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Legionnaires’ Disease

Definition:
Legionnaires’ disease, also known as Legionellosis, is a rare form of pneumonia.It takes its name from the first known outbreak which occurred in a hotel that was hosting a convention of the Pennsylvania Department of the American Legion in 1976...

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Causes:

It is a type of pneumonia caused by bacteria. You usually get it by breathing in mist from water that contains the bacteria.The Legionella bacteria are found naturally in the environment, usually in water. 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. They do not seem to grow in car or window air-conditioners. The mist may come from hot tubs, showers or air-conditioning units for large buildings. The bacteria don’t spread from person to person.The disease is fatal in approximately 5% to 15% of cases.

CLICK & SEE..> :Legionella bacteria under the microscope

Symptoms:
Symptoms of Legionnaires’ disease include fever, chills, a cough and sometimes muscle aches and headaches. Other types of pneumonia have similar symptoms. You will probably need a chest x-ray to diagnose the pneumonia. Lab tests can detect the specific bacteria that cause Legionnaires’ disease.

The bacteria are more likely to make you sick if you:

* Are older than 65
* Smoke
* Have a lung disease
* Have a weak immune system

Legionnaires’ disease is serious and can be life-threatening. However, most people recover with antibiotic treatment. Legionnaires’ has an incubation period of between two and 10 days.
Initial symptoms of are similar to those of flu – headache, musclepain, and a general feeling of being unwell.These symptoms are followed by high fever and shaking chills. Nausea, vomiting, and diarrhoea may occur.On the second or third day, dry coughing begins and chest pain might occur. There may also be difficulty breathing.Mental changes, such as confusion, disorientation, hallucination and loss of memory, can occur to an extent that seems out of proportion to the seriousness of fever. Some patients may develop pneumonia. This could affect both lungs and lead to hospitalisation if severe.

Diagnosis:
Legionnaires’ disease is underreported and underdiagnosed, primarily because special tests are needed to distinguish Legionnaires’ disease from other types of pneumonia. To help identify the presence of legionella bacteria quickly, your doctor may use a test that checks your urine for legionella antigens — foreign substances that trigger an immune system response. You may also have one or more of the following:

* Blood tests
* A chest X-ray, which doesn’t confirm Legionnaires’ disease but does show the extent of infection in the lungs
* Tests on a sample of your sputum or lung tissue
* A CT scan of your brain or a spinal tap (lumbar puncture) if you have neurological symptoms such as confusion or trouble concentrating

Risk Factorts:

Legionnaires’ disease usually strikes middle-aged people. Those at risk include smokers and those with an existing health problem.Many others may contract the bug and yet show no signs of infection. It is likely that many cases of Legionnaires’ disease go undiagnosed.People suffering from cancer or chronic kidney diseases are among those less able to fight infections.Chronic diseases, such as diabetes and alcoholism, also seem to increase vulnerability to Legionnaires’ disease.Cigarette smokers are more likely to contract Legionnaires disease, perhaps because smokers are generally more likely than non-smokers to develop respiratory tract infections.

Treatment:

Legionnaires’ is most often treated with the antibiotic drugs erthryomycin and rifampin. Recovery often takes several weeks.

Prevention:

The likelihood of Legionella infection can be best reduced by good engineering practices in the operation and maintenance of air and water handling systems.Cooling towers and evaporative condensers should be inspected and thoroughly cleaned at least once a year.Corroded parts, such as drift eliminators, should be replaced. Algae and accumulated scale should be removed.Cooling water should be treated constantly. Ideally, an automatic water treatment system should be used that continuously controls the quality of the circulating water.Fresh air intakes should not be built close to cooling towers since contaminated water particles may enter the ventilation system.This page contains basic information. If you are concerned about your health, you should consult a doctor .

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.

