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ParentsCanada - April 2015

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.com 11 UP FRONT PARENTING DR. MARLA In general, many vaccines require booster doses to confer ongoing immunity. For example, we update tetanus every 10 years. On the other hand, some vaccines confer ongoing immunity if the series is completed. In the case of the measles vaccine, it was introduced many years ago and only one vaccine was given. It subsequently had been found that one vaccine does not give sustained immunity to everyone. If you only had one shot, as most did between 1970 and the early 1990s, as many as 15 percent may not have sustained immunity. If you have two shots, as became routine practice in the mid 1990s, the immunity increases to as high as 99.7 percent. When we first introduced the chicken pox vaccine, it too was given as a single shot. With ongoing study it was found a second dose of the vaccine would boost the immunity and offer continuing protection. Typically measles is offered after the first birthday and chicken pox a few months later. At age four, the newer combined vaccine for measles, mumps, rubella and chicken pox is given again. People born before 1970 are thought to be immune to the disease through exposure. Measles is a highly contagious disease that is spread from body secretions. When you cough or sneeze, the virus particles are propelled into the air and can stay suspended indoors for up to two hours. Individuals with measles are infectious and contagious days before the rash appears until four days after the rash appears. It presents with high fever, a runny nose, cough, watery eyes (conjunctivitis), white spots in the mouth called Koplik spots and of course the rash itself. Measles caused 145,000 deaths throughout the world in 2013. One in 3,000 are at risk of dying and there are other serious complications such as encephalitis, pneumonia, otitis media and diarrhea. The best strategy to protect you and your family is to make sure your immunizations are up to date. Keep a record of your vaccinations and review with your health care provider what vaccines need to be updated. Got a question about kids' health? Read Dr. Marla's archived Q & As or submit your question at©Maya Kruchankova I understand vaccines can wear off in some adults. How do I tell if I need a booster shot for measles? All rain is slightly acidic. The Dr. Is In Depending on where you live in Canada, the content of sexual health education in Grade 5 might be a little different. Hopefully the letter sent home tells you some of the key topics that will be covered, but you can call the school and find out what is in the curriculum, to help with homework. Typical content for this age would include the changes of puberty, so young people understand that what is happening in their body is normal. Some of those first changes, like hair starting to grow under the arms, can begin as early as eight or nine. By 12, about half of girls have already had their first period, so it's important to have those conversations early to be prepared for these changes. Some classes might also talk about sexual harassment, sexting and healthy relationships. Although it might feel a bit uncomfortable to think about your son or daughter growing up already, they need accurate knowledge to make healthy choices. But beyond basic biology, they also need you to share your values and hopes for them, to help them make sense of all the different messages they encounter in the media, on the playground or in the music they listen to. Your daughter might ask about your own experiences growing up, and that's a great place to share your honest, thoughtful opinions. It's best to answer questions as briefly and accurately as you can – and it's okay to say you don't know, and offer to learn about it together. (Check for reliable sources online in advance, though!) Chances are your child won't ask detailed technical questions, but will have equally important questions about feelings. They need you to reaffirm this is all part of growing up, and that you're willing to share in their learning. My daughter in Grade 5 has brought home a letter from school saying that they will be starting a sex ed unit. What should I expect and how should I handle her questions? ELIZABETH SAEWYC, PHD, RN, AND A PROFESSOR IN THE SCHOOL OF NURSING AT THE UNIVERSITY OF BRITISH COLUMBIA IN VANCOUVER, RESPONDS: Expert Advice What is hand, foot and mouth disease and is it preventable? DR. MARLA Hand, foot and mouth disease is a descriptive term that is used to describe a common viral illness. It typically affects children younger than five. It can be quite a distressing disease with rash and sores in the mouth. As the Centers for Disease Control describes, the disease is caused by a virus. While there are several viruses in the group, the one many are familiar with is the coxsachie virus. Enterovirus can also cause the disease. Typically the disease presentation can be non-specific with fever, loss of appetite and sore throat. After two days of fever, we typically see the painful lesions in the mouth. This is then followed by a rash, which, as its name suggests, typically appears on the palms of the hands and the soles of the feet (although it can appear elsewhere such as the mouth). The concern in young children is keeping up with fluid intake and avoiding dehydration due to the painful mouth lesions. Usually complications are not common, but on rare occasions meningitis and encephalitis can occur. The virus, like so many other viral diseases, is transmitted through secretions such as saliva or nasal mucus, as well as sputum. Infected blister fluid contains the virus and there is also viral excretion in stools. As a result the virus is spread through the air – so-called airborne transmission – from coughing or sneezing as well as contaminated surfaces. Be sure to wash your hands well, particularly when exposed to soiled diapers. Unlike the measles, there is no vaccine to protect against hand, foot and mouth disease. It is important to wash your hands frequently and for an adequate length of time. Keep surfaces clean as the virus can be transmitted through contaminated surfaces and toys. Don't share cups, glasses and other utensils. There is no specific treatment other than using mouthwashes or sprays to help with pain, pain relievers if required (do not use Aspirin or ASA) and a concerted effort to stay hydrated. As always, consult your health care provider. It's easy to keep track of your entire familiy's immunization records with Immunize Canada's app, available at

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