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LYME DISEASE — What, How, When and Prevention.

lyme disease prevention

As Spring approaches and we think about enjoying the beautiful outdoors please keep in mind a few ways to keep you and your family safe from ticks and possible tick borne illnesses, such as Lyme disease. Knowledge is power, and the following is offered as a basic but thorough overview of what you should do to prevent this common and rather serious disease.


Lyme disease is an illness from a tick bite that has 3 stages:

Early localized disease: 3-30 days after a tick bite.

  • A large red ring (larger than 2inches across) or bull’s eye (called erythema migrans) that starts at the site of the tick bite and can last 2 weeks to 2 months. It is not itchy or painful and is seen in 80% of infected people.
  • A flu like illness with fever, headache, chills, fatigue, joint and muscle pain lasting a few days. Vomiting, diarrhea, abdominal pain and cold symptoms or cough are not typically seen with Lyme disease.

Early disseminated disease: 2-12 weeks after the tick bite in about 20% of people who did not receive treatment will develop these problems.

  • Rashes can be similar but smaller than the primary rash of erythema migrans (chronic migrating redness) with a flu-like illness of fever, fatigue, headache, muscle and joint pain.
  • Eye problems, meningitis, and palsies of the facial nerves can be seen with or without a flu-like illness.
  • Carditis (heart problems) such as heart block can develop.

Late disease: 6 weeks to 2 yr after the tick bite.

  • Arthritis, most commonly the knee but can be other large joints.
  • Rarely neurological problems develop (weakness, numbing/tingling, memory issues.)

Lyme disease is often diagnosed based on history and exams, as lab testing is not helpful in the first 4 weeks of infection and can be difficult to interpret. It is treated with a 2-4 week course of antibiotics. If you have been treated appropriately in the early stage of Lyme disease you almost never develop the later stages.



Lyme disease is caused by a bacteria which is transmitted by the blacklegged tick (in New England, the deer tick). These ticks are very tiny—often the size of a pinhead and do not fly or jump. Tick bites do not hurt or itch. A tick bite can only lead to Lyme disease if the tick is infected with the bacteria and if the tick has been attached longer than 48hrs.


Lyme disease is more common April through October with more than 50% cases occurring during June and July.


Use repellent

  • Products that contain permethrin or picaridin (Duranon, Congo Tick Spray, Permanone) can be used on clothing and shoes, but not on skin.
  • DEET containing products (20-30%) for children 2mo and older applied on skin (except face and hands) and clothing.

Tick checks

  • Remove all clothing and, if possible shower/bath within 2 hr coming in from area where tick exposure is a concern.
  • Do tick checks especially checking scalp, neck, armpits, and groin.
  • Remove any tick (using tweezers grasp as close to skin as possible and pull gently and steadily straight upwards avoiding twisting and jerking.)
  • Check pets and any outdoor gear.
  • Place clothes in a dryer on high heat for 1 hr to kill any ticks.

A great website with more information is

Also check with your child’s doctor’s office as they may have more information and handouts.


national poison prevention week

Did you know that poisonings are the #1 cause of injury related death in the US—most due to drug misuse or abuse?

  • In 2013 there were 2.2 million calls to Poison Control Centers concerning human related exposures to poisons with just under ½ of these calls concerning children under 6 yr old.
  • In 2013 more than 90% poisonings occurred at home.
  • In 2013 more than 70% of the calls to Poison Centers were treated at home thus saving billions of dollars in healthcare expenditure at emergency rooms.

Did you know there are 55 Poison Control Centers across the United States and they are available 24/7 every day of the year?

Poison Control Centers receive only a fraction of their funding through the federal government and have had significant funding cuts. Much of their funding is through state governments, hospital, and other agencies.

Did you know there is no such thing as a POISON PROOF home or environment? Children are often very capable of getting into what we, as adults, think are “child-proof”. ANY medication (prescription or over-the-counter) and almost any household product is potentially poisonous and capable of causing harm in some way.

KEEP 1-800-222-1222 programmed into your mobile phone and this number readily accessible by your home phone in case of any possible poisoning. AND CALL! They will give you advice on how best to handle the situation. It could not only be life saving it could be cost saving!

Measles at Disneyland…what’s the big deal??

measles outbreak

Measles, or Rubeola, is a BIG deal! Although “endemic measles” was declared eliminated in the US in 2000, we continue to see “mini-outbreaks” here in the US. And, measles is still one of the leading causes of death among young children (145,700 deaths globally in 2013) in underdeveloped nations. Here in the US, between 1953-63, an average of 549,000 measles cases and 400 measles related deaths were reported each year. However, it was estimate that 3-4 million cases of measles occurred each year! The measles vaccine was licensed in 1963 (and the MMR in 1971) and since then we have seen a dramatic decrease in the illness-and its complications, including death! The last death related to measles illness in the US was in 2003.


