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Willows Pediatrics Blog - We Know Kids
We Know Kids
The Willows Pediatrics Blog

Category: Disease

COVID 19 Testing: Antibody and Viral tests

There are two kinds of tests for COVID-19: a viral test and an antibody test.

  • A viral test (nasal or oral swab) tells you if you have a current infection
  • An antibody test (blood test) tells you if had a previous infection

Viral Tests: Testing for current infection

To learn if you have a current infection, viral tests are used. A viral test is collected by a nasal or oral swab at a testing center in our area.

Who should be tested?

  • The decision to get tested depends on several different factors including how sick the patient is, what medical problems the patient has and who resides in the patient’s household (e.g. an immunosuppressed family member, a parent who is a health care worker)
  • At this time, we still encourage testing only if you have symptoms suggesting a COVID-19 infection.
  • If you have symptoms suggesting COVID-19 and want to get tested, please call our office.
  • If you have gotten tested and are awaiting the results, please isolate/quarantine to avoid possibly spreading the infection to others.

Interpreting the results

  • If you test NEGATIVE for COVID-19 by a viral test while you have symptoms, then you likely do NOT have COVID-19. Though we know that there are some false negatives, meaning people who actually DO have COVID but get a negative test result, a false negative result is unlikely.
  • If you test POSITIVE for COVID-19 by a viral test then you have an active infection. Please quarantine in your home and isolate as much as possible from others in your home. If you test positive, we can discuss with you how to minimize spread within your home and when you can safely leave isolation.

Antibody Tests: Testing for past infection

Antibody tests are blood tests that check if your body has antibodies from a previous infection with the virus. Antibodies are proteins our immune system makes when we are exposed to a virus and continue to circulate in our blood after we have recovered from the infection. COVID-19 antibody tests cannot be used to see if you have a current infection, as sometimes the antibodies cannot be detected for weeks after the initial infection.

We use antibody testing for many other diseases to tell us if a patient has had an infection or has immunity to a disease. For diseases that have been studied over time we know what level of antibody is effective and we know whether that antibody can give you temporary or permanent immunity. However, since COVID-19 is a new disease we don’t have all the facts yet.

Cautions regarding antibody tests:

  • We do not know at this time if antibodies provide immunity against getting re-infected
  • We do not know how specific the antibody tests are for detecting antibodies to SARS-CoV-2 versus closely related coronaviruses such as the common cold.
  • There are many tests available right now but few of them have been FDA approved, meaning we do not know how accurate these tests are. In other words, if the test says you have antibodies, or don’t have antibodies, how likely is that to be true?

Given all of these cautions, we are not currently recommending antibody testing for most people. The only scenario in which we DO recommend testing is if you have had a positive COVID-19 viral test and are interested in plasma donation.

Why we don’t think you should get an antibody test now:

  • We are concerned that you may get a “positive” result when you don’t actually have antibodies to COVID. This could happen because these tests are still very new, they were released to the market before the FDA validated them and you may have very similar antibodies from a very similar virus you’ve had in the past. If you got a positive result you may interpret that to mean you are immune, when in fact you are not. This could be dangerous as you may not be as rigorous about wearing a mask or social distancing and accidentally expose yourself or others.
  • We don’t know yet what having antibodies to COVID-19 means. We don’t know if those antibodies confer immunity and, if so, how long that immunity lasts.
  • Antibody tests are usually expensive. Since many of the tests on the market are not FDA approved they may not be covered by insurance.
  • Antibody tests require a blood draw in a doctor’s office or hospital. We usually do everything we can to minimize blood draws in kids to avoid discomfort.

Looking forward:

The scientific community is working furiously to learn more about COVID-19 each and every day. We are hopeful that soon we will know more about COVID-19 antibodies and immunity. We are also hopeful that the FDA will review the tests on the market and guide us to which tests are the most accurate. We will continue to follow this issue closely to give you the best guidance and we will update you when our recommendations change.

For now, please continue to social distance, stay home if you or anyone you’ve been in contact with is sick, and wear a mask when social distancing is not possible.

