Unvaccinated children are nine times more at risk for contracting varicella, commonly known as chickenpox, than those who are immunized

Children of parents who refuse vaccines are nine times more likely to get chickenpox compared to fully immunized children, according to a new study led by a vaccine research team at Kaiser Permanente Colorado’s Institute for Health Research. The study was published in the January issue of the journal Archives of Pediatrics & Adolescent Medicine.

Funded by the National Institute of Allergy and Infectious Diseases, this is the first study to examine the relationship between parental vaccine refusal and the risk of varicella infection in children, adding to the body of knowledge on the risk of vaccine refusal. The study used electronic health records of more than 86,000 children who were members of Kaiser Permanente Colorado between 1998 and 2008.

Varicella is one of the most commonly refused childhood vaccines, likely due to perceptions by parents and providers that chickenpox is the least severe of all vaccine-preventable diseases.

Childhood vaccinations have led to dramatic reductions in a number of serious childhood illnesses, but the number of parents refusing immunizations appears to be increasing in the United States. The study could not determine from the information available why parents elected to decline vaccines for their children. The study also did not evaluate the side effects of vaccines.

“Many parents question the need for vaccinations. This study provides evidence to counter the misperception among vaccine-refusing parents that their children are not at risk for potentially serious illness,” said study lead author Jason Glanz, PhD, a senior scientist and epidemiologist at Kaiser Permanente’s Institute for Health Research. “It also provides further information to pediatric health care providers to help them convey the benefits and risks of vaccines. This evidence should assist parents and doctors when having discussions about vaccines and help parents make more informed decisions.”

Varicella is a highly contagious disease that causes a high fever, an itchy rash and red spots or blisters all over the body. The disease can pose a severe risk for children, especially those with bad eczema, cancer, HIV, or other immune-compromising conditions. It can also cause serious complications in pregnant women and newborns. Prior to the widespread use of the varicella vaccine in 1995, there were four million cases of varicella infection annually, resulting in more than 10,000 hospitalizations and 100 deaths per year in the U.S. Since then, immunization has reduced annual morbidity, mortality, and hospitalizations due to varicella by more than 80 percent.

The best way to prevent varicella is through vaccination. Most health experts recommend that all children 12 months of age and older who have not had chickenpox get one dose at 12 to 15 months and a second, booster dose at 4 to 6 years old. Adolescents and adults who are not already immune to the chickenpox virus need two doses at least 4 weeks apart. The varicella vaccine has been shown to be 95 percent effective in preventing moderate to severe infection, and 70 to 90 percent against mild infection.

“Varicella isn’t necessarily a mild illness, and it’s important for parents to know that choosing not to vaccinate their children not only places their child at risk for infection requiring medical care, but also places members of the community at risk. This study adds to the body of information showing that the benefits greatly outweigh the risks of this safe vaccine,” Glanz said.

To assess the risk of varicella vaccine refusal, researchers reviewed the electronic health records of 86,993 children between the ages of 12 months and 8 years who were members of Kaiser Permanente Colorado between 1998 and 2008. First, investigators confirmed which children had varicella infections. Next, they verified whether parents had refused some or all varicella vaccines for their children.

The researchers found 133 physician-confirmed varicella cases that met the study’s criteria. They compared these cases to 493 children of the same age and gender who were not infected with varicella. Based on this analysis, the researchers discovered that children of vaccine- refusing parents were nine times more likely to be infected with varicella than vaccinated children.

Additional study authors include: David L. McClure, PhD, David J. Magid, MD, MPH, Matthew F. Daley, MD, and Simon J. Hambidge, MD, PhD, of the Kaiser Permanente Institute for Health Research; and Eric K. France, MD, MSPH, of the Department of Prevention, Kaiser Permanente Colorado.

Source: Kaiser Permanente


A 5-year study of patients with severe traumatic brain injury conducted at Hennepin County Medical Center in Minneapolis shows significant benefit of hyperbaric oxygen therapy to improve brain metabolism and its ability to recover from injury. The results were recently published in the Journal of Neurosurgery.

Every year, more than 1.4 million Americans sustain a traumatic brain injury (TBI) – the leading cause of death and disability in children and young adults. Those who survive often face months or even years of therapy, and sometimes the damage to the brain is irreversible. Decreased utilization of oxygenated blood to brain tissue immediately after the injury is often to blame.

Cells need oxygen to fuel metabolism for cellular growth and repair. Healthy brains produce their own energy to maintain brain tissue and keep the rest of the body doing what it’s supposed to do. That includes automatic processes like breathing and circulation, as well as voluntary actions like walking and talking. After a traumatic brain injury, the brain itself needs care. Barriers to blood flow can be compromised from the impact of the injury itself, and then when the brain swells inside the skull, a secondary injury can occur that causes even more brain damage.

“There’s a direct correlation between clinical outcome and the degree to which the brain’s metabolism is restored,” explains one of the study’s authors, neurosurgeon Gaylan Rockswold, MD. “In previous research we learned that the brain’s energy production is improved and maintained with hyperbaric oxygen treatment, but this study confirms that hyperbaric oxygen treatment has a major impact in terms of increased energy production.”

