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Zika Virus Awareness

Author: Dr. William Rappaport
May 2016

Mosquito ZikaI have been getting numerous calls from patients concerned about the Zika virus. Below are the facts, background and prevention tips. Remember there have always been dangerous viruses that make us very sick including Yellow fever, Dengue, Ebola, as well as, viruses that cause birth defects such as Rubella (German Measles), and CMV.

Time and patience brings vaccines and medications which prevent horrible outcomes. Understanding the facts and ways to prevent the spread can help society at large.

Let's remain smart!


1-People usually get Zika through a mosquito bite but not just any mosquito. It is a mosquito called Aedes aegypti. They live in the below places.

2- Areas of active transmission in the world include Mexico, Areas of Central America, Aruba, Barbados, Bolivia, Bonaire, Brazil, Columbia, Dominican Republic, the Virgin Islands and other temperate climates. Zika is rarely found at elevations over 6500 feet.

3-The most common symptoms are fever, rash, joint pain and conjunctivitis. Most are mild and do not need to be hospitalized.

4- It is rare but possible for Zika to spread from person to person through sexual contact and blood. It is NOT spread through causal contact.


1-The Zika virus, discovered in 1952 in Uganda Africa causes a mild infection spread by mosquitos after a 3 to 12 day incubation. The vast majority of infections go unnoticed but can cause symptoms that include fever, rash, joint pains and headache.

2-Despite a mild infection the great global concern is that Zika causes congenital malformations in newborns specifically, microcephalus and other brain abnormalities. Again, most women carrying malformed infants live or have visited the above areas and were asymptomatic during their pregnancy. Another fear is that Zika can also cause a paralysis commonly known as Guillain-Barré syndrome in both men and women.

3-Although infected mosquitos have not been found in United States today there are greater than 500 infected pregnant women in the United States who have either visited endemic areas or became infected through sexual contact.

4- Areas of the USA at risk for developing endemic Zika virus with high temperatures and dense mosquito populations include Puerto Rico, US Virgin Islands, Hawaii, Guam, Florida and Texas.


1-Mosquito controls such as applying insect repellant (DEET), wearing long sleeves especially in the evenings, sleeping with mosquito bed nets, and treating clothing with permethrin, avoid standing water.

2- Vaccine development is underway. A phase 1 trial will start in September to study safety. Clinical efficacy trials should start in 2017.

3-Symptomatic women who have traveled to endemic areas should wait at least eight weeks after returning home to attempt conception.

4-Asymptomatic women with possible exposure should also wait 8 weeks before attempting pregnancy. Men visiting endemic areas should wait six months or use condoms during that time before attempting pregnancy.

For further information go to http://www.cdc.gov/zika/pregnancy/


Thoughts on Influenza Vaccines

Author: Dr. William Rappaport
September 2015

Flu VaccinationThe flu is as a very severe respiratory infection that can make your life miserable for up to two weeks. The analogy to a cold is that a cold is a lit match and the flu is a fire buring out of control. Not every cough or fever is influenza and these infections cannot be protected by a vaccine.

Real influenza can be protected by vaccines. This happens by causing antibodies to develop in the body about two weeks after taking the vaccine. These antibodies induce protection against specific flu virus's prevalent in the community. How effective the vaccine is varies with the season and the vaccine match to common strains of influenza circulating the globe. It protects against serious symptoms of influenza including high fever, cough, severe malaise, fatigue, and even post viral depression. The vaccine protects against severe illneses such as pneumonia and subsquent hospitalization which can occur in the very young less than five years of age, people older than 65, and those with a lower immune system. Unfortunately, about 30,000 people die every year in this country. Many of these deaths could be prevented by vaccination.

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Prevention and Treatment of Heat Related Illnesses

Author: Dr. William Rappaport
Date: August 2015

Heat related illness can strike anyone unprepared.
The elderly and especially the young are susceptible to heat related illness.

Types of Heat Related IllnessesHeat Related Illness

  • Heatstroke: The most catastrophic form of heat illness. The body is unable to regulate core temperature dues to excessive water loss with temperatures greater than 90 degrees. Core body temperature can remain greater than 104 degrees F. If this should occur, call 911 immediately. Place child in the shade and apply cold compresses and water. 
  • Heat Exhaustion: This situation occurs with excessive loss of salt and water leading to symptons of headache, nausea, dizziness and weakness. This occurs when the child is exposed to excessive temperature greater than 85 degrees with high humidty. Stop all activity, seek shade and cool the child fluids and fanning.
  • Heat Cramps: Salt and water loss least painful muscle cramps.

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Protection From Stinging Insects

Author: Dr. William Rappaport
Date: August 2015

wasp stinging insectBees, yellow jackets, hornets, wasps and fire ants comprise common stinging insects that come into contact with children and their caretakers in summer and early fall months. Most stings cause painful local reactions with swelling and redness taking almost a week to heal. Rarely, a serious life-threatening allergy reaction called “anaphylaxis" can lead to dizziness breathlessness and loss of consciousness. Avoidance is the main weapon. These insects love gathering with food, sweetened drinks and colorful pool side or barbecue clothing. Honey bees are usually docile but yellow jackets and hornets are aggressive and males under the age of 20 are the most common victims. 

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Protection Against Lyme Disease

Author: Dr. William Rappaport
Date: July 2015

Just as we have to protect against sun damage, parents often worry about Tick borne illnesses.red backed tick on a plant

Protection is the number one way to prevent any insect from causing disease. Especially from tick bites especially during the warmer months.

  1. It’s important to teach our children to avoid heavily wooded areas and trekking through the bush. Rather remain in the middle of a trail when hiking or playing in a wooded or bushy area.
  2. Use an insect repellant with 20-30% DEET avoiding eyes, hands and mouth.
  3. Do a full body examination especially around the ears, knees, in hair, belly button, behind knees and between legs.
  4. A brisk shower in the late afternoon shakes off undiscovered deer ticks before they have a chance to latch on.
  5. If a tick is found, pull it out with tweezers and save it to bring to your doctor. You should call immediately if a tick is found.

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The Best Suncreen for Your Child

Author: Dr. William Rappaport
Date: June 2015

Its that time of the year again. Applying SunscreenSchools are closing for summer vacation.
Camps are open.
Family vacations.
The beach.
The pool.

The SUN!

I am often asked which kind of sunscreen should I use to best protect my child. The most important thing to remember is to use a sunscreen that protects against UVA and UBA rays. The SPF should be 30 or more and applied every two hours. No sunscreen can protect 100%, but teaching your child good skin health starts early.

Here are some of the characteristics that you need to look for in a sunscreen: prevention against cancer and aging of the skin. This means it should be broad spectrum against UVA, UVB, water resistant and a minimum of SPF (sun protection factor) 30. Higher SPF doesn't protect better but reapplying every 80 minutes with at least an once even in cloudy conditions and seeking shade will get great results.

Stay safe and protect.

For frequently asked questions I refer my patients to the American Academy of Dermatology.



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