Leptospirosis, also known as canicola fever, hemorrhagic jaundice, infectious jaundice, mud fever, spirochetal jaundice, swamp fever, swineherd’s disease, caver’s flu or sewerman’s flu, is a bacterial infection resulting from exposure to the Leptospira interrogans bacterium. There is an acute form of human infection known as Weil’s disease, where the patient suffers from jaundice, though this term is often (incorrectly) used to describe any case of infection. Weil’s disease is comparatively rare, though ‘mild’ cases of leptospirosis happen everywhere there are carriers, and it is believed that leptospirosis is one of the most common zoonotic infections in the world. Millions of people are infected each year, but information and treatment can be limited, especially in the developed world where cases are considered ‘rare’ by the medical community. The goal of the LIC and this website is to increase awareness of the infection and how to manage the risks, with clear advice and guidance for all aspects of work and leisure.

via leptospirosis.org

Leptospirosis is a bacterial zoonotic disease caused by spirochaetes of the genus Leptospira that affects humans and a wide range of animals, including mammals, birds, amphibians, and reptiles. It was first described by Adolf Weil in 1886 when he reported an “acute infectious disease with enlargement of spleen, jaundice and nephritis”. Leptospira was first observed in 1907 from a post mortem renal tissue slice.[2]

Though being recognised among the world’s most common zoonoses, leptospirosis is a relatively rare bacterial infection in humans. The infection is commonly transmitted to humans by allowing water that has been contaminated by animal urine to come in contact with unhealed breaks in the skin, eyes or with the mucous membranes. Outside of tropical areas, leptospirosis cases have a relatively distinct seasonality with most of them occurring August – September / February–March.

Causes of Leptospirosis
Leptospirosis is transmitted by the urine of an infected animal and is contagious as long as it is still moist. Although rats, mice and voles are important primary hosts, a wide range of other mammals including dogs, deer, rabbits, hedgehogs, cows, sheep, raccoons, possums, skunks, and even certain marine mammals are also able to carry and transmit the disease as secondary hosts. Dogs may lick the urine of an infected animal off the grass or soil, or drink from an infected puddle. There have been reports of “house dogs” contracting leptospirosis apparently from licking the urine of infected mice that entered the house. The type of habitats most likely to carry infective bacteria are muddy riverbanks, ditches, gulleys and muddy livestock rearing areas where there is regular passage of either wild or farm mammals. There is a direct correlation between the amount of rainfall and the incidence of leptospirosis, making it seasonal in temperate climates and year-round in tropical climates.

Leptospirosis is also transmitted by the semen of infected animals. Abattoir workers can contract the disease through contact with infected blood or body fluids.

Symptoms of Leptospirosis
In humans, leptospiral infection causes a wide range of symptoms, and some infected persons may have no symptoms at all. Leptospirosis is a biphasic disease that begins with flu-like symptoms (fever, chills, myalgias, intense headache). The first phase resolves, and the patient is briefly asymptomatic until the second phase begins. This is characterized by meningitis, liver damage (causing jaundice), and renal failure; because of the wide range of symptoms the infection is often wrongly diagnosed. This leads to a lower registered number of cases than there really are. Symptoms of leptospirosis include high fever, severe headache, chills, muscle aches, and vomiting, and may include jaundice, red eyes, abdominal pain, diarrhea, and/or a rash. The symptoms in humans appear after a 4–14 day incubation period.

In animals, the incubation period (time of exposure to first symptoms) is anywhere from 2 to 20 days. In dogs, the liver and kidney are most commonly damaged by leptospirosis. Vasculitis can occur, causing edema and potentially disseminated intravascular coagulation (DIC). Myocarditis, pericarditis, meningitis, and uveitis are also possible sequelae. [3] One should strongly suspect leptospirosis and include it as part of a differential diagnosis if the sclerae of the dog’s eyes appear jaundiced (even slightly yellow), though the absence of jaundice does not eliminate the possibility of leptospirosis, and its presence could indicate hepatitis or other liver pathology rather than leptospirosis. Vomiting, fever, failure to eat, reduced urine output, unusually dark or brown urine, and lethargy are also indications of the disease.

via wikipedia

Mode of Transmission of Leptospirosis
The infection is commonly transmitted to humans by allowing water that has been contaminated by animal urine to come in contact with unhealed breaks in the skin, eyes or with the mucous membranes. Outside of tropical areas, leptospirosis cases have a relatively distinct seasonality with most of them occurring August–September/February–March.

