Zika Virus | Health Information

zika virus symptomsZika Virus | International Public Health Emergency


Zika Virus is a global health scare, especially for pregnant women.  Due to the October 2015 cluster of 524 cases of newborns in Brazil diagnosed with microcephaly and other neurological disorders reported in Brazil, World Health Organization (WHO) has stated that it is as a Public Health Emergency of International Concern. (bit.ly/1PYrRKs)

What are the symptoms of the Zika Virus?

zika virus microcephalyWhen humans become infected, they may develop symptoms which include fever, itchy rash, headache, red eyes, joint pain, muscle pain, and temporary paralysis.  Typically, symptoms last for 2 to 7 days.  Incubation period is unknown, but ranges from a few days to a week (1.usa.gov/1MMg1Qi).

There has also been an increase in incidence of Guillain-Barré syndrome that has coincided with increased incidence of Zika Virus. (bit.ly/22Tg8mx)

Pregnant women infected with the virus have had newborns with microcephaly and brain damage.  It is believed that the virus has spread from the infected mother to baby in utero and during delivery.  Zika virus has been found in the brain tissue of these infected babies.

Where Did Zika Virus Start?

zika_americas_03-18-2016_webAccording to WHO, it was originally detected in a rhesus monkey in Zika Forest, Uganda in 1947 and in humans in Nigeria in 1954 (bit.ly/1QeAEcO).  Before 2015, the virus was found in Africa, Southeast Asia, and the Pacific Islands.  Currently, there are many countries around the world with local mosquito-borne Zika virus disease cases as noted on the CDC website at 1.usa.gov/1Mv4zhb  Currently, countries affected by local transmission include Aruba, Barbados, Bolivia, Bonaire, Brazil, Colombia, Puerto Rico, Costa Rica, Cuba, Curacao, Dominica, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Nicaragua, Panama, Paraguay, Saint Martin, Saint Vincent and the Grenadines, Sint Maarten, Suriname, Trinidad & Tobago, U.S. Virgin Islands, and Venezuela).

 Is Zika Virus in the United States?

zika-by-state-report_03-23-2016_webYes.  However, only travel associated cases have been reported in the United States.  However, "local mosquito-borne transmission of Zika virus has been reported in the Commonwealth of Puerto Rico, the US Virgin Islands, and America Samoa." (1.usa.gov/1RvWNAq)  As of March 28, there have been 273 travel associated cases have been found in the U.S., including in Hawaii.  There have been 258 locally acquired cases in Puerto Rico, 10 in the U.S. Virgin Islands & 14 cases in the American Samoas.  


How is Zika Virus Transmitted?

It is most commonly transmitted by a mosquito bite.  It can also be sexually transmitted and via blood transfusion. It is unknown how common sexual or blood transmission is among humans.

Can Zika Virus Be Sexually Transmitted?

Yes.  The CDC recently reported on February 2, that this virus was sexually transmitted in Texas, USA (cnn.it/1WSuiRd).  In addition, Florida confirmed on March 9 & California confirmed on March 25, that they too have had their first case of sexually transmitted Zika Virus. As a result of confirmed sexual transmission of the virus, the CDC now recommends that if you are a pregnant women whose "male sexual partner has traveled to or lives in an area with active Zika virus transmission, you should abstain from sex or use condoms the right way every time you have vaginal, anal, and oral sex for the duration of the pregnancy."  The case in Texas did not involve pregnancy.  However, keep in mind that this illness can infect anyone.

Other countries, confirmed that they too have had their first case of sexually transmitted Zika Virus.  France confirmed this occurred on February 27.  Chile confirmed firmed this on March 27.  Be aware that more cases and countries are confirming sexual transmission of the virus.

What Can I Do to Prevent Zika Virus?

Use insect repellent, especially when outdoors.  Avoid travel to areas with active Zika Virus transmission.  If you cannot avoid travel to an area with active transmission, then practice abstinence or use birth control while traveling in that area.  Abstain from sex if your partner has traveled to an area with active transmission.  

What Insect Repellent is Best to Zika Virus Infection?

