Teens Unaware of Hepatitis Risk
Adolescents showed a significant lack of understanding of the risk of hepatitis B from contaminated piercing and tattoo tools, as well as from infected needles and risky sexual behaviors, according to Amy B. Slonim, Ph.D., of the Michigan Public Health Institute in Okemos, and her associates.
In a survey of 17,063 adolescents and young adults aged 13–21 years, 27% could not provide information about hepatitis B vaccination and 20% could provide only incorrect information. Nearly half of those who gave incorrect information thought a vaccination was “something bad.”
Clinic staff members who conducted the surveys suggested a strategy for educating teens about hepatitis including examples of how it is contracted, emphasis of the possible severity of the illness (cirrhosis), and the safety and effectiveness of the vaccine (J. Adolesc. Health 2005;36:178–86).
Tularemia From Hamster Bite
A 3-year-old boy who was bitten by a hamster was diagnosed with tularemia, reported the Colorado Department of Public Health and the U.S. Centers for Disease Control and Prevention (MMWR 2005;53:1202–3).
The boy recovered after an excisional biopsy of a left axillary lymph node to relieve lymphadenopathy and intermittent fever; he was also treated with ciprofloxacin.
The boy was exposed to six hamsters purchased from a pet store, each of which died from diarrhea within a week of purchase.
One hamster bit the boy shortly before it died, and 7 days later, the child developed fever, malaise, painful left axillary lymphadenopathy, and skin sloughing at the bite site on the finger. No other exposures to tularemia risk factors were identified, so the hamster was presumed to be the cause, although the delay between the child's onset of illness and final diagnosis meant that the implicated hamsters were not available for testing.
An adult customer and a pet store employee who developed fevers after being bitten by hamsters from the store tested negative for Francisella tularensis. However, a cat in the store tested positive for F. tularensis, which suggested that other animals in the store might have been exposed to infection.
More Options for HIV
A combination of atovaquone-azithromycin (AT-AZ) is as effective as trimethoprim-sulfamethoxazole (TMP-SMZ) for the prevention of serious bacterial infections in children with HIV aged 3 months to 19 years, said Walter T. Hughes, M.D., of St. Jude Children's Research Hospital, Memphis, and his colleagues.
TMP-SMZ is widely used against bacterial infections in children with and without HIV, but some children experience adverse reactions and need an alternative treatment.
In a randomized, double-blind, placebo-controlled study, 366 children were followed for an average of 3 years (Clin. Infect. Dis. 2005;40:136–45). Serious bacterial infections were 12.9/100 person-years in the AT-AZ group, compared with 18.5/100 person-years in the TMP-SMZ group.
Hematologic problems were the most common adverse events, occurring in 39% of the AT-AZ children and 37% of the TMP-SMZ children. While the high cost of atovaquone-azithromycin prevents its use in most cases, it presents a viable alternative for children who experience adverse effects from TMP-SMZ, researchers said.
Teens and Tobacco Addiction
Adolescents appear to become addicted to cigarettes more easily than adults, according to a study of 220 ninth-graders who smoke.
Other studies have suggested this susceptibility to addiction but have not been able to measure tobacco exposure as well, Mark Rubinstein, M.D., said at the annual meeting of the Society for Adolescent Medicine.
This study measured cotinine levels in saliva, and correlated it with self-reports of craving and an addiction measure. Cotinine, a metabolite of nicotine, persists longer in saliva than nicotine does in blood.
The study found that even among the 20% of adolescents who reported smoking daily, cotinine levels generally were much lower than typically seen in adult smokers. The cotinine level that defines addiction in adults is 200 ng/mL. But only one of the adolescents had a level equal to or above that.
Still, cotinine levels did correlate with addiction, and 34% of the daily smokers were identified as addicted, either by self-report of craving or on a nicotine dependence syndrome scale. Twenty-eight percent of those had undetectable cotinine levels.