Sarah Michelle Gellar: How to Protect Your Baby From Pertussis

You do the most you can to keep your baby healthy and safe. You ask people to wash their hands before holding them. You feed them the healthiest food. But did you know that there’s one big thing you should be doing to protect your baby? Make sure parents, grandparents, and older children have gotten their booster shots to protect against whooping cough, a highly contagious disease that can be deadly for young infants, says actress Sarah Michelle Gellar, who is a a spokesperson for Sounds of Pertussis.

Pertussis is the germ that causes whooping cough, and there have been a big rise in cases in recent years due to a combination of factors, including waning immunity and inadequate vaccination. In 2012, the Centers for Disease Control and Prevention  reported more than 48,000 cases of pertussis in the United States, the most cases in 50 years.

Many adults and grandparents are unaware that their booster shots wane over time (between 5-10 years), so they don’t necessarily know that they need an extra immunity boost, too. “When they trace back how a child got it, 80% of the time it comes from the direct family member,” Gellar says. “And 50% of the time it comes from the parent. You could potentially be coughing on your child, and it could potentially be fatal.”

Pertussis is highly contagious and can cause a cough so severe children may throw up or struggle so hard to breath their lungs make a “whooping” noise as they try to inhale between coughing bouts. Most children get vaccinated (pertussis is the “P” in the DPT shot), but infants don’t get their first dose until 2 months of age. And unfortunately, babies are the most vulnerable to the germ (there were 18 pertussis-related deaths in 2012, most in babies under 3 months).

That’s why it’s so important to protect them by making sure vaccines are up-to-date for all the people around them, says Gellar. “It’s not necessarily the forefront of conversation,” Gellar said. “I am fortunate that I have a doctor that I’m extremely close with and brought it up to me. “

Gellar teamed up with March of Dimes and a vaccine company to create the Sounds of Pertussis website, so parents can recognize what a pertussis cough sounds like. (There is also a Facebook app called the Breathing Room, where you can find local healthcare facilities that provide pertussis vaccinations.)

Gellar and her mother, Rosellen Gellar, have also teamed up to launch the website Grandparents’ Corner, a place for grandparents to easily find information on pertussis and make sure they’re protected so that they don’t accidentally spread the bacteria to a grandchild.

Gellar, an Emmy Award winning actress and mother is also making headlines for her come-back role in the new TV comedy show, “The Crazy Ones,” where she co-stars with Robin Williams. The show premieres tonight at 9|8c on CBS.

Measles Outbreak Hits New York City

The New York City Department of Health announced that it’s investigating a measles outbreak in Manhattan and the Bronx. As of Friday, 16 cases had been confirmed, 7 of them adults and 9 children. Four people have been hospitalized as a result of the highly contagious viral infection, which causes symptoms including a blotchy rash, fever, cough, and runny nose. That’s on the heels of the announcement last month that a UC-Berkeley student might have exposed others in the Bay Area to measles (there have been at least 15 cases confirmed in California this year), not to mention outbreaks last year in Newark, Texas, and Brooklyn.

All this for a disease that had been declared “eliminated” in the United States between 2000 and 2011—meaning it wasn’t continuously transmitted—according to an article published in December in JAMA Pediatrics. But the virus is making a comeback: The Centers for Disease Control and Prevention said there were 175 cases of measles reported in the U.S. in 2013, almost triple the usual number of 60. Which is scary news since measles can lead to complications like pneumonia, dangerous brain inflammation known as encephalitis, and miscarriage. The CDC believes that the spike is the result of unvaccinated people getting infected overseas, where measles is more common, and bringing it back to their communities.

This latest news hits home for me—literally. I live in one of the neighborhoods affected by the current NYC outbreak. I’m also a mother of two young children, and serious complications from measles are more common in children under 5. So I can’t deny that I panicked a little when the news popped up in my Facebook feed.

However, this outbreak reinforces for me—both as a parent and a health journalist—the importance of vaccination. According to news reports, four of the infected children in New York were too young to have been vaccinated, and the parents of two other children opted not to have their children vaccinated. (The CDC recommends that children get one dose of the MMR [measles, mumps, rubella] or MMRV [measles, mumps, rubella, varicella] vaccine at 12 to 15 months, and a second dose at 4 to 6 years.) Several of the adults who were infected could not confirm that they had been vaccinated. There are many myths and fears about vaccines out there, but the fact remains that most of the people who get this disease are unvaccinated. By vaccinating, you’re protecting not only your own family, but people in your community who are too young to get the shot (those babies!) or who can’t be vaccinated for health reasons.

