The Link - March 2025

In the United States, the incidence of tickborne illness is increasing, and geographic distributions of disease-carrying ticks are expanding. Lyme disease alone accounts for an estimated 476,000 new infections, with health care costs of anywhere from $345 to $968 million annually. This figure, though, does not account for the other common tickborne diseases within the U.S.: Rocky Mountain spotted fever/spotted fever rickettsioses (RMSF/SFR), ehrlichiosis, anaplasmosis, babesiosis and tularemia. Delay in diagnosis and treatment of these tickborne illnesses can increase the risk for severe complications such as disseminated intravascular coagulation, meningitis, encephalitis, and even increased mortality, so prompt recognition and treatment is vital when caring for these patients.

Professional societies representing pediatric subspeciality physicians have voiced concerns about the sustainability of their workforces for decades. A large body of literature discusses a wide variety of issues for all pediatric subspecialities. The parable of the blind men and the elephant has seemed to fit, as the causes of the poor fill-rates of most training programs have been theorized to include inadequate exposure of early-stage learners, like or dislike of certain disease types, financial disincentives related to fellowship training, the duration of training, attrition during fellowship, the research requirement, an aging workforce in some subspecialties, among others. The “cause” of the problem very much depends upon the lens through which the problem is viewed, with divergent opinions among pediatric specialties, academic versus private practice, and clinical care versus scholarship versus education. As a result, a multitude of approaches to remedy the workforce shortage have been suggested and have largely failed.

We have now seen two deaths from current measles outbreaks in the United States. The first person who died was an unvaccinated school-age child from West Texas. The child had been hospitalized and died on February 25 at Covenant Children’s Hospital in Lubbock, Texas. Unfortunately, it is likely that more deaths will follow, most of them children. Prior to these recent fatalities, the last death from measles in the United States was in 2015.

Most of us had some musical training in elementary school – remember the recorder? Some may have even continued their musical training into secondary or post-secondary education. However, does this early musical training provide cognitive benefits to the point that we should recommend it to our patients? How can we know when recommending active music participation may benefit a child versus when music training might not be best for a child? This article aims to answer that question, and to discuss the science behind musical training as well as its impact on brain development.