Cyclospora Infection (Cyclosporiasis)

How is Cyclospora spread?

Cyclospora is spread by eating or drinking contaminated food or water. Person-to-person spread is unlikely. Outbreaks in the United States have been associated with imported raspberries and with other fresh produce. Although the route of transmission is unclear, animals may play some role in transmission.

What are the symptoms of Cyclospora?

Watery diarrhea is the most common symptom. It may last a few days to a month or longer. Symptoms may subside and then relapse. Other symptoms may include loss of appetite, weight loss, muscle aches, nausea, vomiting, and fatigue.

How soon after exposure do symptoms appear?

The incubation period is approximately one week after consuming contaminated food or water.

How is it diagnosed?

A stool test performed at a laboratory is needed to make the diagnosis. The immature stage of the Cyclospora parasite (oocyst) can be identified using specialized laboratory methods. Routine stool tests may fail to detect this parasite so health care providers must specifically request the laboratory test for Cyclospora when this infection is suspected in a patient.

How is it treated?

The recommended treatment involves a combination antibiotic called trimethoprim-sulfamethoxazole, also known as Bactrim or Septra.

What can be done to minimize the spread of Cyclospora?

Avoid water or food that may be contaminated with stool or feces. Thoroughly wash fruits and vegetables.



http://www.health.state.ny.us/diseases/communicable/cyclosporiasis/fact_sheet.htm

Hand, Foot and Mouth Disease (Coxsackie viral infection)

What is hand, foot and mouth disease?

Hand, foot and mouth disease is a viral infection caused by a strain of Coxsackie virus. It causes a blister-like rash that, as the name implies, involves the hands, feet and mouth. (Hand, foot and mouth disease is different than foot-and-mouth disease, which is an infection of cattle, pigs, sheep, goats and deer and is caused by a different virus.)

Who gets hand, foot and mouth disease?

Usually this occurs in children under 10 years old, but occasionally can occur in young adults.

How is it spread?

The virus is spread by direct contact with nose and throat discharges, blisters and feces of infected people.

What are the symptoms and when do they start?

Symptoms of fever, poor appetite, runny nose and sore throat can appear three to five days after exposure. A blister-like rash on the hands, feet and in the mouth usually develops one to two days after the initial symptoms.

When and how long can someone spread the disease?

A person is contagious when the first symptoms appear and may continue until the blister-like skin lesions disappear. The virus has been known to be shed in the stool for up to several weeks.

How is hand, foot and mouth disease diagnosed?

The diagnosis is generally suspected on the appearance of blister-like rash on hands and feet and mouth in a child with a mild febrile illness. Although specific viral tests are available to confirm the diagnosis, they are rarely performed due to expense and length of time needed to complete the tests.

Does a prior infection with Coxsackie virus make a person immune?

Specific immunity can occur, but a second episode is possible from a different strain of Coxsackie virus.

What is the treatment?

There is no specific treatment. Treatment is aimed at fever control and maintaining good oral hydration.

Can there be complications associated with hand, foot and mouth disease?

The illness is typically mild, complications are rare. More serious infections have been seen recently with a certain strain of Coxsackie viral infection in Indonesia.

What can be done to prevent the spread of this disease?

Children who feel ill or have a fever should be excluded from group settings until the fever is gone and the child feels well. Thorough hand washing and care with diaper changing practices is important as well.

Is there a risk for pregnant women?

There is debate as to any congenital disorders related to Coxsackie viral infections and pregnancy. Pregnant women should consult their obstetrician for further information.


http://www.health.state.ny.us/diseases/communicable/hand_foot_mouth/fact_sheet.htm

Tobacco

The Burden of Tobacco Use and Secondhand Smoke

Smoking kills 25,500 people every year in New York State. Secondhand smoke kills 2,500 New Yorkers every year. Every year 570,000 New Yorkers are afflicted with serious disease caused by smoking. It is projected that 389,000 New York State youth age 0-17 will die from smoking.

Who We Are

The New York State Department of Health Tobacco Control Program (NYTCP) implements evidence-based and promising strategies to prevent and reduce tobacco use. The NYTCP envisions a tobacco-free society for all New Yorkers. The program began in January 2000, and is built on a foundation of community partners using evidence-based strategies from the Guide to Community Preventive Services to decrease tobacco use. Over time, the program has effectively implemented a strong clean indoor air law, maintained support for high tobacco taxes to keep the price of tobacco high, and worked to increase access to effective cessation services and motivate smokers to try to quit. As a result of programmatic efforts, youth and adult smoking rates are at their lowest levels on record.


http://www.health.state.ny.us/prevention/tobacco_control/

Cholera

What is cholera?

Cholera is a bacterial disease that affects the intestinal tract. It is caused by a germ called Vibrio cholerae. Although only a few cases are recognized in the United States each year, epidemic levels of cholera have recently been reported in parts of Central and South America.

Who gets cholera?

While cholera is a rare disease in the U.S., those who may be at risk include people traveling to foreign countries where outbreaks are occurring and people who consume raw or undercooked seafood from warm coastal waters subject to sewage contamination. In both instances, the risk is small.

How is the germ spread?

The cholera germ is passed in the stools. It is spread by eating or drinking food or water contaminated by the fecal waste of an infected person. This occurs more often in underdeveloped countries lacking adequate water supplies and proper sewage disposal.

What are the symptoms of cholera?

People exposed to cholera may experience mild to severe diarrhea, vomiting and dehydration. Fever is usually absent.

How soon do symptoms appear?

The symptoms may appear from a few hours to five days after exposure.

What is the treatment for cholera?

Because of the rapid dehydration that may result from severe diarrhea, replacement of fluids by mouth or by the intravenous route is critical. Antibiotics, such as tetracycline, are also used to shorten the duration of diarrhea and shedding of the germs in the feces.

Is there a vaccine for cholera?

A vaccine is available and is sometimes recommended for travelers to certain foreign countries where cholera is occurring. However, the vaccine offers only partial protection (50 percent) for a short duration (two to six months). Some physicians feel that foreign travelers almost never contract cholera and that use of the current vaccine cannot be justified.

How can cholera be prevented?

The single most important preventive measure is to avoid consuming uncooked foods or water in foreign countries where cholera occurs unless they are known to be safe or have been properly treated.


http://www.health.state.ny.us/diseases/communicable/cholera/fact_sheet.htm

Psittacosis (ornithosis, parrot fever, chlamydiosis)

What is psittacosis?

Psittacosis is an infectious disease usually transmitted to humans from birds in the parrot family, turkeys and pigeons. Birds in the parrot family, or psittacines, include parrots, macaws, budgerigars (parakeets), and cockatiels. The disease is caused by a bacteria called Chlamydophila psittaci.

Who gets psittacosis?

Because this disease is spread by birds in the parrot family, it is occasionally found in pet store workers and people who have purchased an infected bird. It may also be found in farmers and slaughterhouse workers who process turkeys.

How is psittacosis spread?

Psittacosis is usually spread by inhaling dust from dried droppings from bird cages and by handling infected birds in slaughterhouses. Human-to-human spread has not been reported. Waste material in the bird cage may remain infectious for weeks.

What are the symptoms of psittacosis?

In humans, the symptoms are fever, headache, chills and sometimes pneumonia. Some people may only experience mild flu-like illness, or show no illness at all. In birds, the symptoms include poor appetite, ruffled appearance, eye or nose discharge and diarrhea. Occasionally, birds may die from psittacosis. Some birds may shed the organism while exhibiting no symptoms.

How soon after infection do symptoms appear?

The incubation period typically ranges from five to 14 days, but longer incubations have been reported.



http://www.health.state.ny.us/diseases/communicable/psittacosis/fact_sheet.htm

Chickenpox (varicella zoster infection)

What is chickenpox?