The CDC recommends the use of insect repellents with active ingredients registered with the U.S. Environmental Protection Agency (EPA) for use to be applied to skin and clothing.  EPA registered insect repellents contain DEET, picaridin, IR3535, and some oil of lemon eucalyptus and para-menthane-diol.  Insect repellents with these active ingredients products offer longer-lasting protection.  Insect repellents containing oil of lemon eucalyptus should not to be used on children under the age of three years.  Insect repellents can be used by pregnant and nursing women.  The CDC has many details about use, efficacy, and safety of insect repellents available at 1.usa.gov/25rRxr1.

I'm Worried Myself or My Child Might Have Zika Virus.  What Should I Do?

First, know the symptoms.  Typically, at a minimum, an infected person may have a low grade fever which is frequently accompanied by and a rash.  Next, contact your doctor.  If your doctor is concerned that you or your child might be infected with Zika Virus, they will advise you to schedule an appointment for a more detailed evaluation.  Lastly, if your doctor thinks that you may need to be tested for Zika Virus, then your doctor will refer you to your local health department.  Currently, only local health departments have testing for the Zika Virus. 

Is There a Travel Advisory Due to Zika Virus? 

Yes. There is a Alert Level 2, Practice Enhanced Precautions in areas with active transmission (1.usa.gov/1MMaER1).  There is not yet a Warning Level 3, Avoid Nonessential Travel for areas with active transmission.

I'm Not Pregnant & Plan to Travel to an Area with Zika Virus.  Is There Anything I Should Do?

It is advised to not travel to areas with the Zika Virus.  However, if you do travel to an area where Zika Virus is present, then use insect repellent at all times, especially when outdoors.  It is also recommended that if you are a women that is not currently pregnant, that you take birth control as it is estimated that 50% of all pregnancies are estimated to be unplanned.

I'm Pregnant and I've Traveled to an Area with Zika Virus.  What Should I Do?

Talk to your OB/GYN doctor before any travel, especially if you are traveling to an area with active Zika Virus transmission. Follow up with a phone call with your doctor immediately upon return.  Depending upon your experience or exposure, they may have additional recommendations for you and your unborn baby.

Is a Vaccine for Zika Virus Available?

Not yet.  However, there is work on a vaccine.  As of February, the National Institutes for Health (NIH) has stated that Zika Virus Vaccine trials will begin this summer (wapo.st/1pTCPZO).  They have built upon research on similar viruses, Dengue and West Nile.  They are likely to be able to do a small scale trial of about 20 to 30 people in Summer 2016 with large scale trials likely to occur in 2017.  Until a Zika Virus Vaccine is available, use insect repellent, travel with caution, if pregnant prevent exposure in your travel and with your sexual partner. 


Print Friendly

Common Core Education Changes

Common Core, Flip ClassroomCommon Core has officially hit third grade in my son's school.  This year has been a year of many education system changes.  Aside from all the changes Common Core mandates (www.corestandards.org), he is also using Canvas, an online learning management system, and we are using Remind (www.remind.com).  As a result, his learning life has changed.  
Common Core means more time on the internet, more time on math, and more communication with the teacher.  This is an excellent advantage of this new curriculum.  Communication between teacher and parent helps the students do their best work.  We also receive reminders via an app, Remind.  I’ve actually become reliant on it.  As a result, when there have been times that a reminder wasn't given, it felt as if something went terribly wrong.
My son definitely needs a computer now.  The school uses “a flip classroom”, which essentially reverses the learning model.  The lesson is at home on the computer.  The review at school the next day solidifies the lesson through exercises, projects, explanations, and discussions.  Students view the next day’s math lesson the previous night on the internet.  The math lesson is a YouTube video prerecorded by one of the third grade teachers.  After each class, there is a small quiz available on the Canvas website.  The results of the quiz informs the teacher which students need more help with the next day’s lesson.  It helps me as well to know what lessons my son needs help with day by day.  Why is this so helpful?  With so many required learning strategies, there simply isn’t enough time in the classroom to learn them all expertly.  Hence, teaching, reviewing, and learning continue at home, more so than it did pre Common Core.
The Canvas website has also been a huge change.  Canvas is all-encompassing.  It has links to every math lesson from the beginning of the year.  It has science lessons, writing assignments, homework assignments, and even encourages students to offer positive feedback to fellow classmates on their weekly writing assignments.  Canvas  also allows students to send messages to each other's inbox.  It’s wonderful that this is all available in one place.
Some features of Common Core are very good.  Math can be broken down into many strategies.  These are strategies that I learned on my own over the years.  It’s nice to know that my son is learning them earlier.  However, simple math is more complicated because there are so many new strategies to learn.  Since there isn’t enough time to learn them all in the classroom, parents need to be more involved.
The most important change this year has been the excellent communication between his school and us third grade parents.  A special meeting explained Common Core to us.  The third grade teachers work as a team to maximize children's success with Common Core.  His teacher is amazing.  We communicate in person and via email on how to make the most of his strengths through this growth period filled with so many changes.  
My son has begun his journey with computer education, online lessons as "flip classrooms”, and intranet social communications between classmates.  I feel like a dog learning new tricks, some of which I like a lot, and others, not so much.  Either way, this old dog is learning the new tricks.  The reality is that education changes are just one aspect of his life that is changing.   At the end of the day, one thing is never going to change; I am a mom who is always there for my child.  I will always support and encourage him to be and do his very best!
Print Friendly