I’m glad that both of my children have been vaccinated on schedule. My older child is school-aged and is fully vaccinated against measles. My younger child is a toddler and has received one of the two doses. Though that single dose of MMRV may have given him enough protection against this outbreak, his pediatrician is recommending (in accordance with the NYC Department of Health) that all local patients get the second dose immediately. He’s getting it today—we’re not taking any chances.

Jeannie Kim is the Executive Deputy Editor of Health magazine.

 

8 Things You Didn't Know About Hepatitis

If you’re like most people, you probably don’t give your liver a second thought. But it’s a pretty essential organ, tirelessly breaking down fats, scrubbing your blood of alcohol and other toxins, recycling blood cells, and more. That’s why anything that messes with it can be kind of scary. And one liver condition in particular is a big problem.

An estimated 4.4 million people in the United States and nearly 400 million people worldwide have chronic viral hepatitis, which is caused by a bunch of different viruses that can inflame the liver and affect its ability to function. Hepatitis is the eighth largest killer in the world and just one type, hepatitis C, kills more Americans than HIV. Since today is World Hepatitis Day, here are a few more facts to clue you in on this condition:

Not all forms are related to risky habits

You’ve probably heard that actress Pamela Anderson has hepatitis C, which she says she contracted after sharing a tattoo needle with former husband Tommy Lee. But not all types of the virus are spread through direct exchange of bodily fluids. Of the five different types of hepatitis, some viruses spread through contaminated food or water (more on that below), while type B travels through blood and body fluids, and type C through blood alone. In many cases, the liver can fight the infection on its own, but some can turn into chronic infections with long-term health consequences. As of now, vaccines only exist for types A (which causes food poisoning, but goes away) and B.

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Most people don’t realize they have it

Sometimes hepatitis can be hard to detect because it starts out with mild, flu-like symptoms including fever, fatigue, and body aches. (Other symptoms include dark urine and vomiting.) It can take weeks or months before you see things like skin rashes, loss of appetite, weight loss, and the trademark yellowing of the skin and eyes known as jaundice. But for some people, these symptoms may take years to develop—or they won’t show up at all, particularly when it comes to hepatitis C, says Douglas Dieterich, MD, a professor of medicine and a specialist in liver diseases at the Icahn School of Medicine at Mount Sinai. Up to 3 in 4 people with hepatitis C don’t know they have it, according to the Centers for Disease Control and Prevention. “That could be because with the acute infections [like hepatitis A], people may have a larger immune response that causes inflammation which would bring the symptoms out,” Dr. Dieterich says. “Whereas the immune response with a chronic infection might be smaller so you don’t see many symptoms.”

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Germy water and food are risky

Hepatitis A and E are both considered acute viral diseases: that is, most people recover completely without long-term damage. However, the infections can be more serious in people who already have liver diseases. Both viruses are transmitted by what’s known as the fecal-oral route: that is, eating food or drinking water that’s been contaminated by the feces of someone who has the virus. This is especially common in places with contaminated food or water or sites with flooding. While hepatitis E is rare in the U.S., Americans aren’t in the clear when it comes to either infection. For one, if you plan to travel to countries with poor sanitation, you’ll want to make sure you practice good hygiene, including washing your hands after bathroom trips, drinking purified water, and avoiding uncooked foods—specifically meat from pigs, boar, and deer. These animals can carry the hep E virus, and the CDC warns that it’s possible to get the virus as the result of eating undercooked meat from infected animals. It’s best to be cautious when cooking: The FDA says to cook pork until it reaches an internal temperature of 145 degrees as measured by a food thermometer.

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Some forms can lead to cancer

Unless treated properly, inflammation from chronic hepatitis can lead to cell damage and, eventually, liver cancer. The CDC reported in 2010 that a type of liver cancer called hepatocellular carcinoma (HCC) was on the rise and that chronic hepatitis B and C infections accounted for an estimated 78% of HCC cases worldwide. “Most of the patients we see with liver cancer, the number one reason is chronic hepatitis C followed by chronic hepatitis B,” Dr. Dieterich says. And if you have a family history of liver cancer or your infection has caused internal, irreversible scarring from a condition called cirrhosis, your chances of developing cancer are even greater. Since it can be hard to tell if you even have hepatitis, it’s a good idea to get tested if you think there’s a chance you’ve been exposed, especially if you’ve used injected drugs, been on dialysis, had a blood transfusion before 1992, or were born between 1945 and 1965. Yes, baby boomers are the most likely group to develop hepatitis C, according to a 2013 report.

