a clean washcloth or fresh cotton ball or tissue can be used to cleanse the eye area. Throw away cotton balls or tissues after use; if a washcloth is used, it should be washed with hot water and detergent. Wash your hands with soap and warm water when done.
  • Wash hands after applying eye drops or ointment.
  • Do not use the same eye drop dispenser/bottle for infected and non-infected eyes—even for the same person.
  • Wash pillowcases, sheets, washcloths, and towels in hot water and detergent; hands should be washed after handling such items.
  • Avoid sharing articles like towels, blankets, and pillowcases.
  • Clean eyeglasses, being careful not to contaminate items (like towels) that might be shared by other people.
  • Do not share eye makeup, face make-up, make-up brushes, contact lenses and containers, or eyeglasses.
  • Do not use swimming pools.

If you are around someone with infectious (viral or bacterial) conjunctivitis, you can reduce your risk of infection by following these steps:

  • Wash your hands often with soap and warm water. If soap and warm water are not available, use an alcohol-based hand rub.
  • Wash your hands after contact with an infected person or items he or she uses; for example, wash your hands after applying eye drops or ointment to an infected person’s eye(s) or after putting their bed linens in the washing machine.
  • Avoid touching or rubbing your eyes.
  • Do not share items used by an infected person; for example, do not share pillows, washcloths, towels, eye drops, eye or face makeup, and eyeglasses.
  • Clean and handle your contact lenses as instructed by your eye doctor.

In addition, if you have infectious conjunctivitis, there are steps you can take to avoid re-infection once the infection goes away:

  • Throw away and replace any eye or face makeup you used while infected.
  • Replace contact lens solutions that you used while your eyes were infected.
  • Throw away disposable contact lenses and cases that were used while your eyes were infected.
  • Clean extended wear lenses as directed.
  • Clean eyeglasses and cases that were used while infected.


Influenza is an acute respiratory illness caused by the Influenza virus. It can cause mold or severe illness and sometimes death. The symptoms if influenza include:

  1. Sudden onset o high fever.
  2. Cough
  3. Sore throat
  4. Runny nose/stuffy nose.
  5. Muscle pain/myalgia
  6. Tiredness/Fatigue
  7. Vomiting and diarrhea in children.

Normal course of the illness: in the vast majority of patients who get the flu,it is a mild self limiting illness and most people recover in less than 2 weeks even without any specific medicines.Some can develop complications like ear infections, pneumonia, bronchitis and sinusitis. Some may need hospitalization and antiviral and antibiotic use.

Who is at higher risk of Flu complication?

  1. Children less than 2 years of age and adults over 65 years.
  2. Pregnant women
  3. People with underlying medical conditions like asthma,lungdiseases,heartdisease,neurological disease and also people with diabetes,cancer,kidney disease and some liver diseases.

What is H1N1 flu?

In 2009-2010 flu season a new and different virus called 2009 H1N1 spread worldwide and caused the first pandemic in 40 years. It caused widespread panic in some cities in India and abroad. Fortunately this year a preventive vaccine is available to fight this virus.

Each baby develops in his own manner, so it’s impossible to tell exactly when your child will perfect a given skill. Although the developmental milestones listed in this book will give you a general idea of the changes you can expect as your child gets older, don’t be alarmed if his development takes a slightly different course. Talk to your pediatrician if your baby displays any of the following signs of possible developmental delay in the eight-to twelve-month age range.

How can you protect yourself?

  1. Routine hygiene measures like covering your cough and sneeze, washing your hands with soap and water and staying away from work if you are sick can protect yourself and others from getting sick.
  2. Getting the flu vaccine annually.
  3. Using antiviral medicines if prescribed by the doctor.


The 2010-2011 influenza vaccine will protect against 3 strains of influenza which include the 2009 H1N1 strain,H3 N2 virus and Influenza B virus. The antibodies that protect against the disease are formed about 2 weeks after the shot.

Types of vaccine

  1. Injection : The injection has inactivated virus particles and the injection is given in the deltoid muscle of the arm . It can be used in children over 6 months to adults.

  2. Intranasal vaccine: It is made from live weakened flu virus which will not cause flu and is given as a nasal spray. It can be used in children over 2 years till 49 years and only in nonpregnant women.

Who should receive the vaccine?

Flu vaccine can be safely given to anyone over 6 months .

The people who are at most risk like pregnant women, people with bronchitis , asthma and those working in healthcare are also advised to receive the vaccine.

What are the side effects of the vaccine?

The injection may cause slight pain and soreness at the site and low grade fever for a day or two.

The nasal spray may cause slight sore throat, headache ,vomiting and sometimes wheezing which are usually mild.

Is the vaccine available in India?

Yes, both the nasal spray and injection are available.

In children under 8 years 2 doses of flu shot are needed if using for the first time and in adults it is a single


Rabies is a preventable viral illness of mammals which is transmitted by the bite of rabid animals.

Signs and symptoms

Initially it has a flu like picture with fever, headache and tiredness. There may be pain and tingling at the bite site.

Later the patient has abnormal behavior ,confusion, difficulty sleeping and in the terminal stages difficulty swallowing food and water. The patient gets a choking sensation on seeing water and so it is also called Hydrophobia. Rabies is a fatal illness and once the brain and nervous tissue have been affected survival is rare.

How does it spread?

The rabies virus can infect humans from the bite of animals like dogs, cats, foxes ,raccoon and bats.The virus is present in the saliva of the animal and reaches the nerve s at the wound and migrates to the human brain. It can also spread through corneal transplant and organ transplant .

What is to be done in case of a dog bite?

First important step is to wash the wound with soap and water. Immediate medical attention should be sought.

What is the treatment?

Rabies vaccine and Immunoglobulin are administered within the first 24 hrs. At least 4 doses of the vaccine are to be given in persons who have not been previously vaccinated for rabies. The vaccines are usually given in the muscle of the upper arm .

The dog can be observed in captivity for 10 days to check if the dog developed any signs of rabies.

Once a person develops rabies only supportive care in the ICU is possible. A few patients have recovered from rabies after months of treatment.

How can we protect ourselves from rabies?

Teach children not to pet or tease stray animals like dogs and cats.

Vaccinate your pet against rabies .

Interested in accessing previous issues of our Newsletter? Please visit the following link http://www.allforkidsindia.com/allforkids/Newsletter/index.aspx


Pediatric and Adolescent Clinic

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Sanskrit College Road, Tripunithura-682301

Phone: 0484-645 2772, 0484-6492772
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