Symptoms of Leptosprosis
In humans, leptospiral infection causes a wide range of symptoms, and some infected persons may have no symptoms at all. Leptospirosis is a biphasic disease that begins with flu-like symptoms (fever, chills, myalgias, intense headache). The first phase resolves, and the patient is briefly asymptomatic until the second phase begins. This is characterized by meningitis, liver damage (causing jaundice), and renal failure; because of the wide range of symptoms the infection is often wrongly diagnosed. This leads to a lower registered number of cases than there really are. Symptoms of leptospirosis include high fever, severe headache, chills, muscle aches, and vomiting, and may include jaundice, red eyes, abdominal pain, diarrhea, and/or a rash. The symptoms in humans appear after a 4–14 day incubation period.

Complications of Leptospirosis
Complications include meningitis, extreme fatigue, hearing loss, respiratory distress, azotemia, and renal interstitial tubular necrosis, which results in renal failure and often liver failure (the severe form of this disease is known as Weil’s disease, though it is sometimes named Weil Syndrome). Cardiovascular problems are also possible.

Diagnostics
Kidney tissue, using a silver staining technique, revealing the presence of Leptospira bacteria.
On infection the microorganism can be found in blood for the first 7 to 10 days (invoking serologically identifiable reactions) and then moving to the kidneys. After 7 to 10 days the microorganism can be found in fresh urine. Hence, early diagnostic efforts include testing a serum or blood sample serologically with a panel of different strains. It is also possible to culture the microorganism from blood, serum, fresh urine and possibly fresh kidney biopsy. Kidney function tests (Blood Urea Nitrogen and creatinine) as well as blood tests for liver functions are performed.

Treatment
Leptospirosis treatment is a relatively complicated process comprising two main components: suppressing the causative agent and fighting possible complications. Aetiotropic drugs are antibiotics, such as cefotaxime, doxycycline, penicillin, ampicillin, and amoxicillin (doxycycline can also be used as a prophylaxis). There are no human vaccines; animal vaccines are only for a few strains, and are only effective for a few months. Human therapeutic dosage of drugs is as follows: doxycycline 100 mg orally every 12 hours for 1 week or penicillin 1–1.5 MU every 4 hours for 1 week. Doxycycline 200–250 mg once a week is administered as a prophylaxis.[citation needed.

Supportive therapy measures (esp. in severe cases) include detoxication and normalization of the hydro-electrolytic balance. Glucose and salt solution infusions may be administered; dialysis is used in serious cases. Elevations of serum potassium are common and if the potassium level gets too high special measures must be taken. Serum phosphorus levels may likewise increase to unacceptable levels due to renal failure. Treatment for hyperphosphatemia consists of treating the underlying disease, dialysis where appropriate, or oral administration of calcium carbonate, but not without first checking the serum calcium levels (these two levels are related). Corticosteroids administration in gradually reduced doses (e.g., prednisolone starting from 30–60 mg) during 7–10 days is recommended by some specialists in cases of severe haemorrhagic effects. Organ specific care and treatment are essential in cases of renal, liver or heart involvement. ]]> http://nurseonline.org/leptospirosis-symptoms-transmission-diagnosis-and-treatment/feed/ 0 http://nurseonline.org/herpes-simplex-symptoms-transmission-diagnosis-and-treatment/ http://nurseonline.org/herpes-simplex-symptoms-transmission-diagnosis-and-treatment/#comments Fri, 25 Sep 2009 09:18:00 +0000 Site Admin http://nurseonline.org/herpes-simplex-symptoms-transmission-diagnosis-and-treatment/ Herpes simplex a viral disease caused by herpes simplex viruses; both herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2) cause herpes simplex. Infection with the herpes virus is categorized into one of several distinct disorders based on the site of infection. Oral herpes, the visible symptoms of which are colloquially called cold sores, infects the face and mouth. Oral herpes is the most common form of infection. Genital herpes, commonly known simply as herpes, is the second most common form of herpes. Other disorders such as herpetic whitlow, herpes gladiatorum, ocular herpes (keratitis), cerebral herpes infection encephalitis, Mollaret’s meningitis, neonatal herpes, and possibly Bell’s palsy are all caused by herpes simplex viruses.

