Category Archives: infections

Ticks

Ticks and spiders are both arachnids, but their method of attacking the skin is very different. While a spider merely bites, a tick burrows under the skin to gorge itself on blood. Sometimes ticks on the body can go unnoticed for a few days, which is why it is important to do a body check of your kids when they have been playing outside in the spring and summer. Ticks like hiding places— under your child’s hair, between the toes, etc. After it is finished feeding, the tick will drop off the body.

How to remove a tick? Very carefully! See this brief description from the Centers for Disease Control and Prevention (CDC) about safe removal.

There are a few tick-borne diseases that can be very serious.

Rocky Mountain spotted fever (RMSF) is carried by the dog tick or wood  tick, which is usually about a quarter inch long. The disease is caused by a particular type of bacteria, and the symptoms, according to an American Academy of Pediatrics ( AAP) article, include: “Flu-like symptoms such as fever, muscle pain, severe headaches, vomiting, nausea, and loss of appetite. A rash develops in most cases of RMSF, typically before the sixth day of the illness. This rash tends to appear first on the wrists and ankles, but within hours it can spread to the torso. It can also spread to the palms of the hands and soles of the feet. The rash is red, spotted, and raised. Other symptoms may include joint pain, stomach pain, and diarrhea. In severe cases, the blood pressure can drop and the patient may become confused. As the infection spreads, many organs, including the brain, can be affected.”

If your child has any of these symptoms and you suspect a tick bite, call your pediatrician immediately.

Lyme disease is most common in the Northeast, North Central, and West Coast states. It is spread by deer ticks. The most common symptom is what is sometimes called a “bull’s-eye” rash. This rash is a pink or red circle that can expand over time, even to a diameter of several inches. Another AAP article lists further symptoms:

  • “Headache
  • Chills
  • Fever
  • Fatigue
  • Swollen glands, usually in the neck or groin
  • Aches and pains in the muscles or joints.”

Lyme disease is very treatable in most cases, but if left untreated can cause long-term health problems.

There is also another tick-borne disease that presents itself a little like Lyme disease. It’s called STARI (Southern Tick-Associated Rash Illness) and is most prevalent in, as you may guess, more southern states like ours. The organism that causes this disease is, as yet, unknown, but it is carried by the lone star tick. The rash is similar to the one caused by Lyme disease (see above) and other symptoms according to the CDC include “fatigue, fever, headache, muscle and joint pains.” If your child presents with any of these symptoms and you suspect she has been bitten by a tick, contact your pediatrician immediately. For easy-to-read information about STARI, there is a good series of short articles from the CDC here.

Use insect repellent and avoid places where ticks live, when possible. Have a safe and enjoyable rest of the summer and fall!

© MBS Writing Services, 2015, all rights reserved

Spider bites

Both spiders and ticks are common in our area. We’ll deal with ticks next time.

While most of their bites aren’t dangerous to most people, it’s good to be informed about different types of spiders, their bites, and diseases that might result from some of them.

Spiders use a venom to anesthetize and paralyze their tiny prey. The venom from most species is not dangerous to most humans (see below for exceptions). Watch for signs of infection and report those immediately to your pediatrician. If you are concerned that a bite is getting much larger, note the edges with a Sharpie marker so you can see if it’s continuing to grow.

The female black widow spider can be extremely poisonous to humans, sometimes even fatal. She has an hourglass shape and is dark colored with yellow or red on her abdomen. Symptoms can be severe muscle cramping and pain. Call EMS if you think someone has been bitten by a black widow spider.

The brown recluse spider is fairly common in Kentucky, and can also be fatal at times. People often don’t know they’ve been bitten until the bite starts to swell and get painful. Reactions greatly vary. Call EMS if you are concerned about a brown recluse bite.

According to this article by the American Academy of Pediatrics (AAP), here are things to watch for after a spider bite, and a signal to call your pediatrician or EMS:
• “Tiny fang marks
• Pain
• Pain begins as a dull ache at the bite site
• Pain spreads to the surrounding muscles
• Pain moves to the abdomen, back, chest, and legs
• Blister at the bite site
• Mild swelling and a blue-gray mark at the bite surrounded by lightening of skin color
• Progressive soft tissue damage; the skin becomes dark blue and then black (necrotic).”

