Tag Archives: Chickenpox

Epstein-Barr infection

Description: The Epstein-Barr virus, also called EBV, is an extremely common virus that infects most people at one time or another during their lifetimes. There are several forms of Epstein–Barr virus infection. Infectious mononucleosis, nasopharyngeal carcinoma, and Burkitt’s lymphoma can all be caused by the Epstein–Barr virus.

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It is best known as the cause of infectious mononucleosis (glandular fever). It is also associated with particular forms of cancer, such as Hodgkin’s lymphoma, Burkitt’s lymphoma, nasopharyngeal carcinoma, and conditions associated with human immunodeficiency virus (HIV), such as hairy leukoplakia and central nervous system lymphomas. There is evidence that infection with the virus is associated with a higher risk of certain autoimmune diseases, especially dermatomyositis, systemic lupus erythematosus, rheumatoid arthritis, Sjögren’s syndrome, and multiple sclerosis.

Infection with EBV occurs by the oral transfer of saliva and genital secretions.

Most people become infected with EBV and gain adaptive immunity. In the United States, about half of all five-year-old children and 90 to 95 percent of adults have evidence of previous infection. Infants become susceptible to EBV as soon as maternal antibody protection disappears. Many children become infected with EBV, and these infections usually cause no symptoms or are indistinguishable from the other mild, brief illnesses of childhood. In the United States and other developed countries, many people are not infected with EBV in their childhood years. When infection with EBV occurs during adolescence, it causes infectious mononucleosis 35 to 50 percent of the time.

EBV infects B cells of the immune system and epithelial cells. Once the virus’s initial lytic infection is brought under control, EBV latently persists in the individual’s B cells for the rest of the individual’s life.

Symptoms:
Epstein-Barr virus infection generally causes a minor cold-like or flu-like illness, but, in some cases, there may be no symptoms of infection.Initial symptoms of infectious mononucleosis are fever, sore throat, and swollen lymph glands. Sometimes, a swollen spleen or liver involvement may develop. Heart problems or involvement of the central nervous system occurs only rarely, and infectious mononucleosis is almost never fatal. There are no known associations between active EBV infection and problems during pregnancy, such as miscarriages or birth defects. Although the symptoms of infectious mononucleosis usually resolve in 1 or 2 months, EBV remains dormant or latent in a few cells in the throat and blood for the rest of the person’s life. Periodically, the virus can reactivate and is commonly found in the saliva of infected persons. Reactivated and post-latent virus may pass the placental barrier in (also seropositive) pregnant women via macrophages and therefore can infect the fetus. Also re-infection of prior seropositive individuals may occur. In contrast, reactivation in adults usually occurs without symptoms of illness.

EBV also establishes a lifelong dormant infection in some cells of the body’s immune system. A late event in a very few carriers of this virus is the emergence of Burkitt’s lymphoma and nasopharyngeal carcinoma, two rare cancers. EBV appears to play an important role in these malignancies, but is probably not the sole cause of disease.

Most individuals exposed to people with infectious mononucleosis have previously been infected with EBV and are not at risk for infectious mononucleosis. In addition, transmission of EBV requires intimate contact with the saliva (found in the mouth) of an infected person. Transmission of this virus through the air or blood does not normally occur. The incubation period, or the time from infection to appearance of symptoms, ranges from 4 to 6 weeks. Persons with infectious mononucleosis may be able to spread the infection to others for a period of weeks. However, no special precautions or isolation procedures are recommended, since the virus is also found frequently in the saliva of healthy people. In fact, many healthy people can carry and spread the virus intermittently for life. These people are usually the primary reservoir for person-to-person transmission. For this reason, transmission of the virus is almost impossible to prevent.

The clinical diagnosis of infectious mononucleosis is suggested on the basis of the symptoms of fever, sore throat, swollen lymph glands, and the age of the patient. Usually, laboratory tests are needed for confirmation. Serologic results for persons with infectious mononucleosis include an elevated white blood cell count, an increased percentage of certain atypical white blood cells, and a positive reaction to a “mono spot” test.
Causes:
Epstein–Barr can cause infectious mononucleosis, also known as ‘glandular fever’, ‘Mono‘ and ‘Pfeiffer’s disease’. Infectious mononucleosis is caused when a person is first exposed to the virus during or after adolescence. Though once deemed “The Kissing Disease,” recent research has shown that transmission of EBV not only occurs from exchanging saliva, but also from contact with the airborne virus. It is predominantly found in the developing world, and most children in the developing world are found to have already been infected by around 18 months of age. Infection of children can occur when adults mouth feed or pre-chew food before giving it to the child. EBV antibody tests turn up almost universally positive.

