I was recently involved in the care of a 17 year-old boy in our practice who had meningococcal meningitis. Meningococcal meningitis is a rare bacterial infection, but meningococcal disease continues to cause 75-125 deaths/year in the U.S. ...
An article in the news caught my eye today when I noticed that The World Health Organization (WHO) called an emergency meeting to discuss the infectious disease known as MERS (Middle East Respiratory virus, formerly known as nCoV). ...
I have been receiving a lot of calls, emails and questions on twitter regarding Michael Douglas' admission that his oral cancer was caused by HPV.
Coxsackie virus is rampant once again! I have seen too many kids to count (TMKTC) with symptoms of coxsackie virus and the classic skin rash associated with hand, foot and mouth disease. Many parents are telling me that their day care centers are having outbreaks which is what typically happens at this time of year.
Like many viruses, coxsackie can make some children quite miserable, while others have very few symptoms but never the less are contagious and shed the virus to others. Viruses are just plain ole contagious, even with the best precautions to help prevent spreading the illness. Best prevention continues to be hand washing!
The classic symptoms of hand, foot and mouth disease are a fever, sore throat, and a rash which looks like small red spots or even a bit of a blister, occurring on a childs palms, soles and often in their throats causing pain. We are also seeing many children who have a rash on their buttocks, and legs as well. The rash is often confused for a diaper rash if there are no other associated symptoms.
Coxsackie virus typically lasts from 3 -7 days. While some children are terribly cranky and uncomfortable and will even drool rather than swallow their own spit, other seem to not even notice the rash on their hands or feet. The treatment is totally symptomatic, which means acetaminophen or ibuprofen for fever and discomfort and keeping your child hydrated.
Most kids don't have a great appetite when they have a sore throat (do you?), so I am a big believer in popsicles, Slurpees, ice cream, fozen yogurt, shaved ice.....the list is long. You just want to make sure your child is h
Another on call weekend just completed, and it seems that gastroenteritis, also known as the tummy bug or stomach flu (whatever term you want to use) which causes vomiting and diarrhea, is still around. I walked into a lot of exam rooms with tired parents and kids all of whom had been vomiting and having diarrhea, not a fun weekend for a family at all. The most likely culprit is norovirus.
Norovirus causes about 21 million cases of gastro per year and leads to about 70,00 hospitalizations. You can get norovirus at any time of the year but it is most commonly seen during the winter, and it seems to be hanging around into early spring this year. This has been a particularly bad year for norovirus as there was a new strain so even more people seemed to get sick. That includes my own husband!
Norovirus is the leading cause of gastroenteritis in pre-school children. In a recent study, about 21% of the cases of acute gastroenteritis in children younger than 5 were due to norovirus. That compares to 12% due to rotavirus which used to be the primary cause of viral gastroenteritis. Since the introduction of rotavirus vaccine over 5 years ago the rates of rotavirus disease have steadily been dropping, and now norovirus has taken its place! You know those viruses, they are smart.
Norovirus causes inflammation of the lining of the stomach and intestines resulting in severe nausea, vomiting and diarrhea. These symptoms begin soon after exposure and typically last 1-3 days. Many children will also run a low grade fever (around 101) and complain of tummy cramps.
The only treatment is symptomatic: begin frequent sips o
Do you have a teenager? If so, have they received their HPV vaccine?
HPV stands for Human Papilloma Virus, which may cause cervical and penile cancer, oral cancers and genital warts. There has been a vaccine available since 2007.
A recent study in the journal Pediatrics looked at vaccination rates for teens and the HPV vaccine. While 80% of teens are receiving their Tdap booster, and 63% of teens are current on their meningococcal meningitis vaccine, only 32% of teens have received all 3 doses of HPV vaccine.
Parents whose teenagers had not received a first HPV vaccine or completed the series often said that the vaccine was not needed or necessary.
