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MNAAP Newsletter

Pediatricians as Public Health Sentinels

Moline, Heidi (1)

By Heidi Moline, MD, MPH, pediatric resident, University of Minnesota

Microcephaly. Elevated lead levels. Acute respiratory distress. The past few years have reminded us that pediatricians are at the front line of public health emergencies in our communities and across the globe.

We find ourselves entrenched in outbreaks during their infancy, without case definitions, laboratory guidelines, or media coverage — only patients with curious symptoms.


In early 2015, Brazil experienced a recognized surge of both Zika virus and Dengue virus cases across the country. Several months later, pediatric neurologists Drs. Vanessa van der Linden Mota and Ana van der Linden noted an increase in the number of infants with microcephaly in their Northeastern Brazil clinics.

While in a normal month the might see one microcephalic infant, they were now seeing up to 5-7 per day. The Ministry of Health was notified, and by October, their province which usually has 10 cases of microcephaly per year, had registered 141 cases. Previously known only to cause rash and mild illness, with the aid of observant pediatricians, Zika virus was soon linked to microcephaly and other congenital malformations.

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Screening Instruments: Caring for the Whole Child

AndyBarnesBy Andrew Barnes, MD , MPH, FAAP, Assistant Professor, Developmental-Behavioral Pediatrics, Division of General Pediatrics and Adolescent Health, University of Minnesota

If you’ve ever wondered whether you’re seeing more children with disabilities in your clinic over the past 15 years, you are – from 2000-2010, this population of children grew the fastest since it started to be recorded in the U.S. This increasing prevalence was mostly due to neurodevelopmental differences and mental health conditions – up 20% in the past decade (while physical health disabilities were down 10%), rising fastest among families with higher socioeconomic status. We may be identifying some of these children better in our clinics because of improved standardized developmental screening, as recommended by the American Academy of Pediatrics in their 2006 policy statement. This policy (and other related policies relating to autism, social-emotional, and mental health screenings) recognize that early intervention is critical for children with developmental and behavioral needs, and that these conditions are best managed within a medical home that cares for the whole child.

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