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Paediatrician Consults

How can we avoid infection when children are back in school, kindergarten or crèche after summer holidays in the autumn?

School epidemics

Canadian doctors after multiyear observation have found dramatic rise of asthma exacerbation among school children in various countries. The outbreak of this phenomenon happens just after a new school year beginning.

The rise asthma exacerbation is closely related to the rise of upper respiratory tract infections in te same season. However simple infections are not registered in contraray to asthma exacerbation. This also very closely corelated in time of the school year beginning. Authors applied mathematical modeling to estimate the exact timing and magnitude of these September peaks in Canada. In school-age children, the asthma hospitalization peak occurred on average 17.7 days after Labor Day (first Sunday of September and approximatelly 3 weeks from the school year beginng. When school year starts September 1st (Canada, Scotland) it happened in week 38, and week 35 when school year starts August 15th (Sweden, England) (see the figure).

The scientists believe that this is because of two reasons: very high rise of rhinoviruses causing seasonal respiratory tract infections in children (see figure) and also lack of immune stimuli due to decreased or no contacts with children of the same age during summer holidays.

How could we prevent September infections and how could we ease them?

• Heal underlying disease (if there is any)
• Dress accordingly to the air temperature
• Avoid sudden temperature changes
• Ensure appropriate diet including immune supporting supplements
• Isolate children from sick persons
• Not sending sick children to school, kindergartden or crèche
• Complete missing vaccinations
• Manage the stress related to the school beginning

References: (pdf files in English):

• Sears MR, Johnston NW, Understanding the September asthma epidemic J.Allergy Clin.Immunol. 2007; 120: 526-9.
• Johnston NW, Johnston SL et al. The September epidemic of asthma exacerbation in children, search for etiology J.Allergy Clin.Immunol. 2005; 112: 132-8.
• Johnston NW and Sears MR, The epidemiology of asthma exacerbations Thorax 2006; 61: 722-8.
• Johnston NW, Johnston SL, et al The September epidemic of asthma hospitalization: School children as disease vectors J Allergy Clin.Immunol.2006;117:557-62.

Defining Toughness (Resilience)

Men in particular often confuse toughness with strength, thinking that being strong is automatically the same as being tough, when in fact the two are distinct qualities. As Erwan Le Corre, founder of MovNat, says, “Some people with great muscular strength may lack toughness and easily crumble when circumstances become too challenging. On the other hand, some people with no particularly great muscular strength may be very tough, i.e., capable of overcoming stressful, difficult situations or environments.”

Toughness is the ability to perform well regardless of circumstances. That might mean performing well when you are sick or injured, but it also might mean performing well when your workout gear includes trees and rocks instead of pull-up bars and barbells. “Toughness . . . is the strength, or ability, to withstand adverse conditions,” according to Le Corre.

Being able to do that requires both mental and physical toughness. No amount of mental toughness alone will keep you from freezing in cold temperatures, but if you’ve combined mental training with cold tolerance conditioning, for example, then you’ll fare much better.

Toughen up organism

Hardening the body is a proven, effective and cheap way to support immunity. Just end your bath with a cold shower or use alternating showers. Pour warm water over your body for half a minute and then cold water for a few seconds. Attention! Hardening should be started gradually and only in healthy people. Temperature differences must be changed gradually, and the hardening procedure must always be ended with a bath in warm water.

The positive impact of “cold training” is well known among people living in cold climate countries like Finland and Russia. There are established so called “walrus clubs” where the member have physical activity in very cold conditions. It is often having group bath in freezing water. The members perform such activity regularly and enjoy good health. Their organisms become toughen up.

When you exercise in very cold weather, a number of physiological and mental changes take place that will set you up for a great racing season later this year. Plus, who doesn’t love the feeling of breathing in crisp winter air (followed by a mug of hot chocolate)?

• You will give your heart a workout
• You’ll improve your mind-body connection
• You’ll get mentally tougher
• You’ll keep weight gain at bay
• You’ll be in a better physical shape
• You’ll avoid winter blues
• You’ll get stronger immune system

Remember: Be sure to stay hydrated during cold weather.

