Global & Disaster Medicine

Archive for the ‘Kids-Infants’ Category

3/18/1937: Nearly 300 students in Texas are killed by an explosion of natural gas at their school

History Channel

“…..The Consolidated School of New London, Texas, sat in the middle of a large oil and natural gas field. The area was dominated by 10,000 oil derricks, 11 of which stood right on school grounds. The school was newly built in the 1930s for close to $1 million and, from its inception, bought natural gas from Union Gas to supply its energy needs. The school’s natural gas bill averaged about $300 a month. Eventually, officials at Consolidated School were persuaded to save money by tapping into the wet-gas lines operated by Parade Oil Company that ran near the school. Wet gas is a type of waste gas that is less stable and has more impurities than typical natural gas…..”


It works! Sending community health workers door-to-door to look for sick kids in Mali


“…..When the study began in 2008, one in seven children in the Bamako region died before the age of five. By 2015, that had fallen to one in 142, which is comparable to the rate in the United States. This level would meet the UN’s goal of reducing deaths among children under five to no more than 25 deaths per 1,000 live births by 2030…..

The intervention sent health workers to people’s homes to ask about children’s well-being, provided care at the doorstep and triaged the sickest patients to health care facilities. The community health care workers provided counseling, diagnosed malaria for people of all ages, as well as pneumonia, diarrheal disease and malnutrition for children under five. They treated the uncomplicated cases, and referred patients with danger signs or conditions that were outside their scope of practice to primary health centers.

Over the course of the study, the percentage of young children who had fevers was cut in half and the number of patient visits in the home and the clinic increased by ten times.

The workers offered antimalarial treatment, and the number of children with fevers who received antimalarial treatment within 24 hours of the onset of their symptoms more than doubled, from about 15 percent to just over 35 percent.

The intervention also strengthened government primary care facilities with more infrastructure, training, and staff. And workers were on call, in case someone needed their services. They also made follow-up visits to help patients adhere to their therapy, particularly in the case of diarrheal disease, and searched for sick newborns, pregnant women and those who had just given birth and needed care, to evacuate them to primary care facilities for treatment.

The approach, which the researchers called Proactive Community Case Management, cost between $6 and $13 dollars per person, per year, over what the government was already spending on health care.

During the seven years of the study, the childhood mortality rate in Mali was falling, although not by much, and in 2015, it was still among the highest in the world at 114 deaths per 1,000 live births. By contrast, that same year, the area of the intervention had a child mortality rate of 7 deaths per 1,000 live births. The researchers are currently at work on a large-scale randomized trial that will follow 100,000 people at 137 different sites to see if door-to-door home visits by community health workers lowers childhood mortality……”


Europe: The number of recorded measles cases quadrupled, to 21,315 in 2017 from 5,273 in 2016 with 35 deaths

NY Times

  • The biggest outbreak last year was in Romania, where there were 5,562 cases and which accounted for most of the deaths. The country’s large rural Roma population — also known as Gypsies — often do not vaccinate their children and may not take them to hospitals promptly when they fall ill.
  • The second biggest outbreak was in Italy, with 5,006 cases and three deaths; 88 percent of those cases were in people never vaccinated
  • Ukraine had 4,767 cases of measles in 2017.
  • Other countries reporting outbreaks of up to 1,000 cases were Belgium, Britain, France, Germany, Greece, Russia and Tajikistan.


Venezuela: “I sold my hair to feed my girl.”

NY Times

“…..Venezuela is steeped in economic and political turmoil. Inflation last year surpassed 2,600 percent, according to opposition lawmakers, which has exacerbated severe shortages of food and medicine.……”


Marjory Stoneman Douglas High School in Parkland, FL: Minute-by-Minute


“…..Wed., Feb. 14

2:19 p.m.

Police say Cruz is dropped off at the school by an Uber driver. The school is preparing for dismissal as he arrives so the gates are unlocked to allow cars and buses to enter.

Wearing a school shirt, he carries a black duffle bag and a black backpack inside.

Reports say a school staffer recognizes Cruz and warns a co-worker by radio.

2:20 p.m.

A 15-year-old student says he encounters Cruz loading a rifle inside a second-floor bathroom, according to news sources. “You’d better get out of here,” Cruz tells the student. “Things are going to start getting messy.” The student flees and alerts a staffer.

2:21 p.m.

Police say Cruz activates a fire alarm inside the school. Students begin to evacuate. Cruz opens fire with a .223 caliber AK-15 semiautomatic rifle in a first-floor hallway. Hearing the shots, a staffer broadcasts a  “Code Red” alert over the intercom, signaling a campus lockdown.

Students and teachers take cover in classrooms. Some students flee the school and take cover at a nearby Walmart. Cruz fires into four classrooms and goes to the second floor, continuing to shoot. Police later calculate that more than 100 rounds are fired.

2:23 p.m.

Police receive multiple 911 calls of shooting taking place.

2:25 p.m.

The shooting stops……..”

School shootings in the U.S. since Columbine



  • 50 – The number of mass murders or attempted mass murders at a school since Columbine.
  • 141 – People killed in a mass murder or attempted mass murder at a school since Columbine.
  • 73 – The percentage of school shooters with no prior criminal record
  • 96 – The percentage of school shooters = male.
  • 17 – The number of kids aged 15 or younger who have committed or attempted a mass school shooting since Columbine.
  • 81 – The percentage of school shootings where someone had information that the attacker was thinking about or planning the shooting.
  • 68 – The percentage of school shooters who got their guns from relatives or at home.
  • 65 – The number of school shooters and thwarted school shooters who have referenced Columbine as a motivation.
  • 270 – The number of shootings of any kind at a school since Columbine.
  • 1 – The number of shootings per week, on average, on a school or college campus in 2015.
  •                                                                                                                                                                            …..”

