Chemo & inoculation; fetal alcohol syndrome disorder

— BY MICHAEL ROIZEN, M.D., AND MEHMET OZ, M.D.

Q: My 12-year-old daughter needs chemotherapy. I’m worried that the current measles spread puts her at risk, even though she’s been vaccinated. What should we do? -- Andrea O., Kingston, New York

Chemotherapy and inoculation; fetal alcohol syndrome disorder

A: You are right to be careful about exposure to infectious diseases with a daughter undergoing chemo. Her immune system is tamped way down. We know that exposure to measles is a concern in your region of the country, but it’s everywhere.

There have been reports of measles in 21 states this year. One mom on Twitter said her 8-year-old daughter was going through chemo and was exposed to measles at the grocery store. Even though she ultimately didn’t come down with the measles, the poor kid had to be quarantined at home for a month.

Fortunately, you can have a blood test done that will tell you if your daughter has enough measles antibodies to fight off an infection.

You might also have her checked for other vaccine antibody levels. A study out of the U.K. found that among children undergoing chemo, “titers of anti-pneumococcal and anti-tetanus antibodies were both significantly reduced post-chemotherapy and did not recover during the study.” So it’s not just measles that pose a risk.

Adults also face this risk. Last year there were over 1.6 million new cancer cases, most of which are treated with some form of immunosuppressive therapy. That’s a lot of reasons why everyone needs to get their vaccinations reviewed and updated.

Mass inoculation creates herd immunity -- if enough people are vaccinated, then those at risk or who cannot be vaccinated are protected because the disease has nowhere to take hold in the general population. But, until getting the measles and other vaccines is mandatory with few exceptions, you’re going to have to avoid taking your daughter to congested indoor spaces; she might wear a mask when outside. When it’s over, you can ask your docs about revaccination. Our hearts are with you.

Q: I’m a fourth-grade schoolteacher (in my second year), and I think there’s a child in my class who suffers from fetal alcohol syndrome. I’m not sure what to do, or how I can help the young guy. Should I contact his parents? -- Sandra M., Macon, Georgia

A: Unfortunately, a recent study estimated that around 630,000 babies around the world are born every year with fetal alcohol syndrome disorder (FASD). That comes to 1,700 a day.

The National Institutes of Health estimates that between 2 and 5 percent of children in the U.S. show signs of prenatal alcohol exposure. FASD now appears to be more prevalent than autism spectrum disorder.

Most cases aren’t correctly diagnosed, so you need to be careful with how you proceed. First, check with your principal. There’s probably a protocol for you to follow for special-needs kids. If you’re right about FASD, the special needs will be multidimensional. At some point you’ll probably need to be in touch with the parents, but in the meantime documentation and following your school’s protocols are your best friends, and are most likely to help the child.

FASD can manifest itself with congenital malformations (smaller-than-average body) and growth impairments, but cognitive impairment is probably what, as a teacher, you’re seeing.

Is he argumentative with classmates, falling behind in spelling and/or math?

The sooner you can get this child the help he needs, the sooner he’ll avoid developing bigger emotional and intellectual problems down the road.

As we said in our book “YOU: Having a Baby,” even if you are just thinking about getting pregnant and are not practicing birth control, stop drinking. Half of all pregnancies are not planned, and no amount of alcohol is safe to drink if you are pregnant.

That said, there are specialists out there who can help. The National Organization on Fetal Alcohol Syndrome has a website (www.nofas.org) where you can find professionals in your area. You can also call (800) 66-NOFAS.

•••

(Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is chief wellness officer and chair of Wellness Institute at Cleveland Clinic. Email your questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com. Distributed by King Features Syndicate, Inc.)

Upcoming Events