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Ailmemts & Remedies

Strep throat

Other Names:
Streptococcal pharyngitis, streptococcal tonsillitis, or streptococcal sore throat

Definition:
Strep throat is a disease that causes a sore throat (pharyngitis). It is an infection with a germ called Group A Streptococcus bacteria.  Only a small portion of sore throats are the result of strep throat.

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It  is a contagious infection, spread through close contact with an infected individual.  this is not always needed as treatment may be decided based on symptoms. In highly likely or confirmed cases, antibiotics are useful to both prevent complications and speed recovery.

It’s important to identify strep throat for a number of reasons. If untreated, strep throat can sometimes cause complications such as kidney inflammation and rheumatic fever. Rheumatic fever can lead to painful and inflamed joints, a rash and even damage to heart valves.

Strep throat is most common between the ages of 5 and 15, but it affects people of all ages. If you or your child has signs or symptoms of strep throat, see your doctor for prompt treatment.

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Symptoms:
Symptoms may be mild or severe.One will often start to feel sick about 2 to 5 days after he or she  come in contact with the strep germ.

Fever may begin suddenly and is often highest on the second day. You may have chills.

You can have a red sore throat, sometimes with white patches. It may hurt to swallow. You may feel swollen, tender glands in your neck.

Other symptoms may include:
*General ill feeling, a loss of appetite and abnormal taste & Fever
*Headache
*Nausea
*Throat pain
*Difficulty swallowing
*Red and swollen tonsils, sometimes with white patches or streaks of pus
*Tiny red spots on the soft or hard palate — the area at the back of the roof of the mouth
*Swollen, tender lymph glands (nodes) in your neck
*Headache
*Rash
*Stomachache and sometimes vomiting, especially in younger children
*Fatigue

It’s possible for you or your child to have many of these signs and symptoms, but not have strep throat. The cause of these signs and symptoms could be a viral infection or some other kind of illness. That’s why your doctor generally tests specifically for strep throat.

It’s also possible to have the bacteria that can cause strep in your throat without having a sore throat. Some people are carriers of strep, which means they can pass the bacteria on to others, but the bacteria are not currently making them sick.

Some strains of strep throat can lead to a scarlet fever-like rash. The rash first appears on the neck and chest. Then it spreads over the body. It may feel like sandpaper.

Causes:
Strep throat is caused by group A beta-hemolytic streptococcus (GAS). Other bacteria such as non–group A beta-hemolytic streptococci and fusobacterium may also cause pharyngitis. It is spread by direct, close contact with an infected person and thus crowding as may be found in the military and schools increases the rate of transmission. It has been found that dried bacteria in dust are not infectious, although moist bacteria on toothbrushes or similar items can persist for up to fifteen days. Rarely, contaminated food can result in outbreaks. Of children with no signs or symptoms 12% carry GAS in their pharynx and after treatment approximately 15% remain carriers.

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Diagnosis:
The modified Centor criteria maybe used to determine the management of people with pharyngitis. Based on 5 clinical criteria, it indicates the probability of a streptococcal infection.

One point is given for each of the criteria:

*Absence of a cough
*Swollen and tender cervical lymph nodes
*Temperature >38.0 °C (100.4 °F)
*Tonsillar exudate or swelling
*Age less than 15 (a point is subtracted if age >44)

The Infectious Disease Society of America however recommends against empirical treatment and considers antibiotics only appropriate following positive testing. Testing is not needed in children under three as both group A strep and rheumatic fever are rare, except if they have a sibling with the disease.

Laboratory testing:
A throat culture is the gold standard for the diagnosis of streptococcal pharyngitis with a sensitivity of 90–95%. A rapid strep test (also called rapid antigen detection testing or RADT) may also be used. While the rapid strep test is quicker, it has a lower sensitivity (70%) and statistically equal specificity (98%) as throat culture.

A positive throat culture or RADT in association with symptoms establishes a positive diagnosis in those in which the diagnosis is in doubt. In adults a negative RADT is sufficient to rule out the diagnosis however in children a throat culture is recommended to confirm the result. Asymptomatic individuals should not be routinely tested with a throat culture or RADT because a certain percentage of the population persistently “carries” the streptococcal bacteria in their throat without any harmful results.

Differential diagnosis:
As the symptoms of streptococcal pharyngitis overlap with other conditions it can be difficult to make the diagnosis clinically. Coughing, nasal discharge, diarrhea, and red, irritated eyes in addition to fever and sore throat are more indicative of a viral sore throat than of strep throat. The presence of marked lymph node enlargement along with sore throat, fever and tonsillar enlargement may also occur in infectious mononucleosis.

