streamer = 'Mothers who breast feed and smoke may cause a disturbance in the sleeping pattern of their infant. ~ ~ Global warming will cause a rise in sea level, an increase in respiratory-problems from drought-driven air pollution, an increase in waterborne diseases including Cholera, and an increase in vector-borne diseases such as Malaria and Hantaviruses. ~ ~ Cambodia, Indonesia, Vietnam and Thailand have all experienced the worst outbreaks of Dengue fever. The use of steroids is controversial in some forms of dengue fever. ~ ~ A recent study has shown a an association between pollution and high blood pressure. ~ ~ Cerebral palsy, Fragile X syndrome, Tuberous sclerosis, congenital rubella and Down syndrome have all been associated with autism. 30% of autistic children develop convulsions. ~ ~ A gene named “LRRTM1” seems to increase the possibility for someone to become left handed. The same gene would increase the risk of Schizophrenia. However, the vast majority of left handed people do not have Schizophrenia. ~ ~ People in  charge of providing Humanitarian aid in Darfour are in a state of nervous breakdown. The work is heavy, the food is terrible, and the fear of being attacked or kidnapped is high. ~ ~ In less than a year (9/27/07), 18 countries have been hit by the bird flu H5N1. The situation in some countries such as Egypt, Indonesia, Nigeria, Togo and Ghana is quite difficult. Because these countries do not have the capacity and the mechanisms to respond quickly to a sudden outbreak of bird flu. ~ ~ The updated recommended childhood immunizations schedule for the USA is published in the www.aapnews.org, www.cdc.gov/mmwr, www.pdr.net, www.cdc.gov/travel.  The CDC telephone hotline is 1888-232-4636. ~~ Outbreaks of Infectious Diseases following natural disasters are not common.  Natural disasters disrupt region causing secondary destruction in the infrastructure.  The displacement of people will result in crowding, setting up scenario for potential outbreaks of Infectious Diseases. ~~ Balantidiasis associated with typhoons, typhoid fever and upper respiratory infections  were documented during and after the occurrence of 27 natural disasters between 1970 until 1985. ~~ Floods and earthquakes are the two natural disasters we should be concern of with regard to outbreaks of Infectious Diseases. ~~ The flood in Iowa in 1973 caused  outbreaks of gastro-intestinal illnesses, skin disorders and sporadic Leptospirosis. ~~ The 2000 flood in Mozambique caused an outbreak of diarrhea and malaria. ~~ There was an outbreak of Hepatits A in Khartoum-Sudan following a flood in 1988.  An outbreak of Malaria following the 1983 flood in Ecuador. ~~ Typhoid fever, Measles and Leptospirosis outbreaks followed the 1979 flood in the Dominican Republic and the 1975 flood in Brazil. ~~ Sporadic cases of Vibrio Vulnificus, Vibrio Parahaemolyticus and Cholera followed the flood in New Orleans. ~~ Mosquitoes like water.  A group of researchers from the CDC set up from 1975 until 1997 a surveillance system for Arboviruses diseases.  There was an increase in the number of Mosquitoes after the occurrence of floods and the three most common Infectious Diseases encountered were A) St Louis Encephalitis, B)Western Equine and C) Eastern Equine Encephalitis. ~~ What about earthquakes???  Well, 203 cases of coccidiodomycosis, a fungus, followed the Northridge-California earthquake in 1994.  A large dust cloud was generated by landslide and aftershocks in the mountain North of Simi Valley.  People who spent some time in the dust cloud contracted the fungal infection.  The cases of coccidiodomycosis peaked two weeks after the earthquake. ~~ Costa Rica’s earthquake in 1991 was followed with an outbreak of Malaria that was associated with a heavy rainfall.  Scientists are still unsure if the earthquake or the rainfall were behind the increase cases of Malaria. ~~ What about volcanoes??  ~~ An outbreak of Measles occurred in the Philippines after the eruption of Mount Pinatubo. ~~ In 1991.  Malnutrition and lack of sanitation contributed to the high death rates among children. ~~ Infection with the Hepatitis c virus is the leading cause for liver transplantation among adults in the USA. ~ ~ Sexual transmission of hepatitis c virus occur in 1,5% among monogamous couples. ~ ~ The bird flu has killed more than 130 people worldwide.  