Treatment:
There is no specific treatment for infectious mononucleosis, other than treating the symptoms. No antiviral drugs or vaccines are available. Some physicians have prescribed a 5-day course of steroids to control the swelling of the throat and tonsils. The use of steroids has also been reported to decrease the overall length and severity of illness, but these reports have not been published.

It is important to note that symptoms related to infectious mononucleosis caused by EBV infection seldom last for more than 4 months. When such an illness lasts more than 6 months, it is frequently called chronic EBV infection. However, valid laboratory evidence for continued active EBV infection is seldom found in these patients. The illness should be investigated further to determine if it meets the criteria for chronic fatigue syndrome, or CFS. This process includes ruling out other causes of chronic illness or fatigue.

Prognosis:
There is currently no specific cure for an Epstein-Barr virus infection. Treatment includes measures to help relieve symptoms and keep the body as strong as possible until the disease runs its course. This includes rest, medications to ease body aches and fever, and drinking plenty of fluids. People who are in good health can generally recover from an Epstein-Barr virus infection at home with supportive care, such as rest, fluids and pain relievers.

Prevention:
Treatment of most viral diseases begins with preventing the spread of the disease with basic hygiene measures. However, controlling the spread of the Epstein-Barr virus is extremely difficult because it is so common and because it is possible to spread the Epstein-Barr virus even when a person does not appear sick. Many healthy people who have had an Epstein-Barr virus infection continue to carry the virus in their saliva, which means they can spread it to others throughout their lifetimes. However, avoiding contact with another person’s saliva by not sharing drinking glasses or toothbrushes is still a good general disease prevention measure.

Regular exercise with healthy food habits and healthy life style is the best way of prevention.

Research:
As a relatively complex virus, EBV is not yet fully understood. Laboratories around the world continue to study the virus and develop new ways to treat the diseases it causes. One popular way of studying EBV in vitro is to use bacterial artificial chromosomes.  Epstein–Barr virus and its sister virus KSHV can be maintained and manipulated in the laboratory in continual latency. Although many viruses are assumed to have this property during infection of their natural host, they do not have an easily managed system for studying this part of the viral lifecycle. Genomic studies of EBV have been able to explore lytic reactivation and regulation of the latent viral episome.

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:
http://en.wikipedia.org/wiki/Epstein%E2%80%93Barr_virus
http://en.wikipedia.org/wiki/Epstein–Barr_virus_infection
http://www.healthgrades.com/conditions/epstein-barr-virus

Some Health Quaries & Answers

To walk or not to walk:

Q: I am pregnant with my first child. My relatives tell me not to exercise but rest all day. The doctor, however, has advised walking, morning and evening.

A: Exercise is important during pregnancy. It’s not harmful; on the contrary it has a positive impact on the health of the mother and baby. It enables both to withstand prolonged labour by increasing endurance. It boosts immunity, reduces stress and depression, and helps the mother to rapidly regain her pre-pregnancy physique.

Walking on level ground at a steady pace for 40 minutes in the morning and evening is safe and adequate. But be sure to wear good, supportive flat footwear and drink lots of water.

Abortion pills :

Q: I induced an abortion with tablets last year. After that my periods became irregular and I have not been able to conceive.

A: Medical abortion is safe but must be done under a doctor’s supervision. A scan should be undertaken before taking the pills to ensure all the recommended criteria for a safe termination are met. The pregnancy should be less than 49 days, you can’t adopt this method if you’ve had a caesarian previously, the pregnancy should be in the uterus and not the tubes, and it should not be twins. The pills must be taken on two separate occasions, two days apart. After the abortion has occurred, a repeat scan must be done to ensure it has worked. If you have not followed these recommendations and had bought the tablets over the counter, consult a gynaecologist.

Blood in stools

Q: I have abdominal pain and diarrhoea with blood. The doctor did a stool test and said it is amoebic dysentery.

A: Amoebic dysentery occurs in tropical countries like India and causes diarrhoea with abdominal pain and blood in the stools. It can be distinguished from bacterial diarrhoea by the absence of fever. Treatment requires five to seven days of metronidazole. But consult your doctor for duration and dosage of the medicine. Failure to complete the course may result in chronic infection.

All diarrhoeas with blood and mucous are not due to dysentery. There are non-infective causes like polyps, diverticulitis, ulcerative colitis as well as cancer. If the results of a complete course of medication isn’t satisfactory, consult a gastroenterologist.

Hospital bug

Q: My son is admitted to the ICU with pneumonia. I am worried about the “superbug”. I noticed that a great deal of the time, simple hygienic measures like washing hands between patients is not followed by the medical staff. Neither do visiting relatives and friends follow the rules. What’s more, some of them sit on the patient’s bed.

