A cluster of 22 patients in the Dallas-area hospitals included two patients who were resistant to all three major classes of antifungal medications has just been reported by the Centers for Disease Control and Prevention. Both those patients died.

Candida Auris proves fatal to one in three people it infects in patients who are at risk. The reasons are relatively simple. The fungus is completely resistant to any medication we have, effectively making it a superbug. More worryingly, the cases in Dallas suggest person-to-person transmission rather than infection from surfaces.

Unbelievably, Dallas health officials and the Dallas Fort Worth Hospital Council have decided to play coy, not naming the two hospitals involved. A spokesman for the Hospital Council, Chris Wilson, made the following statement to Dallas News;

“We’ve been contacted multiple times by the media, and I’m afraid we have no information on this,” Wilson said Thursday.

The CDC has also failed to name the hospitals involved, effectively placing patients in harm’s way. Dr. Philip Huang, director of Dallas County Health and Human Services, could not be reached for comment.

The fungus, Candida Auris, is a harmful form of yeast that is considered dangerous to hospital and nursing home patients with serious medical problems. It is most deadly when it enters the bloodstream, heart, or brain. and outbreaks in healthcare facilities have been spurred when the fungus spread through patient contact or on contaminated surfaces.

Dr. Floyd Wormley Jr., the associate provost for research and dean of graduate studies at Texas Christian University, said the superbug primarily affects people who are severely immunocompromised. A healthy person with the fungus has “nothing to worry about” but could be a carrier, potentially infecting others at risk.

Wormley said he was worried to see that the fungus had spread in hospitals where people might be immunocompromised or elderly. It can be difficult to eradicate once it spreads, he said.

“If I was in an intensive-care unit and I saw this, I would be concerned and want to decontaminate,” he said. “No hospital wants it there. Definitely. But for the public, if you are immunocompetent, young and healthy, I would not be concerned.”

If you need to be hospitalized in the Dallas Forth Worth area and you’re at risk from the fungus, then patients should be afforded the option of avoiding the two hospitals involved in the outbreak. The current media blackout from officials makes no sense in terms of protecting patients.

How serious is it? According to the CDC’s Dr. Meghan Lyman;

“This is really the first time we’ve started seeing clustering of resistance” in which patients seemed to be getting the infections from each other.”

Clearly an issue of concern to the general public and patients requiring hospitalization in the Dallas Fort Worth area.

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As Texas reopens and things return to normal, winter viruses are making up for the lost time. North Texas is experiencing a rare summer rise in RSV cases in children.

The Dallas County Health Department released a health alert citing a surge in the identifications of Respiratory Syncytial Virus (RSV). RSV is a common respiratory virus that typically causes mild cold symptoms in a seasonal pattern.

RSV usually spikes in the Fall and goes quiet in the Spring. Scientists are not sure why North Texas is seeing an increase in RSV cases during the hot Texas Summer. The current theory is our increased social isolation during Covid-19 restrictions kept RSV suppressed during the Winter.

The Dallas and Fort Worth Health Departments have noted the rise in cases. The CDC issued an alert for the entire southern United States after spotting the same trend.

Dallas County has asked health providers to test adults and children with viral symptoms with an RSV PCR test. Dallas County also plans to track COVID-19 and RSV coinfection incidence to help prevent a broader outbreak.

Check out this chart showing the spike in RSV cases compared to one year ago. In most years, we would see a surge in the Winter. This year, RSV cases began to increase in late April. The caseload is on a rapid trajectory higher.

Most people who come down with RSV experience mild flu-like symptoms, but RSV can cause serious illness in children under two years old. Premature babies and children with chronic heart or lung disease are more susceptible to severe complications caused by RSV.

When RSV progress, patients can develop pneumonia and require hospitalization. The CDC tracks RSV data across the United States. Each year, RSV causes:

• 2.1 million outpatient visits among children younger than 5 years old
• 58,000 hospitalizations among children younger than 5 years old
• 177,000 hospitalizations among adults 65 years and older
• 14,000 deaths among adults 65 years and older

Like Covid-19, RSV is a respiratory virus. It is passed from person to person through respiratory droplets. Tiny amounts of the virus spread when someone coughs, laughs, or sneezes. We can take the lessons we learned from Covid-19 to reduce the risk of all respiratory infections.