I Am Everything Affirmation

I Am Everything Affirmation

I Am Everything Affirmation

Print Friendly

New Logo


Oh Christmas Tree!

‘Tis the season to be decorating! Many families celebrating Christmas have already or will soon decorate the outside and inside of their homes, celebrating in style. But for some of you, safety may be a concern. Both infants and toddlers can become injured by electrical outlets, ornaments and even a Christmas tree. This may be the first year you’ve had to think about safety issues at Christmas either because you are a first time parent or because your toddler has started developing an interest for these lovely decorations.
If your stories include, “I woke up to find all the ornaments smashed all over the floor,” or “My infant had a glass ornament break in his mouth,” then here are my top 10 suggestions for you:
1. Use plastic ornaments.
Learn to see the world through a child’s eyes. These shiny and sparkling ornaments attract your child like a moth to a flame. Glass or sharp/pointy ornaments in his/her mouth can cause injury.
2. Use garland instead of lights.
Remove the temptation to play with the light bulbs or the electric light sockets.
3. Keep electric sockets covered.
If you have not already purchased these, these covers are available at a number of local pharmacies and stores.
4. Keep lights out of reach from all children.
Depending on the bulbs used, this can hurt sensitive little fingers or hands. Not to mention, older toddlers can pull the bulbs apart from the light set. They can chew on them or offer them to the younger children in the home. In addition, the light set can be pulled causing the Christmas tree to topple onto your child.
5. Avoid ornaments & lights at the bottom of your tree.
Some families decorate the top ½ or ¾ of the tree to help their child resist temptation. Again, for the same reason that when pulled, the Christmas tree could fall onto your child.
6. Use play yard gates to surround your Christmas tree.
To avoid direct contact all together, these gates are the best. You can find them at your local store or by doing an internet search for Superyard XT Pay Yard.
7. Keep candy dishes out of reach.
Your child can choke on a lot of traditional candy. In addition, if they pull the candy dish, it may fall & shatter onto the floor. Then, your child might get glass or ceramic cuts on their hands, feet, or elsewhere.
8. Avoid marshmallows.
This is a fun treat if used appropriately. However, small children and even older children have choked on this. Some have even died. Marshmallow does not dissolve. So, it would be very hard, if not impossible to get this out of your child’s throat, even if you know how to use the Heimlich maneuver.  Two very famous cases involved the death of a 12 year old girl in 1999 and a 32 year old woman in 2006 while playing the "Chubby Bunny" game (http://bit.ly/1sqHoWR).
9. Ask for help; have someone watch your child while you decorate.
It’s hard to keep your children away from all the decor while still trying to decorate. A watchful eye is especially needed if you are decorating the outside of your home. Children have a way of getting into trouble or hurting themselves whenever you are not looking. As a pediatrician, I commonly hear, “It was only a minute.” Then, injury occurs.
10. Lastly, be careful when you gift wrap.
Even wrapping gifts can result in an injury. It may only be bags, wrapping paper, ribbon, tape, & scissors to you, but it’s a gold mine for your child. If left unattended, small children can suffocate in plastic bags and cut themselves with scissors. Keep these items out of your child’s reach at all times.
A Christmas tree and Christmas time decorations can be a wonderfully fun time at home, as long as you keep safety in mind.
Print Friendly

Ebola Virus

ebola - imageedit_14_3363191172

What is Ebola? 