Chickenpox is a highly contagious illness caused by the varicella-zoster virus (VZV), a type of herpes virus. It is often a mild illness, characterized by an itchy rash on the face, scalp and trunk with pink spots and tiny fluid-filled blisters that dry and become scabs four to five days later. Serious complications, although rare, can occur mainly in infants, adolescents, adults and persons with a weakened immune system. These complications include bacterial infections of skin blisters, pneumonia, and encephalitis (inflammation of the brain). In temperate climates, such as the Northeast, chickenpox occurs most frequently in the late winter and early spring.

Who gets chickenpox?

Chickenpox is a common childhood illness with 90 percent of the cases occurring in children younger than ten years of age. Before the availability of the varicella vaccine in the U.S., almost everyone developed chickenpox. Most people who are vaccinated will not get chickenpox. Those who are vaccinated and develop chickenpox usually have a mild form of the illness. They have fewer spots and recover faster.

How is chickenpox spread?

Chickenpox is transmitted from person to person by directly touching the blisters, saliva or mucus of an infected person. The virus can also be transmitted through the air by coughing and sneezing. Chickenpox can be spread indirectly by touching contaminated items freshly soiled, such as clothing, from an infected person. Direct contact with the blisters of a person with shingles can cause chickenpox in a person who has never had chickenpox and has not been vaccinated. Blisters that are dry and crusted are no longer able to spread chickenpox.

What are the symptoms of chickenpox?

Initial symptoms include sudden onset of slight fever and feeling tired and weak. These are soon followed by an itchy blister-like rash. The blisters eventually dry, crust over and form scabs. The blisters tend to be more common on covered than on exposed parts of the body. They may appear on the scalp, armpits, trunk and even on the eyelids and in the mouth. Mild or asymptomatic infections occasionally occur in children. The disease is usually more serious in young infants and adults than in children.

How soon do symptoms appear?

Symptoms commonly appear 14 to 16 days (range of ten to 21 days) after exposure to someone with chickenpox or herpes zoster (shingles).

What are the complications associated with chickenpox?

Newborn children (less than one month old) whose mothers are not immune may suffer severe, prolonged or fatal chickenpox. Any person with a weakened immune system, including those with cancer, human immunodeficiency virus (HIV) or taking drugs that suppress the immune system, may have an increased risk of developing a severe form of chickenpox or shingles.
Reye Syndrome is an unusual complication of chickenpox that is linked to children who take aspirin or aspirin-containing products during the illness. Reye Syndrome is a severe disease affecting all organ systems, but, most seriously the brain and liver and may be fatal. The exact cause of Reye Syndrome is unknown. Aspirin or aspirin-containing products should never be given to children under 18 years of age with chickenpox.

When and for how long is a person able to spread chickenpox?

A person is most able to transmit chickenpox from one to two days before the rash appears until all the blisters are dry and crusted. People with a weakened immune system may be contagious for a longer period of time.

Is there a treatment for chickenpox?

Acyclovir is approved for treatment of chickenpox. However, because chickenpox tends to be mild in healthy children, most physicians do not feel that it is necessary to prescribe acyclovir. Acyclovir can be considered for otherwise healthy people who are at risk of moderate to severe varicella. It is important to consult with your physician for recommendations on the use of acyclovir.

Does past infection with chickenpox make a person immune?

Most people do not get chickenpox more than once. However, since varicella-zoster virus remains in the body after an initial infection, infection can return years later in the form of shingles in some older adults and sometimes in children.

Is there a vaccine for chickenpox?

A vaccine to protect children against chickenpox was first licensed in 1995. Children who have never had chickenpox should routinely be administered two doses of varicella vaccine with the first dose at 12 to 15 months and the second dose at four to six years of age. Persons 13 years of age and older who have never had chickenpox or have not received the varicella vaccine should get two doses of the varicella vaccine at least 28 days apart.
The varicella vaccine may be given along with the measles-mumps-rubella (MMR) vaccine in a combination called measles-mumps-rubella-varicella (MMRV) that is approved for use in children 12 months through 12 years of age.
In New York State, varicella vaccine is required for children enrolled in pre-kindergarten programs and schools. Vaccination is recommended for healthcare personnel and college students who have never had chickenpox.

http://www.health.state.ny.us/diseases/communicable/chickenpox/fact_sheet.htm

Heart Disease

Cardiovascular disease (CVD), including heart disease and stroke, remains the leading cause of death in the United States despite improvements in prevention, detection, and treatment. CVD is no longer thought of as a disease that primarily affects men as they age. It is a killer of people in the prime of life, with more than half of all deaths occurring among women.
Cardiovascular diseases remain the leading cause of disability among working adults. Stroke alone accounts for the disability of more than a million Americans. The economic impact on the health system grows larger as the population ages. In 2001, the estimated cost of health care expenditures and lost productivity attributable to cardiovascular diseases was $298 billion.


http://www.health.state.ny.us/nysdoh/heart/heart_disease.htm

Norwalk Virus Infection (calicivirus)

What is Norwalk virus infection?

Norwalk virus infection is a gastrointestinal illness that occurs sporadically or in outbreaks. The virus was first identified during a gastroenteritis outbreak in Norwalk, Ohio, in 1972. There are a number of strains of Norwalk virus which are also referred to as calicivirus.

Who gets Norwalk virus infection?

Anyone can become infected. It only occurs in humans and is found worldwide.

How is it spread?

Norwalk viruses are spread by exposure to infected people or contaminated food and water. The virus is passed in stool and vomit. Outbreaks have been linked to sick food handlers, contaminated shellfish or water contaminated with sewage. It is generally spread from person to person by direct contact, but some medical reports suggest that the virus can spread through the air during vomiting.

What are the symptoms?

Although the virus is easy to spread, serious illness rarely occurs. The most common symptoms include nausea, vomiting, and stomach cramps. Diarrhea may occasionally accompany vomiting. Fever is usually low grade or absent. Infected people generally recover in one to two days.

How soon after exposure do symptoms appear?

The incubation period is one to two days.

What is the treatment for Norwalk virus infection?

No specific treatment is available. Persons who become dehydrated might need to be rehydrated by taking liquids by mouth. Occasionally patients may need to be hospitalized to receive intravenous fluids.

How can Norwalk virus infection be prevented?

The following recommendations may reduce the risk of acquiring or spreading the infection:

• wash hands thoroughly after each toilet visit and before preparing food.
• people who experience nausea, vomiting or diarrhea should not attend school or work and should not handle food for others while ill.
• avoid drinking untreated water.
• cook shellfish thoroughly before eating.

http://www.health.state.ny.us/diseases/communicable/norwalk/fact_sheet.htm

Brucellosis

What is brucellosis?

Brucellosis is a bacterial disease that can affect any organs of the body. Brucellosis is not very common in the United States with 100-200 cases reported every year.

Who gets brucellosis?

Everyone is susceptible to the bacteria and may get the disease if exposed. It is more likely to be found in people associated with the cleaning and butchering of deer and livestock or the consumption of unpasteurized dairy products.

How is brucellosis spread?

The bacteria that cause this disease are found in unpasteurized milk from diseased cows and also from discharges from cattle or goats that abort their fetus. It is unlikely that this disease would be spread from person to person. However, infected mothers could transmit the infection to their infants through breast milk.

What are the symptoms of brucellosis?

Symptoms of brucellosis include intermittent or irregular fever of variable duration, headache, weakness, profuse sweating, chills, weight loss and generalized aching. Brucellosis can also cause long-lasting or chronic symptoms such as recurrent fevers, joint pain and fatigue.

How soon do symptoms appear?

The time period is highly variable, but symptoms usually appear within five to 30 days.

Does past infection with brucellosis make a person immune?

It is unlikely that an individual will be reinfected. However, if not properly treated, the disease may last for up to a year.

What is the treatment for brucellosis?

Tetracycline or tetracycline plus streptomycin is the treatment of choice. Rifampin and doxycycline may cause fewer intestinal side-effects. Early diagnosis leading to prompt treatment is essential to prevent chronic infection.


http://www.health.state.ny.us/diseases/communicable/brucellosis/fact_sheet.htm

Breastfeeding

Why is Breastfeeding So Good?

