LEPROSY ( HANSEN'S DISEASE )

                                                    LEPROSY ( HANSEN'S DISEASE )

• Leprosy is a chronic disease caused by a slow multiplying bacillus,Mycobacterium leprae.
• M. leprae multiplies slowly and the incubation period of the disease is about 5 years. Symptoms can take as long as 20 years to appear.
• The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and also the eyes.
• Leprosy is curable.
• Although not highly infectious, it is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.

• Leprosy is rod-shaped bacillus. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and also the eyes.
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TYPES OF LEPROSY

In the tuberculoid form of the disease the skin lesions appear as light red or purplish spots. Tuberculoid leprosy is the more benign type, even though it is accompanied by nerve involvement, which leads to numbness (usually of the extremities), contractures, and ulceration.

lepromatous leprosy the skin lesions appear as yellow or brown infiltrated nodules (protuberances) that affect the mucous membranes of the eyes, nose, and throat. There is a general thickening of the skin, especially the face and ears. 

SYMPTOMS

The disease can cause:

• Skin lesions that may be faded/discolored
• Growths on the skin
• Thick, stiff or dry skin
• Severe pain
• Numbness on affected areas of the skin
• Muscle weakness or paralysis (especially in the hands and feet)
• Eye problems that may lead to blindness
• Enlarged nerves (especially those around the elbow and knee)
• A stuffy nose
• Nosebleeds
• Ulcers on the soles of feet

Since Hansen’s disease affects the nerves, loss of feeling or sensation can occur.

TRANSMISSION

Hansen’s disease is caused by infection with bacteria.

Evidence suggests that the bacteria that cause Hansen’s disease can spread from person to person. This might happen when someone with the disease coughs or sneezes. This can release droplets into the air. It might also happen if you are exposed to other nasal fluids (also known as secretions). Droplets and other secretions can contain the bacteria that cause Hansen’s disease.

If you breathe these in, you can become sick with the disease.

Armadillos Can Spread Leprosy 

TREATMENT

Hansen's disease is easily treatable. It’s treated for 6 months to 2 years with a combination of antibiotics.

If you are treated for Hansen’s disease, it's important to:

• tell your doctor about any potential nerve damage take extra care to prevent injuries that may occur (especially if you experience numbness or a loss of feeling in certain parts of the body).
• take the antibiotics until your doctor says treatment is complete (otherwise you may get sick again)

PREVENTION

1. Tests and Vaccines for the Prevention of Leprosy
2. Prevention of Leprosy for Household Contacts
3. People on long-term medication become noninfectious (they do not transmit the organism that causes the disease).

REFERENCES

WHO LEPROSY

CDC LEPROSY

Disease.emedtv.leprosy

YELLOW FEVER

                                                               YELLOW FEVER

• Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes. The "yellow" in the name refers to the jaundice that affects some patients.

• Up to 50% of severely affected persons without treatment will die from yellow fever.

• There are an estimated 200 000 cases of yellow fever, causing 30 000 deaths, worldwide each year, with 90% occurring in Africa.

• The virus is endemic in tropical areas of Africa and Latin America, with a combined population of over 900 million people.

• The number of yellow fever cases has increased over the past two decades due to declining population immunity to infection, deforestation, urbanization, population movements and climate change.

CAUSES

Yellow fever is caused by a virus that is spread by the Aedes aegypti mosquito. These mosquitoes thrive in and near human habitations where they breed in even the cleanest water. Most cases of yellow fever occur in sub-Saharan Africa and tropical South America.

Humans and monkeys are most commonly infected with the yellow fever virus. Mosquitoes transmit the virus back and forth between monkeys, humans or both.

Aedes aegypti feeding. 

SYMPTOMS

• The majority of persons infected with yellow fever virus have no illness or only mild illness.
• In persons who develop symptoms, the incubation period (time from infection until illness) is typically 3–6 days.
• The initial symptoms include sudden onset of fever, chills, severe headache, back pain, general body aches, nausea, and vomiting, fatigue, and weakness. Most persons improve after the initial presentation.
• After a brief remission of hours to a day, roughly 15% of cases progress to develop a more severe form of the disease. The severe form is characterized by high fever, jaundice, bleeding, and eventually shock and failure of multiple organs.

TRANSMISSION

Yellow fever virus is an RNA virus that belongs to the genus Flavivirus. It is related to West Nile, St. Louis encephalitis, and Japanese encephalitis viruses.