5 Islamic State gunmen stormed the Save the Children office in the Afghan city of Jalalabad after an explosion on Wednesday, killing 5 and wounding dozens in a 10-hour siege.

NY Times


Infant Safe Sleep Practices Not Well-Followed


Bombard JM, Kortsmit K, Warner L, et al. Vital Signs: Trends and Disparities in Infant Safe Sleep Practices — United States, 2009–2015. MMWR Morb Mortal Wkly Rep. ePub: 9 January 2018. DOI:

Key Points

•Infant safe sleep practices recommended by the American Academy of Pediatrics (AAP), including placing infants to sleep on their backs, room sharing but not bed sharing, and keeping soft objects and loose bedding out of the infant’s sleep environment, can help reduce sleep-related infant deaths; however, implementation of these recommendations remains suboptimal.

•Approximately one in five mothers reported placing their infant to sleep on their side or stomach. More than one half reported bed sharing with their infant, and more than one third reported using soft bedding in the infant’s sleep environment. Unsafe sleep practices varied by state, race/ethnicity, age, education, and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children.

•Health care providers and state-based and community-based programs can identify barriers to safe sleep practices and provide culturally appropriate counseling and messaging to improve infant safe sleep practices.

•Additional information is available at

Introduction: There have been dramatic improvements in reducing infant sleep-related deaths since the 1990s, when recommendations were introduced to place infants on their backs for sleep. However, there are still approximately 3,500 sleep-related deaths among infants each year in the United States, including those from sudden infant death syndrome, accidental suffocation and strangulation in bed, and unknown causes. Unsafe sleep practices, including placing infants in a nonsupine (on side or on stomach) sleep position, bed sharing, and using soft bedding in the sleep environment (e.g., blankets, pillows, and soft objects) are modifiable risk factors for sleep-related infant deaths.

Methods: CDC analyzed 2009–2015 Pregnancy Risk Assessment Monitoring System (PRAMS) data to describe infant sleep practices. PRAMS, a state-specific and population-based surveillance system, monitors self-reported behaviors and experiences before, during, and shortly after pregnancy among women with a recent live birth. CDC examined 2015 data on nonsupine sleep positioning, bed sharing, and soft bedding use by state and selected maternal characteristics, as well as linear trends in nonsupine sleep positioning from 2009 to 2015.

Results: In 2015, 21.6% of respondents from 32 states and New York City reported placing their infant in a nonsupine sleep position; this proportion ranged from 12.2% in Wisconsin to 33.8% in Louisiana. Infant nonsupine sleep positioning was highest among respondents who were non-Hispanic blacks. Nonsupine sleep positioning prevalence was higher among respondents aged <25 years compared with ≥25 years, those who had completed ≤12 years compared with >12 years of education, and those who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children during pregnancy. Based on trend data from 15 states, placement of infants in a nonsupine sleep position decreased significantly from 27.2% in 2009 to 19.4% in 2015. In 2015, over half of respondents (61.4%) from 14 states reported bed sharing with their infant, and 38.5% from 13 states and New York City reported using any soft bedding, most commonly bumper pads and thick blankets.

Conclusions and Implications for Public Health Practice: Improved implementation of the safe sleep practices recommended by the American Academy of Pediatrics could help reduce sleep-related infant mortality. Evidence-based interventions could increase use of safe sleep practices, particularly within populations whose infants might be at higher risk for sleep-related deaths.


January 7-13: Folic Acid Awareness week


Facts About Folic Acid

Woman reading nutritional information on a cereal box. Nutrition label highlighting 100% Folic Acid.

CDC urges women to take 400 mcg of folic acid every day, starting at least one month before getting pregnant, to help prevent major birth defects of the baby’s brain and spine.

About folic acid

Folic acid is a B vitamin. Our bodies use it to make new cells. Everyone needs folic acid.

Why folic acid is so important

Folic acid is very important because it can help prevent some major birth defects( of the baby’s brain and spine (anencephaly( and spina bifida(

How much folic acid a woman needs

400 micrograms (mcg) every day.

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When to start taking folic acid

For folic acid to help prevent some major birth defects, a woman needs to start taking it at least one month before she becomes pregnant and while she is pregnant.

Every woman needs folic acid every day, whether she’s planning to get pregnant or not, for the healthy new cells the body makes daily. Think about the skin, hair, and nails. These – and other parts of the body – make new cells each day.

How a woman can get enough folic acid

There are two easy ways to be sure to get enough folic acid each day:

  1. Take a vitamin that has folic acid in it every day.
    1. Most multivitamins sold in the United States have the amount of folic acid women need each day. Women can also choose to take a small pill (supplement) that has only folic acid in it each day.
    2. Multivitamins and folic acid pills can be found at most local pharmacy, grocery, or discount stores. Check the label to be sure it contains 100% of the daily value (DV) of folic acid, which is 400 micrograms (mcg).
  2. Eat a bowl of breakfast cereal that has 100% of the daily value of folic acid every day.
    1. Not every cereal has this amount. Check the label on the side of the box, and look for one that has “100%” next to folic acid.

Venezuela: Doctors at 21 public hospitals in 17 states across the country said that their ERs were being overwhelmed by children with severe malnutrition

NY Times

  • Doctors are seeing the kind of extreme malnutrition often found in refugee camps



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