How Immunization Works                                            
The organisms that cause a disease (or materials 
produced from those organisms) are weakened or
killed and then made into vaccines. These vaccines
are injected into the body or are taken by mouth.
The body reacts by making disease-fighting
substances - antibodies - that build up in the system
and guard against these diseases for a long time,
often for a lifetime. Thus, immunization helps the
body to defend itself against a particular disease.

Children and Immunization                                          
Because they have received antibodies from their
mother's blood system, babies are immune to 
many diseases when they are born. But this
immunity wears off during the first year of life.
That's why immunization programs, which help
young bodies build their own defenses against
disease, should be started early and carried 
out faithfully 
A WORD TO PARENTS 

Immunizations are important. The eight childhood diseases (measles, mumps, rubella, diphtheria, tetanus, pertussis, Haemophilus influenzae type b, and polio) which are preventable by immunization, can, and do, cause crippling and, sometimes, death. These illnesses are serious and their complications can be terrible. 

With the exception of tetanus, these diseases are contagious. They can spread rapidly from child to child and from community to community. As long as children remain unprotected against them, serious outbreaks of disease - even epidemics - can occur. 

It is important for parents to understand what protection vaccines give and what risks vaccines create for their children. Generally, vaccines are among our safest and most effective medicines. 

Like other medicines, however, vaccines can cause side effects. These are usually milk - a slight fever, a sore arm, a mild rash - and don't last long. But on rare occasions they are more serious. 

If your child receives a vaccine, gets sick and visits a doctor, hospital, or clinic during the 4 weeks after the immunization, this should be reported to the office or clinic where the vaccine was received. 

The overwhelming majority of medical experts in this country and abroad believe that the benefits of complete immunization far outweigh the risks. The Public Health Service strongly recommends that all healthy children be immunized against all of the vaccine-preventable childhood diseases. State laws require that children must be immunized before being allowed to enter school, with some exceptions. 

The purpose of this booklet, which discusses what you should know about eight dangerous diseases and the vaccines that can prevent them, is to help you make a decision on the basis of accurate information. This booklet covers the eight diseases against which all children should be immunized. New vaccines are now being developed and may be recommended for routine use in the near future. 

Please read the material on the following pages and discuss any questions you have with your doctor or with the staff at the health department clinic. Learn all you can about the serious diseases of childhood. Then, make certain that your children are protected.

DIPHTHERIA                                                                     
Years ago, diphtheria was a widespread and greatly feared disease. Through the 1920's, about 150,000 cases and 15,000 deaths occurred annually. 

Since that time, the disease has gradually declined. There were 910 cases in 1960, 435 in 1970, 146 in 1976. Today, only a few cases occur each year, thanks to parents who have made certain that their children are immunized against this terrible disease. 

Diphtheria is caused by a bacterium that is found in the mouth, throat, and nose of a person infected with the disease. This germ is easily passed to others in the tiny droplets of moisture that are expelled by coughing or sneezing. Diphtheria also can be spread by carriers - people who harbor the bacteria but remain in apparent good health. 

Usually, diphtheria develops in the throat, where a grayish membrane may form. If the membrane continues to grow, it can interfere with swallowing. If it extends to the windpipe, it can block the passage of air and cause the patient to suffocate. Other early symptoms are sore throat, a slight fever, and chills. 

Diphtheria is a treatable disease, but if treatment is inadequate, or if it is not begun in time, a powerful toxin, or poison, may be produced by the diphtheria bacteria and may spread throughout the body. The poison may cause serious complications such as paralysis that may last for as long as 3 or 4 months, heart failure, or broncho-pneumonia. About 1 in every 10 persons who get diphtheria dies of it.



TETANUS (LOCKJAW)                                                       
Tetanus, commonly called lockjaw, is caused by a bacterium that is present just about everywhere, but mostly in soil, dust, manure, and in the digestive tracts of humans, as well as in many animals. Tetanus is not transmitted from one person to another. Rather, the germs enter the body through a wound - sometimes one as small as a pinprick or a scratch, but, more often, through deep puncture wounds and lacerations, such as those made by nails and knives. Such wounds are difficult to clean adequately, and if the tetanus bacteria were present on the nail or knife, they may remain deep in the wound, where they may grow and produce a toxin, or poison, that attacks the body's nervous system. 

The first symptoms are likely to be headache, irritability, and muscular stiffness in the jaw and neck. As the poison increases, the jaw, neck, and limbs become locked in spasm, the abdominal muscles grow rigid, and painful convulsions may occur. 

