DEERFIELD, IL – April 7, 2010 — Dehydration is a condition that can have a significant impact on children and, if left untreated, may lead to serious complications and hospitalization. A national survey of more than 800 parents with children between the ages of one month and 10 years found that three out of five parents reported needing to know more information about dehydration, such as when to see a physician, warning signs, and treatment, if their child became sick – pointing to a greater need for awareness and education around the condition and its treatment.
The poll, fielded by the Harris Interactive Service Bureau on behalf of Versta Research, and sponsored by Baxter International Inc. (NYSE: BAX), uncovered a general lack of understanding of the causes, signs and symptoms of dehydration in children. For example, most parents surveyed (59 percent) believed that June, July or August are peak months when kids are at the highest risk of dehydration. In fact, several illnesses that cause dehydration occur more frequently in cooler months, between winter and spring.1, 2 Additionally, just half (52 percent) of the parents surveyed typically associated dehydration with the flu. Dehydration can occur as a result of viral respiratory diseases including the flu and other conditions that can cause fluid loss.
Dehydration occurs when the body loses more fluids than it is taking in and may not have enough fluids to carry out its normal functions. One of the most common causes of dehydration in children in the United States is acute gastroenteritis (or “stomach flu”), which is responsible for more than 1.5 million outpatient visits, 200,000 hospital stays, and approximately 300 deaths per year.3 Gastroenteritis is often caused by a viral infection, such as rotavirus or norovirus, and causes symptoms that can quickly lead to dehydration. Rotavirus (which occurs winter through spring)1 is estimated to be responsible for approximately 250,000 U.S. emergency room visits each year among children under the age of five.4 Outbreaks of norovirus are common in institutional settings, such as schools and child care facilities and, although frequently referred to as the “winter vomiting disease,” noroviruses can occur anytime throughout the year.2
Dehydration can occur at any age, but can be especially concerning for infants and young children because they may become dehydrated more quickly than adults.5 While the survey indicated that three-quarters of parents (76 percent) are aware that children have a higher risk of dehydration than adults, 61 percent said that they would need to know more about dehydration if their child became sick. Of the surveyed parents who would need more information, more than four out of five (84 percent) said they would need information about when to see a physician, 73 percent would need information about warning signs and 43 percent would need information about how to treat dehydration.
“Parents need to understand that dehydration can happen year-round; it isn’t just associated with hot weather and loss of fluid through perspiration. Dehydration accounts for hundreds of thousands of hospitalizations each year, due to a number of illnesses that can lead to depletion of fluids and electrolytes from the body. These illnesses can range from seasonal flu to stomach flu to other viruses that occur throughout the year,” said Daniel Rauch, MD, associate professor of Pediatrics, Mount Sinai School of Medicine, New York, NY.
Symptoms of Dehydration in Children 6, 7
As parents seek more information related to dehydration, they need to recognize the signs and symptoms of dehydration and seek medical attention when necessary to avoid complications. Some of these signs and symptoms may include:
- Child is tired, restless and irritable (making it difficult to rehydrate by drinking fluids)
- Child is increasingly thirsty
- Child has a dry mouth and tongue
- Child is not urinating as frequently or as much as normal
- Child experiences weight loss
- Child has slightly sunken eyes and/or a depressed fontanel (the soft spots on babies’ heads)
- Child does not produce tears when crying
Parents can find more information on how to avoid fluid loss and dehydration by visiting the Centers for Disease Control and Prevention (CDC) Web site: http://www.cdc.gov/h1n1flu/homecare/fluidlosstips.htm. 8
Rehydration Treatment Options
Administering fluids is important for children experiencing dehydration. The most common methods include oral rehydration therapy (drinking fluids) and intravenous (IV) therapy (fluids given directly into a vein). When parents are unable to give their children fluids through the mouth, often because of vomiting, their pediatrician may send them to the emergency room (ER) to receive fluids. Many pediatric emergency physicians treat dehydrated children with IV therapy. Starting IV treatment in a child can be challenging as children often have small veins which dehydration can further constrict, making it difficult to find and access a vein. Re-sticks can be particularly common with children – a study at an academic children’s hospital found that nearly half of the young patients required two or more IV needlesticks.9
HYLENEX recombinant (hyaluronidase human injection) is available from Baxter as a safe and effective alternative to IV therapy, as it facilitates under-the-skin (subcutaneous) delivery of fluids without the need to access a vein. Treatment with HYLENEX can be started quickly and easily with a very high first attempt success rate.10 HYLENEX can be given in an area that is convenient for both the child and caregiver, such as in the child’s upper back, while the child is held by a parent.10 Results from a recently published clinical study of 51 mild to moderately dehydrated children showed that 94 percent of patients were successfully rehydrated.10 Treatment also was fast and simple to initiate (median time from insertion to start of subcutaneous therapy was two minutes)10 and highly preferred by parents, with nine out of 10 surveyed reporting they were satisfied or very satisfied with the procedure.10
Please see Important Risk Information for HYLENEX recombinant (hyaluronidase human injection) at the end of the press release. Full Prescribing Information is available at http://www.hylenex.com/pdf/prescribe.pdf.