We can slow transmission by avoiding going out when we are feeling sick. We can reduce contact with others who are ill. Parents should encourage children to frequently wash their hands with soap and water and practice good hand hygiene.

Children and adults should avoid touching their faces or rubbing their eyes. RSV can be transmitted when droplets contaminate surfaces and objects. Cleaning surfaces and disinfecting children’s toys also help reduce the spread of respiratory droplets.

The CDC has asked healthcare providers, childcare personnel, or elder-care workers with RSV symptoms to avoid going to work while ill.

RSV symptoms are tricky. Many symptoms are the same as the common cold. Common symptoms include:

• Runny nose
• Decrease in appetite
• Coughing
• Sneezing
• Fever
• Wheezing

In infants and newborns symptoms may include:

• Runny nose
• Cough
• Fussiness
• Poor feeding
• Fever > 100.4

Parents must know when RSV is circulating in a community, we must take these symptoms seriously. Prompt evaluation is needed for any child who is coughing, wheezing, or working hard to breathe.

Most RSV cases resolve on their own in about one week. There are no specific anti-viral medications or treatments for RSV. Severe RSV vaccine clinical trial vaccines are in progress.

Parents can manage a child’s fever with over-the-counter such as acetaminophen or ibuprofen after evaluation by their doctor. Viral illness can cause dehydration so it is important to make sure children are drinking plenty of fluids.

The post Dallas County Reporting a Weird Rise in a Winter Virus This Summer Affecting Kids appeared first on Medika Life.

A bipartisan group of Democratic and Republican representatives from the Dallas Fort Worth area worked hard to prove bipartisanship is not dead in Texas. This coalition fought for prison reform requiring Texas prisons to install air conditioning in all facilities.

HB 357 bill passed the Texas House by a vote of 123-18. In normal times, the bill would have moved to the Texas Senate before heading to Governor Abbott’s desk to sign it into law. Despite bipartisan support for this criminal justice effort, the Texas Senate failed to schedule the bill for a hearing, debate, or vote.

Just in time for Summer, The Texas legislative session is now over, and Texas Prisoners will pay the price. Texas lawmakers killed a bill that would have required air conditioning in prisons and saved lives.

The Dallas Morning News (DMN) reported one out of five lockup facilities has no air conditioning or climate control systems for inmates. Forty-nine prisons only have partial air conditioning. Temperatures can rise well above 100 degrees during the Texas Summers. Inmates confined to their cells no options to keep cool and stay safe.

Some view climate control as a luxury. “[Air conditioning] is seen as a luxury and prison officials don’t want to be seen as running luxurious prisons,” stated David Fathi, director of the ACLU’s National Prison Project. But in Southern states like Texas, regulating temperature can be a matter of life and death.

The lack of air conditioning in Texas prisons places prisoners and staff at risk. Prolonged heat exposure can cause lead to dehydration and heatstroke. Prolonged exposure to extreme temperatures can damage the kidneys, liver, lungs, and brain. Prisoners are at risk of kidney failure and heart attacks.

The DMN published documents showing more than twenty inmates died from the heat inside Texas prisons between 1998 and 2012. Terry Canales, a South Texas Democrat from Edinburg, told the House, “The reality is that we are cooking people in prison in Texas.”

HB 357 provided the Texas prison system with seven years to bring climate control systems to all facilities. The project had a cost cap of $300 million, and the bill is contingent on State or Federal funds approval to assist with cooling costs.

The bill would provide essential climate control and air conditioning to incarcerated people throughout the Texas Penal system. During the vote in House, only 18 members voted against this legislation.

The bill’s sponsors were Democrats and Republicans from the Dallas Fort Worth Metroplex, including Jeff Leach of Plano, Lynn Stuckey of Denton, Speaker Pro Tem Joe Moody, Michelle Beckley of Carrollton, and Carl Sherman of DeSoto.

