Chikungunya reported in the Boston area

by Tripp Underwood on July 8, 2014

tiger mosquitoFour people in the Boston area have been diagnosed with chikungunya, a viral disease spread to people by way of mosquitoes.

Typically, outbreaks of the disease are restricted to Africa, Asia, Europe and the Indian and Pacific Oceans. But as of late, there has been an increase in reported cases in the Caribbean islands, which some believe may eventually lead to more cases in the U.S.

“With the disease now appearing more frequently in islands neighboring the U.S., it’s quite possible we’ll begin seeing more cases of infected travelers bringing chikungunya home with them,” says Jeffrey Dvorin, MD, PhD, of Boston Children’s Hospital’s Division of Infectious Diseases. “And because the types of mosquitoes that can carry and transfer the disease are present in Massachusetts, there’s an increased risk that it could spread more easily once here, like has happened recently with the West Nile virus. There’s a good chance we’ll be hearing much more about it in the coming years.”

People with chikungunya often develop a fever, rash and joint pain a few days after being infected. It rarely results in death—usually only among the very young, old or sick—but the symptoms can be severe in children.

And because chikungunya is transmitted via the Aedes aegypti and Aedes albopictus mosquitos—which are aggressive biters that feed throughout the day instead of just at dawn or dusk—protecting against their bite requires a bit more effort.

To keep your family free of mosquito bites this summer, Dvorin recommends:

Using insect repellents

  • Bug sprays with DEET or picaridin provide the longest lasting protection.
  • If you use sunscreen and insect repellent, put sunscreen on first and the repellent last.
  • Spray repellent on your clothing, not just exposed skin.
  • Always follow the label instructions when using insect repellent or sunscreen.

Knowing your environment

  • Don’t let children play around water that has been standing for a few days, like puddles or small pockets of rainwater as they may be a mosquito breeding ground. If you have a kiddie pool in your yard, drain it daily to keep the water from getting stagnant.
  • Leave doors shut and make sure all your windows have screens without holes. Replace or repair screens if necessary.
  • Wear long sleeves and pants when weather allows, especially when in areas with large mosquito populations like swamps or woods.

“Though a few cases of chikungunya have been discovered in the area, it’s not yet considered a public threat, so parents shouldn’t be afraid to send their children outside,” Dvorin says. “But before you do, make sure they’re protected with the right repellents and clothing. And if a child does come down with an illness with a fever accompanied by a rash and joint pains, you should contact your doctor.”


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When school is online, how much screen time is too much?

by Michael Rich MD MPH on July 7, 2014

Michael RichMichael Rich, MD, MPH, is Boston Children’s Hospital’s media expert and director of Boston Children’s Center on Media and Child Health. Send him a media-related parenting question via and follow him on Twitter @CMCH_Boston.

Q: I teach for an online school that serves students in 4th through 12th grades. All of our lesson content is web-based, and the school would like to add three hours of synchronous lesson delivery four days a week. I believe that the school is trying to satisfy the parent desire for face-to-face contact between students and teachers—in this scenario, students can ask questions in real time and get their answers right away. Personally, I think that it is too much screen time for the students. All of the data I see indicates that screen-time does not count when it is for educational purposes, but that does not seem quite right to me. What are your thoughts on online education and how much time a student in an online school should spend using screens?
- Skeptical about Screen Time, in Alberta, Canada

A: Dear Skeptical, Full story »

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Determined to overcome HLHS

by Tripp Underwood on June 30, 2014

Peter-Dunn-3 Kerri Dunn can always tell when her son Peter is determined to do something because when he gets deeply focused his face scrunches up and he squints one eye tightly shut, which his mother says makes him look like a cute, 2-year-old version of Popeye.

It’s a face Kerri sees a lot, because Peter is a very determined little boy. The youngest of six children, Peter is always trying to keep up with his older brothers and sisters—or “my kids” as he calls them. And, despite his smaller size, he still manages to do so—whether they’re walking, running or even climbing trees.

While his determination to keep pace with his older siblings may seem cute on the surface, it’s actually an incredible testament to Peter’s strong will. Not only is he managing to follow in their much larger footsteps, he’s doing so with only fifty percent of a working heart beating inside his chest. Full story »

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When Priya Moorthy first learned she was pregnant, her plan was to defer medical school for a year, then finish her education when her baby had grown. But shortly after her daughter Vaidehi was born, Priya realized that caring for her would be a full-time responsibility. Even though she wouldn’t be returning to med school in the foreseeable future, raising Vaidehi would give Priya a unique medical education all its own.

A very special type of IBD

Vaidehi-bakesAt just three months old, Vaidehi was diagnosed with chronic granulomatous disease (CGD), a rare genetic immune deficiency that prevents her body from effectively protecting against certain bacteria and fungi. Because CGD is rare (it only effects around 1 out of every 250,000 people), there is a lot the medical community still needs to learn about the disease, especially when it presents with other gastrointestinal conditions Full story »

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Limiting TV: Good for your child, GREAT for you

by Guest Blogger on June 25, 2014

Meaghan O’Keeffe, RN, BSN, is a mother, writer and nurse. She worked at Boston Children’s Hospital for nearly a decade, in both the Cardiac Intensive Care Unit and the Pre-op Clinic.  She is a regular contributor to Thriving.

