Habitat : Gillenia stipulata is native to Eastern N. America – New York to Indiana and Kansas, south to Georgia, Louisiana and Oklahoma. It grows in woods, thickets and rocky slopes.
Gillenia stipulata is a herbaceous, perennial plant growing to 1.2 m (4ft). It is hardy to zone (UK) 5. It is in flower from May to June. The stem is erect, glabrous to pubescent, branching, multiple from base, sub-hollow, greenish to red above, from caudex, rhizomatous.. The flowers are hermaphrodite (have both male and female organs) and are pollinated by Insects.
Leaves – Alternate, stipulate, short-petiolate, trifoliolate. Stipules large, foliaceous, serrate, ovate, +/-2.5cm long and broad, pubescent below, glabrous ir sparse pubescent above. Leaflets sessile, linear-lanceolate, to 9cm long, 2cm broad, serrate, pubescent below, sparse pubescent above, central leaflet slightly larger than lateral leaflets. Leaflets of lowest leaves pinnatifid.
Inflorescence – Axillary and terminal loose few-flowered panicles. Each divisions of inflorescence subtended by reduced foliaceous bract.
Flowers – Petals 5, white, acute to acuminate, 1.2cm long, 3-4mm broad, glabrous, oblong, clawed. Claw to 3mm long. Stamens 20, borne at edge of hypanthium, in two sets. Filaments white, glabrous, 2mm long. Anthers tan, 1mm in diameter. Pistils 5, distinct. Styles white, 3mm long, glabrous. Ovaries yellow-green, 1.9mm long. Hypanthium tube 5-6mm long, 3-4mm in diameter, greenish-white to reddish, truncate at base, glabrous. Sepals 5, acute, 1.1mm long, with some pubescence internally near apex. Follicles to 8mm long, glabrous, with +/-3 seeds.
A common name for this plant is “American Ipecac” because the plant had been used by natives as a laxative and emetic. This is not, however, the common Ipecac of modern medicine. Today’s Ipecac comes from Cephaelis ipecacuanha, a member of the Rubiaceae from South America.
Easily grown in a rather moist but well-drained lime-free peaty soil in semi-shade. Succeeds in a sunny position but requires shade at the hottest part of the day.
Seed – sow spring or autumn in a cold frame. Prick out the seedlings when they are large enough to handle and grow on for the first year in a lightly shaded area of the greenhouse or cold frame. Plant out in late spring and protect from slugs until well established. Division in spring or autumn. Medicinal Uses:
The dried powered root bark is cathatric, slightly diaphoretic,a mild and efficient emetic,expectorant and tonic. Minute dosesare used internally in the treatment of colds, chronic diarrhea, constipation, asthma and other bronchial complications. The root have been used externally in the treatment of rhematism. A cold infution of the roots has been given , or the root chewed in the treatment of bee and insects stings.The roots are harvested in the autumn, the bark is removed and dried for later use. A tea made from the whole plant is strong laxative and emitic.Minute doses are used internally in the treatment of colds, indigestion, asthma and hepatitis.A poultice or wash is used in the treatment of rhematism,bee stings and swellings.A decoction or strong infution of the whole plant has been taken a pint at a time as an emitic.A poultice of the plant has been used to treat leg swellings. The plant has been used in the treatment of toothaches.
The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.
Hypothermia is a condition in which core temperature drops below the required temperature for normal metabolism and body functions which is defined as 35.0 °C (95.0 °F). Body temperature is usually maintained near a constant level of 36.5–37.5 °C (98–100 °F) through biologic homeostasis or thermoregulation. If exposed to cold and the internal mechanisms are unable to replenish the heat that is being lost, a drop in core temperature occurs. As body temperature decreases, characteristic symptoms occur such as shivering and mental confusion.
When your body temperature drops, your heart, nervous system and other organs cannot work correctly. Left untreated, hypothermia eventually leads to complete failure of your heart and respiratory system and to death.
Hypothermia is most often caused by exposure to cold weather or immersion in a cold body of water. Primary treatments are methods to warm the body back to a normal temperature.