Avoiding unnecessary Antibiotics

Antibiotics are important drugs. Many antibiotics can successfully treat infections caused by bacteria (bacterial infections). Antibiotics can prevent the spread of disease. And antibiotics can reduce serious disease complications.

However the overuse and misuse of antibiotics are key factors leading to antibiotic resistance. The general public, health care providers and hospitals all can help ensure correct use of the drugs. This can lessen the growth of antibiotic resistance.

Overuse of antibiotics

The overuse of antibiotics — especially taking antibiotics when they're not the correct treatment — promotes antibiotic resistance. According to the Centers for Disease Control and Prevention, about one-third of antibiotic use in people is not needed nor appropriate.

Antibiotics treat infections caused by bacteria. But they don't treat infections caused by viruses (viral infections). For example, an antibiotic is the correct treatment for strep throat, which is caused by bacteria. But it's not the right treatment for most sore throats, which are caused by viruses.

Other common viral infections that aren't helped by the use of antibiotics include:

• Cold or runny nose
• Flu (influenza)
• Bronchitis (viral origin)
• Most coughs
• Some ear infections
• Some sinus infections (viral origin)
• Stomach flu
• Coronavirus disease 2019 (COVID-19)
• Whooping cough (viral origin)

Taking an antibiotic for a viral infection:

• Won't cure the infection
• Won't keep other people from getting sick
• Won't help you or your child feel better
• May cause needless and harmful side effects
• Promotes antibiotic resistance

If you take an antibiotic when you have a viral infection, the antibiotic attacks bacteria in your body. These are bacteria that are helpful or are not causing disease. This incorrect treatment can then promote antibiotic-resistant properties in harmless bacteria that can be shared with other bacteria. Or it can create an opportunity for potentially harmful bacteria to replace the harmless ones.

Antibiotics and Immune System

Antibiotics can have adverse effects on your immune system. The immune system is your body's defense against invasive bacteria, viruses, and other harmful pathogens. This infection-fighting work happens on a cellular level: White blood cells (leukocytes) fight infections, B cells make antibodies to fight bacteria, and T cells destroy infected cells.

"Sometimes, the body's immune system cannot fight the bacterial infection off alone, which is when antibiotics enter the picture," says Kathleen Dass, MD, a Michigan-based immunologist and allergist. Antibiotics work to either kill off bacteria, or prevent them from reproducing, she explains.

However, these powerful drugs are not without a downside. For instance, taking antibiotics can destroy the normal, healthy bacteria in your gut. This can affect the functioning of your digestive system, metabolism, and parts of the immune system that are in the digestive tract.

The Dark Side of Antibiotics: Adverse Effects on the Infant Immune Defense Against Infection

Mental and Emotional Well-Being

Parents know that it’s nearly impossible to keep young child from touching, smelling and licking nearly everything they come into contact with. And although it is not always hygienic, it helps the child's body to learn about different microorganisms and build immunity. Yet, we’re less often aware of the impact of psychological and mental “immunity” and the impact this plays on our child’s health and wellbeing.

Having good mental health is key to the healthy development of every child. Kids need good mental health to deal with challenges and adapt to change, and so they can feel good about themselves, build strong relationships with others and live a happy and ‘healthy’ life, immune from the multitude of things that can undermine health.

The key to both physical and mental wellbeing is a healthy immune system – sometimes called resilience. And as parents, we can boost this immune system by supporting lifestyle factors that can build both physical immunity and psychological resilience to and ensure our kids live their best lives.

Scientists from Indonesia have shown how the emotional well-being boosts the human body immune response. Indicators showed the increasing immune response could observe objectively through many parameters in saliva, blood, and plasma. Increasing body immune response means improving its resistance towards infection. Psychological well-being could make the quality life of people be better. Psychological well-being made people prosperous, themselves, their families and communities. In addition, psychological well-being could improve the human body immune response, enhance resistance towards diseases (including infectious diseases), and make life more prosperous.

The results of Swedish study indicate that psychological stress may have a general effect on the immune system, causing not only an immune suppression, but also an imbalance that may possibly contribute to an autoimmune reaction against β cells. Moreover, children exposed to psychological stress, especially serious life events, induce an immune response against diabetes-related autoantigens. This may indicate an autoimmune reaction against the insulin-producing β cells, which, in some individuals, initiate progression toward T1D.