Breast milk has the right amount of fat, sugar, water and protein that a baby needs and it is much easier for a baby to digest. It also helps protect the baby from infections such as colds. And, breastfeeding helps strengthen the bond between mother and baby. Breastfeeding also reduces the risk of allergies, obesity and illnesses such as ear infections, diarrhea and respiratory infections.
And, breastfeeding saves money for everyone. Breastfeeding reduces or eliminates formula cost for families. Because breastfed babies and their mothers tend to be healthier, families, businesses and health insurers also save money.


http://www.health.state.ny.us/community/pregnancy/breastfeeding/

Dengue Fever

What is dengue fever?

Dengue fever is a mosquito-borne disease caused by a virus. The disease is mainly tropical in origin but occasionally residents or visitors from other countries may arrive in this country with dengue fever. Although cases originating in the United States are virtually unknown, epidemic levels have recently been reported in parts of the Caribbean and Central America.

Who gets dengue fever?

Dengue fever may occur in people of all ages who are exposed to infected mosquitoes. The disease occurs mainly in tropical Asia and the Caribbean, usually during the rainy seasons in areas with high numbers of infected mosquitoes.

How is dengue fever spread?

Dengue fever is spread by the bite of infected Aedes mosquitoes.

What are the symptoms of dengue fever?

Dengue fever is characterized by the rapid development of a fever that may last from five to seven days with intense headache, joint and muscle pain and a rash. The rash develops on the feet or legs three to four days after the beginning of the fever. The hemorrhagic form of dengue fever is more severe and associated with loss of appetite, vomiting, high fever, headache and abdominal pain. Shock and circulatory failure may occur. Untreated hemorrhagic dengue results in death in up to 50 percent of cases.

How soon do symptoms appear?

Dengue fever may occur from three to 14 days after exposure to an infected mosquito, commonly within four to seven days.

Does past infection with dengue virus make a person immune?

Infection with one of the four strains of dengue virus usually produces immunity to that strain but does not provide protection against the other strains.

What is the treatment for dengue fever?

There is no specific treatment available. Intravenous fluids and oxygen therapy are often used for patients who experience shock during their illness.

What can be done to prevent the spread of dengue fever?

Since cases of dengue appearing in New York are imported, control measures are limited to advising travelers to affected areas to minimize exposure to infected mosquitoes. Use of mosquito netting and repellents may be helpful in minimizing exposure.



http://www.health.state.ny.us/diseases/communicable/dengue_fever/fact_sheet.htm

Breast cancer

What should people know about breast cancer?

Breast cancer is one of the most common cancers among women in New York State.
Each year, about 13,900 women are diagnosed with breast cancer and about 2,900 women die from the disease in New York State. It is estimated that one in eight women will develop breast cancer sometime during her life.
Men also get breast cancer, but it is very rare. About 150 men are diagnosed with breast cancer each year in New York State.

Who gets breast cancer?

Breast cancer is more common among older women. The risk for getting breast cancer increases with age. More than three-quarters of women who get breast cancer are over the age of fifty. White women are more likely to get breast cancer than Black women. Also, women with high socioeconomic status (those whose family income is above average) are more likely to get breast cancer. Scientists believe this may be related to having their first child at an older age, fewer pregnancies, diet and possibly other factors shared by women in higher income groups.

What causes breast cancer?

At this time, scientists do not know exactly what causes breast cancer. We do know that certain personal characteristics increase a woman's chance of developing breast cancer. These risk factors include:

• increasing age – as women get older their risk of developing breast cancer increases.
• family history of breast cancer – women whose relatives have had breast cancer (especially at an early age) are more likely to get breast cancer.
• breast cancer genes – about 5% to 10% of breast cancers are believed to be inherited.
• personal history of breast cancer – a woman who has had cancer in one breast is more likely to develop it in the other breast or in remaining breast tissue.
• history of benign breast disease – women who have a history of certain types of non-cancerous tumors and cysts in their breasts are more likely to develop breast cancer.
• hormonal factors – women who start their periods at a young age, start menopause at a late age, have their first child later in life, and have no full-term pregnancies may have an increased risk of developing breast cancer.

Studies also show that exposure to high doses of x-rays increases a woman's risk of getting breast cancer. Although scientists are not sure, other studies indicate that taking birth control pills, exposure to certain chemicals in the environment, long-term use of hormone replacement therapy, use of alcoholic beverages, obesity and lack of physical activity may be associated with increased breast cancer risk.
Research has also shown that use of underarm deodorant or antiperspirants, underwire bras, induced abortions and silicone breast implants do not increase the risk of getting breast cancer.

What can I do to reduce my chances of getting breast cancer?

Most women who develop breast cancer have no risk factors. Among women with average risk, breast cancer cannot be prevented. Mammograms, breast self-examination, and examination of your breasts by your health care provider increase the chances that breast cancer will be diagnosed early. Among women who have higher than average risk, certain drugs may be useful in preventing breast cancer. All women should discuss their risk and screening or prevention options with their health care provider.


http://www.health.state.ny.us/statistics/cancer/registry/abouts/breast.htm

Botulism (food-borne botulism and infant botulism)

What is botulism?

Botulism is a serious illness caused by a nerve toxin made by the bacterium, Clostridium botulinum. (A toxin is a poison that is released by some bacteria). There are three types of botulism: food, wound and infant botulism. Eating food that has the botulism toxin causes food-borne botulism. It often involves improperly processed home canned foods. Wound botulism occurs when Clostridium botulinum spores contaminate a wound and produce toxin. Botulism in infants under one year of age has been associated with ingestion of Clostridium botulinum spores from the environment or specific foods such as honey.

Can botulism be used as a bioterrorism threat?

In the event of a bioterrorism event, people intentionally exposed who breathe in the toxin or eat the toxin in contaminated food or water might develop the illness. No information is available on the effects of breathing in the botulinum toxin but it may be similar to the food-borne illness.

How is it spread?

Botulism is most often caused by bacteria that have produced the toxin in a wound or in food. Person-to-person spread does not occur.

What are the symptoms?

All types of botulism produce symptoms that affect the nervous system. The classic symptoms of botulism include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth and muscle weakness that goes down the body, first the shoulders, then upper arms, lower arms, thighs, calves, feet. If untreated these symptoms may progress to paralysis. Infants with botulism appear lethargic, feed poorly, are constipated, and have a weak cry and poor muscle tone.

How soon after exposure would symptoms develop?

Symptoms generally begin 12-36 hours after eating contaminated food, but may occur as early as a few hours and as late as 10 days.

Can I spread this to my family?

No, this cannot be spread from person to person.

What is the treatment?

The symptoms of botulism make hospitalization necessary. If diagnosed early, botulism can be treated with an antitoxin, which blocks the action of the toxin circulating in the blood. This can prevent patients from worsening, but recovery still takes many weeks. If left untreated, a patient may need to be on a breathing machine (ventilator) for weeks and would require intensive medical and nursing care. Infant botulism is treated with immune globulin, which is similar to the antitoxin. Most cases of botulism recover with appropriate medical care.


http://www.health.state.ny.us/diseases/communicable/botulism/fact_sheet.htm

Pediculosis (lice, head lice, body lice, pubic lice, cooties, crabs)

What is pediculosis?

Pediculosis is an infestation of the hairy parts of the body or clothing with the eggs, larvae or adults of lice. The crawling stages of this insect feed on human blood, which can result in severe itching. Head lice are usually located on the scalp, crab lice in the pubic area and body lice along seams of clothing. Body lice travel to the skin to feed and return back to the clothing.

Who gets pediculosis?

Anyone may become louse infested under suitable conditions of exposure. Pediculosis is easily transmitted from person to person during direct contact. Head lice infestations are frequently found in school settings or institutions. Crab lice infestations can be found among sexually active individuals. Body lice infestation can be found in people living in crowded, unsanitary conditions where clothing is infrequently changed or laundered.

