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Category Archives: Child Care

It is time to start thinking about getting the Flu vaccine. There will be flu shot clinics offered in the local area in the upcoming weeks that anyone can go to. Often these clinics are underutilized. There is still a great deal of misunderstanding about the flu vaccine and who should be immunized.

Each year an average of 20,000 people are hospitalized, and between 2,000 and 8,000 Canadians can die of influenza and its complications. Those most likely to suffer complications of the flu are the most vulnerable; children under two and adults over 65. The seasonal influenza vaccine is safe and effective and can benefit people of all ages. The flu shot only provides protection up to 12 months; immunization is required each year. This year’s flu shot protects against the H1N1 flu virus as well as two other strains of flu. October to mid-November is the best time for immunization, but the vaccine may still be given in winter months.

Who should get immunized? The following is a list from the recommended guidelines.

People at high risk of influenza-related complications, including:

  •  Adults and children with chronic conditions such as:
  • – Cardiac or lung disorders such as asthma

    – Diabetes mellitus and other metabolic diseases
    – Cancer, immunodeficiency, immunosuppression
    -Renal disease
    -Anemia
     

  • Children and adolescents with conditions treated for long periods with aspirin
  • All residents of nursing homes or other chronic care facilities
  • Seniors aged 65 years or older
  • Pregnant women
  • Children aged 6 months to 23 months of age
  • Persons who are morbidly obese
  • Aborigional peoples

People capable of transmitting influenza to those at high risk of complications, including:

  • Health care and other care providers
  • Household contacts of those at high risk and to infants less than six months
  • Members of a household expecting a newborn during flu season
  • Women at all stages of pregnancy or breastfeeding mothers
  • Those providing regular child care to children 0-23 months
  • Those who provide services within closed settings to persons at high risk

Others

  • People who provide essential community services
  • People in direct contact with avian influenza infected poultry
  • Healthy people aged 5-64 years should consider getting the vaccine even if they are not in one of the above groups

The list of those who should receive the vaccine is extensive. If you have had an anaphylactic reaction to the vaccine or one of its components you should not get the vaccine. Or, if you have an allergy to eggs you should discuss getting the vaccine with your health care practitioner. However, it has been shown that egg-allergic individuals may be vaccinated using the TIV vaccine.

Children 6 months to less than 9 years who have never received the seasonal flu vaccine require two doses, with a minimum of four weeks between doses.

Please remember that the flu shot cannot cause the flu. If you have become sick after getting the shot in the past it was a coincidental infection of some other kind. The main side effect is pain and redness at the site of injection for a day or two afterward.

The flu shot is effective. Scientific studies show the effectiveness of the flu shot to range from 70% to 90%.

Adults over 65 should also look in to getting the pneumococcal vaccine. Pneumococcal disease, a common complication of influenza, is a bacterial disease that can cause meningitis, bacteremia (a bloodstream infection) and pneumonia. You can get this vaccine at the same time as the flu shot through your doctor.

To date you must get your flu shot through your doctor or the flu shot clinics in the area. At some point in the near future this vaccine may become available to be given by your pharmacist who will be trained to give injections.

If you have any questions about any of the above information please call or visit your local pharmacy.

 

 

Warts are a common viral skin infection caused by human papilloma viruses.  In general warts on the hands and feet are harmless and most resolve on their own.  However, they can cause embarrassment and some discomfort.  There are a couple of over-the-counter (OTC) remedies that work well to treat these kinds of warts.

Infection with HPV occurs with skin-to-skin contact.  Warts are caused by viruses and are passed from person to person.  A common way of contracting the virus is by walking barefoot in public pools, showers etc.

About 30% of warts clear spontaneously in six months and 65% to 78% clear in two years without any treatment.  However, most people would like to resolve warts more quickly than this.  Salicylic acid is a first line OTC option.  This medicine slowly destroys virus-infected skin and may stimulate the immune response of the person infected through mild irritation, which in turn helps clear the infection.  There are a number of salicylic products available.  They range in concentration from 17% to 40%.  A 40% product should be used for plantar warts.  The use of salicylic acid on facial warts is not recommended because of a potential risk of hypo- and hyperpigmentation (skin discolouration).

There is a bit of a regimen to follow with salicylic acid products.  Before treatment the warts should be soaked in warm water for five minutes.  Then, an emery board or pumice stone should be used to remove dead tissue.  The salicylic acid treatment should then be applied.  Treatment may need to be continued for up to 12 weeks. If the wart causes pain, patients can take acetaminophen or ibuprofen for the discomfort. Examples of OTC salicylic acid wart removal products include Compound W, Dr. Scholl’s Clear away Plantar, and Duofilm Wart Remover.

Cryotherapy (freezing) is another common wart removal treatment. This causes irritation and tissue destruction so that the individual mounts an immune response against the virus.  Doctors typically use liquid nitrogen which freezes tissues to -196ºC.  There are also home cryotherapy systems available.  These contain dimethyl ether and propane (DMEP).  Examples include Dr. Scholl’s Freeze away wart Remover, Or, Compound W Freeze off.  Evidence shows DMEP and liquid nitrogen are fairly similar in efficacy.  After application of cryotherapy a blister is formed under the wart.  The frozen skin and wart falls off after about ten days and reveals newly formed skin underneath.   It is recommended that OTC cryotherapy only be repeated three times usually in ten day intervals.

The use of duct tape as a wart treatment has gained popularity.  By putting duct tape over the wart they think the virus is deprived of oxygen which causes irritation and stimulates the immune response to the virus.  Typical administration involves applying silver duct tape over the wart and removing a week later.  Scrubbing the area with an emery board and leaving it open over night.  Then reapplying duct tape.  Silver duct tape has been shown to be more effective than clear duct tape, possibly because of the adhesive.