Literature

• Abdurachman SA, Herawati N. The Role of Psychological Well-being in Boosting Immune Response: An Optimal Effort for Tackling Infection Afr J Infect Dis. 2018; 12(1 Suppl): 54–61.
• Carlsson E., Frostell A., Ludvigsson J and Faresjö M. Psychological Stress in Children May Alter the Immune Response J.Immunol (2014) 192 (5): 2071–2081.

Immunologists Consults

To vaccinate or not to vaccinate - that is the question.

The only answer is: V a c c i n a t e !

A child is born with the so-called innate immunity. primary immunity. Unfortunately, these disease-protecting antibodies (antigens) given to you by your mother last only for the first three months after birth. Then, until the age of nine months, the baby's immune system deteriorates. He is only learning to recognize the enemy, i.e. viruses and bacteria and to produce a suitable weapon against them - antibodies. Thanks to vaccines, he learns faster and more effectively.

Vaccine - this is nothing more than weakened or dead pathogenic microorganisms introduced into the body, provoking the immune system to produce antibodies. It is training that prepares the body to instantly recognize germs and send an army of antibodies against them. This army will either protect the child from the infection, or at least significantly mitigate its course. In order for the acquired immunity to last for many years, it is necessary to take the so-called booster doses of the vaccine.

Simply put, vaccines save lives. You have the power to protect your baby from dangerous illnesses like measles, tetanus and hepatitis. Being a parent is a big responsibility, and the best thing you can do for your child's health is to learn the facts so that you can make the best choices.

Thanks to our nation's successful vaccination program, parents today have been spared witnessing the devastating effects of many diseases. Polio, for example, paralyzed millions of children worldwide before the vaccine was created.

Diseases such as hepatitis, pertussis and measles can still infect children that are not protected. In fact, each year the press publishes stories of disease outbreaks in undervaccinated communities across the Europe and the United States. Since 2010, we have been experiencing large outbreaks of pertussis across the country. In 2012, there were 48,277 cases of pertussis and 20 deaths; in 2013, there were over 24,000 confirmed cases of pertussis in the U.S.; in 2014 there were 28,660 reported cases, and the outbreaks continue in 2015. In addition, there are currently a record number of measles cases in the U.S. In 2014, 644 cases of measles were reported to the CDC and like pertussis, measles oubreaks are continuing to affect the U.S. in 2015. The majority of measles cases reported in 2014 were in people who were unvaccinated or who had an unknown vaccination status.

NHS vaccinations and when to have them

It's important that vaccines are given on time for the best protection, but if you or your child missed a vaccine, contact your GP to catch up.

NHS vaccination schedule

Vaccines for adults and vaccines for pregnant women 

→ read more NHS vaccination programme

Dietician Advices

Diet and Immune System

As "the army that marches on its stomach"* our immune system also needs full stomach to defend. Healthy fighters of our immune system Reed good and regular feeding. It has been known for long time that the people living in poverty are more exposed to infectious diseases. Though it not obvious that increase of diseases fraction (percentage) is directly caused by hypoalimentation of immune system. It is still too little research that directly link nutrition to human immune system.

It has been established that deficiency of various nutrients as e.g. zinc, selenium, iron, cooper, folic acid, A vitamin, B6 vitamin, C vitamin, and E vitamin disrupts function of immune system. Taking just multivitamin and multimineral preparations might prove insufficient when we suppose that our diet does not provide all necessary nutrients, due to the fact that it is probably not sufficiently varied. What can we do? Taking individual vitamin or nutrients in mega doses won’t help because more not necessarily means better. Scientists look after various nutritional elements that would support immune system. Group of such agents constitutes various compounds constitutes e.g. high-molecular polysaccharides originated from yeast fungi e.g. β 1,3/1,6-D glucan or/and high-molecular lipopolysaccharides originated from Spirulina platensis like e.g. LCEPEEN complex.