How is pediculosis spread?

For both head lice and body lice, transmission can occur during direct contact with an infested individual. Sharing of clothing and combs or brushes may also result in transmission of these insects. While other means are possible, crab lice are most often transmitted through sexual contact.

What are the symptoms of pediculosis?

Usually, the first indication of an infestation is the itching or scratching in the area of the body where the lice feed. Scratching at the back of the head or around the ears should lead to an examination for head louse eggs (nits) on the hair. Itching around the genital area should lead to an examination for crab lice or their eggs. Scratching can be sufficiently intense to result in secondary bacterial infection in these areas.

How soon do symptoms appear?

It may take as long as two to three weeks or longer for a person to notice the intense itching associated with this infestation.

For how long is a person able to spread pediculosis?

Pediculosis can be spread as long as lice or eggs remain alive on the infested person or clothing.

What is the treatment for pediculosis?

Medicated shampoos or cream rinses containing pyrethrins are preferred for treating people with head lice. Products containing pyrethrins are available over-the-counter, but those containing lindane are available only through a physician's prescription. Lindane-based shampoos are also available but not recommended for infants, young children and pregnant or lactating women. Retreatment after seven to 10 days is recommended to assure that no eggs have survived. Nit combs are available to help remove nits from hair. Dose and duration of shampoo treatment should be followed carefully according to label instructions.

What can be done to prevent the spread of pediculosis?

Physical contact with infested individuals and their belongings, especially clothing, headgear and bedding, should be avoided. Health education on the life history of lice, proper treatment and the importance of laundering clothing and bedding in hot water or dry cleaning to destroy lice and eggs is extremely valuable. In addition, regular direct inspection of children for head lice, and when indicated, of body and clothing, particularly of children in schools, institutions, nursing homes and summer camps, is important.


http://www.health.state.ny.us/diseases/communicable/pediculosis/fact_sheet.htm

Giardiasis (beaver fever)

What is giardiasis?

Giardiasis is an intestinal illness caused by a microscopic parasite called Giardia lamblia. It is a fairly common cause of diarrheal illness and it is estimated that several thousand cases occur in upstate New York each year. Cases may occur sporadically or in clusters or outbreaks.

Who gets giardiasis?

Anyone can get giardiasis but it tends to occur more often in people in institutional settings, people in daycare centers, foreign travelers and individuals who consume improperly treated surface water. Men who have sex with men may also be at increased risk of contracting giardiasis.

How is this parasite spread?

The Giardia parasite is passed in the feces of an infected person or animal and may contaminate water or food. Person-to-person transmission may also occur in daycare centers or other settings where handwashing practices are poor.

What are the symptoms of giardiasis?

People exposed to Giardia may experience mild or severe diarrhea, or in some instances no symptoms at all. Fever is rarely present. Occasionally, some will have chronic diarrhea over several weeks or months, with significant weight loss.

How soon do symptoms appear?

The symptoms may appear from three to 25 days after exposure but usually within 10 days.

For how long can an infected person carry Giardia?

The carrier stage generally lasts from a few weeks to a few months. Treatment with specific antibiotics may shorten the carrier stage.

Where are the Giardia parasites found?

Giardia has been found in infected people (with or without symptoms) and wild and domestic animals. The beaver has gained attention as a potential source of Giardia contamination of lakes, reservoirs and streams, but human fecal wastes are probably as important.

What is the treatment for giardiasis?

Antibiotics such as albenzazole, metronidazole or furizolidone are often prescribed by doctors to treat giardiasis. However, some individuals may recover on their own without medication.


http://www.health.state.ny.us/diseases/communicable/giardiasis/fact_sheet.htm

Blue-Green Algae

What are blue-green algae?

Blue-green algae, technically known as cyanobacteria, are microscopic organisms that are naturally present in lakes and streams. They usually are present in low numbers. Blue-green algae can become very abundant in warm, shallow, undisturbed surface water that receives a lot of sunlight. When this occurs, they can form blooms that discolor the water or produce floating rafts or scums on the surface of the water.

What are the potential health effects from drinking or coming in contact with water containing blue-green algae?

Some blue-green algae produce toxins that could pose a health risk to people and animals when they are exposed to them in large enough quantities. Health effects could occur when surface scums or water containing high levels of blue-green algal toxins are swallowed, through contact with the skin or when airborne droplets containing toxins are inhaled while swimming, bathing or showering.
Consuming water containing high levels of blue-green algal toxins has been associated with effects on the liver and on the nervous system in laboratory animals, pets, livestock and people. Livestock and pet deaths have occurred when animals consumed very large amounts of accumulated algal scum from along shorelines.
Direct contact or breathing airborne droplets containing high levels of blue-green algal toxins during swimming or showering can cause irritation of the skin, eyes, nose and throat and inflammation in the respiratory tract.
Recreational contact, such as swimming, and household contact, such as bathing or showering, with water not visibly affected by a bluegreen algae bloom is not expected to cause health effects. However, some individuals could be especially sensitive to even low levels of algal toxins and might experience mild symptoms such as skin, eye or throat irritation or allergic reactions.
There is less information available about the potential health effects of long-term exposure to low levels of blue-green algal toxins. Some limited evidence from human studies suggests that long-term consumption of untreated surface waters containing high levels of bluegreen algal toxins could be associated with an increased risk of liver cancer. However, people in these studies also were exposed to other factors associated with liver cancer. As a result, it is unknown whether algal toxin exposure contributed to this risk.
Long-term, continuous exposure to algal toxins in the Northeast is unlikely, because blue-green algal blooms are likely to occur only during the hottest part of the summer. New York State public water supplies that use surface water sources also have operational controls to minimize the introduction of blue-green algae in drinking water.


http://www.health.state.ny.us/environmental/water/drinking/bluegreenalgae.htm

Blood and Tissue Resources

The Blood and Tissue Resources Program is responsible for oversight of blood banks and tissue banks operating in New York State. This vital public health responsibility extends to protecting the health and safety of both donors and recipients. Regulations have been developed and implemented to ensure the safe and ethical collection, processing, storage, and distribution of donated blood and tissue for clinical use, as well as the recovery of bodies, body parts, organs, and tissues for use in medical research and education
BLOOD RESOURCES
More than 400 facilities are approved by the department to provide blood services. One and a quarter million blood components are prepared annually. Approximately 90% of the blood is collected at blood centers, with the remainder collected by approximately 42 hospitals and a small number of independent facilities. Oversight is provided through the Blood and Tissue Resources Program support of the New York State Council on Human Blood and Transfusion Services, established in 1973 by Public Health Law (Article 31). The Council enacts and amends regulations affecting the safety of the blood supply in New York State, subject to approval by the Commissioner of Health. These regulations include Blood Banks (Subpart 58-2) and Hematopoietic Progenitor Cell Banks (Subpart 58-5). (hematopoietic progenitor cells are precursors of blood cells found in peripheral blood, umbilical cord blood and bone marrow.) The Council also develops guidelines for the processing and clinical use of blood and blood components, and hematopoietic progenitor cells.
Approval by the Blood and Tissue Resources Program or by the Clinical Laboratory Evaluation Program is required for facilities that perform blood banking activities or offer any blood services in New York State, from collection through clinical use. Through collegial education, inspection, and enforcement of regulations, blood banks are assisted in adhering to acceptable standards of practice and complying with regulations. Hematopoietic progenitor cell banks must be licensed as tissue banks, as described below.
Informational materials on blood services, including guidelines and recommendations, are developed and made available to the public and to regulated parties as appropriate. The Program monitors errors and accidents involving blood for transfusion (more than 50 transfusion-related incidents are reported each year that have significant potential to harm either the donor or the recipient). Guidelines have been developed through review of these incidents, including recommendations for reducing fatalities related to blood recovery during and after surgical procedures and for alerting physicians caring for transfusion recipients of possible transfusion-transmitted infections.


http://www.wadsworth.org/labcert/blood_tissue/

Babesiosis

What is babesiosis?

