According to the World Health Organization (WHO), infectious disease are caused by pathogenic microorganisms (bacteria, viruses, parasites, or fungi) that spread directly or indirectly from one person to another.
The most common infectious diseases are the common cold, flu, strep throat, the stomach flu, and urinary tract infection (UTI). Depending on the type of infectious disease you might in contact with, the symptoms can vary. For example, symptoms for the common cold include: runny or stuffy nose, sore throat, congestion, sneezing, slight body aches, and a low-grade fever.
Listen in as Jason Newland, MD, Washington University pediatric infectious disease physician at St. Louis Children’s Hospital explains what infectious diseases are, the warning signs/symptoms and when you should seek medical treatment.
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Infectious Diseases in Children
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Learn more about Jason Newland, MD
Jason Newland, MD
Jason Newland, MD, is a Washington University pediatric infectious diseases physician at St. Louis Children’s Hospital.Learn more about Jason Newland, MD
Transcription:
Infectious Diseases in Children
Melanie Cole (Host): Infectious diseases kill more people worldwide than any other single cause according to the World Health Organization. My guest today is Dr. Jason Newland. He’s a Washington University Pediatric Infectious Disease Physician at Saint Louis Children’s Hospital. Welcome to the show, Dr. Newland. What are some of the most common infectious diseases that a pediatrician might see?
Dr. Jason Newland (Guest): Well, there’s many infectious diseases that a pediatrician sees every day. Those include ear infections, sore throats, such as group A strep pharyngitis, urinary tract infections, infections of the skin that gives you these abscesses. Then in the winter time, we often see a lot of cold-like illnesses, and influenza virus is by far and away one of the most common and scary ones of our infectious diseases that impact children that we actually have a great vaccine for.
Melanie: Why don’t you speak about the flu vaccine for a minute and what would you like pediatricians to know about convincing their patients to get the annual flu vaccine and what they should be on the lookout for flu?
Dr. Newland: Yes, this is a really, really important topic and it becomes more important all the time. I think influenza vaccine if there’s anything to say to folks, is that we see children die every year from the influenza virus. These are normal, healthy children at times as well as those kids who have underlying medical problems. It has recently been shown that of those children that have had the worst outcomes, that even in years where the influenza vaccine might not be the best in regards to covering the virus, it still helps in protecting against those worse outcomes like death. If anything, for the pediatricians now as we see more and more data, is we definitely know that this vaccine saves lives. It saves many lives every year, and therefore we have to continue to stress the importance of the flu vaccine for folks.
Melanie: What are some of the other infectious diseases you would like them to be on the lookout for?
Dr. Newland: Well, I think some other big ones coming up as we get into the summer time are our diarrheal illnesses such as – we will sometimes see something called cryptosporidium diarrhea, or giardia and this can occur from swimming pools. I think it’s important for pediatricians to keep a look out for that, and for any of the families and parents that are listening, if your child has diarrhea, then they shouldn’t be in a pool because this can be transmissible to others.
I think some other infections that we always see by our pediatricians are these common colds. What we try to do is just support our families – and I know there’s a lot of pressure to feel that you have to prescribe antibiotics at times and I think there are indications to do that, such as ear infections, when you actually see a true ear infection, or when they have a strep throat manifested by a sore throat with fever. In those cases antibiotics are important, but we have to remember antibiotics have side effects and those side effects are not harmless. You can have bad skin rashes; you can have awful diarrhea. What we always talk about with the overuse of antibiotics is the development of resistance that our bacteria become so resistant to some of these antibiotics that we can’t use them. I think commonly, that we need to step back and think, “Do we need these antibiotics, or do we not,” and to have great conversations with our families about the importance of using them when they’re appropriate and to stress the fact, again, that there can be negative consequences to using the antibiotics.
Melanie: Is one of those obstacles in infection treatment – how would you tell a pediatrician to discuss this with their patients? Because as you mentioned, patients come and they’re begging for an antibiotic when maybe it’s a viral infection where there could be side effects with the antibiotic in the first place. What do you want pediatricians to tell their patients about this to convince them?
Dr. Newland: Yeah, so I think -- to step back, the first thing is that we have this notion that families like to come in and demand for antibiotics and I think at times they do, but studies would suggest they don’t demand as much as we assume they do. I think the first step is to be up front and ask, “Are people expecting an antibiotic?” Because we know that expectation if we just think they want an antibiotic will lead us to prescribe antibiotics often times when they’re not necessary. I think step one is just do they want an antibiotic and asking about that, really directly to them.