Foods that support immune system best

Chicken broth (consommé)

Make no bones about it – chicken soup is the nation’s go-to dish when we’re feeling blue or sick - but is there more to this brothy tonic than its comforting connotations? The broad survey revealed the majority of us find sanctuary in the warming goodness of chicken soup – but why are boiled bones so restorative? With the help of nutritionist Jo Lewin, we discovered that the classic tonic delivers more than just a placebo high…

Nothing beats the flavor of homemade chicken broth. If you make this recipe in large batches, you can freeze it in sturdy containers for up to 3 months. Plus, the cooked chicken in our recipe can be added to other dishes.

Recipe for homemade chicken broth

INGREDIENTS

The organic lean chicken meat is the best suitable for good broth. Chicken broth is best cooked on lean meat (you can also cook turkey broth or combine both types of meat). When choosing meat for broth, it is best to choose poultry meat, without the skin (it contains the most fat and cholesterol): chicken wings, turkey wing, chicken or turkey breast. Vegetables give an characteristic broth aroma.

D I R E C T I O N S

Place all ingredients in a soup kettle or Dutch oven. Slowly bring to a boil; reduce heat until mixture is just at a simmer. Simmer, uncovered, for 3-4 hours, skimming foam as necessary.

Set chicken aside until cool enough to handle. Remove meat from bones. Discard bones; save meat for another use. Strain broth, discarding vegetables and seasonings. Refrigerate for 8 hours or overnight. Skim fat from surface.

Garlic

Garlic has a long history of use as an immune system booster because of its antiseptic, anti-fungal and nutritive properties. It is a natural detoxicant protecting against bacterial and viral infections without any of the side-effects associated with antibiotics.

Eaten raw or in a capsule, research shows it is a good preventative medicine against coughs, colds and chest infections during the winter or as a natural fast-acting antibiotic if infection is present. During the First World War raw garlic juice was used as an antiseptic for bathing wounds and helped save saved thousands of lives.

Garlic is packed with nutrients, particularly vitamins B1, B6 and C, iron and phosphorus and alliin which converts to allicin, which is thought to be the major antibacterial constituent of garlic.

There isn't a recommended daily allowance for garlic, but German researchers recommend a dose of 1-4 cloves a day which provides around 4,000mcg of alliin.

To cure a chesty cough crush three cloves of raw garlic, sprinkle one tablespoon of brown sugar and leave in a covered saucer for six hours. Sip the liquid throughout the day until the cough has gone.

Yogurt

Yoghurt together with sour milk, butter milk and kefir belong to so called probiotic food. Probiotic food means food products that have specialy selected strains of live cells of lactic acid bacteria, ie probiotics (from the Greek "pro bios" - "for life"), having the ability to colonize the human gastrointestinal tract. They are present in the product by fermentation or are added to it. (e.g. Bifi dobacterium and Lactobacillus). According to the WHO definition, probiotics are "live microorganisms that, when given in an appropriate amount, have a beneficial effect on the health of the host". They have scientifically proven, beneficial health properties for humans. Their main action is to positively influence the microflora of the digestive system.

Until recently, according to dairy companies, special bacteria added to probiotic foods (yoghurts) were supposed to protect us from all kinds of diseases - from colds to cancer. Actimel, Bactiv, Jogobella, Dr. Maciej, Yakult - these are examples of probiotic products that can be purchased in grocery stores. People buy them because they think they will get sick less when they drink it, but that's not entirely true. On the other hand, our immunity largely "comes" from the digestive tract. A healthy and efficient digestive system is essential for the proper strengthening of immunity. In this case, the correct microflora of the gastrointestinal tract is essential. It is worth enriching the probiotic milk products with an additional portion of fruit.

If you are looking for a way to boost immunity and reduce your chances of catching those nasty cold and flu germs that seem to be lurking everywhere, it just might be worthwhile to add yogurt to your regular meals or snacks. Full of protein and calcium, yogurt is already a healthy diet addition, and research points to its role in boosting immunity as well.

Beneficial Probiotics

So what is it about yogurt that makes it so different from other dairy products? Research continues to focus on probiotics, or live, active microorganisms, which help to balance out harmful bacteria in the gut. The resulting benefits may include improved digestion, protection against colon cancer and gum disease and an overall immunity boost. A 2006 research review published in the "Journal of Applied Microbiology" emphasizes that continued research supports the role of probiotics as part of a healthy diet. Although probiotics are available as supplements, choose food sources like yogurt first, as those probiotics are more easily absorbed by your body.

