Top Docs: 5 facts about infectious disease

This time of year, any mention of infectious disease usually brings to mind the flu. But plenty of other germs are worth worrying about, too.

Here's what you need to know about five infectious diseases:

1. FLU IS NOT TO BE SNEEZED AT

Flu is nothing to take lightly. It can lead to serious complications and death. But it's difficult to diagnose because it can appear to be a common cold.

"The classic symptoms are fever, chills, sore throat, headache and muscle aches and pains," said Dr. Bernard Nash, an infectious disease specialist in West Islip and a professor of medicine at the Hofstra North Shore-LIJ School of Medicine. "In the typical case of influenza, the illness lasts several days, and the vast majority of people recover. However, as was seen with the new H1N1 strain that appeared in 2009 and the possibility of a new strain developing every year, it can cause severe illness and death."

Seek medical assistance if you have a high fever (101 degrees or greater), shaking, chills and aches and pains along with the fever, and a decline in appetite or ability to drink, said Dr. Joseph Cervia, an infectious disease specialist and director of the Comprehensive HIV Care and Research Center at Long Island Jewish Medical Center in New Hyde Park.

To prevent flu, physicians recommend people in a long list of risk groups -- which includes those older than 65, pregnant women, people with asthma and those with diabetes -- get a flu vaccine, Nash said. But anyone who wants to keep from getting the flu should consider one too, he said. Be aware, however, that the vaccine takes 10 to 14 days to take effect, said Dr. Bruce E. Hirsch, an attending physician in infectious diseases at North Shore University Hospital, "so one can still get the flu right after the vaccine."

2. MRSA CAN LOOK LIKE A SPIDER BITE

Better known as MRSA, methicillin-resistant Staphylococcus aureus is a potentially deadly kind of staph infection that used to be found mainly in hospitals. Now, however, people in the wider community often become infected with it. It's caused by bacteria that have become resistant to antibiotics.

"The typical presentation is an abscess that looks like a spider bite," Nash said. "The likelihood of a spider bite on Long Island is very low. In fact, if someone says they were bitten by a spider, it is more likely that they have a MRSA infection."

If you develop a suspicious abscess, "it is important to seek medical care and get on appropriate antibiotics -- usually a sulfa drug or tetracycline -- and avoid squeezing the abscess," he said. The most danger comes if the bacteria spread from the skin into the bloodstream, lungs, heart, bones or joints, as this can lead to life-threatening infections.

Be aware that it's a skin infection that can spread through families, sports teams and children through poor hygiene, Nash said. "A good antiseptic soap and adherence to good hygiene is the best prevention."

3. SHINGLES VACCINE RECOMMENDED IF YOU'RE OVER 60

If you're older than 50 and had chickenpox as a kid, shingles should be on your radar. The dormant virus can make a return appearance, causing skin rashes and plenty of pain.

"It's an extremely painful and debilitating condition, and it can become a source of chronic pain," Cervia said. He recommends that people 60 and older get a vaccination that prevents shingles.

Nash also recommends the vaccine. "It has been shown to reduce the likelihood of getting shingles by 50 percent and the severe pain after by two-thirds," he said. "It is a very beneficial vaccine that can prevent much suffering."

4. PERTUSSIS IS NOT JUST FOR KIDS

Whooping cough -- also known as pertussis or the "100-days cough" -- is no longer a disease only of the very young. It now affects adults, too, Nash said. No one is sure quite why.

"It classically presents as a typical cold, but over a week, severe coughing spells develop with the characteristic whoop heard as you breathe in all the air that was expelled from your lung from the severe coughing," he said. "It can cause severe fatigue due to coughing and is highly contagious."

Newborns and unvaccinated people suffer the most harmful effects from the disease, which can be fatal, Nash noted. "The number of cases on Long Island has increased over the last several years and has caused local outbreaks," he said. "It is now highly recommended by the Centers for Disease Control and Prevention that all susceptible people get vaccinated."

To Nash, that means all adults. "Because most of us have lost our immunity to pertussis, it is important that everyone get a one-time booster of the adult formulation of the Tdap vaccine," he explained. "This is a dead vaccine that not only protects us against tetanus and diphtheria but also pertussis." The CDC urges that all adults, even those who were vaccinated in childhood or have had pertussis, get a Tdap booster, no matter when they got their last tetanus shot.

It's especially important for grandparents to get vaccinated, Nash added, because they often care for newborns when parents work.

5. C. DIFFICILE COLITIS 'ALMOST EPIDEMIC'

Clostridium difficile colitis, or C. difficile, which causes diarrhea and can lead to life-threatening complications, is becoming more common and "is almost at epidemic proportions," Nash said. The reason, he said, is overuse of antibiotics, which has allowed bacteria to develop resistance.

