Tuberculosis

Tuberculosis

What is Tuberculosis (TB) ?

• Tuberculosis (TB) is a serious infectious disease that mainly affect lungs. 
• The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes.
• TB disease caused by a bacterium called Mycobacterium tuberculosis.

What are the symptoms ?

• Coughing that lasts three or more weeks
• Coughing up blood
• Chest pain, or pain with breathing or coughing
• Unintentional weight loss
• Fatigue
• Fever

Prevention

Infants often are vaccinated with bacille Calmette-Guerin (BCG) vaccine because it can prevent severe tuberculosis in children.

• Stay home. 

Don't go to work or school or sleep in a room with other people during the first few weeks of treatment for active tuberculosis.

• Ventilate the room. 

Tuberculosis germs spread more easily in small closed spaces where air doesn't move. If it's not too cold outdoors, open the windows and use a fan to blow indoor air outside.

• Cover your mouth. 

Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.

• Wear a mask. 

Wearing a surgical mask when you're around other people during the first three weeks of treatment may help lessen the risk of transmission.

References

http://www.cdc.gov/tb/

http://www.myhealth.gov.my/index.php/tuberkulosis-tb

Leprosy

Leprosy

What is Leprosy ?

• Leprosy is an infectious disease that causes severe, disfiguring skin sores and nerve damage in the arms and legs.
• You can catch it only if you come into close and repeated contact with nose and mouth droplets from someone with untreated leprosy. 
• Children are more likely to get leprosy than adults.

What are the symptoms ?

• skin sores
• lumps
• bumps 

Prevention and Control

• Leprosy is a long-lasting infection caused by bacteria.

• The disease was once feared as a highly contagious and devastating disease.

BCG 

BCG vaccination has a documented and substantial effect in preventing leprosy and is therefore considered as an important tool for leprosy control.

• Public education and community awareness are crucial to encourage individuals with leprosy and their families to undergo evaluation and treatment with MDT.

• Household contacts of patients with leprosy should be monitored closely for the development of leprosy signs and symptoms.

• A study demonstrated that prophylaxis with a single dose of rifampicin was 57% effective in preventing leprosy for the first two years in individuals who have close contact with newly diagnosed patients with leprosy.

• There is currently no widely used standard for using medications for the prevention of leprosy.

• Currently, there is no single commercial vaccine that confers complete immunity against leprosy in all individuals.

• Several vaccines, including the BCG vaccine, provide variable levels of protection against leprosy in certain populations.

References

http://www.cdc.gov/leprosy/

www.who.int/hiv/pub/guidelines/ethiopia_tb.pdf

HFMD

Hand Foot and Mouth Disease

What is HFMD ?

• It is an infectious disease.
• Can lead to painful sores in mouth, rash in hand, and fever.

What are the symptoms ?

• Fever
• Sore throat
• Mouth ulcers on the inside of the mouth or sides of the tongue
• Rash (flat or raised spots) or small blisters on palms of hands, soles of feet, and/or buttocks.

Prevention and Control

Good hygiene is the best protection against hand, foot, and mouth disease. 

• Wash hands carefully.      

Be sure to wash your hands frequently and thoroughly, especially after using the toilet or changing a diaper and before preparing food and eating. When soap and water aren't available, use hand wipes or gels treated with germ-killing alcohol.

• Disinfect common areas. 

Get in the habit of cleaning high-traffic areas and surfaces first with soap and water, then with a diluted solution of chlorine bleach and water. Child care centers should follow a strict schedule of cleaning and disinfecting all common areas, including shared items such as toys, as the virus can live on these objects for days. Clean your baby's pacifiers often.

• Teach good hygiene. 

Show your children how to practice good hygiene and how to keep themselves clean. Explain to them why it's best not to put their fingers, hands or any other objects in their mouths.

• Isolate contagious people. 

Because hand-foot-and-mouth disease is highly contagious, people with the illness should limit their exposure to others while they have active signs and symptoms. Keep children with hand-foot-and-mouth disease out of child care or school until fever is gone and mouth sores have healed. If you have the illness, stay home from work.

References

http://www.healthline.com/health/hand-foot-mouth-disease#Prevention8

http://www.cdc.gov/hand-foot-mouth/about/prevention-treatment.html

Measles

MEASLES

What is Measles ?

