For people who think of arthritis as a disease of the elderly, learning that children also suffer from arthritic conditions may come as a shock. Across age groups, various forms of arthritis are a growing public health problem in the United States. New cases of juvenile rheumatoid arthritis and other types of autoimmune arthritis in young Americans are two to three times higher than in Canada, with cases occurring within the wider context of proliferating pediatric autoimmune disorders. Over one four-year period (2001-2004), the number of ambulatory care visits for pediatric arthritis and other rheumatologic conditions increased by 50%.
The medical community lumps childhood arthritic disorders under the broader umbrella of “juvenile rheumatoid arthritis” or “juvenile idiopathic arthritis” (JIA). “Idiopathic” means “no identifiable cause.” There has been a predictable rush to pinpoint predisposing genetic factors, even though most of the genetic variations identified in JIA “are shared across other autoimmune disorders.” Of more practical relevance, an emerging consensus points to environmental factors as major contributors to JIA, with childhood infections attracting particular attention.
In light of the interest in infections, how do we explain the deafening silence about the possible role of vaccines as an autoimmune trigger for JIA, when the stock-in-trade of vaccination is the “mimicking [of] a natural infection”? One study out of Brazil alludes to case reports linking autoimmune rheumatic diseases such as JIA to vaccination—but quickly dismisses the vaccine hypothesis as “controversial.” However, American children suffering from JIA and other debilitating autoimmune disorders deserve to know whether the dozens of vaccines they receive through age 18 are at least partially responsible for their misfortune.
Diminished quality of life
Childhood arthritis—a disorder that results in permanent joint damage—is characterized by joint pain, swelling, stiffness and other symptoms that interfere with activities of daily living such as dressing and walking. The National Institutes of Health (NIH) understatedly describes the quality-of-life impact of JIA on all spheres of a child’s life as follows: “Juvenile arthritis can make it hard to take part in social and after-school activities, and it can make schoolwork more difficult.”
Currently, one child in 1,000 develops some form of chronic arthritis—about twice the estimated prevalence of the early 1980s. A diagnosis typically is conferred when a child under age 16 has experienced joint swelling for at least six weeks.
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