Signs and Symptoms
HSV infection causes several distinct medical disorders. Common infection of the skin or mucosa may affect the face and mouth (orofacial herpes), genitalia (genital herpes), or hands (herpes whitlow). More serious disorders occur when the virus infects and damages the eye (herpes keratitis), or invades the central nervous system, damaging the brain (herpes encephalitis). Patients with immature or suppressed immune systems, such as newborns, transplant recipients, or AIDS patients are prone to severe complications from HSV infections. HSV infection has also been associated with cognitive deficits of bipolar disorder, and Alzheimer’s disease, although this is often dependent on the genetics of the infected person.

Diagnosis of Herpes simplex
Primary orofacial herpes is readily identified by clinical examination of persons with no previous history of lesions and contact with an individual with known HSV-1 infection. The appearance and distribution of sores in these individuals typically presents as multiple, round, superficial oral ulcers, accompanied by acute gingivitis. Adults with non-typical presentation are more difficult to diagnose. Prodromal symptoms that occur before the appearance of herpetic lesions help differentiate HSV symptoms from the similar symptoms of other disorders, such as allergic stomatitis. When lesions do not appear inside the mouth primary orofacial herpes is sometimes mistaken for impetigo, a bacterial infection. Common mouth ulcers (aphthous ulcer) also resemble intraoral herpes, but do not present a vesicular stage.

Genital herpes can be more difficult to diagnose than oral herpes since most HSV-2-infected persons have no classical symptoms. Further confusing diagnosis, several other conditions resemble genital herpes, including lichen planus, atopic dermatitis, and urethritis. Laboratory testing is often used to confirm a diagnosis of genital herpes. Laboratory tests include: culture of the virus, direct fluorescent antibody (DFA) studies to detect virus, skin biopsy, and polymerase chain reaction (PCR) to test for presence of viral DNA. Although these procedures produce highly sensitive and specific diagnoses, their high costs and time constraints discourage their regular use in clinical practice.

Serological tests for antibodies to HSV are rarely useful to diagnosis and not routinely used in clinical practice, but are important in epidemiological studies. Serologic assays cannot differentiate between antibodies generated in response to a genital versus or an oral HSV infection, and as such cannot confirm the site of infection. Absence of antibody to HSV-2 does not exclude genital infection because of the increasing incidence of genital infections caused by HSV-1.

Prevention of Herpes simplex
Barrier protection, such as a condom, can reduce the risk of herpes transmission.

For genital herpes, condoms are highly effective in limiting transmission of herpes simplex infection. The virus cannot pass through latex, but a condom’s effectiveness is somewhat limited on a public health scale by their limited use in the community, and on an individual scale because the condom may not completely cover blisters on the penis of an infected male, or the base of the penis or testicles not covered by the condom may come into contact with free virus in vaginal fluid of an infected female. In such cases, abstinence from sexual activity or washing of the genitals after sex is recommended. The use of condoms or dental dams also limits the transmission of herpes from the genitals of one partner to the mouth of the other (or vice versa) during oral sex.

As with almost all sexually transmitted infections, women are more susceptible to acquiring genital HSV-2 than men. On an annual basis, without the use of antivirals or condoms, the transmission risk of HSV-2 from infected male to female is approximately 8-10%.

The risk of transmission from mother to baby is highest if the mother becomes infected at around the time of delivery (transmission risk 30 to 60%), but the risk falls to 3% if it is a recurrent infection, and is less than 1% if there are no visible lesions. To prevent neonatal infections, seronegative women are recommended to avoid unprotected oral-genital contact with an HSV-1 seropositive partner and conventional sex with a partner having a genital infection during the last trimester of pregnancy.

HSV-2 infected individuals are at higher risk for acquiring HIV when practicing unprotected sex with HIV positive persons, particularly during an outbreak with active lesions.