Meaghan_OKeeffe_1Misery loves company, as the saying goes. Swap out “misery” for “happiness” and you’ve got a much better outcome. Happier kids create happier parents.

So, what if I told you that by making just one small change, you could have a child who is happier, healthier, more relaxed and more connected with those around them?

“What is it?” you ask, on the edge of your seat. “What’s the secret?”

“All you need to do…”

“Yes?” you say, your eyes bright and encouraging.

“…is limit television and screen time.”

Did I already lose you?

Full story »

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Michael Rich, MD, MPH, is Children’s Hospital Boston’s media expert and director of Children’s Center on Media and Child Health. Take a look at his blog archive or follow him on Twitter @CMCH_Boston

Michael RichQ: My six year old loves music, and I would like her to have something digital with which to listen to a variety of good music. I want her to have a certain level of independence as she explores her musical tastes, but I don’t want to get her something too advanced. My husband often lets her use his iPhone to search YouTube for a song she likes—then suggestions come up for others like it. I am not comfortable with trusting her musical exploration to marketing search engines, and I want to inspire her to just listen to good music. What do you advise?
-Harmony Hunter

A: Dear Harmony,

Today’s technology offers great ways to allow your daughter a way to explore musical tastes in a controlled environment. There are a few different options, each of which has advantages and challenges:

  • MP3 players: If you’re concerned about the musical content to which she’s exposed, an MP3 player may be your best choice. You can preselect the songs, and you won’t need to worry about marketing or commercials. You’ll likely need to show her how to use the various controls as she needs them. The main challenge for her may be that MP3 players are text based, so how easy it is for her to use will depend in part on her reading skills. Even before she can read, however, she can enjoy a broad and eclectic variety of music on shuffle play.

  • Online streaming services: Services like Pandora will constantly update song lists based on your (or her) preferences. Such a service will expose her to a wider variety of music than you might be able to provide her, and at less expense. But you can’t be sure what songs will get through the filters, and if you use free services, there will likely be marketing and commercial content as well.


  • YouTube: YouTube covers an ever-expanding range of music types, including a children’s version, and it’s “free”. But it is free of charge because it includes advertising, both on the site and embedded in many videos. YouTube also adds a visual element, which means she’ll see other people’s interpretations of songs. At times, that can be a lot of fun, but it may add images she’s not ready for, and the visual component changes the creative interaction between child and music. By supplying images to go with the story, music videos can take away the opportunity for your daughter to use her own imagination. Each time she hears that music, she will recall someone else’s images rather than her own. If the goal is listen to music, then the video component can limit her own imaginative possibilities. Note, however, that many YouTube videos of songs contain a static image of the album cover or the lyrics, rather than actual video, so those videos may be good options for your child.

Deciding which to choose will depend on your priorities: If you want to control the content, an MP3 player is likely the best option. If you want her to be exposed to the most variety, then online streaming may be best. If you do use online streaming or YouTube, consider having an adult present while she uses those services to help filter and interpret content that may otherwise be upsetting or confusing.

Enjoy your media and use them wisely,
The Mediatrician® 

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This story originally appeared on Insight, Dana-Farber’s blog

Insights 1Jessica Tierney never thought she’d experience a harder moment than learning she had cancer at age 15 – until her 7-year-old daughter, Emma, was diagnosed with acute lymphocytic leukemia (ALL) last October.

Emma is undergoing treatment at Boston Children’s Hospital and Dana-Farber’s Jimmy Fund Clinic, just as Jessica did in 1991. “Emma already knew I had once been really sick, so I told her, ‘Look at me. I was treated a long time ago, and the medicine is even better now,” Jessica Tierney recalls of hearing her daughter’s diagnosis.

Jessica is a survivor of acute myeloid leukemia, or AML, a different leukemia than Emma has. Jessica was always told there was no danger of passing AML down to her two children, but there may be an ALL-AML link involved. Full story »

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By Meghan Fredette, MD, Pediatric Resident, Boston Combined Residency Program

MFredetteAs I rode the train the other day, a toothy toddler wiggled and giggled in her stroller across from me, making faces at the people around her. The train was otherwise silent except for the steady announcements of stops over the loudspeaker. The train was packed and yet no one looked up from their phones to see the little girl make faces—not even her mother, who sat expressionless, silently swiping at her touchscreen.

This scene is common. It is clear that smartphones and handheld mobile devices have changed how we interact with the world around us. We’ve all been on a silent train with no interaction between passengers or observed date nights where individuals seem more interested in their phones than in conversation. At some point, we’ve all probably been guilty of it too, robotically walking through the street face down while checking our emails or texts instead of taking in the world around us.

Face-to-screen time seems to steadily be replacing face-to-face time in our lives. Full story »

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