In 2021, The Texas Winter Storm caused problems in the Texas prisons that do not have climate control. Mother Jones reported Texas prisoners attempted to set fires to try and keep warm during the historic freezing subzero temperatures and failure of the power grid. Inmates used toilet paper, scrap paper, and socks as kindling.

Prison Air conditioning bills have failed over and over again in Texas. Despite being one of the hottest states in the US, lawmakers have failed to provide basic climate control systems for inmates. Many thought 2021 would be different. The bipartisan effort which passed with flying colors in the house seemed destined to succeed in the Senate.

Speaker Pro Tem Joe Moody offered gratitude to the House members for their votes, reminding them, “We dehumanize people who are justice-involved.”

Sadly, The Texas Senate did not bring the bipartisan bill to the floor in the 2021 legislative session.

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The West Nile Virus was detected through PCR testing of Culex quinquefasciatus mosquitoes. No humans have been infected at this time, but typically human cases begin to appear in communities two to three weeks after West Nile Virus appears in mosquito surveillance.

The identification of the first positive trap on May 11 in Grand Praire prompted officials to remind Dallas Fort Worth residents to take mosquito bite precautions.

Mosquitos contract West Nile Virus from biting birds. The infected mosquitos then spread the virus to humans when they bite our skin. The CDC reports West Nile virus is the leading cause of mosquito-borne disease in the continental United States.

West Nile Virus cases increase in communities during the Mosquito season from late Spring to early Fall. Most people who contract West Nile Virus will be asymptomatic. About 20% of people infected will develop signs and symptoms.

Common symptoms included fever, headache, muscle aches, joint pain, weakness, vomiting, diarrhea, or a rash. The fever resolves within a few days, but muscle aches and fatigue can linger for months. As we are learning from Long Covid, any viral illness can lead to long-term problems from the post-viral syndrome.

West Nile Virus cases severe and sometimes fatal disease in about 1 in 150 people. Anyone who contracts the virus is at risk for serious illness, but the risk is higher in those 50 years old and older. People with suppressed immune systems are also at higher risk. Immune suppression occurs from diseases such as cancer, diabetes, hypertension, kidney disease, HIV, and organ transplants.

The CDC lists the symptoms of severe illness, including “high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness, and paralysis.”

West Nile Virus sometimes infects the membranes surrounding the brain or spinal cord, causing encephalitis and meningitis. When West Nile Virus affects the central nervous system, symptoms sometimes become permanent. 10% of people with central nervous system infections do not survive.

There is no vaccine or specific treatment for West Nile Virus. Doctors treat patients with over-the-counter pain relievers such as Acetaminophen or Nonsteroidal anti-inflammatory medication to reduce fever and alleviate symptoms. Physical rehabilitation is helpful for those who develop lingering symptoms after infection.

People who develop viral symptoms after a mosquito bite can undergo specialized testing for West Nile Virus.

Prevention is the best medicine for West Nile Virus.

We can reduce our risk by avoiding mosquito bites. Long sleeve shirts and long pants protect the skin from exposure when in a high-risk area.

Spraying the skin with Environmental Protection Agency (EPA)-registered insect repellents, such as DEET, are safe and effective ways to reduce our risk.

EPA-registered repellants must have at least one of the following ingredients:

• DEET
• Picaridin (known as KBR 3023 and icaridin outside the US)
• IR3535
• Oil of lemon eucalyptus (OLE)
• Para-menthane-diol (PMD)
• 2-undecanone

In our homes, we can take steps to control mosquitos. Screens on windows and doors prevent bugs from entering the house. Air conditions and home cooling systems make rooms less hospitable to mosquitos. Monitoring areas outside for stagnant water can reduce the risk. Old tires, buckets, and children’s toys often contain small amounts of water where mosquitos can lay eggs.

