Wednesday, December 30, 2009

Risk of Severe H1N1 Disease With Asthma Again Confirmed

I read this article out of Boston. They have gone back to look at risk factors among people hospitalized in Massachusetts with severe H1N1 influenza. It turns out that asthma was the biggest risk factor, affecting 31% of the people hospitalized. The article also highlights the significant risk of seasonal influenza to asthmatics as well.

If your child has asthma, please contact us about getting him or her vaccinated against H1N1 influenza and seasonal influenza.

Monday, December 28, 2009

New Years Day

The office will be open, with limited hours, on January 1st.

Hope you had a great holiday!

Thursday, December 17, 2009

More on H1N1 vaccine recall

Thanks to Dr. Packer for posting an explanation of the H1N1 recall. You can find out more about the recall at this link.

A few highlights:
-- The recall only affected four lots of the thimerosal-free (single dose syringes) vaccine for infants aged 6-35 months.
-- The vaccine was found to be slightly weaker than the required strength in followup testing after it had been distributed to providers. It met strength requirements at the time of production and shipping.
-- Our clinic did receive vaccines from the affected lots.
-- There are no safety concerns from these lots.
-- Children in this age group should receive their booster dose to insure that they are well protected from H1N1 influenza.
-- We have vaccine available for this age group. It is from multi-dose vials that contain the thimerosal preservative to avoid contamination. Numerous large studies have shown that there is no connection between thimerosal in vaccines and autism or other developmental problems. For children 24 months and older, the nasal vaccine is also an acceptable and safe option for vaccination.

Tuesday, December 15, 2009

Recall

One of the makers of the H1N1 vaccine (Sanofi Pasteur) has announced that some of their vaccine was not as potent as it should have been. The vaccine in question is for children 6 to 35 months old. They have no concerns about the safety of the vaccine, just the potency. Children in this age range should be getting two doses of the vaccine (1 month apart), so with both shots they should be protected.

Bottom line: if your child is between 6-35 months, make sure they get their booster dose.

You can read more about it here.

Thursday, December 3, 2009

Shaking Things Up

In an effort to better accommodate our patients, Dr. Packer has changed her clinic days from Tuesday/Friday to Monday/Friday. If you have any comments or suggestions on scheduling, what you like and especially what you don't like please shoot us an email at southpointpediatrics.gmail.com.

Wednesday, November 25, 2009

Vaccine Numbers for 2009; Update on H1N1 Vaccine

We just completed our annual report to VFC summarizing the numbers of vaccines we have given. I thought you all might be interested in some of these factoids:

-- From January 1, 2009 to November 21, 2009, we gave a total of 20,077 vaccines. (This excludes H1N1 vaccine, but includes seasonal influenza vaccine.)

-- 15, 296 of those were vaccines that we purchased, and 4,781 were provided through the government program, Vaccines for Children (VFC).

-- We have given 3,762 seasonal influenza vaccines this year (that includes some for last flu season and some for this flu season). We still haven't received all of the 3,500 doses of seasonal influenza vaccine that we pre-ordered.

-- We have given about 1,000 doses of H1N1 vaccine, mostly to patients who are high risk (asthma, other chronic illnesses) and the infants and toddlers under age 2 years. We are starting to receive regular, if small, shipments of H1N1 vaccine.

OUR CURRENT POLICY FOR H1N1 VACCINES:

If your child is in a high risk category, including chronic illness (asthma, diabetes, chronic kidney disease, congenital heart disease, immuno-compromised), children under two years of age, or family members of infants under 6 months of age, we will try to get you in as soon as possible.

If your child is not in a high risk category, but you would like him or her to receive H1N1 vaccine, call and we will schedule an appointment in our regular flu shot clinic.

PLEASE BE AWARE THAT THERE IS A CHARGE OF $18 FOR THE H1N1 VACCINE THAT WILL BE REQUIRED AT THE TIME OF REGISTRATION. WE WILL NOT BILL YOUR INSURANCE FOR THIS VACCINE.

Tuesday, November 24, 2009

Recalls

  • Stork Craft has recalled over 500,000 cribs. The support bracket can break, causing the mattress to fall. You can find out more information here.
  • CSI: Crime Scene Investigation Kits have been recalled because the white fingerprint powder in the kits contains asbestos, which can be harmful if inhaled or ingested. This product is part of a class-action settlement. You can visit www.csitoyssettlement.com for more information.
  • Bunk Beds from Big Lots, sold from May 2008 to February 2009 with model number WP-9108-1 or WP 9108-2, have been recalled because the support slats can break and cause the bed to collapse. Call 866-244-5687 or visit www.biglots.com for more information
  • Hungry Figures and Magnets have been recalled because sewing needles have been found in the stuffing. Call 866-288-3891 or visit www.weightwatchers.com or here

Monday, November 23, 2009

True Colors

U of U? BYU? Where does your loyalty lie? This rivalry week we are hosting a food drive to support the Utah Food Bank. Bring a can of food to your next visit, and support your favorite team. Or, you can donate a dollar and we will purchase the food for you.

Go.....Cougars!
Go.....Utes!

