PATCHS PROGRAM PUBLIC HEALTH NURSING ADVOCATES TEACHING CHILD HEALTH AND SAFETY HEALTH CARE PROGRAM FOR CHILDREN IN FOSTER CARE (HCPCFC)
Volume 1, Issue 11		APRIL 2003

Medical Information Fact Sheet

Human Immunodeficiency Virus (HIV) & Acquired Immunodeficiency Syndrome (AIDS):

AIDS is a chronic life threatening disease that is caused by the Human Immunodeficiency Virus (HIV). The virus damages or destroys the cells of the immune system. HIV interferes with the body’s ability to fight off viruses, bacteria and fungi that cause disease. This makes the infected person more susceptible to opportunistic infections that the body would normally resist.

Signs & Symptoms:
(vary according to phase of infection)

When first infected, a person may not have any symptoms although it is more common to develop a brief flu-like illness 2-6 weeks after becoming infected. These symptoms however resemble other illness so the person may not be aware they are infected with HIV. Even if the person has no symptoms, they can still transmit the virus to others. The person may remain symptom free for 8-9 years, at which time tests may show a decline in immune system cells. When this happens a person will begin showing evidence of mild infections or chronic symptoms such as:

• Swollen lymph nodes (typically the first sign of HIV infection)
• Diarrhea
• Weight loss
• Fever
• Cough and shortness of breath

During the last phase which is 10-11 years following initial infection the more serious symptoms begin to appear and the infection may then meet the official definition of AIDS.

The Center for Disease Control (CDC) defined AIDS to mean the presence of HIV infection as shown by a positive HIV-antibody test plus at least one of the following:

• The development of opportunistic infection.
• CD4 lymphocyte count of 200 or less.

When AIDS develops the immune system is very weak and makes the person susceptible to opportunistic infections. The signs & symptoms of these infections may include:

• Soaking night sweats
• Shaking chills or fever greater than 100 for several weeks
• Dry cough or shortness of breath
• Chronic diarrhea
• Persistent white spots or unusual lesions on tongue or in the mouth
• Headaches
• Blurred or distorted vision
• Weight loss

Also if infected with HIV a person is more likely to develop certain cancers, especially Kaposi’s Sarcoma, cervical cancer and lymphoma.

Children who are HIV-positive often fail to gain weight or grow normally. As the disease progresses they may have difficulty walking or delayed mental development and may develop cerebral palsy. Children are also susceptible to the same infections as adults and may have severe forms of common childhood illness such as ear infections, pneumonia and tonsillitis.

Transmission:

Infection can occur in several ways, including:

• Sexual transmission
• Transmission through infected blood
• Transmission through needle sharing
• Transmission through accidental needle sticks
• Transmission from mother to child
• Other modes of transmission (transplants or unsterilized medical or dental surgical equipment)

WAYS IT IS NOT TRANSMITTED:

• Through contact with infected person’s sweat or tears
• Sharing food, utensils, towels or bedding, a swimming pool, telephone or toilet seat with someone who has the virus
• Being bitten by bedbugs or mosquitoes
• Kissing someone who is HIV positive or who has AIDS
• Donating blood

Treatment:

There is no cure. Drugs are available to treat HIV/AIDS and opportunistic infections. These drugs can have severe side effects and be very costly. Treatment is focused on maximum suppression of symptoms for as long as possible. The aim is to reduce the amount of virus in the blood to very low or even nondetectable levels, although this does not mean the virus is gone. This is usually accomplished with a combination of three or more drugs. Treatment issues also emphasize quality of life, thus the goal of AIDS treatment is to find the strongest possible regimen that is also simple and has the fewest side effects.

Mayo Clinic, (January 31, 2003). HIV/AIDS. [On-line]. Available: http://www.mayoclinic.com/invoke.cfm?id=DS00005

---

Lead Poisoning:

Childhood lead poisoning is a major preventable environmental health problem in the United States. About a half a million children younger than 6 years of age in the U.S. have blood lead levels of at least 10 micrograms per deciliter (µg/dl), a level high enough to adversely affect their intelligence, behavior and development.