Hypothermia is the opposite of hyperthermia which is present in heat exhaustion and heat stroke. The lowest documented body temperature from which anyone has recovered was 13.0 °C (55.4 °F), in a drowning incident involving a 7-year-old girl in Sweden in December 2010
Clasification:– Normal human body temperature in adults is 34.4–37.8 °C (94–100 °F). Sometimes a narrower range is stated, such as 36.5–37.5 °C (98–100 °F). Hypothermia is defined as any body temperature below 35.0 °C (95.0 °F). It is subdivided into four different degrees, mild 32–35 °C (90–95 °F); moderate, 28–32 °C (82–90 °F); severe, 20–28 °C (68–82 °F); and profound at less than 20 °C (68 °F). This is in contrast to hyperthermia and fever which are defined as a temperature of greater than 37.5 °C (99.5 °F)-38.3 °C (100.9 °F).
Other cold-related injuries that can either be present alone or in combination with hypothermia include:
*Chilblains are superficial ulcers of the skin that occur when a predisposed individual is repeatedly exposed to cold.
*Frostbite involves the freezing and destruction of tissue.
*Frostnip is a superficial cooling of tissues without cellular destruction.
*Trench foot or immersion foot is due to repetitive exposure to wet, non-freezing temperatures
The signs and symptoms vary depending on the degree of hypothermia and may be divided by the three stages of severity.
Symptoms of mild hypothermia may be vague with sympathetic nervous system excitation (shivering, hypertension, tachycardia, tachypnea, and vasoconstriction). These are all physiological responses to preserve heat. Cold diuresis, mental confusion, as well as hepatic dysfunction may also be present. Hyperglycemia may be present, as glucose consumption by cells and insulin secretion both decrease, and tissue sensitivity to insulin may be blunted. Sympathetic activation also releases glucose from the liver. In many cases, however, especially in alcoholic patients, hypoglycemia appears to be a more common presentation. Hypoglycemia is also found in many hypothermic patients because hypothermia often is a result of hypoglycemia.
Low body temperature results in shivering becoming more violent.(Shivering is your body’s automatic defense against cold temperature — an attempt to warm itself. Constant shivering is a key sign of hypothermia) Muscle mis-coordination becomes apparent. Movements are slow and labored, accompanied by a stumbling pace and mild confusion, although the victim may appear alert. Surface blood vessels contract further as the body focuses its remaining resources on keeping the vital organs warm. The victim becomes pale. Lips, ears, fingers and toes may become blue.
Difficulty in speaking, sluggish thinking, and amnesia start to appear; inability to use hands and stumbling is also usually present. Cellular metabolic processes shut down. Below 30 °C (86 °F), the exposed skin becomes blue and puffy, muscle coordination becomes very poor, walking becomes almost impossible, and the victim exhibits incoherent/irrational behavior including terminal burrowing or even a stupor. Pulse and respiration rates decrease significantly, but fast heart rates (ventricular tachycardia, atrial fibrillation) can occur. Major organs fail. Clinical death occurs. Because of decreased cellular activity in stage 3 hypothermia, the body will actually take longer to undergo brain death.
As the temperature decreases further physiological systems falter and heart rate, respiratory rate, and blood pressure all decreases. This results in an expected HR in the 30s with a temperature of 28 °C (82 °F).
Twenty to fifty percent of hypothermia deaths are associated with paradoxical undressing. This typically occurs during moderate to severe hypothermia, as the person becomes disoriented, confused, and combative. They may begin discarding their clothing, which, in turn, increases the rate of heat loss.
Rescuers who are trained in mountain survival techniques are taught to expect this; however, some may assume incorrectly that urban victims of hypothermia have been subjected to a sexual assault.
One explanation for the effect is a cold-induced malfunction of the hypothalamus, the part of the brain that regulates body temperature. Another explanation is that the muscles contracting peripheral blood vessels become exhausted (known as a loss of vasomotor tone) and relax, leading to a sudden surge of blood (and heat) to the extremities, fooling the person into feeling overheated.
In the final stages of hypothermia, the brain stem produces a burrowing-like behavior. Similar to hibernation behavior in animals, individuals with severe hypothermia are often found in small, enclosed spaces, such as under the bed or behind wardrobes.
Hypothermia occurs when your body loses heat faster than it produces it. The most common causes of hypothermia are exposure to cold weather conditions or cold water, but prolonged exposure to any environment colder than your body can lead to hypothermia if you aren’t dressed appropriately or can’t control the conditions. Specific conditions leading to hypothermia include:
How your body loses heat
The mechanisms of heat loss from your body include the following:
*Radiated heat. Most heat loss is due to heat radiated from unprotected surfaces of your body. Your head has a large surface area and accounts for about half of all heat loss.