Thursday, November 19, 2009

Fever Fighter


With all the bugs out there, chances are you've had a kiddo with a fever recently. A few fever tidbits:
  • If your baby is under 2 months old, a temperature over 100.4=a trip to the office and most likely the emergency room. Babies this young are at increased risk for urine, blood or brain infections so these things need to be ruled out. That said, even with the higher risk most of the time it is just a virus.
  • Taking the temperature rectally is the most accurate. But if your little one is not so little anymore, a forehead thermometer is a good second choice. If you use the armpit method you can add a degree for a more accurate reading. Make sure the room isn't too cold if you're using an ear thermometer, and you haven't just given a cold drink if you are using the oral thermometer.
  • For babies over 6 months, the number itself doesn't matter as much as how your child looks. I would be much more worried about a child with a temperature of 100 who looks awful than a child with a temperature of 104 who is running around playing.
  • We like to see children with fever because of what they represent (ear infection, urine infection, strep, virus, etc) not because the fever itself will be harmful to your child or their brain. I once had a patient with a temperature of 107 for a week! He was a-okay.
  • Tylenol and Motrin will help bring the fever down and make your child feel better. You can alternate them every three hours (Tylenol at noon, Motrin at 3, Tylenol at 6, Motrin at 9, etc). Just make sure you give them the correct dose.
  • Fluid, fluid, fluid. Keep 'em hydrated.
  • With H1N1 the medicine is most effective within 24-48 hours from the start of the fever, so if you're going to bring them in try to make it within that window.
Good luck! And, remember, if you're worried we are always happy to see you and your sicklings.
Post-edit: The original post had an incorrect schedule for the Tylenol/Motrin dosing. This has been fixed.

Thursday, November 12, 2009

Croup is Raging!

So, your little angel (?) goes to bed happy as can be, then at the lovely hour of 3:00 a.m. wakes up out of the blue breathing harder than Darth Vader and barking like a trained seal. What's this all about?

Croup. It's back and raging right now. Croup is caused by several respiratory viruses (most commonly parainfluenza virus, but also RSV, influenza A, and other cold viruses). It is most common among children ages 2-4 years of age. For some reason, children with these viruses can have a significant amount of swelling in the larynx (voicebox) region. This gives them a constricted, whistly breathing pattern called STRIDOR that you will notice more with breathing in than breathing out, and more when they are breathing fast (crying or physically active). They may also get very hoarse or lose their breath altogether. In severe cases, the children can develop significant respiratory distress, with loud breathing both in and out, trouble swallowing, and retractions (the skin of the neck or under the ribs pulling in with breathing).

Typically kids will have tight breathing and croupy cough for the first 3-4 days (nights!) of the infection, then their cough will loosen up and become more productive, like a regular cold. It may take another week for their cold to go away.

You can usually treat croup at home unless it is severe. We recommend the following home treatments for your croupy child:

-- Run a cool mist humidifier or a steam vaporizer near their bed when they sleep. (If you use the vaporizer, be careful that they don't burn their fingers on the steam.)
-- If your child wakes up with stridor or severe cough, take him/her into the bathroom and run the shower on hot with the door closed. Sit with your child in the steam for twenty minutes or so, until the tight breathing starts to improve.
-- Another treatment for stridor that works well is to take your child outside in the cold night air. Be sure to bundle up, because you will need to stay outside from 15-30 minutes until the stridor improves.
-- If these things don't work, take your child to an emergency room for a special breathing treatment with racemic epinephrine. This will open up their throat, but it will require several hours of observation afterwards.

We can see your child in the office if he or she has stridor. Treatment with a steroid called dexamethasone (Decadron) will often help open up the airway.

Croup typically does not have fever with it, but the past week we have been seeing a lot of fevers (102-103) with croup. We should check your child if he or she has croup with a fever that lasts more than a day or two.

Summary of Influenza Weekly Update

The State Health Department sends out a weekly influenza activity report. A couple of interesting items from today's report:

-- Influenza Like Illness rates have FALLEN this week from 5.9% of visits the previous week to 4.7% this week.

-- Influenza-associated hospitalizations rose by 103 this past week, to a season total of 623 (there is some lag time in reporting hospitalizations, however).

-- 100% OF SPECIMENS SENT FOR CONFIMRATORY TESTING WERE H1N1 (PANDEMIC) INFLUENZA STRAIN. This means that there is no seasonal influenza activity yet.

-- There have been 14 deaths related to H1N1 influenza this season. There were no new deaths reported this past week.

Here is a link to the Influenza Report.

tv


A new study came out that showed children who are exposed to television before age three tend to be more aggressive. They included both active television watching, and just having the TV on.

Does this mean we should NEVER have the TV on? Maybe. Is that realistic? Not in my house. Do your best to limit your child's exposure and try to read to them at least once a day.

You can read more about the study here

Flu Finder

Google has recently introduced a tool to help you get a flu shot. They have a new site where they keep track of who has vaccine and who doesn't, among retail clinics. I'm not sure how updated they keep it, but it might be worth checking into.

Flu Vaccine Update November 12

Today we received a shipment of seasonal flu vaccine for VFC only for all ages.

Regular
6-35 months only

H1N1 we are out of supply but hope to receive more at some point.

Keep checking back

Wednesday, November 11, 2009

H1N1 Update November 11

At the close of clinic today we are out of H1N1 vaccine.

VFC
We are out of all flu vaccine.

Regular
6-35 months only

We hope to receive more H1N1 vaccine, we will keep this updated with the lastest vaccine supply.

Update H1N1

As of today we only have 35 doses left of H1N1 and will only be giving them to the children 4 years and older with asthma, heart disease or diabetes.

Please keep checking back!

Tuesday, November 10, 2009

Flu Update, November 10

H1N1
We have 75 doses of H1N1, which are only approved for children over 4 years old. These doses will be given to those children with asthma or other medial conditions such as diabetes, heart conditions, etc. There is an $18 administration fee with this vaccine that will be collected at the time of the visit.


VFC
Small (and going fast) supply of all seasonal flu vaccine.

Regular Insurance
6-35 months

Thanks for your patience!

Thursday, November 5, 2009

Correction, November 5th

Apparently we are NOT getting more flu supply on November 6th. We are very sorry for the confusion.

Tuesday, November 3, 2009

Flu supply update, November 3

Here's what we've got:

VFC
Under 2 years old
Flumist (for those without asthma)
Injectable for under 3 years old
Injectable for over 4 years old
*So, if your child is between 3-4 and has asthma, we do not have vaccine. Otherwise we have all ages.