There are also a number of prescription products that can be used for warts if OTC treatments are ineffective.  Patients with diabetes should consult their physicians before beginning treatment for their warts.  Also, genital warts must be treated by physicians and are not suitable for treatment with OTC methods.

In general OTC wart treatments are effective, however, it may take several weeks for the wart to be removed.  For proper selection of a treatment method come in and speak to your pharmacist.

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Head lice is a very common problem that can affect anyone.  Head lice are tiny insects that are the size of a sesame seed.  They live on the scalp of humans where they feed on blood and lay their eggs (nits). Young lice are transparent but as they feed on blood they become reddish brown or black in colour.  Nits are whitish-grey tan, or yellow ovals about the size of a grain of sand.

To check for head lice look at the back of the head at the base of the skull.  Diagnosis of a lice infestation requires detection of a living louse.  The presence of nits alone is a sign of a past infestation and may not indicate an active infestation.    You may not be able to see the actual lice but you can probably spot the nits which will be attached to the shaft of the hair, usually in a tear drop shape.  The farther the nits are away from the scalp indicates the longer the individual has been infected.

Head lice can not fly or jump from one person to another.  They can move quickly and transmission occurs through close contact with an infected individual.  Sharing hats brushes, combs, or pillows, can spread head lice.  Also, when children are playing together and they have close head to head contact they can transmit head lice.  To help avoid them advise your child not to try on dress-up clothes at school, and to tuck their hat and mittens in their coat when they are not wearing them.

There are a couple of treatment options available over the counter in Canada.  These include Nix, Kwellada-P, R&C, and Resultz.  Nix, Kwellada-P, and R&C contain insecticides.  Resultz contains ingredients that are not classified as traditional insecticides that work by dissolving the wax that covers the exoskeleton of head lice causing subsequent dehydration and death.  All of the products are considered safe if they are used as directed.

Do not rinse the products while your child is in the bath to avoid over exposure to the active ingredients. Read the instructions on the packaging carefully. Some products must be applied to dry hair and others to wet hair.  All close contacts to the infected individual should be treated regardless if lice can be detected on them or not.  Also, the  affected individual should be retreated within in 7 to 10 days of the first infestation.  In addition to using an OTC product, manual removal of lice and nits is necessary.  The hair should be inspected in one inch segments. A fine-toothed come can be used to comb out remaining live lice and nits.  This may need to be repeated several times throughout the week.  Not doing proper manual removal can cause failure of treatment.

Wash all bedding, stuffed animals and soft toys in the washer, and dry in a hot dryer.  Vacuum areas that can not be washed.  Do not use mayonnaise, petroleum jelly, olive oil, margarine, or other natural products.  There is little evidence to prove efficacy and/or safety.

If all of the steps are followed and the lice persist, they may be resistant to traditional treatment.  In some cases the individual can be prescribed an antibiotic (trimethoprim/sulfamethoxazole) which will kill the lice when they take blood from the host.  Another option is to try permethrin 5% cream left on the head overnight.  If you run into treatment resistant lice you will need to contact your physician before these methods are attempted.

Although lice can be troublesome and time consuming to treat, most problems can be solved by following the directions of the products and being persistant in making sure the problem is eradicated.

For further information on lice treatment please come and speak to your pharmacist.

In the last few months we have seen a number of people for treatment of Pinworms.  This type of infection is fairly common most often found in children five to ten years of age because of poor hand washing and close contact in school.  The treatment is simple but some steps need to be followed to help prevent reinfection and spread of this problem.

The most common symptom of this problem is an itchy rectal area.  This is caused by tiny eggs deposited around the anus by a female worm.  When someone with pinworms scratches their perianal area, eggs may lodge under their fingernails and spread to anything he or she touches.  Infested dust, clothing, bedding, or toys can also spread eggs.  When someone accidentally ingests these eggs they become infected.  Adult females live for approximately three months in a human host.  At night they migrate from the rectum to the anus and deposit their eggs.  In moist, humid conditions eggs can survive for up to two weeks.

Pinworms do not cause abdominal pain, bloody stools, fevers, or poor appetite.  If you have these symptoms you should go to the hospital.

If you suspect your child has pinworms the best way to detect them is the “Scotch tape test”.  This is best done at night after a few hours of sleep.  Wrap a piece of cellophane tape around a tongue depressor sticky side out and press it to the skin around the anus to collect any eggs.  Take the tape to the doctor who can look under a microscope to look for pinworm eggs.  If you can collect several samples of tape, 90% of cases will be detected.

If one person in the household is diagnosed with pinworms all of the members of the family should be treated for the condition.  There are two main types of treatment.   The first is Combantrin (taken as a single dose as a liquid or tablet) which is purchased without a prescription.  It is dosed based on weight and should not be given to pregnant women or children under one year of age.  The second is Vermox.  This is a prescription medication also not recommended for pregnant woman, or children under two years of age.  Both types of treatment may need to be repeated because eggs can survive for a few weeks.

Other steps to take include careful hand washing (including scrubbing under fingernails), especially after using the toilet and before eating.  All bedding, clothing and toys need to washed.   Clean underwear and pajamas need to be worn every night.  Bathrooms should also be cleaned particularly well to remove eggs.

It is common to become reinfected with pinworms several months after treatment.  If this happens the doctor should be contacted and everyone should be retreated.

Pinworms are an annoying, but usually, unserious infection.  With proper treatment and care it can be cured.  Talk to your doctor or pharmacist if you suspect you or a family member is infected.