*Direct contact. If you’re in direct contact with something very cold, such as cold water or the cold ground, heat is conducted away from your body. Because water is very good at transferring heat from your body, body heat is lost much faster in cold water than in cold air. Water that is 65 F (18 C) — a relatively mild air temperature — can lead to hypothermia very quickly. Similarly, heat loss from your body is much faster if your clothes are wet, as when you’re caught out in the rain.Wind.
*Wind removes body heat by carrying away the thin layer of warm air at the surface of your skin. A wind chill factor is important in causing heat loss. For example, if the outside temperature is 32 F (0 C) and the wind chill factor is minus 15 F (minus 26 C), your body loses heat as quickly as if the actual temperature outside were minus 15 F (minus 26 C).
A number of factors can increase the risk of developing hypothermia:
*Older age. People age 65 and older are more vulnerable to hypothermia for a number of reasons. The body’s ability to regulate temperature and to sense cold may lessen with age. Older people are also more likely to have a medical condition that affects temperature regulation. Some older adults may not be able to communicate when they are cold or may not be mobile enough to get to a warm location.
*Very young age. Children lose heat faster than adults do. Children have a larger head-to-body ratio than adults do, making them more prone to heat loss through the head. Children may also ignore the cold because they’re having too much fun to think about it. And they may not have the judgment to dress properly in cold weather or to get out of the cold when they should. Infants may have a special problem with the cold because they have less efficient mechanisms for generating heat.
*Mental impairment. People with a mental illness, dementia or another condition that impairs judgment may not dress appropriately for the weather or understand the risk of cold weather. People with dementia may wander from home or get lost easily, making them more likely to be stranded outside in cold or wet weather.Alcohol and drug use.
*Alcohol may make your body feel warm inside, but it causes your blood vessels to dilate, or expand, resulting in more rapid heat loss from the surface of your skin. The use of alcohol or recreational drugs can impair your judgment about the need to get inside or wear warm clothes in cold weather conditions. If a person is intoxicated and passes out in cold weather, he or she is likely to develop hypothermia.
*Certain medical conditions. Some health disorders affect your body’s ability to regulate body temperature. Examples include underactive thyroid (hypothyroidism), malnutrition, stroke, severe arthritis, Parkinson’s disease, trauma, spinal cord injuries, burns, disorders that affect sensation in your extremities (for example, nerve damage in the feet of people with diabetes), dehydration and any condition that limits activity or restrains the normal flow of blood.
*Medications. A number of antipsychotic drugs and sedatives can impair the body’s ability to regulate its temperature.
Accurate determination of core temperature often requires a special low temperature thermometer, as most clinical thermometers do not measure accurately below 34.4°C (94°F). A low temperature thermometer can be placed rectally, esophageally, or in the bladder. The classical ECG finding of hypothermia is the Osborne J wave. Also, ventricular fibrillation frequently occurs at <28°C (82.4°F) and asystole at <20°C (68°F). The Osborn J may look very similar to those of an acute ST elevation myocardial infarction. Thrombolysis as a reaction to the presence of Osborn J waves is not indicated, as it would only worsen the underlying coagulopathy caused by hypothermia.
As a hypothermic person’s heart rate may be very slow, prolonged palpation could be required before detecting a pulse. In 2005 American Heart Association recommended at least 30 – 45 seconds to verify the absence of a pulse before initiating CPR.
Most physicians are recommended not to declare a patient dead until their body is warmed to a normal body temperature, since extreme hypothermia can suppress heart and brain function.
Aggressiveness of treatment is matched to the degree of hypothermia. Treatment ranges from noninvasive, passive external warming, to active external rewarming, to active core rewarming. In severe cases resuscitation begins with simultaneous removal from the cold environment and concurrent management of the airway, breathing, and circulation. Rapid rewarming is then commenced. A minimum of patient movement is recommended as aggressive handling may increase risks of a dysrhythmia.