Regular insurance
Under 2 years old

We are hoping to get another shipment on November 6th for both seasonal flu vaccine and H1N1. CALL AHEAD before coming in.

Monday, November 2, 2009

H1N1 vaccine clinics at SL County Health Department

The Salt Lake Valley Health Department (SLVHD) will take appointments Tuesday for H1N1 vaccination clinics. Clinics will take place Wednesday, Thursday and Friday at four clinic locations.

The public may begin making their appointments Tuesday starting at 9:00 a.m. until all available time slots are filled. Appointments can be made either online or by calling the SLVHD Vaccination Hotline at (801) 743-7280 (details below).

“We are excited to announce this shift in how we offer H1N1 vaccine in Salt Lake County,” says Gary Edwards, director of SLVHD. “We anticipate appointments will better serve those at highest risk and help to avoid the long lines seen at previous clinics.”

Starting Tuesday (11/3) at 9:00 a.m. appointments can be booked:
Online via: www.slvhealth.org
Direct web link: https://www.securedata-trans12.com/ap/saltlakevalleyhealthdepartment/index.php?page=10
SLVHD Appointment Hotline at (801) 743-7280
Open from 9:00 a.m.-1:00 p.m., or until all time slots have been reserved.

Individuals who secure an appointment will be given a half hour time slot and clinic location for vaccination. All clients with an appointment will be screened at the clinic to confirm eligibility.

Those eligible to receive the H1N1 vaccine:
Pregnant womem
Those who live with or care for children younger than 6 months of age
Health care or emergency medical personnel with direct patient contact
Children age 6 months to 24 years of age
Those under the age of 64 with chronic medical conditions associated with higher risk of medical problems from influenza
The vaccine is provided at no out-of-pocket cost to individuals at SLVHD clinics, however those with health insurance are encouraged to bring their card. Individuals without health insurance will still receive the vaccination at no cost

SLVHD clinic locations taking appointments for vaccination Wednesday, Thursday and Friday

Salt Lake City Public Health Center
610 South 200 East
Salt Lake City, Utah 84111

Southeast Public Health Center
9340 South 700 East
Sandy, Utah 84070

Friday, October 30, 2009

Are We Discriminating?

As you have noticed in my posts about influenza vaccines, we split out insured children from Medicaid/CHIP children. One parent called in to tell us we were discriminating against insured children.

So I thought I would explain why we separate them out. We purchase vaccines from suppliers. Those vaccines are then given to our patients, and the vaccine charges are billed to the insurance company. Vaccines are very expensive; the charges for a typical well baby check are $300-400 in vaccines alone.

For that reason, the government has a special program called Vaccines For Children, or VFC. The government purchases vaccines for this program and distributes them through selected sites, which includes Southpoint. The government has strict rules about who we can give these vaccines to. They are only to be used for uninsured patients, children on Medicaid, children on CHIP, or Native Americans/Inuit. If we violate this policy we will not be able to participate in the program.

We often have discrepancies in the vaccines available for insured versus uninsured patients; usually our insured patients have all vaccines available, whereas our VFC-eligible patients often do not. It just happens that VFC sent us a recent shipment of seasonal flu vaccines, which we had been out of for several weeks. Our seasonal flu vaccine supply is gone, since we have given out almost 4,000 doses already this year. We are still working with suppliers to see if we can order more, but it is in very short supply nationwide.

Wednesday, October 28, 2009

Flu Vaccine update, Wednesday Oct 28th

We are out of H1N1 vaccine today. We are hoping to have some nasal doses within the next two weeks.

We have injectable flu vaccine for insured children 6-35 months only. We have no nasal flu vaccine for insured children.

For Medicaid and CHIP (VFC program) we have seasonal flu vaccine and some nasal flu vaccine as well today.

Many of you have scheduled flu vaccine appointments for your children in advance. Since we are having a very difficult time getting flu vaccines from our suppliers, you may be called to reschedule. I WOULD RECOMMEND CALLING OUR OFFICE THE DAY BEFORE OR DAY OF YOUR APPOINTMENT TO CONFIRM THAT WE WILL HAVE VACCINE AVAILABLE, or at least checking this site.

We are sorry for the inconvenience of having to double check even after you've scheduled an appointment. It reminds me of the Seinfeld episode when he "reserves" a rental car only to find that they are out of rental cars, and he tells the clerk that she obviously doesn't understand what a "reservation" is! In the best of all worlds, we would have all the flu vaccine that we need, when we need it. Apparently we don't yet live in that world.

Monday, October 26, 2009

What Flu Vaccines Do We Have Today?

We are sorry to announce that we are currently out of nasal vaccine (Flu Mist) for the seasonal flu. We are several shipments behind and are working with the supplier to try to get some vaccine, although it doesn't look promising.

We still have some thimerosal-free vaccine for seasonal flu for children under 3 years of age. We do not have any injectable vaccine for children 3 years and over.

We have a few doses of injectable H1N1 vaccine, which we are saving for infants ages 6-23 months, and children with high risk medical conditions such as asthma or diabetes. We are expecting to have nasal H1N1 vaccine for children 2 years and older (without asthma) within the next two weeks.

If you have scheduled an appointment in our flu shot clinic, please call the day of the appointment to check to see if we have vaccine available. Our vaccine supply has been very undpredictable this year.

Please be patient with our front desk and nursing staff as we try to find ways to get all of our patients protected against the strains of influenza this year. It is quite a challenge, but we are committed to doing our best to help you protect your family.

Wednesday, October 21, 2009

How Long Do I Have To Wait In Between Flu Shots?

There has been some confusion (including me!) about how long to wait between flu shots. We reviewed the MMWR/CDC guidelines and contacted the State Health Department to confirm the rules. Here they are:

1. You should wait 28 days after a LIVE vaccine (FluMist seasonal, Nasal H1N1, MMR or Varicella vaccines) to receive another LIVE vaccine.