Wash the affected area with soap and water, and treat a bite with an ice pack (make sure you put a layer of cloth between the ice pack and the skin) Another resource for your questions about spider bites is the Poison Control Center.

As with anything, whenever you have a concern, call our office.

© MBS Writing Services, 2015, all rights reserved

Roseola

Let’s say this first: anytime your infant or young child has a fever of 102°F for twenty-four hours, call the pediatrician.  The issue may be minor or serious, and the doctor should help you determine what it might be.

One possibility is roseola, usually not a series condition, which is yet another in the herpes family of viruses.  (It is not the same as the herpes strains that cause genital herpes or cold sores.)  It’s human herpes virus 6 (HHV-6) and is relatively common in children aged six months to two years.

Symptoms, in addition to the fever (which may last up to a week), may include a cough and runny nose, less appetite and mild diarrhea.  Finally, after the fever is gone, generally a slightly raised red rash will appear.  It usually starts on the torso before spreading to the rest of the body.

Roseola is contagious, and a child with a fever should be kept away from other youngsters until the fever is gone.  Once roseola is at the rash stage the child is no longer contagious and can return to daycare.  The incubation period is one to two weeks.

If the pediatrician suspects roseola in your child, you might be asked to treat the fever with age-appropriate doses of acetaminophen (always be sure to check dosing instructions and note that they have changed in the last few years) and keep him hydrated.  The doctor may want to talk to you again to make sure the child isn’t sick with something more serious.

You can find out more about roseola in the two articles from which our research was drawn, here and here.  Both articles were published by the American Academy of Pediatrics.

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Fifth disease: What is it? When to call the doctor.

 

Fifth disease was given its name because it’s the fifth in a list of viruses that can cause rashes in children (the other four are chicken pox, rubella, measles and roseola). Its other name is Parvovirus B19. This might sound a little scary to you, since you may have heard of a canine parvovirus that is very serious for dogs. While in the same family as the canine virus, Parvovirus B19 is only a human virus and cannot be transmitted either from dogs to people or from people to dogs. In children, Parvovirus B19—fifth disease—is relatively common and generally quite benign.

 

Fifth disease in children is not usually dangerous, unless the child has anemia or an autoimmune disease. It’s contagious through the droplets of coughing and sneezing or through saliva (or from a pregnant mother to her fetus), and can show up 4 to14 days after exposure. Frequent hand washing is the best way to reduce the spread of viruses.

 

The first symptoms are similar to those of a cold: runny nose; mild fever; itching; soreness; headache. A few children experience achy joints.

 

After a week or so, a red rash may appear on the cheeks. It may, over the next few days, also appear on the torso and arms, buttocks and thighs. Within another week, the rash will likely fade. It might return, even months later, when the child gets overheated. By the time the rash appears, the child is no longer contagious.

 

When should you call our office? If your child has anemia, especially sickle cell anemia, or an autoimmune condition, call right away. Fifth disease can be dangerous for these patients. Also, if your child develops joint swelling or if symptoms worsen over time instead of improving, call us.

 

In normal cases, we treat symptoms with acetaminophen to reduce fever, or antihistamines to control itching. However, sickle cell patients and some others may need to be hospitalized because the blood counts can be seriously compromised. A pregnant woman with fifth disease should also be seen by a physician, because serious complications can occur.

 

Most of the information in this article came from the American Academy of Pediatrics article on the subject, which you can read here.

 

Fifth disease is more common late winter through spring, so you may want to keep an eye out for it this time of year. The good news is that most children will develop only mild symptoms that will go away without treatment.

 

 

 

© MBS Writing Services, 2015, all rights reserved

 

 

Appendicitis

Do you ever wonder whether abdominal pain warrants a call to the doctor, or even a visit to the emergency room?  How can you tell?

One worry with children and teens is appendicitis.  The appendix is a small, tubular-shaped organ in the lower right abdomen, that has no known function.  Sometimes it can become inflamed and needs to be surgically removed.  If left alone, an inflamed appendix can rupture and cause very serious illness.

Appendicitis can occur at any age, and is often difficult to diagnose.

