Salmonella and eggs:

Here’s the CDC Guidelines on properly cooking eggs:

Red Tide

Dr. Bayrun’s Blog re: Red Tide:

What is Red Tide?

There have been many families recently in the office that are asking about red tide, so I wanted to quickly talk about this subject.

So what exactly is this red tide? Red tide is a harmful algal bloom and is caused by the toxic dinoflagellate Karenia brevis. Blooms typically last until winter or spring but sometimes can remain for more than 1 year.

When inhaled, it can cause Aerosolized Red Tide Respiratory Irritation (ARTRI), which can cause symptoms such as nasal and respiratory irritation, runny nose, and bronchoconstriction (causes the airways to constrict causing a sensation of shortness of breath). Normally symptoms are temporary while exposed, but those with asthma or other chronic lung disease can have a flare up of respiratory symptoms. If having persistent symptoms, you should seek medical care.

When sea life is exposed to this algal bloom, it can cause large scale death, which if you have been to the beach recently you may have seen. People and animals (including pet dogs) who drink or come in contact with the water can also become sick. Exposure can cause eye and skin irritation. Ingestion can cause GI upset. Ingesting contaminated shellfish, can cause neurotoxic shellfish poisoning which can cause symptoms such as nausea, vomiting, diarrhea, dizziness, changes in speech, and tingling.

What does the Health Department recommend to do to protect your family from Red Tide?
-Check your local health department’s website for information about red tide.
-Look for signs posted at the beach for information regarding red tide
-Avoid coming in contact with affected water and dont let your animals near the water as well.
-Those with asthma or chronic lung disease should especially avoid the beach areas affected by red tide.
-If you live near a beach affected by red tide, make sure you close your windows and run your A/C. Make sure your filter is changed as per the manufacturer’s instructions.
-If you, your family, or a pet has come in contact with red tide, wash with soap and clean water as soon as possible. Wash your clothes that have come in contact with it as well.
-Consider wearing a mask if you are near an affected area.
-Avoid eating affected sealife. Cooking/heat it does not get rid of the red tide. Check out the health department website for specifics on what to avoid.

If exposed to red tide and having concerning symptoms, call 1-800-222-1222 to discuss with a poison specialist and seek medical care. Please report symptoms to the Florida Poison Information Center.

If your animal was exposed and having symptoms, contact their vet immediately.

If you have any further questions, please check out the Lee Health Department website (link below) or you can call the Florida Department of Health in Lee County at 239-690-2100.

2023_03_06-HealthOfficials Issue Red Tide Alert For Lee County | Florida Department of Health in Lee (
2023_03_06-HealthOfficials Issue Red Tide Alert For Lee County | Florida Department of Health in Lee

Healthy Media Plan:

The AAP has a newly enhanced Family Media Plan. It’s free and customizable for the whole family.*1ar6g2e*_ga*MTM4Nzg5OTEyNi4xNjc1OTcwMjA4*_ga_FD9D3XZVQQ*MTY3NTk3MDIwNy4xLjAuMTY3NTk3MDIwOC4wLjAuMA..&_ga=2.57754985.2141072781.1675970208-1387899126.1675970208#/

Dr. Bayruns Blog

Happy New Year! We hope you and your family had a wonderful holiday season, and have a safe and happy new year. As our kids go back to school, the flu season is definitely here! We hope this post helps you while navigating this respiratory season.

What is the flu? The flu is caused by a virus called influenza. The most common types of flu viruses are influenza A and influenza B. The flu can cause fever, chills, cough, runny nose, sore throat, congestion, body aches, vomiting, headache, and poor appetite. It is commonly caught through respiratory droplets like when someone sneezes into the air, coming in close contact with someone who has the flu, or by touching objects that has the flu virus on it.

What can you do to protect your child and your family? Have your child wash their hands often and especially before they eat or touch their face. Practice with your child sneezing into their elbow rather than their hands. Avoid being around others who are sick. Maintain a healthy lifestyle such as getting good sleep, eating healthy, and exercising. Have your child receive their annual flu shot. It is a great proactive defense against the flu and the vaccine does not cause the flu. Flu shots are available here in office and you can schedule a dedicated vaccine visit to receive it.

What prescriptions are available when your child has the flu? After your child has been diagnosed with the flu, their doctor may offer you a medication such as oseltamivir (a common brand name of this medication is called tamiflu). Oseltamivir is an antiviral medication (not an antibiotic) for the flu that prevents the release of more flu virus from the cells in your body. This medication can be given if symptoms have started within the last 48hrs. If it is given within 48 hours of your child’s symptoms starting, it can reduce symptom duration (the number of days that they feel sick) by 24hours. It can cause some side effects, most commonly nausea and vomiting. Because the flu is a virus and not a bacteria, no antibiotics can be used for the flu unless your child has another infection such as strep throat or an ear infection.