The condition can be tough to treat and recurs about 25 percent of the time. "I have taken care of many patients who have had multiple recurrences and require treatment with medication that can last for months to several years," he said.

For prevention's sake, don't push doctors to prescribe antibiotics, Nash said. "Most of the time, a good exam to rule out a bacterial infection and reassurance is all that is needed."

Hematologists, pathologists, infectious disease specialists

HEMATOLOGY

Dr. Steven Lee Allen

Monter Cancer Ctr.

450 Lakeville Rd.

Lake Success

516-734-8959

Dr. Louis Avvento

1333 E. Main St.

Riverhead

631-727-8500

Dr. Jonathan E. Kolitz

450 Lakeville Rd.

Lake Success

516-734-8970

Dr. Kanti R. Rai

LI-Jewish Medical Ctr.

Div. of Hematology-Oncology

410 Lakeville Rd.

Ste. 212

New Hyde Park

718-470-4050

Dr. Philip Schulman

Memorial Sloan

Kettering at Suffolk

650 Commack Rd.

Commack; 631-623-4100

Dr. Michael W. Schuster

Stony Brook Univ. Med. Ctr.

HSC T-18, Room 030, Z-8183

Stony Brook; 631-444-3577

Dr. Harry Staszewski

200 Old Country Rd., Ste. 450

Mineola; 516-663-9500

INFECTIOUS DISEASE

Dr. Joseph S. Cervia

North Shore-LIJ Health System

400 Community Dr.

Manhasset; 516-562-4280

Dr. Burke A. Cunha

222 Station Plz. N, Ste. 432

Mineola; 516-663-2507

Dr. Bruce Farber

North Shore-LIJ Health System

Div. Infectious Disease

400 Community Dr.

Manhasset; 516-562-4280

Dr. Joel Greenspan

44 S. Bayles Ave., Ste. 216

Port Washington; 516-767-7771

Dr. Bruce E. Hirsch

North Shore-LIJ Health System

Div. Infectious Disease

400 Community Dr.

Manhasset; 516-562-4280

Dr. Diane H. Johnson

222 Station Plaza N., Ste. 432

Mineola; 516-663-2507

Dr. Natalie Klein

222 Station Plaza N., Ste. 432

Mineola; 516-663-2507

Dr. Joseph McGowan

North Shore-LIJ Health System

Div. Infectious Disease

400 Community Dr.

Manhasset; 516-562-4280

Dr. Bernard J. Nash

500 Montauk Hwy., Ste. S

West Islip; 631-587-7733

Dr. Anne C. Sacks-Berg

120 New York Ave., Ste. 5W

Huntington; 631-423-9809

Dr. Steven Samuels

500 Montauk Hwy., Ste. S

West Islip; 631-587-7733

Dr. Max Scheer

15 Irving Pl.

Woodmere; 516-374-6750

PATHOLOGY

Dr. James M. Crawford

North Shore-LIJ Laboratories

10 Nevada Dr.

Lake Success; 516-719-1060

Dr. Michael John Esposito

6 Ohio Dr., Ste. 202

Lake Success; 516-304-7271

Dr. Leonard B. Kahn

6 Ohio Dr., Ste. 202

Lake Success; 516-304-7264

Dr. Alice Laser

6 Ohio Dr., Ste. 202

Lake Success; 516-304-7284

Dr. Carmen Tornos

Stony Brook Univ. Med. Center

Dept. Pathology

Level 2, Rm. 749

Stony Brook; 631-444-2222

How they were picked

Castle Connolly Medical Ltd. is a health-care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and top hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of top doctors and the medical leadership of leading hospitals.

Castle Connolly's physician-led team of researchers follows a rigorous screening process to select top doctors on both the national and regional levels. Its online nominations process -- located at castleconnolly.com/ nominations -- is open to all licensed physicians in America who are able to nominate physicians in any medical specialty and in any part of the country, as well as indicate whether the nominated physician is, in their opinion, among the best in their region in their medical specialty or among the best in the nation in their medical specialty.

Careful screening of doctors' educational and professional experience is essential before final selection is made among those physicians most highly regarded by their peers. The result -- Castle Connolly identifies the top doctors in America and provides the consumer with detailed information about their education, training and special expertise in their paperback guides, national and regional magazine "Top Doctors" features and online directories. Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors. (Newsday is not part of the selection process.)

Physicians selected for inclusion in this "Top Doctors" feature may also appear as Regional Top Doctors online at castleconnolly.com, or in one of Castle Connolly's Top Doctors guides, such as America's Top Doctors® or America's Top Doctors® for Cancer.

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