The American Academy of Pediatrics has a great article here about appendicitis.  The main symptom is pain, which begins as a “vague stomachache near the navel,” and then is described as a combination of a sense of fullness and pressure on the lower right side.  Here is the complete list of symptoms they give, some of which are similar to stomach viruses, and some of which are different:

  • “Persistent abdominal pain that      migrates from the midsection to the right lower abdomen
  • Nausea and vomiting
  • Constipation
  • Gas pain
  • Diarrhea
  • Low fever, beginning after other      symptoms
  • Tenderness in the right lower abdomen
  • Abdominal swelling
  • Elevated white blood cell count
  • Appetite loss.”

Call your doctor immediately if your teen or child experiences these symptoms.  Have him lie quietly and “don’t offer water, food, laxatives, aspirin or a heating pad.”  Any movement can increase her pain.  If appendicitis is suspected, a blood test (to determine white blood cell count) will likely be taken, possibly with other diagnostic tests.

 

© 2014 MBS Writing Services, all rights reserved

 

E. coli and other nasty things: how to have good food safety for your cookout or picnic

The holiday weekend approaches, with plans for picnics, cookouts, reunions, and fun!  At the same time we’re hearing about a recall of nearly 2 million pounds of ground beef that is possibly contaminated with E. coli bacteria.  How can you be sure about the safety of the food you’re serving your family?

You are right to be cautious.  Foodborne illnesses can be very serious, even deadly.  E. coli, in particular, can cause organ failure, and children may be especially vulnerable.

Here are some basic rules to keep in mind.

  • Cook ground meats ALL the way through.  Pink interiors mean raw meat, and when that meat is ground, microbes that used to be on the surface of the meat can now be deep inside it.  If the meat is fully cooked, any E. coli should be taken care of.
  • Cook poultry completely through.  Chicken, in particular, can be contaminated with Salmonella.
  • Don’t reuse the plate that held raw meat or poultry.  It must be washed before being used to hold cooked meat or other foods.  The same goes with knives and other utensils.
  • Keep food separate.  Fruits and vegetables shouldn’t be stored in the same container with uncooked meat and poultry, for example.
  • Chill leftovers soon.  This is important when you’re at a picnic and far from your refrigerator.  Take a cooler and ice packs.
  • Keep your hands clean.  Wash them often.  Take hand sanitizer on your picnic.  Don’t change a baby’s diaper while preparing food.
  • Wash your fruits and vegetables.  When you clean poultry in the sink, be sure to sanitize the sink afterwards so that you don’t contaminate food, dishes and utensils.

More information is available here from the Centers for Disease Control and Prevention.

A fun holiday is a safe holiday.  Enjoy the time together and have a great weekend!

© 2014, MBS Writing Services, all rights reserved

Stomach virus recovery

“Stomach bugs” are making their rounds right now.  Rotavirus, in particular, is quite contagious and may have even made the rounds through every member of your household.  It causes diarrhea, vomiting, stomach pain, etc.  Sound a little too familiar?

What to do?

According to the American Academy of Pediatrics, usually, the virus goes away on its own.  Watch, though, for dehydration and high fever.  Dehydration can be serious in a small number of cases.  Give small amounts of fluids until the vomiting ceases.  Water is fine, but fluids like Gatorade can add electrolytes.  Stay clear of acidy drinks (like orange juice) and milk.

Be watchful regarding dehydration.  Pay attention to the frequency of urination.  The urine will become more concentrated and less frequent, but child should still be urinating.

While your child is sick, give a very bland diet:  avoid dairy, fried foods, fast foods, hot dogs, etc.  Some good foods are bananas, rice, applesauce and toast (BRAT).

However, it’s recommended that as soon as the stomach is settled, you should return to a balanced diet of fruits, vegetables and protein (meat, yogurt).

Call the pediatrician if diarrhea and vomiting don’t subside within three days, if there’s been no urine output for 10 hours, or if the fever is high or doesn’t subside.  See our blog about when to be concerned about a fever.

As always, stay healthy!

 

© 2014 MBS Writing Services, all rights reserved

Flu vaccinations are working

Having encouraged all of you to be vaccinated against the flu, we think this is a good time to give you a local update.