2. You can give INACTIVATED VACCINES (injectable seasonal flu vaccine, injectable H1N1 vaccine, all other common childhood vaccines except MMR and Varicella) anytime after a LIVE vaccine.

3. You can give LIVE vaccines any time after an INACTIVATED vaccine.

4. WE CANNOT GIVE BOTH NASAL SEASONAL FLU AND NASAL H1N1 AT THE SAME VISIT. There is insufficient data to show whether or not they are effective when administered together.

So..... it may be a little tricky to get both seasonal flu and H1N1 flu for your kids in a timely manner, if they are 2 years or older and are getting nasal vaccines. We are hoping to get more injectable vaccine for both seasonal and H1N1, which would give us more options.

SO WHAT DO I RECOMMEND? If your child (2 years or older) has not had any flu shots yet, I would prioritize getting the H1N1 vaccine first, since that is at epidemic levels right now. ( Our other doctors might have a different opinion on this, so feel free to ask them.) We hope to have nasal H1N1 vaccine within the next two weeks in the office. We do have nasal seasonal flu vaccine right now, and should be getting some more injectable seasonal flu vaccine in the next few days. There is no seasonal flu activity yet in our area. It is hard to say when it will start, but it often starts after the Thanksgiving holiday.

Friday, October 16, 2009

H1N1 Vaccine, 10/16

We have received a limited number of doses of the H1N1 vaccine in the shot form. This will be available on a first come first serve basis for the following groups of patients:

  • Children ages 6 months to 2 years
  • High-risk patients, meaning those with asthma, immunodeficiency or living with those who are immune compromised

We do not know if we will get more vaccine, but there is currently still vaccine available at the State Health Departments.

Wednesday, October 14, 2009

Jump ‘n Jive Doorway Jumpers Recalled

Graco has just recalled their Jump 'n Jive Doorway Jumper because of a design flaw that could expose children to a small part choking hazard. You can find out more information here.

H1N1 and Regular Flu Update

Southpoint Pediatrics has applied to become a center to distribute H1N1 vaccine for the state of Utah, and we just received word that in two weeks we will receive the vaccine. We will continue to update the blog as we get more information.

We are seeing more and more cases of H1N1 (swine flu) in the office, so it is a great idea to get vaccinated. Right now the only place to receive the vaccine is at the State Health Department.

As far as regular flu vaccine, we have all ages and all insurances EXCEPT those over 3 years old who have asthma with regular insurance (we currently only have Flu Mist for patients over 3 with regular insurance, and Flu Mist is not approved for children with asthma).

In other news, phase one of the construction is completely done and we are working out of our new rooms. Phase 2 is well on its way, so hopefully the transformation will be complete soon!

Thursday, October 8, 2009

Flu shot update

We received a new shipment of flu vaccine, so now we have vaccine for children 6-35 months who have regular insurance. We also have vaccine for all ages for those with VFC (any type of Medicaid or self pay). We are still waiting for vaccine for children over 3 years old with regular insurance. Hopefully soon.

Wednesday, October 7, 2009

Somebody Looks Fabulous!-- Dr. Buchanan on TV

Check out this link to see our famous Dr. Buchanan getting his H1N1 vaccine today!

Wasatch Pediatrics Looking for I.T. Director

I know we have several parents of patients who work in IT and Networks. Our current director is moving on to a new company, so we will be interviewing. Here is the ad that will appear in newspaper and internet sources:

Director of I.T. for Medical Practice

Will direct all technology needs of medical practice. Design, support, configure, and implement network infrastructure for integrated practice management and EHR system. Minimum of 5 years progressively responsible experience in information systems, with two years in ambulatory health care setting. Experience with VMware, phone systems, SAN, terminal services support, CISCO routers and Microsoft Operating Systems. Must be able to work comfortably with physicians, technical vendors, software company, and large staff. Ability to present in large groups and interact well on all levels, provide training and support, and make technical recommendations for network. Will be required to manage I.T. staff effectively and deal with people. Flexibility in work schedule is needed to assure optimal system function. To be considered for this fulltime immediate opening, submit resume by October 12, 2009 to jsauric@wasatchpeds.net.

H1N1 Influenza vaccine information

Some nasal spray doses of H1N1 vaccine are available today at Salt Lake County Health Clinics.

Several of our patients have called to say that they were unable to get the vaccine because they had received seasonal flu nasal vaccine (Flu Mist) within the previous 28 days.

There is a general rule about vaccines that you must wait 28 days after receiving any live-virus vaccine (Flu Mist/nasal influenza, MMR, Varicella) before you can receive another live-virus vaccine.

The CDC has been encouraging us to vaccinate all children with seasonal flu vaccine as soon as possible, even though this may interfere with receiving H1N1 vaccine if they receive the nasal live virus vaccine (FluMist).

If you have questions about your child's vaccines, please call us at 801 565-1162.

We have applied to be a vaccination center for H1N1 vaccine. We are waiting to hear from the Utah State Health Department about when we will receive vaccine, and other details such as cost, etc. As soon as we know, we'll let you know.

Monday, October 5, 2009

Flu Shot Update, Monday October 5th

Good Morning. We have been having some supply issues (big surprise) with seasonal flu vaccine. There is plenty of vaccine, but the manufacturers are having trouble shipping it because of the big shipments of H1N1 vaccine that are going out right now.

Here is where things stand at our office:

For regular insurance patients: We are out of seasonal flu vaccine for infants under 2 or for any children with asthma until later this week. We do have the nasal spray "FluMist" vaccine, which can be used for 2 years and up but not for asthma patients.

For Medicaid and CHIP patients, who qualify for VFC vaccines: we currently have all kinds of flu vaccine.

We still don't have any word on when we will get H1N1 vaccine in our office, but are expecting to hear any day now.

