Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

7 Nissan 5762 - March 20, 2002 | Mordecai Plaut, director Published Weekly









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Home and Family
Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

Before we delve into the depths of the ocean to speak about bites from dwellers of the ocean floor, a couple of notes.

First, I had a wonderful two-day getaway in Tiveria, where I met Mrs. S. from London. She is a reader of my column and I hope she is feeling well. I also received word that I shouldn't take offense at the title `Mister' which in Great Britain is a mark of respect for surgeons. My point in making an issue about being called 'Doctor' was not for my own honor, but only to make it clear that Yated is the only religious newspaper -- to the best of my knowledge -- that uses a physician to write their regular medical column. Other medical editors of most periodicals are laymen.

Bottom dwellers of the ocean can be very dangerous. Yellow-bellied sea snakes can cause severe muscle pain and even gangrene, but like the box jelly fish, large sharks and crocodiles -- they are found mostly in Australia. Sea Urchins are common in Israel, they look like a pincushion with spines sticking out that easily break off into a person's foot after stepping on them. They are painful, and often lead to infection from retained pieces, but fortunately they are not dangerous.

Stingrays and skates hide in the sand and stepping on them can cause severe pain, and even affect the heart and cause seizures. Cone shells have a stinger that comes out of the shell to give a person a nice shot of toxin that can stop breathing. The scorpion fish can cause the most painful bite in the animal kingdom, while the stonefish can cause death within an hour if their spines find their way into the skin.

If you are careful to identify these fish before going into their environments, or better yet, not touch any corals or fish you see while swimming, and you swim on a supervised beach that is used often by humans, you probably will not meet up with any of these sea monsters.

Let's move on to insects. Mosquitoes are all over and their stings are well known. We have written about them before -- they are not usually dangerous in themselves unless you are allergic to them, but they can carry a number of diseases.

In Africa and Asia (but not Israel) malaria is rampant; it is the most common disease in the world. Travelers should check with their local health bureau concerning the need for taking anti-malarial drugs before departing. Fevers that come and go are characteristic of malaria. Yellow fever is also spread by these pests - - a vaccine is available.

West Nile Fever has now spread to the USA and will probably be worldwide soon. It causes flu-like symptoms that can be dangerous in the elderly. Encephalitis -- infection of the brain -- is devastating and can be traced to certain mosquitoes who live in climates similar to the Midwest USA. AIDS has not been found to be transmittable by mosquitoes, despite the mosquito using the same stinger to extract blood from all its victims.

By the way, only females sting. Males are much bigger. Mosquito lights do not work, but repellent does. Write me in care of the Yated.

A message from Glaxo, sponsor of this column. We haven't spoke about asthma in a while, but Glaxo is the world leader in medications against this disease. Seretide combines an inhaled steroid with the long- acting bronchial relaxant Serevent, making it the most potent protection against asthma attack. Speak to your doctor about Seretide.

Your Medical Questions Answered!

by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

Ticks are not common in Israel, but they are in cooler areas where Yated reaches. Ticks are blind and affix to their victims by attaching to them as they pass by a tree or stroke an animal. They bury their heads underneath the skin and begin to imbibe blood.

Ticks transmit many diseases. Babeosis is a disease of the Massachusetts area and Lyme disease originated in Lyme, Connecticut. It is transmitted by a very small tick and causes arthritis, a rash and can cause heart disease. Tick paralysis is paralysis of an arm or leg that continues to spread up the rest of the body until the tick is removed. Rocky Mountain Spotted Fever is seen outside the Rocky Mountains and may present without the fever and without the spots. It can cause a person to be very sick and can cause death.

Ticks should be removed carefully, as pulling hard can leave the head pieces in. Killing them with mineral oil beforehand may make it easier. In any case, in all people who do not feel well, a past tick exposure must be reported to the doctor.

Another horror is a little bug that sucks our blood, but does not cause disease transmission as far as we know. Nevertheless, the Middle Eastern version is quickly becoming immune to all known substances. We are of course speaking about lice.

The basics again: Comb out all live specimens daily. Eggs are impossible to remove with any substances known to man (oil, vodka, cement remover, etc.).

The following probably work the best to remove all infestations, once daily combing hasn't succeeded: petroleum jelly (Vaseline) in the hair for a few days is messy, but it suffocates the little buggers. Resprim (Bactrim in the USA) affects the bacteria in their stomachs and can kill them. Ivermectin is a drug against the mite scabies (another scourge that we did not talk about) and it works here too, although it is not available in Israel.

Some other bugs of note: The puss caterpillar of the Western USA can cause vomiting from a toxin in its hairs. The conenose or kissing bug can cause a severe allergic reaction. Centipedes can do the same and cause local redness and burning. Millipedes are harmless. Pinworms like to come out in the early morning and cause a severe anal itching. These are often picked up from children who play in sand frequented by other children playing in the same sand while wearing a dirty diaper. Since sand is hard to clean, and is frequented by cats as well (who can spread the dangerous toxoplasmosi to pregnant women) we advise children to play elsewhere, or that rubber replace sand in playgrounds as a shock absorbing material underneath the sliding board. Write me in care of the Yated.

A message from Glaxo, sponsor of this column. Chicken pox is not innocuous and is definitely more dangerous when it occurs in adults. If it reaches the lungs, a bad pneumonia occurs. It can also reach the brain and cause a bad skin superinfection -- the flesh- eating bacteria. Getting Glaxo's Varilrix immunization against this disease may prevent these problems. This shot is currently given to all children in the USA.


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