Dr. Randall G. Fisher

Certain types of infections contracted by a mother can and do affect the fetus during pregnancy, but the majority do not. Common colds, vomiting illnesses, etc., will not affect the fetus. Influenza infection can be particularly bad in pregnant mothers, so you should make sure you are up to date on flu vaccination.

The diseases that do affect babies most commonly are CMV, toxoplasmosis, HSV, HIV, syphilis, rubella, and parvovirus (there are others, too, but these are the main ones). You should have been vaccinated against rubella. Toxoplasmosis is contracted in America mostly by cleaning cat litter; pregnant women should NEVER clean a litterbox. Eating raw beef (like steak tartare) can also cause toxo and should be avoided. Herpes simplex virus, HIV, and syphilis are all sexually transmitted; a pregnant woman should always protect herself against sexually transmitted infections by requiring her partner to wear a condom. There is nothing much that can be done to protect oneself against CMV or parvovirus.

Final thing I forgot to mention is that there is a bacterial infection called Listeriosis that can sometimes cause severe disease in newborns. It is transmitted generally through lunch meats and hot dogs. Avoiding lunch meats and hot dogs while pregnant isn’t a bad idea.

Randall Fisher, M.D.

The answer to your question is that it depends. Many younger adults get pneumonia and are able to be successfully treated with oral antibiotics and do fine. The vast majority, in fact. However, sometimes if the pneumonia is complicated or is due to certain types of organisms (particularly Group A strep), the prognosis can be more guarded. Rarely, a healthy younger adult can succumb to a particularly severe pneumonia. So, the question is kind of hard to answer. I guess I’d say that most of the time the disease, though it can make you feel really terrible, is not particularly dangerous if diagnosed and treated appropriately. But dangerous forms of the disease do exist.

Randall Fisher, M.D.

Most of the time a so-called stomach bug will make a person extremely miserable for between 24-48 hours. There can be frequent diarrhea and/or vomiting. The biggest danger is becoming dehydrated. I would encourage your son to take small sips of water or Gatorade (or a similar product) fairly frequently. This usually works better than trying to get a lot of fluids in at one time, which is more likely to cause more nausea and vomiting. Sometimes intravenous hydration becomes necessary. If your son’s eyes are sunken or he hasn’t peed in 6-8 hours or more, he may need fluids. A “stomach bug” is not the only thing that can cause vomiting. Take him to medical care if he has high fever, if he is having hallucinations, if he vomits blood or poops blood, or if he becomes dehydrated.
I hope this helps.

Randall Fisher, M.D.

Depending on where you get the blood drawn, it could take anywhere from about one day to perhaps a week at the longest. Usually, results come back within 1-3 days. If you are at all concerned that you might be HIV infected or that you might have been exposed to HIV, please go get tested as soon as you can.

Randall Fisher, M.D.

You cannot get the flu from the flu vaccine because it is not a live virus. People can get a sore arm for a couple of days, and sometimes for about 24 hours after you get the shot. You may not feel completely active or may have slightly reduced energy. These are both signs that your body is making a good response to the vaccine. At the time flu vaccinations are given, there are a lot of other respiratory viruses circulating. Sometimes people get the vaccine and then develop infection with one of these other common cold viruses. The coincidental timing makes them believe that the vaccine made them sick. It is impossible for the flu vaccine to actually make you sick.

I hope this was helpful.

Randall Fisher, M.D.

There is good information at the CDC site on the web. There are several things that have been proven to repel mosquitoes effectively: DEET and picaridin are the most well studied. If you choose to go with DEET, preparations come with a variety of concentrations. Higher concentrations mean that protection will last longer. Wash it off when you no longer need it. Avoid going outside at dusk, which is the peak feeding time for most mosquitoes. Keeping your skin covered is another option. I have found that sun sleeves (which you wear on your arms to prevent sunburn and aging effects of sunlight) also seem to protect me from mosquito bites.

Randall Fisher, M.D.

Yes, there is a flu epidemic every year, and this year will be no exception. About 15% of the population contracts the flu when it comes around. It can make you really sick. Flu vaccination is not perfect, but it is much better than nothing, is not particularly painful, isn’t hard to find, isn’t expensive, and in some places you can get a $5 gift certificate for getting vaccinated. You may also protect those around you by getting yourself vaccinated. So, yes, by all means, you should get your vaccine this year.

Randall G. Fisher, M.D.

There is not an epidemic of meningitis in school children. Bacterial meningitis has, indeed, become much less common over the past decade or so, largely due to the fact that we have great vaccines against Streptococcus pneumoniae and Neisseria meningitidis, the two most common causes. For a long time we lacked a vaccine against N. meningitidis type b, but now we have one of those, too. The incidence of bacterial meningitis is actually highest during the freshman year of college, particularly in students who live in the dorms. Most colleges, therefore, require N. meningitis vaccination for their incoming students. Having said that, even before the vaccines, the risk was quite low. The disease can certainly be devastating, but it was never common.

