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Need to Know!

Dr Jinan Harith Darwish is a paediatric allergy specialist and clinical immunology fellow at the King Faisal Specialist Hospital and Research Center. Each month she answers your health questions.

My little girl is six months old, she goes to daycare, as I’m at work, and seems to be constantly coming down with coughs, colds and other illnesses. Is there anything I can do to boost her immune system or something else I should be looking at?

Numerous typical illnesses found in day-care settings, including the common cold, stomach bugs, red eye and hand, foot and mouth disease, are caused by viruses. These bugs are effortlessly spread through direct and indirect contact between infants and toddlers in close proximity, who are likely wiping their noses, sneezing and coughing, while sharing toys, furniture and food. There is also a lot of contact between parents or caregivers and children: holding hands, picking up, feeding, changing diapers and so on.

The ‘common cold’ is caused by viruses that infect the nose, throat and sinuses. Infants get lots of colds, some as many as eight to 10 each year before they turn two. Colds tend to be more common in autumn and winter, when children are indoors and in closer contact with each other, so it may seem like your child has one cold after another all winter long. Young children have more colds than older children and adults because they haven’t built up immunity to the 100-plus different cold viruses.

Cold viruses can live on objects for several hours and can be picked up on the hands of other children who touch the same object. These children then get infected when they touch their eyes, nose or mouth. Caregivers can get viruses on their hands and spread them between children by touch.

If a child gets many colds, it’s not a sign of a weak immune system. It just means she’s exposed to many viruses. The only reason to have a child’s immune system tested is if the colds often lead to more serious problems.

Serve foods that are rich in protein, zinc and vitamin C, and free of refined sugar. Also consider supplementing her diet with immune-boosting vitamin D and probiotics.

My cousin’s little one was a very sickly child, had contracted one infection after another and, sadly, passed away a few weeks ago. We’re all struggling to come to terms with this and wondering if there was something that could have been done differently?

First and foremost, I am extremely sorry to hear about your loss. Losing a loved one, especially a child, can be devastating because no parent expects to outlive their child. I am positive the parents and you, as an extended family, did everything within and beyond your capacity.

Many primary immunodeficiency disorders are passed down from one or both parents. Problems in the DNA , the genetic code that acts as a blueprint for producing the cells that make up the human body, cause many of the immune system defects in primary immunodeficiency.

There are numerous types of primary immunodeficiency disorders. In fact, research has led to a dramatic increase in the number of these disorders recognised in recent years, so they’re not as rare as once thought, especially in societies with consanguineous marriages. They can be broadly classified into six groups based on the part of the immune system that’s affected.

In an attempt to facilitate clinical reasoning concerning when to suspect primary immunodeficiency disease (PID) in clinical practice, the USA’s National Primary Immunodeficiency Resource Center developed a list of 10 warning signs:

• Four or more new ear infections within a year.
• Two or more serious sinus infections within a year.
• Two or more months on antibiotics with little effect.
• Two or more pneumonias within a year.
• Failure of an infant to gain weight or grow normally.
• Recurrent, deep skin or organ abscesses.
• Persistent thrush in mouth or fungal infection on skin.
• Need for intravenous antibiotics to clear infections.
• Two or more deep-seated infections including septicemia.

A family history of PID.
Diagnosis of specific PID from a large spectrum of disorders requires expertise in clinical and laboratory evaluation. A wide array of investigations is available for evaluation of the immune system which help immensely in the diagnosis of PIDs. At King Faisal Specialist Hospital & Research Center we have a molecular genetics panel that includes 264 genes known to cause PID. Our panel supersedes the 70 gene TIGER panel in the UK. We also, have a faster turnover time of four to six weeks for the results. Once, we have a known gene defect we offer genetic counselling and refer the family, if willing, for pre-gestational diagnosis to prevent having more affected children in the future.

If you have a question for Dr Jinan, please email editor@redhousemarketing.com

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