Dr. Jens Kort

Based on data from China much fewer children seemed to have gotten the infection when compared to adults: perhaps 1-2 children among 100 total infected adults and children combined. One report showed 3 deaths among the 171 children who were infected. The children with serious infections all had pre-existing medical conditions. Majority of infected children had mild disease.

I would not make the trip.

Yes. Varicella-zoster vaccine. According to CDC recommendations, children should receive the vaccine at age 12-15 month (1st dose) and age 4-6 years old (2nd dose). Check your child's vaccination record if it lists "MMRV" (ProQad, this is 4 different vaccines in one) or "VR" (Varivax) she did receive the vaccine. If not, you can ask for a "catch-up"vaccination if your daughter did not receive the vaccinations as per recommended schedule.

Measles vaccine if given at age 12-15 month (1st dose) and 4-6 years (2nd dose) should induce long lasting immunity and protection against measles infection, potentially for life. It's one of the most effective vaccines we have. I think immunity against measles develops in approximately 95-98% of children who receive the 2 doses of the vaccine.

In an abundance of caution I would do so.

Thank you for your question and concern.
There is little information to let me draw any conclusion that the risk to get the current coronavirus infection is any different for children than for adults.
What we do now from the children who have been identified having the infection from China data that the disease has been milder in children. So children may have milder symptoms but may still be infected and may transmit the virus to others.

Thank you for your question. Given the long time following your travel and all of you family travellers were fine since then- I think it is unlikely that you contracted coronavirus infection during your cruise.

Thank you for your question, which is not as simple as asked. There are different types of "bacterial ear infections" some are in the external ear canal- which is what you see when you look at the ear, and other infections behind the ear drum called middle ear. If the ear drum is busted and pus drains into the ear canal this would be a typical sign of a bacterial middle ear infection. Some of these can resolve without antibiotics. Repeated bacterial middle ear infections may require antibiotics as well as determination whether the infection was due to an unusual bacteria, or there are predisposing risk factors in a child for ear infections. This would require specialist consultation and examination of the ear.

Thank you for your question. To the best of my knowledge the current coronavirus that is causing the pandemic is likely now present in most if not all communities in the US. So precautions against exposure as released by your local health department, the CDC, and US government should be followed everywhere. Including but not all listed here include wash your hands often with soap and water for 20 seconds- and don't touch your mouth nose, or eyes after you have touched surfaces that may be contaminated. Stick to social distancing and avoid gatherings with more than a few people. Avoid handshakes- see more advice from your local health department, cdc or recent announcements from the federal government.
Like influenza, the coronavirus is transmitted through the air via droplets of excretions from people who are infected and coughing and sneezing. It also can survive for few days on several surfaces depending on the amount of virus and environmental condition- so you could acquire it by touching such stained surface and then touching your mouth eyes or nose. There is also evidence that coronavirus is shed via the stool and thus could be transmitted from soiled toilets, bathrooms and persons with poor hand hygiene.

Thank you for your question. To the best of my knowledge the coronavirus that originated from China this year seems to be about 10 times more "deadly" overall by comparison the seasonal influenza virus across all patients. This is simply based on the number of deaths and number of overall cases that are know from China and may not be completely accurate, as they likely had not identified all infected patients. Unlike the flu for which we have vaccination and anti-flu meidcines we don't have an antiviral medication proven effective (yet) and no vaccine against the coronavirus yet- which leaves only supportive care treatment options.
We know that likelihood to get serious disease up to death from this coronavirus infection increases with age and if another significant medical condition is present; this includes conditions of the heart, blood vessels, kidneys, liver, lungs, diabetes, cancer or state in which the immune system is compromised to name important ones. We also know that the vast majority of coronavirus infections are associated with mild disease (probably 80+%)-I would say that the risk for a healthy 41 year old- to get serious or life threatening disease is low.

Influenza or also called the common flu is a viral infection that is transmitted through droplets that may be carried through the air, for example, sneezing, coughing from an infected person to another one. Can also be transmitted from contaminated surfaces. So hand washing is important and wearing face masks that will not allow the droplets from an infected person to be spread from sneezing and coughing.
For this year's circulating influenza strains, the vaccine is not fully protective against one of the strains of influenza covered by the vaccine and we are seeing more cases despite vaccination. This is not uncommon specifically for the influenza vaccine that is developed for each annual season with some uncertainty about the major strains of influenza that will circulate in the future.

The spores of a fungus called Histoplasma are found in pigeon droppings.
Histoplasma spores when inhaled can cause a pneumonia called histoplasmosis with the fungus growing in the lung and may invade into other parts of the body. Larger inner city areas are typically attracting larger pigeon populations and hence with increased risk for the transmission of histoplasma from pigeons droppings to people.

Yes it is an infectious disease. However it is typically not spread from one person to another.
In most cases, the malaria parasite has to first pass from a human host into a mosquito as the mosquito takes a blood meal, and then from the mosquito into another human via the mosquito’s saliva. This severely limits the amount of person-to-person transmission that exists. In fact, the only mechanisms for direct transmission between humans are when malaria parasites are passed between a mother and her unborn child via the placenta (congenital transmission) and through unscreened blood transfusions.

Yes, children should be vaccinated. This would prevent many vaccinated children to get a full blown infection and avoids many severe infections which may also leave skin scars. 2nd it prevents the spread of the infection to other unvaccinated or not protected children because the vaccinated children won't carry the disease even before it becomes symptomatic and spread it. Think of a child with cancer whoms immune system is weakened and could die from a chickenpox infection. 3rd Everyone who had chickenpox is essentially at risk for getting Zoster at older age when the immune system wanes because the virus stays with the person who had chicken pox forever.

Not all UTIs should be treated with antibiotics. A large number of uncomplicated UTIs resolve on their own. You should have the discussion with a local doctor who can assess your individual case better.

Yes!

Not having sex, sex with one partner only you know; always use condoms - know your partner(s) and history of STDs; persons at higher risk for STDs are "sex workers", persons with multiple sex partners, men who have sex with men, using high risk sex practices, sex with people you don't know. You should be able to have that conversation with your sex partner before engaging into sex.
With your preference mentioned - you cannot protect yourself completely even when following all precautions. Get tested regularly. Consider also that you should not want to spread STDs to others.

Regarding the source of the infection - preschool, daycare, kindergarten, Sunday school, places where children congregate and touch each other are typical higher risk places for transmission. Less typical could be transmission from adults who may or may not have symptoms.

The virus(es) who cause the disease are not transmitted by animals. Need good hand hygiene, washing with soap and water and handling diapers with disposable gloves in children who have the disease.

This might be "ringworm infection"- which is caused by a fungus causing a scaly-itchy red rash in groin, or between toes "athlete's foot". It is not the water, but contaminated surfaces, towels, etc in showers and lockers, or direct contact with other infected people, through which the fungus is transmitted.

In people with a normal immune system and who receive treatment soon after the outbreak of the rash, it typically lasts 3-5 weeks until skin rash heals and the pain subsides.