Babesiosis is a rare, severe and sometimes fatal tick-borne disease caused by various types of Babesia, a microscopic parasite that infects red blood cells. In New York state, the causative parasite is Babesia microti.

Who gets babesiosis?

Babesiosis is seen most frequently in the elderly or in immunocompromised individuals. Cases of this disease have been primarily reported during spring, summer and fall in coastal areas in the northeastern United States, especially Nantucket Island off the coast of Massachusetts and on Long Island in New York. Cases have also been reported in Wisconsin, California, Georgia, Missouri and some European countries. Babesiosis can be more severe in people who have had their spleen removed.

How is babesiosis transmitted?

Babesiosis is transmitted by the bite of an infected deer tick, Ixodes scapularis. Transmission can also occur via transfusion of contaminated blood.

What are the symptoms of babesiosis?

The disease can cause fever, fatigue and hemolytic anemia lasting from several days to several months. Infections can occur without producing symptoms.

When do symptoms appear?

It may take from one to eight weeks, sometimes longer, for symptoms to appear.

Does past infection with babesiosis make a person immune?

It is not known whether past infection with babesiosis can make a person immune.

What is the treatment for babesiosis?

While many people do not become sick enough with babesiosis to require treatment, there are effective therapies, usually either a combination of quinine and clindamycin or a combination of atovaquone and azithromycin. It is possible to become infected with babesiosis and Lyme disease at the same time, so be sure to seek medical attention if you become ill after a tick bite.

What can be done to prevent babesiosis?

When in tick-infested habitat - wooded and grassy areas - take special precautions to prevent tick bites, such as wearing light-colored clothing (for easy tick discovery) and tucking pants into socks and shirt into pants. Check after every two to three hours of outdoor activity for ticks on clothing or skin. Brush off any ticks on clothing before skin attachment occurs. A thorough check of body surfaces for attached ticks should be done at the end of the day. If removal of attached ticks occurs within 36 hours, the risk of tick-borne infection is minimal.
Repellents can be effective at reducing bites from ticks that can transmit disease. But their use is not without risk of health effects, especially if repellents are applied in large amounts or improperly. Repellents commonly available to consumers contain the active ingredients DEET (N, N-diethyl-m-toluamide), picaridin (also known as KBR 3023), oil of lemon eucalyptus, permethrin, or botanical oils. DEET products have been widely used for many years, but have occasionally been associated with health effects. Skin reactions (particularly at DEET concentrations of 50 percent and above) and eye irritation are the most frequently reported health problems. Picaridin and oil of lemon eucalyptus have been shown to offer long-lasting protection against mosquitoes but there are limited data regarding their ability to repel ticks. Products containing permethrin are for use on clothing only, not on skin. Rather than acting as a repellent, permethrin kills ticks and insects that come in contact with treated clothes. Permethrin can cause eye irritation. Insect repellents containing botanical oils, such as oil of geranium, cedar, lemongrass, soy or citronella are also available, but there is limited information on their effectiveness and toxicity. If you decide to use a repellent, use only what and how much you need for your situation. In addition:

• Be sure to follow label directions.
• Use repellents only in small amounts, avoiding unnecessary repeat application. Try to reduce the use of repellents by dressing in long sleeves and pants tucked into socks or boots.
• Children may be at greater risk for reactions to repellents, in part, because their exposure may be greater. Do not apply repellents directly to children. Apply to your own hands and then put it on the child.
• Do not apply near eyes, nose or mouth and use sparingly around ears. Do not apply to the hands of small children.
• After returning indoors, wash treated skin with soap and water.

How should a tick be removed?

Grasp the mouthparts with tweezers as close as possible to the attachment (skin) site. Be careful not to squeeze, crush or puncture the body of the tick, which may contain infectious fluids. After removing the tick, thoroughly disinfect the bite site and wash hands. See or call a doctor if there are concerns about incomplete tick removal. Do not attempt to remove ticks by using petroleum jelly, lit cigarettes or other home remedies because these may actually increase the chance of contracting a tick-borne disease.

How do I obtain information on a tick?

Tick identification services are available through the New York State Department of Health and some local health departments. The New York State Department of Health Tick Identification Service will tell you the species of the tick, whether it is engorged with blood and, if so, how long it may have been feeding. The Tick Identification Service will also report whether the mouthparts are present (if not, they may have remained in the skin and need to be removed, as you would a splinter). The Tick Identification Service will not tell you whether the tick is infected with disease-causing organisms. There is no charge for this service.
If you wish to have a tick identified, place it in a small jar containing rubbing alcohol, seal the container to prevent leakage and complete the Tick Identification Submittal Form . Mail the tick in the sealed container, along with the completed submittal form, to the New York State Health Department's Tick Identification Service, c/o HVCC Central Receiving, 80 Vandenburgh Avenue, Troy, NY 12180. Once you send a tick to be identified it will not be returned.


http://www.health.state.ny.us/diseases/communicable/babesiosis/fact_sheet.htm

Mycoplasma Infection (walking pneumonia, atypical pneumonia)

What is mycoplasma infection?

Mycoplasma infection is respiratory illness caused by Mycoplasma pneumoniae, a microscopic organism related to bacteria.

Who gets mycoplasma infection?

Anyone can get the disease, but it most often affects older children and young adults.

When do mycoplasma infections occur?

Mycoplasma infections occur sporadically throughout the year. Widespread community outbreaks may occur at intervals of four to eight years. Mycoplasma infection is most common in late summer and fall.

How is mycoplasma spread?

Mycoplasma is spread through contact with droplets from the nose and throat of infected people especially when they cough and sneeze. Transmission is thought to require prolonged close contact with an infected person. Spread in families, schools and institutions occurs slowly. The contagious period is probably fewer than 10 days and occasionally longer.

What are the symptoms of mycoplasma infection?

Typical symptoms include fever, cough, bronchitis, sore throat, headache and tiredness. A common result of mycoplasma infection is pneumonia (sometimes called "walking pneumonia" because it is usually mild and rarely requires hospitalization). Infections of the middle ear (otitis media) also can result. Symptoms may persist for a few days to more than a month.

How soon after exposure do symptoms appear?

Symptoms generally begin 15 to 25 days after exposure. The symptoms generally develop slowly, over a period of two to four days.

How is mycoplasma infection diagnosed?

Mycoplasma infection is usually diagnosed on the basis of typical symptoms. A nonspecific blood test (cold agglutinins) is helpful in definitive diagnosis, but is not always positive. The use of more specific laboratory tests is often limited to special outbreak investigations.

Does past infection with mycoplasma make a person immune?

Immunity after mycoplasma infection does occur, but is not lifelong. Second infections are known to occur, although they may be milder. The duration of immunity is unknown.

What is the treatment for mycoplasma infection?

Antibiotics such as erythromycin, clarithromycin or azithromycin are effective treatment. However, because mycoplasma infection usually resolves on its own, antibiotic treatment of mild symptoms is not always necessary.

What can be done to prevent the spread of mycoplasma?

At this time, there are no vaccines for the prevention of mycoplasma infection and there are no reliably effective measures for control. As with any respiratory disease, all people should cover their face when coughing or sneezing.



http://www.health.state.ny.us/diseases/communicable/mycoplasma/fact_sheet.htm

Arboviral Infections (arthropod-borne encephalitis, eastern equine encephalitis, St. Louis encephalitis, California encephalitis, Powassan encephalitis, West Nile encephalitis)

What are arboviral infections?

Arboviral (short for arthropod-borne) infections are caused by any number of viruses transmitted by arthropods such as mosquitoes and ticks. These infections generally occur during warm weather months, when mosquitoes and ticks are active.

Who gets arboviral infections?