Doctors treat the terrible symptoms of tetanus with powerful tranquilizers and anti-spasmodic drugs. The symptoms last for several weeks and require intensive hospital care. Complications of tetanus include pneumonia and fractures, and simple exhaustion from the muscle spasms. In the United States, four in every 10 persons who get tetanus die of it.

Hospital Release and Newborn Health 

HealthNews from the publishers of the New England Journal of Medicine 

When is the ideal time for mothers and newborns to go home from the hospital? Two studies in the July 23/30 Journal of the American Medical Association don't resolve the question. Although the larger study suggests that discharge just one day after birth may be detrimental to some babies, newborn health may hinge more on a mother's knowledge and support at home. 

The larger study compared 2,029 rehospitalized newborns with 8,657 others. Babies sent home within 30 hours of birth were 28 percent more likely to be rehospitalized in the following week--primarily for jaundice, dehydration, or sepsis. Those at greatest risk for rehospitalization were born to mothers who were younger than 18, had no other children, or went into labor early. 

A smaller study found that babies who went home on the day of birth or the next day were no more likely to be rehospitalized for feeding-related problems than those discharged on day 3. Readmitted babies were more likely to have been breastfed, firstborn, born prematurely, or born to mothers who had not completed high school, were unmarried, or were receiving Medicaid. 

Public outrage over "drive-through deliveries"--the discharge of newborns 24 hours after birth--prompted federal legislation that, as of January 1998, will require insurers to pay for at least 48 hours in the hospital after childbirth. 

An editorial accompanying the studies notes that the optimal time for discharge may be impossible to determine and that the difference between a one- or two-day hospital stay may not be significant. 

HealthNews associate editor David Rosen, MD, says babies should be seen by a doctor soon after discharge, but parents should call earlier if they notice yellow skin that signals jaundice, any change in the baby's appearance or behavior, or less than vigorous feeding or if a breastfeeding mother is not producing milk. For feeding problems, you may be referred to a lactation consultant. All mothers, he says, benefit from the help of a relative or friend who has experience with babies. 

"Whether discharge is 'early' or 'late,' the best determinant of good outcomes is to have resources and support available in the first few days after delivery," Rosen says.



PERTUSSIS (WHOOPING COUGH)                                 
Pertussis, or whooping cough, as it is more commonly known, is a highly contagious disease. Pertussis is caused by a bacterium that is found in the mouth, nose, and throat of a person infected with it. It is spread to others in the tiny droplets of moisture that are expelled by coughing or sneezing. 

Pertussis causes severe spells of coughing which can interfere with eating, drinking, and breathing. In the United States, approximately 70 percent of reported pertussis cases occur in children younger than 5 years, more than half in infants less than 1 year of age. Pertussis is most serious in young children, and more than half of the children who get this disease are hospitalized. In recent years, over 2,000 cases of pertussis in the United States have been reported each year to the Centers for Disease Control. 

Complications occur in a substantial proportion of reported cases. Pneumonia occurs in 1 in every 6 children with pertussis. For every 1,000 reported children with pertussis, 20 develop convulsions, and 4 develop inflammation of the brain (encephalitis). In recent years, an average of 9 deaths due to pertussis occurred each year.


POLIO                                                                                
As recently as the 1950's, polio was a fairly common disease, much feared by parents of small children. With the development of the first inactivated polio vaccine, in 1954 which was given by injection, this picture began to change. Over the next several years, as this vaccine gained acceptance and as the newer oral vaccine (first licensed in 1961) came into use, the number of cases of paralytic polio plummeted, from more than 20,000 in 1952 until today when only a few cases occur each year in the United States. 

Poliomyelitis is a contagious viral disease that, in its severe form, can cause permanent paralysis, and occasionally death. Polio is an extremely dangerous disease, and every parent should know about it. 

Polio is caused by a virus that lives in the nose, throat and, especially, in the intestinal tract of a person infected with it. 

Many people who are infected by the polio virus have no symptoms but may still spread the infection to others. 

The milder forms of polio usually begin abruptly and last, at most, a few days. When symptoms are present, they include fever, sore throat, nausea, headache, and stomach ache. Sometimes, the patient will feel pain and stiffness in the neck, back, and legs. 

Paralytic polio begins with these same symptoms, but severe muscle pain is usually present, and if paralysis occurs, it does so within the first week. There is no specific treatment for polio, and the degree of recovery varies from patient to patient. About half of all patients who recover have mild disabilities or none at all. The rest may suffer permanent paralysis. 

