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1. Has my child been vaccinated?
The first dose of MMR is given at 12 months and the second dose is given at the 4 or 5 year visit. Unless you have missed appointments or declined recommended vaccines, your child should be up to date! You can verify your child’s vaccines on MyChart (https://mychart.luriechildrens.org/MyChart/).
2. How effective is the MMR vaccine?
1 dose of MMR gives 93% protection against measles and 2 doses raises that to 97% protection! Titers are not routinely recommended to check for protection.
3. Can my child get the MMR vaccine before 12 months? Does my child need a booster vaccine if he’s already had 2 doses?
The MMR vaccine is approved for infants 6 months and older. Infants 6-12 months should get an early MMR vaccine if traveling to areas with high levels of measles (Europe has been struggling with worse outbreaks than the United States). Currently, there are no recommendations from the CDC or IDPH to routinely immunize infants starting at 6 months. Any infant who receives the vaccine before 12 months will still need two doses on the regular schedule. If your child is up to date on vaccines no booster is needed.
4. What are the symptoms of measles?
Measles is a virus that causes fever and rash. The rash of measles starts at the face and spreads down the body. People with measles may start with cough and runny nose but soon develop high fevers, red/watery eyes, and overall look sick. The rash typically starts 14 days after exposure to the virus.
See some photos here: https://www.cdc.gov/measles/about/photos.html
5. How contagious is the measles?
Very! The measles virus is spread through the air (coughing, sneezing) and can stay in the air for 2 hours after an infected person leaves that space. It is so contagious that 90% of susceptible people will come down with the infection.
6. What should I do if I think my child has the measles?
Unless your child is experiencing a medical emergency, CALL US before leaving the house! Measles is incredibly contagious so precautions will need to be taken before arriving at a doctor’s office, urgent care, or emergency room. We are working closely with the department of public health to triage and test patients on a case by case basis.
Its that time of year again...the weather is finally warm, your kids are playing in the grass, and you find a tick. Should you panic?? Not quite. Lyme disease is harder to get than you think and pretty easy to treat!
Where is Lyme disease found?
Lyme disease is caused by a bacteria called Borrelia burdgorferi which is transmitted by certain types of ticks called Ixodes ticks. Lyme disease is almost exclusively found in New England/mid Atlantic states, northern Midwest, and a little in the rest of the country.
How is Lyme disease transmitted?
It is transmitted through tick bites. A minority of ticks have the Lyme bacteria in their stomach. In these cases, if a tick is attached for at least 48 hours the bacteria can make it up to the salivary glands of the tick and be transmitted to a human. Some studies have even shown that Lyme disease cannot be transmitted unless a tick is attached for at least 72 hours.
What are the symptoms?
The early symptom of Lyme disease is a rash called erythema migrans. It starts as a small red bump and expands to be very large (can be over 6-12 inches) over the next couple days. The rash can be a large red circle or might look like a bulls eye with a light ring. Usually the rash doesn’t bother kids but sometimes it is a little itchy or uncomfortable. Some people may also have fever, muscle aches, joint pain, or headaches. The rash typically is seen 7-14 days after exposure, but may be anywhere from 1-32 days. Later symptoms of Lyme disease include multiple erythema migrans lesions, facial droop, or joint swelling (typically just of one large joint such as the knee).
How is Lyme disease diagnosed?
This is the tricky part—tests for Lyme disease are not very good. We usually diagnose Lyme disease clinically based on the presence of an erythema migrans rash after a tick bite from an area known to have Lyme disease. Antibodies take weeks and weeks to develop; they are typically not detectable when the rash first develops. Only 1/3 of people who are tested early in infection are positive. In fact, some people who are treated early in the disease never develop antibodies at all. When testing is required, we do a blood test that looks for different types of antibodies.
What is the treatment?
Lyme disease is treated with antibiotics for 14-21 days. We use amoxicillin or doxycycline, depending on the child’s age. Outcomes are excellent with no reported bacterial resistance. Blood tests after completion of antibiotics are not recommended.
What should I do if I find a tick on my child?
Remove the tick by grasping it with fine-tipped tweezers as close to the skin as possible and pull the tick straight out. If part of the tick stays in the skin, don’t worry about it. Digging to get it all out will cause more skin damage and may increase the risk of bacterial skin infections. The body will push the rest of the tick out over time.
Antibiotics for an asymptomatic person after tick removal are not routinely recommended.
How do I prevent Lyme disease?
Use insect repellant with DEET up to 30% (for children 2 months and older). Clothing and gear can be treated with 0.5% permethrin. After your children have been outside in grassy or wooded areas, especially up in Wisconsin, check them over for ticks. Remember, a tick that hasn't been attached for at least 48 hours cannot transmit disease.
Other common questions:
Can Lyme disease be transmitted from mom to baby during pregnancy?
All studies say no. There are no documented infections of a fetus or infant. Studies have found no difference in birth outcomes between moms who have Lyme antibodies and moms who do not have Lyme antibodies.
Can Lyme disease be transmitted from breastfeeding?
Again, studies say no. Transmission through breastmilk has not been documented.
Dr. Luu's awesome blog post is too long to put in text--click here to read all about baby poop! Warning, graphic photos!
Car Seats 101
Rear-facing, convertible, booster seats, oh my! Choosing and installing the right carseat for your child can be a daunting task for novice and expert parents alike. The American Academy of Pediatrics (AAP) has a great car seat guide to help navigate the world of car seat safety.
The type of car seat that a child needs depends on their age and size. Your little one should be in a rear-facing seat from birth until at least 2 years old, so when it is time to graduate from the infant car seat to a convertible or 3-in- 1 seat, the new seat needs to remain rear facing. In fact, it is best to keep that toddler rear facing until they reach your particular car seat manufacturer’s height or weight limit. It is okay for their feet to touch the back of the seat while rear facing; this is not a reason to turn their car seat around. Because his head is so big in proportion to the rest of his body, rear facing protects the neck better if you get into an accident. Many countries in Europe now keep kids rear facing until 4 years old!
Hooray, your big toddler is ready for the world of forward-facing travel! They should remain in a forward-facing seat with 5 point harness (this includes your seemingly brand new convertible or 3-in- 1) until at least 4 years old, as long as they remain below the height and weight limits of the manufacturer. Once one of these limits is met, it is time to transition to a booster seat (high-back or backless). The booster seat is needed until your child reaches the magic height of 4’9” and is 8-12 years old. Then, they are big enough to use a seat belt without a safety seat, but cannot call “shotgun” until after they turn 13!