The Center of Disease Control has marked measles for extermination in this country.
They may even have a pretty good shot at it.
Everybody is also trying to eradicate head lice (and nits).
That's a war that's been waged for thousands of years. There's some progress, but extermination? There's a lot better shot at measles.
But between the two, there is room for a lot of things a parent can do to get a child ready to enter or go back to school next month.
Spokesman at the Center for Disease Control in Atlanta have seen measles cases drop significantly, but they'd like there to be none. No measles. Not one red spot.
Meredith Hickson, public health education specialist at CDC's Immunization Division noted recently that it's a lot easier to "raise immunizations from 80 to 90 percent than from 90 to 91 percent because it means searching out those last little pockets."
"Now we're starting to get cases recorded brought in from England, Canada, Mexico, and we're really investigating each case and following up on contacts. We hope to start a world wide movement if we can. The vaccines are there. It's just a matter of getting them out."
The District of Columbia hasn't had a proven case of measles in a local child since September 1978, according to Dr. Martin E. Levy, head of the Communicable Diseases Control Division of the D.C. Department of Human Services. (Last month, a 22-month-old child from Wales contracted something that is believed to be measles, although the final tests aren't in yet.) Even a couple of years ago when there was mini-epidemic just over the D.C. line in Prince George's County, Levy says proudly, "There wasn't a single case on our side of the street."
Meanwhile, the measles battleground is basically among preschoolers who haven't been immunized yet and among adolescents and some young adults who may have received early kill-virus vaccines that are not believed to afford much protection, or vaccines from a poor or too-old batch.
With CDC eager to send measles the way of smallpox "schools all over the country are getting pretty hard-nosed" about requiring proof of immunizations, says Dr. George Cohen of Children's Hospital. (And now that smallpox has been essentially wiped off the face of the planet, these vaccinations are not only no longer required, but doctors now recommend against having them at all. "The risk of illness or fatality from the vaccination is now more likely than from the disease itself," says Cohen.)
Basic immunizations should begin at the age of two months with the so-called DPT (Diphtheria, Pertusissis -- whooping cough -- and Tetanus) and with the anti-polo vaccine. As a genral rule, there should be three doses, two-months apart, and a booster shot a year later.
(These can be telescoped in certain cases, Levey notes, as in the child ready to start school without having had the full series, for example.) The MMR -- measles, mumps and rubella, so-called German measles -- begin at about 15 months, with a booster three months later.
Booster shots should be maintained -- especially for tetanus, but also for diphtheria and polio -- over a lifetime, usually at about 10-year intervals.
"Fortunately," says Levy, "diphtheria is not frequent, but it's still around." So is polio, as witness the recent outbreak in Amish communities in Pennsylvania and Maryland.
An Meredith Hickson points out that about half the cases of tetanus in the U.S. are among adults, even past 50, who have failed to keep up immunities.
None of the so-called childhood diseases should be regarded as "kid stuff," warns Hickson. Complications from measles can include encephalitis (brain inflammation) and subsequent retardation. Mumps can leave males sterile. Rubella in a pregnant woman can cause retardation and disfigurement in the fetus. Polio, diphtheria and tetanus are themselves life threatening and whooping cough is no fun. (Believe me, I had it.)
Schools and local health departments have requirements and clinic locations. Most allow some time period to make up immunizations, but it's safer to check.
Getting the youngsters and their older siblings immunized is essential, but, says Cohen, it is also important to "remember to keep an exact record of every shot your child has ever had. It saves a lot of hassle later on." And school officials and you will have the certainty that your youngsters are safe.
Levy notes that when in doubt, even when a parent "thinks" the child might have had measles or one of the other often ambiguous childhood illnesses (except for mumps, which is genrally unmistakeable) it doesn't hurt to revaccinate. "If you're immune, the virus in the vaccine will be inactivated anyway, and if not, you needed it," is his logical rule of shot.
Before school starts is also a good time to check for hearing or vision difficluties in a child -- county and city schools or health departments often have useful tips on that -- and even for those ever-present head lice which have, for the past few years, been at a cyclical peak.
All authorities are quick to note that the louse problem has nothing to do with cleanliness, sanitation, good habits. The louse, which can neither jump nor fly, is spread most often from child to child at play or when hats or combs are exchanged. (For reasons scientists do not entirely understand, relatively few blacks are afflicted.)
Cohen suggests that before the youngster goes off to preschool or school, parents sit them under a gooseneck lamp and check for the pest's eggs, known as nits, which look like flecks of dandruff, but are firmly attached to the hair. (Only one or two lice at a time are ever on any given scalp, genrally, but if there, they -- or it -- may be found lurking behind an ear or at the nape of the neck. Nits are more easily spotted.)
These unpleasant creepies are more easily dealt with these days. But check with a doctor for a prescription or over-the-counter preparation. (The Medical Letter, the nonprofit newsletter on drugs, notes that most major anti-louse chemicals can have side effects. It notes that by and large the non-prescription preparations are less toxic than those containing lindane -- now available only by prescription. The letter also suggests that sheets and clothing "can be disinfected by machine washing with hot water, machine drying on the hot cycle for 20 minutes, ironing, dry cleaning or storage in plastic bags for about two weeks." There are anti-louse household sprays, but the letter suggests that "they are no more effective than vacuuming and should not be used.")
Above all, teach your youngsters to keep their comb and their hats and their scarves to themselves. And whereas the phrase "putting your heads together" may be splendid way to teach concensus and cooperation, it should be emphasized that, taken literally, it is a perfectly lousy line . . .