  • Measles is highly contagious—even 4 days before you are sick you can spread the disease!
  • Measles causes a high fever, fatigue, cough, runny nose and red watery eyes and a rash. The rash typically comes 3-5 days into the illness and spreads from the head on down. Measles infection is more serious in children under 5yr old and adults over 20 yr old.
  • Complications such as ear infections leading to deafness, pneumonia, severe diarrhea and possible dehydration, or a brain swelling illness called encephalitis can occur in 2-3 out of 1,000 with measles and 1-3 out of 1000 infected with measles may die. A rare complication from measles leading to a fatal disease of the central nervous system developing 7-10 yr AFTER the infection can also occur, especially in children under 2 yr of age who get measles.


  • The measles vaccine (only available as the MMR—measles, mumps, and rubella) is a safe and highly effective vaccine. Given at 12mo and a booster at 4-6yr of age (although can be given earlier as long as 4 weeks apart) provides close to 99% protection! One dose is felt to be 95% effective but a second dose is given as up to 5% will “lose” protection. And some people cannot get the vaccine—children under 12mo (doesn’t work as well), immunocompromised children (cancers, transplant patients, immune deficiencies), and pregnant women.
  • HERD IMMUNITY – This is an important aspect of public health—for ALL of us! The more of us who have the vaccine means the less likely the disease will occur and thus protect those who may not be able to GET the vaccine (not chose not to get it!) or didn’t develop immunity to the disease. It also means the more of us who opt NOT TO GET the vaccine the less effective the vaccine may become in our community.


  • There is NO LINK between the MMR and autism. The vaccine is safe and adverse effects are mild and include the following, typically 6-14 days after the shot and less likely after the second shot: -fever (1 in 6) -mild rash (1 in 20) -swelling of the glands in the neck or cheek (1 in 75) -seizure caused by a high fever (1 in 3,000)

Rare adverse effects include temporary decrease in platelet count which can lead to a problem with bleeding (1 out of 30,000 doses) or an allergic reaction (1 in 1 million doses).
Vaccines are one of the most important aspects of being healthy and one of the most important things we can do for our children. So before you say NO think about it…you may not only be helping your own child, but all our children, grow up to be healthy!

Get Smart About Antibiotics

issues with antibiotics


WHY use antibiotics smartly??

Antibiotics, like amoxicillin or Zithromax, do not fight viral illnesses such as colds or URIs (upper respiratory tract infections). In fact, taking antibiotics for colds can be harmful and make future infections harder to treat. Here are some facts on antibiotics we all need to be aware of to keep us healthy!

  • Antibiotics are life saving — when used wisely to preserve their strength for future bacterial illnesses.
  • Antibiotics only treat bacterial infections — Colds, the flu, coughs, URIs, some ear infections DO NOT get better with an antibiotic. Saline nose sprays with nose blowing, fever reducers or pain medications can help but not antibiotics.
  • Most sore throats DO NOT need, or get better with an antibiotic — most sore throats are viruses, and not strep throat. Thus antibiotics do not help.
  • Green colored mucus is NOT a sign that an antibiotic is needed — Sinus infections are not a cold or nasal stuffiness that has only been for 3-5 days, even if the mucus is green. Antibiotics do not help this — saline nose sprays and good nose blowing help much more.
  • There are potential risks taking antibiotics — these medications can cause diarrhea, upset tummy and, rarely, a serious life threatening reaction. And, antibiotic use can cause bacteria to develop resistance (not work) to the antibiotic. These resistant bacteria multiply, can cause severe illnesses AND not respond to our current antibiotics.

Antibiotic Resistance — WHY the big deal?

Antibiotics kill bacteria, but not viruses, that can cause infection but bacteria can change and become resistant to antibiotics and thus not be killed but multiply and spread.

Every time a person takes an antibiotic, sensitive bacteria die but leave resistant bacteria to grow and multiply. This means infections caused in the future by these bacteria may not respond to antibiotics.

Almost every type of bacteria has become less responsive to antibiotic medication.

Use of antibiotics when not needed (such as for a cold, URI, cough, the flu, bronchitis, most sore throats—all usually viral infections) is one of the main causes of antibiotic resistance.

Antibiotic resistance means that our body may not get better with the antibiotic when we really need it—this can lead to more serious infection and even death.

Summer Safety Tips for Families

Summer is almost here! Playing outside, riding bikes, trips to the playground, beach, and/or pool should be fun and not cause for stress or worry! To keep your summer fun and safe, here are some tips from the American Academy of Pediatrics worth sharing.