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Drinking alcohol can make it worse

While certain medications can help people manage hepatitis, lifestyle choices can affect how it progresses. For one, patients need to make sure they’re not drinking too much. “In both types B and C, alcohol definitely makes the scarring of the liver worse and progress faster,” Dr. Dieterich says. A study published in Alimentary Pharmacology & Therapeutics found that patients with chronic hepatitis C who had three or more drinks a day were five times more likely to die than heavy drinkers without the disease. Even those who had a moderate two drinks a day were still twice as likely to die. That’s why the CDC recommends chronic hepatitis patients receive counseling about alcohol use. And shedding some extra pounds isn’t a bad idea either, as a build up of fat in the liver can also lead to cirrhosis, Dr. Dieterich says.

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Pregnant women should be tested for one type

The most common cause of hepatitis B transmission globally is mother to infant, Dr. Dieterich says. So pregnant women should be screened for the virus when they receive prenatal care, according to the CDC. While infants born to mothers with hep B can be vaccinated right away and receive antibodies to help fight the infection, both can fail to prevent transmission up to 10% of the time if the mother already has high levels of the virus in her blood, he says. If you’ve had the hepatitis B vaccine, you should be protected from catching the virus and later passing it on to your child. But if you haven’t had it yet and want to get pregnant, now’s a good time to make the appointment.

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Two of the diseases are linked

People who already have chronic hepatitis B are at risk for becoming infected with a second virus, hepatitis D, also called delta hepatitis. That can be even more difficult to treat as delta does not respond well to the available medications. “It makes hepatitis B worse by far even when you treat the original condition,” Dr. Dieterich says. Some patients who contract it can experience a simultaneous infection with both viruses—not good if you want to avoid serious complications like liver failure. The best way to protect yourself is to get the hepatitis B vaccine, which is up to 95% effective at preventing infections, according to the World Health Organization. The CDC recommends the vaccine for all sexually active people who are not in long-term relationships.

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Treatments have evolved

In the past, Interferon has been the drug of choice to treat chronic hepatitis C, but the medication often has uncomfortable side effects, like nausea, diarrhea, fatigue, and muscle aches. But thanks to two recent FDA drug approvals—Sovaldi and Olysio—hepatitis patients have more reason to be optimistic about being able to eliminate the virus. While the pills can be used along with Interferon, most of the time they can be taken on their own. A recent trial treated patients using both Sovaldi and Olysio and found a 94% cure rate in chronic hepatitis C patients. “We can treat completely without interferon now,” Dr. Dieterich says. “And we have so many new drugs coming to help cure hepatitis C.”

State Farm Drops Rob Schneider Ad Over Anti

State Farm is pulling an ad featuring Rob Schneider after a social media campaign drew attention to the comedian’s anti-vaccination views and called on State Farm to drop him as a spokesperson.

The spot, starring Schneider as his classic “Richmeister” character from Saturday Night Live, was met with backlash from pro-science groups, who called on the public to call their State Farm agents, post on the company’s Facebook page, and tweet their protests. “State Farm provides health insurance, and nothing ensures public health more than getting vaccinated,” a video made for the campaign states.

In 2012, Schneider publicly lobbied against a California law requiring parents to meet with a physician before opting out of vaccines for their children, citing the widely discredited theory that vaccines cause autism.

In a statement to The Hollywood Reporter, State Farm said, “This particular ad has unintentionally been used as a platform for discussion unrelated to the products and services we provide. With that, we are working to remove the ad from our rotation at this time.”

In response, Schneider tweeted, “‘If the Freedom of Speech is taken away then dumb and silent we may be led, like sheep to the slaughter,’ George Washington.”

Watch the video from the anti-Schneider campaign:

What You Need to Know About the New Mumps Outbreak

Pro hockey players’ health woes usually involve concussions or broken bones, but three NHL teams are fighting an unexpected ailment: the mumps.

Two players on the Anaheim Ducks—Corey Perry (above) and Francois Beauchemin—were diagnosed with the old-fashioned viral illness, reports CBS Sports, and there are probable cases on the teams of the Minnesota Wild and the St. Louis Blues.