Hypoglycemia is a frequent complication of hypothermia, and therefore needs to be tested for and treated. Intravenous thiamine and glucose is often recommended as many causes of hypothermia are complicated by Wernicke’s encephalopathy
Rewarming can be achieved using a number of different methods including passive external rewarming, active external rewarming, and active internal rewarming. Passive external rewarming involves the use of a person’s own heat generating ability through the provision of properly insulated dry clothing and moving to a warm environment. It is recommended for those with mild hypothermia. Active external rewarming involves applying warming devices externally such as warmed forced air (a Bair Hugger is a commonly used device). In austere environments hypothermia can sometimes be treated by placing a hot water bottle in both armpits and groin. It is recommended for moderate hypothermia. Active core rewarming involves the use of intravenous warmed fluids, irrigation of body cavities with warmed fluids (the thorax, peritoneal, stomach, or bladder), use of warm humidified inhaled air, or use of extracorporeal rewarming such as via a heart lung machine. Extracorporeal rewarming is the fastest method for those with severe hypothermia.
As most people are moderately dehydrated due to hypothermia induced cold diuresis, intravenous fluids are often helpful ( 250-500 cc 5% dextrose and normal saline warmed to a temperature of 40-45 C is often recommended ).
Rewarming collapse (or rewarming shock) is a sudden drop in blood pressure in combination with a low cardiac output which may occur during active treatment of a severely hypothermic person. There is theoretical concern that external rewarming rather than internal rewarming may increase the risk. However, recent studies have not supported these concerns.
There is considerable evidence that children who suffer near-drowning accidents in water near 0°C (32°F) can be revived over an hour after losing consciousness. The cold water lowers metabolism, allowing the brain to withstand a much longer period of hypoxia. While survival is possible, mortality from severe or profound hypothermia remains high despite optimal treatment. Studies estimate mortality at between 38% – 75%. If there are obvious fatal injuries or chest is too frozen, compression resuscitation is futile
The Government offers extra support for some of the most vulnerable people in the form of winter fuel payments, to help keep their homes warm.
Other ways to prevent hypothermia include:
•Stay indoors as much as possible and limit your exposure to the cold
•Eat regularly and include plenty of carbohydrates (the body needs a reliable and constant energy supply to generate heat)
•Keep as active as possible
•Avoid alcohol – it causes dilation of peripheral blood vessel, increasing heat loss
•Avoid caffeine – it’s a diuretic and increases the risk of dehydration, which aggravates heat loss
•Avoid nicotine – it constricts blood vessels and increases the risk of cold damage such as frostbite
•Wear multiple thin layers of clothing that help to trap air layers and hence traps heat, rather than one thick jumper
•If you go outside, always wear a hat (it can prevent as much as 20 per cent of heat loss), scarf and gloves
•Take a flask of caffeine-free hot drink with you, and click-activated heat pads you can keep in your pockets to set off when you need them
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose
Most cases are caused by Legionella pneumophila. The rest of the cases are caused by other Legionella species.
Spread of the bacteria from person to person has not been proven.
Most infections occur in middle-aged or older people, although they have been reported in children. Typically, the disease is less severe in children.
Legionellosis takes two distinct forms:-
*Legionnaires’ disease, also known as “Legion Fever,” is the more severe form of the infection and produces pneumonia.
*Pontiac fever is caused by the same bacterium but produces a milder respiratory illness without pneumonia that resembles acute influenza
Legionnaires’ disease acquired its name in July 1976 when an outbreak of pneumonia occurred among people attending a convention of the American Legion in
Philadelphia. On January 18, 1977 the causative agent was identified as a previously unknown bacterium, subsequently named Legionella. Some people can be infected
with the Legionella bacterium and have only mild symptoms or no illness at all.
Outbreaks of Legionnaires’ disease receive significant media attention. However, this disease usually occurs as single, isolated cases not associated with any
recognized outbreak. When outbreaks do occur, they are usually in the summer and early autumn, though cases may occur at any time of year. The fatality rate of
Legionnaires’ disease has ranged from 5% to 30% during various outbreaks. “The death rate for patients who develop Legionnaire’s disease while in the hospital is
close to 50%, especially when antibiotics are started late,” according to the NIH and U.S. National Library of Medicine service’s MedlinePlus. Most infections occur
in those who are middle-age or older.
Signs and symptoms:-
Symptoms tend to get worse during the first 4 – 6 days. They typically improve in another 4 – 5 days.
Symptoms may include:……….
•Coughing up blood
•Gastrointestinal symptoms, such as diarrhea, nausea, vomiting, and abdominal pain
•General discomfort, uneasiness, or ill feeling (malaisemalaise)
•Lack of coordination (ataxiaataxia)
•Loss of energy
•Muscle aches and stiffness
•Shortness of breath
Laboratory tests may show that patients’ renal functions, liver functions and electrolytes are deranged, including hyponatremia. Chest X-rays often show pneumonia
with bi-basal consolidation. It is difficult to distinguish Legionnaires’ disease from other types of pneumonia by symptoms or radiologic findings alone; other tests
are required for diagnosis.
