Q. My neighbor's 4-year-old son has not been vaccinated for whooping cough, and his parents have no intention of having it done. What danger is there to people who come into contact with him, or to him when he comes into contact with others? Also, aren't there laws requiring vaccination before children can attend public school? A. Whooping cough, also known as pertussis (meaning intensive coughing), is a serious childhood illness causing severe coughing fits and a whoop-like sound that the sick child makes when taking a breath between coughs. Whooping cough can cause pneumonia, brain damage and death, especially in infants. Before pertussis immunization became available in the 1940s, whooping cough killed 7,000 children each year. Now, only about 10 fatalities occur annually.
Your neighbor's son has a small chance of getting whooping cough, but it's much higher than it would be if he had been immunized. He poses no danger to those he comes into contact with.
Without going into the entire controversy, let me emphasize that the American Academy of Pediatrics continues to recommend pertussis vaccination, which is usually given as the DPT (diphtheria, pertussis, tetanus) shot at 2, 4, 6 and 18 months, and 4 1/2 to 5 years.
A current shortage of pertussis vaccine has prompted the Centers for Disease Control to recommend that children under 1 be immunized in preference of older children, who should receive their final booster shots when supplies become more plentiful. The AAP supports this recommendation.
But the general policy of using the vaccine remains, and I fully support it, as long as children who shouldn't get the vaccine don't.
Children who have had any of the following reactions should not receive additional pertussis immunizations: seizures, impaired brain function, collapse or shock, persistent screaming episodes (prolonged periods of peculiar crying or screaming that cannot be controlled by comforting the infant), high fever (105 degrees or greater), or excessive sleepiness. Fortunately, these reactions are rare. Children with a progressive neurologic disorder should receive pertussis immunization only when the physician judges the benefit to outweigh the risk.
Laws in the District, Maryland and Virginia require pertussis immunization, among others, for public school attendance. Exceptions to this are those children with medical or religious restrictions prohibiting the vaccination. Q. I am a 23-year-old woman and have some questions about iron. How do I know if I need an iron supplement? What are the symptoms of anemia? What are the dangers of self-prescribed over-the-counter iron pills? Is it possible to get enough iron through diet alone? A. Because of menstrual blood loss, women of child-bearing age require more iron than men. Pregnant women have increased iron needs and usually require iron supplements. The recommended daily allowance of iron is 10 milligrams for men, 18 milligrams for women (10 milligrams after menopause) and 30 to 60 milligrams for pregnant women.
Lack of adequate iron leads to iron deficiency anemia, the most common form of anemia, or reduced amount of blood. A simple blood test will tell you if you have anemia or not. If you do, your doctor may do further tests to find out what kind of anemia it is and what treatment you need.
Many people with anemia aren't aware of it, but some people tire easily or develop shortness of breath with activity.
You can get enough iron in your diet by eating iron-rich foods such as liver, beef, eggs, dark green leafy vegetables like kale, and iron-fortified cereals. Also, cooking in iron skillets can add some iron to your diet.
Over-the-counter iron pills are generally safe if you take them as directed. They can be poisonous in large amounts, so keep iron supplements out of the reach of children.
Another possible danger is that iron supplements might mask the signs of a serious cause of iron deficiency, such as intestinal cancer. In older people particularly, iron deficiency should be viewed as a sign of something wrong -- whether it be poor nutrition or hidden blood loss from the intestines -- and investigated by a physician.