Thailand has confirmed the death of two young farmers form the bird flu (August,06). ~ ~ Chloroquine-resistant malaria has been described in South America, Africa, Thailand, Cambodia and Burma. ~ ~ Typhoid fever acquired in India, Pakistan and Egypt may be resistant to conventional antibiotics treatment. ~ ~ Rotavirus is a leading cause of vomiting and diarrhea in infants and young children.  A Rotavirus vaccine-Rotateq is now available.  It is administered as a three-dose series to infants between the age of 6 to 32 weeks.  Children are more likely to have mild, temporary diarrhea or vomiting within 7 days after getting a dose of Rotateq. ~ ~ Gardasil is another vaccine, administered in three doses for the prevention of cancer of the cervix.  The vaccine is given to young ladies between the age of 9 and 26 years. ~ ~ Worldwide Trichinella Spiralis is the most common cause of human infection.  Trichinella Spiralis is a roundworm that causes trichinosis.  People get infected from eating pork. ~~ Poverty,crowding, poor sanitary conditions and poor hygiene contribute to the spread of lice.  Lice is the vector of three diseases; 1-relapsing fever, 2-trench fever, 3-epidemic typhus. ~~ Tuberculosis disease for all ages are higher in urban, low-income areas and in nonwhite racial and ethnic groups. The strongest risk factor for melanoma in children is the presence of more than 100 nevi that are 2 mm or larger in diameter.  Sunscreen is important but it does not provide complete protection.  Children should wear hats and sunglasses as well. ~ ~ A sudden onset of fever, chills, a rash, muscle ache, vomiting and headache followed few days later by joints pain may suggest Rat-bite fever.  Join bebedoc to learn more about Rate-bite fever. ~ ~ Education of children to avoid contact with stray or wild animals is of primary importance. In the USA, Raccoons, Skunks, Foxes and Bats are more likely to be infected with rabies than other animals.  But coyotes, cattle, dogs may also be infected with rabies.  An unprovoked bite by an animal is more suggestive of Rabies, than a bite that occurs during attempt to feed and handle an animal. ~ ~ Pneumoccocus infection is the most common cause of acute otitis media.  Pneumococcus occurs more often during Winter months and is more common in African-American and American Indian than in other racial and ethnic groups. ~ ~ A sudden onset of fever, a rash, headache, muscle ache and a cough are features of Rickettsia.  Join bebedoc to learn more about Rickets. ~ ~ Whooping cough (Pertussis) is a disease on the rise.  A study has shown that mom, dad and older siblings are the known or suspected source of Pertussis in the young infant.  Vaccination is key to Pertussis protection.  A new vaccine named ADACEL is indicated for the protection of Pertussis among people 11 through 64 years old. ~ ~ Pertussis or whooping cough is most severe when it occurs during the first 6 months of life particularly for infants who were born premature. “ Kissing disease” or infection mononucleosis is characterized by fatigue, fever, sore throat and generalized adenopathy.  The majority of children under four years of age with “Kissing disease” have no symptoms. ~ ~ Parents should be informed about the risks associated with the consumption of unpasteurized milk or milk products such as cheese and butter.  Salmonella, Campylobacter, tuberculosis and Escherichia Coli have all been associated with the ingestion of unpasteurized milk, including certified raw milk. Unpasteurized cheese has been associated with Brucella and Listeria infections. ~ ~ Children who bite pose a risk of transmission of Hepatitis B virus and the Human immunodeficiency virus (HIV) in child care settings.~~ Hepatitis B virus can survive in environmental surfaces, outside the human body, for at least 7 days.~~ Skin infection after cat bites can be more than 50%.  Skin infection after Human and dog bites can be around 20%.~~Parents should be aware that ticks transmit diseases. ~~ Culling millions of chickens and ducks has failed to eradicate the bird flu H5N1.~~ One in every 100 females,16-18 years-old, has anorexia nervosa.  The most common complaints of anorexia nervosa are sleep disturbances, absence of menstruations, constipation and vomiting with secondary oesophagitis.