Randall Fisher, M.D.

Pinkeye can be viral, allergic, or bacterial. Treatment depends to a great extent on what is causing the problem. Allergic pinkeye is treated with antihistamine drops. Viral conjunctivitis and even bacterial conjunctivitis generally resolve on their own, with or without treatment. Sometimes it’s hard for the doctor to tell the difference, so antibiotic drops or ointments are often prescribed, even though they are usually not necessary. I would avoid sulfa-antibiotic containing eye drops at all costs, as allergic reaction to them can be severe. The condition, unless allergic, is highly contagious, so good hand washing is important.

Randall Fisher, M.D.

The chances of developing Zika virus infection from mosquito bites obtained on a recent trip to Florida is extremely low. There have not been any Zika cases in the recent past.

Randall Fisher, M.D.

Yes, it is theoretically possible to contract herpes virus infection from sharing cups, as the virus is shed in the saliva, sometimes even when no cold sore is present. Other infections can also be spread in this way. It is probably best to avoid cup sharing.

Randall Fisher, M.D.

Of course herpes virus can spread in children. Most commonly, herpes virus is spread when there are active lesions. In children, this is usually a cold sore (herpes lesions around the lips). Sometimes, toddlers will develop much worse problems with their first infection with herpes, generally a condition called herpes gingivostomatitis. In this situation, there are many lesions all around the lips and inside the mouth on the gums and the mucosal surfaces in the mouth. Sometimes this is severe enough to make it so that they can’t eat and drink well because of pain.

Herpes virus can also be spread when no lesions are present, but the probability of spread is highest with gingivostomatitis, then with an isolated cold sore, and finally, when no lesions are present. Children probably spread the virus more readily than adults, especially toddlers, because they are less careful with their secretions. At certain ages, they are mouthing objects and drooling as well, which increases the risk of spread. Herpes infection is very common; at least 60%-65% of adults in America have been infected by the virus (not all of them have shown symptoms).

Randall Fisher, M.D.

Yes. There is a vaccine for chickenpox, and it’s part of the routine childhood immunization series. It’s called Varivax. You can ask your doctor for it.

Randall G. Fisher, M.D.

There is no such thing as “slapped cheek syndrome,” or “slapped cheek disease,” but there is a disease that causes a rash that is described as a slapped cheek appearance. The disease name is erythema infectiosum, but it is often called “fifth disease” or, incorrectly, “fifth’s disease.” It is a common viral infection/rash syndrome of childhood. It is called “fifth disease” because it was the fifth of the common childhood rash diseases to be described. It is caused by a virus called Parvovirus B19, and yes, it is contagious. However, once the rash appears, the period of contagion is generally over. Incidentally, the parvovirus that causes erythema infectiosum is not the same virus as the parvovirus that dogs get. Dogs cannot contract human parvovirus infections, and humans cannot contract dog parvovirus infections. Erythema infectiosum is generally fairly benign. It goes away on its own and is usually not a serious problem. In addition to the slapped cheek rash on the face, there is often a lacy rash on the shoulders and upper arms. It should be noted that the rash of this disease can last for weeks or even up to a couple of months, or it can go away and then come back for about that same time period. If the rash does go away and come back, that is nothing to worry about.

Randall Fisher, M.D.

Treatment of children with Lyme disease is very similar to that of adults, except if the child is less than 8 years of age. Uncomplicated Lyme is treated with doxycycline for 14-21 days. For children under 8 years of age, amoxicillin is used instead. Duration of treatment is the same.

Randall Fisher, M.D.

Strep is spread from person-to-person, in a similar fashion to the common cold.

Randall Fisher, M.D.

Children with chickenpox are contagious until all the pox lesions have crusted over. The amount of time this takes varies, but is usually about 5-7 days. Contagiousness actually starts before the skin lesions even appear, so that part is not predictable. The END of the contagious period is very easy to ascertain because you just wait until the lesions are all crusted over and no new lesions are appearing.

Randall Fisher, M.D.

He is okay to go back to school after he has been on antibiotics for 24 hours.

Randall Fisher, M.D.

It is not uncommon at all for a child to have a low-grade fever after receiving a vaccination. If anything, it’s a good sign. His immune system is responding to the vaccine. As long as the fever does not become high and he doesn’t act like he is sick in some other way, I wouldn’t worry about it at all.

Randall Fisher, M.D.

It’s perfectly fine to have the booster at the time your son got it. Getting two doses increases vaccine effectiveness from 86% to 98%. People who get two doses are more than three times less likely to get breakthrough chickenpox versus those who only get one shot.

Randall Fisher, M.D.