Possible Complications & Risk Factors:

*Acute rheumatic fever….click to see
*Scarlet fever
*Streptococcal toxic shock syndrome
*Glomerulonephritis
*Ear infection
*Glomerulonephritis
*Guttate psoriasis
*Mastoiditis
*Peritonsillar abscess
*Sinusitis

Treatment:
A number of medications are available to cure strep throat, relieve its symptoms and prevent its spread.

Antibiotics:
If you or your child has strep throat, your doctor will likely prescribe an oral antibiotic such as:
Penicillin. This drug may be given by injection in some cases — such as if you have a young child who is having a hard time swallowing or is vomiting.
Amoxicillin. This drug is in the same family as penicillin, but is often a preferred option for children because it tastes better and is available as a chewable tablet.

If you or your child is allergic to penicillin, your doctor likely may prescribe:
A cephalosporin such as cephalexin (Keflex)
Clarithromycin (Biaxin)
Azithromycin (Zithromax, Zmax)
Clindamycin

These antibiotics reduce the duration and severity of symptoms, as well as the risk of complications and the likelihood that infection will spread to classmates or family members.

Once treatment begins, you or your child should start feeling better in just a day or two. Call your doctor if you or your child doesn’t feel better after taking antibiotics for 48 hours.

If children taking antibiotic therapy feel well and don’t have a fever, they often can return to school or child care when they’re no longer contagious — usually 24 hours after beginning treatment. But be sure to finish the entire course of medicine. Stopping medication early may lead to recurrences and serious complications, such as rheumatic fever or kidney inflammation.

Untreated streptococcal pharyngitis usually resolves within a few days. Treatment with antibiotics shortens the duration of the acute illness by about 16 hours. The primary reason for treatment with antibiotics is to reduce the risk of complications such as rheumatic fever and retropharyngeal abscesses and they are effective if given within 9 days of the onset of symptoms

Analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol (acetaminophen) help significantly in the management of pain associated with strep throat. Viscous lidocaine may also be useful. While steroids may help with the pain they are not routinely recommended. Aspirin may be used in adults but is not recommended in children due to the risk of Reye’s syndrome.

Prognosis:
The symptoms of strep throat usually improve irrespective of treatment within three to five days. Treatment with antibiotics reduces the risk of complications and transmission; children may return to school 24 hours after antibiotics are administered. The risk of complications in adults is low. In children acute rheumatic fever is rare in most of the developed world. It is however the leading cause of acquired heart disease in India, sub-Saharan Africa and some parts of Australia.

Prevention:
Tonsillectomy may be a reasonable preventive measure in those with frequent throat infections (more than three a year). The benefits are however small and episodes typically lessen in time regardless of measures taken. Recurrent episodes of pharyngitis which test positive for GAS may also represent a person who is a chronic carrier of GAS who is getting recurrent viral infections. Treating people who have been exposed but who are without symptoms is not recommended. Treating people who are carriers of GAS is not recommended as the risk of spread and complications is low.

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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/Streptococcal_pharyngitis
http://www.nlm.nih.gov/medlineplus/ency/article/000639.htm
http://ww.mayoclinic.com/health/strep-throat/DS00260

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Ailmemts & Remedies

MRSA

Staphylococcus aureus bacteria, MRSA
Staphylococcus aureus bacteria, MRSA (Photo credit: Microbe World)

Definition:
MRSA(Methicillin-resistant Staphylococcus aureus)   is a bacterium responsible for several difficult-to-treat infections in humans. It may also be called multidrug-resistant Staphylococcus aureus or oxacillin-resistant Staphylococcus aureus (ORSA).

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MRSA is, by definition, any strain of Staphylococcus aureus that has developed resistance to beta-lactam antibiotics which include the penicillins (methicillin, dicloxacillin, nafcillin, oxacillin, etc.) and the cephalosporins.

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Most MRSA infections occur in people who have been in hospitals or other health care settings, such as nursing homes and dialysis centers. When it occurs in these settings, it’s known as health care-associated MRSA (HA-MRSA). HA-MRSA infections typically are associated with invasive procedures or devices, such as surgeries, intravenous tubing or artificial joints.

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Another type of MRSA infection has occurred in the wider community — among healthy people. This form, community-associated MRSA (CA-MRSA), often begins as a painful skin boil. It’s spread by skin-to-skin contact. At-risk populations include groups such as high school wrestlers, child care workers and people who live in crowded conditions.

