I just had my umbilicus pierced and now have a red rash and the site is quite tender. I am 22. What should I do?

From your brief history, it looks like you have an infection after piercing. It seems that the infection is moderately severe. 

The safest remedy is to get the ring out of the umbilicus and see a doctor. The longer the ring remains, the longer the infection will fester. You may also need antibiotics and hence a visit to a doctor is recommended. 

Just wiping with warm water or peroxide usually is not the way to treat an infection from a pierced ring. If you are not sure about the severity of your skin condition, go see a doctor as soon as possible. 

These infections can spread rapidly and be quite serious.

I noticed my 4 year old son has small worms on his anus. He has numerous scratch marks on the anal skin and this is how I noticed the worms. How do I get rid of them?

The only way to get rid of these worms (pinworms) is take a medication known as mebendazole. This drug will kill both the mature worm and any newly hatched eggs. 

The treatment has to be repeated a week later to ensure no more worms are present. In the meantime, maintain excellent hygiene at home. Make sure everyone in the family washes the hands frequently. Bathe your son at least twice a day to get rids of the eggs near the anus.

These worms can easily be transmitted to other members of the family. Wash all linen separately and get the treatment as soon as possible. Pinworms by the way are not life threatening. 

Is there a vaccine for malaria? I am going to travel to an endemic region

Well, there is no vaccine available yet. However, if you go to an endemic region and you must exercise a great deal of caution. There are several prophylactic drugs that can be used but you need to consult with your doctor to determine the right drug for you. Different drugs are now used in different parts of the world because of resistance.

Secondly, use the topical insect repellant DEET from dusk to dawn. Everything else on the market is not very effective. Wear long sleeved permethrin coated clothes as long as you are not allergic to permethrin. Before going to sleep, spray DEET under the bed and other nearby furniture. 

Scan around the walls and curtains and kill any mosquitoes that you see. Try to make it a habit of sleeping under fine nylon netting impregnated with permethrin. Avoid wearing perfumes and colognes-for some reason mosquitoes love fragrance. With the above precautions, you will be about 99% protected but you should understand that mosquitoes are also very smart and hardy. They will nip you when you least expect it.

Bed Bugs 101: Part 2

Bed bugs generally do not require any treatment. These creatures are not life threatening. Bed bugs are associated with a certain stigma and are more of a social problem. If the itching is intense, one can apply a cortisone cream or taken an anti histamine. Secondary infected sites may need an antibiotic. In general, bed bugs do not cause any major illness, but are a nuisance. 

Once you have bed bugs in your home, getting rid of them is almost impossible. The first thing to do is look for egg cases or fecal stains but to see the actual bug is a rarity Make a thorough search of your home- look under every furniture, couch, mattress, linen and bedspring. Sometimes you may need a pest control specialist to help you search for a bed bug.

If a bed bug is identified, you definitely need a professional. There is no home remedy to get rid of these creatures. There are plenty of over the counter sprays but blind application of these chemicals will only cause you to become sick. If you do intend to treat the problem yourself, there are 100s of sprays and insecticides available and these must be applied to all suspected areas. 

Any area with a crevice or crack must be sprayed. If you suspect your mattress is infested, in most cases you need get rid of it. The amount of spraying you will require will be too toxic for you- so just get rid of the mattress.

All furniture, bedposts and tables need to be deeply cleaned and scrubbed with special wire brushes to get rid of the sticky eggs. The furniture may need to be taken apart and all the cracks and crevices need to be examined. You may even need an industrial vacuum to suck out all the crevices.

Unfortunately, there is no way to avoid bed bugs except being aware. If you have a bed bug problem, you need continual professional assistance from pest control. To prevent bed bugs examine your beds regularly and check up on all your home visitors. Do not allow any personal items from outside, unless you have checked them thoroughly.

Final point. If you have bed bugs, stop mucking around with over the counter remedies. Call pest control and let them take care of the problem. Just spraying a can of insecticide is not the answer. The whole house has to be turned upside down and thoroughly checked- and the problem may still persist.

Bed Bugs 101: Part 1

Bed bugs are small oval shaped insects that do not have the ability to fly. They look like miniature cockroaches. When fully grown they measure about 5-7 mm, appear reddish brown and they do bite humans. Bed bugs feed by sucking on humans and animals. 

Bed bugs were quite rare until recently. With the use of insecticides and pesticides, bed bugs were almost eradicated but these creatures are hardy. Bed bugs have made a comeback in the USA to an unusual extent, chiefly due to mass migration of people. Even though bed bugs are associated with poor hygiene and sanitation, this is not altogether true. These creatures can be found in clean environments and have even been reported in the most luxurious hotels. Of course, crowded living quarters make it easy for them to spread.

Bed bugs live anywhere in the home such as furniture, bed, mattresses and chairs. Anywhere where humans sleep, bed bugs can be found. In general, bed bugs are not found in open spaces but usually in the crevices and cracks. Bed bugs are also found along the carpet edges, curtains, inside dressers, cupboards and food cabinets.

Bed bugs can go without food for months and hence they are found in many empty homes and isolated furniture.

Recently bed bugs have been reported in hotels and cinemas. These bed bugs most likely arrived in visitor luggages or clothing. Bed bugs are easily transferred in luggages, clothes, boxes and bags.

Bed bugs generally tend to bite at night. In most cases, the bites occur on the face, neck, arms and legs. The bite is not painful but one may see small raised areas on skin- the site may itch and become swollen. Often the scratched areas do become infected. Bed bugs tend to bite in linear rows. Many times, these bite marks are mistaken for a mosquito or an insect bite. To date, bed bugs have-not been shown to transmit other infections. However, in tropical countries they are suspected of passing on certain parasitic infections.

How can I prevent MRSA?

At present, we have no magic bullet to rid of MRSA. All the novel antibiotics available to fight off this organism are designed only for hospital use. However, one can fight and control this infection by adopting the following defense methods:

 -          washing your hands is the best defense against not only MRSA but all germs

-          Do not share personal items with anyone. MRSA can rapidly spread from contaminated clothing and equipments well as through direct contact

-          If you have a wound, keep it clean and covered. If you are active in sports and have a wound, take a break and let the wound heal

-          regularly wash your linen, esp. gym clothes

-          when you are prescribed antibiotics, finish the course and do not stop half way and share your antibiotics with other people

For the moment, there is no need to get one’s self tested for MRSA. The most cost effective way to control the spread MRSA is washing hands. If these basic hygiene precautions are undertaken, the risks of developing an infection and/or transmission of MRSA are significantly minimized.

Does everyone who gets MRSA become sick?

No,  many healthy individuals have been found to carry staphylococcus in their nose or skin at any given time. While the bacteria do not cause infections, it does become colonized. Once colonized, these bacteria only cause an infection if the individual becomes sick, cuts himself or is involved in a traumatic incident. The majority of healthy individuals who are colonized with MRSA do not become sick but are quite capable of transferring the organism to others by sharing personal care items or by coming in close contact.

Even though several newer antibiotics have been developed to fight off MRSA, experts believe that it is only a matter of time before the staphylococcus develops resistance to these new drugs.

While the vast majority of MRSA are found in the hospital, the community based MRSA has been found in clusters among athletes, law enforcement and military personnel, children and many minority ethnic groups.