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Family of girl with rare autoimmune disorder given exemption from UK quarantine

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The family of a girl with a rare autoimmune disease has been granted hotel quarantine waiver when traveling to the UK to seek treatment for her.

Roberta Wakeling, 11, developed pediatric autoimmune neuropsychiatric disorders related to strep or pandas infections after an untreated Strep A infection two years ago.

The young resident of Abu Dhabi is autistic and drug resistant.

It is thought to develop when antibodies to strep infections stick to a part of the brain called the basal ganglia.

We always thought that it could be stronger when the flights came back. But it is not stronger. She is weaker

Nicola Wakeling

This caused inflammation and resulted in behaviors such as obsessive-compulsive disorder and tics.

Other complications can include eating disorders. The onset is typically quick.

Roberta, a former student at Al Khubairat (Bsak), a UK school where her father is a teacher, suffers from an extreme case of the disorder.

Her symptoms developed very quickly after she was diagnosed with strep, reaching a point where she was completely bedridden and unable to lift her head.

Her mother Nicola, a teacher who used to work at (Bsak), wants to bring Roberta back to the UK for treatment.

“I remember being sick at the time of the strep, but she got over it pretty quickly,” said Ms. Wakeling.

“But after that, she struggled to go back to school.”

Roberta began to experience extreme anxiety and obsessive-compulsive symptoms, Ms. Wakeling said.

The family knew something was wrong but suspected it was an autistic shutdown.

Roberta after treatment in the hospital. Courtesy: Wakeling family

Roberta’s fighting lasted for months, but her condition had improved by March last year, just before schools closed to face-to-face learning after the coronavirus pandemic began.

She returned to the UK in November to spend time with her family and was fine, but her condition worsened when she returned to the United Arab Emirates in December.

Her mother believes it was due to a flare-up of the condition that occurs with autoimmune diseases.

“It happened very quickly and it shocked me,” said Ms. Wakeling.

In March Roberta appeared to be recovering, but she collapsed and needed hospital treatment.

The hospital suggested returning to the UK for treatment.

Ms. Wakeling arranged an online consultation with a specialist in the UK who said Roberta’s case was urgent and they should return as soon as possible.

Roberta had pandas diagnosed by doctors after a mother suggested to an autism support group that she might have the disease.

Ms. Wakeling found a specialist in Dubai and spent three hours with her going over Roberta’s medical history.

“She said yes she did and it’s a clinical diagnosis, but she said she’s still doing tests to find out her treatment,” said Ms. Wakeling.

Roberta’s struggles put a lot of pressure on the family and Mrs. Wakeling personally.

She collapsed three months after her daughter began experiencing symptoms.

But the mother of two accepted her condition, which helped.

“I’ve always said that acceptance is what got through us,” said Ms. Wakeling. “It was all I could do to help her. But after I accepted it, I adapted. “

She said she was very grateful for the support the family received from the ward.

You’re going to the UK on Saturday.

Ms Wakeling said it was difficult to get an exemption from mandatory hotel quarantine in the UK and that she only came after seeking legal advice.

“We needed support, not more battles,” she said.

The next challenge is to find a suitable place to treat Roberta.

“We are working pretty hard to find a suitable hospital for her treatment as pandas are not recognized in the UK,” said Ms. Wakeling. “It’s really important that it goes to the right place.”

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Individuals and Families | Georgia Department of Public Health

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prevention

There are several steps you can take to prevent it

Opioid

Abuse and Addiction:

  • Never take more than that



    required

    Dose and always follow the prescribed instructions. If you forget a dose, do not take a double dose to make up for the dose.

  • Do not combine opioids with alcohol.
  • Do not combine opioids with any other medication or medication without your doctor’s approval.
  • Stop taking opioid medications as soon as your doctor agrees they are no longer needed.
  • Always follow the prescribed instructions.
  • When taking liquid doses, use an accurate measuring device and measure only the prescribed amount.
  • Only use the drug in the form in which it was prescribed.
  • Never use someone else’s recipe or share your recipe with anyone.
  • Do not drive or use heavy machinery.