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MRSA is capable of resisting Beta-Lactamase resistant Antibiotics via the mecA gene. This is a gene that encodes Penicillin-binding-protein 2a (PBP2a). ?-lactam antibiotics have a low affinity for PBP2a, therefore cell wall synthesis is able to proceed in their presence.

Symptoms:
S. aureus most commonly colonizes the anterior nares (the nostrils), although the rest of the respiratory tract, open wounds, intravenous catheters, and urinary tract are also potential sites for infection. Healthy individuals may carry MRSA asymptomatically for periods ranging from a few weeks to many years. Patients with compromised immune systems are at a significantly greater risk of symptomatic secondary infection.

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In most patients, MRSA can be detected by swabbing the nostrils and isolating the bacteria found inside. Combined with extra sanitary measures for those in contact with infected patients, screening patients admitted to hospitals has been found to be effective in minimizing the spread of MRSA in hospitals in the United States,  Denmark, Finland, and the Netherlands.

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MRSA may progress substantially within 24–48 hours of initial topical symptoms. After 72 hours MRSA can take hold in human tissues and eventually become resistant to treatment. The initial presentation of MRSA is small red bumps that resemble pimples, spider bites, or boils that may be accompanied by fever and occasionally rashes. Within a few days the bumps become larger, more painful, and eventually open into deep, pus-filled boils.  About 75 percent of community-associated (CA-) MRSA infections are localized to skin and soft tissue and usually can be treated effectively. However, some CA-MRSA strains display enhanced virulence, spreading more rapidly and causing illness much more severe than traditional healthcare-associated (HA-) MRSA infections, and they can affect vital organs and lead to widespread infection (sepsis), toxic shock syndrome and necrotizing (“flesh-eating”) pneumonia. This is thought to be due to toxins carried by CA-MRSA strains, such as PVL and PSM, though PVL was recently found to not be a factor in a study by the National Institute of Allergy and Infectious Diseases (NIAID) at the NIH. It is not known why some healthy people develop CA-MRSA skin infections that are treatable whereas others infected with the same strain develop severe infections or die.  The bacteria attack parts of the immune system, and even engulf white blood cells, the opposite of the usual.

The most common manifestations of CA-MRSA are skin infections such as necrotizing fasciitis or pyomyositis (most commonly found in the tropics), necrotizing pneumonia, infective endocarditis (which affects the valves of the heart), or bone or joint infections.  CA-MRSA often results in abscess formation that requires incision and drainage. Before the spread of MRSA into the community, abscesses were not considered contagious because it was assumed that infection required violation of skin integrity and the introduction of staphylococci from normal skin colonization. However, newly emerging CA-MRSA is transmissible (similar, but with very important differences) from Hospital-Associated MRSA. CA-MRSA is less likely than other forms of MRSA to cause cellulitis.

Causes  :
It’s all about survival of the fittest – the basic principle of evolution. Bacteria have been around a lot longer than us, so they’re pretty good at it.

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There are countless different strains of a single type of bacteria, and each has subtle natural genetic mutations that make it different from another. In addition, bacterial genes are constantly mutating.

Some strains’ genetic makeup will give them a slight advantage when it comes to fighting off antibiotic attack. So when susceptible strains encounter antibiotics they die, while these naturally resistant strains may prove harder to kill. This means the next time you encounter S.aureus, it’s more likely to be one that has survived an antibiotic encounter, (i.e. a resistant one). Eventually, the strain becomes resistant to different antibiotics, even though they work in slightly different ways.

When you are prescribed antibiotics, you are advised to finish the entire course. If you don’t do this, there’s a chance that you’ll kill most of the bugs but not all of them – and the ones that survive are likely to be those that have adapted to be more resistant to antibiotics.

Over time, the bulk of the S.aureus strains will carry resistant genes and further mutations may only add to their survival ability. Strains that manage to carry two or three resistance genes will have extraordinary powers of resistance to a range of different antibiotics.

The reason hospitals seem to be hotbeds for resistant MRSA is because with many vulnerable patients, infections are common and easily spread. So many different strains are thrown together with so many doses of antibiotics, vastly accelerating this natural selection process.

Click & see: MRSA study shows spread from animals to hospitals

.Risk factors:
At risk populations include:

*People with weak immune systems (people living with HIV/AIDS, cancer patients, transplant recipients, severe asthmatics, etc.)

