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Vortherms Experience with Febrile Seizures
In young children, a rapidly rising body temperature can cause a seizure or a convulsion. This is called a
fever seizure or febrile seizure. It typically affects children between the ages of 6 months and 5 years and lasts a few minutes.
A seizure triggered by a sudden fever is usually harmless and doesn't indicate a long-term or ongoing problem. In fact, it
is fairly common — affecting about 2 percent to 4 percent of children under age 5. Medical attention should be sought
to determine the cause of the fever. The most common cause is a typical childhood illness such as middle ear infection or
roseola.
Our daughter Emma Hai Ling experienced a febrile seizure. We have since learned information on febrile seizures
and are passing it on as we wouldn't want you to be as terrified as we were if your child should experience a febrile seizure.
Signs may include:
Repeated rhythmic jerking or stiffening of your child's arms, legs and face.
Eyes rolled back in your child's
head.
Breathing problems.
Loss of consciousness.
Vomiting.
Loss of urine.
An elevated body temperature-usually
higher than 102 degrees.
Emma's seizure was caused by her MMR vaccination, to the best of our doctors knowledge. One
of the mild risks of the MMR vaccination is a fever of 102 degrees. One of the moderate risks of the MMR is a seizure occurring
8 to 14 days after the vaccination. In Emma's case, she spiked a fever of 104 degrees and had a febrile seizure 10
days after her MMR vaccination. Febrile seizures are caused by the fever-not by the vaccination itself.
Sometimes
parents don't even know when their child has had a seizure- for example overnight. I did know because I was holding Emma at
the time. Her arms and legs started jerking and her skin color turned a mottled blue. We immediately went to our local hospital's
emergency room and had Emma checked over and tests were ordered. The doctor told us Emma would be very sleepy and she did
sleep for a couple hours, and then woke up smiling like nothing had happened. If Emma ever has another episode, the doctor
will order an EEG.
We were to alternately dose Emma with ibuprofen and acetaminophen, which we did and can do again whenever
she gets a fever, to reduce the chance of possible future seizures. The most common complication of febrile seizures is more
febrile seizures. About a third of children who have a febrile seizure will have another one with a subsequent fever.
***
As a side note, no less than 3 children from Emma’s orphanage, that were adopted in the same time frame,
have reported seizures. One of the children has been diagnosed with epilepsy. Emma’s seizures are believed to be from
fever caused by the MMR shot, and the other child’s seizure is thought to be from fever caused by a DPT shot.
Needless to say I was very nervous about getting Alia’s shots since she was the last scheduled to see
the doctor. Our doctor assured us that febrile seizures are not
uncommon in children everywhere and although it is something to watch for, it is not something to panic about.
***
Bill and Carly have returned from China and also had an experience with seizure. At this writing
it is being attributed to a virus and sinus infection.
Frymark’s experience with Giardia
Although Alia was not sick like Emma, we did deal with a couple of medical issues. Like Zoe, Alia came home
with a sinus infection that required antibiotics to clear up. This did not cause her a great deal of discomfort — but
her nose was a mess.
Our “big” medical issue was Giardia. Alia had no symptoms. I decided to have her tested (stool
sample) as other parents from our orphanage group were reporting that their children had Giardia. (This is a good reason to
join your orphanage group.) Alia’s test came back positive and she was put on medicine. Tip: If you have to use
this medication DO NOT put it in their bottle. It is very bitter and nasty — Alia wouldn’t eat for days
when I tried to sneak it in her bottle. Below is some information I have found on the internet regarding Giardia:
Giardia is often referred to as the orphanage parasite. It causes symptoms including diarrhea, abdominal distension,
chronic belly pain, and gas. Stools can be watery, but are often thick and formless, large in volume and very foul smelling.
Some people have minimal symptoms, but the parasites are still shed in their stool and are a source of infection. Asymptomatic
cyst passers should be treated! A follow-up culture should be obtained after treatment to insure irradication. Children with
Giardia can be irritable and have behavior problems. The malabsorption of nutrients can cause them to fail to thrive and
suffer growth failure. It is recommended that 3 stool samples be collected as the cysts are inconsistently shed. Adults
that traveled to the child’s country should also be assessed if there is abdominal pain or any change in bowel habits.
Diaper changes should be followed by hand washing as Giardia is easily transmissible.
