expert type icon EXPERT

John G. McNeil

Infectious Disease Specialist

Dr. John McNeil is an infectious disease specialist practicing in Warner, New Hampshire . Dr. McNeil specializes in infections that are difficult to diagnose or unresponsive to treatments, such as HIV or airborne infections from a foreign country. Infectious disease specialists usually work with conditions that are not treatable by a primary physician but it is important to keep contact with the primary physician in order to receive information about the patients history and for deciding which diagnostic tests are appropriate.
John G. McNeil
  • Warner, New Hampshire
  • Wake Forest University
  • Accepting new patients

Do we need the Covid-19 booster?

I will give you two answers: 1) the "Party Line" answer promulgated by the US government and 2) my answer as a life-long infectious disease vaccinologist: 1) get the booster; 2) READ MORE
I will give you two answers: 1) the "Party Line" answer promulgated by the US government and 2) my answer as a life-long infectious disease vaccinologist: 1) get the booster; 2) vaccination booster is not needed because natural infection induces far better immune responses than the vaccine booster. In essence, having contracted COVID, you have been boosted by a whole live virus instead of the RNA of the spike protein alone. The induced immune responses are much more complex, comprehensive and the neutralizing antibodies longer lasting. In addition, you were most likely infected with the Delta variant and you now have immunity to this variant. The vaccine booster does not include delta variant RNA and so there are no delta-specific immune responses generated by the vaccine booster. God makes better vaccines than man. Natural infection is superior to a subunit vaccine like the ones for COVID.

Vaccine?

You may receive COVID-19 vaccination anytime after you have completed the required 10-day quarantine (10 days after appearance of first symptoms), especially when confirmed by READ MORE
You may receive COVID-19 vaccination anytime after you have completed the required 10-day quarantine (10 days after appearance of first symptoms), especially when confirmed by a negative SARS-CoV-2 test result.

My son has been diagnosed with a HFM infection. How long does the treatment take?

HFMD is caused by a virus (often Coxsackievirus A16 or Enterovirus 71). It generally takes 2-3 days for symptoms to appear after infection and the clinical course is almost always READ MORE
HFMD is caused by a virus (often Coxsackievirus A16 or Enterovirus 71). It generally takes 2-3 days for symptoms to appear after infection and the clinical course is almost always completely resolved within 5-7 days. Your son will remain contagious to others for many weeks after resolution of his symptoms and should avoid sharing food, cups, utensils, etc., and should wash his hands frequently. There is no medication to take to treat these viral infections, but symptoms can be treated with over-the-counter remedies such as Tylenol or Motrin.

Can pimples spread from one person to another?

Yes, acne is very prone to spread to both contiguous and discontiguous areas of the skin.

Is eczema an infectious disease?

No eczema is a form of autoimmune dermatitis. It is not contagious.

Is there medication required for pink eye?

More than likely the medication is antibiotic drops; either sulfacetamide or clindamycin. Please check the label, if it is one of the antibiotics, the treatment is appropriate. READ MORE
More than likely the medication is antibiotic drops; either sulfacetamide or clindamycin. Please check the label, if it is one of the antibiotics, the treatment is appropriate.

Is herpes cold sores an infectious disease?

Unless the sores, or fluid from the sores, comes into contact with your child's mucous membranes, the risk of transmission is very low. Cold sores are caused by Herpes Simplex READ MORE
Unless the sores, or fluid from the sores, comes into contact with your child's mucous membranes, the risk of transmission is very low. Cold sores are caused by Herpes Simplex type 1 virus. Most transmissions are through direct mucous membrane to mucous membrane contact, such as through kissing.

I suddenly have pus filled pimples around my underarms. What is it?