*Diabetics

*Intravenous drug users

*Use of quinolone antibiotics

*Young children

*The elderly

*College students living in dormitories

*People staying or working in a health care facility for an extended period of time

*People who spend time in coastal waters where MRSA is present, such as some beaches in Florida and the west coast of the United States

*People who spend time in confined spaces with other people, including prison inmates, military recruits in basic training, and individuals who spend considerable time in changerooms or gyms.

*Hospital patients

*Prison inmates:

*People in contact with live food-producing animals

*Athletes

*Children

Diasgnosis:
A century or more ago people knew that an infection was bad news and could rapidly kill a patient. But these days, since the rapid development of antibiotics after World War Two, we often take the power of antibiotics for granted, and expect them to work without question. MRSA is dangerous because it takes us back to the days when little could be done to stop an infection.

MRSA is particularly dangerous in hospitals. It’s a fact of life in the NHS that hospital patients are at higher than normal risk of picking up a S.aureus infection on the wards.

This is for two reasons. Firstly, hospital populations tend to be older, sicker and weaker than the general population, and therefore more vulnerable to infection. Secondly, conditions in hospitals involve a great many people living cheek by jowl, examined by doctors and nurses who have just touched other patients – the perfect environment for the transmission of all manner of infections. This is why there are strict hand-washing and hygiene measures when entering and leaving wards, and between seeing different patients.

Once these patients develop an infection they’re less able than a healthy person to fight it and urgent treatment with antibiotics may be critical. But because MRSA is resistant to many antibiotics, it may quickly overwhelm a weak patient, or cause a festering infection (for example in a wound or a joint implant) that causes tissue destruction and chronic disability.

Strains:
In the UK, where MRSA is commonly called “Golden Staph”, the most common strains of MRSA are EMRSA15 and EMRSA16.  EMRSA16 is the best described epidemiologically: it originated in Kettering, England, and the full genomic sequence of this strain has been published.   EMRSA16 has been found to be identical to the ST36:USA200 strain, which circulates in the United States, and to carry the SCCmec type II, enterotoxin A and toxic shock syndrome toxin 1 genes.  Under the new international typing system, this strain is now called MRSA252. It is not entirely certain why this strain has become so successful, whereas previous strains have failed to persist. One explanation is the characteristic pattern of antibiotic susceptibility. Both the EMRSA15 and EMRSA16 strains are resistant to erythromycin and ciprofloxacin. It is known that Staphylococcus aureus can survive intracellularly,   for example in the nasal mucosa   and in the tonsil tissue ,.   Erythromycin and Ciprofloxacin are precisely the antibiotics that best penetrate intracellularly; it may be that these strains of S. aureus are therefore able to exploit an intracellular niche.

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Community-acquired MRSA (CA-MRSA) is more easily treated, though more virulent, than hospital-acquired MRSA (HA-MRSA). CA-MRSA apparently did not evolve de novo in the community but represents a hybrid between MRSA that spread from the hospital environment and strains that were once easily treatable in the community. Most of the hybrid strains also acquired a factor that increases their virulence, resulting in the development of deep-tissue infections from minor scrapes and cuts, as well as many cases of fatal pneumonia.

In the United States, most cases of CA-MRSA are caused by a CC8 strain designated ST8:USA300, which carries SCCmec type IV, Panton-Valentine leukocidin, PSM-alpha and enterotoxins Q and K, and ST1:USA400.  Other community-acquired strains of MRSA are ST8:USA500 and ST59:USA1000. In many nations of the world, MRSA strains with different predominant genetic background types have come to predominate among CA-MRSA strains; USA300 easily tops the list in the U. S. and is becoming more common in Canada after its first appearance there in 2004. For example, in Australia ST93 strains are common, while in continental Europe ST80 strains predominate (Tristan et al., Emerging Infectious Diseases, 2006). In Taiwan, ST59 strains, some of which are resistant to many non-beta-lactam antibiotics, have arisen as common causes of skin and soft tissue infections in the community. In a remote region of Alaska, unlike most of the continental U. S., USA300 was found rarely in a study of MRSA strains from outbreaks in 1996 and 2000 as well as in surveillance from 2004–06 (David et al., Emerg Infect Dis 2008).

In June of 2011, the discovery of a new strain of MRSA was announced by two separate teams of researchers in the UK. Its genetic make-up was reportedly more similar to strains found in animals, and testing kits designed to detect MRSA were unable to identify it.

Treatment:
Antibiotics are not completely powerless against MRSA, but patients may require a much higher dose over a much longer period, or the use of an alternative antibiotic, often needing intravenous administration or with less tolerable side-effects, to which the bug has less resistance.