Dallas County Health Service will continue to monitor mosquito traps in the area. Local officials work with State public health services to detect any spike in West Nile cases. Any resident in Dallas County may report mosquito problems by calling 214-819-2115.

People can request a free service request here.

The post Dallas County Reports First West Nile Virus Positive Mosquito Trap appeared first on Medika Life.

After completing a brief screening questionnaire, residents may book their own Covid-19 vaccine appointment at the Dallas Fair Park Community Vaccination Center. The country has increased its available supply of messenger RNA vaccines from Pfizer and Moderna, making the wait system unnecessary.

Over the past few months, many Dallas Fort Worth residents have been frustrated over the long waiting period and effort required to find an available vaccine. This self-scheduling program should reduce the wait time, improve efficiency and increase vaccine access throughout the Metroplex.

Dallas County Judge Clay Jenkins said in a press release, “There is plenty of vaccines. What’s stopping you from getting yours this week?”

Residents who are 55 and older do not need an appointment to get their Covid-19 vaccine. Those who meet the age requirements may bring a photo ID to Gates 2 and 10 during regular operating hours. The full calendar with operations hours is listed here.

Dallas County continues to set the bar high through its efforts to ensure equitable vaccine access. The County partnered with the Office of Emergency Management to offer the Covid-19 vaccine to homebound residents who cannot physically get to a vaccine site. Many older adults and people with disabilities face challenges finding access to Covid-19 vaccination. The Visiting Nurse Association (VNA) and Meals on Wheels programs will bring Covid-19 vaccines to the homes of our city’s senior and most vulnerable population.

The FDA-approved Moderna and Pfizer vaccines are currently in use, offering 95% protection against Covid-19. The Covid-19 vaccines from Pfizer and Moderna use messenger RNA (mRNA). A single strand of mRNA delivers instructions to human cells to produce an antibody against the SARS-CoV-2 spike protein.

The Moderna vaccine is approved for those 18 years old and up. The Pfizer vaccine is approved starting at age 16. Both vaccines are highly effective in preventing death

The CDC and FDA hit the pause button on the Janssen/Johnson and Johnson vaccine on April 14 after six cases of a rare clotting disorder have been identified out of the 6.8 million US doses given. This news comes as the single-dose vaccine is in short supply due to a Baltimore facility’s manufacturing problems.

Source: FDA Twitter.com

The CDC convened a meeting on Wednesday, April 15, with the Advisory Committee on Immunization to determine the next steps. The US is addressing concerns for a potential link between the vaccine and rare clotting disorders seriously. The committee plans to continue the Johnson and Johnson vaccine pause until more research and data analytics can be done.

Many fear this move by the FDA and CDC may increase vaccine hesitancy. Others highlight the transparency and quick action should inspire public confidence by the regulatory agencies. Despite the Johnson and Johnson setback, The US has enough supply of the Moderna and Pfizer vaccine to provide coverage for any adult who wants it.

Many vaccine-hesitant individuals express fears over the vaccine approval process. The Food and Drug Administration (FDA) has a strict protocol for vaccine approval. Enough data to qualify for emergency use authorization of the Covid-19 vaccines was made possible because of the substantial $10 billion financial investment combined with the virus’s high prevalence worldwide. The FDA did not rush the vaccine approval. It was well-funded, and there were a massive number of trial candidates. AN EFFECTIVE VACCINE IS ONLY USEFUL IF PEOPLE GET IT.

Thanks to the Dallas County Health and Human Services department, residents will be able to get the protection they need.

Resident can book a Covid-19 vaccine appointment in Dallas here or call 1-888-IMMUNE9.

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The Steven A. Cohen Military Family Clinic at Metrocare is a non-profit mental health clinic serving veterans and their families throughout North Texas. The Addison clinic previously offered couples and group therapy to active duty servicemen and women. This expansion of services announcement opens the door for any active-duty personnel to seek individual treatment.

Veterans and active-duty members face a variety of potential mental health challenges. Like civilians, Covid-19 has exacerbated these life stressors.