Yeast

Yeast has a high nutritional value, which can be skillfully used in the treatment and prevention of many diseases. Due to the content of large amounts and easily digestible building, energy and regulating ingredients, yeast has a generally strengthening and mobilizing effect of regeneration, compensation and immunity processes; restore the proper intestinal microflora, have an outstanding effect on the activities of the skin and its products: nails and hair. Beta-glucan is obtained from yeast, which has prebiotic properties and stimulates gastrointestinal motility. It is also credited with immunostimulating properties through macrophage activation. In addition, yeast is a very rich and valuable natural source of many vitamins (especially from group B) and microelements - especially selenium, an element extremely important for protection against free radicals and for immune processes.

References:

• Immune-modulatory effects of dietary Yeast Beta-1,3/1,6-D-glucan Nutr J. 2014; 13: 38.
• A Double-Blind, Randomized, Placebo-Controlled Nutritional Study Using an Insoluble Yeast Beta-Glucan to Improve the Immune Defense System Food and Nutrition Sciences, 2012, 3, 738-746
• Immunomodulating Effects of Fungal Beta-Glucans

There are many ready-made preparations containing yeast on the market. But the best is regular baker's yeast for food purposes. Below is a recipe on how to prepare them. The most popular are British marmites in the form of yeast marmalade. They have a very specific salty taste and not everyone will want to use them, but if they like it, it is very strong and forever. Marmite is very popular in Great Britain, but due to its specific taste it is either loved or hated.

How to prepare yeast for drinking? Put a quarter of a standard cube of baker's yeast (for baking) into a glass, mash it with a fork and pour about 1/2 cup of boiling water over it and mix. After it has cooled down, you can add sweetener or honey to the yeast prepared in this way, and when it is already lukewarm, you can add 1/2 cup of milk. Some people mix such a drink with a banana and a pinch of cinnamon. Please notice! Yeast must be poured with boiling water because these are mushrooms that must be "killed". Otherwise, they can grow and ferment in our stomach, leading to not very pleasant ailments.

People who want to enjoy the benefits of yeast, but do not accept its taste, can buy yeast in tablets. There are several such dietary supplements available on the market.

Products rich in Vitamin C

Vitamin C is one of the most important vitamins helpful in maintaining the proper immunity of the body. It takes part in the creation of a protective barrier that enables the body to effectively defend itself against bacteria or viruses, and to quickly rebuild damaged cells and tissues.

Cranberry, rosehip, sauerkraut, watercress, parsley and citrus fruits are rich in vitamin C. Regular consumption of sauerkraut at this time of year and preparation of rosehip tea protects against colds and infections. Wild rose additionally contains other vitamins essential for immunity: beta-carotene, vitamins B1 and B2, and polyphenols, which neutralize the harmful effects of free radicals.

A combination of vitamin C with rutosides is especially preferred. From this combination, vitamin C is gradually and depending on the demand taken up by the body. In addition, rutoside contains compounds that protect vitamin C from being destroyed by free radicals. In this combination, the body makes better use of vitamin C.

Spirulina

Spirulina belongs to the so-called "super food", ie organic food with particularly rich properties. Arthrospira platensis and Arthrospira maxima cyanobacteria from which spirulina is produced should be grown and harvested in accordance with GAP (Good Agricultural Practice) standards. This applies primarily to the purity of the water in which the algae grow. Spirulina is the trade name of Arthrospira platensis concentrated and freeze-dried cyanobacteria. Cyanobacteria can be grown in seawater or freshwater. The main difference in spirulina from marine cultured cyanobacteria is the high content of iodine and such spirulina is not indicated in hyperthyroidism.

Arthrospira platensis algae, belonging to the cyanobacterial group, have been used for centuries as a dietary supplement in many countries of the world due to their exceptional nutritional value, including high protein content (approx. 50 - 70%), many vitamins (A, B1, B2, B6, B12, folic acid, nicotinamide, C, D, E, K), minerals (potassium, calcium, magnesium, iron, chromium, copper, selenium, zinc) and the content of unsaturated fatty acids, including the very valuable GLA (gamma linolenic acid).

