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Lice Treatment & Prevention

Author: Dr. William Rappaport
Date: November 2016

Has your child ever had head lice? If so you know just how irritating it can be to get rid of them!

What are Lice? hair lice identification

Lice and their nits are annoying frustrating little parasites that are not dangerous, but highly contagious if not treated. They do not spread disease. However, they are itchy on the scalp causing scratching, which can lead to infection on the head and the spreading of these bloodsuckers. Adult lice are wingless parasites that attach themselves to the hair shaft. They have claws that allow them to crawl and cling firmly to the hair. It is easy to spread lice from person to person. Children get them by sharing hats, laying head to head, and using pillows of someone infested with the bugs and nits. They are common at summer camps, schools, childcare centers, slumber parties, sports activities, and potentially seats on a train. Some schools will have lice checks at the beginning of the year. However if your child is itching or has been away in areas where kids are in close contact with each other you should always just do a head check.

Lice have an evolution like all living things in the universe. Lice start out as eggs called nits, which are laid close to the hair shaft on the scalp. The eggs hatch 1 or 2 weeks after they are laid. The newborn nymphs immediately start feeding and quickly develop into adults which can feed up to several times a day. Most lice infestations are caught when they are eggs or have just hatched.


Medicated over the counter lice treatments such as Pyrethrins (Rid, Nix) usually kill the lice, but it may take a few days for the itching to stop. Treatment consists of washing the hair with medicated shampoo and removing the lice and nits by hand using a fine toothcomb section by section. It must be done on wet conditioned hair. The combing must be repeated every day for at least 7-10 days. The use of oils, (Tee Tree, Olive) have varying results and are popular to use daily after combing. Lice are often resistant to OTC medications. If this should occur, Malathion (Ovide), Benzyl Alcohol (Olesfia), Spinosad (Natroba), and Ivermectin (Sklice) can be used on older children.

At home it is recommended all sheets, pillowcases, hats, stuffed animals, and clothes should be washed and dried on a high temperature to ensure the bugs die. Carpets and upholstery must be vacuumed. If you treat properly, follow the directions, and are vigilant each night the infestation should be over.


Caring for and causes of Allergies

Author: Dr. William Rappaport
Date: October 2016

Allergies and those pesky symptoms that accompany them can be kept under control with smart preventative measures. Symptoms are key to detection. Keep a diary in order to help your doctor discover exactly what may be causing the uncomfortable, sometimes dangerous, allergies you may be experiencing.

this young woman sneezing into a tissue either has a cold or really bad allergies

  1. Do you or your child find certain foods cause constant cramping or diarrhea?
  2. When you or your child touch furry animals do you experience a rash or uncontrollable sneezing?
  3. Does walking through a park during certain times of the year cause itchy watery eyes, runny nose, sneezing and/or coughing?
  4. How about those itchy, stopped up, popping and infected ears?

They can all be caused by allergies.


  • Skin Rashes (eczema) or Hives
  • Stomach Upset
  • Sneezing, Coughing, Runny Nose, Itchy Eyes
  • Breathing Difficulty (Asthma)


  • OUTDOORS: Tree and Plant Pollens, Insect Bites, Stings
  • INDOORS: Dust Mites, Mold, and Animal Fur
  • FOODS: Peanuts, eggs, shellfish, finned fish, milk, cheese, wheat, tree nuts, soy
  • IRRITANTS: Perfume, Cigarette Smoke, Exhaust from Vehicles, Paints


For dust control taking up the rugs, getting rid of old stuffed animals and encasing the bedding with dust mite covers is very helpful. HEPA filtration units are excellent to control animal dander and changing the air conditioning filters during the spring and fall hay fever seasons reduce the pollen burden in homes. For patients with severe food allergies such as peanuts or tree nuts, complete avoidance of these products in home is essential.


Immunotherapy can be a safe form of long-term treatment to decrease symptoms for people with allergic asthma, rhinitis, insect and conjunctivitis allergies.  These injections, given by an allergist, can be a cost effective long-term approach for most people. For people with food allergies, simply avoiding the trigger is the best way to deal with the situation.


Vitamin D - The Wonder Vitamin

Author: Dr. William Rappaport
Date: August 2016

Did you know it is important for kids to take this supplement as well as teens and adults?

We have all heard about the Vitamin D supplement craze for adults. For our kids, it plays an important role in the bone building process by helping the body absorb calcium. Unfortunately, our kids do not get enough and this could affect their body’s ability in the future to maintain strong bones and teeth.Vitamine D the Wonder Vitamin

Driven by the power of sunlight, vitamin D is synthesized starting in the skin and finished off by the liver and kidneys. Without sunlight the body’s level are very low. Living in the Northeast United States, without regular sunlight, leaves much of the population with insufficient levels of vitamin D in all age groups.

Supplements are needed starting in the infancy to ensure proper bone building for life. Infants and preschoolers should be taking 600 international units daily either as a liquid or chewable. Teenagers and young adults as much as 2000 international units daily to ensure rapid bone growth and bone density as adults.

The importance of Vitamin D supplements for your child go beyond just building bones. Not only is Vitamin D important for strong bones, it has been proven to be a very important part of maintaining a healthy immune system. It can also lower people’s chance of developing cancer, heart disease, arthritis, and diabetes.

You may think that because it is summer and kids are outside and playing in the sun that they are getting enough vitamin D. However, the opposite is true, especially if you are vigilant about using sunscreen. Sunscreen blocks UV rays that cause sun damage and cancer. It also blocks UV rays from penetrating the skin. UV rays set off the process in the body that produces the vitamin D.

Vitamin D can be found in many foods such as fatty fish, fortified milk, soy milk, some cereals, beef, liver, cheese, and egg yolks. Tell me how many of your kids are eating these foods daily. Also, remember our bones reach their maximum density by age 18 so it’s very important to take vitamin D daily.

It is recommended you give your kids this wonder supplement everyday.

Enjoy the summer and happy playing!


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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