MRSA is just one of a number of infections causing major challenges for health workers, and some are concerned that the situation can only get worse. There is no doubt that there is an urgent need to develop new and better antibiotics and, more importantly, to work harder to prevent infection spreading and use the antibiotics we already have more efficiently.

There is some evidence that MRSA in hospitals is already decreasing, as a result of better protocols to deal with the bacteria and prevent infection developing (with strategies such as regular screening of patients and use of eradication treatments).

Prevention:
To keep MRSA and other infections at bay, prevention is your best weapon. It is highly recommended that all individuals keep their immune system functioning to its best ability.
This can be done most efficiently by:

* taking a good daily multi-vitamin and mineral supplement

* drinking a minimum of 32 oz. of pure water every day

* practice good hygiene methods

* take a good immune system booster like astragalus or ashwagandha every day (be sure to check for allergic reactions)

* only take echinacea if you feel like you are fighting off some bacterial or viral infection AND…..do not take echinacea for longer than 3-4 weeks at a time (it will loose its effectiveness if taken regularly as a preventative).

* you can use a hand sanitizer, which is mostly alcohol, or an effective substitute is Aloe Gel. Aloe is an excellent anti-bacterial and is also a wonderful skin lotion, where as alcohol can be drying.

* the following herbs have proven beneficial in the treatment of MRSA:

For Pneumonia: usnea, garlic, goldenseal, cryptolepsis, eucalyptus, boneset, wormwood, juniper, grapefruit seed extract, oils of thyme or oregano and olive leaf extract.

For surgical/skin infections: any of the above plus honey or sage.

For Bacteremia: echinacea, garlic, usnea or boneset, all given in massive doses.

* A complementary treatment that should not be overlooked is LIGHT THERAPY. A blue light with a frequency of 470nm (nanometers) has been shown to kill MRSA in as little as 2 minutes when shown on the skin at the infection site. This is an extremely useful therapy for those exposed to this infection. Please contact a CAM practitioner for more information on light therapy and other therapies for the treatment of MRSA and other health conditions.

MRSA is a serious medical condition that, unfortunately, has become more prevalent in recent years as this bacteria becomes more resistant to antibiotics.

Research;
ClinicalIt has been reported that maggot therapy to clean out necrotic tissue of MRSA infection has been successful. Studies in diabetic patients reported significantly shorter treatment times than those achieved with standard treatments.

Many antibiotics against MRSA are in phase II and phase III clinical trials. e.g.:

Phase III : ceftobiprole, Ceftaroline, Dalbavancin, Telavancin, Aurograb, torezolid, iclaprim…
Phase II : nemonoxacin.

Pre-clinicalAn entirely different and promising approach is phage therapy (e.g., at the Eliava Institute in Georgia[98]), which in mice had a reported efficacy against up to 95% of tested Staphylococcus isolates.

On May 18, 2006, a report in Nature identified a new antibiotic, called platensimycin, that had demonstrated successful use against MRSA.

Ocean-dwelling living sponges produce compounds that may make MRSA more susceptible to antibiotics.

Cannabinoids (components of Cannabis sativa), including cannabidiol (CBD), cannabinol (CBN), cannabichromene (CBC) and cannabigerol (CBG), show activity against a variety of MRSA strains.

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://www.healthalternativesonline.com/MRSA.html
http://www.mayoclinic.com/health/mrsa/DS00735
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus
http://www.bbc.co.uk/health/physical_health/conditions/mrsa.shtml

http://www.cdc.gov/mrsa/mrsa_initiative/skin_infection/mrsa_photo_003.html

http://www.suite101.com/view_image_articles.cfm/1307955

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Ailmemts & Remedies

Legionnaires’ disease

Definition:
Legionnaires’ disease is a severe form of pneumonia. It is a potentially fatal infectious disease caused by Gram negative, aerobic bacteria belonging to the genus Legionella.  Over 90% of legionellosis cases are caused by Legionella pneumophila, a ubiquitous aquatic organism that thrives in temperatures between 25 and 45 °C (77 and 113 °F), with an optimum around 35 °C (95 °F).

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People usually get it by breathing in mist from water that contains the bacteria. The mist may come from hot tubs, showers or air-conditioning units for large buildings. The bacteria don’t spread from person to person.

Older adults, smokers and people with weakened immune systems are particularly susceptible to Legionnaires’ disease.

