Archive for March 2016

Monthly Archive

New Zika Advice: Sex And Ways To Protect Yourself

Zika Test Tube

I’ll continue to monitor and track Zika news to share with you as I learn about it. My inboxes keep filling up with Zika questions even though I think the risks to our families, if you’re not pregnant or not thinking of getting pregnant, is low. That being said, if you’re thinking of having a baby now or in the next 6 months or if you are not using contraception and are sexually active, listen up.

Last Friday, the Centers for Disease Control and Prevention (CDC) presented new guidelines for preventing the sexual transmission of the Zika virus. The news and recommendations regarding transmission and our behavior is evolving and changing rapidly as researchers, doctors and medical experts learn more about Zika. This science is not complete, but these guidelines best attempt to keep our population the safest it can be with the information we have. Here is a short rundown on the new guidelines.

New CDC Updates And Reminders About Zika:

Number one reason for this is that although daytime-biting mosquitos are the primary transmission of Zika virus (in areas with Zika — click here for info and world maps) sexual transmission of Zika has been documented here in the United States after travel/exposure —> infection). As of March 23rd, of the 273 travel-associated Zika infections documented in the US, 19 cases are in pregnant women and 6 were sexually transmitted.

The below info helps shape ways to protect yourself:

  • WOMEN: If a woman has been diagnosed with Zika (or has symptoms of Zika after possible exposure) it’s recommended she wait at least 8 weeks after her symptoms first appear before trying to get pregnant. As a reminder, symptoms of Zika include rash, red eyes, joint aches, overall feeling of being unwell. Secondary reminder, and one that makes this advice a bit of a challenge to interpret, only 1 in 5 who get Zika virus will have symptoms in the first place. Therefore, if we want to be really careful consider this: if you’ve traveled to a Zika-affected area you may want to wait 8 weeks after returning home before attempting to get pregnant, with or without symptoms.
  • MEN: If a man has been diagnosed with Zika (or has symptoms of the illness), he should wait at least 6 months from those first signs of the illness before having unprotected sex. This recommendation comes off news that the virus has been found live in semen 62 days. The 6 months is a conservative calculation.The CDC took the longest known risk period (about 2 months) and then multiplied that by 3 for conservative recommendations to ensure no transmission.
  • MEN WHO TRAVEL AND HAVE PREGNANT PARTNERS: Men who travel to areas with Zika outbreaks need to prevent transmission to pregnant partners for the rest of the pregnancy. CDC recommends: “Men who have traveled to or reside in an area with active Zika virus transmission and their pregnant sex partners should consistently and correctly use condoms during sex (i.e., vaginal intercourse, anal intercourse, or fellatio) or abstain from sex for the duration of the pregnancy. This course is the best way to avoid even a minimal risk of sexual transmission of Zika virus, which could have adverse fetal effects when contracted during pregnancy. Pregnant women should discuss their male sex partner’s history of travel to areas with active Zika virus transmission and history of illness consistent with Zika virus disease with their health care provider; providers can consult CDC’s guidance for evaluation and testing of pregnant women
  • The CDC is NOT recommending that that men and women living in Zika-affected regions postpone pregnancy all-together like other countries (think Ecuador).
  • Infectious Disease experts feel that a Zika virus infection in a woman who is not pregnant would not pose a risk for birth defects in future pregnancies after the virus has cleared from her blood (roughly about a week after infection is over).
  • They have also updated their Question/Answer page that is chalk full of helpful information.

Blood Testing For Suspected Zika Virus:

For Men, at this time, CDC advises that testing of exposed, asymptomatic men (men with no Zika symptoms but who have traveled) for the purpose of assessing risk for sexual transmission is not recommended.

For men and for women, regardless of pregnancy status, get tested if you develop two or more of the following symptoms during or within two weeks of travel to an area of active Zika virus transmission OR within two weeks of unprotected sex with a man who tested positive for Zika virus or had symptoms of Zika infection during or within two weeks of return from travel to an area with Zika transmission: Read full post »

No Controversy, No Censorship — When Tribeca Got It Right

Screenshot 2015-02-01 12.30.40We don’t know what causes all autism but we do know vaccines don’t. Continuing to elevate myth does NO ONE any good. That’s why the Tribeca Film Festival got it right when pulling a documentary written and co-directed by vaccine science villain, Dr. Andrew Wakefield. Giving him another platform and more voice just isn’t insightful. To me it’s more noise and less what we need. There isn’t controversy here and there isn’t anything new to uncover. Allowing Wakefield more air time and the catapult generated by a film festival just ISN’T going to help us perfect parenthood and it won’t improve our jobs protecting our families, our children, and our communities. The Injustice of Immunization Interviews continues…

Tribeca Film Festival And Vaccines:

Wakefield is a doctor whose work connecting vaccines to autism was retracted from a medical journal (this is nearly UNHEARD of) and a doctor who lost his license to actually practice medicine. He’s not respected nor is his work something for us to learn from. His work may go down as one of the biggest frauds in medical history. Read: Wakefield’s article linking MMR to autism was fraudulent.