Resources:
BBC NEWS:8 Feb, 2003
http://www.nlm.nih.gov/medlineplus/legionnairesdisease.html
http://www.mayoclinic.com/print/legionnaires-disease/DS00853/METHOD=print&DSECTION=all

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The Wheezing That Could Signal Childhood Asthma

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LATE last fall, Carrie R., a public relations executive who lives in Riverdale in the Bronx, noticed that her 2-year-old daughter had been suffering from a nagging cough for far too long. She assumed the toddler had caught a cold or was reacting to the change in weather.

But when the cough hung on for several more weeks, and became so severe that her daughter vomited, Carrie began to worry about something more serious. Still, she was stunned by her pediatricians diagnosis  asthma.

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“I was completely blindsided, said Carrie, who asked that her surname not be used to protect the privacy of her daughter. “I thought asthma would look more like an ˜attack not just coughing. My pediatrician is wonderful, but I ended up taking my daughter to a specialist because this diagnosis was very serious and seemed so out of the blue that I wanted to be sure.

Though asthma is a common disorder, particularly in childhood, it can be difficult to diagnose. Doctors can struggle to figure out whether a child who is having trouble breathing has asthma rather than a virus, nasal allergy or other upper-respiratory problem.

Unlike the tests for some diseases, checking for asthma does not involve using high-technology equipment or techniques. While there are tests — the most common uses a device called a spirometer, which measures airway efficiency — doctors often rely more on family histories and thorough questioning about symptoms and exposure to allergens.

 

There is no definitive test, said Dr. Stuart Stoloff, a family practice physician in Carson City, Nev. “There are no easy markers or a single blood test to tell when it’s asthma and when it’s not. Instead you have to carefully look at the whole picture.”

Dr. Stoloff is on an expert panel that is rewriting the federal guidelines for diagnosing and managing asthma. By early summer, the National Heart, Lung and Blood Institute and the National Asthma Education and Prevention Program will introduce these new recommendations, which place added emphasis on analyzing symptoms, looking for allergens, gathering histories and confirming the diagnosis with spirometry.

Asthma is a chronic respiratory disease that affects 20 million Americans, including 9 million children, or 6.5 percent of the under-18 population. It is characterized by attacks of inflammation and narrowing of the small airways of the lungs, generally sparked by a viral infection (like those that cause colds), exercise or exposure to pet hair, pollen or other allergens. But because attacks can vary in intensity and show up as shortness of breath, wheezing, coughing, chest pain, rapid breathing or a combination of these symptoms, asthma can often be confused with other illnesses.

The growing incidence of obesity in children has made diagnosing asthma even trickier. “Investigators are reporting that more and more children, particularly adolescents, are coming in with a diagnosis of asthma and they are also obese,” said Dr. Alkis G. Togias, the section chief, asthma and inflammation, division of allergy, immunology and transplantation at the National Institutes of Health in Bethesda, Md. “But it is not clear that they have asthma. It might be that the obesity is causing shortness of breath.”

Experts worry that asthma is often not diagnosed, particularly in young children. “Younger children, under 7 or 8, sometimes can’t express themselves well,” said Dr. Norman H. Edelman, the chief medical officer for the American Lung Association and professor of preventive medicine at Stony Brook University Medical Center, in Stony Brook, N.Y.

A spirometer test can help confirm an asthma diagnosis. This device measures the amount of air blown out of the lungs over time. But if the test is done when the patient is not having symptoms, it may not show any abnormality. Furthermore, not every doctor’s office has such equipment, and some patients whose airway function seems normal might still have asthma. In addition, children under 4 generally cannot perform the test.

Dr. Sandra Braganza, an assistant professor of pediatrics at the Children’s Hospital at Montefiore in the Bronx, estimated that about a fourth of all the patients she sees suffer from the disease. “The rates of asthma in our community are so high that when a child comes in with wheezing, coughing or shortness, we immediately suspect asthma,” she said. “Parents, too, need to know how to recognize the signs and symptoms of asthma,” she added. “There’s nothing worse than seeing a child who can’t breathe. But being empowered with education makes it a lot less scary.”

Source: The New York Times