Sources and Suggested Reading

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html

https://www.scientificamerican.com/article/what-covid-19-antibody-tests-can-and-cannot-tell-us/

https://www.idsociety.org/news–publications-new/articles/2020/emphasizing-need-for-more-information-idsa-releases-antibody-testing-primer2/

Pediatric Multisystem Inflammatory Syndrome: What Parents Should Know

You may have seen recent news reports about a syndrome affecting kids during the COVID-19 pandemic called Pediatric Multisystem Inflammatory Syndrome. This new syndrome has only been recently detected and is still being investigated. We know some of these reports can be scary so we would like to try to separate fact from fiction and give you clear information.

The first reports about this syndrome came out of the United Kingdom at the end of April. Last week, the first U.S. cases were reported in New York City. Today, cases have been reported in Connecticut. While this new syndrome is serious, the good news is that the number of children affected so far is very small compared to the staggering number of people affected by COVID-19.

What is Pediatric Multisystem Inflammatory Syndrome?

This syndrome is a new health condition in which children who have had the coronavirus and recovered from it develop an excessive immune response that causes significant inflammation to their organs. Children with this syndrome have prolonged fever (greater than 5 days), their blood work shows inflammation, and they present with certain clinical findings such as:

  • abdominal pain
  • eye redness
  • enlarged lymph nodes or glands on one side of the neck
  • skin rash
  • red, cracked lips or a red “strawberry” tongue
  • swollen hands or feet

IMPORTANT: Children with this syndrome will look very ill. They will not bounce back from their fever with Tylenol or ibuprofen. They will have persistent symptoms over several days. This is NOT something you can easily miss.

What should I do if I think my child has this new syndrome?

If you are concerned that your child meets these criteria, but she only has mild symptoms, please call our office. If your child is very ill and it is an emergency, as always, please call 911.

If my child was sick before (either with a positive COVID test or not) should I get my child checked?

At this time, if your child has recovered from a prior illness and is doing well, there is no recommendation to do so. If your child becomes ill and has a high fever for several days in a row please call our office so we can evaluate him or her.

What is Kawasaki Disease and is it related?

Kawasaki Disease is a rare inflammatory disease that only occurs in children. It is still unclear how or if Kawasaki Disease and COVID-19 are related but they have similar symptoms and presentations.

Kawasaki Disease existed long before COVID-19, and we are not sure what causes the immune systems in these children to go into overdrive. In Kawasaki’s Disease, children present with a prolonged fever, some clinical symptoms (rash, strawberry tongue, swollen lymph nodes, swelling of hands and feet) and signs of inflammation throughout the body eventually including swelling of the blood vessels of the heart. Typically, there are about 3,000 cases per year in the United States. This is an easily treatable condition and typically children do not have long-term complications.

Is there treatment for Pediatric Multisystem Inflammatory Syndrome?

Doctors are working hard to determine the best treatment. If we suspect your child has this syndrome, we would likely direct you to a hospital or emergency room for evaluation. Patients with Kawasaki Disease or Pediatric Multisystem Inflammatory Syndrome need monitoring and specialist evaluation. Treatments for Kawasaki Disease are being tried for patients with this new syndrome. These treatments include supplemental doses of immunoglobulin (intravenous immunoglobulin, IVIG) and steroids. Rarely, children have gotten very sick and needed to be in an intensive care unit for fluids, medications for blood pressure, and assistance with breathing. While this new disease is serious, remember that children with this syndrome will look very ill and that this is NOT something you can easily miss.

Coronavirus: News and resources for families

We understand that families are concerned about coronavirus (COVID-19). All of us at Willows Pediatrics are carefully monitoring the situation on a daily basis. We are here to answer your questions, and let you know how we can help you and your family stay safe at the same time we address the more routine questions and concerns about your child’s health. The CDC website is a reliable source of information for news and updates on COVID-19: cdc.gov/coronavirus. Below are steps you can take to protect yourself, your family, and our community. While most families are already aware of them, they are still key:  Read More

Eastern Equine Encephalitis – Q & A

Mosquito bites and eastern equine encephalitis

Many families are aware that the Connecticut State Department of Health recently reported a mosquito infected with the virus causing Eastern Equine Encephalitis (EEE) has been detected in Fairfield County. While infections due to this virus are rare in people, two cases of EEE, one fatal, have also recently been reported in Connecticut shoreline towns. As many families are spending a great deal of time outside during the early fall, with possible exposure to mosquitoes, we would like to provide answers to questions about keeping your infants, children, and adolescents safe during this year’s EEE season. Read More