It sounds as if you probably have a condition known as hydradenitis suppurative. This is an annoying problem generally thought to be caused by blockage of sweat glands adjacent READ MORE
It sounds as if you probably have a condition known as hydradenitis suppurative. This is an annoying problem generally thought to be caused by blockage of sweat glands adjacent to, or emptying into, hair follicles. The condition is treated based on its severity. You should start by using warm compresses several times a day and take Motrin or Advil for discomfort relief. If the condition persists, treatment with antibiotics (I suggest dicloxicillin 250mg four times a day for 10 days) is appropriate. Steroids may also be indicated in particularly severe and resistant cases. I suggest seeing your primary care physician if warm compresses do not help within four to five days.

How can one distinguish between a viral and a bacterial infection?

If your son acquires a "cold" with nearly every change of season, it may be due to neither a bacteria or virus, but rather a seasonal allergy. I would suggest application of an READ MORE
If your son acquires a "cold" with nearly every change of season, it may be due to neither a bacteria or virus, but rather a seasonal allergy. I would suggest application of an allergy panel to see if your son is reacting to certain pollens and grasses that bloom during change of seasons.

Most colds are due to viruses (>95%) and do not respond at all to antibiotics. Your physician is most likely correct that these are colds are viral in origin, but incorrect to prescribe antibiotics - that treat bacterial infections only. Bacterial infections often have accompanying signs and symptoms that are somewhat more severe than common cold viruses. The only true way to differentiate bacterial infections from viral infections is by culture. It is common for doctors to prescribe antibiotics to their patients presenting with cold symptoms, but it is also incorrect to do so.

What is the way to treat antibiotic-resistant bacteria?

This means the bacteria recovered from your wound was co-cultured with several different antibiotics. The read-out for this test is called MIC, or minimum inhibitory concentration. READ MORE
This means the bacteria recovered from your wound was co-cultured with several different antibiotics. The read-out for this test is called MIC, or minimum inhibitory concentration. The bacteria from your wound shows a pattern where the antibiotics, in their typical dose/concentration, are not inhibiting the growth of the bacteria in a culture dish. The best way to choose an antibiotic(s) to treat your infection is by using this test to see what antibiotics inhibit bacterial growth best.

Is malaria an infectious disease?

Your son is at no risk of contracting malaria from your husband, if he has malaria. Malaria can only be transmitted to humans by the bite of an infected mosquito.

Is athlete's foot an infectious skin condition?

Athletes foot is caused by a superficial fungal infection of the skin; it is very contagious. Most cases are transmitted from person to person in group showers or sharing contaminated READ MORE
Athletes foot is caused by a superficial fungal infection of the skin; it is very contagious. Most cases are transmitted from person to person in group showers or sharing contaminated clothing. Sharing a locker is unlikely to cause the fungus from spreading from one player to another. Treatment is with tinactin, lamisil, or similar over-the-counter anti-fungal preparations. Extensive and hard-to-cure cases are treated with oral anti-fungal prescription medication, such as a fluconazole.

Why is augmentin 625 not working for my throat infection?

The vast majority of cases of pharyngitis (sore throat) are due to a viral infection. Antibiotics, like Augmentin, have no effect on viral infections. Did your doctor obtain a READ MORE
The vast majority of cases of pharyngitis (sore throat) are due to a viral infection. Antibiotics, like Augmentin, have no effect on viral infections. Did your doctor obtain a positive result on a rapid test for Group A Strep before putting you on Augmentin? Did your throat and tonsils have pus coating them? If the answers are no, you should not have been prescribed Augmentin. Here are things you can do at home to control the symptoms:

The following remedies may help soothe a sore throat:

- Getting rest
- Avoiding alcohol
- Quitting smoking
- Drinking warm liquids, such as lemon tea or tea with honey
- Gargling with warm salt water (1/2 tsp of salt in 1 cup of water) throughout the day
- Drinking cold liquids or sucking on fruit-flavored ice pops
- Sucking on hard candies or throat lozenges (for adults only)
- Running a cool-mist vaporizer or humidifier
- Taking over-the-counter pain medications, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Children under 19 should not take aspirin.