Legionella bacterium also causes Pontiac fever, a milder illness resembling the flu. Separately or together, the two illnesses are sometimes called legionellosis. Pontiac fever usually clears on its own. But untreated Legionnaires’ disease can be fatal. Although prompt treatment with antibiotics usually cures Legionnaires’ disease, some people continue to experience problems after treatment.

The disease and the bacterium were discovered following an outbreak at an American Legion convention in Philadelphia in 1976, hence the name.

Symptoms:
Legionnaires’ disease usually develops two to 14 days after exposure to legionella bacteria. It frequently begins with the following signs and symptoms:

*Headache
*Muscle pain
*Chills
*Fever that may be 104 F (40 C) or higher

By the second or third day, you’ll develop other signs and symptoms that may include:

*Cough, which may bring up mucus and sometimes blood
*Shortness of breath
*Chest pain
*Fatigue
*Loss of appetite
*Gastrointestinal symptoms, such as nausea, vomiting and diarrhea
*Confusion or other mental changes

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.

A mild form of Legionnaires’ disease — known as Pontiac fever — may produce symptoms including fever, chills, headache and muscle aches. Pontiac fever doesn’t infect   lungs, and symptoms usually clear within two to five days.

Causes:
Legionnaires’ is caused by a bacteria known as Legionella pneumophila.

The bacteria is found widely throughout natural water systems such as rivers and ponds but temperature is critical to its growth and it is in the warm or hot water of artificial water systems such as heating plants or whirlpools that it can really thrive, forming a biofilm or layer of living bacteria over artificial structures.

Other sources include the water systems of large buildings, cooling towers of air conditioning systems, fountains and ponds, and communal showers.

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It used to be thought that people caught Legionella when they breathed in an aerosol or fine mist of contaminated water. But while this may be true in some cases it is now thought that Legionella more commonly occurs when contaminated water in the mouth (drinking water for example) is able to get past the body’s normal defences and passes down into the lungs.

This is known as aspiration and it explains why smokers and those with chronic lung disease are especially vulnerable to Legionella. Normally fluid in the mouth is pushed down the gullet and into the stomach where any particles such as bacteria can be broken down.

The gag reflex prevents water entering into the breathing tubes, and the action of tiny hair-like projections or cilia on the mucosal membranes surface brushes back any particles that have passed towards the lungs.

But in smokers and those with lung disease or weakened immunity these mechanisms may not work properly and bacteria can pass more easily into the lungs to establish a pneumonia.

Occurrences are more common in late summer and early autumn. Men are affected more than women, particularly middle-aged men.

Complications:
Legionnaires’ disease can lead to a number of life-threatening complications, including:

*Respiratory failure. This occurs when the lungs are no longer able to provide the body with enough oxygen or can’t remove enough carbon dioxide from the blood.

*Septic shock. This occurs when a severe, sudden drop in blood pressure reduces blood flow to vital organs, especially the kidneys and brain. The heart tries to compensate by increasing the volume of blood pumped, but the extra workload eventually weakens the heart and reduces blood flow even further.

*Acute kidney failure. This is the sudden loss of your kidneys’ ability to perform their main function — filtering waste material from your blood.

When your kidneys fail, dangerous levels of fluid and waste accumulate in your body.When not treated effectively and promptly, Legionnaires’ disease may be fatal, especially if your immune system is weakened by disease or medications.

Diagnosis:
Legionnaires’ disease is similar to other types of pneumonia. To help identify the presence of legionella bacteria quickly,  doctor may use a test that checks your urine for legionella antigens — foreign substances that trigger an immune system response.  One or more of the following test may also be required:

*Blood tests

*A chest X-ray, which doesn’t confirm Legionnaires’ disease but can show the extent of infection in your 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

Treatment:
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.

Prognosis:
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

Prevention:
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 washer systems filled with pure water. The finding came after researchers spotted that professional drivers are five times more likely to contract the disease. No cases of infected systems were found whenever a suitable washer fluid was used.

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): They die within 32 minutes
*At 55 °C (131 °F): They 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): Growth range
*Below 20 °C (68 °F): They can survive but are dormant

Removing slime, which can carry legionellae when airborn, may be an effective control process

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/Legionellosis
http://www.mayoclinic.com/health/legionnaires-disease/DS00853/DSECTION
http://www.nlm.nih.gov/medlineplus/legionnairesdisease.html
http://www.bbc.co.uk/health/physical_health/conditions/legionnaires1.shtml

http://www.primehealthchannel.com/legionnaires-disease-symptoms-causes-tests-prevention-and-treatment.html

http://www.cruiselawnews.com/articles/legionnaires-disease/

http://rpgrecords.com/wp-content/uploads/2011/04/legionnaires-disease.jpg

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Ailmemts & Remedies Pediatric

Impetigo

Definition:

Impetigo is a highly contagious skin infection which is most commonly seen in babies as well as small children. It causes red sores that can break open, ooze fluid, and develop a yellow-brown crust. These sores can occur anywhere on the body but most often appear around the mouth and nose.