This survey was conducted among 804 parents in the U.S. who had children between the ages of one month and 10 years (inclusive). Data were collected between December 3 and December 15, 2009 by the Harris Interactive Service Bureau (HISB) on behalf of Versta Research. HISB was responsible for the data collected and Versta Research was responsible for all survey design and analysis. The sample included 411 women and 393 men.
HYLENEX recombinant (hyaluronidase human injection), approved by the U.S. Food and Drug Administration (FDA) for subcutaneous fluid administration, works by temporarily making the tissue beneath the skin more permeable and able to absorb fluid, allowing fluids to be more readily absorbed into the blood vessels. Once HYLENEX has been injected into the skin, fluids can be administered subcutaneously in that same area. Special care must be taken in pediatric patients to avoid over hydration by controlling the rate and total volume of the infusion.11 When solutions devoid of inorganic electrolytes are given subcutaneously, some complications, such as a state of decreased blood volume, may occur.11 Baxter is the exclusive distributor of HYLENEX recombinant (hyaluronidase human injection), which the company licensed from Halozyme Therapeutics, Inc. (Nasdaq: HALO).
Baxter International Inc. (NYSE: BAX), through its subsidiaries, develops, manufactures and markets products that save and sustain the lives of people with hemophilia, immune disorders, infectious diseases, kidney disease, trauma, and other chronic and acute medical conditions. As a global, diversified healthcare company, Baxter applies a unique combination of expertise in medical devices, pharmaceuticals and biotechnology to create products that advance patient care worldwide.
Important Risk Information for HYLENEX recombinant (hyaluronidase human injection)
- Hypersensitivity to hyaluronidase or any other ingredient in the formulation is a contraindication to the use of this product.
- Discontinue HYLENEX recombinant (hyaluronidase human injection) if sensitization occurs.
- Hyaluronidase should not be used to enhance the absorption and dispersion of dopamine and/or alpha agonist drugs.
- Hyaluronidase should not be injected into or around an infected or acutely inflamed area because of the danger of spreading a localized infection.
- Hyaluronidase should not be used to reduce the swelling of bites or stings.
- Hyaluronidase should not be used for intravenous injections because the enzyme is rapidly inactivated.
- Furosemide, the benzodiazepines and phenytoin have been found to be incompatible with hyaluronidase.
- The most frequently reported adverse experiences have been mild local injection site reactions, such as erythema and pain.
- Hyaluronidase has been reported to enhance the adverse events associated with co-administered drug products.
- Anaphylactic-like reactions following retrobulbar block or intravenous injections have occurred, rarely.
- Edema has been reported most frequently in association with subcutaneous fluid administration.
- The rate and volume of subcutaneous fluid administration should not exceed those employed for intravenous infusion. As with all parenteral fluid therapy, use the same precautions for restoring fluid and electrolyte balance.
- Special care must be taken in pediatric patients to avoid over hydration by controlling the rate and total volume of the infusion.
- When solutions devoid of inorganic electrolytes are given subcutaneously, hypovolemia may occur.
Baxter and Hylenex are trademarks of Baxter International Inc.
Halozyme is a registered trademark of Halozyme Therapeutics, Inc.
1 Turcios RM, Curns AT, Holman RC, et al. Temporal and geographic trends of rotavirus activity in the United States, 1997–2004. Pediatr Infect Dis J 2006;25:451–4.
2 Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/dvrd/revb/gastro/faq.htm. Accessed 3/10/10.
3 King C, Glass R, Bresee J, et al. Managing Acute Gastroenteritis Among Children. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention; 2003. Nov. 21. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5216a1.htm Accessed 3/17/10.
4 National Foundation for Infectious Diseases. Media Fact Sheet. http://www.nfid.org/rotavirus/resources/Rotavirus_Fact_Sheet.pdf. Accessed 1/7/10.
5 National Digestive Diseases Information Clearinghouse, a service of the National Institute of Diabetes and Digestive Kidney Diseases. What I Need to Know About Diarrhea. http://digestive.niddk.nih.gov/ddiseases/pubs/diarrhea_ez/ Accessed on 3/15/10.
6 Iannelli V. Symptoms of Dehydration—Symptoms of Childhood Illness. About.com: Pediatrics.
http://pediatrics.about.com/od/symptoms/a/05_symp_dehydtn.htm. Updated February 20, 2005. Accessed 1/7/10.
7 Medline Plus. Dehydration. http://www.nlm.nih.gov/medlineplus/ency/article/000982.htm. Accessed 3/10/10.
8 Centers for Disease Control and Prevention. H1N1 Flu, “Caring for Someone Sick at Home.” http://www.cdc.gov/h1n1flu/homecare/fluidlosstips.htm. Accessed 3/15/10.
9 Spandorfer PR, Evaline A., Joffe MD, et al. Oral Versus Intravenous Rehydration of Moderately Dehydrated Children: A Randomized, Controlled Trial. Pediatrics. 2005; 115; 295-301.
10 Allen CH, Etzeiler LS, et al. Recombinant Human Hyaluronidase-Enabled Subcutaneous Pediatric Rehydration. Pediatrics. 2009. 124: 859-868.
11 HYLENEX recombinant (hyaluronidase human injection) Full Prescribing Information. December 2009.