Drug withdrawal

Unwanted prescription drugs should be disposed of at an official drug collection point. This prevents prescription drugs from falling into the wrong hands.

Prescription Drug Abuse Prevention Webinars

Information on prevention for parents, students, educators and coaches can be found here.

Signs of overdose

The # 1 sign of opioid overdose is unresponsiveness

Other signs are:

  • Awake but unable to speak
  • Saggy posture
  • The face is pale or clammy
  • Blue fingernails and lips
  • In fair-skinned people, the skin tone becomes bluish-purple; if the skin is darker, the skin tone becomes greyish or ashen
  • Breathing is very slow and shallow, erratic, or has stopped
  • Pulse is slow, irregular, or not there at all
  • Choking noises or a snoring-like gurgling sound (sometimes called a “death rattle”)

Steps to be taken if a drug overdose is suspected:

  1. Immediately call 911, report a drug overdose, and provide the address and location of the suspected overdose. If more people are available, send someone to wait for the ambulance and guide the emergency services to the person. Georgia has one medical amnesty law protects those who may suffer an overdose and callers who see a doctor about an overdose of alcohol and drugs.
  2. Try to wake the person up by talking loudly, pinching, or vigorously rubbing their ankles on the sternum (the bony part in the center of the chest).
  3. Make sure the person is breathing. If not, try providing emergency mouth-to-mouth ventilation by pinching the person’s nose and blowing into their mouth. After breathing on their own again, lay the person on their side.
  4. Give naloxone when you have it and know how to use it.
  5. Stay with the person until help arrives and act quickly to give rescue breaths if they stop breathing.
  6. Encourage the person to work with the ambulance crew.

Georgia’s Medical Amnesty Act

Although most overdoses occur in the presence of others, fear of arrest and prosecution prevents many people from calling 911. Georgia’s Medical Amnesty Act protects victims and callers who seek medical help during a drug or alcohol overdose. This law provides:

  • Limited liability for possession of small amounts of drugs and / or alcohol; this applies to both the victim and the caller
  • Limited liability for parole, injunction, probation and other violations
  • Naloxone Immunity for Prescribers, Pharmacists, and First Responders

Naloxone administration



Naloxone

is only a short term treatment for overdose. It is important that healthcare professionals are notified as soon as possible.

Naloxone blocks or changes the effects of opioid drugs, including extreme sleepiness, slow breathing, or loss of consciousness. Naloxone is used to treat an emergency in the event of an overdose of narcotics. It should be used until the patient can receive emergency medical care for an overdose.

Learn how to



Administer naloxone

.

Standing order for naloxone

There are two ways to get a naloxone rescue kit from a pharmacy in Georgia:

1. Get a prescription from your prescribing doctor and take it to a pharmacy that stocks naloxone.

2. Go straight to a pharmacy and request a naloxone kit. ON



To stand

order

for naloxone was dispensed to all pharmacies in Georgia on December 14, 2016, and a prescription for naloxone is not required.

Damage minimization

Fentanyl or other stronger opioids are added to many illegal drugs today. People who use illegal drugs can take steps to reduce their risk of overdose, such as: B. to have naloxone on hand and never to use it alone.

In addition to the risk of overdose, injectable drug use can lead to people becoming infected with or transmitting infectious diseases such as HIV or hepatitis. To reduce this risk, people who inject drugs should always use safe injection practices, including never sharing needles and always keeping the injection site sterile. For more information on harm reduction resources in Georgia, visit the Atlanta Harm Reduction Coalition.

Neonatal abstinence syndrome

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome that occurs when the mother suddenly stops taking medication during pregnancy.

NAS is most commonly caused when a woman takes opioids (e.g., morphine, methadone, oxycodone) during pregnancy, but it can also occur with antidepressants and benzodiazepines. It can also occur when a woman is using illegal drugs such as heroin, methamphetamines, and barbiturates.

NAS has been reportable in Georgia since January 1, 2016. Gathering information about the occurrence of NAS will help DPH develop policies and programs aimed at reducing the number of babies born with NAS. For more information on NAS, see Neonatal Abstinence Syndrome.

