Dear Doctor: I recently read that more than 30 students at a school in North Carolina all got chickenpox during an outbreak. Growing up, I got chickenpox, too, before there was a vaccine. Is the vaccine really that necessary for kids? Like I said, I got chickenpox as a kid and turned out fine!

Dear Reader: It's true that most children who develop chickenpox, a highly contagious disease caused by the varicella-zoster virus, go on to make a full recovery. Most often the virus causes an itchy rash that is often accompanied by a fever, headache, and some aches and pains.

However, that's not the whole story. First, it's important to note that from 2 to 6 percent of children who become infected with the chickenpox virus go on to develop complications as a result of the illness, some of them serious. These include pneumonia, bacterial infections, infections of the brain or the blood, and can lead to death. It's when you look beyond the individual consequences and consider the community that chickenpox becomes a health threat far more widespread than an individual child stuck at home for a few weeks with a rash and a fever.

Those at risk of grave complications from a case of the chickenpox include infants under 12 months old, who are too young to receive the vaccine and whose immune systems are not yet fully developed. The same goes for the elderly, whose immune systems become less robust as they age. Also at risk are people whose immune systems are compromised, such as someone undergoing cancer treatment or someone who is HIV-positive.

For a pregnant woman, a case of chickenpox prior to her 20th week can result in health complications for her unborn baby, including scars, eye problems, malformed limbs, poor growth, small head size and delayed development. When the virus is contracted in the third trimester, there is a chance of problems with the baby's central nervous system. The risk is small -- just 1 to 2 percent -- but with safe and effective vaccines available, it's unnecessary. Again, it's all about caring for one's wider community.

When it comes to prevention, the Centers for Disease Control and Prevention recommends that children get an initial dose of chickenpox vaccine between the ages of 12 and 15 months. This should be followed by a second dose of the vaccine between the ages of 4 and 6 years. For people who are 13 or older and have either never been vaccinated, or have never had chickenpox, the recommendation is two doses of the vaccine, given a minimum of 28 days apart. It's true that, despite receiving the vaccine, some people do go on to contract the disease. When that happens, symptoms are usually milder, meaning there are fewer blisters and often no fever. The illness will also typically be of shorter duration.

Most insurance plans will cover the chickenpox vaccine. If not, the Vaccines for Children Program offers help to individuals who qualify. For more information on this program, go to cdc.gov/features/vfcprogram.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I read that a doctor knew that a woman had thyroid cancer just by seeing her neck on TV. Why was a visual diagnosis so easy? What happens next?

Dear Reader: The incident you're referring to took place in the spring of 2018, when a head and neck surgeon from New York was watching "Beachfront Bargain Hunt," a popular real estate show on HGTV. He noticed an area of swelling on the front of the home buyer's throat; when she turned her head or stretched her neck to look upward, the swelling became prominent enough that he believed it could be a thyroid mass.

Unsure of how to find the woman, he posted his concerns to his Facebook page. With the power of the internet, the surgeon and the home buyer were quickly put in touch with each other. He explained his suspicion and urged her to undergo diagnostic tests, specifically a sonogram and a fine needle biopsy. She followed his advice, learned that she did indeed have a malignant tumor, and immediately sought appropriate treatment.

Interestingly, this was not the first time that thyroid cancer has been diagnosed on HGTV. Several years prior, a nurse watching the popular home renovation show "Flip or Flop" discerned what she believed to be a tumor on the neck of one of the hosts. Her concerns proved to be correct. The tumor was malignant, and the host underwent successful treatment for his thyroid cancer.

The reason these tumors were visible is due to the location of the thyroid gland, which sits below the Adams apple and is just beneath the skin. The thyroid measures about 2 inches across and consists of two main lobes, which make it appear somewhat like a bow tie, or a butterfly. The gland produces the hormones used by the body to regulate metabolic rate. It also contains specialized cells that produce calcitonin, a hormone that plays a role in managing blood levels of calcium and phosphate. Diseases of the thyroid such as Graves' disease, hyper- or hypothyroidism, and thyroiditis often cause the entire thyroid to swell, which is referred to as a goiter. Thyroid cancers are more often asymmetrical swellings, and thus can be distinctive.

In addition to a visible tumor, symptoms of thyroid cancer can include trouble swallowing, difficulty in breathing, a persistent cough in absence of a cold and pain in the front of the neck that may radiate up to the ears. When thyroid cancer is suspected, diagnostic tests may include imaging of the gland, blood tests, a radioiodine scan to test thyroid function, and a biopsy to search for cancer cells. Depending on the type of cancer that is present, as well as the stage at which it is identified, treatment consists of surgery, radioiodine or hormone therapy, chemotherapy or radiation. Targeted therapies that enlist the aid of the immune system to fight the cancer are also now being used.

The good news is that the most common types of thyroid cancer are very treatable, with five-year survival rates of 98 percent. Both of the individuals in the HGTV diagnoses have reported successful treatment.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: My son and daughter are now 17 and 19, and my sister, who worries about everything, keeps telling me that STDs in teens are on the rise. Is this really true? If so, is there anything I can say to my kids? You know how teens are; will they even listen?

Dear Reader: Considering the context, we regret to inform you that your sister is correct. According to data collected by the Centers for Disease Control and Prevention, the rate of sexually transmitted diseases in the United States has hit a record high for the fourth year in a row, and a whopping 50 percent those new infections were acquired by young people aged 15 to 24 years old. It's estimated that one-quarter of all adolescent females who are sexually active currently have an STD, such as chlamydia or human papillomavirus, also known as HPV.

Despite an increase in the numbers of young people using condoms, which are an effective (but not foolproof) barrier against STDs, and the fact that teens and young adults are less sexually active and have fewer partners than did previous generations, the numbers continue to climb. Statistics show that adolescents between the ages of 15 and 19 and young adults between the ages of 20 and 24 have the highest risk of acquiring an STD.

This trend is believed to be the result of a complex combination of factors. A drop in federal funding for STD prevention education, as well as clinics for screening and outreach, has certainly played a role. So have cultural factors. The advent of effective antiviral drugs, which have turned once-deadly AIDS into a manageable chronic condition, may have also had the unintended effect of making other STDs seem less dangerous. Also at play may be the increasingly changing views of gender identity, with more young people having sexual partners of both sexes.

Whatever the cause, the spike in STDs in people of all ages is a serious concern. In their early stages, these diseases are asymptomatic, which makes it easy for an infected person to unknowingly transmit the disease. That's why baseline STD screening for young people who are sexually active is so important. In its later stages, each STD comes with its own serious health concerns. A number of viruses and bacteria have become antibiotic-resistant, which means problems continue even after seeking treatment.

The truth is the only foolproof way to avoid STDs is to not have sex. But whether or not your kids are sexually active, protection begins with education. That means teaching your kids about STDs and the grave health problems they cause. Stress using condoms as a barrier, even when other birth control methods are in use. As you point out, a single conversation probably won't be enough. Young people feel invincible, so this should be an ongoing dialogue. And don't forget about the HPV vaccine, which is recommended for preteens and young adults of both sexes. You'll find specifics at vaccines.gov/diseases/hpv.

Some parents fear the STD talk implies approval of sexual activity. In our opinion, it's an opportunity to state (or restate) your position on sex, and to offer up some stark reality.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)