Secondly, is if you look at the studies, what families what is that they want reassurance and then they want a plan of what to do next in case things don’t get better. I think that’s important. One is reassurance, saying, “Okay, this is a viral infection, I understand that you’re concerned,” acknowledge that concern, and provide some other options for things that they can do, such as if they’re having pain or fever that they can use things like acetaminophen, or things like ibuprofen and such. I think these are important strategies.
Lastly, I think, is give them a contingency plan. If you’re not better in the next two or three days, call us back, and we can reevaluate. There have been strategies where you can actually give an antibiotic and say, “Hey, don’t fill this antibiotic unless they don’t get better.” And while some people might often think that -- people just say, “Oh, well I’m just going to go fill that antibiotic,” they find frequently that they don’t go get an antibiotic. I had a recent experience, personally, where someone came and talked to me about using antibiotics – that someone had prescribed them antibiotics for sinusitis, but the physician had told them, “Don’t fill it, unless you’re not getting better,” and they said, “You know what? I never filled it. I realized that I didn’t need it because I had started getting better in the next couple of days.”
I think these strategies will work, though it’s not easy. I don’t want to make it sound easy because I know these are hard conversations, at times. I just think that we need to continue to try to look at that.
Melanie: Along the line of vaccines, Dr. Newland, meningitis for college students – I mean, there are things that we’re hearing about going around at places --
Dr. Newland: Some of the more scary illnesses in infectious disease we worry about, yeah, meningitis is definitely one of them. Now, we have been blessed with vaccines in this era, so the most common bacteria that causes meningitis is a bacteria called streptococcus pneumonia. We have a great vaccine that has really almost eliminated that bacteria causing meningitis. We have rarely seen cases in the last couple of years with the newest version of that vaccine. And as you mentioned, often in teenagers and those going to college, we worry about something called meningococcus, or Neisseria Meningitidis, which also can cause meningitis, and thankfully, again, we have a vaccine that can be given now down to the younger child at the age of two years and above, but it’s really recommended to occur in their teenage years. This is also an effective vaccine. Now, it’s not a perfect vaccine because it doesn’t cover all of the types of this Neisseria Meningitidis, but it is definitely something that all children should receive at these time points, and I have three kids of my own that will also receive it.
I think probably another vaccine that should be mentioned as we talk about vaccines is the human papillomavirus vaccine. This is truly an amazing vaccine in that it prevents cancer. It is truly probably the first, or some might say the second vaccine that prevents cancer. It prevents cervical cancer; it prevents penile cancer, which is often not talked about, among men. It is so, so important that our children receive this vaccine and it’s usually recommended, now I think down to the age of eight or nine years of age. Often kids will get it around 11 or 12 years of age. It’s now -- I think just two doses. This is something that is a must, and it is a cancer-preventative vaccine.
Melanie: So wrap it up for us, Dr. Newland, if you will, when you would like pediatricians to refer to a specialist if they have patients with one of these infectious diseases we’ve been discussing, and what you would like them to know about recognizing some of these things?
Dr. Newland: I think first, and foremost is that pediatricians care for infectious diseases all the time and they, in some respects, are experts in some of the things that we’ve talked about – ear infections, colds, sinusitis, strep pharyngitis – those they can care for. But there are times when a specialist like myself and other of my infectious disease colleagues are necessary. These can be such things as prolonged fever, so fever for longer than ten days where you just don’t know what’s going on and they need some additional assistance. They also could be in children that have recurrent episodes of fever that continue to be occurring over, and over and you need some additional help.
Secondly, we can be useful in regards to more serious infections such as bone infections or bad, complicated pneumonia that require drainage-type procedures while they’re in the hospital. And finally, I think we can be very helpful when it comes to those patients and families that you’ve worked on regarding vaccine hesitancy where they’re not wanting vaccines, and you need another person just to have these discussions. I think we, as infectious disease physicians, see ourselves as a resource to our fellow subspecialists, as well as to all of the pediatricians and others who have concerns around these areas and we’re always willing to discuss cases and be any type of resource to people when they have questions.
Melanie: And tell us about your team, why is Saint Louis Children’s Hospital so great to work with?
Dr. Newland: Saint Louis Children’s Hospital is one of those gems that all communities need to have. When you have the number of specialists and dedicated folks that want to help others, this is a place you’d like. I think among the infectious disease faculty members, there’s about eleven of us who all have our unique interests, but I think what’s most important is that we really care about our community, about our children, about our families, and we want to do whatever we can to help others out in this area.