Persons with Pontiac fever experience fever and muscle aches without pneumonia. They generally recover in 2 to 5 days without treatment.
The time between the patient’s exposure to the bacterium and the onset of illness for Legionnaires’ disease is 2 to 10 days; for Pontiac fever, it is shorter,
generally a few hours to 2 days.
L. pneumophila is specifically considered as a pathogen of the respiratory tract. Other infections have also been reported, including haemodialysis fistulae,
pericarditis, and wound and skin infections. Bacteraemia is often associated with Legionnaires’ disease. Intestinal infections may only occur as part of respiratory
infections, and where gastrointestinal symptoms have on occasion been described.
No animal infections have been specifically recorded.
Infections of protozoa such as Hartmannella vermiformis and related protozoa have been shown to be able to support the growth of L. pneumophila in tap water. Also
Acanthamoeba, Naegleria and Tetrahymena can be infected by L. pneumophila. pathway may be how these organisms survive in the environment.
Legionellosis infection normally occurs after inhaling an aerosol (suspension of fine particles in air) containing Legionella bacteria. Such particles could
originate from any infected water source. When mechanical action breaks the surface of the water, small water droplets are formed, which evaporate very quickly. If
these droplets contain bacteria, the bacteria cells remain suspended in the air, invisible to the naked eye but small enough to be inhaled into the lungs. This often
occurs in poorly ventilated areas such as prisons where a condensating air conditioner can spread it throughout the entire room, infecting anyone not immune to the
strain of bacteria. Potential sources of such contaminated water include cooling towers used in industrial cooling water systems as well as in large central air
conditioning systems, evaporative coolers, hot water systems, showers, windshield washers, whirlpool spas, architectural fountains, room-air humidifiers, ice making
machines, misting equipment, and similar disseminators that draw upon a public water supply. The disease may also be spread in a hot tub if the filtering system is
defective. Freshwater ponds, creeks, and ornamental fountains are potential sources of Legionella. The disease is particularly associated with hotels, cruise ships
and hospitals with old, poorly maintained pipework and cooling systems. A study published by the European Journal of Epidemiology points to automotive windshield
washing systems as a source, recommending the addition of an antibacterial agent to the system’s reservoir.In several cases Compost sparks Legionnaire’s fear as
The bacteria grow best in warm water, like the kind found in hot tubs, cooling towers, hot water tanks, large plumbing systems, or parts of the air-conditioning
systems of large buildings. Indoor ornamental fountains have been confirmed as a cause of Legionnaires’ disease outbreaks. In all documented cases submerged lighting
as a heat source was attributed to the outbreak. Controlling the growth of Legionella in ornamental fountains is touched on in many of the listed guidelines.
However, specific guidelines for ornamental fountains have also been published.
People of any age may suffer from Legionnaires’ disease, but the illness most often affects middle-age and older persons, particularly those who smoke cigarettes or
have chronic lung disease. Immunocompromised patients are also at elevated risk. Pontiac fever most commonly occurs in persons who are otherwise healthy.
The most useful diagnostic tests detect the bacteria in sputum, find Legionella antigens in urine samples, or the comparison of Legionella antibody levels to in two
blood samples taken 3 to 6 weeks apart. A urine antigen test which is simple, quick, and very reliable will only detect Legionella pneumophila serogroup 1. In
addition the urine antigen test will not identify the specific subtypes so it cannot be used to match the patient with the environmental source of infection.
Exams and Tests:-
The health care provider will perform a physical exam, and may hear abnormal sounds called crackles when listening to the chest with a stethoscope.
Tests that may be done include:
•Arterial blood gasesArterial blood gases
•Chest x-rayChest x-ray
•Complete blood count (CBCCBC), including white blood cell countwhite blood cell count
•Erythrocyte sedimentation rateErythrocyte sedimentation rate
•Liver function testsLiver function tests
•Sputum cultureSputum culture for the Legionella bacteria
•Sputum indirect fluorescent antibody test for the Legionella bacteria
•Urine tests to check for Legionella pneumophila bacteria
Current treatments of choice are the respiratory tract quinolones (levofloxacin, moxifloxacin, gemifloxacin) or newer macrolides (azithromycin, clarithromycin,
roxithromycin). The antibiotics used most frequently have been levofloxacin and azithromycin. Macrolides are used in all age groups while tetracyclines are
prescribed for children above the age of 12 and quinolones above the age of 18. Rifampicin can be used in combination with a quinolone or macrolide. Tetracyclines
and erythromycin led to improved outcomes compared to other antibiotics in the original American Legion outbreak. These antibiotics are effective because they have
excellent intracellular penetration and Legionella infects cells.
