Monday, November 15, 2010

Children are Prone to Ear Infections

Though researchers don't yet have a way to stop this suffering, they are working on at least three experimental vaccines with the potential to prevent ear infections.

Developing vaccines for ear infections is tricky because more than 100 types of germs cause such infections, Rosenfeld says.

Because children develop ear infections so often, and because parents miss so much work because of them, certain vaccines against ear infections could actually be cost-effective, even if they cost $65 to $125 each, says Tracy Lieu of Children's Hospital Boston, co-author of the Pediatrics paper.

Three candidate vaccines might offer relief:

Prevnar 13
The Prevnar vaccine, licensed in 2000, prevents infection with seven of the bacteria that cause pneumococcal pneumonia, meningitis and blood infections, which can be fatal. The same bacteria also cause ear infections, Rosenfeld says.

Prevnar has helped reduce cases of invasive pneumococcal disease, such as pneumonia and meningitis, by 34%, according to the Centers for Disease Control and Prevention.

But the vaccine has barely made a dent in the number of ear infections, Rosenfeld says. That's because many other types of pneumococcus also cause ear infections, and these strains have proliferated to replace the bacteria blocked by the vaccine.

Wyeth, which makes Prevnar, has applied for approval of a second-generation vaccine to block 13 strains of pneumococcus, hoping to offer even better protection against pneumonia and meningitis.

The company expects the Food and Drug Administration to decide on approval by the end of September, says spokeswoman Lili Gordon.

Doctors don't yet know how the new vaccine will affect ear infections, Rosenfeld says.

GlaxoSmithKline has developed a vaccine called Synflorix, approved in Europe in March, against 10 types of pneumococcal bacteria that cause ear infections and more serious illness. 

In a 2006 study in The Lancet, an early version of Synflorix reduced ear infections by 34%. GlaxoSmithKline doesn't know how well the final version will prevent ear infections, because researchers haven't yet completed a definitive trial, says company spokesman Jeff McLaughlin. The company has not yet applied for FDA approval.

A topical vaccine
Hoping to spare children from the pain of shots, researchers at Nationwide Children's Hospital in Columbus, Ohio, are testing a topical vaccine against ear infections. The vaccine — so far tested only in chinchillas, a type of rodent — is rubbed into the skin around the ear.

The topical vaccine still needs to be tested in humans. And even if it's successful, it would take years before it would be ready for approval, says researcher Lauren Bakaletz, a professor at the Ohio State University College of Medicine.

If the vaccines are approved, Gordon says she would definitely consider them for her boys. "I see what my son goes through," she says. "The pain is really bad."

Until then, parents and children are left to take comfort in the fact that children eventually grow out of ear infections, Rosenfeld says. Ear infections tend to become much less common by age 3 or 4 and almost disappear by age 7.

"It's an occupational hazard of childhood," Gordon says. "The only cure is to feed them and water them and let kids grow up."

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