Mongolian Spots
About 90% of children of non-white races have Mongolian spots. Because they resemble bruises, it is
important that parents get their pediatrician to record specific references to them in the child's records. It is also important
that parents show and explain their child's Mongolian spots to others who may see the spots on their own. There are parents
that have stories of being reported for abuse when they have overlooked informing a sitter. One adoptive mother said that
her homestudy social worker told of being reported by her church nursery worker because her adopted Korean child had a large
spot. Another parent, when picking up her Chinese daughter from a new sitter's, remarked to the sitter that she had meant
to talk about the toddler's Mongolian spots and asked the sitter if she knew what they were (as she pulled up the child's
shirt). The sitter replied, "No. But I saw them and I didn't know what to do. I called up my girlfriend and she said to ask
you about them."
Health-oriented parenting guidebooks, for example, The Baby Book (Sears & Sears) and Your Child's
Health (Schmitt), usually have a few paragraphs on Mongolian spots. The spots are not related to disease; they
may fade with time and may disappear completely.
Alia has spots on her low back, mid back and shoulder blade. They look exactly like bruises. They have been
recorded in her medical records. Zoe also has spots and her parents have taken the precaution of photographing them to show
that she has always had them and to be able to recognize these as her spots and not bruises from other sources.
Chronic Sinus Infections
We seem to have several of our babies come home with sinus infections. I was under the mistaken impression that sinus infections
were rare in infant. Below is some information I found on the internet.
Chronic sinus infections are among the most common form of upper respiratory infection in children & adults. Contrary
to common belief, they are common in children & infants and have been well documented in medical publications within the
last 15 years. The most common symptoms of chronic sinus infection include:
Viral infections
Allergy
Bad breath.
Environmental irritants such as smoke, dust fumes
Other irritants such as water.
While chronic sinus infections are not life threatening (unlike some forms of acute sinus infection), there are some complications
which may include worsening of asthma symptoms, fatigue, chronic headache, & constant sore throats.
Two important things need to be done: Recognize symptoms of chronic sinus infection & prevent the causes, including
removing irritants from the environment or treating the allergies. Treatment includes:
Prevention.
The use of antibiotics for 1-4 weeks.
The use of topical nasal anti-inflammatory medications (steroids - very safe).
Occasional use of decongestants & antihistamines.
Saline (salt water) nasal sprays.
Occasional warm packs to the sinus areas.
Occasionally in recalcitrant cases, a needle may need to be introduced into the sinus area to irrigate & drain the
sinuses.
On occasion, blood tests evaluating infection, allergies, or immunity may be performed, as well as x-rays. Certain vaccinations
such as the Haemophilus influenza or Pneumococcal vaccines may be given to prevent sinus infection.
In summary chronic sinus infections are common and prevention is essential.
Scabies
Scabies are
ectoparasites (mites which cannot be seen by the naked eye). They burrow under skin causing intense itching 6-8 weeks after
they have initially affected the skin. The itching is a hypersensitivity reaction to the waste products deposited under the
skin. Tiny red raised spots called papules are found on the palms of the hands, soles of the feet, armpits, face, and waist. The red papules can become blister-like and can be secondarily infected with
bacteria, particularly Group A streptococci. When these bacteria infect the scabies lesions, the diagnosis is Impetigo.
Scabies are spread by close personal contact such as that found in orphanages.
Anyone suspected of having scabies should not share clothing, towels, or sheets with any other family member. Routine
bathing in warm water with borax added; saunas; and frequent washing of towels, clothing, sheets, etc. in hot water and borax
all seem to help prevent the spread of scabies.
Most U.S. cases are treated with a 5% permethrin product which
should be applied from the head down in a child and from the neck down in an adult. It is applied to all the skin of the body
before bedtime and kept on for 12 hours. It is then bathed/showered off. One application is quite effective, but if the scabies
is widespread or if the lesions progress then another application one week later is appropriate. DO NOT USE any
product containing LINDANE, as this has caused severe reactions in some people. Frequent warm baths or saunas are recommended
as part of the treatment. Moisturizing lotions, hydrocortisone creams, olive
oil, Benadryl, oatmeal baths, baking soda baths, and gently popping the blisters and applying Eucalyptus oil have all been
suggested as ways to help stop or lessen the itching associated with scabies
or post-scabies.