About 15 grams of algae are eaten daily, traditionally. This amount of nutrients contained in algae is also appropriate for modern man and that is why spirulina was developed - a concentrated preparation in the form of a powder or tablets, which is consumed in the amount of 2 - 5 grams a day, preferably in 2 - 3 doses a day.

Spirulina Super Cocktail:
Preparation time: 15 minutes;
Ingredients for 2 cups: 2 bananas, half apple, juice from one large orange, one kale leaf finally chopped (can be replaced by 1 tbsp of parsley leaves finally chopped ), 1 teaspoon of good and approved quality spirulina powder.
Directions: all ingredients mix thoroughly in blender and pour into two cups, drink at once.

Bee Honey and Royal Jelly

Honey has many properties, incl. antibacterial, regenerating or even healing. We divide honey according to the type of raw material from which they were created: flower and honeydew. Each type of honey is good for a different type of disease, e.g. linden honey helps with diseases of the upper respiratory tract, cough, hoarseness, nervousness, and diseases of the heart and circulatory system. It has a warming effect, but it should be remembered that its taste is slightly spicy with a slight bitterness, so give it to children with bread. Rapeseed honey helps with pharyngitis and runny nose. Multiflower honey is mild in taste, and when taken regularly, it alleviates the symptoms of spring allergies. Honeydew honeys (mostly fir and spruce honeys) are almost black, are quite spicy sweet in taste, have a slightly resinous, spicy aroma, sometimes even slightly sour. Children may not eat them very willingly, but they are good for diabetes because they lower blood sugar levels. They are also indicated for diseases of the upper respiratory tract, pharyngitis or asthma. Any kind of honey is good as long as children are accustomed to it and not abused, so we can give it instead of sweet to protect the child from infections. However, remember not to add it to very hot drinks or dishes, because its properties are lost at 40 degrees C.

Mushrooms

Some edible mushrooms: Oyster mushroom (Latin: Pleurotus ostreatus) and Japanese shiitake mushroom (Lat. Lentinula edodes)

These mushrooms have a number of undoubtedly wonderful culinary and nutritional properties. In addition, they are a source of polysaccharides from the beta-glucan group, such as pleuran (from oyster mushroom) and lentinan (from shiitake mushroom). They have a number of health properties.

They strengthen the immune system The beta-glucans contained in mushrooms (oyster mushrooms and shiitake mushrooms) make them one of the best foods in the world for regulating the immune system, unlike some other foods that stimulate or suppress the immune system. Mushrooms are loaded with other antioxidants that help prevent free radical damage and oxidative stress, so your immune system can defend against aging.

1. van Steenwijk HP, Bast A, de Boer A: Immunomodulating Effects of Fungal Beta-Glucans: From Traditional Use to Medicine Nutrients;2021,13,1333. https://doi.org/10.3390/nu13041333

2. Bovacak M, et al: Effect of Pleuran (β-glucan from Pleurotus ostreatus) supplementation on cellular immune response after intensive exercise in elite athletes Applied Physiology, Nutrition, and Metabolism 2010;19.

3. Minov J, Bislimovska-Karadzhinska j, et al: Effects of Pleuran (β–Glucan from Pleurotus Ostreatus) Supplementation on Incidence and Duration of COPD Exacerbations. Open Access Maced J Med Sci. 2017;5; 5(7): 893–898.

4. Muszyńska B, Pzadur P, et al: Lentinula Edodes (Shiitake) – Biological Activity Med.Inter.Rev.2017;189-195.

• Anti-Inflammatory Properties
  The beta-glucans and antioxidants in oyster mushrooms make it a great food for lowering inflammation. Some research shows that beyond beta-glucans, some of the oyster’s anti-inflammatory properties come from a unique and somewhat unknown amino acid called ergothioneine. According to the research, ergothioneine lowers “systemic” inflammation across the entire body which often contributes to diseases like dementia and diabetes.
• Anti-Cancer Properties
  The beta-glucans in mushrooms like oysters function as potent antioxidants that may protect the body against cancer. One study found that oyster mushrooms have potential to be effective for certain types of cancer cells. (3)