Treatment of Herpes simplex
Antiviral medications used against herpes viruses work by interfering with viral replication, effectively slowing the replication rate of the virus and providing a greater opportunity for the immune response to intervene. All drugs in this class depend on the activity of the viral enzyme thymidine kinase to convert the drug sequentially from its prodrug form to monophosphate (with one phosphate group), diphosphate (with two phosphate groups), and finally to the triphosphate (with three phosphate groups) form which interferes with viral DNA replication.

There are several prescription antiviral medications for controlling herpes simplex outbreaks, including aciclovir (Zovirax), valaciclovir (Valtrex), famciclovir (Famvir), and penciclovir. Aciclovir was the original, and prototypical, member of this drug class; it is now available in generic brands at a greatly reduced cost. Valaciclovir and famciclovir—prodrugs of aciclovir and penciclovir, respectively—have improved solubility in water and better bioavailability when taken orally. Aciclovir is the recommended antiviral for suppressive therapy for use during the last months of pregnancy to prevent transmission of herpes simplex to the neonate in cases of maternal recurrent herpes. The use of valaciclovir and famciclovir, while potentially improving treatment compliance and efficacy, are still undergoing safety evaluation in this context.

Prevention
Improving sanitation is the most important measure, which consists of proper treatment and disposal of human waste, higher standards for public water supplies, improved personal hygiene procedures and sanitary food preparation. Thus, prevention strategies of this disease are similar to those of many others that plague developing nations, and they require large-scale international financing of water supply and water treatment projects. A vaccine based on recombinant viral proteins has been developed and recently tested in a high-risk population (military personnel of a developing country). The vaccine appeared to be effective and safe, but further studies are needed to assess the long-term protection and the cost-effectiveness of hepatitis E vaccination.

Transmission
Hepatitis D Virus is rare in most developed countries, and is mostly associated with intravenous drug abuse. However Hepatitis D Virus is much more common in Mediterranean countries, sub-Saharan Africa, the Middle East, and countries in the northern part of South America. In all, about 20 million people may be infected with Hepatitis D Virus.

Transmission
Sexual activities and practices were initially identified as potential sources of exposure to the hepatitis C virus. More recent studies question this route of transmission. Currently it is felt to be a means of rare transmission of hepatitis C infection. These are simply the current known modes of transmission and due to the nature of Hepatitis there may be more ways that it is transmitted than the current known methods.

Injection drug use
Those who currently use or have used drug injection as their delivery route for drugs are at increased risk for getting hepatitis C because they may be sharing needles or other drug paraphernalia (includes cookers, cotton, spoons, water, etc.), which may be contaminated with HCV-infected blood. An estimated 60% to 80% of intravenous recreational drug users in the United States have been infected with Hepatitis C Virus. Harm reduction strategies are encouraged in many countries to reduce the spread of hepatitis C, through education, provision of clean needles and syringes, and safer injecting techniques.

Blood products
Blood transfusion, blood products, or organ transplantation prior to implementation of Hepatitis C Virus screening (in the U.S., this would refer to procedures prior to 1992) is a decreasing risk factor for hepatitis C.

Iatrogenic medical or dental exposure
People can be exposed to Hepatitis C Virus via inadequately or improperly sterilized medical or dental equipment. Equipment that may harbor contaminated blood if improperly sterilized includes needles or syringes, hemodialysis equipment, oral hygiene instruments, and jet air guns, etc. Scrupulous use of appropriate sterilization techniques and proper disposal of used equipment can reduce the risk of iatrogenic exposure to Hepatitis C Virus to virtually zero.

Occupational exposure to blood
Medical and dental personnel, first responders (e.g., firefighters, paramedics, emergency medical technicians, law enforcement officers), and military combat personnel can be exposed to HCV through accidental exposure to blood through accidental needlesticks or blood spatter to the eyes or open wounds. Universal precautions to protect against such accidental exposures significantly reduce the risk of exposure to Hepatitis C Virus.

Recreational exposure to blood
Contact sports and other activities, such as “slam dancing” that may result in accidental blood-to-blood exposure are potential sources of exposure to Hepatitis C Virus.