Our success in preventing the spread of wild polio virus has been so great that most of the recent cases have resulted from the rare side effects of oral polio vaccine. Because of this fact, some people have asked why we should continue to use oral polio vaccine. The reason is that, even though we may not have much wild polio virus spreading here now, there are thousands of cases in the rest of the world; therefore, there is a risk of polio being reestablished here if our children are not immunized. Oral polio vaccine is thought to establish a more effective community barrier to polio infection than inactivated polio vaccines.

Polio Immunization

Immunizations with "live" oral polio vaccine (OPV) is one of the best ways to prevent polio. It is given by mouth starting in early infancy. Several doses are needed to provide good protection. Young children should get two or more doses in the first year of life and another dose at 15 months of age. An additional dose is important for children when they enter school or when there is a high risk of polio, such as during an epidemic or when travelling to a place where polio is common. 

The vaccine is easy to take and is effective in preventing the spread of polio. A primary series of OPV gives protection in over 90 percent of those who receive the vaccine, probably for life. Because OPV viruses live for a time in the intestinal tract of the person who is immunized, some of the viruses pass in the stool and can spread from the immunized person to those in close contact (usually household members). This may help to immunize these persons and is one of the advantages of OPV. 

Besides the "live" oral polio vaccine (OPV), there is also an inactivated (killed) polio vaccine (IPV) given by injection which protects against polio after several shots. Because OPV seems to provide stronger immunity in the intestinal tract (where infection first occurs), is simpler to administer, and is more effective in preventing the spread of polio virus than IPV; most polio experts feel that the oral vaccine is more effective for controlling polio in the United States. 

Both the Immunization Practices Advisory Committee of the Public Health Service an the American Academy of Pediatrics recommend oral polio vaccine as the preferred polio vaccine for people up to the 18th birthday. 

Inactivated polio vaccine is recommended for persons needing polio immunization who have low resistance to serious infections or who live with persons with low resistance to serious infections. It may also be recommended for previously unimmunized adults who plan to travel to a place where polio is common or for previously unimmunized adults whose children are to be immunized with OPV. It is not widely used in this country at the present time, but it is available. 

Possible Side Effects and Adverse Reactions to Polio Immunization 

Very rarely (about 1 in every 7.8 million doses distributed), oral polio vaccine (OPV) causes paralytic polio in the person who is immunized. The risk is higher following receipt of the first dose of OPV and in persons with abnormally low resistance to infection and may be higher in adults being immunized. Also, on rare occasions (about 1 in every 5.5 million doses of OPV distributed), paralytic polio may develop in a close contact of a person recently immunized with OPV. This risk also is somewhat higher to contacts of persons receiving their first dose of OPV. These risks are very low, but they should be recognized and balanced against the risk of disease. Inactivated polio vaccine (IPV) is not known to produce any side effects other than minor local pain and redness.




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What are the benefits of mammography screening? 

Mammography screening refers to the routine practice of breast evaluation by "x-ray" in women who have no apparent symptoms of breast cancer. 

Mammography screening seeks to detect breast cancer at early stages of development, resulting in more treatment options. 

Treatment of early stage breast cancer is not only more effective but potentially less disfiguring and toxic. 

The Times They Are a Changin'

By Jason Osher
For many women of the baby boomer generation (people born from 1946-1964) "the change" is happening—menopause. Menopause is one of the major transitions in a woman's life, as was menstruation, a first sexual experience, and the birth of a child. While often experienced as a time of renewed freedom and a completely natural life cycle stage, the transition to menopause does not usually pass unnoticed. The changes that happen during perimenopause (the period of transition leading to menopause) can be quite dramatic for many women. Perimenopause, the gradual period leading up to menopause, produces a change in a woman's hormone levels, that affect her physically, mentally, and emotionally. The typical symptoms of [more..]


Mifepristone: The New Face of Abortion                     
For a decade around the world, several million women have used a pill to end pregnancy in its earliest weeks. Now mifepristone has crossed US borders. Also known as RU-486 or the "French abortion pill," the drug should be ready for widespread use in the US by 2000. Like all abortion methods, mifepristone has been the subject of controversy, in part because it promises to make abortion even safer, more effective and more accessible. [more..]
The Times They Are a Changin'
By Jason Osher
For many women of the baby boomer generation (people born from 1946-1964) "the change" is happening—menopause. Menopause is one of the major transitions in a woman's life, as was menstruation, a first sexual experience, and the birth of a child. While often experienced as a time of renewed freedom and a completely natural life cycle stage, the transition to menopause does not usually pass unnoticed. The changes that happen during perimenopause (the period of transition leading to menopause) can be quite dramatic for many women. Perimenopause, the gradual period leading up to menopause, produces a change in a woman's hormone levels, that affect her physically, mentally, and emotionally. The typical symptoms of

menopause are:


achy joints 
difficulty concentrating 
headaches 
hot flashes 
insomnia 
mood changes 
night sweats 
changes in sexual desire 
frequent urination 
vaginal dryness

These symptoms often occur at the time in a woman's life when other major life changes are happening: children leaving home, divorce or widowhood, retirement, responsibility for aging parents, loss of parents, and loneliness. These major life transitions usually exacerbate the already existing symptoms and make them even more difficult.