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It can occur in adults but is seen far more often in children. Impetigo is contagious and can be spread to others through close contact or by sharing towels, sheets, clothing, toys, or other items. Scratching can also spread the sores to other parts of the body.

Symptoms:
You or your child may have impetigo if you have sores:

*Small red spots typically appear on the skin of the face (especially around the mouth and nose), neck or hands, although any part of the body may be affected.The spots may be clustered or merge together. The centre of each one rapidly becomes a blister, which then bursts, oozing a typical golden fluid. Crusts form over the red spots, which may be itchy or slightly sore.

* The sores begin as small red spots, then change to blisters that eventually break open. The sores are generally not painful, but they may be itchy.

*That ooze fluid and look crusty. Sores often look like they have been coated with honey or brown sugar.

*That increase in size and number. Sores may be as small as a pimple or larger than a coin.

*In babies, impetigo often occurs in the nappy area.

*New crops of spots may appear over several days or weeks (if untreated) and the infection is easily spread to other parts of the body.

Causes:
Impetigo is caused by one of two kinds of bacteria—strep (streptococcus) or staph (staphylococcus). Often these bacteria enter the body when the skin has already been irritated or injured because of other skin problems such as eczema, poison ivy, insect bites or scratches, or nappy rash (in babies), chickenpox, burns, or cuts. Children may get impetigo after they have had a cold or allergies that have made the skin under the nose raw.In these situations the bacteria can more easily penetrate the skin’s defences and establish an infection. However, impetigo can also develop in completely healthy skin.
Risk Factors
Factors that increase your chance for impetigo include:

*Age: preschool and school-aged children
*Touching a person with impetigo
*Touching the clothing, towels, sheets, or other items of a person with impetigo
*Poor hygiene, particularly unwashed hands and dirty fingernails
*Crowded settings where there is direct person-to-person contact, such as schools and the military
*Warm, humid environment
*Seasonal: Summer
*Poor health or weakened immune system
*Tendency to have skin problems such as eczema , poison ivy , or skin allergy
*Cuts, scratches, insect bites , or other injury or trauma to the skin
*Chickenpox
*Lice infections (like scabies , head lice , or public lice ), which cause scratching

Diagnosis:
Doctors can usually diagnose impetigo just by looking at  child’s skin. Sometimes doctor gently remove a small piece of a sore to send to a lab in order to identify the bacteria. If you or your child have other signs of illness,  the doctor may order blood or urine tests

Treatment:
Impetigo is treated with antibiotics. For cases of mild impetigo, a doctor will prescribe an antibiotic ointment or cream to put on the sores. For cases of more serious impetigo, a doctor may also prescribe antibiotic pills.

After 3 days of treatment, you or your child should begin to get better. A child can usually return to school or daycare after 48 hours of treatment. If you apply the ointment or take the pills exactly as prescribed, most sores will be completely healed in 1 week.

At home, you should gently wash the sores with soap and water before you apply the medicine. If the sores are crusty, soak them in warm water for 15 minutes, scrub the crusts with a washcloth to remove them, and pat the sores dry. Do not share washcloths, towels, pillows, sheets, or clothes with others and be sure to wash these items in hot water before you use them again.

Try not to scratch the sores because scratching can spread the infection to other parts of the body. You can help prevent scratching by keeping your child’s fingernails short and covering sores with gauze or bandages.

Call your doctor if an impetigo infection does not improve after 3 or 4 days or if you notice any signs that the infection is getting worse such as fever, increased pain, swelling, warmth, redness, or pus.

Prevention:
f you know someone who has impetigo, try to avoid close contact with that person until his or her infection has gone away. You should also avoid sharing towels, pillows, sheets, clothes, toys, or other items with an infected person. If possible, wash any shared items in hot water before you use them again.

If you or your child has impetigo, scratching the sores can spread the infection to other areas of your body and to other people. Keeping the sores covered can help you or your child resist scratching them. Washing your or your child’s hands with soap can also prevent spreading the infection.

If your child has a cut or insect bite, covering it with antibiotic ointment or cream can help prevent impetigo.