Sexual exposure
Sexual transmission of Hepatitis C Virus is considered to be rare. Studies show the risk of sexual transmission in heterosexual, monogamous relationships is extremely rare or even null. The CDC does not recommend the use of condoms between long-term monogamous discordant couples (where one partner is positive and the other is negative). However, because of the high prevalence of hepatitis C, this small risk may translate into a non-trivial number of cases transmitted by sexual routes. Vaginal penetrative sex is believed to have a lower risk of transmission than sexual practices that involve higher levels of trauma to anogenital mucosa (anal penetrative sex, fisting, use of sex toys).

Body piercings and tattoos
Tattooing dyes, ink pots, stylets and piercing implements can transmit HCV-infected blood from one person to another if proper sterilization techniques are not followed. “underground,” or non-professionally are of particular concern since sterile techniques in such settings may have been or be insufficient to prevent disease. Despite these risks, it is rare for tattoos to be directly associated with HCV infection and the U.S. Centers for Disease Control and Prevention’s position on this subject states that, “no data exist in the United States indicating that persons with exposures to tattooing alone are at increased risk for Hepatitis C Virus infection.”

Shared personal care items
Personal care items such as razors, toothbrushes, cuticle scissors, and other manicuring or pedicuring equipment can easily be contaminated with blood. Sharing such items can potentially lead to exposure to Hepatitis C Virus. Appropriate caution should be taken regarding any medical condition which results in bleeding such as canker sores, cold sores, and immediately after flossing.

Nursebitz.com ALERT: Hepatitis C Virus is not spread through casual contact such as hugging, kissing, or sharing eating or cooking utensils.

Vertical transmission
Refers to the transmission of a communicable disease from an infected mother to her child during the birth process. Mother-to-child transmission of hepatitis C has been well described, but occurs relatively infrequently. Transmission occurs only among women who are HCV RNA positive at the time of delivery; the risk of transmission in this setting is approximately 6 out of 100. The risk of vertical transmission of HCV does not appear to be associated with method of delivery or breastfeeding.

Diagnosis
Hepatitis C testing begins with serological blood tests used to detect antibodies to HCV. Anti-HCV antibodies can be detected in 80% of patients within 15 weeks after exposure, in >90% within 5 months after exposure, and in >97% by 6 months after exposure. Overall, HCV antibody tests have a strong positive predictive value for exposure to the hepatitis C virus, but may miss patients who have not yet developed antibodies (seroconversion), or have an insufficient level of antibodies to detect. Rarely, people infected with HCV never develop antibodies to the virus and therefore, never test positive using HCV antibody screening. Because of this possibility, RNA testing (see nucleic acid testing methods below) should be considered when antibody testing is negative but suspicion of hepatitis C is high (e.g. because of elevated transaminases in someone with risk factors for hepatitis C)

Prevention
According to Centers for Disease Control, hepatitis C virus is spread by exposure to large quantities of blood, either through the skin or by injection:

* Injection drug use
* Receipt of donated blood, blood products, and organs
* Needlestick injuries in healthcare settings
* Birth to an HCV-infected mother
HCV can also be spread infrequently through
* Sex with an HCV-infected person (an inefficient means of transmission)
* Sharing personal items contaminated with infectious blood, such as razors or toothbrushes
(also inefficient vectors of transmission)
* Other healthcare procedures that involve invasive procedures, such as injections (usually
recognized in the context of outbreaks)

No vaccine protects against contracting hepatitis C, or helps to treat it. Vaccines are under development and some have shown encouraging results.

Treatment
There is a very small chance of clearing the virus spontaneously in chronic HCV carriers (0.5% to 0.74% per year). However, the majority of patients with chronic hepatitis C will not clear it without treatment. Current treatment is a combination of Pegylated interferon-alpha-2a or Pegylated interferon-alpha-2b (brand names Pegasys or PEG-Intron) and the antiviral drug ribavirin for a period of 24 or 48 weeks, depending on hepatitis C virus genotype.

Treatment is generally recommended for patients with proven hepatitis C virus infection and persistently abnormal liver function tests. Sustained cure rates (sustained viral response) of 75% or better are seen in people with HCV genotypes 2 and 3 with 24 weeks of treatment.[25] Sustained responses are rarer with other genotypes, at about 50% in patients with HCV genotype 1 given 48 weeks of treatment and 65% in those with genotype 4 given 48 weeks of treatment.