Metrocare providers have been offering North Texan veterans evidence-based care since 2016 for a wide range of mental health challenges. Help is available for depression, anxiety, and post-traumatic stress. Other families seek help for adjustment issues, anger management, and grief counseling. The clinic also provides therapy for service members struggling with family issues and relationship problems. The family-friendly environment also provides care for children.

The Cohen Clinic at Metrocare also offers case management services to connect veteran families to community resources and services.

The Addison clinic is nearing its fifth anniversary serving the community. This office is one of the original sites of the now nationwide Cohen Veterans Network (CVN). Military families now can get the help they need at one of the 19 Steven A. Cohen Military Family Clinics across the country.

Clinic Director Dr. Amy M. Williams highlights the need to provide mental health care throughout the continuum of military service, stating, “By including the individual active duty service members, we can begin to address problems closer to their onset instead of waiting until after service discharge. Providing timely and effective mental health care strengthens our military and, ultimately, our veteran population.”

The Cohen Clinic is partnered locally with Metrocare, the largest behavioral health services provider in Dallas County. Together, they have served over 2,000 North Texas veterans and family members.

To reach more people in need, The Cohen clinic builds on existing partnerships with the Department of Defense, the VA, and veteran service organizations (VSOs) throughout North Texas. The VA offers specific tools to help veterans cope with the challenges of the Covid-19 pandemic. They acknowledge making the transition to civilian life was already difficult. The pandemic adds to the stress and mental toll.

The 2020 National Defense Authorization Act authorized the Department of Defense to find community-based care for veterans if DoD could not arrange an internal referral. The Cohen clinic fills the void for our service members making the transition to civilian life.

The Covid-19 did not stop the Cohen Clinic at Metrocare from providing mental health treatment access. Telehealth and virtual care access continued through the CVN Telehealth platform. Virtual therapy options expanded access for service members in various military installations across the Dallas Fort Worth Metroplex.

As in-person visits resume the clinic plans to restart its Military Family Clinic Classes to help provide holistic and comprehensive care to the entire family.

Improving access is an essential step in caring for those who serve in the Us military. Data from 2012 showed veterans reported severe psychological distress more often than nonveterans, but less than 5% report the distress. Public health experts now prioritize the well-being of military personnel and their families.

Any active-duty service member is eligible for care with a Tricare referral.

For more information, check the company website: Cohen Veterans Network news release.

Learn more about the Cohen clinic’s mission and values here.

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Dallas County Health Services (DCHHS) is partnering with the Office of Emergency Management to offer the Covid-19 vaccine to homebound residents who are unable to get to a vaccine site physically.

Many older adults and people with disabilities face challenges finding access to Covid-19 vaccination. The Center for Disease Control (CDC) recommends state and local agencies work together to ensure equitable vaccine access.

Dallas County is setting the bar high.

Judge Clay Jenkins reports DCHHS will work with the Dallas Fire-Rescue Department to directly bring the Janssen/Johnson and Johnson vaccine to people’s homes. Cedar Hill Fire Department, located in the southwest corner of Dallas County, was the first to party with the health department to help homebound seniors.

Dallas county will work with The Visiting Nurse Association (VNA), a local nonprofit community-based health care entity offering homebound care through Meals on Wheels to local seniors since 1934.

The U.S. Food and Drug Administration (FDA) approved the Janssen Covid-19 Vaccine under emergency use authorization (EUA) on February 27. Janssen Pharmaceutical Companies is the vaccine arm of Johnson & Johnson.

The Janssen vaccine is now approved for use in people 18 years and older. It only requires a single dose to be effective and is not burdened by the cold storage requirements, which slowed the distribution of the two previously approved vaccines from Moderna and Pfizer. This vaccine can be mass-produced and widely distributed to help get more shots in more arms as fast as possible.

Like the Moderna and Pfizer vaccines, the Jansen vaccine does not contain a live virus. One cannot catch Covid-19 from these vaccines.

The Janssen vaccine uses much older technology by altering a common adenovirus to be used as a delivery system. Adenoviruses are the group of viruses causing the common cold. These viruses can be genetically altered to maintain their efficient ability to get into our bodies but remove their ability to make us sick. This combination makes them excellent vectors to create vaccines.