Treatment and recreational resources

Georgia Crisis and Access Line for Opioid Addiction and Withdrawal
The longer opioid drugs are used, the greater the risk of addiction. With addiction, withdrawal symptoms occur when the drug is stopped. These include pain, nausea, vomiting, muscle spasms, depression, and anxiety, and they can last a week or more. It is dangerous to go through opioid withdrawal without medical attention. Call the Georgia Crisis and Access Line at 800-715-4225 for assistance.

SAMHSA Treatment Services Locator has resources for finding addiction treatment service providers in Georgia and across the country, and collects information on thousands of government-licensed providers specializing in the treatment of addictions, addictions, and mental illnesses.

The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) Addiction Disorders Office provides information about DBHDD strategic planning and community search resources.

Georgia Overdose Prevention is a grassroots organization made up of parents, health professionals, harm reduction advocates, and friends of people who have lost loved ones to accidental drug overdoses. The group was formed to create and advocate the passage of the Georgia 911 Medical Amnesty Law. Inspired by the lives saved by the passage of the Medical Amnesty Act, Georgia Overdose Prevention is now focused on educating, implementing and developing resources for Georgia’s 911 Medical Amnesty Law.

Dose of Reality GA contains information about the dangers of opioid use, addiction prevention, and safe medication storage.

The Emory Center for Maternal Substance Abuse and Child Development provides information on opioid use during pregnancy.



directory

of Georgia Women’s Treatment and Recovery Services



hope

Home restoration assistance for women

How to Contact Law Enforcement / Reporting a Complaint to the Drugs Agency:

To report an increase in overdose, a potential overdose group, or other unusual drug-related event, call the Georgia Poison Center at 1-800-222-1222.

PDMP

The Georgia Prescription Drug Monitoring Program is an electronic database for monitoring the prescription and dispensing of controlled substances. The PDMP can help avoid duplicate prescriptions and overdoses of controlled substances, provide a prescribing doctor or pharmacist with critical information about a patient’s prescribing history with controlled substances, and protect patients from abuse.

Patients can have copies of their PDMP reports. To do this, please fill out a patient inquiry form and send it to pdmpsupport@dph.ga.gov. Patients will then receive a copy of their report.

Page last updated on 07/28/2021

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Pfizer says vaccine’s power wanes over time. Are you still protected?

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The effectiveness of the Pfizer-BioNTech Covid-19 vaccine waned over six months, but experts say the data still does not indicate an immediate need for booster vaccines.

The study, which has not yet been peer-reviewed or published in a medical journal, found that the vaccine was 97 percent effective at preventing serious Covid illnesses for at least six months – but effectiveness against any symptomatic illness fell from 96 Percent to 84 percent over the same period, every two months by about 6 percent.

Full coverage of the Covid-19 pandemic

“I was generally encouraged by the results of the paper,” said lead study author Dr. Stephen Thomas, a coordinating investigator for the Pfizer vaccine study and director of the SUNY Upstate Institute for Global Health & Translational Science in New York.

He said the expectation is always that the protection of the vaccine would wear off. The big question, he said, was whether protection would wane to the extent that the disease was affecting so-called public health; namely, hospitalizations and deaths. So far this does not seem to be the case.

“Although we saw protection wear off after six months, protection from the serious consequences that really put the disease’s public health burden in place,” said Thomas.

Overall, the study found that within six months, the vaccine was 91 percent effective in preventing symptoms of Covid, which ranged from mild to severe symptoms. Pfizer announced these specific results in a press release in April.

Dr. Paul Offit, a vaccine researcher at Philadelphia Children’s Hospital, said he was “pleasantly surprised” that it was as effective as it was in preventing symptoms.

“These data are all very encouraging and exactly what you would expect,” he said.

“You will never be so well protected from an asymptomatic infection or a mildly symptomatic infection, and that’s fine,” he said. “They just want to keep people out of the hospital and keep them from dying. That is the goal.”