Melanie: Thank you, so much, for being with us today. A physician can refer a patient by calling Children’s Direct Physician Access Line at 1-800-678-HELP, that’s 1-800-678-4357. You’re listening to Radio Rounds with Saint Louis Children’s Hospital. For more information on resources available at Saint Louis Children’s Hospital, you can go to SaintLouisChildrens.org, that’s SaintLouisChildrens.org. This is Melanie Cole. Thanks, so much, for listening.
Infectious Diseases in Children
Melanie Cole (Host): Infectious diseases kill more people worldwide than any other single cause according to the World Health Organization. My guest today is Dr. Jason Newland. He’s a Washington University Pediatric Infectious Disease Physician at Saint Louis Children’s Hospital. Welcome to the show, Dr. Newland. What are some of the most common infectious diseases that a pediatrician might see?
Dr. Jason Newland (Guest): Well, there’s many infectious diseases that a pediatrician sees every day. Those include ear infections, sore throats, such as group A strep pharyngitis, urinary tract infections, infections of the skin that gives you these abscesses. Then in the winter time, we often see a lot of cold-like illnesses, and influenza virus is by far and away one of the most common and scary ones of our infectious diseases that impact children that we actually have a great vaccine for.
Melanie: Why don’t you speak about the flu vaccine for a minute and what would you like pediatricians to know about convincing their patients to get the annual flu vaccine and what they should be on the lookout for flu?
Dr. Newland: Yes, this is a really, really important topic and it becomes more important all the time. I think influenza vaccine if there’s anything to say to folks, is that we see children die every year from the influenza virus. These are normal, healthy children at times as well as those kids who have underlying medical problems. It has recently been shown that of those children that have had the worst outcomes, that even in years where the influenza vaccine might not be the best in regards to covering the virus, it still helps in protecting against those worse outcomes like death. If anything, for the pediatricians now as we see more and more data, is we definitely know that this vaccine saves lives. It saves many lives every year, and therefore we have to continue to stress the importance of the flu vaccine for folks.
Melanie: What are some of the other infectious diseases you would like them to be on the lookout for?
Dr. Newland: Well, I think some other big ones coming up as we get into the summer time are our diarrheal illnesses such as – we will sometimes see something called cryptosporidium diarrhea, or giardia and this can occur from swimming pools. I think it’s important for pediatricians to keep a look out for that, and for any of the families and parents that are listening, if your child has diarrhea, then they shouldn’t be in a pool because this can be transmissible to others.
I think some other infections that we always see by our pediatricians are these common colds. What we try to do is just support our families – and I know there’s a lot of pressure to feel that you have to prescribe antibiotics at times and I think there are indications to do that, such as ear infections, when you actually see a true ear infection, or when they have a strep throat manifested by a sore throat with fever. In those cases antibiotics are important, but we have to remember antibiotics have side effects and those side effects are not harmless. You can have bad skin rashes; you can have awful diarrhea. What we always talk about with the overuse of antibiotics is the development of resistance that our bacteria become so resistant to some of these antibiotics that we can’t use them. I think commonly, that we need to step back and think, “Do we need these antibiotics, or do we not,” and to have great conversations with our families about the importance of using them when they’re appropriate and to stress the fact, again, that there can be negative consequences to using the antibiotics.
Melanie: Is one of those obstacles in infection treatment – how would you tell a pediatrician to discuss this with their patients? Because as you mentioned, patients come and they’re begging for an antibiotic when maybe it’s a viral infection where there could be side effects with the antibiotic in the first place. What do you want pediatricians to tell their patients about this to convince them?
Dr. Newland: Yeah, so I think -- to step back, the first thing is that we have this notion that families like to come in and demand for antibiotics and I think at times they do, but studies would suggest they don’t demand as much as we assume they do. I think the first step is to be up front and ask, “Are people expecting an antibiotic?” Because we know that expectation if we just think they want an antibiotic will lead us to prescribe antibiotics often times when they’re not necessary. I think step one is just do they want an antibiotic and asking about that, really directly to them.
Secondly, is if you look at the studies, what families what is that they want reassurance and then they want a plan of what to do next in case things don’t get better. I think that’s important. One is reassurance, saying, “Okay, this is a viral infection, I understand that you’re concerned,” acknowledge that concern, and provide some other options for things that they can do, such as if they’re having pain or fever that they can use things like acetaminophen, or things like ibuprofen and such. I think these are important strategies.