The Janssen Pharmaceutical Companies proprietary vaccine technology platform, called AdVac, successfully created the Ebola vaccine currently used in the Congo and Rwanda. The AdVac system is being used to develop vaccine candidates against HIV, RSV, and Zika.

The Janssen vaccine uses Adenovirus 26 (AD26) as the vector to deliver DNA material into our cells to provoke an immune response. Scientists modify the adenovirus by removing its nucleus. They replace the nucleus with genetic instructions to recreate the SARS-CoV-2 spike protein.

Our bodies then produce the spike protein triggering our immune system to produce protective antibodies without causing us to get sick. Forty-four thousand people participated in Janssen’s safety and efficacy clinical trials in the United States, South Africa, and Latin America. The data shows the Janssen vaccine is 72% effective and offered 86% protection against severe disease. Some may be alarmed by the lower efficacy rate of 72% compared to the 95% efficacy offered by Pfizer and Moderna. It is important to remember these numbers are not direct head-to-head comparisons. Scientists performed the clinical trials for each vaccine in different parts of the world at various pandemic stages.

To date, Dallas County has issued 282,330 doses of the Covid-19 vaccines. Twenty-nine thousand seventy-three have gone to residents over 75 years old. People 85 and older are at the highest risk for severe illness and death from COVID-19.

This joint effort by the Dallas public service departments will help save the lives of our city’s senior and most vulnerable population.

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The White House Press Briefing is not always so exciting. But in today’s press brief, the Covid Response Team discussed OkCupid and Tinder dating advice. Dr. Anthony Fauci and Andy Slavitt handed out free tips to get people to swipe right.

According to Slavitt, people who display their vaccination status are 14% more likely to get a match.  He said, “We have finally found the one thing that makes us more attractive, a vaccination.”

Match Group, with headquarters in Dallas, has the largest online dating app portfolio, including popular brands like OkCupid, Tinder, Match.com, and Plenty of Fish. The company’s mission is “to spark meaningful connections for every single person worldwide.”

It seem no aspect of meaningful connection includes infection.

Covid-19 is spread through person-to-person contact via respiratory droplets — droplets first spread through coughing, sneezing, and respiratory particles. These particles get on our clothes and hands and are passed through handshakes, hugging, kissing, and other close human contacts.

Single people can help protect themselves and others by disclosing their vaccination status to those they date. Open disclosure allows people to make conscious choices about who they meet or date on apps. #SafeSex2021

Covid-19 shaming and finger-pointing reduce our ability to fight the pandemic. Stigmatization may lead people to hide infections and avoid testing. If those infected avoid disclosure and limit dialogue, others may not make safe choices to reduce their risk.

The hope is that sharing vaccination status on dating apps will encourage good public health and help individuals make informed personal choices regarding their health and safety.

The world is reopening, and people are ready to get out of the house. The White House partnership with Match Group helps promote public health as dating ramps up again. The campaigns are starting now and will run through July 4 across the various dating apps.

“Human connection is so vital for healthy lives — it’s why I am so committed to this business,” said Shar Dubey, CEO of Match Group, in the press release. “We are honored to work with the White House on increasing vaccinations across America, which will allow people to once again meet in person and engage in meaningful ways. This will make dating safer for everyone, everywhere.”

To promote Covid-19 vaccinations, the apps will help users find a location to get Covid-19 vaccine sites. People can add vaccination badges to their profiles. Some of the apps will offer boost features to profiles displaying vaccine badges.

Match Group reports dating app users have asked for these features to help them make decisions about dating safety.

Here are the features that will be available on various apps.

Tinder

On Tinder, members can add a variety of profile stickers celebrating Covid-19 vaccines. Profile stickers like “I’m Vaccinated” or “Vaccines Save Lives” help share vaccine status with prospective dates. In June, Tinder will offer a “Super Like” feature to help vaccinated members stand out from the crowd.