Symptoms of Hepatitis B
Jaundice in a man with hepatic failure.Acute infection with hepatitis B virus is associated with acute viral hepatitis – an illness that begins with general ill-health, loss of appetite, nausea, vomiting, body aches, mild fever, dark urine, and then progresses to development of jaundice. It has been noted that itchy skin has been an indication as a possible symptom of all hepatitis virus types. The illness lasts for a few weeks and then gradually improves in most affected people. A few patients may have more severe liver disease (fulminant hepatic failure), and may die as a result of it. The infection may be entirely asymptomatic and may go unrecognized. Chronic infection with Hepatitis B virus may be either asymptomatic or may be associated with a chronic inflammation of the liver (chronic hepatitis), leading to cirrhosis over a period of several years. This type of infection dramatically increases the incidence of hepatocellular carcinoma (liver cancer). Chronic carriers are encouraged to avoid consuming alcohol as it increases their risk for cirrhosis and liver cancer. Hepatitis B virus has been linked to the development of Membranous glomerulonephritis (MGN)

Transmission of Hepatitis B
Transmission of hepatitis B virus results from exposure to infectious blood or body fluids containing blood. Possible forms of transmission include (but are not limited to) unprotected sexual contact, blood transfusions, re-use of contaminated needles & syringes, and vertical transmission from mother to child during childbirth. Without intervention, a mother who is positive for HBsAg confers a 20% risk of passing the infection to her offspring at the time of birth. This risk is as high as 90% if the mother is also positive for HBeAg. HBV can be transmitted between family members within households, possibly by contact of nonintact skin or mucous membrane with secretions or saliva containing Hepatitis B Virus.

Diagnosis of Hepatitis B
The tests, called assays, for detection of hepatitis B virus infection involve serum or blood tests that detect either viral antigens (proteins produced by the virus) or antibodies produced by the host. Interpretation of these assays is complex

Acute hepatitis B infection does not usually require treatment because most adults clear the infection spontaneously.[35] Early antiviral treatment may only be required in fewer than 1% of patients, whose infection takes a very aggressive course (”fulminant hepatitis”) or who are immunocompromised. On the other hand, treatment of chronic infection may be necessary to reduce the risk of cirrhosis and liver cancer. Chronically infected individuals with persistently elevated serum alanine aminotransferase, a marker of liver damage, and Hepatitis B Virus DNA levels are candidates for therapy

Infants born to mothers known to carry hepatitis B can be treated with antibodies to the hepatitis B virus (hepatitis B immune globulin or HBIg). When given with the vaccine within twelve hours of birth, the risk of acquiring hepatitis B is reduced 95%. This treatment allows a mother to safely breastfeed her child.

Prevalence
Hepatitis A Virus is found in the feces of infected persons and those who are at higher risk include travelers to developing countries where there is a higher incidence rate and those having sexual contact or drug use with infected persons

Transmission
The virus spreads by the fecal-oral route and infections often occur in conditions of poor sanitation and overcrowding. Hepatitis A can be transmitted by the parenteral route but very rarely by blood and blood products. Food-borne outbreaks are not uncommon, and ingestion of shellfish cultivated in polluted water is associated with a high risk of infection.

Prevention
Hepatitis A can be prevented by vaccination, good hygiene and sanitation. Hepatitis A is also one of the main reasons not to surf or go in the ocean after rains in coastal areas that are known to have bad runoff. The vaccine protects against Hepatis A Virus in more than 95% of cases for 10 years. It contains inactivated Hepatitis A virus providing active immunity against a future infection. The vaccine is given in two doses in the muscle of the upper arm. The first dose provides protection two to four weeks after initial vaccination; the second booster dose, given six to twelve months later, provides protection for up to twenty years.

Symptoms
Early symptoms of hepatitis A infection can be mistaken for influenza, but some sufferers, especially children, exhibit no symptoms at all. Symptoms typically appear 2 to 6 weeks, (the incubation period ), after the initial infection. Symptoms can return over the following 6–9 months and include, fatigue, Fever, Abdominal pain, Nausea, Diarrhea, Appetite loss, Depression, Jaundice, a yellowing of the skin or whites of the eyes, Sharp pains in the right-upper quadrant of the abdomen, Weight loss, Itching.

