Treating strep carriers

[KaraM]

I copied thie from the FAQ. Does anyone know where I can find any of the "mounting evidence?" Are there some studies or articles?

 

Q: My doctor has said that my daughter is a strep carrier and that the positive strep culture is meaningless. Is this true?

A: About 5% of children carry strep without any other symptoms. This is thought to be caused by some interaction with other flora in the throat or some defect in the immune system that prevents it from removing the offending bacteria. There is mounting evidence that carriage is not as benign as once thought. Most doctors only treat asymptomatic carriers if someone else in the family is immuno-compromised. Carriage is typically broken by stronger antibiotics like azithromycin or clindimycin.

 

 

Thanks,

Kara

[EAMom]

Hi Kara,

 

I believe that the above statement (about carriage not being as b-9 as once thought) was based on personal communication with Ed Kaplan (WHO strep expert). Maybe Buster will offer more info.

 

This is also interesting (on carriage) from Dr. T., but probably not what you are looking for: http://www.adhdnews.com/testforum/test26840.htm

 

He says that 80 to 90 percent of those with OCD and Tourettes are strep carriers. They may not get a sore throat but they can shed the bacterium, he explains. Something is different about their immune system.

Edited February 18, 2011 by EAMom

[Buster]

I believe that the above statement (about carriage not being as b-9 as once thought) was based on personal communication with Ed Kaplan (WHO strep expert). Maybe Buster will offer more info.

 

EAMom is correct. The original comment came from a discussion with Dr. Ed Kaplan regarding research he has been doing for well over 20 years on carriage. A good paper on the topic was the Th17 activation in nasal innoculation/colonization in Cleary and Wang's recent paper. See http://www.pnas.org/content/early/2010/03/11/0904831107.full.pdf

 

This is one of several papers that are looking at the effects of carriage (in this case in mice). There's a lot of distance between mice and men, but this is part of the research that is looking at the immune systems response to just carriage.

 

Regards,

 

Buster

[eljomom]

What is the best way to determine "carriage?" We saw I.D. doctor yesterday (sent to by our pandas doc) and she seemed to believe that it's almost impossible to completely eradicate (well, to KEEP eradicated) in a carrier....meaning, you can treat for it (bleach baths, special gargles, nasal mupirocin) and even clindamycin, but as soon as that carrier is even exposed to strep again, they will be back carrying it. So she didn't even test anyone for it

Edited February 18, 2011 by eljomom

[EAMom]

Our younger dd is a carrier and we have been able to clear her with 5 days of Azith (several times). She's now been clear for 2 years. In Kindergarten (after clearing in preschool) she tested positive a couple of times (after we got strep notices in school and we were able to clear her with Azith. When I got strep (myself!) that spring, strangely, nobody else in the family got strep (although PANDAS dd's handwriting did fall apart).

 

 

So, I would say it is very possible to clear a carrier, it just may take Azith. or clindamycin. And, you need to test a few weeks after to make sure they really cleared...and be prepared that they may be carriers in the future (so check periodically, esp. if strep is going around).

[KaraM]

Thank you EA Mom and Buster!.

Kara

 

I believe that the above statement (about carriage not being as b-9 as once thought) was based on personal communication with Ed Kaplan (WHO strep expert). Maybe Buster will offer more info.

 

EAMom is correct. The original comment came from a discussion with Dr. Ed Kaplan regarding research he has been doing for well over 20 years on carriage. A good paper on the topic was the Th17 activation in nasal innoculation/colonization in Cleary and Wang's recent paper. See http://www.pnas.org/...831107.full.pdf

 

This is one of several papers that are looking at the effects of carriage (in this case in mice). There's a lot of distance between mice and men, but this is part of the research that is looking at the immune systems response to just carriage.

 

Regards,

 

Buster

[eljomom]

Another interesting tidbit from I.D. doc (at Georgetown Univ. Hospital---department head)....she does not like Zithromax for Group A strep It seems like everywhere I turn, I get a different doc saying this or that abx is good/bad, etc.....I guess it really does depend on the kid. I was not comfortable putting dd on clindamycin b/c of my past experience with it---major diarrhea after just 2 days!

[EAMom]

Yup...some of the East Coast docs are very anti-Azith. Supposedly there is some Azith. resistant strep strains in the Eastern US, not so much a problem in the West Coast I guess.

 

 

re Clindamycin:

Our ped originally wanted us to use Clindamycin to clear our strep carrier non-pandas dd when we didn't clear on Augmentin. But (she was 5 at the time) she didn't know how to swallow pills and the liquid Clindamycin was insanely nasty tasting. We only got through 2 doses (of 3x daily for 10 days)...each dose took 1 hour plus lots of tears b/c of the bad taste. So, we broke down and got switched to Azith which tasted fine (and was only 1x daily for 5 days.)

Edited February 19, 2011 by EAMom