However, there are ways to relieve perimenopausal symptoms, and make the transition through menopause more comfortable. Hormone Replacement Therapy (HRT) is a pharmaceutical approach used by many perimenopausal and menopausal women. HRT, by patch, pill or cream, restores estrogen and other hormones lowered during this transition. However, HRT poses both benefits and risks. The benefits include reducing or eliminating the symptoms associated with menopause, helping prevent osteoporosis, and probably reducing the risk of heart disease. The risks, while infrequent, may include increasing one's risk for breast cancer, endometrial cancer, blood clots and gall bladder problems. Other considerations include possible side effects, such as vaginal bleeding, fluid retention, nausea, and headaches.

Alternative ways of dealing with the symptoms of menopause are becoming ever more popular, and more widely accepted by the medical community. Increasingly, research is showing that "natural therapies" have real benefits. 

An effective natural product that may ease the transition through perimenopause is soy. Soy, which contains isoflavones, is considered an "estrogen lite" for menopausal women. It comes in ready-to-drink milk, powdered forms, beans, and tofu (soybean curd). Experts agree that drinking a powdered concoction containing 40 grams of soy each day can reduce the most common symptoms of perimenopause; one study found that women who incorporated soy into their diets experienced a 40 percent reduction of hot flashes. 

Soy can also help women maintain and strengthen their bones; in a six-month study of postmenopausal women who were not on HRT, the group that received soy saw their spinal bone density increase by nearly 2 percent. While this may seem like a thin margin, it indicates that there was an improvement that could increase over time. 

The best way to supplement one's diet with soy is through foods, such as roasted soynuts, tofu, soy burgers, tempeh, miso, textured vegetable protein (TVP), and soymilk. If you think making recipes with soy products are difficult, just check your local bookstore, as there is a whole host of cookbooks dedicated to cooking with soy products. A few exceptionally rated books are The Whole Soy Cookbook, 175 delicious, nutritious, easy-to-prepare recipes featuring tofu, tempeh, and various forms of nature's healthiest bean (Patricia Greenberg, Helen Hewton Hartung, February 1998), Tofu Cookery (Louis Hagler, March 1991), and The Art of Tofu (Akasha Richmond, September 1997).

Other things you can do to help alleviate the symptoms of menopause are:

exercise regularly to relieve hot flashes and night sweats; 
take calcium supplements to reduce the loss of bone mass and help prevent osteoporosis; 
reduce your intake of tea, alcohol, coffee, and spicy foods to relieve hot flashes; 
use stress reduction techniques (meditation, yoga, breathing exercises) as tension may trigger hot flashes; 
drink eight glasses of water daily; 
try over-the-counter vaginal lubricants to relieve vaginal dryness with intercourse (such as Astroglide®, Slippery Stuff®, or KY Jelly®, which are all condom compatible); try Replens® for relief of day-to-day dryness; 
ask a practitioner about using herbal extracts, capsules and infusions, especially those rich in phytosterols—plant estrogens and progesterones (such as flax seed oil, black cohosh, and Dong Quai); and 
try acupuncture treatments to manage stress. 

Not all of these supplements, products, and helpful hints will alleviate every woman's perimenopausal symptoms. Some will, and so each woman must examine her options and choose the methods that work best for her lifestyle. Most importantly, see your doctor to determine what methods for easing perimenopauseal symptoms (including the natural alternatives described above) are best for you. As well, your doctor may recommend HRT even if you don't have symptoms. HRT is used as prevention for health risks such as low bone density, heart disease risk and others.

Many women forget that they can still get pregnant late in life. While it is uncommon, women should check with their doctors about their pregnancy risk and use contraception if needed. 
10 Differences Between Men and Women
that Make a Difference in Women's Health


After consuming the same amount of alcohol, women have a higher blood alcohol content than men, even when you allow for size differences.


Women who smoke are 20 to 70 percent more likely to develop lung cancer than men who smoke the same amount of cigarettes.


Women tend to wake up from anesthesia more quickly than men—an average of 7 minutes for women and 11 minutes for men.


Some pain medications, known as kappa-opiates, are far more effective in relieving pain in women than in men.


Women are more likely than men to suffer a second heart attack within one year of their first heart attack.