1. Measles is a highly contagious viral disease, which affects mostly children. It is transmitted via droplets from the nose, mouth or throat of infected persons.
2. Measles is a very contagious (easily spread) infection that causes a rash all over your body.
3. MMR (measles, mumps, and rubella) and MMRV (measles, mumps, rubella, and chickenpox) vaccines.

What causes Measles ?

• Measles is caused by a virus. 
• It is spread when an infected person coughs, sneezes, or shares food or drinks. 
• The measles virus can travel through the air.

What are the symptoms ?

The first symptoms of measles are like a bad cold—a high fever.

• Cough, runny nose, and red eyes
• Rash of tiny, red spots that start at the head and spread to the rest of the body
• Diarrhea
• Ear infection

Incubation Period

• appear 10–12 days after infection.

Prevention and control 

Children should get 2 doses of MMR vaccine:

• The first at 12-15 months of age
• The second before the start of school at 4-6 years of age.

These are the recommended ages. But children can get the second dose at any age, as long as it is at least 28 days after the first dose.

Virus

Virus

References

https://myhealth.alberta.ca/health/pages/conditions.aspx?Hwid=hw198187
http://www.who.int/topics/measles/en/

HFMD

Hand, Foot, and Mouth Disease (HFMD)

What is HFMD ?

• It is an infectious disease.
• Can lead to painful sores in mouth, rash in hand, fever.

Where is this disease infected the most ?
--> Common places such tropical and subtropical countries.
--> Mostly in nursery.
--> HFMD is an acute illness.

• Dehydration - if intake of liquid is limited due to painful.
• Develop aseptic or viral meningtis.
• Cardiovascular or respiratory.

Common about HFMD

• Hand, foot, and mouth disease, or HFMD, is a contagious illness that is caused by different viruses.
• Infants and children younger than 5 years old are more likely to get this disease. 
• However, older children and adults can also get it.

Hand, foot, and mouth disease is caused by viruses that belong to the Enterovirus genus (group). This group of viruses includes polioviruses, coxsackieviruses, echoviruses, and enteroviruses.

• Coxsackievirus A16 is the most common cause of hand, foot, and mouth disease in the United States, but other coxsackieviruses have been associated with the illness.
• Enterovirus 71 has also been associated with hand, foot, and mouth disease.

Dengue

DENGUE

in Malaysia

• Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. It is an acute illness of sudden onset.

• Symptoms such asheadache, fever, exhaustion, severe muscle and joint pain, swollen glands (lymphadenopathy), and rash.

• Caused by one of four serotypes of virus, it is possible to get dengue fever multiple times. 

• The virus is contracted from the bite of a striped Aedes aegypti mosquito that has previously bitten an infected person.

Symptoms

• Severe headache
• Severe eye pain (behind eyes)
• Joint pain
• Muscle and/or bone pain
• Mild bleeding manifestation (e.g., nose or gum bleed, petechiae, or easy bruising)

Prevention & Control

• Eliminate the places where the mosquito lays her eggs.

• In urban areas, Aedes mosquitos breed on water collections in artificial containers.

• Larvicide treatment is another effective way to control the vector larvae.

Effective ways to reduce:

• Empty children's wading pools at least once a week.
• Change water in birdbaths at least weekly.
• Get rid of old tires in your yard, as they collect standing water.
• Empty unused containers, such as flower pots, regularly or store them upside down.
• Drain any collected water from afire pit regularly.

References 

http://www.healthmap.org/site/diseasedaily/article/controlling-spread-dengue-fever-82511

http://www.cdc.gov/dengue/symptoms/

Black Death

Black Death

History

• Plague has a remarkable place in history and has had enormous effects on the development of modern civilization. Some scholars have even suggested that the collapse of the Roman Empire may be linked to the spread of plague by Roman soldiers returning home from battle in the Persian Gulf in 165 .

• For centuries, plague represented disaster for people living in Asia, Africa and Europe and because the cause of plague was unknown, plague outbreaks contributed to massive panic in cities and countries where it appeared.

"Black Death" or the Great Plague

The second pandemic, widely known as the "Black Death" or the Great Plague, originated in China in 1334 and spread along the great trade routes to Constantinople and then to Europe, where it claimed an estimated 60% of the European population (Benedictow, 2008). 

How Did the Black Death Spread?

