Smallpox
Latest News: Smallpox was wiped out worldwide 20 years ago, but experts fear the contagious and often fatal disease could return thorough a biological terrorist attack. In light of heightened fears because of a possible war with Iraq, President Bush is expected to order the vaccination of 500,000 health workers and 500,000 military personnel against smallpox. Later the vaccinations will be broadened to other health-care workers and emergency responders, such as fire fighters and police. Eventually the vaccine may be made available to all Americans. (Routine smallpox vaccinations for children were ended in 1972 and for military servicemen and women and in 1980s.)

Potential Dangers: The smallpox vaccine itself is dangerous. It often causes fever and sore, swollen arms, but in a few cases it leaves people scarred or blinded. It can even cause death.

How It Affects You: If you're pregnant, you're at a greater risk for serious side effects from the smallpox vaccine and shouldn't receive it. Also if you're breastfeeding, you should avoid getting it; the vaccine could be passed on to the baby. The vaccine would only be advisable for pregnant or nursing women as a method of treatment if they were exposed to the smallpox virus. Other people who should not get the vaccine include those who suffer from eczema or other allergic rashes (even if it's mild or was just a childhood condition) and those with weakened immunity (e.g., due to treatment for cancer or being HIV-positive).

Listeriosis
Latest News: A major outbreak of the food-borne bacteria listeria in the Northeast in 2002 killed seven people and sickened 52, resulting in the recall of 27.4 million pounds of turkey and chicken.

Potential Dangers: Eating food contaminated with listeria can causes a bacterial disease called listeriosis. It feels like the flu, with symptoms such as high fever, severe headache, and nausea. It's rare, but foods that are likely to carry it include unpasteurized milk, soft cheeses, undercooked poultry or meat, ready-to-eat meats such as hotdogs and deli cold cuts, refrigerated pates, and seafood. Unlike most other food-borne bacteria, listeriosis multiplies in food that's been contaminated once it's refrigerated.

Most healthy people who eat food contaminated with listeria get a mild illness (fever, abdominal pain, and diarrhea), but it can cause a more serious infection in some people.

How It Affects You: Women who are pregnant (as well as newborns, the elderly, and the sick) are at a greater risk of contracting listeriosis because of their compromised immune systems. It can cause miscarriage in pregnant women, and if an expectant mother transmits the disease to her baby, it could lead to a stillbirth. Or the baby could develop sepsis (a blood infection) or encephalitis (an inflammation of the brain). Listeriosis can be treated with antibiotics, but you should nonetheless take these precautions during pregnancy to protect yourself and your baby:
 

• Avoid soft cheeses such as feta, Brie, Camembert, and Mexican-style cheese.
   
• Cook leftover foods or ready-to-eat foods (such as hotdogs and deli meats) until steaming hot before eating.
   
• Cook raw meat, poultry, and seafood thoroughly. Chicken should be cooked until the center reaches 165 degrees.
   
• Don't eat uncooked fish including smoked trout, sushi, sashimi, or ceviche.
   

West Nile Virus
Latest News: In 1999, an outbreak of West Nile virus (previously known to circulate among mosquitoes and birds in Africa and Europe) was reported in New York City. Since then the virus has spread throughout much of Eastern U.S. and into the Midwest and South, causing close to 300 cases and more than 30 deaths. In October 2002, a mother in Michigan contracted West Nile from a blood transfusion during delivery. Lab analysis found evidence of the virus in her breast milk. When her baby was tested, she also was found to be positive for West Nile, although the child is healthy and has no symptoms. The infant is the youngest person reported to have West Nile virus.

Potential Dangers: People living in areas where West Nile has been reported are at risk, although catching West Nile from one mosquito bite is rare. (Mosquitoes get the virus by feeding on infected birds.) Most cases seem to occur in late summer or early fall, but in warmer Southern climates the virus can circulate year round, according to the Centers for Disease Control and Prevention (CDC). Fortunately, most people who are infected with West Nile virus don't get sick at all. Another 20 percent have a mild flulike illness, which includes fever, headache, and body aches, and occasionally a skin rash on the torso and swollen lymph glands. Only 1 percent of people--generally the elderly--get a severe infection (called West Nile encephalitis or meningitis). Symptoms include headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, and paralysis. In rare cases it can be fatal. Symptoms usually occur 5 to 15 days after a bite from an infected mosquito.

How It Affects You: Pregnant women are not at greater risk of contracting West Nile virus than the rest of the population. They also aren't at a greater risk of getting a serious reaction to the virus. As for nursing, because of how beneficial breastfeeding is known to be and the fact that the risk for West Nile virus transmission through nursing is unknown, the case of the Michigan woman doesn't change current breastfeeding recommendations, according to the CDC. The American Academy of Pediatrics recommends that infants be breastfed for the first year of life.

However, if you live in a risk area for West Nile, take these precautions during the West Nile season to protect yourself from the virus:
 

• Apply insect repellent with DEET (you'll see the chemical name, N, N-diethyl-m-toluamide, on the bottle) when you're outdoors.
  NOTE: Although, according to the CDC, there have been no reported adverse events following the use of DEET insect repellents by pregnant women, you can take some extra precautions: use the spray sparingly, choose lower concentration formulations (10 percent or less of DEET), and use the product on clothing (not on your skin).
   
• Wear long-sleeved clothing outdoors.
   
• Stay inside during peak mosquito hours--dawn, dusk, and early evening.
   

Bubonic Plague
Latest News: In November 2002, a man and woman who traveled from New Mexico to New York City were hospitalized with the first reported cases of the disease in the city in a century.

Potential Dangers: Bubonic plague is a bacterial disease in rodents. It's transmitted to humans through the bites of infected fleas. Fortunately the plague doesn't spread from person to person, and it's also very rare. Only 10 to 20 persons a year are infected in the United States, and only in rural areas of Western states. More than half of the cases are in New Mexico. A wood rat and fleas from the property of the New Mexico couple in the news tested positive for the plague. Symptoms of bubonic plague are swollen and painful lymph nodes, fever, chills, and extreme exhaustion. The illness can be treated with antibiotics.

How It Affects You: Pregnant women are at no greater danger of contracting the disease. Of course, avoid contact with live and dead rodents.

Sources: Centers for Disease Control and Prevention; New York Times, November 12, 2002; www.about-listeria.com; www.cnn.com; National Pesticide Information Center; Daniel L. Sudakin, MD, MPH, assistant professor, department of Environmental and Molecular Toxicology, Oregon State University

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.
 

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