Meanwhile, H1N1 flu is circulating at mild to moderate levels in the community right now, along with Parainfluenza (croup) and Group A Strep (strep throat).

Monday, September 28, 2009

What We're Seeing the Week of September 28, 2009

Hey everyone. Summer's over, at least as far as respiratory illnesses. We are seeing a lot of strep throat right now-- sore throat, fever, headache, stomach ache/vomiting without runny nose or cough. We are also starting to see H1N1 influenza again-- fever, runny nose, cough, body aches, sore throat, headache, and sometimes vomiting. Remember, influenza is different than "stomach flu", which is really gastroenteritis and is caused by different viruses. We would recommend NOT using any aspirin products at this time (including children's aspirin and Pepto Bismol, which has a derivative of aspirin) because of the risk of Reye Syndrome in children with influenza A who get aspirin products. Ibuprofen and tylenol do not cause this problem and are safe to use.

Thursday, September 24, 2009

Construction Phase One Complete!

We moved the reception desk yesterday and started using our new rooms on the west side. There is a surprise for the kids-- each room has a brightly colored "accent wall" -- yellow, blue, green or orange-- that we think they'll love. The furniture hasn't been re-covered yet, so not everything matches. But we're getting there. PIctures soon.

Sunday, September 20, 2009

Tylenol Recall

We received the following letter from the makers of Tylenol. If you have any of the suspect Tylenol, we recommend you throw it away and call the number below to get a free replacement bottle. If you have used the recalled Tylenol, and are concerned about your child, feel free to call us or come in and have them examined. {Although it is likely that the recalled Tylenol caused no harm, so don't worry too much!}


Dear Healthcare Professional:

I am writing to inform you that, in consultation with the U.S. Food and Drug Administration (FDA), McNeil Consumer Healthcare is voluntarily initiating a recall of certain lots of Children's and Infants' TYLENOL® products that were manufactured between April 2008 and June 2008. The full list of recalled product lots is below.

The company has implemented this recall because examination of bulk raw material detected that one of the inactive ingredients did not meet internal testing requirements. Specifically, the gram-negative bacteriaBurkholderia cepacia (B. cepacia) was detected. The portion of raw material in which the bacteria was found was isolated and was not used in the production of any finished product. However, it was decided, as a precaution, to recall all product that utilized any of the raw material manufactured at the same time as the raw material that tested positive for the bacteria. Please note: No bacteria has been detected in finished product and the finished product has met all specifications.

A review of the relevant published scientific literature regarding B. cepacia indicates that while ingestion of contaminated pharmaceutical product is not known to be a route of transmission of B. cepacia infection, infection has been reported following the use of contaminated pharmaceutical products such as mouthwashes and nasal sprays. Adverse health consequence of B. cepacia infections could be potentially severe especially in high-risk patients, such as those with underlying pulmonary disease, cystic fibrosis or compromised immune systems.

McNeil has conducted an assessment of post-marketing safety surveillance data and did not identify any safety signals or batch-related safety concerns for Infants' and Children's TYLENOL® products over the time period, starting with the introduction of these batches, in or around April 2008.

McNeil is advising parents and caregivers who have administered affected product to their child or infant and have concerns to contact their healthcare providers. Parents and caregivers can find the lot numbers on the bottom of the box containing the product and also on the sticker that surrounds the product bottle. If your patients determine that they have affected product, they can contact our Customer Care Center at 1-800-962-5357 and we will send them a coupon for a new bottle.

If you have any questions, please call our Medical Affairs Department at 1-800-962-5357 (available Monday-Friday 8 a.m. to 8 p.m. Eastern Time).

Sincerely,
Edwin Kuffner
Edwin K. Kuffner, MD
Vice President, Medical Affairs
McNeil Consumer Healthcare

Recalled Products - Full List
UPC #Code #Lot #Product Description
3004503910493910400SBM041, SBM067, SCM037, SDM027, SEM109Children's TYLENOL® Plus Cold MS Suspension 4 oz. Grape
3004502960472960400SBM042, SCM015, SCM036, SDM034Children's TYLENOL® Suspension 4oz. Grape
3004504070474070400SBM043, SBM044, SCM029Children's TYLENOL® Suspension 4oz. Bubble Gum
3004504930404930400SBM045, SCM011, SCM030, SDM035Children's TYLENOL® Suspension 4oz. Strawberry
3004501224071224000SBM064, SCM033, SDM020Infants' TYLENOL® Grape Suspension Drops 1/4oz.
3004501861571861500SBM065, SCM005, SCM006, SDM032Infants' TYLENOL® Suspension 1/2oz. Cherry
3004501660431660400SBM066, SCM068Children's TYLENOL® Dye Free Suspension 4oz. Cherry
3004501230461230400SBM068, SCM035, SCM070, SCM080, SDM005Children's TYLENOL® Suspension 4oz. Cherry
3004502490432490400SBM069, SBM070, SCM081, SDM006Children's TYLENOL® Plus Cough & Runny Nose 4oz. Cherry
3004501221551221500SCM012, SCM067, SDM007, SDM068Infants' TYLENOL® Suspension Drops 1/2oz. Grape
3004503860453860400SCM013, SCM014, SCM069Children's TYLENOL® Plus Flu 4oz. Bubble Gum
3004503870423870400SCM016, SFM024Children's TYLENOL® Plus Cold Suspension 4oz. Grape
3004502470492470400SCM017Children's TYLENOL® Plus Cough/ST Suspension 4oz. Cherry
3004501220181220100SCM082, SDM039, SDM040Infants' TYLENOL® Suspension Drops 1oz. Grape
3004501670191670100SCM083, SCM084, SDM008Infants' TYLENOL® Dye Free Suspension 1oz. Cherry
3004501230151230100SDM064Children's TYLENOL® Pediatric Suspension 1oz. Cherry
3004501863001863000SDM038, SDM009Infants' TYLENOL® Suspension Drops 1oz. Cherry
3004503900423900400SDM033Children's TYLENOL® Plus Cold/Allergy 4oz. Bubble Gum
3004501221001221000SDM078Infants' TYLENOL® Drops 1oz. Grape
3505801441831221800SCM034Infants' TYLENOL® Grape Suspension Drops H/G 1/2oz.
3505801230341230300SDM028Children's TYLENOL® Suspension 4oz. Cherry, Hospital Govt.