The mortality at the original American Legion convention in 1976 was high (34 deaths in 180 infected individuals) because the antibiotics used (including
penicillins, cephalosporins, and aminoglycosides) had poor intracellular penetration. Mortality has plunged to less than 5% if therapy is started quickly. Delay in
giving the appropriate antibiotic leads to higher mortality.
Antibiotics are used to fight the infection. Treatment is started as soon as Legionnaire’s disease is suspected, without waiting for confirmation by lab test.
Other treatments may include:
•Fluid and electrolyteelectrolyte replacement
•Oxygen (given through a mask or breathing machine)
According to the journal Infection Control and Hospital Epidemiology, hospital-acquired Legionella pneumonia has a fatality rate of 28%, and the principal source of
infection in such cases is the drinking-water distribution system.
Legionnaire’s disease can be life-threatening. The death rate is higher in patients with other diseases. The death rate for patients who develop Legionnaire’s
disease while in the hospital is close to 50%, especially when antibiotics are started late.
Legionnaire’s disease can be life-threatening. The death rate is higher in patients with other diseases. The death rate for patients who develop Legionnaire’s
disease while in the hospital is close to 50%, especially when antibiotics are started late.
Treating water delivery systems can prevent the spread of disease.
Various studies have shown that some 40% to 60% of cooling towers tested contained Legionella.
A recent research study provided evidence that Legionella pneumophila, the causative agent of Legionnaires’ disease, can travel airborne at least 6 km from its
source. It was previously believed that transmission of the bacterium was restricted to much shorter distances. A team of French scientists reviewed the details of
an epidemic of Legionnaires’ disease that took place in Pas-de-Calais in northern France in 2003–2004. There were 86 confirmed cases during the outbreak, of whom 18
died. The source of infection was identified as a cooling tower in a petrochemical plant, and an analysis of those affected in the outbreak revealed that some
infected people lived as far as 6–7 km from the plant.
A study of Legionnaires’ disease cases in May 2005 in Sarpsborg, Norway concluded that: “The high velocity, large drift, and high humidity in the air scrubber may
have contributed to the wide spread of Legionella species, probably for >10 km. …”
In 2010 a study by the UK Health Protection Agency reported that 20% of cases may be caused by infected windscreen wiper water. The finding came after researchers
spotted that professional drivers are five times more likely to be infected.
Temperature affects the survival of Legionella as follows:-
*70 to 80 °C (158 to 176 °F): Disinfection range
*At 66 °C (151 °F): Legionellae die within 2 minutes
*At 60 °C (140 °F): Legionellae die within 32 minutes
*At 55 °C (131 °F): Legionellae die within 5 to 6 hours
*Above 50 °C (122 °F): They can survive but do not multiply
*35 to 46 °C (95 to 115 °F): Ideal growth range
*20 to 50 °C (68 to 122 °F): Legionellae growth range
*Below 20 °C (68 °F): Legionellae can survive but are dormant
Removing slime may be an effective control process.
Philadelphia, United States, 1976
The first recognized outbreak occurred on July 27, 1976 at the Bellevue Stratford Hotel in Philadelphia, Pennsylvania, where members of the American Legion, a United
States military veterans association, had gathered for the American Bicentennial. Within two days of the event’s start, veterans began falling ill with a
then-unidentified pneumonia. They were tachypneic and complained of chest pain. As many as 221 people were given medical treatment, and 34 deaths occurred. At the
time, the U.S. was debating the risk of a possible swine flu epidemic, and this incident prompted the passage of a national swine flu vaccination program. That cause
was ruled out, and research continued for months, with various theories discussed in scientific and mass media that ranged from toxic chemicals to terrorism
(domestic or foreign) aimed at the veterans.