Within 24 hours after injury, eligible patients for the study were randomized into three groups: One group received “normobaric” treatment: oxygen delivered at the patient’s bedside; another group received hyperbaric treatment in Hennepin County Medical Center’s hyperbaric oxygen chamber; and a third (control) group did not receive additional oxygen therapy. All groups received the intensive standard of care for brain injury consistent with good clinical practice. The patients who received higher levels of oxygen (hyperoxia) via the hyperbaric oxygen chamber were found to have a marked increase in positive brain metabolism when compared to the normobaric and control group.

“Our goal was to evaluate the brain’s metabolism and intracranial pressure, and whether or not too much oxygen posed a concern with hyperbaric oxygen treatment in these patients,” said Dr. Rockswold. “The results indicate that hyperbaric oxygen treatment was found to significantly enhance the brain’s energy production and reduce intracranial pressure without any toxic effects on the brain or lungs from too much oxygen.”

This research provides important preliminary data for a National Institutes of Health (NIH) supported multicenter trial. NIH trials directly assess the ability to improve clinical outcomes, which is the final step needed to change standard clinical processes. Currently standard clinical practice does not include hyperbaric oxygen for traumatic brain injury.

“TBI is not only devastating for the patient, it’s also heart wrenching for his or her family. We couldn’t be more pleased about the impact this study will have for patients with traumatic brain injury.”

The Traumatic Brain Injury Center at Hennepin County Medical Center offers comprehensive, multidisciplinary patient care education and research to serve people who have sustained a traumatic brain injury. Providing a full range of state-of-the-art medical and rehabilitative services, HCMC’s expertise spans the entire continuum of care for adult and pediatric TBI patients, from prevention to emergency care, neurosurgery, critical care, rehabilitation and the Mild to Moderate Traumatic Brain Injury Clinic.

Traumatic Brain Injuries

Each year, more than 1.5 million Americans sustain a traumatic brain injury (TBI). In Minnesota, nearly 100,000 brain injuries occur annually. A large percentage of those injuries are mild to moderate cases and often go untreated. As a Level 1 Trauma Center, Hennepin County Medical Center admits and treats the most traumatic brain injuries in the state. More information about HCMC’s Traumatic Brain Injury Center can be found at www.savethisbrain.org.

Source: Hennepin County Medical Center


North Carolina goes Smoke-Free on Jan. 2 in historic step for health

  • Author: Health Informer
  • Filed under: Health News
  • Date: Jan 2,2010

North Carolina on January 2 will take an historic step for health when it becomes the first major tobacco-growing state to implement a statewide smoke-free law that includes all restaurants and bars.

This new law will protect the right of North Carolinians to breathe clean air. North Carolina’s hospitality workers can now earn a living and the public can enjoy a night out without putting themselves at risk of lung cancer, heart disease and the other serious illnesses caused by secondhand smoke. North Carolina is setting a powerful example for other tobacco-growing states and communities, indeed for the entire nation, by taking strong action to address the devastating toll of tobacco use and secondhand smoke.

We applaud the North Carolina leaders who have championed the new law, including Governor Bev Perdue, bill sponsors Representative Hugh Holliman and Senator Bill Purcell, and the North Carolina Alliance for Health. Their legacy will be better health for North Carolinians for generations to come.

The North Carolina law adds to the growing momentum across the country and around the world to protect everyone’s right to breathe smoke-free air. Once all enacted state and local laws have been implemented, 62 percent of Americans will be protected by strong smoke-free laws that include restaurants and bars.

Smoke-Free States and Countries

In total, 27 states, Washington, D.C., and Puerto Rico have enacted smoke-free laws that include restaurants and bars. The states are Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan (effective May 1, 2010), Minnesota, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Rhode Island, Utah, Vermont, Washington and Wisconsin (effective July 5, 2010). South Dakota has also enacted such a law, but it is on hold pending a voter referendum in November 2010.

A growing number of countries have also passed strong smoke-free laws, including Bhutan, Chad, Colombia, Djibouti, Guatemala, Guinea, Iceland, Iran, Ireland, Lithuania, Marshall Islands, Mauritius, New Zealand, Norway, Panama, Turkey, Tuvalu, the United Kingdom, Uruguay and Zambia. All Canadian provinces/territories and Australian states/territories have also enacted such laws.

Background on Secondhand Smoke and Smoke-Free Laws

The need for protection from secondhand smoke in all workplaces and public places has never been clearer. In issuing a groundbreaking report on secondhand smoke in June 2006, U.S. Surgeon General Richard Carmona stated, “The debate is over. The science is clear: Secondhand smoke is not a mere annoyance, but a serious health hazard that causes premature death and disease in children and nonsmoking adults.” Secondhand smoke contains more than 4,000 chemicals, including at least 69 carcinogens. The Surgeon General found that secondhand smoke is a proven cause of lung cancer, heart disease, serious respiratory illnesses such as bronchitis and asthma, low birth weight and sudden infant death syndrome. The Surgeon General also found that secondhand smoke is responsible for tens of thousands of deaths in the United States each year, there is no safe level of exposure, and only smoke-free laws provide effective protection from secondhand smoke. A report released earlier this year by the Institute of Medicine concluded that secondhand smoke causes heart attacks while smoke-free laws prevent them.

The evidence is also clear that smoke-free laws protect health without harming business. As the Surgeon General concluded, “Evidence from peer-reviewed studies shows that smoke-free policies and regulations do not have an adverse impact on the hospitality industry.”

It’s time for every state and community to protect everyone’s right to breathe clean air.

Source: Campaign for Tobacco-Free Kids


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