New Jersey has a new Bicycle Helmet Law, which went into effect as of March 1, 2006. People under the age of 17 now must wear a helmet while riding a bicycle, roller skating, in-line skating and skateboarding.  The previous law only applied to children 14 years of age and younger. We recommend that all people participating in the above activities, as well as scooter riding, wear a helmet, regardless of age, both for their protection and to set an example for the younger children.

According to the Division of Highway Traffic Safety, many bicyclists are injured or killed each year in New Jersey due to bicycle crashes. Some of these involve motor vehicles; others do not. Head injuries are the most serious and the most common cause of death in bicycling injuries, especially if there is brain injury.

Regular helmet use would protect from and prevent these types of injuries. Helmets should meet the standards of the American National Standards Institute or the Snell Memorial Foundation. Make sure the helmet fits properly and is worn properly by having the chin strap tight enough to keep the helmet from slipping. The helmet should be placed directly over the forehead and only two fingers should fit under the chinstrap.

Bicyclists should also obey traffic laws and make sure their bikes are in good working order. They should also ride within their own abilities, not do stunts or tricks, never ride with an extra person on the bike and never "hitch" rides by holding onto moving vehicles.

As we approach the warmer weather, children are playing outside more, which we certainly encourage. However, one of the activities that many children participate in, jumping on trampolines, in their own or friends’ backyards, is extremely dangerous. The American Academy of Pediatrics recommends that trampolines never be used at home, in routine gym classes or on playgrounds.

The most common injuries are broken bones, concussions and other head injuries, neck and spinal injuries, injuries to the spleen (which can be life-threatening and may require surgery), sprains and cuts and bruises. These generally occur by falling off the trampoline, landing wrong while jumping, attempting stunts, colliding with another person on the trampoline or landing on the springs or frame of the trampoline.

Therefore we would ask that you seriously think about all of these risks before allowing your children to use home trampolines.

Fifth disease is common at this time of year (late winter/early spring). It is caused by a virus, called parvovirus. The medical term for fifth disease is erythema infectiosum. It is the least well known—and least serious—of five childhood infections, the others being measles, mumps, rubella (German measles) and chicken pox.

Fifth disease can start with a sore throat or fever, but usually is asymptomatic during the initial phase. The diagnosis is made when the rash occurs—first the classic "slapped cheek" rash on the face and then a fine lacy rash on the trunk and extremities. The rash may be itchy and may come and go several times over 1-6 weeks. It may worsen with temperature changes or exposure to sun. By the time the rash breaks out, the child is no longer contagious. Adults who develop fifth disease can get joint pain and swelling, in addition to the rash. The incubation period (time from exposure to onset of illness) is 6-14 days.

For most people, fifth disease is a benign illness; it comes and goes without complications. However, it can cause miscarriage if a woman contracts it during the first trimester of pregnancy. This can only occur if she has not had the disease in the past. Once a person has had it, he or she develops immunity and does not get it again. Fifth disease can also be dangerous for people who have certain red blood cell abnormalities, such as sickle cell disease or thalassemia, or who are immunocompromised (cancer, chemotherapy, HIV positive).

The treatment is symptomatic—acetaminophen (Tylenol) and fluids for the fever, sore throat and achiness, if present, and antihistamines for relief of itching. Since children are no longer contagious once the rash occurs, they may return to school or day care when they seem well enough, even though the rash is still present.

Office closure: Please note that due to major family events in both Dr. Yankus (his son’s wedding) and Dr. Ungerleider’s (her daughter’s Bat Mitzvah) families at the end of August and Labor Day weekend, the doctors will not be in the office from the afternoon of August 30 through Labor Day weekend. The office staff will be here for most of the day on August 30 and 31 and September 1 to answer questions, triage and fill out forms. There will be a covering physician available for any problems (not for physicals) needing to be seen for those days and for Labor Day weekend. Please keep this in mind as you schedule physicals for your children.

Consent: Occasionally a caregiver other than a parent brings a child into the office for care. If you know that this will be the case when you make your child’s appointment, please mention it and give verbal consent for your child to be seen with that person. If this is going to be a regular occurrence, we have a consent form which should be filled out. This also applies to patients under the age of 18 who are coming here by themselves.

Sunburn: Remember to apply sunscreen even in the spring months. Many people got sunburned the first weekend in April this year.

Lacerations: Many people call our office after their child has had a fall and ask for advice about a laceration (cut). Although each case is different, some general guidelines are:

Website: If you haven’t already, check out our website: www.yankusandungerleider.com. We will continue to post new information and reminders in between our newsletters, as well as having our current and past newsletters available for review.

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