The U.S. Centers for Disease Control and Prevention mounted an unprecedented investigation and, by September, the focus had shifted from outside causes, such as a
disease carrier, to the hotel environment itself. In January 1977, the Legionellosis bacterium was finally identified and isolated, and found to be breeding in the
cooling tower of the hotel’s air conditioning system, which then spread it through the entire building. This finding prompted new regulations worldwide for climate
United Kingdom, 1985
In April 1985, 175 patients were admitted to the District or Kingsmead Stafford Hospitals with chest infection or pneumonia. 28 died. The medical diagnosis showed
that this was Legionnaires’ disease and the immediate epidemiological investigation traced the source of the infection to the air-conditioning cooling tower on the
roof of the Stafford District Hospital. A Government Inquiry was set up to investigate how the infection occurred and why it became Britain’s largest epidemic of
Legionnaires’ disease. The infection was linked to one small zone in the hospital: the outpatients department. The initial investigation searched for engineering
reasons to explain why this particular zone was the risk area. More detailed and wider epidemiological surveys subsequently showed that staff working in the whole
area supplied with fresh air taken adjacent to the tower, had antibodies to the disease. The outpatients department was unique in having a very large transient
population of susceptible individuals either receiving treatment or accompanying friends.
In March 1999, an outbreak in the Netherlands occurred during a flower exhibition in Bovenkarspel. 200 people became ill and at least 32 people died. There is a
possibility that more people died from it, but these people were buried before the Legionella infection was recognized. The source of the bacteria were probably a
whirlpool and a humidifier in the exhibition area.
Melbourne, Australia, 2000
In April 2000, an outbreak of Legionella pnemophila serogroup 1 occurred in Melbourne, Australia. The outbreak resulted in 125 confirmed cases of Legionnaire’s
disease, with 95 (76%) hospitalised. It is reported that 4 died from the outbreak. The investigation traced the source of the infection to the cooling tower at the
newly opened aquarium. Since this outbreak, legionella infection statistics are required to be reported by the state government as a notifiable disease.
Stringent Regulations were introduced by the State to control legionella in 2001.
The world’s largest outbreak of Legionnaires’ disease happened in July 2001 (patients began appearing at the hospital on July 7), in Murcia, Spain. More than 800
suspected cases were recorded by the time the last case was treated on July 22; 636–696 of these cases were estimated and 449 confirmed (so, at least 16,000 people
were exposed to the bacterium) and 6 died (a case-fatality rate of approximately 1%).
A case-control study matching 85 patients living outside the city of Murcia with two controls each was undertaken to identify the outbreak source; the
epidemiological investigation implicated the cooling towers at the Morales Meseguer Hospital. An environmental isolate from these towers with an identical molecular
pattern as the clinical isolates was subsequently identified and supported that epidemiologic conclusion.
United Kingdom, 2002
Main article: 2002 Barrow-in-Furness Legionnaires’ disease outbreak
In 2002, Barrow-in-Furness in the U.K. suffered an outbreak of Legionnaires’ disease. Six women and one man died as a result of the illness; another 172 people also
contracted the disease. The cause was found to be a contaminated cooling tower at the town’s Forum 28 arts centre. Barrow Borough Council later became the first
public body in the UK to be charged with corporate manslaughter but were cleared. They were, however, along with architect Gillian Beckingham, fined for breaches of
Health and Safety regulations in a trial that ended in 2006.
In Fredrikstad, Norway, 56 people became ill and ten died from Legionnaires’ disease caused by bacteria growing in an air scrubber of a nearby factory.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Legionnaire’s disease is normally caused by the bug Legionella pneumophili, which lives naturally in rivers, lakes, and reservoirs, and can also be found in man-made structures containing water such as air conditioning systems.
Legionella longbeachae is a less common and is mostly found in soil and potting compost.
In the UK, just nine cases have been reported since 1984.
However, it is much more common in Australia, New Zealand and Japan, where it accounts for about 30% of all cases of Legionnaire’s disease and has been linked to gardening.
Dr Simon Patten, who treated the patient at the Royal Alexandra Hospital, said: “I think doctors and gardeners need to be aware of this. The risk may be low, but precautions can be taken.”
The Royal Horticultural Society acknowledged Legionnaire’s was a risk, but called for a “common-sense approach”.
It recommends wearing gloves, not opening composts bags with your head right over them and folding the top of the bags over when they are not in use.
It said gardeners may also want to consider wearing dust masks when turning composts heaps.
