The American Academy of Pediatrics (AAP) and the American Pain Society have issued a September 2001 policy statement calling for pediatricians to respect and manage the pain that children feel from injuries, illnesses, and (too often) from medical procedures. I hope we heed it well! Kids’ pain is routinely ignored, minimized, or under treated in our medical culture. Anticipating or noticing the child’s pain is the first step, wheth…

The state of Wisconsin has reported suspected monkeypox in two healthcare workers who had no known animal exposure but who had been caring for earlier monkeypox patients on May 22. The symptoms are strongly suggestive of monkeypox. If the lab tests confirm this, these would be the first documented cases of person-to-person spread in this hemisphere. The boyfriend of one of the workers has now developed symptoms, and is suspected of having monke…

Dr. Greene`s Answer: Picture this scene: A couple is spending a quiet evening at home with their one-year-old daughter, who has had a bit of a cold. At about 8 o’clock she begins coughing — an unusually loud, resonant cough. Over the next few hours the sporadic cough becomes more and more frequent. She gets a fever. At 11 o’clock (when all the After Hours Clinics have closed and her doctor is in bed), her breathing becomes nois…

When your child first packs up and heads off for college, it is a bittersweet moment. How horrible if meningitis were to make the separation permanent. The first year is the critical time. Freshmen living in dormitories are at the greatest risk — more than 7 times higher than undergraduates in general — according to a study in the August 8, 2001 issue of the Journal of the American Medical Association JAMA). In another study in the…

Babies get so many shots these days! About a quarter of parents are concerned that the sheer number of vaccines might overwhelm, weaken, or use up a baby’s immature immune system. Evidence published in the Jan. 2002 issue of Pediatrics suggests that the opposite is true. By conservative estimates, their sturdy immune systems are built to able to respond to as many as 10,000 foreign proteins by making antibodies to them. The study explains that…

Related concepts: HBV Introduction to hepatitis B: The hepatitis B vaccine is the first one that babies get – for good reason. The most likely time for children to catch hepatitis B is around the time of birth. More than two million adults in the United States have chronic hepatitis B infections. About 1/3 of them were first infected as children. What is hepatitis B? Hepatitis B virus (HBV) is a virus that attacks the liver, causing serious dis…

We’ve all been hearing about the worst case scenarios regarding the H1N1 flu, otherwise known as the swine flu. We don’t know how bad H1N1 will be this fall, but it looks like it could be several times worse than the usual seasonal flu (which kills about 36,000 people a year in the US), but with this one children, college- and grad school-age adults, and pregnant women are especially vulnerable. Boys who catch H1N1 in particular see…

So you’re ready to be a parent. Congratulations! That’s a big decision. To give yourself the best chance for a healthy pregnancy and baby, there are a few things to do before you get pregnant. 1. Go see your doctor before you conceive. This preconception visit with your OB, family physician, internist or other care provider usually consists of a physical exam and a thorough discussion about your family history, personal medical history and any…

A simple flu shot for every child with asthma could prevent 100,000 hospitalizations this year in the U.S. alone, according to an analysis by the American Lung Association released on September 18, 2003. Sadly, last year 90 percent of children with asthma and 61 percent of adults with asthma missed the opportunity to get the vaccine. Todd Whitley, who oversees web operations for the American Lung Association, wrote me today and asked us to hel…

I hear from parents almost everyday, wishing that vaccines were available to protect their children from smallpox or anthrax or other agents of bioterror. Routine smallpox vaccination was discontinued more than 20 years after the last smallpox case in the United States. Before September 11th, I heard from many parents who felt that vaccines such as those for polio or diphtheria should be discontinued because these once-dreaded infections had n…

It seems like kids these days get so many shots. One of the recent additions to the routine vaccine schedule is the pneumococcal conjugate vaccine (PCV or Prevnar). Pneumococcal bacteria are the leading bacterial cause of ear infections in the United States, as well as of several serious infections such as meningitis and pneumonia. Before the vaccine was widely introduced, researchers hoped that it would noticeably reduce episodes of ear infect…

The highly respected Institute of Medicine has completed its Immunization Safety Review: Thimerosal-Containing Vaccines and Neurodevelopmental Disorders (October 2001). They strongly urge removing all mercury from vaccines, as part of the overall effort to reduce mercury exposure in children. Nevertheless, they found no evidence that the thimerosal form of mercury that has been used in vaccines has caused autism, attention deficit disorder, sp…

Prevention of any disease is what you want to do for your children. You want to give them the best life possible. Physicians know that the HPV (human papilloma virus) causes many diseases. And HPV vaccinations (like Gardasil) can prevent most of them. We have heard all about HPV vaccine being able to prevent cancer of the cervix in girls/women. But now we know that it can also prevent other serious diseases that can produce pain, suffering, mut…

A severe form of allergic reaction called anaphylaxis can occur after eating peanuts, shellfish, eggs, bananas, kiwi, avocado, or other foods. It can occur after bee stings, in those who are allergic. It can also occur after receiving medicines, including the shots in the routine immunization schedule. How often does this occur? Researchers examined the medical records associated with more than 7.5 million vaccine doses, and found only 5 cases…

Fewer needle sticks… the same protection! On Tuesday, December 16, 2002, the FDA approved a new five-vaccine combination for children. Pediarix contains vaccines for diphtheria, tetanus, pertussis (whooping cough), polio, and hepatitis B, all in one syringe. The injection is to be given at the 2, 4, and 6 month well-baby exams. These 3 shots could replace as many as 9 the baby would have gotten. I’m a fan of reducing pokes by combining injecti…

The polio virus, once widely feared for its power to cripple and kill, may be the key to treating deadly brain tumors. A report at the May 2001 meeting of the American Society for Microbiology described how the virus targets and destroys the tumor cells of malignant gliomas, which are among the most common and lethal of brain cancers. An inactivated form of the virus, something similar to a vaccine, has been used to treat brain tumors in anima…

Flu season is almost here. Most people who get the flu feel miserable, but recover without major problem. Nevertheless, each year, the flu kills an average of about 36,000 people in the US alone. Overall, kids are the most likely to catch the flu, but not the most likely to have serious cases. Those most likely to have serious illness or death are adults over age 65, children under age 2, and people at any age who have other medical conditions…

Dr. Greene’s Answer: Almost all adults are susceptible to pertussis, or whooping cough. Between 60 and 80 percent of infants are protected after the first 3 doses of vaccine, but this protection begins to disappear when they are toddlers. After the 4th immunization at 18 months old, 80 percent are protected for the next 3 to 4 years. The 5th dose, at kindergarten entry, protects them for another few years. A booster vaccine is given to ado…

Parents express their concern that the chickenpox vaccine  might not give lifelong immunity. These parents sometimes want their children to catch “real chickenpox” as kids so that they will never get it as adults. For years I have suggested that chickenpox immunity does not work this  way — that one of the reasons children tended to get natural chickenpox only once was the “booster” effect of being exposed so many…

Today, children routinely receive 21 vaccinations before they even enter kindergarten — more than double what they received even a decade ago. Vaccine fears are at an all time high, intensified by the recall of the rotavirus vaccine and the problem of mercury-containing vaccines. The debate has reached Congress, which conducted hearings in August 1999. Like antibiotics, vaccines have prevented unfathomable suffering, but they also have a…