Mumps is a contagious disease that often starts with fever, headache, body aches, and fatigue, followed by swollen salivary glands, according to the Centers for Disease Control and Prevention (CDC). While often mild in kids, the sickness can be more serious in adults, with possible complications such as hearing loss, meningitis (swelling of the membranes that cover the brain and spinal chord), and testicular inflammation.

Wonder why we hardly ever hear about mumps? The illness is pretty rare these days, thanks to the MMR (Measles, Mumps, Rubella) vaccines given in childhood. Still, there’s been a spike in cases in 2014, with 1,055 reported so far, says Walter Orenstein, MD, President-Elect of the National Foundation for Infectious Diseases. That’s more than double the number seen in all of 2013.

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Part of the problem is that protection from some vaccines can wear off over time. With a growing number of American parents choosing to not vaccinate their children, and more people traveling internationally, the CDC recommends that adults born after 1957 who aren’t sure if they’ve been fully vaccinated get at least one booster shot as an adult. The two Anaheim players had indeed been vaccinated in childhood, according to tweets from Los Angeles Times reporter Helene Elliott, who interviewed the team doctor. The entire Ducks hockey team is receiving MMR boosters, just in case.

It’s key to make sure your own MMR shots are up to date, but not because you might catch mumps from a pro athlete; there’s been a big resurgence of measles in the U.S., with cases at a 20-year high. While you’re at it, look into your Tdap–Tetanus, Diptheria, Pertussis (whooping cough)—status, since whooping cough cases are also on the rise.

And as for that Outbreak on Ice: Ducks’ star Corey Perry has returned to action, as have the Blues players; the two defensemen on the Wild are still sidelined. With a 12-25 day incubation period, mumps could make more skaters sick (“It’s less contagious than measles but still very contagious,” says Dr. Orenstein). Hockey players famously don’t like to sit things out, though, so we’re guessing that more NHL teams will be rolling up their hockey-jersey sleeves for a protective shot in the arm.

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California Dad Asks School to Bar Unvaccinated Children to Keep His Son Safe

Things have gotten a little more heated in the vaccination debate, which was rebooted earlier this month after a measles outbreak was tied to unvaccinated children who visited California’s Disneyland parks.

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Now, one California parent of a 6-year-old in remission from leukemia has a strong message for parents against vaccinations.

Carl Krawitt of Marin County, near San Francisco, told NPR, “If you choose not to immunize your own child and your own child dies because they get measles, OK, that’s your responsibility, that’s your choice. But if your child gets sick and gets my child sick and my child dies, then … your action has harmed my child.”

Krawitt and his wife have emailed the superintendent of their son Rhett’s school to “require immunization as a condition of attendance, with the only exception being those who cannot medically be vaccinated,” reports NPR. While school officials are “monitoring the situation closely,” no official action is planned as of yet.

Rhett cannot receive a measles vaccination due to a weakened immune system. Until he’s back to full health, Rhett can only rely on the people around him to get vaccinated so they can’t pass the disease on to him, they said.

It’s a concept called herd immunity, meaning the more people who get vaccinated, the less likely a contagious disease is to spread to people–often the elderly, chronically ill, or infants–who can’t get a vaccine. Herd immunity also protects people who have been vaccinated. At least six people in the Disneyland outbreak had been vaccinated, according to the Centers for Disease Control and Prevention. Although vaccines protect against diseases, not everyone reacts well enough to be fully protected–so herd immunity can help them stay healthy too. At least 68 people from 11 states were reported to have measles, according to the CDC, including five who were too young to be vaccinated.

Unfortunately for Rhett and his family, they happen to live in a Bay Area county where many parents don’t believe in vaccinations or worry about the health risks–although numerous studies have shown vaccines are not associated with a risk of autism, a theory that has long been debunked. In fact, 7.8% of Marin County parents opted out of vaccines for their children last year, citing “personal beliefs.” That’s the highest in the Bay Area and one of the highest in the state, reports local public media outlet KQED.

Most of these opt-out policies still allow families to send their kids to school, despite being unvaccinated for measles, chicken pox, and whooping cough, another disease making a comeback.