Here are some very interesting statistics:

  • So far this season, Georgetown Pediatrics has administered 4200 doses of flu vaccine, including both shots and nasal mist.
  • We have had 76  positive flu tests in our office.  Of those 76, one was influenza type B, one was both influenza A and B, and 74 were influenza type A (H1N1).
  • Only 22 patients who received flu vaccine in our office also tested positive in our office for the flu.  Of course, some patients may have been diagnosed with the flu elsewhere or had the flu and weren’t diagnosed at all, or some may have received the vaccine elsewhere.  Even so, we are happy to note that only 1 in 190 patients who received our vaccines tested positive for flu here.

 

The bottom line is that flu vaccine works.

Something else you should know:  it isn’t too late to get the vaccine.  Even if you’ve already had the flu, it was likely type A, and you can still contract type B.  Both types are covered by the vaccines.  Once kids are back in school after these snow days the virus is bound to be spread more.
We often see cases of influenza B all the way until spring break, so don’t hesitate to come in.  Just remember that if you receive the nasal mist you will test positive for the flu for about two weeks, because it’s a live vaccine and the test is a nasal swab.

As winter drags on, you may not be able to stop the snow and ice, but you can certainly lower the risk of your family getting the flu.

 

© 2013, MBS Writing Services, all rights reserved

Medical websites you can trust

As we enter 2014, many families will decide to be healthier this year.  One way to be on top of your health is to be knowledgeable.  The problem is that there is so much information out there, it can be overwhelming.  Even worse, a lot of the advice is misleading, incomplete, trying to sell a product, or just plain wrong.

What to do, then, if you’re looking answers to your pediatric health questions?  We have a few sites we trust that you may find helpful.

Your first stop should be here, on our own website.  There you’ll find 21 links that we trust to provide good information, on everything from general health and pediatrics to a few common illnesses and conditions, such as allergies, asthma, and disabilities.  Here are a few of the best:

  • American Academy of Pediatrics.  If you read our blog, you know that we refer to the AAP regularly.  They are the go-to organization for reliable information on the health of children and teens, including physical, social, psychological, and intellectual health.  Some of their pages are full of statistics and medical jargon, but check out healthychildren.org.  It’s very readable, practical, and up-to-date. You can search your topic or question by typing it into the search box.
  • The National Institutes of Health has a huge amount of information.  Some of it is written for health professionals, but much of it—particularly the medline plus section—is also written for the general population.  It’s a great source of health information for all ages, birth to old age.  You can even sign up here to receive e-mail updates on children’s health topics.
  • The Centers for Disease Control and Prevention gives you an alphabetized list of topics and diseases for your research.

If you have a particular issue you’re interested in researching, check with your pediatrician, who can suggest additional specific resources.

Happy internet hunting, and Happy New Year!

Artwork by Audrey

Artwork by Audrey

 

© 2014, MBS Writing Services, all rights reserved

Keeping Healthy

Cold and flu season is here.  It arrives with colder weather as people spend more time indoors, in close quarters, where germs are more easily passed from one person to another.

Here are just a few reminders of how to help keep your family healthy.

  • Wash hands.  Good old soap and water are still the best protection against contagious diseases that get passed through touching surfaces, shaking hands, etc.  Get your family in the practice of washing their hands often.  When soap and water are not handy, use hand sanitizer.
  • Get plenty of sleep.  Being well-rested keeps your immune system stronger.
  • Don’t share.  Okay, you teach your kids to share, but some things ought to be for just one person.  Water and soda bottles, lip balm, musical instruments all fall into this category.  If you have a youngster in child care, make sure the provider sanitizes toys and tables daily.
  • Cover.  Cough or sneeze into a tissue.  If there’s no tissue, use the crook of your elbow instead of your hand.  Germs on the hand are more easily transferred to other people or surfaces.

Already have a cold?  Continue to do all the above, and make sure you stay hydrated.  Drinking plenty of fluids keeps mucous thin and your throat moist.  Avoid caffeinated beverages.

It’s going to be a long winter, and your family will likely get colds at some point.  Use the common sense advice above, and you may have fewer of them.

 

artwork by Kennedy

artwork by Kennedy

© 2013, MBS Writing Services.  All rights reserved.