Friday, September 18, 2009

Roundworm

Recently a few cases of roundworm (ascaris) have been reported. The worms were contracted in the sand near Oquirrh Lake. If you think your child may have been exposed, please call our office at 801-565-1162 to make an appointment so we can get them tested and treated.

Friday, September 11, 2009

Construction Update

New desk (looking at old desk)


Waiting Room

Hallway





Swine Flu

A vaccine for the Swine Flu (H1N1) is currently in production, and slated for release in October. At this time we don't know what the recommendations will be for children, but we will keep you posted. In the meantime, we saw our first case of regular influenza here in the office. So....come in and get your flu shots!!!

Wednesday, August 26, 2009

Construction update






We're making progress!

Saturday, August 22, 2009

Flu Shots

Flu season is just around the corner, so get an early start and protect your kids. We have our first shippment of flu vaccine with more to come. Our flu shot clinic will be
Wednesday 9-5
Friday 2-5
Saturday 9-1
We currently have flu shots for all ages. We do not have Flu Mist or shots for those with Medicaid, but hopefully those will be coming soon. It's probably a good idea to call (801-565-1162) before coming in to make sure we still have vaccine available.

Monday, August 10, 2009

H1N1 influenza and school absences

H1N1 Update: CDC Issues Guidance for School Districts for Upcoming Academic Year

This is from Journal Watch, based on CDC guidelines:


When contemplating school dismissals for flu, officials should balance the goal of reducing exposure to H1N1 virus against the social disruption brought about by sending students home, the CDC recommends in new guidance issued for the upcoming academic year (grades K–12).

If H1N1 severity is the same as during the spring outbreak, the CDC advises that:

ill students and staff should remain at home for 24 hours after they are free of fever (without use of fever-lowering drugs);
those who are sick at school should be separated from others until they can be sent home.
If the virus shows increased severity compared with the spring outbreak:

students and staff should be screened on arrival at school and sent home if ill;
people at high risk for complications or with ill household members should stay home;
sick people should stay home for at least 7 days, even if they become asymptomatic.

Flu Shot update

It's that time of year again, believe it or not. We will be starting our annual Flu Vaccine clinics around September 1st. This will be vaccine against "SEASONAL" influenza, meaning the standard influenza A and B subtypes that are expected this winter. Please contact our office for an appointment time for your kids to get their flu shots. The CDC recommends that all children 6 months of age and older get the flu shot.

As far as H1N1 "swine" flu shots, the CDC has announced that there will be a vaccine available later this Fall. The recommendations are for the following groups to receive H1N1 vaccine:
-- children 6 months of age up through adults 24 years of age,
-- household contacts of children less than 6 months of age during the flu season,
-- adults with chronic health conditions, and
--PREGNANT WOMEN; this is one of the highest risk groups for morbidity and mortality based on the recently completed H1N1 flu epidemic.

We still don't have information about who will be giving the H1N1 flu shot, whether it will be in doctor's offices, health departments, or even in schools. We will keep you posted as we learn more.

Dr. Lash

Thursday, July 23, 2009

Plastics


Recently BPA and phthalates have been in the news , so we thought we'd give a bit of info about these ubiquitous plasticizers. Both BPA and phthalates are added to products to add flexibility and durability. Phthalates are found in things like toys, packaging, wall coverings, cosmetics and building supplies. BPA is found in the linings of cans (such as formula), and some plastic bottles. The potential for harm to humans remains inconclusive, but there is growing evidence from animal studies that they could disrupt hormone production and cause problems.


Because we don't know for sure what types of problems may arise from the use of these substances, we recommend avoiding whenever possible just to be safe. Look for BPA and phthalate free products. If no label exists, look at the recycling label. Avoid #3, 6 and 7 plastics. Safe plastics include #1, 2, 4 and 5. Also avoid high heat situations such as microwaving plastics or running them through the dishwasher. When possible chose fresh or frozen foods rather than canned and glass over plastic.


This doesn't mean that you need to go crazy and tear your whole house apart in search of all things BPA. But next time you buy a new bottle or choosing which foods to buy, keep the plasticizers in mind.

Thursday, July 16, 2009

Pardon Our Dust








If you've been in the office lately, you've noticed things are looking a bit different. We are undergoing major construction to expand and remodel. Thanks for being patient with us as we grow--it's going to look great when it's all done.

Wednesday, June 3, 2009

Bug Off

With summer comes another hazard...bug bites. Here are some tips for bug safety.
  • To remove a visible stinger from skin, gently scrape it off horizontally with a credit card or your fingernail.
  • Combination sunscreen/insect repellent products should be avoided because sunscreen needs to be reapplied every two hours, but the insect repellent should not be reapplied.
  • Insect repellents containing DEET are most effective against ticks, which can transmit Lyme Disease, and mosquitoes, which can transmit West Nile Virus and other viruses.
  • Children over 2 months of age should use 30 percent DEET. (DEET should not be used on children under 2 months of age.)
  • The concentration of DEET in products may range from less than 10 percent to over 30 percent. Ten percent DEET only protects for about 30 minutes – inadequate for most outings.
  • Don't apply DEET on hands, eye area or around the mouth. Children should wash off repellents when back indoors.
  • Don't use scented soaps, perfumes or hair sprays on your child.
  • Avoid areas where insects nest or congregate, such as stagnant pools of water, uncovered foods and gardens where flowers are in bloom.
  • Avoid dressing your child in clothing with bright colors or flowery prints.
    http://www.aap.org/advocacy/releases/summertips.cfm


***Update***
The FDA recently approved a non-DEET bug spray called Picaridin. It is found in Cutter Advance and Avon Skin So Soft Bug Guard plus Picardin
.