“When your immune system isn’t working as well, it allows many different infections to be worse,” Rhett’s oncologist Dr. Robert Goldsby told NPR. “It’s not just Rhett. There are hundreds of other kids in the Bay Area that are going through cancer therapy, and it’s not fair to them. They can’t get immunized, they have to rely on their friends and colleagues and community to help protect them.”

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Even some doctor’s offices may be off-limits to unvaccinated children. This week, a Reddit user posted a photo from her pediatrician’s office with this message: Although I respect each person’s free choice, I have a bigger responsibility to all of the patients I care for. Because of this, the office no longer accepts new patients who have decided not to immunize their children.”

Still, even children who aren’t vaccinated require education and care. “After all, it’s the parents, not the children, who make the choice to avoid vaccines—what is my responsibility to those kids?,” notes Dr. Sydney Spiesel in an essay for Slate, written last March.

It’s a tricky question for many physicians and educators amidst a debate that probably won’t reach a conclusion for some time. The bottom line is vaccinations are the only medically proven way to give kids a chance to avoid a wide variety of dangerous infections.

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Newborn of Mom Who Posted Viral Anti

Finally, some good news about measles: The baby exposed to measles in a doctor’s waiting room whose story went viral is in the clear.

As Toronto-area mom Jennifer Hibben-White recounted on Facebook last week, she got a call from local public officials warning her that on January 27, both she and her newborn baby may have been in the vicinity of a measles patient in a waiting room. At the time, baby Griffin was just 15 days old, and not yet vaccinated (Hibben-White was). Officials told her to keep him at home, isolated, until yesterday, February 17, since measles has an incubation period ranging from 7 to 21 days.

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Hibben-White, who had previously lost a child to illness and also has a 3-year-old, famously took to Facebook to express her outrage toward anti-vaxxers in a post that’s been shared nearly 300,000 times, to date. As she ranted:

I’m angry. Angry as hell. I won’t get angry at or blame the person in the waiting room. I would have likely done the same thing…you get sick, you go to the doctor. I have no idea what their story is and I will never know. But I do know one thing:

If you have chosen to not vaccinate yourself or your child, I blame you.

I blame you.

You have stood on the shoulders of our collective protection for too long. From that high height, we have given you the PRIVILEGE of our protection, for free. And in return, you gave me this week. A week from hell. Wherein I don’t know if my BABY will develop something that has DEATH as a potential outcome.

DEATH.

You think you are protecting your children from thimerosal? You aren’t. It’s not in their vaccine.

You think you are protecting them from autism? You aren’t. There is no, none, nada, nothing in science that proves this. If you want to use Google instead of science to “prove me wrong” then I am happy to call you an imbecile as well as misinformed.

You think you are protecting them through extracts and homeopathy and positive thoughts and Laws of Attraction and dancing by candlelight on a full moon? You aren’t. I PROTECT YOUR CHILD. We protect your child. By being concerned world citizens who care about ourselves, our fellow man, and our most vulnerable. Se we vaccinate ourselves and our children.

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Yesterday, Hibben-White’s husband Glenn told CTV Toronto that the couple’s kids have not shown symptoms of the virus. Meanwhile, 16 confirmed cases of the measles have been reported in Ontario, with one in Toronto.

It’s been heartening to hear about the impact Hibben-White’s words have had. “People all over the world who were on the fence emailed me saying they saw my post and it made them look at the data for themselves, make an informed decision, and vaccinate their children,” she told The Daily Mail.

Still sobering, though, are the facts: The United States had a record number of measles cases in 2014—644 cases in 27 states reported to the Centers for Disease Control and Prevention. That’s the highest number of cases since measles was officially eliminated in this country.

So far, 141 cases of the measles have cropped up in 2015, federal health officials reported yesterday. The cases stem from the outbreak that started at two Disney theme parks in Southern California, with the majority of people who’ve gotten infected being unvaccinated.

Here’s hoping that the growing number of stories in the news about real babies and real children and real people affected by exposure, factually or potentially—like that father of a child with cancer who recently asked his California school district to ban non-immunized students—will start making those who’ve taken a stand against vaccines reconsider. It’s a matter of life and death.

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5 Old

Measles, tuberculosis, bubonic plague?! If headlines about old-time diseases on the comeback have you worried, you’re not alone. Here’s what you need to know to stay safe (and sane) amid recent outbreaks.

 

Plague

Think this notorious killer died with the Middle Ages? The disease actually persists in parts of Africa, Asia, and South America. And there have been 16 reported cases of plague, with four deaths, in the United States this past year. Most recently, a 16-year-old girl from Oregon was sickened and hospitalized after apparently being bitten by a flea on a hunting trip.