The science, on the other hand, is clear and well established. Vaccines have repeatedly and repeatedly been studied with respect to development of neurodevelopment changes and diagnoses on the autism spectrum. Don’t believe the preposterous things the politicians say. The 2011 comprehensive and enormous report from The Institute of Medicine analyzed over 1,000 studies on adverse side effects from vaccines. They concluded, “the evidence shows there are no links between immunization and some serious conditions that have raised concerns, including Type 1 diabetes and autism.” (read more here)

Ongoing research, motivated primarily because of the distrust and fear for vaccine safety propagated in movies, media, and documentaries alike continue to find the very same thing. Science continues to come out on the side of vaccines. Vaccines have adverse effects (fever, pain, seizure, and fainting, for example) but not autism. Read full post »

Candy Or Medicine? Safe Medicine Storage

candy or medicine

Image c/o Strong Health

The role parents play in poison prevention is paramount. The above image shows just how easy it is to confuse medicine with candy. Especially if we message this improperly. When my boys were young I started calling liquid medicines “yum-yums” in an effort to get them to take acetaminophen or other medicine easily only to realize as I was doing it I was advertising the wrong thing…totally novice move as a mom and pediatrician. Clearly as parents we’re always a work in progress.

Safe medicine storage is one of those obvious things we feel we have under control. But numbers for accidental ingestion in the US prove we don’t. Young children are earnestly dependent on us doing this better.

Check out the above image — the packaging of medication earnestly isn’t any different to most of us than the packaging for candy. Imagine a 3 year-old trying to differentiate between the two in a moment of discovery. Pretty easy to imagine a 4 year-old stumbling upon a skittle and seriously impossible to imagine them over-riding their curiosity to explore/enjoy with their mouth. Chances are, that medication/skittle is going into their mouth.

Medication storage isn’t just for your typical over-the-counter (OTC) medications. With our households changing and many people coming though them, we have to think about prescription medications, liquid nicotine, marijuana and household products that all need to be up and out of reach. To that end, safe medicine storage is an important part of family and household safety. This week is National Poison Prevention Week so the perfect time to perfect our homes a little more. This includes any home your child plays in or stays in. Read full post »

One Image Of Parenthood

Usually I arrive here to write and share things that might help. I mean, my hope as a mom and pediatrician is to elevate research, share vulnerability, toss out the irony in the isolation of ideas trapped in an ivory tower and bring in hope for more understanding. I’m usually here to share because I believe if we swap ideas through narrative we all move towards calm and confidence or knowledge and skill as parents, caregivers, adults, children, and partners.

But today I’m just here at my kitchen counter wanting to share an incredible image. Just wanting to make sure you’ve beheld it, too. I haven’t read a single word about the image and I will keep it that way. I don’t want others’ ideas or personal narratives or their agendas to taint what I see. And my hope here is to do the same for you.

All I can say is that for me the image is a triumphant, loud reminder of the immense privilege, the singular honor, and the wired intuition we hold when we get to parent a child. I mean life happens. In all its messy truths and horrific pains, mistakes and brilliant saves, and in our jubilant discoveries and the small gifts given every…single…day. But there was moment this past Saturday, captured by a lens, that explains so much about what and how we fear, what comes flying at all of us on Planet Earth, and what we can truly handle.

Enjoy this photo worthy of a long stare. I get lost in it.

HPV Vaccine Decreases HPV Infections!

Great news about reducing cancer risk. Nothing controversial here…

There is early evidence from a recent Pediatrics study that the HPV vaccine is doing what it was intended to do: decrease the rates of HPV infection in teens and young adults. The study compared HPV in two groups of teen girls and young women–one group during a time prior to the vaccine being used (pre-vaccine era 2003-2006) and another group of similar girls and young women after the vaccine’s introduction (vaccine era 2009-2012). They evaluated prevalence of HPV infection in both groups (from cervicovaginal swabs) to see the effects of the vaccine on the population. The DNA tests from those swabs identified evidence of HPV infection from HPV strains that have been included in the vaccine and also additional strains of HPV infections not previously in the vaccine. Researchers also had information about the girls’ self-reported vaccine status and behavior (sexual activity).

The results are exciting and hopeful when it comes to protection from HPV vaccine.

The study shows a 64% decrease in HPV strains found within the vaccine in immunized girls ages 14-19 and a 34% decrease in HPV in girls ages 20-24 who had received the HPV shot. In my opinion, there are 2 big takeaways to this progress and learning:

  1. The vaccine is effective in protecting teens from acquiring HPV, especially so during teen years. When the shot was given in younger teens they were more likely to have better protection — likely because they are immunized early and thus if/when exposed to HPV infections during their life, they were already protected.
  2. The earlier the HPV vaccine is given, the better the hope for protection against HPV during teen and young adult years. No safety benefit in waiting to be immunized — the risks are the same from the injection but waiting allows more time when a teen could be exposed to HPV. The data out last month may also reflect previous research that the immune response is better when the immunization is given to younger girls and boys (age 11 for example, over age 16 years).

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