Another consequence of uncontrolled spread of HIV among adults: vertical transmission

Article Abstract:

As of December 1990, of the 2,789 children with AIDS who were less than 13 years old, 84 percent had been infected with HIV by their mothers prior to birth. (HIV is the causative agent of AIDS.) More than half of these children have died. Prevention of this type of transmission depends on how well the disease is controlled among adults. The course of HIV infection in children is very different from the usual course in adults. Children have one of two types; some develop severe symptoms during the first year of life, and often die from Pneumocystis carinii pneumonia. In other children, HIV infection has a slower progression, and they have frequent bacterial infections. As many as 2,000 HIV-infected children will be born this year; this projection is based on the finding that one-quarter to one-third of infants born to infected mothers will themselves become infected. However, there is reason to believe that the infection rate is substantially lower among women with less advanced disease. HIV-infected women having their first baby, and those who have a history of sexually transmitted diseases are more likely to infect their newborns. Whether the birth is vaginal or cesarean does not seem to matter. Diagnosing HIV infection in babies is difficult, but polymerase chain reaction (which examines DNA) is somewhat sensitive at birth and almost 100 percent accurate once the baby is a month old or more. Screening of women at risk for HIV infection is the best way to prevent maternal-fetal transmission; if a woman knows that she is infected with the AIDS virus she may choose to refrain from having children. However, it will be necessary to develop better methods of diagnosis, treatment, and prevention of HIV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, HIV infection, HIV infections, Disease transmission, AIDS (Disease), AIDS (Disease) in pregnancy, AIDS (Disease) in children, Pediatric AIDS (Disease)

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Resurgence of congenital rubella syndrome in the 1990s: report on missed opportunities and failed prevention policies among women of childbearing age

Article Abstract:

A review of 21 cases of congenital rubella syndrome in infants born in Southern California found that many of the mothers had never been screened or vaccinated for rubella. Twelve of the women had missed at least one opportunity to be screened or vaccinated. Nine of the women had had a previous pregnancy, but none of the eight who had either a negative or equivocal rubella test were vaccinated. Of seven women who had had abortions in previous pregnancies, none were screened for rubella at the abortion clinic. There were many reasons why these women were never tested or vaccinated. California requires premarital rubella screening, but only four of the women had been married in California. Many of the women had not been vaccinated in school, and the colleges they were attending did not require proof of vaccination. Rubella screening and vaccination should be offered by all universities, and by all family planning, abortion, sexually transmitted disease and drug treatment clinics.

Evaluation, Diseases, Infants (Newborn), Medical screening, Health screening, Neonatal diseases, Rubella, Rubella in pregnancy

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Uninsured children: an unintended consequence of health care system reform efforts

Article Abstract:

A change in the way Medicaid is structured could increase the number of uninsured children. Studies have shown that many children become temporarily uninsured when a parent loses employer-provided insurance. These children are less likely to receive needed vaccinations or to have a reliable source of health care. Many of the children can be covered by Medicaid, but the enrollment process can be long and complicated. Congress is considering giving every state a block grant for Medicaid, but it is unlikely that funding will be available at the same levels as before. If the public sector cannot absorb children who are temporarily uninsured, these children will not receive adequate health care. This in turn could increase health care costs, because uninsured children without a regular physician usually have more health problems.

Social aspects, Editorial, Children, Political aspects, Medically uninsured persons, Health care reform, Insurance

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