What can you do to help your child feel better at home? Other things that we can do to make your child feel better would be treating the symptoms. It is what you may hear doctors saying is “supportive care.” Having your child drink plenty of fluids (or for babies under 1 year of age, their regular formula or breastmilk) and get plenty of sleep are some of the best things you can do to help your child feel better. For children over 1 year of age, warm fluids like tea or soup are great to loosen up that mucus to help make it easier to remove. Just make sure it’s not too hot in temperature to avoid burns. A cool mist humidifier in the room can also help loosen up secretions, just make sure to clean it often. For babies, suctioning their nose with a bulb suction or nose frida with nasal saline drops is important. Try doing this before feeds and before bedtime. 1 teaspoon of honey can be given to children over the age of 1 year old, and can help soothe a cough that tickles the back of their throat. Children 7 and up who can follow directions can have cough drops if supervised to prevent choking. Some over the counter medicines can help as well. Acetaminophen (commonly known as tylenol) can be used for children 2 months and older, and Ibuprofen (commonly known as motrin and advil) can be used for children 6 months and older. Both acetaminophen and ibuprofen can help with pain, body aches, and fever. Avoid cough and cold medications for children under 7yrs of age. Never give a child under 18yrs of age any medication that contains “salicylates” (commonly seen in pepto-bismal and aspirin) as this can cause a rare and life-threatening syndrome called Reyes syndrome.

When should you seek medical care? If you have any concerns over your child’s health, you should always contact your healthcare provider. If your child is having trouble breathing, you should seek medical care. For your little ones, signs of problems with breathing would be if they are breathing fast, their nostrils are flaring outward, belly breathing, and if the skin in-between their rib cage or near their neck is pulling inward. If your child is not able to drink fluids or your baby is not taking their formula or breast milk, you should seek medical care. We want to prevent dehydration. Signs of dehydration are dry mouth, crying without tears, or decrease in urination (babies should make 4 or more wet diapers in 24hrs and children that are potty trained should urinate at least every 8hrs). If your child is 2months and younger and has a fever of 100.4, this is a medical emergency and should be seen by a doctor immediately. If your child has a fever above 104.5 or if your child has a fever above 100.4 that lasts for more than 4 days, you should seek medical care.

Any time you have questions or concerns, we are happy to see you for a same day sick visit or answer questions over the phone during our normal business hours (8am to 5pm, Monday through Friday). If you have urgent concerns after business hours, please call our after hours urgent line and our nurse practitioners will help assist you. If you feel your child is having a life threatening emergency, please call 911 or head toward the nearest emergency room.

Have more questions about the flu? Don’t hesitate to call our office at 239-415-1131.

Holiday Hours!

All of us here at MacKoul Pediatrics Fort Myers wish the very happiest and safest holiday season to all of our patients and their families!

Our work family will be celebrating with our home families on December 26, 2022 and January 2, 2023. The office will be closed on those two Mondays.

Should you have emergent issues that cannot wait for the office to open on Tuesday morning, you can always call us at 239-415-1131 and when promted, press #1. My nurse practitioners at All Children’s Hospital will be happy to help you.

Thank you,
Annette St. Pierre-MacKoul, MD

Calling all new parents:

If you call and make an appointment to meet our new Board Certified Doctor Bayruns, you can receive this book as our gift to you!

‘The New Baby Blueprint’ by Whitney Casares, MD, MPH, FAAP

Hurricane Nicole / Tropical Storm Nicole

Update as of 1250 on 11-9-22, we will be following what the Lee County schools are doing.

MacKoul Pediatrics Fort Myers will be closed on 11-10-22.

Please be safe with your families and stay off the roads as much as possible.

Thank you,
Annette M. St. Pierre-MacKoul, MD

Masks in the office:

A 13 year old boy asked me on Friday, ‘Dr. MacKoul, why do we have to wear masks?’

I answered him very honestly. ‘We all have to wear masks for many reasons. First, we are entering what is predicted to be the worst respiratory season for children in the recent past. We are already seeing record hospitalization rates for respiratory disease in children in the majority of states in the United States. We are protecting the babies who are too young to get vaccines. We are protecting my patients and parents with compromised immune systems so that they don’t catch any illness while being in the office. We are protecting each other so that I don’t catch your germs and you don’t catch mine! We are wearing masks because we care about other people. I make my staff go one step further and wear masks and shields so that we have another barrier to spreading illness.’

We want you to bring your masks and wear them at the office. I charge a fee of a dollar donation for a mask. That money is donated to charity. I am not trying to get money from our patients and families. I am trying to get you to bring and wear your own mask. I am using the parenting technique of negative reinforcement to get you to bring your own mask. We were able to donate over $375 to the Deaf and Hard of Hearing Center last month. Kaitlin in the front office is on their Board of Directors.