Wednesday, May 27, 2009

Summer Loving

With summer upon us, remember to slather on the sunscreen.
  • Choose a sunscreen that is at least SPF 15, preferably SPF 30
  • It's best to lather up 30 minutes before heading out
  • Don't worry about buying special "kids" sunscreen, since most of the time they really aren't any different than those marketed for adults
  • Sunscreens labeled "physical" or "chemical-free" (made with zinc oxide or titanium dioxide) are less likely to cause irritation
  • Always use a waterproof or water resistant sunscreen
  • Sunscreen has not been tested on children younger than 6 months, so try to use lightweight clothing and shade to protect your babies. It's okay to use a little sunscreen where they are exposed, such as on the back of the hands
  • Reapply every 2 to 3 hours

Sunday, May 3, 2009

What We're Seeing in the Office Right Now

So, with all the hype about H1N1 Flu (Swine Flu), I thought I'd update you on what diseases we're seeing in the office right now.

There has been a new round of croup in the last 4-5 days. This particular croup has a high fever with it (102) and the typical barky "seal" cough. We should see your child if he or she has trouble breathing at night due to tightness in the throat. Remember to try a steamy bathroom or going out in the cool night air if your child is struggling to breathe, and if that doesn't work, go to the emergency room.

We are still seeing quite a bit of "seasonal" flu: Influenza A and Influenza B. Kids have a lot of body aches with this, along with fever, runny nose and cough. We are testing with our rapid flu tests if children have these symptoms, and anyone positive for Influenza A will also have a test sent out for H1N1 flu.

There has been quite a bit of Strep throat in the past week as well. Remember, Strep symtpoms in kids and teenagers usually are fever, sore throat, stomach ache, vomiting and headache. Most kids will NOT have runny nose or cough, although they may have a stuffy nose with Strep. We should see kids with Strep-like symptoms so we can test them and treat them if they are positive.

Remember to wash your hands! The CDC recommends singing the "Happy Birthday to You" song while you wash your hands to make sure you wash long enough to get viruses and bacteria off your skin.

Monday, April 27, 2009

Swine Flu Q & A

You've probably heard about swine flu already. We don't currently have any cases in Utah, but it's hard to predict how influenza will act. We are still seeing lots of cases of both Influenza A and B.
A good link to answer your questions about swine flu is here, at the www.cdc.gov website.
If your child has fever, chills, runny nose, cough or vomiting, it would be a good idea to have them come in to the office within the first 48 hours of illness so we can test them for influenza and possibly treat with antivirals. If it has been longer than 48 hours, you can watch them at home if they're doing OK, or call for an appointment if you have concerns.
Dr. Lash

Sunday, April 19, 2009

It's Baaaack...

No, not the sun, although this sunny Sunday was a welcome relief from the cold and wet weather we've been having. What's back is Influenza A. We have seen a bump in flu cases this past week at our office. This strain seems a little different though... we've seen lots of older kids who complain mostly of severe muscle aches and fever, but have fairly mild runny nose and cough. We were a little puzzled until we had a few rapid flu tests come back positive.
If your child has flu-like symptoms, we can do a rapid flu test within the first 48 hours of fever. If it shows up positive, their are anti-viral drugs that we can use to make the flu symptoms milder and shorter, but only if we start them in the first two days. After that the horse has left the barn, so to speak. Family members can also be put on anti-virals preventatively to avoid catching influenza from their household contact. One reminder: anti-viral drugs can't be used on infants under the age of 12 months.

Monday, April 13, 2009

Got Colic?

Don't give up, there may be hope! A new study showed that breastfed infants with colic responded to a group of probiotics called "Lactobacillus reuteri." In this study, after 28 days of receiving probiotics, the average daily crying time was 51 minutes compared with 145 minutes in infants receiving Mylicon. 51 minutes is not ideal, but it's better than 145!

Colic is defined as more than three hours of crying on more than three days in the week, typically occuring in the evening hours.

Probiotics (as opposed to antibiotics) restore the healthy bacteria that we all naturally have in our body. One theory as to why babies get colic is that it is an inbalance in the digestive system, so it makes sense that restoring the bacteria balance might help.

Lactobacillus is available in multiple forms. When my infant was colicky, I tried Udo's Infant's Probiotics. I purchased it at a health food store, and I felt like it made a difference. The dose is 1/2 teaspoon a day. You can dissolve the powder in a little water and feed it to your baby in a bottle or with a syringe. Good luck!

Keep your toddler in a rear-facing car seat until age 2 (not 1)

Lori O’Keefe
Correspondent

New research indicates that toddlers are more than five times safer riding rear-facing in a car safety seat up to their second birthday. Following are some safety tips for car seat use:

All infants should ride rear-facing in either an infant car seat or convertible seat.

If an infant car seat is used, the infant should be switched to a rear-facing convertible car seat once the maximum height (when the infant’s head is within 1 inch of the top of the seat) and weight (usually 22 pounds to 32 pounds) have been reached for that infant seat as suggested by the car seat manufacturer.

Toddlers should remain rear-facing in a convertible car seat until they have reached the maximum height and weight recommended for the model, or at least the age of 2.

To see if your car seat is installed properly and to find a certified passenger safety technician in your area, visit www.seatcheck.org or www.nhtsa.dot.gov/cps/cpsfitting/index.cfm. You also can call 866-SEATCHECK (866-732-8243) or 888-327-4236.