They are everywhere! Ticks, mosquitoes, black flies, wasps/bees- UGH! Avoiding them can be tricky but avoiding areas where they may be—such as stagnant pools of water, tall grassy areas near woods, and not being out in the early morning and early evening can limit our exposure. Not using scented soaps, perfumes, and hair sprays on your child and not dressing them with bright colors can limit bugs from being attracted to your kids. DEET containing bug repellent products can be used on children older than 2 months of age—including up to 30% DEET. 30% DEET protects for a longer period of time (5hr) than 10% DEET (2hr). DEET is safe as long as it is not put in the mouth or eyes and washed off when your child comes inside. It can protect your child from not only mosquito bites but ticks as well. Ticks can carry Lyme disease and mosquitoes can carry infections like Wet Nile, Dengue Fever and EEE. Never use the combined bug and sun products—as sunscreen should be reapplied every 2 hours, but bug repellents should not.


To prevent a trip to the Emergency Department, ensuring the playground is safe is a must!

  • Ideally, the playground area should have at least 9-inches of sand or wood chips/bark or 6-inches of shredded rubber underneath the equipment and 6 ft in all directions around the equipment.
  • Check for protruding bolts/nails or open “S” hooks which can lead to injuries.
  • Make sure your child cannot reach any moving part that might pinch or trap any body part.
  • Check to make sure the slide or bars or seats are not too hot—this can cause burns.
  • NEVER attach ropes, jump ropes, leashes or other similar items to playground equipment—children can get rope burns or strangle themselves.
  • Make sure your child wears shoes to prevent tripping or injuries to their feet!
  • ALWAYS supervise your child.
  • Many injuries occur when children play on a trampoline—if you have one ensure only one child jumps at a time and that the trampoline is enclosed.

Bike Safety

Always make sure your child—at any age and any place—wears a helmet! A helmet should have a sticker that says it meets the CPSC safety standard and fit properly—it should be snug on the head and worn level on the head to cover the forehead and not tipped backwards or forwards. The strap should be fastened with about 2 fingers able to fit between the chin and the strap. AND, if your child does fall and the helmet hits the ground, it needs to be replaced. Also the bike should fit the child—an over-sized bike can be dangerous and lead to injuries.

Skateboard, Scooter, Heelys Safety

Not only are helmets (that meet ASTM safety standards) needed but so are protective wrist, elbow, and knee pads. Children should use skateboarding parks and avoid riding in streets or using homemade ramps and jumps. Also, ensure your child rides alone on the skateboard/scooter/heelys and is not being pulled by someone—this can lead to falls and broken bones!


Can be beautiful to see, but can result in severe burns and scars—even sparklers! It is best to attend community firework displays run by professionals and NOT use fireworks at home.


Always ensure your child has sunscreen (even on cloudy days!) with an SPF 15 or greater that protects against both UVA and UVB rays. It should be applied liberally and reapplied every 2 hours OR after swimming or sweating. Eyes can also be “sunburned” so wearing sunglasses that protect against UVA and UBV rays—especially if at the beach or if your child is very light skinned- is a must!

Water Safety

NEVER leave your child alone near water (any pool, spa, beach, river, pond)—not even for a moment. NO ONE should swim alone—not even an experienced older teen. Inflatable swimming aids are not safe and should not be used as a substitute for an approved life vest. Swim lessons can help, but do not make your child “drown-proof”. If you have a pool of any kind, check out for tips to keep you and your child safe while enjoying the pool! If you go to a beach or public pool, never let your child swim unless there is a lifeguard (or an adult who knows about water rescue) present. For more water safety tips, visit



Kids in cars – THE SAFE WAY!

by Brenda Foley, MD

Motor vehicle related accidents are one of the leading causes of death in children in the U.S. It has been demonstrated that the appropriate use of car-seats can reduce traffic deaths of children by at least 80%. However, it is thought that as many as 80% of car-seats are not used correctly.

Tips using car-seats to keep your child safe

  • There is no “best” or “safest” car-seat. How much a car-seat cost does not determine how “good it is”!
  • New is better – Using a used car-seat bought at a yard sale or thrift store may not be safe, as car-seats wear over time and older seats might be missing parts, labels, and instructions on proper use. Also, they may have damage you cannot see or have been recalled.
  • Make sure the car-seat not only “fits” your child but fits properly in your car—in the backseat! The car-seat should be buckled tightly in the car and should not wiggle more than one inch side to side or front to back. Your child should fit “snugly” in the seat and you shouldn’t be able to pinch any of the harness straps between your fingers.