The new study examined follow-up data collected as of March 13 from more than 44,000 people who participated in Pfizer’s Phase 3 clinical trial last year. People received either two doses of the vaccine or two doses of placebo three weeks apart. Since the study only looked at data through mid-March, it remains unclear how the shots against the Delta variant, which became the most common strain of the virus in the United States in early July, remains unclear.

The results come as experts continue to consider whether or not booster injections are needed. Pfizer CEO Albert Bourla has long said that a refresher would be needed in the coming months, although federal health officials say there is still no evidence to warrant this.

In a conference call Wednesday morning, Pfizer said a third dose increases antibody levels specific for the Delta variant by five-fold in people ages 18 to 55 and eleven-fold in people ages 65 to 85 have. Although these results suggest better protection against the variant, whether this leads to better protection against disease remains to be explored.

Offit stressed that it was too early to definitively say that booster vaccinations are needed as the vaccine remains very effective in preventing serious illness and hospital admissions.

“If the number of people who are fully vaccinated and still being hospitalized or killed increases to 5, 10, or 20 percent, you can think about a booster, but we’re not there yet,” he said.

Download the NBC News app for full coverage of the Covid-19 pandemic

Dr. Bob Wachter, chairman of the medical school at the University of California, San Francisco, agreed with Offit that the new data does not suggest that it is not yet time to rush and get a booster shot.

“It just goes to show that someone who was injected seven or eight months ago is at a slightly higher risk [for a breakthrough infection] than we thought, and it’s a perfectly good justification for self-vaccinated people to wear masks indoors again, “Wachter said, referring to the Centers for Disease Control and Prevention’s decision on Tuesday to put vaccinated people on wearing masks Recommended indoors in areas with high concentrations of community spread.

However, the dominance of the delta variant, combined with the vaccine’s declining effectiveness over time, suggests that boosters will be needed at some point, he said.

“I don’t think it’s a reason to panic and I don’t think it’s a reason to run out and find a booster today because the overall protection against super sickness and dying remains extremely high,” said Wachter. “But I think it’s part of the puzzle that tells us all that boosters will be in our future.”

Thomas, the study’s author, said more research is needed.

“I believe [the study] says it is possible that if the protective effect of the vaccine continues to wear off over time, we may need booster doses, ”said Thomas. “But that’s still an unanswered question for me.”

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How to stop eye twitching, and why it happens

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Usually the eye twitching is mild and goes away on its own after a few seconds or a few minutes. It is usually not a sign of an underlying disease. However, there are a few things people can try to stop it.

Mild eyelid twitching or eyelid myokymia is common. It has associations with stress, fatigue, and caffeine consumption. Reducing the factors that contribute to eyelid twitching can help reduce the frequency of its occurrence.

This article takes a closer look at eye twitching, what causes it and how to stop it.

A slight twitch occurs when the orbicularis oculi muscle, responsible for closing the eyelids, contracts spontaneously, causing small and uncontrollable twitching movements. The medical term for this condition is eyelid myokymia.

Eyelid myokymia can affect the upper or lower eyelid, but most commonly it affects the lower eyelid. Usually the twitches are light and brief and go away on their own after a few seconds or minutes. In some cases, they can last for hours. Less often they can become chronic.

Learn more about eyelid twitching here.

Other less common types of eyelid twitching include:

Essential blepharospasm

Essential blepharospasm causes the eyelids to close spontaneously. This may be like a blink or a wink, but the eyelids may close for a longer period of time in some cases. Blepharospasm can last a few seconds to a few hours, and some people may not be able to see during this time.

Doctors believe a problem with the nerves around the eyes is causing essential blepharospasm, but aren’t sure why it develops. Sometimes another condition such as Parkinson’s disease can be the cause.

Hemifacial spasm

Hemifacial spasm is a rare condition that causes the muscles on one side of the face to contract. Sometimes this starts near the eye and causes eyelid cramps before other areas of the face are affected.

Hemifacial spasm can occur alone, because something is pressing on the nerves that control the muscles of the face, or as a result of another condition.