~~ Even a single dose of Ibuprofen or Motrin can result in gastrointestinal bleeding and ulcer formation.  Parents are advised not to give their children Motrin but to use Tylenol as the number one drug for fever treatment. ~ ~ The Food and Drug administration has approved the use of Tamiflu as a prophylactic measure in children as young as 1 year who have had close contact with someone infected with influenza A and B.  Vomiting is the most common side effects.  Possible neuropsychiatric events have been reported with 19 cases of convulsions, 13 cases of hallucinations/delirium.  The vast majority of these cases were reported from Japan.  In addition Tamiflu has not been effective in four of eight bird flu-H5N1 cases as reported by Vietnamese officials. ~ ~ Two vaccines are available for the prevention of disease caused by N Meningitidis (groups A,C,W135 and Y).  There is no vaccine available against  Group B.  Group B  accounts for 30 to 90% of all cases in the USA and Europe.  Researchers are investigating new ways to develop vaccines against group B-N meningitidis. ~ ~ Brucellosis in children can cause fever, night sweats, weakness, malaise, weight loss, Headache and abdominal pain.  Children acquire brucellosis from drinking unpasteurized milk or by having direct contact with cows, goats or pigs. Hiccups and sneezing are common in the newborn period. Join Bebedoc to read about Lyme disease,fibromyalgia and chronic fatigue syndrome. The most common complaint of fibromyalgia is muscle pain.  The pain is worst in the morning.  The pain intensifies with the change of weather and is relieved by heat.  Some experts consider that Fibromyalgia has been provoked by a case of Lyme disease. The signs and symptoms of bird flu in chickens are: 1) decrease in activity, 2) gasping for breath, 3)diarrhea, 4)paralysis, 5)facial swelling, 6)sudden death. H5N1 kills domestic fowl quickly and can destroy entire flocks overnight.  It is difficult for humans to catch it.  People who become seriously infected did so after holding, dismembering and coming in close contact with large numbers of infected birds. Children under 4 years of age with a urinary tract infection would complain mostly of diarrhea. The most common causes of traveler’s diarrhea are E.coli and Shigella. In 1980, the world health organization declared that smallpox had been eradicated successfully worldwide.  But there is increasing concern that smallpox may be used in acts of bioterrorism.  Chickenpox is the condition to be mistaken for smallpox.  Both diseases are easily confused in the first few days of the rash.  If you are in doubt call the center for Disease Control at 770-488-7100 for an evaluation. Influenza and meningococcal disease are two diseases associated with the onset of winter. ~ ~ Influenza infection is self-limiting in most cases.  By contrast, the risk of death is quite high among children with meningococcal disease. Meningococcal disease is spread by close contact such as kissing, sharing a drink,sharing from the same food plate, sharing a cigarette or being coughed upon. Millions of wild birds left Europe flu-free last autumn to spend winter in Africa.  There, they will mix with migratory birds from Southeast Asia where the strain H5n1 is far more common.  Therefore, millions of infected wild birds will likely be returning this spring to Europe.  The European governments are worried since they have no control over migration. The celebration of Halloween is over but the spirit of Halloween continues because Halloween is about fear.  And Children face fear everyday.  They fear the dark, fear of being alone,fear strangers and fear death.  There are children who are always afraid of everything. Your children are not your children,They come through you but not from you, you may give them your love but not your thoughts.  Travelers to North Africa, India and Latin America are the most affected by a condition known as Travelers diarrhea. Ciprofloxacin or levofloxacin or azythromycin are the treatment of choice of traveler’s diarrhea.  Ciprofloxacin and levofloxacin are contraindicated in children and adolescents younger than 18 years of age.  ~ ~ Worldwide, Rotavirus is the single most common agent of severe diarrhea in children younger than 2 years of age. Rotavirus is an important cause of vomiting and diarrhea in children attending Daycare. Because Rotavirus can be found on toys and hard surfaces in child care centers. ~ ~ Accidental injuries, suicide and homicide now account for more than 75% of all adolescents’ deaths. ~ ~ Hippocrates said that there were more deliveries during a full moon.  Hippocrates made this observation 2000 years ago. Until now, scientific studies are divided in their conclusions. The moon affects the ocean’s tides. Therefore, the moon should have a powerful effect on the human body since the human body is composed mostly of water. But the moon only affects unbounded water while the water in the human body is bounded.~ ~ Children may be vulnerable to a bioterrorist attack, because they breath faster than adults and they have an increased skin permeability.  Accurate diagnosis may be difficult in children because they are not able to describe their complaints.  An infectious bacterium called Anthrax have the potential to be used in acts of bioterrorism.  Anthrax can cause damage to the skin, lungs or guts.  Inhalation of Anthrax is the most deadly form of the illness.  Naturally occuring Anthrax in the USA is rare. Pediatricians should think fast when they suspect Anthrax in a child and should act fast in notifying the public health authorities. ~ ~ Bebedoc believes that knowledge is power. Give us your feedback at bebedoc@bebedoc.com. ~ ~ Hunger, underfeeding and overfeeding may play a role in the production of infantile colic.  Nervous families may also trigger colicky symptoms in a first-born.  Colicky babies scream in agony and they cry for a long time.  Measurement of the body temperature is important in colicky babies. At present, the method of choice for determining the presence of fever in infants and children is a rectal temperature taken at a depth of 2 to 3 cm past the anus margins until the temperature stabilizes. ~ ~ The onset of head banging is anywhere between few weeks and two years of age.  Head banging serve to relieve tension and in rare instances may go on into preadolescence. ~ ~ Nail biting is one form of expression of inner tension. Nail biting is associated with restless sleep, gritting the teeth, crying out and talking.  The treatment of nail biting must begin with the removal of the causes of the tension or tensions. People infected with the bird flu strain-H5N1 are young and previously healthy individuals. They usually have pneumonia leading to respiratory failure and death in more than half of all cases. The 1918 flu pandemic strain-H1N1 also attacked young and healthy people. Fortunately, there are no reported cases of man-to-man transmission of the bird flu-strain H5N1. ~ ~ Research does not support a belief that multiple vaccines weaken the immune system and make children susceptible to diabetes. However, there may be an association between multiple vaccines and the occurrence of asthma. French researchers found an association between the injection of Hepatitis B to adults and the occurrence of multiple sclerosis.  But American researchers do not agree with the French findings. Internationally adopted children should be immunized against mumps, rubella, measles and chicken-pox viruses upon entry to the U.S.A.  Most refugees and immigrants children have received the poliovirus and hepatitis B vaccines prior to entering the USA.  But, adopted children coming from Asia or Africa should be screened for Hepatitis B. Unfortunately, Tuberculosis remains an important public health problem for refugees and immigrants. Therefore, internationally adopted children should be skin tested upon entry into the United States and retested three months later.  Researchers identified tuberculosis among adopted children coming from Guatemala, Russia, Kazakhstan, India, China and South Korea. ~ ~ Autism-The current estimates of autism prevalence is 1child/166 children.  Parents should be concerned if their child does not respond to his name by 12 months of age or does little to no eye contact or no single words by 16 months of age or if there is a loss of language at any age. Joint attention involves the coordination of sharing attention between the infant, another person and an object. Joint attention is absent in children with autism. Studies do not support the idea that the measles vaccine causes autism. Give us your feedback at bebedoc@bebedoc.com.';