There are many types of car-seats:

  • Infant only carrier type car-seats
  • Convertible safety seats
  • Combination seats
  • Booster seats

Always follow the manufacturer guidelines of the car-seat. Ideally, children under 2 should be REAR-facing but many children will “outgrow” the infant carrier type car-seat. This is based on your child’s weight and height and they can still be rear-facing in a convertible car-seat. Continue using a 5-point harness type car-seat for as long as possible—until your child has reached the max height/weight limit. ALWAYS refer to the car-seat manufacturer’s instructions on proper use.

Children should not sit in the front seat until they are 13 years or older and should always where a seat belt with a shoulder strap. The lap belt should fit on the hips and NOT the belly and the shoulder strap should fit snugly across the center of your child’s shoulder, not the neck.

Check out this website for more information on picking out a car-seat and using it properly:

Protecting Our Children: VACCINATE!

Vaccines save lives

Diseases like tetanus, polio, H.Influenzae, smallpox and diphtheria often led not only to significant illness but to death or permanent injuries have essentially been eliminated here in the US because of vaccines.

Vaccines improve health

Pertussis, mumps, measles, chickenpox, pneumococcal, meningococcal, Hep A, Hep B, or rotavirus infections—all which often caused many acute illnesses/ED visits/hospitalizations, and occasionally death or severe injury, have also been significantly lessened because of vaccines.

Vaccines protect others and future generations

In 1960, there were 90 reported deaths from polio, 76 from pertussis/whooping cough, 68 from Diphtheria, and 380 from measles. In 2007, there were no deaths from any of these illnesses! We no longer need smallpox vaccination because the disease has been eliminated through vaccination. Polio hasn’t been seen in the US in decades because of vaccination. In the future some of the diseases we now vaccinate for today may be fully eliminated and the vaccines not needed—just like smallpox!

Vaccines can prevent cancer

HPV vaccine prevents cervical cancer in young women and penile cancer in young men.

Vaccines ARE safe

Although they may cause some pain and discomfort they have NOT been linked to autism or autoimmune disorders and serious side effects are extremely rare. The benefits provided from vaccines—prevention of serious illnesses—are much greater than the risk of serious side effects. And, they have been studied and reviewed by numerous scientists and doctors who have NO financial incentive in the vaccines.


COSTS of Child Abuse in the U.S.

Child abuse continues to be a problem in the U.S. and occurs at every socioeconomic level, across all cultural lines, and within all levels of education. Child abuse comes in many forms: neglect—not meeting the basic needs of the child, physical abuse, sexual abuse and psychological abuse. Kids who are abused are much more likely to abuse drugs/alcohol as teens and adults, experience teen pregnancy and risky sexual behavior. This puts them at greater risk for contracting sexually transmitted diseases, developing a psychological disorder, engaging in criminal behavior and abusing their own children.

Child abuse stats:

  • More than 4 children die every day as a result of child abuse
  • The estimated financial cost of child abuse and neglect in the US is over $150 billion each year
  • 14% of men and 36% women in prison were abused as children—twice the frequency seen in the general population
  • Kids who have been abused are 9 times more likely to become involved in criminal activity
  • Abused children are 25% more likely to get pregnant as a teenager
  • Over 60% of all people in treatment for drug abuse report being abused or neglected as children
  • Teens who were abused or neglected are 3 times more likely to have a substance use disorder before they turn 18
  • About 80% of 21-year-olds who were abused as kids have a psychological disorder


The Truth About Teen Drinking


teen drinking statistics

Teen drinking is a serious health problem.

Did you know that..?

  • 37% of 8th graders report having consumed alcohol
  • more than 50% of all teens report having had at least 1 drink by 15 years old
  • more than 70% of all teens report having had at least 1 drink by 18 years old
  • more teens use alcohol than smoke
  • teens who start drinking before age 15 are 5 times more likely to develop alcohol dependence/abuse than those who begin drinking after age 21
  • about 5,000 kids under age 21 die every year as a result of under-aged drinking
  • binge drinking, consuming many drinks in a short period of time, occurs in almost 20% of boys age 15 and girls age 16-17
  • teens who drink are more likely to be victims of physical or sexual assault than their peers who do not drink

Why teens drink…

  • teens, as they mature, often try to assert their independence and take risks and do not realize or understand the consequences of their choices and actions
  • peer pressure, to fit in
  • to feel good, reduce stress, to relax
  • easy access: most teens who drink get it from their home
  • drinking often portrayed in the media as fun, relaxing, entertaining, sexy
  • poor self esteem, depression, anger

Ways parents can prevent under-aged drinking…

  • make it harder for teens to obtain it (do not let them have ANY access in home)
  • drink responsibly if you, as apparent do drink in front of your teen
  • TALK to your teen about the dangers of alcohol
  • KNOW your teen’s friends, and their families
  • have dinners together and talk about how life is going—BE involved in your teen’s life!