You can get plague from fleas that have carried the Yersinia pestis bacteria from an infected rodent, or by handling an infected animal, according to the Centers for Disease Control and Prevention (CDC). Bubonic plague is the most common form in the U.S., while pneumonic plague (affecting the lungs) and septicemic plague (affecting the blood) are less prevalent but more serious. Symptoms of bubonic plague include fever, chills, headache, and swollen lymph glands.

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The good news is that plague is extremely rare, has a very low risk of person-to-person transmission, and can be effectively treated with antibiotics, explains Michael Phillips, MD, Associate Director of the Division of Infectious Diseases in the Department of Medicine at NYU Langone Medical Center. (The bad news is that plague can be fatal if treatment isn’t started within 24 hours of the arrival of symptoms.) To stay safe, avoid contact with wild rodents (that means squirrels and chipmunks, in addition to rats), steer clear of dead critters, and call your doctor if you develop any symptoms after being exposed to fleas or rodents, particularly in western states, where U.S. cases tend to occur. “While we can expect to see occasional cases in parts of America, it’s highly unlikely that there would be a wide-scale outbreak,” says Dr. Phillips. “As long as you’re not mucking around where you might come up against mice and fleas, you don’t have to worry.”

Mumps

Once a common illness among children and young adults, cases of mumps in the US have dropped by 99% since a vaccine was introduced in 1967. But occurrences crop up, particularly among close-knit communities. The CDC reports that there have been 688 reported cases of mumps in the US in 2015, including small outbreaks at universities in Pennsylvania, Iowa, and Wisconsin. In 2014, there was a mini-outbreak among professional hockey players.

The virus that causes mumps is spread in close quarters (think college dorms or locker rooms) via coughing, sneezing, talking, or sharing cups or eating utensils. Symptoms of mumps include fatigue, fever, head and muscle aches, and loss of appetite, followed by puffy cheeks caused by swelling of the salivary glands. There is no treatment, but most people recover fully in a few weeks. Complications are rare, but can include hearing loss, meningitis, and inflammation of the testicles or ovaries.

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The only way to prevent the mumps (aside from avoiding people with it) is to get the MMR (measles-mumps-rubella) vaccine. Though usually administered to kids, you can get the vaccine at any time. It’s not foolproof (two doses are 88% effective at preventing the disease, per the CDC), and its protection can wear off over time, but it’s vastly better to get the shot than not. Booster doses are often recommended during outbreaks.

Measles

Like mumps, measles was once widespread: in its heyday, nearly every American child got the disease before they turned 15, and an estimated 400 to 500 Americans died from it each year, according to the CDC. Widespread adoption of the vaccine in the 1960s, however, led to the elimination of the disease from the U.S. in 2000.

Not so fast: measles has made a troubling comeback of late, with a spike of 667 cases reported in 2014, and another 189 in 2015. Many of this year’s cases stemmed from an outbreak at two Disney theme parks in California.

The virus that causes measles is spread via coughing and sneezing, and is so contagious that 90% of non-immune people near someone infected will get it, according to the CDC. “It travels like a gas through the air,” says Dr. Phillips, making it “the ultimate transmissible infection.” Symptoms of measles include fever, cough, runny nose, red eyes, and a rash that typically begins at the hairline and spreads downward across the body. Complications can include diarrhea and ear infections, and in rare cases, life-threatening pneumonia and encephalitis.

There is no treatment, which makes vaccination imperative. Experts have attributed the recent surge to lax vaccination habits; in some cases, unvaccinated people may have picked up the bug overseas and spread it to communities of unvaccinated people. Two doses of the MMR (measles, mumps, and rubella) vaccine are about 97% effective at preventing the disease; it’s particularly important to get vaccinated if you’re traveling internationally. “Prevention is the hallmark,” says Dr. Phillips. “If we develop pockets of under-vaccinated people and start having enough transmission, even those individuals who are vaccinated will be at risk.”

