Salmonella Poisoning is known medically as salmonellosis, this major type of food poisoning is caused by bacteria that multiply rapidly at room temperatures. Every year about four million cases of salmonellosis are reported in the United States. Children are the most likely to get salmonellosis, and young children are among those most likely to have severe infections. Experts estimate that about 600 people die each year with acute salmonellosis.

Salmonellosis is very common in this country; bonemeal, fertilizer, and pet foods all may be implicated in the spread of the disease. In particular, recent outbreaks have been linked to chickens and eggs; it is estimated that 35 percent of all chickens in processing plants harbor the bacteria. The largest outbreak ever recorded occurred in 1994 and involved more than 200,000 Americans. In this case, commercially pasteurized ice cream premix was contaminated by bacteria during transport to a Minnesota ice cream plant in tanker trailers that had previously carried nonpasteurized liquid eggs. The outbreak ended only after sales of the ice cream were stopped.

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At one to two months of age the baby will probably receive the second dose of the hepatitis B vaccine (the first was probably given just after birth.) At two months (and again at four months), the baby will be given several vaccines:

• diphtheria, tetanus, and acellular pertussis (DTaP) vaccine
• Haemophilus influenzae type B vaccine
• polio vaccine

Some of these safeguards against serious childhood illnesses can cause reactions (usually mild), such as fever or irritability. Parents should discuss side effects with the doctor and obtain guidelines for what to do if there are any reactions.

Four to Seven Months
From four to seven months is a time of incredibly rapid growth. In addition to continuing concerns about eating and sleeping, parents may begin to wonder whether the child is growing and developing properly. During this stage, the doctor will monitor the baby’s progress and answer any questions. The doctor will probably want to see the baby at four months and at six months, although this may differ from one doctor to the next. Of course, if there has been any problem in the past, the doctor may want to schedule extra visits. Well-baby visits vary from doctor to doctor, but may include:

• length, weight, and head circumference measurements (baby’s growth will be plotted on his own growth chart)
• physical exam
• check of the baby’s soft spots (the fontanelles) at the top and back of the head
• examination of the baby’s mouth for signs of teething

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A family of drugs used to treat allergic conditions, such as itching and hives. The drugs work by blocking the action of histamine, a chemical that is released during an allergic reaction. Examples of antihistamines include diphenhydramine, promethazine, terfenadine, and chlorpheniramine.

Without treatment, histamine dilates small blood vessels, causing redness and swelling; antihistamines block this effect, while preventing the irritation of nerve fibers that would otherwise cause itching. Antihistamines are the most effective treatment for hives.

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Medications that treat diarrhea. The drug loperamide (Imodium A-D) slows the passage of stools through the intestines. Adsorbents such as attapulgite (Kaopectate) pull diarrhea- causing substances from the digestive tract. Bismuth subsalicylate (Pepto-Bismol) decreases the secretion of fluid into the intestine and inhibits the activity of bacteria. It not only controls diarrhea but also relieves the cramps that often accompany diarrhea.

Patients should not use antidiarrheal drugs for more than two days unless told to do so by a doctor. Bismuth subsalicylate may cause the tongue or the stool to temporarily darken harmlessly. Children with flu or CHICKEN POX should not be given bismuth subsalicylate because it can lead to REYE’S SYNDROME, a life-threatening condition that affects the liver and central nervous system. Children may have unpredictable reactions to other antidiarrheal drugs; loperamide should not be given to children under six, and attapulgite should not be given to children under three years, unless directed by a physician.

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Abrasion is a superficial rubbing off of the uppermost layers of the skin, usually caused by a scrape or a brush burn. Abrasions are usually minor injuries that can be treated at home. The skin may bleed or drain small amounts of pus at the time of the injury. A physician should be contacted if the abrasion is located close to the eye or on the face, if there is embedded dirt, stones, or gravel, if there are signs of infection (increased warmth, redness, swelling, or drainage), or if the abrasion covers a large area of the body (such as the chest or back or an entire limb).

Skin Abrasion Treatment
The abraded area should be washed well with soap and water (but not scrubbed). Any dirt should be removed by running water over the area for several minutes. A dirty abrasion that is not well cleaned can cause scarring.

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Prozac (fluoxetine) is an antidepressant medication that is the only newer drug approved to treat depressed children. Studies suggest that younger people respond to Prozac with very small doses, and that a sizable portion of young people who do not respond to other antidepressants do respond to Prozac.

Introduced in 1988, Prozac was the first of a new class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), which increase the levels of a neurotransmitter called serotonin. Many people who are depressed have low levels of this chemical and therefore improve when serotonin levels rise. Like other pharmaceutical interventions for depression, Prozac is usually prescribed as part of a treatment plan that includes psychosocial interventions.

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Antitussive Drugs

Antitussive Drugs is a type of medication used to suppress coughing, possibly by reducing the activity of the child’s cough center in the brain or by depressing breathing. These drugs include both narcotics and nonnarcotics that act on the central and peripheral nervous systems to suppress the cough reflex. Because the cough reflex is important in clearing secretions from the upper respiratory tract, antitussives should not be used with a cough that produces mucus.

Codeine and hydrocodone are strong narcotic antitussives. Dextromethorphan is equally effective but does not carry the danger of inducing dependence as the narcotics do. Antitussives are given by mouth (usually in a syrup with an expectorant and some alcohol). The medications also may be given as a capsule combined with an antihistamine and a mild painkiller.

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