The best way to stop excessive sweating is to find the cause. For example, if it only occurs when you are nervous or anxious, stress reduction techniques in combination with the proper use of an antiperspirant may go a long way toward getting this under control. However, if the perspiration affects multiple areas of your body no matter what the situation, you may have a form of excess sweating known as hyperhidrosis. As for the odor, it’s most likely caused by the bacteria on your skin as it comes in contact with the perspiration. But one thing is clear: The symptoms are affecting the quality of your life and it’s time to regain control with a visit to your physician.
The pattern of perspiration may be different depending upon the situation. For instance, when you’re nervous, the sweat often appears under the armpits, the hands and even on the forehead. In contrast, when you exercise, the sweat tends to occur throughout the body.
Needless to say, the location, amount, odor and frequency that the sweating occurs are unique to each individual. For some, it’s explainable and hardly noticeable. For others, the potential for embarrassment exists and can change life experiences. This makes it especially important to speak with your physician and provide the answers to the following questions:
*Where does your sweating occur (armpits, groin, whole body, hands, feet, face)?
*At what age did it begin (early to mid teenage years) and does heavy perspiration run in your family?
*How often does it occur (everyday, a few times per week, once a month)?
*When does it occur (during the daytime, wakes you up at night, day and night)?
*How often do you need to change your clothes (shirts, socks, others) due to excessive perspiration (once, twice or several times per day)?
*Do you get skin irritations or infections in the areas where you constantly sweat?
*How often do you need to shower during the day to get rid of the odor?
*Are you afraid to shake hands because of your sweaty palms? If so, how often do you find yourself drying them off due to excess perspiration?
*Are you afraid to wear certain colors because the sweat stains will show through?
*What products have you tried (deodorants, antiperspirants) and did they provide any relief?
*Do certain situations make your sweating worse (spicy foods, when you are anxious or upset, meeting a new person)?
*Have other symptoms occurred since your sweating problem began (fever, cough, joint pains, rash)
*Are you taking any prescription, non-prescription or herbal medications?
*Does your sweating or fear of sweating keep you from certain events or social activities?
Next, It is advised to encourage you to take a look at the information at the International Hyperhidrosis Society to see how you rate on the hyperhidrosis disease severity scale. A result of 3 or 4 means you’re sweating is life-altering and may clue your physician to check for the conditions known as primary focal or secondary generalized hyperhidrosis.
Techniques to decrease perspiration:
If excess perspiration occurs only when you are stressed or nervous, relaxation techniques learned through biofeedback, hypnotherapy, yoga and/or meditation might help to decrease your anxiety induced sweating. Acupuncture may even provide some relief. However, if your sweating is made worse by a multitude of factors including hyperhydrosis, other suggestions to consider include but aren’t limited to the following:
*Avoid or decrease the consumption of caffeinated products
*Bathe daily to limit the amount of bacteria contributing to the sweaty odor
*Eliminate odor-producing foods (onions, garlic, others) from your diet
*Wear loose fitting clothes containing materials such as cotton, wool and silk. These “breathable” fabrics allow for a better flow between your skin and the surrounding air.
*Use antiperspirants daily to stop the sweat and the odor, instead of deodorants, which stop the odor, but not the sweat.
*While these products are commonly applied to the armpits, they are also effective in other areas such as the hands and feet.
*Antiperspirants are available with and without a prescription. Look for the ingredient aluminum chloride hexahydrate, a very effective agent for problem sweating. Preparations containing 10-15 percent aluminum chloride hexahydrate work well for excessive perspiration in the armpits, while those containing 30 percent tend to work better for problem sweating of the hands and feet. Apply the antiperspirant after the area has been dried (use a towel or cool air from a blow dryer) once per night (works better than a morning application as it takes six to eight hours for the antiperspirant to plug the pores and block the flow of sweat) or twice per day (morning and night).
*Consider the use of iontophoresis for extreme and uncontrolled sweating of hands and/or feet. This technique uses very low levels of electric current applied during a 15 to 20 minute session over a period of time (days or weeks). It seems to slow or shut down the flow of perspiration through the sweat glands.
*Injection of botulinum toxin type A (Botox) to the affected areas (armpits, hands, feet and even the face) where sweating is not controlled by other methods. One treatment is very effective at stopping the flow of sweat for a period of four to seven months, sometimes longer.
Fortunately, much can be done to help prevent or minimize the discomfort and embarrassment caused by your drenching underarm sweating. If you wish you may contact Mayo Clinic to help you.
Therapeutic treatment of excessive sweating is :IONOSPHERES