The same drug can cause different reactions and different side effects in women and men—even common drugs like antihistamines and antibiotics.


Just as women have stronger immune systems to protect them from disease, women are more likely to get autoimmune diseases (diseases where the body attacks its own tissues) such as rheumatoid arthritis, lupus, scleroderma and multiple sclerosis.


During unprotected intercourse with an infected partner, women are 2 times more likely than men to contract a sexually transmitted disease and 10 times more likely to contract HIV.


Depression is 2-3 times more common in women than in men, in part because women's brains make less of the hormone serotonin.


. After menopause women lose more bone than men, which is why 80 percent of people with osteoporosis are women.

What are the known risk factors for breast cancer? 

Age - The risk of breast cancer increases as a woman gets older. About 85 percent of breast cancers occur in women aged 50 and older. 

The risk is especially high for women older than age 60. Breast cancer is uncommon in women younger than 35. 

Family History - The risk of getting breast cancer increases for a woman whose mother, sister, daughter, or two or more close relatives, such as cousins, have had the disease. 

Personal History - Women who have had breast cancer may develop it again. Women with a history of breast disease (not cancer but a condition that may predispose them to cancer) and women having so much dense breast tissue on a previous mammogram that a clear reading is difficult are also at increased risk. 

Laboratory evidence that a woman is carrying a specific genetic mutation or change will also increase her susceptibility to breast cancer. 

Other Risk Factors - Other risk factors include having a first child after age 30, or never having children. Current research is investigating the roles of obesity, hormone replacement therapy, diet, and alcohol use.


Mifepristone: The New Face of Abortion 

For a decade around the world, several million women have used a pill to end pregnancy in its earliest weeks. Now mifepristone has crossed US borders. Also known as RU-486 or the "French abortion pill," the drug should be ready for widespread use in the US by 2000. Like all abortion methods, mifepristone has been the subject of controversy, in part because it promises to make abortion even safer, more effective and more accessible. 

How does it work?
Mifepristone blocks the effects of progesterone, causing the uterus to shed its lining. This dislodges the fertilized egg or embryo. A second drug, misoprostol, is given two days after mifepristone. Misoprostol has the same effect as a specific prostaglandin produced in the body. The drug combination of mifepristone and misoprostol is more than 95% effective in terminating a pregnancy within the first 7 weeks. 

Use in other countries
Mifepristone became available for medical abortion in France during the 1980s. In 1988 Roussel-Uclaf, the pharmaceutical company that developed the drug and named it RU-486, reacted to the protests of abortion opponents and removed the drug from the market. The French government forced Roussel to return the drug to the market, deeming it the "moral property of women." Since then, roughly 300,000 women in Europe, and possibly more than 3 million in China have used it. 

Implications for abortion in the US
Since it can terminate pregnancy so early — even before a woman misses her period — medical abortion is more politically acceptable in the United States. A 1998 New York Times/CBS poll showed that almost two thirds of American adults believe women should have the legal right to have abortions performed during the first three months of pregnancy. 1 

Medical abortion also offers women more privacy, away from anti-choice violence. Mifepristone can be dispensed in the anonymity of a doctor's office, clinic, or hospital, away from the jibes of right-to-life picketers. 

The drug also promises to make abortion more accessible. In 1996, 86% of all U.S. counties lacked an abortion provider. A 1998 Kaiser Family Foundation poll, however, showed that 45% of family practitioners were "very" or "somewhat" willing to prescribe mifepristone. Fifty-four percent of nurse practitioners and physician's assistants were also "very" or "somewhat" willing to prescribe it.

Hurdles for U.S. approval
With support from President Bill Clinton, feminist organizations jumped high hurdles to bring mifepristone to this country. Within the first year of preliminary approval from the U.S. Food and Drug Administration, additional setbacks delayed the drug's market appearance. Remaining threats to mifepristone even after it is approved by the FDA include: legislative restrictions on who can provide it, and limiting its use to doctors' offices. (Clinical evidence shows that the second drug in the regimen, misoprostol, is effective when women administer it at home and that most women prefer to use it this way. The preferred scenario is for clinicians to dispense mifepristone in their offices and for women to take misoprostol at home two days later.) The possibility also exists that the FDA will not be able to protect the anonymity of the drug's distributors and that abortion opponents will focus terrorist attacks or boycotts against them. 

Other Potential Uses                                                      
Mifepristone's potential goes beyond early abortion. It has proven 99% effective as an emergency contraceptive. It can also be used as a monthly birth control pill, as well as a treatment for breast and prostate cancer, meningioma, Cushing's syndrome, and other conditions.


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