Dwarfism 155

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Diphtheria, tetanus, and whooping cough are all serious childhood diseases that can be fatal. Since the organisms that cause them are still widely present in the community, continued vaccinations and regular booster shots are highly recommended. The DTaP vaccine is recommended as a five-dose series: three doses given to infants at two, four, and six months of age, followed by two additional booster doses at 12 to 18 months and at four to six years. Tetanus and diphtheria toxoids (Td) is recommended at age 11 to 12 years if at least five years have elapsed since the last dose of tetanus and diphtheria toxoid-containing vaccine. Subsequent routine Td boosters are recommended every 10 years.

The original "whole-cell" form of the vaccine (DTP) was reported to cause side effects including high fever and seizures. However, researchers believe that, contrary to rumors, there is no link between the DTP vaccine and sudden infant death

SYNDROME.

DTP vaccine See DTaP vaccine.

dwarfism Unusually short stature that can be caused by a variety of genetic and other conditions. Between one in 14,000 and one in 27,000 babies are born each year with some form of dwarfism. Dwarfism is generally defined as adult height of four feet 10 inches or less.

Many types of dwarfism are conditions marked by abnormal bone growth that are divided into two types: short-trunk and short-limb dysplasias. Children with short-trunk dysplasia have a shortened trunk with relatively longer limbs, whereas those with short-limb dysplasia have a near-normal size trunk but small arms and legs. Both types result in parts of the body that are not in proportion to one another. In the past, the term dwarfism was only used to refer to these cases of disproportionate short stature, while midget was applied to conditions in which all parts of the body match in size. However, the word midget is today considered offensive by many people of short stature. Today the terms little person, person of short stature, or person with dwarfism are the preferred terms.

Cause

More than 200 conditions cause dwarfism, most of which result either from a spontaneous mutation or from defective genes inherited from one or both parents. It is possible for two average-size parents to have a child with short stature; 85 percent of children with the most common form of dwarfism (achondroplasia) have average-size parents.

In instances of spontaneous genetic change, for some unknown reason a single normal gene in a chromosome inherited by the child suddenly mutates, leading to dwarfism. Spontaneous mutation can occur in any pregnancy and is a more common cause of a child with dwarfism born to average-size parents.

Inherited dwarfism is caused by a genetic trait carried by one or both parents. If both parents carry a recessive gene for a particular condition that produces dwarfism (which means they do not have the condition themselves), and they each pass that gene to their child, the child would be born with dwarfism.

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