Tinder plans to offer a “Vaccine Center” hosting Covid education and vaccination site locations.

Match.com

Match.com users will be able to add a “Vaccinated” badge to their personal profiles. Match.com will provide a free “boost” to vaccinated profiles to give them more exposure on the site.

OkCupid

OkCupid will also offer “I’m Vaccinated” badges and free profile boosts. But OkCupid plans to allow members to search for other vaccinated people as part of its matching categories.

Plenty of Fish profiles will feature the “I Got My Shot” badge. BLK will add “Vaxified” profile badges, and Chispa will add “Vacunado.”

Dallas’ Match Group has been the industry leader in online dating for many years. These proactive steps promote public safety and help single people learn to live in our new normal.

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Dallas-based Cedar Health Research is enrolling local patients in two pediatric studies to expand the safe and effective treatment options for children with migraines. Cedar Health Research partners with physicians, like me, in the Dallas/Fort Worth Metroplex and across Texas to expand patient opportunities in clinical trial participation.

Migraine headache is a common childhood problem affecting up to 10% of children age 5-15 and up to 28% of teenagers. When simple measures do not ease the pain, some children require migraine relief medication such as acetaminophen or ibuprofen. Despite these treatments, many children still suffer excruciating pain and require prescription medication. The good news is approximately 25% of children will outgrow migraines by the age of 25. Until then, parents are searching for options to help.

Many drugs approved for adults have not been tested in children resulting in “off-label” use. The Food and Drug Administration initiated a pediatric program to allow well-controlled clinical trials to test the safety and efficacy of adult-approved medication in children.

Parents may find more effective migraine therapy options by enrolling a child in one of these clinical trials.

Headaches in Children

There are two common types of headaches that affect children. A pediatrician or pediatric neurologist will assess a child with recurrent headaches to determine the cause based on a series of diagnostic criteria.

1.Tension headaches. Tension-type headaches cause pain, pressure, or tightness on both sides of the head. The pain can be severe but usually does not interfere with daily activities.

2. Migraine headaches. Migraine headaches often start on one side and get worse over time. Children often have other accompanying symptoms like nausea, light sensitivity, dizziness, or visual changes. Other symptoms include mood changes, fatigue, anxiety, concentration problems, food cravings, neck stiffness, and hyperactivity. The pain can become progressively worse and keep the child from daily activities.

A doctor will help parents and children learn to recognize migraine signs and teach preventative and management steps.

The goal of migraine treatment is to find safe and effective pain relief to help the child return to normal functions as soon as possible. Headache calendars can help identify triggers that lead to migraines. Early interventions, such as taking a nap or resting in a dark room, may help prevent headaches. Lifestyle modifications like stress reduction, improving sleep habits, and dietary changes may help some children.

When these remedies are not effective, doctors will recommend over-the-counter medications such as acetaminophen and nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen. For patients who continue to suffer from migraines, doctors may prescribe FDA-approved medications such as zolmitriptan and sumatriptan.

Rimegepant; A new option for pediatric migraines

Cedar Health Research, located in Dallas and Irving, is currently enrolling candidates in two clinical trials to evaluate the safety and tolerability of Rimegepant in children aged 6-18 with a history of migraines. Rimegepant, from Biohaven Pharmaceuticals, is an FDA-approved medication for adults for the acute treatment of Migraines.

Rimegepant helps adult patients find migraine relief by reducing calcitonin gene-related peptide (CGRP) induced symptoms. The drug’s mechanism of action blocks exaggerated pain signaling, inhibits blood vessel dilation, and reduces inflammation. Although Rimegepant is currently FDA-approved for adults, clinical trials are needed to determine children’s safety and efficacy. 

Phase 1 trial

The phase one clinical trial evaluates the pharmacokinetics of Rimegepant to determine the appropriate weight-based dosing regimen. Participants receive one dose of medication, and then blood samples are performed at four intervals after dosing. This allows scientists to track the body’s absorption of the medicine.

All qualifying candidates will receive the medication and are compensated for their participation.