A: Hand washing reduces the spread of infection (and possibly the superbug) in the community and in a hospital setting by 50 per cent. It is proven to be the single most effective method to reduce infection. A sanitising liquid can also be used.

Unfortunately, these simple methods are often not followed by lay people or even the medical fraternity. There is nothing much you can do except keep a bottle of sanitising liquid with you and request visitors to use it. You may offend some people, but at least it will reduce your son’s chances of infection.

Chicken pox :

Q: Is there any way to prevent chicken pox? Or is it one of the inevitable diseases of childhood?

A: Varicella vaccine to prevent chicken pox has been available since 1995. Immunised children do not get the disease. Although in most children, it may be mild and recovery complete in five to seven days, it isn’t possible to predict if your child will be one of the unfortunate 10 per cent that develop complications.

Diabetic drug

Q: My doctor gives me metformin for diabetes, which I have to take three times a day. My grandmother too was on metformin. I wonder if there isn’t anything better and if I should change my doctor.

A: Metformin is one of the oldest diabetic drugs on the market, and the safest and mildest. It prevents low blood sugars from occurring accidentally and this protects against heart attacks and strokes. Also, since it is taken after food, you are unlikely to take a tablet and then forget to eat.

If you do not like to take pills thrice a day, you may ask your doctor for the longer acting, sustained release formulations. This will increase your dosage intervals.

Leg cramps :

Q: My son complains of pain in the leg at night. We have tried iron tonics, zinc supplementation and calcium, but nothing works. He wakes up with pain every night.

A: Add a tablespoon of rock salt in a bucket of hot water. Ask your son to stand in it for 10 minutes every night before sleeping.

Source : The Telegraph (kolkata, India)

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The Vitamin D Solution

A press release by the publisher Penguin declares the release of Dr. Michael F. Holick’s latest book about the remarkable health benefits of vitamin D.

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“What do obesity, heart disease, depression, diabetes, and fibromyalgia have in common?

The answer is vitamin D deficiency,” the press release states.

“More than 200 million Americans lack this essential vitamin. In the landmark book The Vitamin D Solution, Dr. Michael F. Holick identifies the causes of vitamin D deficiency, outlines why it is essential to your health, and provides a 3-step program to attain optimal levels of Vitamin D.

Increasing levels of vitamin D can treat, prevent, and even reverse a remarkable number of daily ailments, from high blood pressure to back pain. It can lessen the symptoms of chronic conditions such as diabetes and arthritis, and actually prevent infectious diseases, including H1N1 and cancer. Dr. Holick also credits vitamin D with improving infertility, weight control, memory and mood.”

Source: Eurekalert April 1, 2010

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Some Health Quaries & Answers

My wifw eats bricks

Q: When my wife and I visited the Taj Mahal we bought a souvenir, a replica of the Taj made of chalk. It disappeared a few days after we returned. My wife finally confessed to having eaten the whole thing! Then I discovered that she has also been eating uncooked rice and occasionally red bricks too from the housing construction next door. I realise she needs help. Should I go to a psychiatrist?

A: Your wife has “pica”, a craving to eat things not normally considered food. People eat clay, chalk, mud and brick. Pica is an uncontrollable habit, so you’ll have to watch her for some time as she might resort to hiding the fact that she’s still eating non-food items. The urge is uncontrollable even though she knows it is wrong. It is often due to mineral deficiency. It is not a psychiatric problem. Consult a physician. She probably needs antihelminthics (de-worming), and supplements of iron, calcium and zinc.

Doggy pain..

Q: I take my Labrador for a walk in the mornings. He is exuberant, poorly trained and pulls on his leash. Of late I have noticed that my right hand tingles while holding the leash and that this sensation also wakes me up at night. The fingers are often stiff in the morning.

A: Your regular walk probably keeps you fit and provides you with the required amount of exercise. However, if the dog’s personality is as described, you need to take some precautions to prevent injury. Keep the dog on a short leash — holding it firmly at the distance of about one and a half feet, even if the leash is longer. Wear wrist guards and elbow guards. This will prevent injury due to sudden pulls and tugs.

The symptoms you describe sound like “carpal tunnel syndrome” where one of the nerves to the hand is trapped in the ligaments and bones at the wrist. It may have occurred due to injury while controlling the dog. It is better to see an orthopaedic surgeon who specialises in hand injuries.

Measles rash?

Q: My one-year-old son developed fever and the doctor prescribed amoxicillin. After three days of he developed red rashes all over the body. My mother says it is measles but he is immunised.