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://www.bing.com/images/search?q=pictures+of+impetigo&id=66954188E428748C5C3FE74DC0B51F5FB5506A49&FORM=IGRE2
*http://www.everydayhealth.com/health-center/impetigo.aspx
*http://www.bbc.co.uk/health/physical_health/conditions/impetigo2.shtml

*http://www.lifescript.com/Health/A-Z/Conditions_A-Z/Conditions/I/Impetigo.aspx?gclid=CK-inOjLmKkCFcW8KgodIhWnwQ&trans=1&du=1&ef_id=S81NxKI5DCoAAIRd:20110603013319:s

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Stop Dengue in its Tracks

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Dengue fever is caused by the Aedes egypti mosquito. Culex and Anophelesmosquitoes (which cause diseases like malaria and filaria) are nocturnal — that is, they emerge and bite at night. They can be effectively kept at bay by using mosquito nets while sleeping at night. Aedes egypti, however, is a daytime urban insect. It cannot live above 1,220m or fly more than a hundred metres. It is easily identifiable — its body is striped like that of a tiger. It lives in houses and breeds in stagnant water. This could be in flower vases, old tyres, upturned bottle caps, and even water that collects on leaves and plants.

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Eradication of their breeding grounds is, therefore, a Herculean task, which cannot be achieved by the government alone. Citizens need to do their bit, awaken their civic sense and keep their neighbourhood garbage free. At home, flower vases, water cooler trays, and all sorts of open containers — including broken mugs and bottle caps — should be emptied.

The government often uses frogs or sprays of insecticides to reduce the population of Aedes egypti in populated areas. The sprays need to be used every eight to 10 days to interrupt the cycle of virus transmission. Also, people must leave their doors and windows open so that the insecticide can penetrate indoors, into the nooks and crannies where the mosquitoes rest. We often close all openings to prevent the “harmful chemicals” from entering inside. This negates the effects of spraying.

Once an infected mosquito bites, there is an asymptomatic incubation period of five to six days. After this, dengue sets in abruptly with headache and high fever. There is pain behind the eyes and on moving the eyes. Severe body ache makes it difficult for the person to move, giving dengue the nickname “back breaking” fever. There may be rashes on the skin and inside the mouth. There may also be bleeding into the conjunctiva of the eyes, making them appear blood shot.

After three or four days, the temperature returns to normal. But this is only a temporary respite; the fever returns a few days later with all the previous symptoms but in a milder form. Dengue is, therefore, also called “saddle back” fever.

Unfortunately, there is no specific treatment for dengue. There is no vaccination (as yet) to prevent infection or specific antiviral medication to combat the condition. Affected persons have to ride out the disease with supportive treatment, hoping for the best. Treatment is symptomatic with paracetamol for lowering the fever and fluids for hydration. Aspirin and non-steroidal anti-inflammatory agents like brufen must be avoided. Blood transfusions may have to be given if there is bleeding and shock.

The first attack of dengue usually takes a few weeks to completely recover from. Overall, the disease has a five per cent mortality. It is especially dangerous in children. The dangerous form, called dengue haemorrhagic fever, which is accompanied by shock and bleeding, occurs with subsequent infections with the virus, especially if they are of a different “serotype”.

Humans are infective during the first three days when the virus is multiplying in the blood. During this period, it’s important they lie inside a mosquito net all day and night. This is to prevent them from infecting other members of the household.

The diagnosis is made by excluding other causes of fever. Blood tests may show a low white cell count and platelets. There are, however, some confirmatory tests, like complement fixation, Elisa and an increasing number of antibodies.

Dengue is a self-limited disease. The severity of the symptoms depends on the serotype of the virus, immunological status of the host and, to some extent, genetics.

Herbal products — such as fresh leaves and extracts of neem and tulasi — are being investigated for their anti viral and immune boosting properties. The results are not conclusive. Claims and counterclaims about the efficacy of herbal products are difficult to evaluate. Double blind control studies have not yet been done to prove or disprove their efficacy.

One can prevent mosquito bites to a certain extent by wearing long-sleeved clothing, sleeping inside a mosquito net, and using mosquito meshes for windows and doors. Water should not be allowed to stagnate in containers in and around residential areas. Adding a handful of rock salt or pouring kerosene into stagnant water prevents mosquitoes from breeding.

Remember, no vaccine or specific treatment exists — the only way to escape dengue is to prevent being stung by these pesky insects.

Source: The Telegraph (Kolkata, India)

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