The Black Death of the 1340s and 1350s was, in terms of the percentage of the population lost, the worst recorded plague in human history. It wiped out as much as a quarter of the world’s population, probably including more than half the population of Europe, and records suggest that it sometimes did so in a spectacularly gruesome way—routinely covering its victims in exploding cysts and rotting their extremities with gangrene. It was the pneumonia and not these more visible symptoms that killed most victims, but all told, it was a terrible way to die. The grief and horror that survivors must have felt would have been enough to break anyone’s heart, and that’s essentially where Europe was in these years leading up to the Renaissance—a grieving, terrified, brokenhearted continent.

Symptoms

Bubonic plague affects the lymph nodes (another part of the lymph system). Within 3 to 7 days of exposure to plague bacteria, you will develop flu-like symptoms such as fever,headache chills, weakness, and swollen, tender lymph glands.

How do we get ?

Usually, you get bubonic plague from the bite of an infected flea or rodent. In rare cases, Y. pestis bacteria, from a piece of contaminated clothing or other material used by a person with plague, enter the body through an opening in the skin.

Treatment

When plague is suspected and diagnosed early, a health care provider can prescribe specific antibiotics (generally streptomycin or gentamycin). Certain other antibiotics are also effective.

Left untreated, bubonic plague bacteria can quickly multiply in the bloodstream, causing septicemic plague, or even progress to the lungs, causing pneumonic plague.

Prevention

Antibiotics

Health experts recommend antibiotics if you have been exposed to wild rodent fleas during a plague outbreak in animals, or to a possible plague-infected animal. Because there are so few cases of plague in the United States, experts do not recommend taking antibiotics unless it's certain a person .

References

http://www.medicinenet.com/script/main/art.asp?articlekey=141316

Type of Plague

DO YOU KNOW WHAT IS PLAGUE ??

PLAGUE

The plague is a serious bacterial infection that can be deadly. Sometimes referred to as the "black plague," the disease is caused by bacteria called Yersinia pestis. This bacteria is found on animals throughout the world and is usually transmitted to humans through fleas.

Plague is a rapidly progressing disease that can lead to death. Immediate medical intervention is necessary.

There are three different types of plague: 

• bubonic plague,
• septicemic plague, 
• and pneumonic plague.

Bubonic Plague

1. The most common type is bubonic plague.
2. Septicemic plague occurs when the Yersinia pestis bacteria (the organism responsible for the disease) multiply in the blood.
3. Pneumonic plague is the most serious of the three types of plague.
4. It occurs when plague bacteria infect the lungs, causing pneumonia.

An infectious disease, bubonic plague is primarily transmitted through the bites of infected fleas or rodents. The bacteria that cause the disease are rarely spread through human-to-human contact. Symptoms tend to develop within six days. However, other conditions are ruled out before making a firm diagnosis. If left untreated, the mortality rate for bubonic plague is 50 to 90 percent; it drops to 15 percent with early diagnosis and treatment.

Causes of Bubonic Plague

Bubonic plague is caused by bacteria called Yersinia pestis. These bacteria are found mainly in rodents, particularly rats, and in the fleas that feed on them. Other animals and humans usually contract the bacteria from rodent or flea bites. 

How Is It Spread?

Usually, bubonic plague is spread by being bitten by an infected flea or rodent. In rare cases, Yersinia pestis bacteria that is present on a piece of contaminated clothing or other material used by an infected person may enter through an opening in the skin. The bacteria are rarely spread from person to person.

Symptoms

• fever and chills
• headache
• muscle pain
• general weakness
• seizures

Septicemic Plague

1. Septicemic plague is one form of plague. It develops when Yersinia pestis enters the bloodstream.
2. one of three types of plague caused by Yersinia pestis.
3.  develops when the bacteria enters the bloodstream.
4.  It is possible for the disease to also develop as a complication of untreated bubonic or pneumonic plague, or from being bitten by an infected flea or rodent.

When the bacteria multiply in the lungs, you have pneumonic plague—the most serious form of the disease. When a person with pneumonic plague coughs, the bacteria from their lungs are expelled into the air. Other people who breathe that air can also develop this highly contagious form of plague, which can lead to an epidemic.

Causes of Septicemic Plague

The root cause of septicemia is a bacterial infection (typically severe) in another part of the body. Urinary tract infections, lung infections, and infections in the abdominal area are all potential causes of septicemia. Bacteria from these infections enter the bloodstream and multiply, causing immediate symptoms.

How It Is Spread

Sepsis is a serious medical condition caused by an overwhelming immune response to infection. Chemicals released into the blood to fight infection trigger widespread inflammation.

Symtoms

The most common initial symptoms are:

• chills,
• elevated body temperature,
• very fast respiration and/or heart rate.