We have also had an issue with parents not being honest with us and coming into the office and exposing our staff and patients to diseases that should have been disclosed on our telephone prescreening call prior to coming into the office.

Masks help to keep all of us safe!

This is the last Hurricane Ian Update:



MacKoul Pediatrics Fort Myers will open tomorrow at 8 am. Please be patient as we come back from 13 days without power. Our number is 239-415-1131.

Thank you for our patience in this difficult time for all.

Annette M. St. Pierre-MacKoul, MD

10/7/22 Hurricane Ian update:

We still have no power at the office. I have been assured by Florida Power and Light that there is a 95% assurance that we will have power by midnight!

As always, I am reachable 24/7 at 239-415-1131 and when prompted, press # 1.

Annette M. St. Pierre-MacKoul, MD

Hurricane Ian update – 10/6/22


As the staff and I were getting the office set for power this morning, the power trucks for Florida Power and Light came down Granite Court! They were a welcome sight and hopefully will be getting us up and working!

We still have no power today! Water is working, so that is progress!

I am hopeful for tomorrow and will be ready for when the power returns!

Annette M. St. Pierre-MacKoul, MD

Update: Hurricane Ian 10/5/22

To my patients and their families:

MacKoul Pediatrics Fort Myers still has no power or electricity. Florida Power and Light has stated that it will be repaired by midnight, Friday, October 7, 2022. Worst scenario, we should be open on Monday, October 10, 2022. They have notified me that there is a rare chance that it might be longer.

As always, I am available 24/7 for any questions or concerns at 239-415-1131, press for option number 1.

Annette St. Pierre-MacKoul, MD

Hurricane Irma update 10/4/22

Please stay safe all my patients and families!

It is still recommended that we all do our parts and stay off the roads unless it is necessary.

MacKoul Pediatrics Fort Myers still is without power and water. I check on the office often and will open as soon as we have the ability to safely open.

As always, I am here for you 24/7. If you have emergent questions / concerns, you can always call the office at 239-415-1131 and press #1 when prompted.

Annette M. St. Pierre-MacKoul, MD

Hurricane Ian

Hello to all my wonderful patients and families:

Thank you to all who have reached out to us. We all have survived the storm and are ready to return to work. The building is safe and the parking lot has been cleared of all storm damage. All we are waiting on is electricity and water. Once that is set, we will open!

As always, you can call us 24/7 for anything you need emergently at 239-415-1131 and press option 1. My answering service will contact me with your message. After 5 pm until 8 am, the Nurse Practitioners at All Children’s Hospital will answer your questions.

Please be well and safe,
Annette M. St. Pierre-MacKoul, MD

Flu Vaccines are in!

So sorry for the late post but … Flu Vaccines are in!

As always, we are here for all your child’s needs. From preventive care Well Checkups to testing for when they are ill (including flu, strep, covid and rsv testing) to immunizations (we have them all including Coronavirus Vaccines).

Just call to make an appointment! 239-415-1131

Courtney Bayruns, MD

Dr. Courtney Bayruns was born in Middlesex, New Jersey, and grew up in many places including Los Gatos, California, and Marietta, Georgia. She received a BS in Human Physiology and a BA in Neuroscience from Boston University, after which she attended medical school at Boston University School of Medicine. After completing medical school, Dr. Bayruns moved to Memphis, Tennessee, for her pediatric residency training at LeBonheur Children’s Hospital and St. Jude Children’s Research Hospital.

In her free time, she enjoys walking on the beach, jigsaw puzzles, gardening, traveling, as well as spending time with family and her two puppies: Tillie and Douglas. Dr. Bayruns is getting married in September, 2022, to her fiancé Stephen who has supported her throughout her long medical training journey. She is excited to be moving closer to her family in Florida and working with all the wonderful families in Southwest Florida!

Exciting Announcement!

Starting November 1, 2022, I will be introducing a practitioner to MacKoul Pediatrics Fort Myers.

Courtney Bayruns, MD

I will add separate post introducing her to you!

Cute Kid of the Day!

Covid had me crazy busy! Time to bring back our ‘Cute Kid of the Day!’

Masks in the office:

Masks are required for everyone 2 years of age and older in the office. You need to wear your mask before entering the office and keep it on until after you leave the office.

When you take it off, your germs contaminate the air surrounding you and the room you are in.

Your germs do not magically go away when you put your mask back on.

This is why I ask that everyone wear their mask the whole time they are here.

You must remember that more than half of my patients are not vaccinated for Coronavirus due to age restrictions on the vaccination. For their safety and for all of my immunocompromised patients, our goal is to make our office safe for all our patients and their families.