– A.B., JerusalemHealth Ministry chief epidemiologist Dr. Paul Slater answers: There is little question that you have been exposed to mumps, as it is contagious for a couple of days before the salivary gland infection becomes obvious. Nevertheless, I think you can relax, for the following reasons: Most people your age who came from North America are immune to mumps from either prior disease or vaccination. If your parents usually gave you the recommended immunizations when you were a child, then one dose of mumps vaccine was included among them in the early 1970s. If you didn’t get the vaccine as a small child and any of your siblings had mumps, you probably became immune, even if you weren’t ill. About 30 percent of mumps infections are without symptoms, but these subclinical infections nevertheless provide strong lifetime immunity. The usual incubation period for mumps, by the way, is between 14 and 18 days, so you’re probably out of the woods by now anyway.Mumps in pregnant women is not known to cause malformations in the fetus, and only in the first trimester does mumps increase the miscarriage rate. If you do get mumps, be sure to keep your temperature below 39 degrees Celsius with paracetamol, because high fever from any cause can bring about premature contractions.The measles-mumps-rubella (MMR) vaccine contains live virus and is not recommended for pregnant women. After you give birth, review your immunization history more carefully with your parents, and if you haven’t gotten two doses of MMR vaccine, arrange to get a dose at your well-baby (Tipat Halav) clinic, mostly for the rubella component of the vaccine. And while we’re talking about vaccines, don’t forget to get the pandemic flu vaccine, which is strongly recommended for all pregnant women.I am a 63-year-old woman and have been suffering for years from fungus under some of my fingernails and toenails. I have tried various lacquers and drops, but it keeps coming back. I don’t want to take pills, as I have a liver condition that can be affected by such oral drugs. I have heard ads on the radio and seen them in the newspapers from clinics that offer “laser treatment” claimed to eliminate such fungal infections. Is there any scientific proof that lasers are effective? What kind of lasers are used?
– L.S., Tiberias
Dr. David Friedman, a veteran Jerusalem dermatologist, laser expert and director of the Lase-Ohr Clinics, comments: At this time, there are no peer-reviewed articles in the medical literature documenting a controlled study that proves lasers are effective against onychomycosis (fungal infections of the nails). In addition, the US Food and Drug Administration has not approved lasers for this use.Nevertheless there are a number of podiatrists in Israel and abroad who have been marketing the procedure. Many other physicians are either not impressed with the results or feel that we do not have enough proof of the efficacy of the procedure to perform or recommend it.There are two basic approaches to the laser treatment. The first and more widely available is using a standard Yag laser to destroy the fungi by bulk heating of the tissue. The second method is to utilize specific wavelengths that are absorbed by the laser light and destroy the fungi without heating the tissue. I believe that it is too early to recommend the procedure. For those patients who would like to give it a try, the potential damage would probably be limited to their wallet.I am in the middle of pregnancy, and for the past several months I’ve noticed significantly drier skin on my face and scalp especially. Is there some nutritional supplement I may be lacking?
– G.D., HaifaDr. Julian Schamroth, a veteran Jerusalem dermatologist, replies: Dry skin is a very common condition, especially during winter, when the air’s humidity is low. Patients with eczema (or dermatitis) also tend to have dry skin. In the elderly, the skin becomes dryer due to less oil production by the oil glands that lubricate the skin. Excessive washing and bathing may also wash off the skin’s natural lubricants, leading to dry skin. In addition, there are some rather rare disorders of the skin that are characterized by dry scales – but dry skin is not related to pregnancy.Minerals, vitamins and herbal remedies do not have any effect on skinhydration. For that matter, even drinking large amounts of water won’tmake a difference. The best treatment for this condition is frequentapplications of a moisturizing cream and avoidance of excessive washing.Rx for Readers welcomes queries fromreaders about medical problems. Experts will answer those we find mostinteresting. 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 firstname.lastname@example.org, giving your initials, ageand residence.