Ebola is a virus that was first discovered in 1976 near the Ebola River in Africa. Sporadic outbreaks have occurred in Africa since then. There are five (5) strains of Ebola that infect animals in Africa. Four of the strains infect humans.


What are the Signs & Symptoms of Ebola?

Symptoms include fever, headache, muscle aches, vomiting, diarrhea, abdominal pain, unexplained bleeding or bruising.  Ebola can only be spread when symptoms begin. Symptoms typically occur between 8 to 10 days after infection.  However, symptoms may occur as late as 21 days after exposure to Ebola. 


How is Ebola Spread?

If a person is ill with Ebola virus, they can spread it by blood, body fluids (urine, saliva, sweat, feces, vomit, breast milk, and semen).  It can also be transmitted via objects contaminated with the virus (like needles and syringes). Lastly, it can spread via infected bats, apes, gorillas, and monkeys. (http://1.usa.gov/1rCptdl)


Where is the Ebola Outbreak? Where Has Ebola Spread?

This year is the largest Ebola outbreak in history.  It has taken place largely in West Africa.  Currently, areas designated by the U.S. Centers for Disease Control and Prevention (CDC) as having widespread transmission of Ebola are in West Africa, specifically Guinea, Liberia, and Sierra Leone.  Countries that have had travel associated transmission and local transmission are (Port Harcourt and Lagos) Nigeria, (Madrid) Spain, and (Dallas and New York City), New York.  Countries that have had travel associated transmission are (Kayes) Mali and (Dakar) Senegal.


Are there are recent updates in Florida?

As of October 26, 2014, Florida Governor Scott issued an order mandating the Department of Health to have a 21 day monitoring of anyone who has returned from areas where individuals have been infected by Ebola virus, as designated by the CDC. (http://bit.ly/1wH4o6M) New York, New Jersey, Illinois and now Florida have instituted a 21 day health evaluation plan. Twice daily monitoring is to include measuring temperature twice daily.  Gov. Scott also stated that if individuals monitored are assessed to be high-risk, then a mandatory quarantine will be required.


Are There U.S. Guidelines for Healthcare Workers Caring for Patients with Ebola?

The CDC has issued guidelines for healthcare workers and healthcare settings for those caring for patients infected with, suspected to be infected with, or having died of Ebola. (http://1.usa.gov/1yJblVf) There are also CDC Ebola waste management guidelines. On October 14, 2014, the CDC admitted that they were unprepared for Ebola in the U.S. (http://bit.ly/1E4V6F4)  Since then, the CDC has formed the previously mentioned guidelines.  


Are there flight Restrictions from Africa?

As of October 21, 2014, the U.S. Homeland security Department announced that travelers from Guinea, Liberia, and Sierra Leone have limited airport entry into the U.S.  They are limited to five (5)  international airports in New York, New Jersey, Atlanta, Chicago, and Washington, DC.  These airports will have extra screening of passengers for possible Ebola exposure, which include taking temperatures and other assessments as well.  All U.S. airports are screen for possible Ebola exposure. (http://www.cdc.gov/vhf/ebola/pdf/ebola-algorithm.pdf)  Currently, there is no travel ban from or to Guinea, Liberia, and Sierra Leone to U.S. due to Ebola.


It is highly unlikely that Ebola will spread in the U.S. as it has in endemic West Africa. However, we must keep a vigilant eye on developments, travel screenings are necessary, and healthcare workers must follow CDC guidelines to prevent spread of this disease.


Print Friendly

Enterovirus D68 (EV-D68)

enterovirus - 2014-1008 -imageedit_7_9044717870What is Enterovirus D68?

Enterovirus is a non-polio virus that was first discovered in California in 1962. (http://1.usa.gov/1rVzPYU) It typically exists during the Summer and Fall, with frequency of the virus decreasing in late Fall.  