Yellow fever virus is transmitted to humans primarily through the bite of infected Aedes or Haemagogus species mosquitoes. Mosquitoes acquire the virus by feeding on infected primates (human or non-human) and then can transmit the virus to other primates (human or non-human). Humans infected with yellow fever virus are infectious to mosquitoes shortly before the onset of fever and for 3–5 days after onset.

Yellow fever virus has three transmission cycles: jungle (sylvatic), inter­mediate (savannah), and urban.

PREVENTION

Use insect repellent. When you go outdoors, use an EPA-registered insect repellent such as those containing DEET, picaridin, IR3535, or oil of lemon eucalyptus on exposed skin. Even a short time outdoors can be long enough to get a mosquito bite. For details on when and how to apply repellent

Wear proper clothing to reduce mosquito bites. When weather permits, wear long-sleeves, long pants and socks when outdoors. Mosquitoes may bite through thin clothing, so spraying clothes with repellent containing permethrin or another EPA-registered repellent will give extra protection. Clothing pre-treated with permethrin is commercially available. Mosquito repellents containing permethrin are not approved for application directly to skin.

Be aware of peak mosquito hours. The peak biting times for many mosquito species is dusk to dawn. However, Aedes aegypti, one of the mosquitoes that transmits yellow fever virus, feeds during the daytime. Take extra care to use repellent and protective clothing during daytime as well as during the evening and early morning. Staying in accommodations with screened or air-conditioned rooms, particularly during peak biting times, will also reduce risk of mosquito bites.

To reduce your exposure to mosquitoes:

• Avoid unnecessary outdoor activity when mosquitoes are most active.
• Wear long-sleeved shirts and long pants when you go into mosquito-infested areas.
• Stay in air-conditioned or well-screened housing.
• If your accommodations don't have good window screens or air-conditioning, use bed nets. Nets that have been pre-treated with insecticide offer additional protection.

TREATMENT

No antiviral medications have proved helpful in treating yellow fever. As a result, treatment consists primarily of supportive care in a hospital.

This includes providing fluids and oxygen, maintaining adequate blood pressure, replacing blood loss, providing dialysis for kidney failure, and treating any other infections that develop. Some people receive transfusions of plasma to replace blood proteins that improve clotting.

If you have yellow fever, your doctor will likely recommend that you stay inside, away from mosquitoes, to avoid transmitting the disease to others.

Once you've have yellow fever, you'll be immune to the disease for the rest of your life.

REFERENCES

WHO YELLOWFEVER

CDC YELLOWFEVER

Mayoclinic yellowfever

HAWAR (PLAGUE)

                                                       
                                                             HAWAR ( PLAGUE )



PENGENALAN

Hawar adalah jangkitan wabak secara semulajadi yang melibatkan tikus berlaku di merata tempat di seluruh dunia. Penyakit epidemik akut yang melibatkan tikus dan roden liar berlaku di bahagian tengah, timur dan selatan Afrika, Amerika Selatan, bahagian barat Amerika Utara dan di sebahagian besar Asia.

Di sesetengah kawasan, kontak antara tikus hutan dan tikus rumah biasa berlaku dan boleh menyebabkan kes jangkitan manusia dan kadang-kala menjadi wabak.

Agen penyebab

  Yersinia pestis

Cara jangkitan

 Jangkitan kutu yang  menular dari tikus ke haiwan lain dan manusia. Jangkitan manusia ke manusia tidak berlaku kecuali semasa wabak pneumonik, apabila titisan cecair pernafasan daripada pesakit menjangkiti orang lain semasa berdekatan.

Wabak juga boleh merebak melalui sentuhan dengan objek yang tercemar (contoh: tisu/tuala), atau cecair atau nanah haiwan yang dijangkiti.

Tempoh pengeraman

 1 hingga 7 hari

Pelancong adalah berisiko rendah. Walau bagaimanapun perjalanan ke kawasan dimana penyakit hawar biasa berlaku (endemik) di kawasan luar bandar mempunyai risiko, terutamanya jika berkhemah atau memburu atau jika tersentuh tikus.

TANDA TANDA DAN GEJALA

• Demam
• Batuk
• Bengkak  yang sakit di pangkal peha, leher dan ketiak
• Muntah

Jangkitan terbahagi kepada 3 jenis:

Hawar Bubonik

 Berpunca dari gigitan kutu yang dijangkiti menyebabkan radang pada kelenjar limfa (limfadenitis) dan sekitar kelenjar limfa. Ciri utama: Bengkak yang sakit dan bernanah.