Other parents whose children had not received the HPV vaccine and who did not intend to vaccinate their children stated that they were worried about the safety or side effects of the vaccine.
The HPV vaccine has had a good safety record and has been shown to be very effective in preventing HPV infections. The vaccine has been studied in the United States for amost 7 years, and in Europe and Australia for almost 10 years.
The vaccine does not treat HPV disease, but rather prevents it, so the vaccine needs to be given to adolescents prior to any exposure to the virus. While many parents feel comfortable discussing sexuality with their children, other parents are uncomfortable with vaccinating their children for a sexually transmitted disease.
Getting parents to complete the series (which is given over a 6 month period) has also been a hurdle and the vaccine is not effective until all 3 shots in the series has been completed.
If you have questions about the HPV vaccine, talk to your doctor in order that all of your questions can be answered. I know I have given my 3 children the vaccine and encourage all of m
Flu Frenzy is rampant in Dallas and across the country. It is a very busy flu season and it did start earlier than usual in the southern part of the country. Texas has been hit especially hard. I started seeing flu cases in my office at the end of October.
But, with that being said, if you look at flu statistics over the past few years, January and February are typically the peaks of the flu season. I know that these are usually the busiest months in the office and it seems like there is not a child who doesn't have a cough or cold and many have a fever lasting a few days. Don't panic!
We have been lucky for several years to have had a light flu season, so this year's flu season does seem worse. Fortunately, the majority of children we are seeing with flu symptoms are handling the virus very well (like many childhood viruses) and actually do not appear to be too sick.
The children I am seeing are running 2-4 days of fever, many as high as 102 or 103 degrees, which is not unusual with the flu. They have coughs, congestion and scratchy throats and the older kids are complaining of feeling achy as well. But they are also still drinking fluids, appear well hydrated, and when their temps come down with the help of acetaminophen or ibuprofen, they play, watch a movie, or even run around our waiting room. With a practice of 13 pediatricians we have literally seen hundreds of kids with the flu (both types A and B) but we have not had to hospitalize anyone!
Parents always want to watch their children for respiratory distress or for prolonged fever, but most of the children may be treated symptomatically. Remember fever is your friend, and higher temps do not necessar
Fever blisters are fairly common and are also often called cold sores, but have nothing to do with a cold. These sores typically appear on the outside of the mouth, on the lips. The majority (about 95%) of fever blisters are due to a virus, typically herpes type 1. Because the fever blister is due to a virus they are contagious and most people will be exposed to the virus during their lifetime. Children are typically exposed via contact from an adult, a sibling or a relative who has a fever blister, or by other children who have mouthed toys etc that may have been contaminated with the virus. In many cases the exposure may be asymptomatic while others will develop painful vesicles appearing both inside the mouth, on the tongue and gums, as well as on the lips about 3 -5 days after their exposure. This initial illness is called herpetic gingivostomatitis. The initial infection tends to be more uncomfortable and may take up to two weeks for the lesions to resolve. The most difficult problem is due to oral discomfort so it is important to make sure that these young children stay hydrated. Popsicles are often helpful for this. Once you have been exposed to the herpes virus the virus remains in nerve endings where it may be dormant and asymptomatic for years. About 60% of children are positive for HSV -1 by adolescence. At other times the virus may become active (times of stress, sun exposure, fever, menstrual periods) and result in a fever blister. If a child develops a fever blister, they too are contagious and may spread the virus to others by touching or picking at the lesion and then touching other people or objects with their mouths. Fever blisters may be treated in most cases by using a topical antiviral that may be applied to the lesion. These are prescription medications that may shorten the duration of the fever blister by a day or two, especially if started early and applied frequently. If children experience recurre
Today kicks off Get Smart About Antibiotics Week, which was developed by the Center for Disease Control (CDC) to educate everyone about the overuse of antibiotics.