Other symptoms that commonly emerge as the septicemia progresses include:

• confusion or inability to think clearly,
• red dots that appear on the skin,
• a reduction in urine volume,
• inadequate blood flow (shock).

Pneumonic Plague

1. Pneumonia is an infection in one or both lungs. The infection may be caused by fungi, bacteria, or viruses. 
2. Pneumonia causes inflammation in your lung’s air sacs, also referred to as alveoli. The alveoli fill with fluid or pus, making it difficult to breathe.
3. The severity of pneumonia usually depends on the cause of the inflammation or by the type of organism causing the infection, a person’s age, and their general health.

Pneumonic plague occurs when the lungs become infected with the bacteria that cause plague (Yersinia pestis). This disease is most often transmitted when respiratory droplets from an infected person or animal are breathed in. It can also develop if bubonic or septicemic plague is left untreated. Antibiotics must be given within 24 hours of the first symptoms of this illness to reduce the chance of death.

Causes Of Pneumonic Plague

Bacterial Pneumonia

Bacterial pneumonia can affect anyone at any age. It can develop on its own or after a serious cold or flu.

Viral Pneumonia

In most cases, respiratory viruses can cause pneumonia, especially in young children and the elderly.However, the flu virus can cause viral pneumonia to be severe or fatal.

Mycoplasma Pneumonia

Mycoplasmas are not viruses or bacteria, but they have traits common to both. They are the smallest agents of disease that affect humans.

How It Is Spread ?

Pneumonic plague can spread from person to person through the air. Transmission can take place when someone breathes in aerosolized (gaseous) bacteria, as could happen in a bioterrorist attack. Pneumonic plague is also spread by breathing in Yersinia pestis that is suspended in respiratory droplets, from a person (or animal) with pneumonic plague. Becoming infected in this way, however, usually requires direct and close contact with the ill person or animal.

Symptoms

• chest pain
• shaking chills
• fever
• dry cough
• muscle aches
• nausea/vomiting
• rapid breathing
• rapid heartbeat
• difficulty breathing

References

http://plague.emedtv.com/plague/types-of-plague.html

http://www.webmd.com/a-to-z-guides/sepsis-septicemia-blood-infection

How to control leptospirosis using epidemiological triangle?

      

1- AGENT

Leptospirosis is a bacterial disease that affects humans and animals. It is caused by bacteria of the genus Leptospira. In humans, it can cause a wide range of symptoms, some of which may be mistaken for other diseases. Some infected persons, however, may have no symptoms at all. Without treatment, Leptospirosis can lead to kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, respiratory distress, and even death.

MODE OF TRANSMISSION

 Leptospirosis is transmitted by the urine of an infected animal and is contagious as long as the urine is still moist. Although Leptospira has been detected in reptiles and birds, only mammals are able to transmit the bacteria to humans and other animals. Rats and mice are important primary hosts—but a wide range of other mammals including dogs, deer, rabbits, hedgehogs, cows, sheep, raccoons, opossums, skunks, and certain marine mammals carry and transmit the disease as secondary host. House-bound domestic dogs have contracted leptospirosis, apparently from licking the urine of infected mice in the house. The type of habitats most likely to carry infective bacteria are muddy riverbanks,and muddy livestock rearing areas where there is regular passage of wild or farm mammals. The incidence of leptospirosis correlates directly with the amount of rainfall, making it seasonal in temperate climates and year-round in tropical climates. Leptospirosis also transmits via the semen of infected animals. Humans become infected through contact with water, food, or soil that contains urine from these infected animals. This may happen by swallowing contaminated food or water or through skin contact. The disease is not known to spread between humans, and bacterial dissemination in convalescence is extremely rare in humans. Leptospirosis is common among water-sport enthusiasts in specific areas, as prolonged immersion in water promotes the entry of the bacteria.

PREVENTION

•  Prevention of leptospirosis include wearing protective clothing for people at occupational risk and avoidance of swimming in water that may be contaminated. 
• Leptospirosis control in animals is dependent on the serovar and animal species but may be either vaccination, a testing a culling programme, rodent control or a combination of these strategies. 
• The large number of serovars, variety of infection sources and the wide differences in transmission conditions, the prevention and control of leptospirosis is complex.
•  Effective prevention and control can be achieved by controlling the reservoir or reducing infection in animal reservoir populations such as dogs or livestock treatment or vaccination of the animals.
•  Control of wild animals may be difficult. Preventive measures must be based on knowledge of the groups at particular risk of infection.
• Prevention and control should be targeted at is a the infection source, The route of transmission between the infection source and the human host or Prompt and proper treatment of infection.