Hawar Septisemik

Merebak dari wabak bubonik atau berlaku semasa ketiadaan limfadenitis. Jangkitan menular ke dalam aliran darah menyebabkan keradangan di selaput otak (meningitis), renjatan endotoksid dan pendarahan yang teruk akibat Penggumpalan Intravasel Tersebar (Disseminated Intravascular Coagulation - DIVC).

Hawar Pneumonik

 Jangkitan boleh menular ke paru-paru dan menyebabkan pneumonia yang teruk. Pesakit boleh merebakkan penyakit melalui titisan cecair pernafasan. Individu yang terkena titisan/cecair  tersebut boleh mendapat jangkitan paru-paru.

KOMPLIKASI

Tanpa rawatan segera dan berkesan, 50 hingga 60% dari kes boleh membawa maut.

Kesan septisemik yang tidak dirawat boleh menyebabkan renjatan endotoksid dan Penggumpalan Intravasel Tersebar (Disseminated Intravascular Coagulation - DIVC) manakala pneumonia teruk berlaku semasa wabak pneumonik.

RAWATAN

Rawatan khusus: Streptomisin adalah disarankan. Ubat lain termasuklah gentamisin, tetrasiklin dan kloramfenikol.

PENCEGAHAN

Jika anda melawat kawasan yang dijangkiti:

• Elakkan memegang tikus yang hidup atau mati
• Elakkan berada di tempat yang sesak
• Elakkan gigitan kutu dengan menggunakan repelan dan racun serangga
• Elakkan mengendali tikus mati dan laporkan kepada pihak kesihatan jika terjumpa tikus mati
• Jika anda berhubungan dengan orang yang dijangkiti, elakkan menyentuh cecair tubuh pesakit dan dapatkan rawatan awal
• Simpan dan lupuskan sisa makanan/sampah dengan betul supaya tikus tidak mencerobohi makanan dan tempat tinggal anda.

RUJUKAN

• International Travel & Health, WHO 2006
• Control of Communicable Diseases Manual, 18th Edition by David L. Heymann, MD, Editor, 2004
• myhealth.gov

TUBERCULOSIS ( TB )

                                                   
                                                           TUBERCULOSIS ( TB ) 

Tuberculosis (TB) is a potentially serious infectious disease that mainly affects your lungs. The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes.

Once rare in developed countries, tuberculosis infections began increasing in 1985, partly because of the emergence of HIV, the virus that causes AIDS. HIV weakens a person's immune system so it can't fight the TB germs. In the United States, because of stronger control programs, tuberculosis began to decrease again in 1993, but remains a concern.

Many strains of tuberculosis resist the drugs most used to treat the disease. People with active tuberculosis must take several types of medications for many months to eradicate the infection and prevent development of antibiotic resistance.

                  Tuberculosis is caused by the infectious agent known as Mycobacteriumtuberculosis (Mtb).

SYMPTOMS

Signs and symptoms of active TB include:

• Coughing that lasts three or more weeks
• Coughing up blood
• Chest pain, or pain with breathing or coughing
• Unintentional weight loss
• Fatigue
• Fever
• Night sweats
• Chills
• Loss of appetite

Tuberculosis can also affect other parts of your body, including your kidneys, spine or brain. When TB occurs outside your lungs, signs and symptoms vary according to the organs involved. For example, tuberculosis of the spine may give you back pain, and tuberculosis in your kidneys might cause blood in your urine.

• Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious. It can turn into active TB, so treatment is important for the person with latent TB and to help control the spread of TB in general. An estimated 2 billion people have latent TB.
• Active TB. This condition makes you sick and can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later.

WHEN TO SEE DOCTOR?

See your doctor if you have a fever, unexplained weight loss, drenching night sweats or a persistent cough. These are often signs of TB, but they can also result from other medical problems. Your doctor can perform tests to help determine the cause.

The Centers for Disease Control and Prevention recommends that people who have an increased risk of tuberculosis be screened for latent TB infection. This recommendation includes:

• People with HIV/AIDS
• IV drug users
• Those in contact with infected individuals
• Health care workers who treat people with a high risk of TB

TREATMENT

If you have latent tuberculosis, you may need to take just one type of TB drug. Active tuberculosis, particularly if it's a drug-resistant strain, will require several drugs at once. The most common medications used to treat tuberculosis include:

• Isoniazid
• Rifampin (Rifadin, Rimactane)
• Ethambutol (Myambutol)
• Pyrazinamide

If you have drug-resistant TB, a combination of antibiotics called fluoroquinolones and injectable medications, such as amikacin, kanamycin or capreomycin, are generally used for 20 to 30 months. Some types of TB are developing resistance to these medications as well.