Infant acropustulosis
is a reoccurrence of itchy pustules - a post scabies condition that is not a result of still having the live mite. These
blisters dry up and flatten out in a day or two, then the dead skin may peel off. Itching seems most intense when the
skin is beginning to turn red and when the blisters first appear, especially at night. The outbreaks occur in 3-4 week
cycles, lessening in severity over time. This skin condition can persist for
YEARS after having scabies. Retreating with Elimite is useless if you do not have the live parasitic mite in your system. Relief comes through 1) topical application of 1% cortisone and 2) oral dose of Atarax
(prescription antihistamine) if given early it can actually thwart an outbreak. This skin condition also seems to pop up more
in international adoptees .
Scabies is
common in the US especially in daycare settings. It is also very common in orphanages abroad. It is easy to treat scabies,
but sometimes it is not so easy to recognize. Children in orphanages actually get used to the itching and discomfort of scabies
because they are unable to communicate their feelings. Sometimes scabies can cause scaling and it can look like eczema. It
is often treated with steroids which then can alter its appearance and then it is called scabies incognito and it is more
difficult to diagnose. Itching can continue for weeks even after effective therapy
because this is a hypersensitivity reaction which has been ongoing for weeks or months. If the lesions are affected by Impetigo,
an antibiotic to be administered by mouth should be prescribed.
It is essential
that the parents traveling with the newly adopted child be simultaneously treated for scabies to prevent transmission that
is so common with scabies. Moisturization of the skin is also beneficial
in helping to lessen the itching. Occasionally a child or an adult will need an antihistamine like henadryl or atarax to help
the intense itching that can interfere with a good sound sleep!
Should I be concerned about lead toxicity in my Internationally
adopted child? by James Reilly, M.D.
What does lead do to the body?
High lead can disrupt the kidneys, teeth, brain (seizures, attention deficit
disorder, behavior problems and a decreased
IQ), and the body’s ability to produce blood. Depending on the level it
can have devastating consequences.
How do children get exposed to lead?
Usually from motor vehicle emissions, lead based paint, canned foods and water (either
contaminated with lead or leeched from lead pipes). All of these have decreased as governments
have banned lead from these sources.
Children are more at risk from lead exposure. Adults absorb only 5-10% of dietary lead
and retain little, however, children absorb 40-50% and retain 20%. Fetuses seem
to be more at risk.
More than 4% of children in the US have lead poisoning. Rates of lead poisoning are higher
in large cities and among people with low incomes.
The most common cause of lead poisoning today is old paint. Lead has not been used in
house paint since 1978. However, many older houses and apartments (those built before 1960) have lead-based paint on the walls.
Burning painted wood with lead in it can liberate lead into the air where it is absorbed into the lungs.
Toddlers explore their world by putting things in their mouths. Therefore, those who
live in older buildings (like orphanages tend to be) are at high risk of getting lead poisoning. They can get lead poisoning
by chewing on pieces of peeling paint or by swallowing dust or soil that contains tiny chips of the paint from these buildings.
Lead can also be in air, water and food. Lead levels in the air have gone down since
it was taken out of gasoline in the 1970s. Lead is still found in some water pipes, although
using lead solder to mend or put together water pipes is no longer allowed in the US. Lead can also be found in food or juice
stored in foreign-made cans or improperly fired ceramic containers.
What is the risk that my child will have lead poisoning if they are internationally adopted?
It is difficult to give a number that is meaningful to a parent because all of these
things are changing all the time. Although it can be said that children from
China or certain parts of Russia are at increased risk, if a child from that area came from a low risk institution their individual
risk may be lower.
Circumstances of poor nutrition definitely puts children at risk for lead poisoning and
this is a recurring theme in international adoption.
It is recommended that all internationally adopted children be screened
for lead.
What will my doctor do if my child's blood has a high level of lead?
If the blood lead level is above the acceptable range, your doctor will give you information
on how you can lower it. Your doctor will test your child's blood lead level every few months until it drops into the normal
range. Children who grow up with a poor dietary intake of iron and calcium can have increased absorption of lead if they are exposed to it, so it is important to give a diet with an ample supply of these nutrients.
If the lead level is high there are medicines that we can use to chelate the lead out of the body, but only a small number
of children have high enough levels lead in their blood that they need treatment.
Unfortunately even with low blood lead levels there can be an effect on the child’s
IQ and this effect may not be reversible after the lead is removed. In fact it has been shown that early exposure to lead,
leads to later scholastic and behavior problems, as well as an increased
risk for social mischief and problems with the law later in life.
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