John T. Rowe, MD

Hepatitis B Vaccine Immunity Wanes after 15 Years

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A Serious Viral Liver Infection

          Hepatitis B is a serious viral liver infection.  While most individuals with Hepatitis B recover, some may develop a chronic infection that can eventually lead to cirrhosis, liver cancer and even death.  Symptoms may include jaundice, malaise, loss of appetite and nausea.  The Hepatitis B virus is transmitted through blood or body fluids, including saliva, menstrual and seminal fluids.  Sharing needles, sexual contact and perinatal exposure of a baby to an infected mother are common causes of Hepatitis B.  It is important to note that transmission can also occur from sharing inanimate objects such as toothbrushes, razors and towels.  Tattoos and body piercing are also known causes of both Hepatitis B and Hepatitis C transmission.

Hepatitis B Vaccine

          Fortunately, there is a vaccine for Hepatitis B that is usually given as three injections.  The first is given shortly after birth, the second at one to two months of age and the third at six to eighteen months of age.  Recent studies have shown that immunity wanes about 15 years after completion of the initial vaccination series, with only 67% of those who received the initial vaccine series still showing immunity after that period of time.  Since Hepatitis B is acquired mainly through behaviors that occur in adulthood, it may make sense to have a booster dose in the late teen years, although this recommendation has not yet been officially made by infectious disease experts.

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The Americas Declared Free of Measles

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The Americas Are Declared Free of Measles

          Global health experts at the Pan American Health Organization in Washington, D.C. declared this month that the Americas are free of measles…another victory for public health and preventive medicine efforts.  This is both a testament to the effectiveness of immunizations and a reminder of their importance in controlling infectious diseases.  Children in the United States receive the measles vaccine as part of the measles-mumps-rubella (MMR) vaccine at 12 to 15 months and again at 4-6 years.

          Measles or rubeola is a highly contagious respiratory disease caused by a virus.  It begins with a cough, runny nose and fever.  Three to five days after the onset of symptoms a rash appears usually on the forehead and then spreads downward to the rest of the body and out to the extremities.  Health care providers can often identify measles by the characteristic red spots with white centers (known as Koplik’s spots) that can be seen inside the mouth and precede the rash by two the three days.

          While the Americas are the first region in the world to have eliminated measles, twenty million cases still occur annually worldwide.  Since the measles virus can still be imported from other parts of the world where the infection is still endemic, it is important to continue vaccinations for children in the Americas.  While most cases of measles are mild, severe complications can occur, including ear infection with hearing loss, pneumonia, encephalitis and even death.    

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New Report Raises Questions About Progressive Transgender Policies

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Essential Reading for Those Interested in Having a Balanced View

          A new study, Sexuality and Gender, published recently by the journal The New Atlantis calls into question the theories advanced by progressives concerning sexual orientation and identity and specifically ideology surrounding transgender behavior.  The authors, Dr. Lawrence Mayer and Dr. Paul McHugh, are both eminent scholars in the field of psychiatry at the Johns Hopkins University School of Medicine in Baltimore, Maryland.  This article is essential reading for anyone interested in having a balanced view on this controversial subject.

Link to the Article:

http://www.thenewatlantis.com/

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Mosquito Borne Diseases

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Illnesses Transmitted By Mosquitoes

          The following partial list of diseases transmitted by mosquitos should be a reminder to all of us of our responsibility to eliminate standing water, the breeding ground for mosquitos, and of the necessity for local government mosquito abatement programs including spraying.  Many of these diseases have been known to occur in North America.

Mosquito Borne Diseases/Agents

Malaria

West Nile Virus

Elephantiasis

Dengue Fever

Yellow Fever

Encephalitis, various types

Chikungunya Virus

Zika Virus

Sources of Standing Water

Ponds, Pools

Old Tires

Containers

Toys

Gutters and Blocked Drains

Pet Water Dishes

Bird Baths

 

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Congenital Syphilis Rates Increasing

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Congenital Syphilis Rates Increasing

          While ‘men who have sex with men’ account for the majority of cases of both primary and secondary syphilis in the United States, the rates of syphilis in women are increasing.  It naturally follows that the rates of congenital syphilis are increasing as well.  Congenital syphilis occurs when a pregnant mother is infected with the spirochete, Treponema pallidum, and transmits the infection through the placenta to her unborn child.  The Centers for Disease Control and Prevention (CDC) recommends that all pregnant women should be screened for the syphilis infection.  Treatment with penicillin is extremely effective in preventing transfer of the infection to the unborn baby, while without treatment, 70% of mothers will transmit the infection to their child.  Babies born with congenital syphilis can have deformities and abnormalities affecting multiple organ systems.

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Increase in Incidence of Hepatitis C

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A Blood Borne Virus

          Hepatitis C is a liver infection caused by a blood borne virus, the Hepatitis C Virus or HCV.  Like Hepatitis B, the infection can cause a short term illness, but some individuals will develop a chronic form of Hepatitis C that can lead to a more serious illness and even death.  Most cases of Hepatitis C are acquired by sharing needles to inject drugs.  According to the CDC (Centers for Disease Control and Prevention) the incidence of Hepatitis C is increasing, making it the largest ongoing infectious disease epidemic in the United States.  It is estimated that 3.2 million individuals in the United States have the HCV infection and 30,000 new cases are acquired each year, accounting for the large number of deaths caused by HCV. 

Drug Abusers at High Risk

          Chronic Hepatitis C infection may take 20 to 30 years to manifest itself, all the while slowly damaging the liver.  This is why many individuals do not know that they have the HCV infection until late in the disease process.  About 75% of those with Hepatitis C infection are aging baby boomers who used drugs in their youth.  The current dramatic increase in HCV infections is due to a younger population now using drugs, such as injecting heroin.  The CDC is calling for more screening of high risk populations (Baby Boomers and now the younger population of drug abusers) for the Hepatitis C Virus.  With early identification, effective treatments can be implemented; however, with a total cost of treatment between $50,000 and $80,000, the best approach would seem to be the prevention of drug abuse.  It only makes sense that gateway drugs like marijuana should remain illegal.     

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