A number of new drugs are being looked at as add-on therapy to the current drug-resistant combination treatment including:

• Bedaquiline
• Delamanid
• PA-824
• Linezolid
• Sutezolid

Medication side effects.

Serious side effects of TB drugs aren't common but can be dangerous when they do occur. All tuberculosis medications can be highly toxic to your liver. When taking these medications, call your doctor immediately if you experience any of the following:

• Nausea or vomiting
• Loss of appetite
• A yellow color to your skin (jaundice)
• Dark urine
• A fever that lasts three or more days and has no obvious cause

PREVENTION.

Protect your family and friends.

Finish your entire course of medication

Vaccinations

• Stay home. Don't go to work or school or sleep in a room with other people during the first few weeks of treatment for active tuberculosis.
• Ventilate the room. Tuberculosis germs spread more easily in small closed spaces where air doesn't move. If it's not too cold outdoors, open the windows and use a fan to blow indoor air outside.
• Cover your mouth. Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.
• Wear a mask. Wearing a surgical mask when you're around other people during the first three weeks of treatment may help lessen the risk of transmission.

TEST AND DIAGNOSIS

• Blood test
• Imaging test
• Sputum test

REFERENCES
CDC tuberculosis ( TB )
mayoclinic TUBERCULOSIS

Hand Foot Mouth Disease ( HFMD )

                                                                        HFMD 

 Hand, foot, and mouth disease is a common viral illness that usually affects infants and       children younger than 5 years old. However, it can sometimes occur in adults. Hand foot and mouth disease a mild, contagious viral infection common in young children is characterized by sores in the mouth and a rash on the hands and feet. Hand foot and mouth disease is most commonly caused by a coxsackievirus.

     The painful palms, feet etc caused by HFMD haemorrhaging effect.

SYMPTOMS

• Fever
• Sore throat
• Feeling of being unwell (malaise)
• Painful, red, blister-like lesions on the tongue, gums and inside of the cheeks
• A red rash, without itching but sometimes with blistering, on the palms, soles and sometimes the buttocks
• Irritability in infants and toddlers
• Loss of appetite
• A fever is often the first sign of hand-foot-and-mouth disease, followed by a sore throat and sometimes a poor appetite and malaise.
• One or two days after the fever begins, painful sores may develop in the mouth or throat. A rash on the hands and feet and possibly on the buttocks can follow within one or two days.

INCUBATION PERIOD

The usual period from initial infection to the onset of signs and symptoms (incubation period) is three to six days.

PREVENTION

Hand, foot, and mouth disease is spread from person to person through nose and throat secretions (such as saliva, sputum, or nasal mucus), blister fluid, or stool of infected persons. You can lower your risk of being infected by

• Washing your hands often with soap and water
• Disinfecting dirty surfaces and soiled items
• Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with infected persons
• If a person has mouth sores, it might be painful to swallow. However, drinking liquids is important to stay hydrated. If a person cannot swallow enough liquids, these may need to be given through an IV in their vein.
• Teach good hygiene. Show your children how to practice good hygiene and how to keep themselves clean. Explain to them why it's best not to put their fingers, hands or any other objects in their mouths.
• Isolate contagious people. Because hand-foot-and-mouth disease is highly contagious, people with the illness should limit their exposure to others while they have active signs and symptoms. Keep children with hand-foot-and-mouth disease out of child care or school until fever is gone and mouth sores have healed. If you have the illness, stay home from work.
• Disinfect common areas. Get in the habit of cleaning high-traffic areas and surfaces first with soap and water, then with a diluted solution of chlorine bleach and water. Child care centers should follow a strict schedule of cleaning and disinfecting all common areas, including shared items such as toys, as the virus can live on these objects for days. Clean your baby's pacifiers often.

TREATMENT

There is no specific treatment for hand, foot and mouth disease. However, some things can be done to relieve symptoms, such as

• Taking over-the-counter medications to relieve pain and fever (Caution: Aspirin should not be given to children.)
• Using mouthwashes or sprays that numb mouth pain
• There's no specific treatment for hand-foot-and-mouth disease. Signs and symptoms of hand-foot-and-mouth disease usually clear up in seven to 10 days.
  A topical oral anesthetic may help relieve the pain of mouth sores. Over-the-counter pain medications other than aspirin, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) may help relieve general discomfort.

Persons who are concerned about their symptoms should contact their health care provider.

  REFERENCES

MAYOCLINIC HFMD

CDC HFMD

CDC PREVENTION CONTROL