If you develop a high fever or experience prolonged or worsening symptoms, seek care from your doctor or from an infectious disease specialist.

Is influenza an infectious disease?

Yes, influenza is a viral infectious disease that is highly communicable through respiratory transmission (droplets from sneezes and coughs and contaminated surfaces) with respiratory READ MORE
Yes, influenza is a viral infectious disease that is highly communicable through respiratory transmission (droplets from sneezes and coughs and contaminated surfaces) with respiratory infection of those contaminated by the virus. Pneumonia secondary to flu is often not due to the flu virus, but rather to a secondary bacterial infection. Pneumonia with flu should be treated with both anti-virals and antibiotics. The flu vaccine should be taken every year; however, this year it is not very effective since the
predominant circulating strain (H3N2) is genetically different than the H3N2 strain in the vaccine.

Who should I consult for a rash after unprotected sex?

You should seek evaluation from your GYN.

Is sudden fever with sniffing a sign of dengue?

Dengue fever does not present with cold and a runny nose. If you have travelled to an overseas location endemic for Dengue or other tropical infectious diseases, the specific location READ MORE
Dengue fever does not present with cold and a runny nose. If you have travelled to an overseas location endemic for Dengue or other tropical infectious diseases, the specific location may be relevant to your diagnosis. At this particular point in time, your clinical presentation should be considered an influenza-like illness (ILI) until flu is ruled out as the cause. Irrespective of what healthcare provider you see, you should be evaluated while you still have a fever.

Is chicken pox really something you need a vaccine for?

Chickenpox (varicella-zoster virus) is one of the most contagious viruses of humans. It's rapid spread, prior to the fielding of a vaccine, often resulted in widespread outbreaks READ MORE
Chickenpox (varicella-zoster virus) is one of the most contagious viruses of humans. It's rapid spread, prior to the fielding of a vaccine, often resulted in widespread outbreaks among school-age and nursery school children. Adults who had never contracted chickenpox, those whose immunity had waned or who were immunosuppressed were at risk of a particularly severe form of chickenpox with high rates of severe morbidity and even mortality. Perhaps the most important benefit of vaccination is elimination of the occurrence of shingles (zoster) in adults - which is a sequelae of infection with wild type chickenpox virus. The duration of immunity to chickenpox inferred by vaccine is still being determined, and there may indeed be a need for boosting of this vaccine in adults who received it as children. Adults who had naturally-occuring chickenpox as a child should be immunized with the zoster vaccine to reduce the risk of shingles.

Can ringworm infection be treated?

Ringworm infections are not worms, but rather due to superficial fungal infections (called dermatophytosis). These are very common infections, especially among athletes (athlete's READ MORE
Ringworm infections are not worms, but rather due to superficial fungal infections (called dermatophytosis). These are very common infections, especially among athletes (athlete's foot and jock rot). Ringworm is acquired by coming into direct contact with the causative fungus, usually contaminated towels, clothes, shower floors, etc. Most cases are readily treated using topical treatments (tinactin, lamicil), while severe and resistant infections may require short course treatment with an oral antifungal medication such as fluconazole. Topical treatment takes up to four weeks to cure the infection and recurrences are common.

In how much time should an infection show up in the blood count report?

An increase in lymphocytes in the white blood cell compartment of blood often accompanies viral infections. However, the increase may not rise above the upper limit of normal for READ MORE
An increase in lymphocytes in the white blood cell compartment of blood often accompanies viral infections. However, the increase may not rise above the upper limit of normal for certain viral infections (rhinoviruses, coronaviruses) or with other mild viral infections. Typically, when white cell counts increase above the upper limit of normal (i.e., lymphocytes), it is concurrent with the onset of signs and symptoms. Viral infections causing fever are almost always associated with an increased white cell count.

If I have a stomach infection is it likely to affect my unborn baby?

No, the infection will not be transmitted to your baby. Make sure you drink lots of fluids to stay hydrated - that is important for both you and your baby.