Anyone can get an arboviral infection but the elderly appear to be most susceptible. Young children may experience more severe illness with eastern equine encephalitis and certain types of California encephalitis.

How are arboviral infections transmitted?

Most arboviral infections are spread by infected mosquitoes. Fortunately, only a few types of mosquitoes are capable of transmitting disease and only a small number of the mosquitoes will actually be carrying a virus at any one time. Occasionally, migrating birds have the ability to carry viruses from one area of the country to another; humans, however, cannot become infected by birds, only mosquitoes. Some arboviral infections, such as Powassan encephalitis, may be transmitted by infected ticks.

What are the symptoms of arboviral infections?

Symptoms of the various types of viral infections transmitted by mosquitoes and ticks are usually similar, except for their severity. Most infections do not result in any symptoms. Mild cases may occur with only a slight fever and/or headache and bodyaches and resolve with no complications. Severe infections are marked by a rapid onset, headache, high fever, disorientation, tremors, convulsions, paralysis, coma or death.

When do symptoms appear?

Symptoms usually occur three to 15 days after a bite from an infected mosquito or tick.

Does past infection with an arbovirus make a person immune?

Infection with an arbovirus may provide immunity to that specific virus and perhaps to related viruses.

What is the treatment for an infection due to an arbovirus?

Health care providers will usually attempt to relieve the symptoms of the illness, but there is no specific treatment available for arboviral infections.

How can arboviral infections be prevented?

To minimize exposed skin, insect repellents containing DEET can be used by persons spending time outdoors in mosquito- or tick-infested areas. Be sure to follow label directions carefully. Consider wearing long sleeves and tucking pants into socks and shirt into pants when in tick habitat or outdoors at dusk or dawn, the time of day when mosquitoes are most active. Wear light-colored clothes to spot ticks easily.
To reduce the mosquito population around your home and property, reduce or eliminate all standing water:

• Dispose of tin cans, plastic containers, ceramic pots or similar water-holding containers.
• Remove and recycle all discarded tires on your property. Used tires are a significant mosquito-breeding site.
• Drill holes in the bottoms of recycling containers that are kept outdoors.
• Make sure roof gutters drain properly and clean clogged gutters in the spring and fall.
• Remove leaf debris from yards and gardens.
• Turn over wading pools and wheelbarrows when not in use.
• Change the water in birdbaths twice weekly.
• Clean vegetation and debris from edges of ponds.
• Clean and chlorinate swimming pools, outdoor saunas and hot tubs.
• Drain water from pool covers.
• Use landscaping to eliminate standing water that collects on your property.
• Make sure window and door screens fit properly and are in good condition.

http://www.health.state.ny.us/diseases/communicable/arboviral/fact_sheet.htm

Anthrax (malignant edema, woolsorters' disease)

What is anthrax?

Anthrax is a rare infectious disease caused by the bacterium Bacillus anthracis. Anthrax occurs naturally around the world in wild and domestic hoofed animals, especially cattle, sheep, goats, camels and antelopes. It can also occur in humans when they are exposed to the bacterium, usually through handling animals or animal hides. There are three forms of anthrax infection: cutaneous (skin), inhalation (lungs) and gastrointestinal (stomach and intestine). If people have been intentionally exposed, as in a bioterrorist release, contact with skin would be the most likely route of exposure. Breathing in the spores that have been spread through the air could cause inhalation anthrax.

How common is anthrax and who can get it?

Anthrax can be found around the world. It is most common in agricultural regions where it occurs in animals. It is more common in developing countries or countries without veterinary public health programs. Anthrax is reported more often in some regions of the world (South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean and the Middle East) than in others. It has been extremely rare in the United States in recent decades, and until cases in Florida and New York City in 2001, has been limited to the cutaneous (skin) form. When anthrax affects humans, it is usually due to an occupational exposure to infected animals or their products. However, anthrax is considered to be one of a number of potential agents for use in biological terrorism.

How is anthrax spread?

Anthrax is usually spread in the form of a spore. (A spore is a dormant form that certain bacteria take when they have no food supply. Spores can grow and cause disease when better conditions are present, as in the human body.) Anthrax is generally spread in one of three ways. Most persons who are exposed to anthrax become ill within one week:

• Skin (cutaneous) - Most anthrax infections occur when people touch contaminated animal products like wool, bone, hair and hide. The infection occurs when the bacteria enters a cut or scratch in the skin.
• Inhalation (lung) - Some anthrax infections occur when people breathe in the spores of the bacteria. However, the infectious dose for inhalational anthrax is quite high, and requires exposure to a large number of spores (8,000-10,000).
• Gastrointestinal - Some people may get anthrax by eating infected meat that has not been properly cooked.

What are the symptoms of anthrax?

• Skin (cutaneous) - This is the most common form of anthrax. Infection requires a break in the skin. The first symptoms include itching where the skin has been exposed. Then, a large boil or sore appears. The sore becomes covered by a black scab. If not treated, the infection can spread to the lymph nodes and bloodstream.
• Inhalation - Inhalation anthrax has been very rare in the U.S. First symptoms include fever, fatigue, malaise and a cough or chest pain. High fever, rapid pulse and severe difficulty breathing follow in two to five days. Inhalation anthrax is often fatal.
• Gastrointestinal - This form occurs only after eating infected, undercooked meat. First symptoms include fever; abdominal pain; loose, watery bowel movements; and vomiting with blood.

How soon after exposure do symptoms develop?

Symptoms usually develop between one and seven days after exposure but prolonged periods up to 12 days for cutaneous (skin) anthrax and 60 days for inhalation anthrax are possible, though rare.

Can anthrax be spread person to person?

Inhalation (lung) anthrax is not spread from person to person. Even if you develop symptoms of inhalation anthrax, you are not contagious to other persons. If you develop cutaneous (skin) anthrax, the drainage from an open sore presents a low risk of infection to others. The only way cutaneous (skin) anthrax can be transmitted is by direct contact with the drainage from an open sore. Anthrax is not spread from person to person by casual contact, sharing office space or by coughing and sneezing.

How is it diagnosed?

Anthrax is diagnosed when the Bacillus anthracis bacterium is found in the blood, skin lesions or respiratory secretions by a laboratory culture. It can also be diagnosed by measuring specific antibodies in the blood of infected persons. Nasal swabs are not a good way to diagnose anthrax because a swab cannot definitively determine if someone has not been exposed to anthrax.

What is the treatment for illness caused by anthrax?

There are several antibiotics that are used successfully to treat anthrax. Treatment is highly effective in cases of cutaneous (skin) anthrax and is effective in inhalation and gastrointestinal anthrax if begun early in the course of infection. The United States has a large supply of these antibiotics and can quickly manufacture more if needed.

Is there a way to prevent infection?

Persons known to be exposed to confirmed anthrax spores will be given antibiotics, usually ciprofloxacin (cipro) or doxycycline, to prevent infection.

Do I need to disinfect myself or my belongings if I believe I was exposed to anthrax?

Most threats regarding anthrax have proven to be hoaxes. However, in the event of a possible exposure to a powder or other unknown substance with a threat that may indicate anthrax, call 911 and leave the material alone. To prevent infection if you have a skin exposure to the powder or other substance, wash your hands vigorously with soap and water, and shower with soap and water if necessary. Similarly, washing possibly contaminated clothes in the regular laundry will safely remove any possible anthrax. To be inhaled, anthrax spores must first be aerosolized (dispersed in the air) which does not usually occur. In the unlikely event that you do inhale spores, medical evaluation and treatment is needed, usually after spores are identified.



http://www.health.state.ny.us/diseases/communicable/anthrax/fact_sheet.htm

Asthma Information

Asthma is a chronic disease of the lungs. In New York State (NYS), more than 1.1 million adults have asthma ¹. Asthma occurs at any age but is more common in children than adults. Nationally, nearly one in 13 school-age children have asthma, and that rate is rising more rapidly in preschool-aged children and those living in urban inner cities than in any other group. Although there is no cure for asthma, asthma attacks can be prevented and controlled with proper care. New York is actively working with health care providers, community coalitions, schools, families and many others to fight asthma so people with asthma can live a full and active life.
This web site is designed to provide accurate, current and useful information for people with asthma and for the people who care for them. New resources will be added often. Please check back frequently.



http://www.health.state.ny.us/diseases/asthma/

Ammonia Releases in New York State

This fact sheet¹ summarizes information on 107 ammonia spills investigated by the New York State Department of Health for the Hazardous Substances Emergency Events Surveillance (HSEES) project. This state-based project is funded by the Agency for Toxic Substances and Disease Registry to describe and evaluate the public health consequences of spills involving non-petroleum hazardous substances.