Diagnosis
Serum IgG, IgM and ALT following Hepatitis A virus infection. Although Hepatitis A Virus is excreted in the feces towards the end of the incubation period, specific diagnosis is made by the detection of HAV-specific IgM antibodies in the blood. IgM antibody is only present in the blood following an acute hepatitis A infection. It is detectable from one to two weeks after the initial infection and persists for up to 14 weeks. The presence of IgG antibody in the blood means that the acute stage of the illness is past and the person is immune to further infection. IgG antibody to Hepatitis Virus is also found in the blood following vaccination and tests for immunity to the virus are based on the detection of this antibody. During the acute stage of the infection, the liver enzyme alanine transferase (ALT) is present in the blood at levels much higher than is normal. The enzyme comes from the liver cells that have been damaged by the virus. Hepatitis A virus is present in the blood, (viremia), and feces of infected people up to two weeks before clinical illness develops.

Treatment
There is no specific treatment for hepatitis A. Sufferers are advised to rest, avoid fatty foods and alcohol (these may be poorly tolerated for some additional months during the recovery phase and cause minor relapses), eat a well-balanced diet, and stay hydrated. Approximately 15% of people diagnosed with hepatitis A may experience one or more symptomatic relapse(s) for up to 24 months after contracting this disease

The occurrence and spread of dengue are now not only confined to the known wet and rainy months of the year anymore because in some parts of the country, rain comes even during the dry season and summer time. Hence, the possibility of having more breeding grounds than the usual is high and very likely. And we all know what could happen next: the inevitable increase of dengue cases.

We can beat and outsmart dengue. But our success will largely depend on the willingness of our people to help and cooperate with the campaign. The community needs to actively participate in the search and destruction of unnecessary containers where these killer mosquitoes breed. We will win this battle if we will fight this together.

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1. Epidemiology of Dengue Fever
2. Diagnostic Test for Dengue Fever ]]> http://nurseonline.org/anti-dengue-campaign/feed/ 0 http://nurseonline.org/what-is-tuberculosis-l-department-of-health-anti-tuberculosis-program/ http://nurseonline.org/what-is-tuberculosis-l-department-of-health-anti-tuberculosis-program/#comments Mon, 10 Aug 2009 04:53:00 +0000 Site Admin http://nurseonline.org/what-is-tuberculosis-l-department-of-health-anti-tuberculosis-program/ Posted by: Rey-Ryan P. Mapiles RN

Tuberculosis is transmitted from person to person through the air when a patient with active tuberculosis disease coughs, sneezes or speaks. Because it is air-borne, it is especially important for those living in or traveling to a tuberculosis risk area to be aware that they are at risk for the disease, to know the symptoms of tuberculosis and to be tested, if they think they have been exposed.

Most people who are infected with the tuberculosis germ do not have the active form of the disease. They have no symptoms and are not infectious. However, they carry the germ, which may grow and lead to the active, infectious disease at some time in the future.

If you have the symptoms of tuberculosis you should see a doctor right away. And if you notice someone who has the symptoms of tuberculosis you should encourage them to see a doctor right away.

“If a person waits to be treated, they may become very sick and even more contagious.” tuberculosis symptoms include a persistent cough, fever, night sweats, and unintended weight loss. tuberculosis germs are spread through the air.

Anyone can get tuberculosis, but certain people are at a higher risk. People with conditions that affect their immune systems, such as HIV, diabetes or cancer, and people who are homeless, who use street drugs, or who have been in prison or jail are at higher risk.

The rising incidence of tuberculosis has economic repercussions not only for the patient’s family but also for the country. Eighty percent of people afflicted with tuberculosis are in the most economically productive years of their lives, and the disease sends many self-sustaining families into poverty. The rise in the incidence of tuberculosis has been due to the low priority accorded to anti-tuberculosis activities by many countries. The unavailability of anti-TB drugs, insufficient laboratory networking, poor health infrastructures, including a lack of trained health personnel, have also contributed to the rise in the incidence of the diseases.