A: Measles immunisation is given at the age of nine months. At that time antibodies, transferred from the mother through the placenta, are present but waning. If there is a high level of maternal antibodies, the vaccine may not produce a satisfactory response. This is the reason for a booster, which is given as the MMR (measles, mumps and rubella) vaccine at 15 months. Once this is also given the immunity is almost 100 per cent.

All rashes are not due to measles. Other viral infections can also lead to rashes. Amoxicillin causes non-specific red rashes in some people. Allergies can also cause rashes, in which case there will be associated itching.

Ulcer baby…..

Q: My baby is 10 months old and has developed severe ulcers in the mouth. My doctor says it is due to herpes infection. I always thought that herpes was a sexually transmitted disease.

A: Herpes is the name given to a group of viruses. Different viruses from this group can cause various diseases like chicken pox, ulcers in the mouth or herpes progenitalis. These ulcers are painful. So the baby may find it difficult to swallow. The doctor will usually prescribe some local treatment and antiviral medication.

Although this infection occurs in a large number of children, it is less common in those who are not bottle fed or given pacifiers.

Chikungunya

Q: I had a chikungunya infection about six months ago but my ankles still hurt. I find locomotion difficult as there are sudden attacks of excruciating pain.

A: Unfortunately a chikungunya infection has a long lasting impact in some people. The joint pain either persists or keeps flaring up unexpectedly intermittently for as long as two years. When there is pain apply a capsaicin-containing ointment locally, then place ice on the joint as a cold compress, alternate it with heat from a hot water bottle, have physiotherapy and use analgesics for pain relief.

Sources: The Telegraph (Kolkata, India)

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Some Health Quaries & Answers

Jobless and lethargic :-

Q: My parents did not want me to study engineering, as I am an only child and a girl. Their old fashioned idea was that I should get a bachelors degree and get married. I finished my BE and was recruited on campus. Unfortunately, the company has been postponing my joining. Now I feel I may never get the job. I feel lethargic, am putting on weight and sleep all day.

A: Perhaps a feeling of being out of control and uncertainty about your professional future has caused this change in your personality. It is unsettling and depressing. Try to establish a routine even though at present you do not need to. Get up in the morning, jog for 40 minutes, do some ground exercises and keep an eye on your diet. Join a course that will enhance your skills. If you are still worried, check your haemoglobin and thyroid functions to see if your symptoms are due to some correctable extrinsic cause like anaemia or thyroid malfunction.

Irregular periods ..
Q: I have irregular periods which appear embarrassingly unscheduled. I am now 23 years old and my parents are looking for a “suitable alliance”. They are convinced that “everything will be alright after marriage” but I am not. Will pregnancy be a problem?

A: Your body won’t change and start behaving differently just because you are married. It is better to investigate the reasons for your irregular periods before you proceed with an “alliance”. The doctor will probably do an ultrasound scan of your uterus and ovaries and suggest blood tests to check your hormone levels. The cause of the irregularity can usually be treated. It is better to know and be aware rather than proceed blindly with the surmise that “everything will be alright after marriage”.

No sex :-
Q: I was recently diagnosed as being diabetic and hypertensive. Now I am facing erectile problem and the problem of premature ejaculation. Can these be cured?

A: This problem can occur in people with diabetes and hypertension. It is due to a neuropathy or nerve dysfunction. It can get aggravated if the diabetes is uncontrolled and also by some medications prescribed for hypertension. You need to control your blood sugar well and inform your physician about this problem so that suitable alterations can be made in the medication.

Small head :
Q: My child has a very small head and is also not developing normally. The doctor said this is “microcephaly”. She is three years old and has stiff limbs. She speaks only a few words and has seizures. Will this recur in the next pregnancy?

A: Microcephaly can be present at birth or it may develop in the first few years of life. It occurs due to interference with the growth of the brain during the early months of development in the uterus. It can be genetic, or occur because the mother unfortunately develops an infection with cytomegalovirus, rubella (German measles) or varicella (chicken pox) virus.

If there are other affected family members, or if you are married to a close relative, the likelihood of recurrence is greater. Immunisations against varicella and rubella are available. Folic acid supplements (5 mg a day) started even before pregnancy occurs and continued for the first five months of conception also helps normal brain development.

Thumping headache :

Q: I develop a severe headache on one side of the head whenever I have a cold and then I cannot concentrate.

A: Your nose may be blocked because of the discharge caused by the cold. Try putting saline nose drops into each nostril with the head tilted back and then take steam inhalations. Avoid vaporising mosquito repellents (available as mats coils and liquids) or room fresheners which aggravate the problem. If the headache still persists try taking paracetemol and an over the counter antihistamine like non-sedating levocetrizine.


Sources
: The Telegraph (Kolkata, India)

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