Exposure:

The major source of lead exposure among U.S children is lead-based paint and lead contaminated dust found in deteriorating buildings. Lead-based paints were banned from use in 1978. However approximately 24 million housing units in the U.S. have deteriorated leaded paint and elevated levels of lead-contaminated house dust. More than 4 million of these dwellings are homes to one or more young children.
Other sources of lead poisoning are related to:

• Hobbies (making stained-glass windows
• Work (recycling or making automobile batteries)
• Drinking water (lead pipes, solder, brass fixtures, valves can all leach lead)
• Home remedies (arzacon and greta, which are used for upset stomach or indigestion; pay-loo-ah, which is used for rash and fever.

Who is at risk?

• Children under the age of 6 years because they are growing rapidly and they tend to put their hands or other objects in their mouths.
• Children from all social and economic levels can be affected, although children living at or below the poverty line who live in older housing are at a greater risk.
• Children of some racial and ethnic groups are disproportionately affected by lead. For example, 22% of black children and 13% of Hispanic children living in housing built before 1946 have elevated blood levels compared with 6% of white children living in comparable housing.

Can Lead poisoning be prevented?

Lead poisoning is entirely preventable. The key is stopping children from coming into contact with lead and treating children who have been poisoned by lead.

• Lead hazards in the child’s environment must be removed.
• Public and health care professionals need to be educated on lead poisoning and how to prevent it.
• Children who are at risk of lead poisoning need to be tested, and if necessary, treated.

What can be done to reduce blood lead levels?

• Get the child tested if it is a concern.
• Talk to local or state health department about having paint and dust tested if one lives in a house or apartment built before 1978.
• Damp-mop floors, damp-mop surfaces and frequently wash children’s hands, pacifiers and toys to reduce exposure to lead.
• Use only cold water from the tap for drinking, cooking and making baby formula. Hot water is more likely to contain higher levels of lead, and most of the lead comes from the plumbing in your home, not from the local water supply.
• Avoid using home remedies (such as arzacon, greta, pay-loo-ah) and cosmetics (such as kohl, alkohl) that contain lead.
• Take basic steps to decrease your exposure to lead (for example, by showering and changing clothes after finishing the task) if you remodel buildings built before 1978 or if work or hobbies involve working with lead-based products.

Symptoms:

• Nausea & Vomiting
• Abdominal pain
• Tiredness
• Muscle Weakness
• Irritability.

Many people with lead poisoning do not have symptoms.

Effects of lead poisoning:

Lead poisoning can cause diminished intelligence, including loss of IQ points, developmental delays, kidney and liver damage, reproductive problems, seizures and death. It takes a very small amount of lead to lead to cause decreased IQ.

Treatment:

Removing the source of lead and eating a healthy diet is the best way to treat lead poisoning. If lead levels are extremely high, hospitalization may be required along with chelating medicine, which helps to remove lead from the body. A diet high in iron, calcium and vitamin C can help prevent lead poisoning.

Testing:
A lead test is a simple blood test that is done to determine lead levels. If you are concerned and would like a test done speak with your health care provider.
Also lead test kits are available for your home and surfaces at any hardware store

Riverside County Childhood Lead Poisoning Prevention Program. (April 14, 2003). Lead: What you need to know. [On-line]. Available: http://www.rivcoph.org/cms/lead.htm

---

HCPCFC PROGRAM UPDATES and ANNOUNCEMENTS!!! Kristen Thompson, Peter Tran, and William Chavez attended the Child Abuse and Neglect Conference April 21-23 in Sacramento. Special features included Legal, Judicial, and Medical Symposiums and Family Violence Institute.

 

Editor: Kristen Thompson, PHN
Contributors: Kim Robitaille, PHN, MSN, Assistant Nurse Manager; and Judy Earp, MHA, Director of Public Health Nursing.