Otitis media, an infection of the middle ear, is on the rise and can lead to hearing loss if left untreated
One night in March last year, Shivain Shory, then four, woke up crying from acute pain in his left ear. Doctors at a public hospital thought it was from a build-up of wax and prescribed a solution to wash it out. However, he continued to suffer more pain in both ears, coupled with a high fever. Two weeks later, his mother, housewife Rakhee Shory, now 37, was shocked to find blood and pus oozing out of his left ear. Shivain had developed otitis media, or an infection of the middle ear. If left untreated, it can result in hearing loss, which can be detrimental to speech and language development.
The condition has struck more children in recent years. KK Women’s and Children’s Hospital (KKH) treated 1,911 children with otitis media in 2009, up from 1,363 in 2005 when it first started tracking the ailment. Dr Eng Soh Ping, an ear, nose and throat surgeon at Mount Elizabeth Medical Centre, has treated about 30 per cent more children with otitis media than two years ago. The rise could be because of a higher incidence of influenza and other upper respiratory tract infections, which can lead to otitis media, he says. Such infections are believed to be spiking due to increased frequency of international travel, which brings bacteria and viruses here. More than half of otitis media cases are caused by bacteria, of which 40 per cent are of a type called pneumococcal bacteria, Dr Eng says.
By the age of three, at least three in four children worldwide have had one episode of otitis media, and a third have had repeated infections. Children below three years old are especially vulnerable to otitis media because their immune system is less robust than that of older children and adults. Their ears are also not fully developed. The tube that connects the middle ear and the nose is shorter, wider and more collapsible compared to that in adults, making it easier for infections in the nose to spread to the middle ear, explains Dr Eng.
Associate Professor Henry Tan, who heads KKH’s otolaryngology department, notes that parents often do not know that their child is stricken with the condition. “This is partly because the child will be unable to communicate his extreme pain and discomfort. As a result, parents must be vigilant and watch out for constant tugging or rubbing of the ears, or incessant crying,” he says.
To create awareness of the causes of hearing loss in children, Mrs Alana Stewart set up a website called Singapore Little Hands, Big Voices (www.littlehandsbigvoices.sg) last June. It also aims to highlight services for hearing-impaired children here. The 38-year-old’s second child, Orson, was just four months old in 2009 when he was diagnosed with hearing loss without a known cause and fitted with hearing aids. The Australian housewife, who has been here for three years, got another scare last month. Orson contracted the flu and complained of pain when his hearing aids were put in his ears. Fortunately, with prompt prescription of antibiotics – usually prescribed to treat otitis media – the fluid slowly receded from the middle ear and did not inflict damage.
A small tube called a grommet can also be fitted into the eardrum to ventilate the ear and drain the build-up of fluid. It is removed after six months to a year. Shivain underwent such a procedure in April last year. His adenoids and tonsils, which became inflamed due to otitis media, were also removed. Fortunately, his hearing was not damaged.
PROTECT YOUR KIDS
Get vaccinated: Vaccines against pneumococcal bacteria reduce the incidence of otitis media by six to 33 per cent. A child may need up to four doses, which cost about $150 to $170 a shot. Children as young as six weeks old can be immunised.
Feed right: Let the child feed in a reclined position, and not lying down fully, to reduce the risk of food refluxing into the tube which connects the nose and middle ear, and causing an infection.
Practise good hygiene: Children often catch upper respiratory tract infections, which cause otitis media, from other kids in childcare centres and schools. Teach them to wash their hands thoroughly to reduce the risk of catching infections.
Watch out for signs: If the child is inattentive, it may be a sign of an ear infection. He may also talk more loudly than usual or raise the volume of the TV set to a much louder level than is normal. Take him to a doctor immediately.
Treat respiratory infections: If the child has an upper respiratory tract infection, take him to the doctor to have early treatment.