Table 1. Summary of Accidental Ammonia Releases

Number of Ammonia releases1	107
Fixed facility	101
Transportation	Road – 5 Rail – 1
Range of amounts released2	1-850 gals. 1-4,000 lbs.
Number of events with injury	21 (19%)
Number of injured persons and fatalities  Employees  Responders  General Public	61 27 9 25
Maximum number of persons injured in one event	13
Number of releases with hazmat response	49 (46%)
Number of events involving an evacuation	42 (39%)
Number of persons evacuated3	>1,889
Maximum number of persons evacuated in one event	500
Duration of all evacuations (person-hours)4	>8,452
1Two threatened and 105 actual ammonia releases. 2A release may be reported in pounds or in gallons, not both. For spills reported in gallons, the median was 18 gallons and the average was 128 gallons. For spills reported in pounds, the median was 202 pounds and the average was 530 pounds. 3This number is a minimum count. For some events, no data were recorded because the evacuation time or the number of evacuated persons were unknown and could not be estimated from available information. 4Person-hours is calculated by multiplying the number of persons evacuated by the length of the evacuation for each event, and summing the results for all events.http://www.health.state.ny.us/environmental/chemicals/hsees/ammonia.htm

Avian Influenza (Bird Flu)

Avian influenza (AI) or bird flu is a group of viruses that occur naturally in birds. A virus is pathogenic if it can cause illness or death. Some AI viruses can infect birds but not cause many bird illnesses or death. Other AI viruses, termed highly pathogenic avian influenza (HPAI), can cause large numbers of bird illnesses and deaths. Currently there is concern about one of these viruses, known as highly pathogenic H5N1, because it is causing severe disease in chickens and other poultry on several continents. It has also been found in wild birds in the same areas. In some instances, people who have had close contact with sick poultry have also become infected and gotten very sick. Approximately half of the people known to be infected have died.
Although officials are watching closely, this severe form of bird flu has not been found in the United States. It is important to remember that right now almost everyone who got sick with avian flu had close contact with infected poultry.
Both human and avian influenza viruses are constantly changing. There is concern that highly pathogenic H5N1 could change into a form easily spread from birds to humans and then from human to human.
If this were to happen, what is known as an influenza pandemic could occur.


http://www.health.state.ny.us/diseases/communicable/influenza/avian/

Amebiasis (amebic dysentery)

What is amebiasis?

Amebiasis is an intestinal illness caused by a microscopic parasite called Entamoeba histolytica. Approximately 1,000 cases are reported each year in New York State.

Who gets amebiasis?

Anyone can get amebiasis, but it is recognized more often in people arriving from tropical or subtropical areas, individuals living in institutions, and men who have sex with men.

How is amebiasis spread?

Amebiasis is contracted by consuming contaminated food or water containing the cyst stage of the parasite. It can also be spread by person-to-person contact.

What are the symptoms of amebiasis?

People exposed to this parasite may experience mild or severe symptoms or no symptoms at all. Fortunately, most exposed people do not become seriously ill. The mild form of amebiasis includes nausea, loose stools, weight loss, abdominal tenderness and occasional fever. Rarely, the parasite will invade the body beyond the intestines and cause a more serious infection, such as a liver abscess.

How soon after exposure do symptoms appear?

The symptoms may appear from a few days to a few months after exposure but usually within two to four weeks.

For how long can an infected person carry this parasite?

Some people with amebiasis may carry the parasite for weeks to years, often without symptoms.

Where are the parasites that cause amebiasis found?

The parasite lives only in humans. Fecal material from infected people may contaminate water or food, which may spread the parasites to anyone who consumes them.

How is it diagnosed?

Examination of stools under a microscope is the most common way for a doctor to diagnose amebiasis. Sometimes, several stool samples must be obtained because the number of amoeba being passed in the stool, which varies from day to day, may be too low to detect from any single sample.

What is the treatment for amebiasis?

Specific antibiotics such as metronidazole can be prescribed by a doctor to treat amebiasis.

Should an infected person be excluded from work or school?

Although people with diarrhea due to amebiasis should not attend school or go to work, it is not necessary to exclude infected persons when they feel better and stools are normal. Casual contact at work or school is unlikely to transmit the disease. Special precautions may be needed by foodhandlers or children enrolled in daycare settings. Consult your local health department for advice in such instances.

What precautions should the infected person follow?

The most important precautions are careful handwashing after each toilet visit and proper disposal of sewage. Homosexual males should refrain from intimate contact until effectively treated.


http://www.health.state.ny.us/diseases/communicable/amebiasis/fact_sheet.htm

website clock

Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that causes acquired immunodeficiency syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections. Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. The four major routes of transmission are unsafe sex, contaminated needles, breast milk, and transmission from an infected mother to her baby at birth (Vertical transmission). Screening of blood products for HIV has largely eliminated transmission through blood transfusions or infected blood products in the developed world.

HIV infection in humans is now pandemic. From 1981 to 2006, AIDS killed more than 25 million people.^[1] HIV infects about 0.6% of the world's population.^[1] In 2005 alone, AIDS claimed an estimated 2.4–3.3 million lives, of which more than 570,000 were children. A third of these deaths are occurring in sub-Saharan Africa, retarding economic growth and increasing poverty.^[2] According to current estimates, HIV is set to infect 90 million people in Africa, resulting in a minimum estimate of 18 million orphans.^[3] Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but routine access to antiretroviral medication is not available in all countries.^[4]

HIV primarily infects vital cells in the human immune system such as helper T cells (specifically CD4⁺ T cells), macrophages, and dendritic cells. HIV infection leads to low levels of CD4⁺ T cells through three main mechanisms: firstly, direct viral killing of infected cells; secondly, increased rates of apoptosis in infected cells; and thirdly, killing of infected CD4⁺ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4⁺ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections.

Eventually most HIV-infected individuals develop AIDS. These individuals mostly die from opportunistic infections or malignancies associated with the progressive failure of the immune system.^[5] Without treatment, about 9 out of every 10 persons with HIV will progress to AIDS after 10–15 years. Many progress much sooner.^[6] Treatment with anti-retrovirals increases the life expectancy of people infected with HIV. Even after HIV has progressed to diagnosable AIDS, the average survival time with antiretroviral therapy (as of 2005) is estimated to be more than 5 years.^[7] Without antiretroviral therapy, death normally occurs within a year.



http://en.wikipedia.org/wiki/HIV

It is a common type of cell division that occurs in all the cells of an organism. Hence, it is commonly called as somatic cell division. In mitosis, the resulting daughter cells will have the same number of chromosomes and contain the same amount of DNA, as that of the parent cell. Hence, mitosis is commonly described as equational division.

Mitosis occurs in two stages namely karyokinesis, the division of nucleus and cytokinesis, the division of cytoplasm. Just prior to karyokinesis, the cell will be in interphase.

fig. 17.2 - Stages of Mitosis

Interphase

It is the preparing phase. It is of varying duration depending on the cell type function. It is the period in which the cell carries out synthesis of organelles and increases in size. The nucleoli are prominent and actively synthesising ribosomes. Just prior to division, the DNA undergoes replication. Each chromosome exists as a pair of chromatids joined together by a centromere.