Where is Enterovirus D68 in the United States in 2014?

This year, Enterovirus D68 is documented with severe respiratory illness in the United States. Currently, the Centers for Disease control (CDC) or state labs have confirmed 628 people infected with this virus in 44 states and the District of Columbia.  Yesterday, the Florida Department of Health confirmed Florida's first Enterovirus D68 infection in a 10 year old girl from Polk county who was treated in Hillsborough County at Tampa General Hospital one (1) month ago for six (6) days. (http://on.wtsp.com/ZQzSw3)  The reality is that Enterovirus D68 is everywhere.


Enterovirus D68 Updates:

Update 10/8/14: Enterovirus D68 appears to be winding down.  Fewer severe respiratory illnesses reported last week.  Peak was three (3) weeks ago. (http://usat./1vUOJPz)

Update 10/16/14: CDC new rRT-PCR test for Enterovirus D68 allows more rapid test for the more than 1,000 remaining specimens from since mid-Sept. (http://bit.ly/ZC9JzW).  This will result in an increased number of positive results.  However, this will be for past infections, not recent ones.  Enterovirus D68 still appears to be winding down.  


What Are the Symptoms of Enterovirus D68?

Enterovirus is typically misdiagnosed as a common cold, rhinovirus, RSV, or the flu. Typical symptoms include those of cold symptoms, runny nose, cough, sneezing, and achiness.  In more severe cases, wheezing and difficulty breathing has occurred. There have been four (4) deaths associated with Enterovirus. (http://1.usa.gov/1yLuo52)  In addition, the Colorado Health Department reports that partial paralysis has occurred in 12 Colorado children infected with Enterovirus D68. (http://dpo.st/1CTtJgp)  The CDC is investigating the deaths and the potential paralysis link. 


Who's at Highest Risk for Contracting Enterovirus D68?

Infants, children, and teenagers are at highest risk for contracting the disease as they have not had sufficient exposure and therefore immunity against this virus.  Those who have asthma and reactive airway disease are at higher risk to have more severe symptoms and illness from the virus.


How Do I Prevent Enterovirus D68?

•Hand washing, hand washing, and hand washing! Hand sanitizers are not effective in prevention.  This virus spreads by cough, sneeze, or touching an infected surface.  

•Non-alcohol disinfectants are effective. However, hand washing is still the best.

•Keep your sick child home.  This is very important to prevent the spread of this virus. Remember, in some, this virus acts like the common cold.  However, if your child spreads it to someone else, the child may develop more severe symptoms.

•Cough and sneeze into your elbow.

•Clean commonly used surfaces (countertops, door knobs, toys, etc) with bleach water.


When Should I See a Doctor?

If you or your child have asthma or reactive airway disease, develop cold symptoms, fever, wheezing or shortness of breath, then go see a doctor.  


What is the Treatment for Enterovirus D68?

There is no cure for this virus.  There is supportive care.  The sooner you or your child receive supportive care, the better the outcome. That being said, it doesn't mean that the moment you or your child gets sick, you should run to the pediatrician.  However, if you or your child has asthma or reactive airway disease, become ill with fever, cold symptoms, is wheezing or short of breath, your pediatrician should examine your child.

Enterovirus D68 is most commonly a mild disease.  However, this year, it has become a scary one.  Knowing your child's health, closely observing them if they are ill, and follow-up care with your pediatrician will help in the treatment of Enteovirus D68, so it won't terrify you.