Antibiotic prescribing is highest for young children. But, antibiotics need to be used appropriately in order to ensure that drugs are effective, as well as to prevent antibiotic resistance. The whole country is just entering the cough and cold season and most of these illnesses are caused by viruses. ANTIBIOTICS can only cure bacterial illnesses - not viral illnesses.
Taking an antibiotic for a viral illness will NOT cure your child's cough and cold, nor will it help your child feel better any faster, and it will NOT keep others from catching your child's viral illness. These viral illnesses include colds, influenza (flu), RSV, most sore throats (unless strep) and even most sinus infections. Not even all ear infections may need an antibiotic to resolve, especially in children over the age of 2-3 years.
Although many people believe that green mucous means a bacterial infection, as your body's immune system works to fight off a viral upper respiratory infection mucous can change color. It is quite common for the color to change from clear, to yellow to green before the viral infection resolves. This does not mean that a child (or adult) needs an antibiotic.
Lastly, while antibiotics may be life saving, there are potential complications that can occur when taking an antibiotic, including tummy aches and diarrhea as well as serious allergic reactions. You want to only take antibiotics when really needed.
I have spent the last 2 weekends on call and already feel like I have seen a million green runny noses, including my own!! But a little saline nose rinse, lots of kleenex, some steamy showers and time will work for the majority of us. Almost every parent asks me don't you have something else t
The weather has been up and down all over the country with some unseasonably hot days, followed by cold days and then warm days in between. At the same time lots of people are experiencing the first colds of the fall season. Funny, I continue to hear the reason I am sick is this weather, hot and cold, up and down, just makes you sick!
But, I am sure that you really do know that the weather change does not make you sick. That seems to be a long-standing old wives tale that my grandmother used to tell us as well. She would also say, don't go to bed with a wet head or you will catch a cold.
The change in weather does not cause illness. It may mess up your wardrobe choices, or cause a last minute change in birthday plans when your outdoor party is moved indoors due to a 30 degree drop in temperature, but it will not cause an illness.
The truth is that viruses live better in cooler weather. Children are spending more time in together in a classroom sharing knowledge and germs. As the weather turns cooler, wetter and gloomier, we all tend to move from outdoor activities to indoor activities. The combination of all of these factors suddenly converge and viral upper respiratory season arrives.
Bottom line: it is not the change in weather that is making you catch a cold, but rather the usual respiratory viruses that are back as the seasons change. It is just the beginning of the cold season, so despite ups and downs with temperatures, the best protection is not a coat, but rather good hand washing and covering those mouths when you cough. Personally, I love this weather; every day is different!
Fall weather is finally here across most of the country and with the new season, and school back in session, the first fall colds have hit. I am already seeing a lot of runny noses and coughs, many of which are in the toddler and preschool set who still haven't learned to cover their mouths when coughing (don't worry, not yet age appropriate behavior, it takes some time to learn).
With the common cold, or upper respiratory infection it is also not uncommon to have a sore throat. Many parents worry that every sore throat is strep throat which is a bacterial infection. A new article in the journal Clinical Infectious Disease published guidelines for doctors to help determine when it is appropriate to test for strep throat and use antibiotics when strep is confirmed.
Studies have shown that up to 70% of patients who complained of a sore throat received antibiotics which are not necessary when the sore throat is due to a viral upper respiratory infection. Strep throat is most common in children, where it accounts for between 20-30% of sore throats (and only 5-15% of adult sore throats). Strep is less common in children under the age of 3 years, and is most common during the elementary school years.
Most viral upper respiratory infections cause runny nose, coughs, sore throat, hoarse voices and the symptoms develop over several days. In the case of strep, there is usually a rapid onset with a fever and cough and runny nose are not present. The child typically has very swollen and tender nodes in their neck as well.
If a child is suspected of having strep throat a quick throat swab should be taken and a rapid strep test should be performed. These tests are performed in almost every doctors office. If the swab is negative for strep it may be sent for overnight culture as well. Even the most seasoned doctor is not always correct in assuming a beefy red throat is strep.