SYMPTOMS

• Leptospirosis infection in humans causes a range of symptoms, and some infected persons may have no symptoms at all. 
• The symptoms appear after an incubation period of 7–12 days.The first phase (acute or septicemic phase) ends after 3–7 days of illness. 
• The disappearance of symptoms coincides with the appearance of antibodies against Leptospira and the disappearance of the bacteria from the bloodstream. 
• The patient is asymptomatic for 3–4 days until the second phase begins with another episode of fever.
•  The hallmark of the second phase is meningitis (inflammation of the membranes covering the brain). 
• Symptoms caused disease leptospirosis are fever and headache persistent vomiting diarrhea muscle and joint pain abdominal pain Jaundice (yellow eyes) cough, eye inflammation and rash.

2-HOST

Prevention

• Can be reduce by reducing swimming in contaminated water.
• Not in contact with animals that have been exposed to infection
• Wear the PPE
• Wearing protective clothing or footwear
• Increasing the frequency goes wellness center
• Give lepto vaccine to pets although, not 100% immune.
• Pet's owner should take antibiotics as doxycyline or penniciline.
• Do not hold the urine, the blood of animals that not have proper treatment.
• Always wash hand with anti-bacterial cleaning solution. 

Mode of transmission

• Leptospirosis can effect human directly or indirectly through exposure to animal urine of the bearer. The genus leptospira bacteria enter the bloodstream through wounds,skin abrasions and through mucous membranes such as eyes, nose and mouth.
• Also spread via semen of infected animals, abattoir workers may be infected through contact with bodily fluids and direction.
• Human can be infected through exposure of water, food or soil containing urine from infected animals bacteria. May happen by swallowing contaminated food or water or by contact with the skin.
• Dog lick urine then go near this master.

3-ENVIRONMENT

Leptospirosis

          Ø  Is an emerging zoonotic disease.

Ø  It is an infectious disease caused by pathogenic bacteria called leptospires.

Ø  That are transmitted directly or indirectly from animal to human

Environment Factor

•  Animal stocking density (eg.all the animals in a place)
•  Animal movement between groups.
•  Housing (eg.ventilation,sanitation)
•  Environment condition (eg.temperature)
• Nutrient (eg.protein )

Control of Environment 

1.  Sources of infection such as exposure to infected animal and potentially contaminated bodies of water.
2. It may also include environment clean-ups and draining

•    Alert public or users regarding the hazards of possible contaminated areas.
•    Health hazards signage should be posted in areas found to be contaminated through   environment risk.
•    Advise public to keep their homes and premises free from rodents.
•   Advise public to vaccinate their pets.
•   Promote cleanliness at the recreational areas ,food premises.
•   Reduce by not swimming which contaminated with animal urine.
•    Removal of rubbish and keeping areas clean.

What are the symptoms of this disease?

- The incubation period of time, namely the period of time of exposure to onset of symptoms is between 2 to 10 days. This disease shows of variety of clinical symptoms.  Among the symptoms of leptospirosis infection can be shown by patients are high fever, headache, chills, muscle pain, vomitting, jaundis, inflammation of the eyes, abdominal pain, diarrhea, cough and a rash on the skin.

-This disease can be categorized into for category based on the clinical signs in as follow (WHO, 2003) 

• Influenza like illness that light.
• Weil's syndroms - jaundis, renal failure, bleeding in flammation of the heart muscle with an irregular heart beat.
• Meningitis
• Pulmonary hemorrhage with respiratory failure.    

Confirmation of Leptospirosis is through : 

• Verification leptospira bacteria through culture of blood samples, cerebrosipinal fluid, and urine.
• Serology test to detect specific antibodies such as Microscopic Agglutination Test ( MAT ), test immunofluorescent  techniques (IF ), and ELISA

Whether the disease can be treated?

• This disease can be treated with certain antibiotics. For those who show symptoms as above shall hasten to the nearest clinic for examination and treatment, especially for those who have a history of exposure to contaminated water and food. Early treatment with antibiotics can prevent complications and death.

Doxycyline antibiotics can be given as prophylaxis to those who are exposed to infection through work ( military, rescue workers and other ). However, the doctor's advice should be obtained before taking prophilaxis.