Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
My children were not vaccinated against chickenpox. When they were young, we
were living in Europe, where the medical community does not encourage
immunization against this disease. Consequently, my kids developed chickenpox at
an early age, during one month in which over 30 children in our neighborhood
became infected.
I had, in fact, planned to have the children immunized for chickenpox on our
next visit to the U.S., but the infection came before that happened. My oldest
child, who was 4 at the time, contracted chickenpox from a friend at
preschool. He hardly suffered at all; there were perhaps only 20 or 25 skin
lesions in total. Not so for my youngest two children, then aged 2 and a half and 16
months. Because their exposure came from their older brother at home
("prolonged" exposures in the home can lead to more severe disease than casual
or onetime exposures) they were both covered from head to toe with the itchy
spots. Even the membranes of their mouths and eyes were affected, and they were
listless with fever. While no serious complications developed, they were
decidedly miserable and uncomfortable for days.
Living in Europe and talking with other parents, I encountered a good bit of
skepticism about the chickenpox vaccine in use in the U.S. While hardly anyone
considered the vaccine to be dangerous, most felt it wasn't necessary to
vaccinate a child against what they perceived to be a "harmless" disease that
even "strengthened" their child's immune system.
Chickenpox is a common childhood skin disease caused by a viral infection. The virus involved is called the varicella-zoster virus. Today, chickenpox is less common in the United States due to universal vaccination with the varicella virus vaccine, though it still occurs in populations that are not routinely vaccinated. Varicella-zoster virus is often categorized with the other common so-called "viral exanthems" (viral rashes) such as
measles (rubeola), German measles (rubella), fifth disease (parvovirus B19), mumps virus, and
roseola (human herpesvirus 6), but these viruses are unrelated except for their tendency to cause rashes.
In unimmunized populations, most people contract chickenpox by age 15, the majority between ages 5 and 9, but all ages can contract it. Chickenpox is usually more severe in adults and very young infants than children. Winter and spring are the most common times of the year for chickenpox to occur.
How does chickenpox spread?
Chickenpox is very highly contagious. It is easily passed between
members of families and school classmates through airborne particles,
droplets in exhaled air, and fluid from the blisters or sores. It also can be transmitted indirectly by contact with articles of clothing
and other items exposed to fresh drainage from open sores. Patients
are contagious up to five days (more commonly, one to two days) before and five
days after the date that their rash appears. When
all of the sores have crusted
over, the person is usually no longer contagious.
What are chickenpox symptoms and signs?
Symptoms tend to appear 14 to 16 days after the initial exposure but
can occur anytime from 10 days up to 21 days after contact with the virus.
Chickenpox is characterized by one to two days of mild fever up to 102
F, general weakness, and a rash, often the first sign of the
disease. Rarely, a person may have the disease without the
rash. The rash of chickenpox develops in crops with raised red spots
arriving first, progressing to blisters that burst, forming open
sores, before crusting over. This process usually starts on the
scalp, then the trunk (its area of greatest concentration), and
finally the arms and legs. Any area of skin that is irritated (by
diaper rash, poison ivy, eczema, sunburn, etc.) is likely to be hard
hit by the rash. The rash is typically very itchy (pruritic).
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Shingles (herpes zoster) is a skin rash caused by the same virus that causes chickenpox. Under certain circumstances, such as emotional stress, immune deficiency, or with cancer, the virus re-activates causing shingles. Shingles are catching and can spread from an infected person to others who have not had chickenpox. There are a variety of treatments for shingles.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Becoming infected with chickenpox during pregnancy could cause birth defects in your unborn child. Likewise, shingles could also cause problems for your unborn child. If you are pregnant and haven't had chickenpox, avoid exposure to infected people. Zostavax, the shingles vaccine, can reduce the incidence of shingles by half. Women should wait at least three months after receiving the vaccine before trying to get pregnant.
Reye's syndrome (RS, or Reye syndrome) is a sudden, sometimes fatal, disease of the brain with degeneration of the liver. Reye syndrome occurs in children and comes after the chickenpox or an influenza-type illness, is also associated with taking medications containing aspirin. Symptoms include vomiting, listlessness, irritability or combativeness, confusion, delirium, delusions, convulsions, and loss of consciousness. Treatment depends on early diagnosis and focuses on protecting the brain against irreversible damage by reducing brain swelling, reversing the metabolic injury, preventing complications in the lungs, and anticipating cardiac arrest.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
Lymph nodes are an important component of the body's immune system and help
in fighting infections.
They are small, soft, round or oval structures that are found throughout the
body and are connected to each other in chain-like (lymphatic chains) fashion by
channels similar to blood vessels. Each individual lymph node is covered
by a capsule made up of connective tissue.
Within the capsule, lymph nodes contain certain kinds of
immune cells. These
cells are mainly lymphocytes, which produce proteins that capture and fight
viruses and other microbes, and macrophages, which destroy and remove the
captured material.
Where are the lymph nodes located in the body?
Lymph nodes are located throughout the body. Some are directly under the skin
while others are deep inside the body. Even the most superficial (close to the
skin) lymph nodes are usually not visible or palpable (felt by touchi...
My children were not vaccinated against chickenpox. When they were young, we
were living in Europe, where the medical community does not encourage
immunization against this disease. Consequently, my kids developed chickenpox at
an early age, during one month in which over 30 children in our neighborhood
became infected. 
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