Original article found here

Saturday, March 21, 2009

Home remedies to soothe your child's cold symptoms

by Allison Bond


Figure 1

Cough and cold medicines specifically made for children under age 2 recently were removed from store shelves due to the potential for misuse. In addition, a panel of advisers to the Food and Drug Administration has recommended against giving over-the-counter cough and cold medicines to children under age 6.

The American Academy of Pediatrics offers parents plenty of advice on how to soothe their child's symptoms without medication:


  • When your child has a cold, make sure he or she gets plenty of rest and drinks extra fluids.
  • Use a suction bulb to clear the nose of a child too young to blow his own, and help or encourage an older child to blow his or her nose.
  • Consider using saline nose drops to soften the mucus. Drops can be made by adding 1/2 teaspoon of salt to 1 cup (8 ounces) of warm water. Use two to three drops per nostril at least four times a day or as often as needed for children over age 1. Kids under age 1 need only one drop at a time.
  • Protect the skin around stuffy noses with petroleum jelly.
  • Treat a fever and its accompanying aches and pains with ibuprofen or acetaminophen for children over age 6 months. Follow the recommended dosage by age. However, never give pain relievers to children who are vomiting continuously or dehydrated.
  • Sore throats can be remedied with cough drops or hard candy for children over age 4, and with warm chicken broth for kids over age 1.
  • Contact your pediatrician at the first signs of illness for infants younger than 3 months of age.
Original article found here

Crib Bumpers

Crib bumpers in the night: a hazard to infants

Allison Bond


Figure 1

As a parent, your primary aim is to protect your child and that includes providing a safe sleeping environment. But the pillow-like crib bumpers often used to prevent bruising can pose serious risks to your child's safety.

A September 2007 study in the Journal of Pediatrics concluded that crib and bassinet bumpers are unsafe because they can suffocate or strangle an infant.

Parents should keep pillows—including crib bumpers—and other soft materials out of their baby's sleeping area, according to the American Academy of Pediatrics (AAP) and the "Back to Sleep" campaign, which reduced Sudden Infant Death Syndrome (SIDS) deaths by more than 40% between 1992 and 2000. Additionally, data from the U.S. Consumer Product Safety Com mission show it is extremely rare for the contact between an infant and the sides of the crib to cause long-term injury.

So while crib bumpers may give parents a feeling of security, in reality these soft objects pose a serious safety risk to infants.

The AAP, Centers for Disease Control and Prevention and First Candle SIDS Alliance offer these additional tips to parents with children in cribs:


  • Always put your baby to sleep on his or her back.
  • Until age 6 months, move your baby's crib near your bed.
  • Don't overdress your baby for naps or bedtime. (One-piece sleepers work best; young children generally need one more layer of clothing than an adult might need.)
  • Remove loose bedding (blankets, pillows, sheepskins, etc.) from your child's sleeping area. If a blanket must be used for warmth, tuck it in around the crib mattress, reaching only as far as the baby's chest.
Original article found here

Tuesday, March 17, 2009

Splish Splash


Drowning is the second most common cause of injury death for children age 0 to 14 in the United States. A new study just came out that found formal swimming lessons were strongly associated with a lower risk of drowning for preschool children age 1 to 4 years old. So sign up for those lessons, and head to the pool!

Friday, March 6, 2009

It's not too late!



It looks like Influenza is going to come late this year. According to state epidemiologists, it has not yet peaked and you still have time to get your flu shot.
Here at Southpoint we still have influenza vaccine available, although we do not have the thimerosal-free vaccine that we typically use for children under three years old. (I will still be giving my 6 month-old her booster with the non-thimerosal-free vaccine, however!)

Adult vaccines are also available. Check out this article in the Deseret News for more information.
-Dr. Packer

Should we stay or should we go???

The AAP recently came out with new guidelines for when you should keep your child home from school, daycare and other group activities.

Check them out here.

(You have to create a login to access this site, but it is easy and free, and you don't get spam or other unwanted mail.)

Tuesday, March 3, 2009

The Problem With Alternative Vaccination Schedules

You might like reading The Problem With Dr. Bob's Alternate Vaccine Schedule, by Paul Offit, MD and Charlotte A. Moser.
It is a detailed examination of the logic behind proposed alternate vaccination schedules, and why it doesn't hold up very well to evidence-based medicine.

Sunday, February 22, 2009

Keeping Things in Perspective

Author Anna Quindlen wrote this perceptive paragraph in her book, Loud and Clear:

“The biggest mistake I made [as a parent] is the one that most of us make. . . . I did not live in the moment enough. This is particularly clear now that the moment is gone, captured only in photographs. There is one picture of [my three children] sitting in the grass on a quilt in the shadow of the swing set on a summer day, ages six, four, and one. And I wish I could remember what we ate, and what we talked about, and how they sounded, and how they looked when they slept that night. I wish I had not been in such a hurry to get on to the next thing: dinner, bath, book, bed. I wish I had treasured the doing a little more and the getting it done a little less”(Loud and Clear [2004], 10–11).

So take some time this week to burn some memories to your mental hard drive, and enjoy some time with your kids. Even if their noses have been running for a solid month now!

-- Dr. Lash

Friday, February 13, 2009

The Elephant in the Living Room

It's the elephant in the living room. 99% of American households own a television, and the typical schoolchild spends as much time watching TV as she does in class. But before you throw your set (or, let's be honest - sets) out the window, Dimitri Christakis has some suggestions for making TV work for your family. Christakis is the director of the Child Health Institute at the University of Washington, and he talked to KUER about how parents can take charge of their children's viewing and make it a beneficial part of their life. Check it out here.

Monday, February 9, 2009

Child's Play

New research shows that unsupervised, freewheeling imaginative play is more important to a child's development than we previously thought. Check it out here .

Nerf Recall


Click on the picture to enlarge.

Graco Recall


Click on the picture to enlarge.