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Tuberculosis

Leading up to the 1882 discovery of the bacteria Mycobacterium tuberculosis, this scourge killed one out of every seven people living in the United States and Europe. Antibiotics have dramatically reduced its deadliness, particularly in the US, and as recently as the 1990s it was believed that tuberculosis could be eliminated from the world by 2025, according to the National Institute of Allergy and Infectious Diseases. But it persists, killing between 2 and 3 million people globally each year. Though most Americans don’t consider TB a threat, it’s showing signs of a resurgence: there were 9,421 reported US cases of TB in 2014, according to the CDC, and 555 deaths in 2013 (the last year for which data are available). Recent cases include three teachers at a New York City elementary school, a San Antonio high school student, and another high school student outside of San Diego.

TB is caused when Mycobacterium tuberculosis attacks the lungs. It’s spread through the air when an infected person coughs, sneezes or talks (though not by shaking hands, kissing, or sharing food, drink, or toothbrushes). People with compromised immune systems are especially vulnerable. Symptoms of TB include a cough that lasts three weeks or longer, often producing blood, as well as fatigue, fever and weight loss.

“Many cases we’re seeing involve folks who were infected years before, were asymptomatic, and then the disease reactivates later in life,” explains Dr. Phillips.

The good news is that TB is curable with treatment, though several different antibiotics must be taken over 6 to 12 months. To stay safe, avoid contact with TB patients, particularly in crowded, enclosed environments. If you think you may have been exposed to someone with TB, see your doctor immediately for testing and possible treatment.

TB is scary enough on its own, but health professionals are particularly worried about the rise of antibiotic-resistant TB throughout the world. “We’re seeing more and more cases that are multi-drug-resistant, which means it requires a second or a third line therapy to treat,” says Dr. Phillips. “We have to think globally about this one: helping to prevent cases overseas and working on new drug development can only help keep us safe domestically.”

Scarlet fever

Largely forgotten over the past century thanks to the rise of antibiotics, this bacterial infection is perhaps best known for the role it plays in the classic children’s book The Velveteen Rabbit. (When the young protagonist comes down with scarlet fever, all his toys, including his beloved rabbit, must be destroyed, on doctor’s orders.)

Researchers have recently been tracing scarlet fever’s comeback in Asia (with more than 5,000 cases over the past five years in Hong Kong and 100,000 in China) and the United Kingdom (roughly 12,000 cases over the past year).

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Caused by the same type of bacteria behind strep throat (Streptococcus), scarlet fever commonly afflicts children ages 5 to 12, and shares many symptoms with strep (fever, sore throat, headache, nausea), along with a red, sandpapery rash that appears on the chest and neck and may spread across the body. Like strep, scarlet fever can be diagnosed via a throat swab or throat culture, and can be effectively treated with antibiotics. Researchers are concerned, however, that newer outbreaks may be related to antibiotic resistance, which can make scarlet fever harder to knock out with drugs.

To stay safe, avoid contact with infected people (the disease spreads via sneezes or coughs), wash your hands regularly (as you would to ward off any communicable disease), and seek treatment as soon as symptoms develop. “It’s easily transmitted in group settings,” says Dr. Phillips, “so there is the risk that when a toxigenic strain moves into a community, it would spread rapidly.”

 

Risk of Seizures After Childhood Vaccinations Is Very Low, Study Says

By Amy NortonHealthDay Reporter

MONDAY, June 6, 2016 (HealthDay News) — Certain vaccines can trigger fever-related seizures in young children, but the risk is so low that pediatricians might see one case every five to 10 years, a new study estimates.

It has long been known that some vaccines carry a small seizure risk. But the researchers said the new report offers some hard numbers.

And it suggests that even when babies and toddlers get three vaccines at once, they only develop fever-related seizures at a rate of 30 per 100,000—at most.

The findings should be “reassuring” to parents, said lead researcher Dr. Jonathan Duffy, of the U.S. Centers for Disease Control and Prevention.

“Looking at the big picture, the benefits of vaccination are much greater than the risk of febrile [fever-related] seizures,” Duffy said.

Up to 5 percent of young children will have a fever-related seizure at some point, according to the CDC. It usually happens when they have the flu, a cold or other infection, the agency said.

But while the seizures are scary for parents, Duffy said, they do not cause lasting harm.

According to Dr. Mark Sawyer, a member of the American Academy of Pediatrics Committee on Infectious Diseases, “This study is an important contribution to our understanding of how common—or how rare—this vaccine side effect is.”

Sawyer wrote an editorial accompanying the study, which was published online June 6 in the journal Pediatrics.

He said it’s common for parents to worry about the safety of giving multiple vaccines on the same day.