Eyelid myokymia often goes away on its own. However, if a person wants to stop or reduce this symptom, they can try the following:

  1. With a warm compress: People can use a warm compress and apply it over the eyelid area. This can help relax the muscles around the eye and stop the cramps.
  2. Reduce stress: Eyelid myokymia is linked to stress, so it may help reduce the exposure to stress. People can do this by delegating tasks to others, taking time each day to relax, trying stress relieving hobbies, and practicing stress management techniques like breathing exercises or mindfulness.
  3. Avoid caffeine: Tea, coffee, some sodas, and chocolate can all contain caffeine, which can trigger or worsen eyelid twitching. Try to gradually reduce or eliminate caffeine intake.
  4. Getting enough sleep: Taking a nap can help resolve the eyelid twitching. It’s also good to get enough sleep each day by setting a regular schedule for falling asleep and waking up. If a person is having trouble falling asleep, a doctor, sleep specialist, or other health care provider can provide advice.
  5. Fight dry eyes: Dry, irritated, or gritty eyes can make your eyelids twitch. People can use moisturizing eye drops to relieve dryness.

More severe or persistent eyelid cramps, such as blepharospasm and hemifacial spasms, may require medical treatment.

Scientists aren’t entirely sure what causes eyelid myokymia. It is a common condition that can occur in healthy people for no apparent reason. It seems to be related to lifestyle factors such as:

The side effects of some medications, including topiramate, flunarizine, and clozapine, can also cause eyelid twitching. However, this is unusual.

A 2017 study from Taiwan on chronic eyelid twitching found that around half of the participants had differences in nerve function. This could be due to a nerve conduction defect that explains why some people develop persistent twitching.

Chronic eye twitching also seems to be more common in women, although experts don’t know why.

The authors of the study suspect that this could be due to the fact that women, especially in China, are exposed to higher levels of stress than men due to social or cultural pressure. Overall, however, more research is needed.

Doctors don’t know what causes blepharospasm, but it can sometimes be related to underlying conditions, such as:

The underlying conditions that can cause hemifacial spasm are similar and include:

  • traumatic injury
  • Brain lesions
  • Bell’s palsy
  • Mastoid or ear infections
  • Tumors
  • other structural abnormalities in the posterior region of the cranial cavity

Many of the known triggers for mild eye twitching are lifestyle related, so changing their daily routine may help people avoid this symptom. This can mean:

  • go to sleep earlier
  • Sleep and wake up at similar times each day, including weekends
  • Practice sleep hygiene
  • Switch to decaffeinated drinks
  • Reducing activities or habits that cause stress, such as B. Revision
  • Seek support from a therapist for anxiety or high levels of stress
  • Avoiding tobacco smoking or alcohol consumption

If eye twitching is common, it can be helpful to record when it occurs and note any other contributing factors. This can help someone see a pattern.

However, if the eye twitching is bothersome and doesn’t seem to be related to daily habits, a doctor may be able to offer other treatments to contain or prevent it.

This could include botox injections, which temporarily paralyze the affected muscles to prevent the twitching.

In rare cases, doctors may recommend an eyelid angle myectomy to correct blepharospasm or hemifacial spasm. This procedure removes the muscles that are causing the cramps. Identifying any underlying medical conditions that are causing the convulsions will allow a doctor to manage or control this symptom.

Most of the time, eye twitching is mild and goes away on its own. However, people should see an ophthalmologist if they experience:

  • Twitching that has lasted for more than a few weeks
  • severe twitching that affects vision
  • spontaneous closing of the eyelids
  • Twitching in other parts of the face
  • often dry eyes
  • other new symptoms that could indicate an underlying condition

Many people experience slight, temporary twitches in their eyes. It is usually not a sign of serious health and often does not require treatment.

People may find that twitching occurs less often if they can reduce stress, anxiety, trouble sleeping, or caffeine consumption.

The more bothersome forms of eye twitching include essential blepharospasm and hemifacial spasm. These can affect a person’s eyesight and make activities such as working or driving difficult to perform.

If a person has severe eye twitching, it is important to speak to a doctor.

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