M.N., Hod Hasharon Prof. Giora Pillar of the Haifa Technion sleep lab replies:According to statistics, children aged four and over do not have to sleep during the day but only at night. They should then get an average of 10 or 11 hours of sleep.Younger toddlers should naturally sleep during the day, and that is why day-care centers have foldable beds for their charges to take a nap.But you can’t force young children to nap. They seem to naturally sleep the amount of time they need – if they do not suffer from a sleep disorder or other disease, are able to function and their growth patterns are normal.To get younger children to nap, there is no need to create darkness. The daylight will not disturb them.If you, the parents, are exhausted on Shabbat, you can try to encourage them to nap at the same time for your convenience, but you can’t force them. If you think that the sleep patterns of the younger children under four are abnormal, consult with your doctor.Is a vaccine for shingles available in Israel and if so where? My doctor says he doesn’t know.
N.S., Jerusalem Judy Siegel-Itzkovich replies; This question was asked three years ago and answered by Avi Raz, the most veteran pharmacist in the country, who died in his 80s about a year ago. Here is his answer below, followed by an update from Howard Rice, a former chairman of the Israel Pharmacy Association: Shingles is a viral disease known to doctors as herpes zoster. Its symptoms include a very painful skin rash with blisters, usually on one side of the body. Its origin is chicken pox, the acute viral infection in children. There is an effective vaccine against chicken pox, so the number of children and teenagers who now get it is very small. If someone had chicken pox, the virus remains in the body – sitting on nerves for decades – and it can suddenly cause shingles, which has very different symptoms than the initial infection. An attack is more likely in older people with a weak immune system and can be triggered by stress. Shingles symptoms can carry on for months or even longer as a condition known as postherpetic neuralgia.The US Food and Drug Administration did approve a live-virus vaccine against herpes zoster that is marketed as Zostavax that four years ago was shown in the US to prevent half the cases of herpes zoster in older people who had had chicken pox. But it has not yet been approved by Israel’s Health Ministry. While the vaccine has been shown to be safe, it has not been proven for how long it provides protection. Approval by the ministry in Jerusalem is not the automatic result of FDA approval. It has been sent for testing at Sheba Medical Center.The delay is not red tape but a matter of caution. While it could very well be approved, it certainly won’t be put into the state-subsidized health funds’ basket of health services in the near future.Howard Rice adds: Zostavax as a branded product or “zoster vaccine live” (its generic name) is still not available on the open market in Israel. One would have thought that an updated reference would be available via the Ministry of Health’s Pharmaceutical site, (www.health.gov.il/units/pharmacy/trufot/ index.asp?safa=e), but I suppose this is too much to expect. Theoretically one could import it using a special form, but this would prove difficult due to refrigeration needs.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.