Lastly, I think, is give them a contingency plan. If you’re not better in the next two or three days, call us back, and we can reevaluate. There have been strategies where you can actually give an antibiotic and say, “Hey, don’t fill this antibiotic unless they don’t get better.” And while some people might often think that -- people just say, “Oh, well I’m just going to go fill that antibiotic,” they find frequently that they don’t go get an antibiotic. I had a recent experience, personally, where someone came and talked to me about using antibiotics – that someone had prescribed them antibiotics for sinusitis, but the physician had told them, “Don’t fill it, unless you’re not getting better,” and they said, “You know what? I never filled it. I realized that I didn’t need it because I had started getting better in the next couple of days.”
I think these strategies will work, though it’s not easy. I don’t want to make it sound easy because I know these are hard conversations, at times. I just think that we need to continue to try to look at that.
Melanie: Along the line of vaccines, Dr. Newland, meningitis for college students – I mean, there are things that we’re hearing about going around at places --
Dr. Newland: Some of the more scary illnesses in infectious disease we worry about, yeah, meningitis is definitely one of them. Now, we have been blessed with vaccines in this era, so the most common bacteria that causes meningitis is a bacteria called streptococcus pneumonia. We have a great vaccine that has really almost eliminated that bacteria causing meningitis. We have rarely seen cases in the last couple of years with the newest version of that vaccine. And as you mentioned, often in teenagers and those going to college, we worry about something called meningococcus, or Neisseria Meningitidis, which also can cause meningitis, and thankfully, again, we have a vaccine that can be given now down to the younger child at the age of two years and above, but it’s really recommended to occur in their teenage years. This is also an effective vaccine. Now, it’s not a perfect vaccine because it doesn’t cover all of the types of this Neisseria Meningitidis, but it is definitely something that all children should receive at these time points, and I have three kids of my own that will also receive it.
I think probably another vaccine that should be mentioned as we talk about vaccines is the human papillomavirus vaccine. This is truly an amazing vaccine in that it prevents cancer. It is truly probably the first, or some might say the second vaccine that prevents cancer. It prevents cervical cancer; it prevents penile cancer, which is often not talked about, among men. It is so, so important that our children receive this vaccine and it’s usually recommended, now I think down to the age of eight or nine years of age. Often kids will get it around 11 or 12 years of age. It’s now -- I think just two doses. This is something that is a must, and it is a cancer-preventative vaccine.
Melanie: So wrap it up for us, Dr. Newland, if you will, when you would like pediatricians to refer to a specialist if they have patients with one of these infectious diseases we’ve been discussing, and what you would like them to know about recognizing some of these things?
Dr. Newland: I think first, and foremost is that pediatricians care for infectious diseases all the time and they, in some respects, are experts in some of the things that we’ve talked about – ear infections, colds, sinusitis, strep pharyngitis – those they can care for. But there are times when a specialist like myself and other of my infectious disease colleagues are necessary. These can be such things as prolonged fever, so fever for longer than ten days where you just don’t know what’s going on and they need some additional assistance. They also could be in children that have recurrent episodes of fever that continue to be occurring over, and over and you need some additional help.
Secondly, we can be useful in regards to more serious infections such as bone infections or bad, complicated pneumonia that require drainage-type procedures while they’re in the hospital. And finally, I think we can be very helpful when it comes to those patients and families that you’ve worked on regarding vaccine hesitancy where they’re not wanting vaccines, and you need another person just to have these discussions. I think we, as infectious disease physicians, see ourselves as a resource to our fellow subspecialists, as well as to all of the pediatricians and others who have concerns around these areas and we’re always willing to discuss cases and be any type of resource to people when they have questions.
Melanie: And tell us about your team, why is Saint Louis Children’s Hospital so great to work with?
Dr. Newland: Saint Louis Children’s Hospital is one of those gems that all communities need to have. When you have the number of specialists and dedicated folks that want to help others, this is a place you’d like. I think among the infectious disease faculty members, there’s about eleven of us who all have our unique interests, but I think what’s most important is that we really care about our community, about our children, about our families, and we want to do whatever we can to help others out in this area.
Melanie: Thank you, so much, for being with us today. A physician can refer a patient by calling Children’s Direct Physician Access Line at 1-800-678-HELP, that’s 1-800-678-4357. You’re listening to Radio Rounds with Saint Louis Children’s Hospital. For more information on resources available at Saint Louis Children’s Hospital, you can go to SaintLouisChildrens.org, that’s SaintLouisChildrens.org. This is Melanie Cole. Thanks, so much, for listening.