Print Friendly

Good Choices Affirmation

Good Choices Affirmation

Good Choices Affirmation

Print Friendly

First Day of School

school, home, family, childrenThis is a Flashback post!  Somehow, I never published it, but seeing as school starts this month, it's quite appropriate.  Not to mention it's filled with memories for me.  This still applies to everyone's first day at school.   Enjoy!
Our son just started Kindergarten. It was really exciting! I didn’t cry, but was amazed by the flashbacks of when I was little girl in school. I loved to learn. It was great to be with other kids. Kindergarten was filled with playtime.
Kindergarten sure isn’t playtime anymore. And everyone doesn’t have the same experience anymore either. Previously, regulated daycares & pre-K classes didn’t exist. As for my son, he has been in daycare since he was 3 months old. You’d think he’d be ready. But it’s just as hard for him as the other kids who have stay at home mommies. He had to say goodbye to his old routine, his old friends, his old teachers, basically to the life he knew for over 5 years. Now, playtime is over; it’s learning time with a little bit of playtime. After school, there’s the bus ride to daycare too. He has a long day. That’s hard on anybody.
Did I mention it’s hard on us too? No one likes change. And this was a lot of change. This house wakes up earlier. He has to eat breakfast within a certain timeframe. Lunch bags need to be prepared. How is a 5 year old going to carry a backpack, a lunch bag & a snack bag? How is he going to put it all up, repack stuff, coordinate all those little things? I don’t know; but it’s been done by others for years. It’s just my turn this time.
Technology has changed as well in schools. My son’s teacher has his homework schedule on her blog which is very convenient. She also offers communication via email. Remember when it used to only be notes and/or phone calls? Even the PTA is modernized. The PTA has its own website with many helpful links. They even have a Facebook page. If we want to know what the PTA school functions are, we may refer to the website and Facebook. For example, Family Bingo Night was run by the PTA with details online. Relying on technology, a lot can be accomplished. I must say, I’m amazed that this school is using technology as a part of communication, not a replacement for it. It’s a public school that has family at its heart.
Despite all the changes, there is one thing that doesn’t change … the human experience. Letting go isn’t easy. Trusting others to teach your kids & care for them isn’t easy either.
Yet, somehow, we are surviving. He’s starting to make friends, but it’s not as easy as in daycare. And he feels it. Positive affirmations and pep talks are given. Reviewing the day, homework, and coaching are done. Clearly, our roles have expanded. I must admit I’m feeling more tired than before. Great news is that he is excited. In the end, that’s all that matters.
So, this Pediatrician, this Mommy, is going through growing pains along with my patients’ moms. It’s nice to bond with families at this special time in our children’s lives. It’s nice to share in the difficult times and the joyous ones as well. After all, being a parent is the toughest and most rewarding job of all.
Here's a helpful resource.  Being prepared for your child's first day of school with this checklist should help to minimize your stress (http://bit.ly/1xGZO8E).
Print Friendly

Postpartum Depression

postpartum depressionRecently, I became a mother once again.  Once again, this baby had severe reflux.  Once again, our life was turned upside down.  Yes, a new baby will do that.  A sick new baby that cries and writhes in pain for hours and hours on end will do that big time.
I am grateful, very grateful for another healthy baby.  It's just hard, really, really hard to recover from a c-section, help a baby in pain & still be a mother to another child.  After all, the world keeps spinning; homework needs to be done and the home still needs upkeep.
Hormonally, I was also emotional. I was feeling sad at what was & sad at what is now.  Yet, I was grateful.  And I was keenly aware that it would all get better.   In fact, it would be better than before. So, why did I still get moments of sadness?  Suddenly, it dawned on me that once again, I had the Baby Blues.  I had it after the birth of my son.  It lasted about 3 weeks before I improved.  And I  finally returned to "me" at 6 weeks postpartum.  It may not seem like a long time.  However, when your mind is stuck in a trap, it feels never-ending.  Support of family and friends has been critical to my sanity.  Without it, I'd suffer so much more.  So, here's a big thank you to all who have helped in many little and big ways.
This is just a reminder to all new moms and dads to be aware of the Baby Blues, Postpartum Depression & even the not-so-common Postpartum Psychosis.  The Baby Blues typically last about 1-2 weeks and start within the first few days after delivery. Postpartum Depression typically lasts longer than 3 weeks.  Also, Postpartum Depression may not start immediately after birth; it and can start anywhere from 6-12 months after delivery.
Be watchful of the signs of Postpartum Depression.  If you or the new mom is showing any signs of depression, loss of appetite, or difficulty sleeping even when baby us asleep, consider discussing it with her OB/GYN or her regular doctor. There is help available.  Also get help from those around you. Meals, kind words & reassurance can make a big difference.
For more information about Baby Blues and Postpartum Depression, including signs and symptoms and available treatment options, please go to http://bit.ly/Qc9wj5.
Print Friendly
Back to Top