Human Papilloma Virus Vaccine – Myth vs. Reality

If you could protect your child against a cancer-causing virus with three doses of a safe and effective vaccine, why wouldn’t you? While most parents are committed to vaccinating their child against all vaccine preventable diseases, some parents are still reluctant to have their child receive the HPV vaccine. In response to these concerns, Willows Pediatrics wants to remind families about the benefits of the vaccine and why we recommend it.
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Willows Wants You to Know About Tick Bites & Lyme Disease

Tick Bites

As warm weather approaches (rather early this year!), we know that kids will be playing outside. Here in Westport and in the surrounding towns, wooded areas are home to deer … and along with the deer come deer ticks. So Willows Pediatrics thought it would be a good idea to review our recommendations on tick bites and Lyme disease today.

We have an excellent article on tick bites on our blog, and we encourage you to read it thoroughly. In essence, we recommend that parents or caregivers do a daily inspection for ticks. The reason daily checks are important is because we know that a tick must be on the body for 36-48 hours to pass any illness to humans. If a tick is promptly found and removed, Lyme can be prevented.

If you find a tick, remove it using tweezers. (We suggest you purchase a pair of fine-nosed tweezers specifically for this purpose.) Grab the base of the tick against the skin with and steadily pull the tick out. Don’t worry if part of the head, or part of a limb cannot be removed, as the disease-carrying portion of a tick is the abdomen. After removing the tick you can keep the bite area clean with soap and water and apply a topical antibiotic for a few days. Read More

A “Symptom Checker” Tool To Help You At Home!

If you’re out of town or can’t make it into Willows Pediatrics when your child gets injured or seems ill, there’s a new online tool for you! HealthyChildren.org has developed a KidsDoc Symptom Checker app that may very well become one of your most-used apps.

We like the app because it offers advice derived from clinical protocols … plus definitions of diseases and decision charts about when to call us or to call 911.

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Willows Pediatrics And FDA Do Not Recommend Cough And Cold Medicines For Children Under Two Years Of Age

CareBack in 2008, the Food and Drug Administration (FDA) recommended that over-the-counter (OTC) cough and coldmedication should not be used in infants and children under the age of two, and Willows Pediatrics agrees. The FDA found that these products could cause serious and potentially life-threatening side effects in young children including convulsions, rapid heart rates, decreased levels of consciousness and death. This recommendation led to a voluntary recall of these types of products marketed to children under two. Read More

Willows Pediatrics Reminds Parents That Fever Is Not Typically Dangerous

Did you know that, in most cases, a fever alone does not harm your child … and can actually be beneficial? It’s true, and that’s why Willows Pediatrics wants to address the topic of “fever phobia” today!

Many parents and caregivers immediately rush to give their child acetaminophen or ibuprofen the minute they see their child’s temperature rise. That’s not always necessary or the best plan. “Fever is a physiological mechanism that has beneficial effects in fighting infection,” said a recent article in the AAP News. The article also notes that the degree of fever does not always correlate with the severity of illness, and that there is no evidence that fever alone, even high fever, causes any long-term complications. (The exceptions to this would be in children with certain underlying chronic diseases or conditions.)

Most importantly, “Fever, in and of itself, is not known to endanger a generally healthy child; in contrast, fever actually may be of benefit.”

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Preventing Pertussis Outbreaks: Vaccination is the Key

DPT Vaccine

Photo via Wikimedia

Most of our patients at Willows Pediatrics have heard of the DPT vaccine, but fewer know a whole lot about the diseases it was designed to prevent. Today, in light of a recent outbreak in California, we would like to shed some light on the “P” in DPT: Pertussis. Before vaccines, pertussis (also known as whooping cough) was a common childhood disease that caused thousands of deaths annually back in the 1920s and 1930s. The development of a pertussis immunization in the 1940s and the acellular version (which we now use in the DPT shot) in the 1990s, has reduced the cases of this disease significantly.

However, pertussis still exists and is a highly contagious childhood disease. According to the CDC, a typical case of pertussis in children and adults starts with a cough and runny nose for one to two weeks, followed by weeks (or even months) of rapid coughing fits that sometimes end with a whooping sound. It is most often transmitted via airborne droplets from a cough or sneeze or direct contact with the respiratory secretions from an infected person. When it comes to symptoms, pertussis is most severe in infants. It can lead to pneumonia, apnea, neurological complications (such as seizures), dehydration and even death. Read More