The new findings do suggest that the risk of fever-related seizure is higher when certain vaccines are given together. “But it’s still quite small,” Sawyer said.

For the study, Duffy’s team combed through a health care database with information on nearly 10 million Americans. The investigators focused on 333 cases of fever-related seizures among babies and toddlers aged 6 months to 23 months.

Overall, the study found, a child’s risk of fever-related seizure was no greater than normal after the flu shot or the DTaP vaccine for diphtheria, tetanus and whooping cough.

There was, however, a small excess risk linked to the pneumococcal vaccine, the findings showed. The risk increased further when the flu shot was given with the pneumococcal vaccine or DTaP—or both.

When all three are given, the CDC estimated, seizures may happen at a rate of up to 30 per 100,000 children.

Sawyer put it another way: Over five to 10 years, the average pediatrician would see one case of fever-related seizure connected to the vaccine trio.

“The total risk is still very small,” Duffy agreed.

The CDC recommends that the DTaP and pneumococcal vaccines be given on the same day. The flu shot is seasonal, so it may be given alone, Sawyer pointed out. But if the timing is right, he said, it is given on a day when a child is getting other routine vaccinations.

Sawyer acknowledged that if there is no extra risk of seizure when the flu shot is given alone, some parents may want the vaccine on a separate day.

“But we know that if we don’t give simultaneous vaccinations, some kids always fall through the cracks,” Sawyer said.

Parents get busy, children get sick and appointments get canceled or delayed, he noted. That’s a problem even if a child eventually catches up on the recommended vaccinations, according to Sawyer.

“When you space out vaccinations,” he said, “your child is at risk of infection during that time.”

Those infections can come with complications, including fever-induced seizure. “So if you want to avoid febrile [fever-related] seizure,” Sawyer said, “delaying vaccinations is not the way to do it.”

More information

The CDC has more on vaccines and febrile seizures.


Thanks to 2

THURSDAY, Sept. 1, 2016 (HealthDay News) — Chickenpox—which is caused by the varicella-zoster virus—has continued declining in the United States since 2006, when doctors began routinely recommending a second dose of chickenpox (varicella) vaccine, U.S. health officials said Thursday.

States reporting vaccination data noted an 85 percent drop in the highly contagious disease between 2005-2006 and 2013-2014, according to a report from the U.S. Centers for Disease Control and Prevention.

The fall-off was greatest among kids aged 5 to 14, health officials said. This is also the age group most likely to have received the second dose of varicella vaccine.

Symptoms of chickenpox include an itchy, blistery rash, tiredness and fever. It tends to be more serious in babies, adults and people with a weakened immune system, the CDC noted.

Before vaccination, chickenpox was commonplace, with 4 million Americans on average getting the virus annually in the early 1990s. Of those, as many as 13,500 were hospitalized, and 100 to 150 died in a given year, according to the CDC report.

The CDC has credited vaccination with preventing more than 3.5 million cases of chickenpox, 9,000 hospitalizations, and 100 deaths each year.

The vaccine doesn’t prevent chickenpox in everyone, but when cases do occur in people who’ve received the vaccine, the disease is usually milder than it is in unvaccinated people, the report said. For instance, people who’ve been vaccinated tend to have fewer lesions.

Now, with fewer cases to monitor, state health officials can better study the characteristics of new outbreaks — such as symptom severity, the number of hospitalizations and whether or not patients were vaccinated, the agency said.

Scientists say it’s essential to understand why severe cases still occur and whether they occur among vaccinated people.

“Further reduction in the number of varicella cases will provide states with increased opportunities for enhancing varicella surveillance and improving completeness of reporting to monitor impact of the vaccination program,” study corresponding author Adriana Lopez and colleagues wrote.

When the single-dose vaccine was launched in the United States in 1996, a 90 percent decline in cases followed over the next 10 years. But, because of continued outbreaks, the CDC implemented the two-dose schedule starting in 2006.

The CDC recommends kids get the first dose at age 12-to-15 months and the second dose when they are 4 to 6 years old.

By 2014, 40 states were reporting data on chickenpox. Just four—Illinois, Michigan, Texas, and West Virginia—have been submitting data annually since before the varicella vaccination program began.

The report was published in the CDC’s Sept. 2 issue of the Morbidity and Mortality Weekly Report.

More information

There’s more on chickenpox at the U.S. Centers for Disease Control and Prevention.