Candidates must meet eligibility criteria, including:

• Age 6-12 years old
• Weight greater than 15 kg (33 lbs)
• Participants must be able to read and comprehend written instructions
• Participants must have a medically documented 6-month history of migraines
• A qualifying score on the Sheehan Suicidality Tracking Scale (S-STS)
• Must be able to be tolerate blood draws

Phase 3 trial

The phase three trial is a multicenter, randomized, double-blind, placebo-controlled study to assess the efficacy and safety of Rimegepant for treating migraines in children age 6-18 years old. This study aims to test how well the study drug works in children compared to a placebo. Up to 1440 participants will undergo evaluation during a 19-week timeline to treat up to two migraines of moderate to severe intensity.

All qualifying candidates will be randomly assigned to receive the medication or placebo and are compensated for their participation. 

Candidates must meet eligibility criteria including:

• Age 12 and 18 years old.
• Participants must experience at least one migraine a month.
• Participants must have a history of migraines for at least 6 months.

Learn more about the FDA Clinical trial process here in this video from theFood and Drug Administration.

Disclosure: The author serves as a principal investigator and sub-investigator in Women’s health studies through Cedar Health Research.

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A March 12 Dallas country press release reported 401 additional positive Covid-19 cases in Dallas County. The new totals are 249,011 PCR test confirmed cases and a cumulative total of 37,073 probable cases.

Dallas also reported an increase in the number of cases of the UK B.1.1.7 variant. The B.1.1.7 variant was first detected in the United Kingdom but has rapidly spread worldwide. The Center for Disease Control (CDC) data shows this new variant is now present in all 50 US states. Current data projections suggest it will become the predominant strain in the US in the next few weeks.

The B.1.1.7 variant is more contagious due to a mutation in the receptor on the SARS-CoV-2 spike protein. While this variant is more contagious, it is uncertain at this time if it is more lethal.

A new March report from the UK’s New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) contains concerning findings. The Center for Disease Control (CDC) summarized the results as “ evidence suggests the B.1.1.7 variant may be associated with an increased risk of death compared with other variants.” 

Reuters reports UK health officials are concerned early data may demonstrate the B.1.1.7 may be more contagious in children and infants.

Dallas Judge Clay Jenkins released a written statement saying, “The emergence of these strains is another strong reason to continue to wear a mask, social distance, wash hands frequently, avoid crowds and forego get-togethers. By practicing the fact-based approaches that provided protection for the past year coupled with registering in as many places as you are willing to drive, and being vaccinated as soon as it is your turn, we will beat COVID-19 this year.”

Image CC Twitter.com

It is essential to know that new variants of SARS-CoV-2, the virus that causes Covid-19, are expected. Viruses naturally mutate. Some mutations will persist while others fade away. Scientists study the genetic changes of the virus to monitor for potential threats.

While there are many identified SARS-CoV-2 mutations, there are three under a higher level of scrutiny. The B.1.1.7 (UK variant) is being monitored because it spreads so quickly. Epidemiologists are also closely watching the B.1.35 South African and the P1 Brazilian variant.  

Data suggests these three variants are more contagious and spread faster than others. A sudden spike in one of these variants could potentially strain health resources as states try to scale out vaccination rollouts as fast as possible. 

The good news is evidence so far indicates the currently available Covid-19 tests can accurately detect these variants. In addition, the FDA-approved Covid-19 vaccines are effective against these variants. Vaccine efficacy studies are in progress and are being closely monitored. 

The current FDA-approved vaccines from Moderna, Phizer, and Johnson and Johnson are still effective against the B.1.1.7 variant. The Moderna and Phizer vaccines offer 95% protection against Covid-19. Johnson and Johnson’s Janssen vaccine offers 72% protection against infection and 86% against severe disease.

All three are highly effective in preventing death. To date, 3,275 Dallas County residents have lost their lives due to COVID-19.

Image Dallas Country Health Department

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To get your vaccine, you must register. Follow the links below to get started:

For Dallas County click here. For Tarrant County click here.

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