By Dr. Anthony Policastro

In 1994 the diagnosis of Asperger’s Disorder was noted for the first time. In 2013 the diagnosis was removed and became part of the overall diagnosis of Autism Spectrum Disorders. Thus it only existed as a separate diagnosis for less than 20 years.

What is also relevant is that anyone born before about 1990 might have had the diagnosis but it would not have been diagnosed. That suggests that anyone over age 30 with that form of Autism Spectrum Disorder might not even know they have it. It is usually a pediatric diagnosis so adult physicians might not even consider it.

One might wonder what such an individual would have in the way of symptoms. The key symptoms of autism is language delay. The symptoms of that in adulthood involve things like not being able to be succinct in speech. They involve things like writing things such that others find them very difficult to understand.

Another one of their features is a problem with social interactions. Interpersonal relationships are difficult. An individual might not have any close friends outside of the family. They may appear to be introverted. They might not speak much to others in public. They might even be quiet at home.

Associated with this is an inability to pick up on the feelings of others. They might not be very sympathetic. They might not recognize when someone is feeling badly. Therefore, they cannot sympathize with them. Their thoughts tend to be self centered.

A good example of this is the character Sheldon on The Big Bang Theory. He tends to not realize it at all when he upsets someone else. He also tends to only stay on the topic that he thinks is of interest. If someone tries to change the topic, he goes right back to it.

This inability to move off a topic of interest is another major symptom for this group of patients. Autistic children will become obsessed with a topic. For some it might be dinosaurs. For others it might be trains. For adults the topics change but the need for something to obsess over remains. Their memory for information about their obsession is great. It is not as good for other things because they see no reason to remember them in the first place.

Alternatively, these individuals may be loners. They might do things repetitively. That could take the form of computer games. It could take the form of doing the same task over and over again. They might not even complete the task. The goal is in doing it and not in completing it.

The need to stay on topic may lead them to hoard things that they see as necessary for their belief system. They might have many items on a topic that they will never stop saving. It is like the autistic child who needs to have all of their cars lined up in a certain way and has a meltdown if one is moved.

These characteristics have always been present in individuals. They just weren’t recognized as a separate diagnosis before 1994. Therefore, people born before that time have often gone through life with an undiagnosed condition.

COVID update- Nationally, the figures showed little change this week. The number of new cases was 511,000 compared to 520,000 last week. Sussex County numbers have continued to drop. Last week we were at 581 new cases. This week we are at 443 new cases.

To this point 99.9 percent of adults over age 65 in Sussex County have had one dose of vaccine. Overall 89.9 percent of that group are fully vaccinated.

Sussex County remains a high transmission area. The CDC defines high transmission as either more than 100 cases per 100,000 people or a positive test result of greater than 10 percent of people tested. We currently stand over the last seven day period at 201.94 cases per 100,000 people. We are at a 6.61 percent positive test rate.

The total number of cases puts us in the high range. However, the test numbers have us in the moderate range. The total number of cases have dropped by 13.53 percent over the last seven day period. We would still require a drop in cases of about 50 percent to move from high to substantial which is the next category down.

I had my booster dose of Moderna vaccine last week. I had fewer side effect symptoms with the third half dose than I did with the second full dose.

Now that we are looking at COVID-19 immunization for children, it raises questions. Most children with COVID-19 infections have mild cases. Some do not. There are some undesirable side effects to the vaccines. The result is that we look at the risks, benefits and alternatives.

The risk of getting the vaccine is related to side effects. So far the vaccine has been studied in about 5,000 children. Mild side effects are common but not of concern. About 40 percent get fatigue. About 25 percent get headache. About 11 percent get muscle pains. Fever, chills, and joint pain are all between five and 10 percent. Rare side effects might not appear until more children have the vaccine.

The benefits to the vaccine are a little clearer. It will prevent severe cases of COVID-19 in that age group. It would prevent the generalized inflammatory disease that occurs in one out of 3,000 children in this age group. It would also prevent long COVID in children.

The alternatives are similar to what they are for adults. Children can get the vaccine. If they do not, they will likely get the infection. The question is whether the risks outweigh the benefits when more patients are vaccinated. That is likely a question that will only have an answer over a longer period of time.

An antidepressant called fluvoxamine (Luvox) has shown a decreased rate of hospitalization in early studies. It is an oral medication. It needs to be taken early in the illness. The number of patients studied so far is still small. The initial decrease is hospitalization rate is modest. It reduces hospitalization by 31 percent. There is more to come on this drug.