Karyokinesis

It is the division of nuclear material, represented by a sequence of events in the cell. It can be distinguished into four phases namely prophase, metaphase, anaphase and telophase.

Prophase

It is the longest stage of the division cycle. It is characterised by significant changes.

• Chromatids shorten (to about 4% of their original length) and thicken by spiralisation and condensation of DNA

• Centrioles move to the opposite poles of the cell

• Short microtubules develop, radiating from the centrioles. These are called asters

• Nucleolus gradually decreases in size and disappears

• Nuclear membrane disintegrates

• Spindle fibres appear in the cytoplasm

Metaphase

In this phase, chromosomes move to the equator of the cell.

• Pairs of chromatids become attached to the spindle fibres at their centromeres

fig. 17.3 - Stages of Mitosis

Anaphase

It is a rapid stage.

• Each centromere splits into two

• Spindle fibres pull the daughter centromeres to the opposite poles

• The separated chromatids, now called chromosomes, are pulled along with centromeres to the opposite poles

Telophase

It is the last phase of Karyokinesis.

• Chromosomes reach the poles of the cell, uncoil and lengthen to form chromatin

• Spindle fibres disintegrate and centrioles replicate

• A nuclear membrane is formed around chromosomes in each pole

• Two daughter nuclei are formed

As telophase is in progress, cytokinesis begins in the cell.

Cytokinesis

It is the division of cytoplasm. It occurs in animal cells by the appearance of a furrow in the middle of the cell. The furrow deepens and divides the cell into two. Two daughter cells are formed.

fig. 17.4 - Differences between Mitosis in Plant and Animal cells

Significance of Mitosis

Mitosis becomes significant for the following reasons.

• Mitosis forms two daughter cells which will have the same chromosome number and same genetic material as the parent cell.

• Daughter cells formed from mitosis are genetically identical to their parent cell and no variation would be introduced during mitosis. This results in genetic stability within the populations of cells derived from parental cells, as in a clone.

• The number of cells within an organism increases by mitosis and this process is called hyperplasia. It forms the basis for growth.

If mitotic division goes uncontrolled in any part of the body, it results in the formation of malignant cells. These cells continue to divide resulting in the formation of malignant tumours. This condition is called cancer.

• Mitosis is the basis of asexual reproduction in both plants and animals. This becomes the basis for vegetative propagation.

Mitosis is also responsible for repair and regeneration of the injured and lost parts of the body

Health

At the time of the creation of the World Health Organization (WHO), in 1948, Health was defined as being "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity".^[1][2]

This definition invited nations to expand the conceptual framework of their health systems beyond issues related to the physical condition of individuals and their diseases, and it motivated us to focus our attention on what we now call social determinants of health. Consequently, WHO challenged political, academic, community, and professional organisations devoted to improving or preserving health to make the scope of their work explicit, including their rationale for allocating resources. This opened the door for public accountability [3].

Only a handful of publications have focused specifically on the definition of health and its evolution in the first 6 decades. Some of them highlight its lack of operational value and the problem created by use of the word "complete." Others declare the definition, which has not been modified since 1948, "simply a bad one." [4]. More recently, Smith suggested that it is "a ludicrous definition that would leave most of us unhealthy most of the time." [5].

In 1986, the WHO, in the Ottawa Charter for Health Promotion, said that health is "a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities." Classification systems such as the WHO Family of International Classifications (WHO-FIC), which is composed of the International Classification of Functioning, Disability, and Health (ICF) and the International Classification of Diseases (ICD) also define health.

Overall health is achieved through a combination of physical, mental, emotional, and social well-being, which, together is commonly referred to as the Health Triangle.

http://en.wikipedia.org/wiki/Health

lung cancer treatment

Treatment for lung cancer depends upon a variety of factors. The most important factors are the histopathologic (diseased tissue) type of lung cancer and the stage of the cancer.

Cancer

Cancer (medical term: malignant neoplasm) is a class of diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, and do not invade or metastasize. Most cancers form a tumor but some, like leukemia, do not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of cancer is oncology.

Cancer may affect people at all ages, even fetuses, but the risk for most varieties increases with age.^[1] Cancer causes about 13% of all human deaths.^[2] According to the American Cancer Society, 7.6 million people died from cancer in the world during 2007.^[3] Cancers can affect all animals.

Nearly all cancers are caused by abnormalities in the genetic material of the transformed cells.^[4] These abnormalities may be due to the effects of carcinogens, such as tobacco smoke, radiation, chemicals, or infectious agents. Other cancer-promoting genetic abnormalities may be randomly acquired through errors in DNA replication, or are inherited, and thus present in all cells from birth. The heritability of cancers are usually affected by complex interactions between carcinogens and the host's genome. New aspects of the genetics of cancer pathogenesis, such as DNA methylation, and microRNAs are increasingly recognized as important.

Genetic abnormalities found in cancer typically affect two general classes of genes. Cancer-promoting oncogenes are typically activated in cancer cells, giving those cells new properties, such as hyperactive growth and division, protection against programmed cell death, loss of respect for normal tissue boundaries, and the ability to become established in diverse tissue environments. Tumor suppressor genes are then inactivated in cancer cells, resulting in the loss of normal functions in those cells, such as accurate DNA replication, control over the cell cycle, orientation and adhesion within tissues, and interaction with protective cells of the immune system.

Diagnosis usually requires the histologic examination of a tissue biopsy specimen by a pathologist, although the initial indication of malignancy can be symptoms or radiographic imaging abnormalities. Most cancers can be treated and some cured, depending on the specific type, location, and stage. Once diagnosed, cancer is usually treated with a combination of surgery, chemotherapy and radiotherapy. As research develops, treatments are becoming more specific for different varieties of cancer. There has been significant progress in the development of targeted therapy drugs that act specifically on detectable molecular abnormalities in certain tumors, and which minimize damage to normal cells. The prognosis of cancer patients is most influenced by the type of cancer, as well as the stage, or extent of the disease. In addition, histologic grading and the presence of specific molecular markers can also be useful in establishing prognosis, as well as in determining individual treatments.

http://en.wikipedia.org/wiki/Cancer

what is tumour?

In some instances the cells of a tumour are normal in appearance; the differences between them and normal body cells can be discerned only with some difficulty. Such tumours are more often benign than not. Other tumours are composed of cells that appear different from normal adult types in size, shape, and structure; they usually belong to tumours that are malignant. Such cells may be bizarre in form or may be arranged in a distorted manner. In more extreme cases, the cells of malignant tumours are described as primitive, or undifferentiated, because they have lost the appearance and functions of the particular type of (normal) specialized cell that was their predecessor. As a rule, the less differentiated a malignant tumour’s cells are, the more quickly the tumour may be expected to grow.

Malignancy refers to the ability of a tumour ultimately to cause death. Any tumour, either benign or malignant in type, may produce death by local effects if it is appropriately situated. The common and more specific definition of malignancy implies an inherent tendency of the tumour’s cells to metastasize (invade the body widely and become disseminated by subtle means) and eventually to kill the patient unless all the malignant cells can be eradicated.

Metastasis is thus the outstanding characteristic of malignancy. Metastasis is the tendency of tumour cells to be carried from their site of origin by way of the circulatory system and other channels, which may eventually establish these cells in almost every tissue and organ of the body. In contrast, the cells of a benign tumour invariably remain in contact with each other in one solid mass centred on the site of origin. Because of the physical continuity of benign tumour cells, they may be removed completely by surgery if the location is suitable. But the dissemination of malignant cells, each one individually possessing (through cell division) the ability to give rise to new tumours in new and distant sites, requires complete eradication by a single surgical procedure in all but the earliest period of growth.

A mass of tumour cells usually constitutes a definite localized swelling that, if it occurs on or near the surface of the body, can be felt as a lump. Deeply placed tumours, however, may not be palpable. Some tumours, and particularly malignant ones, may appear as ulcers, hardened cracks or fissures, wartlike projections, or a diffuse, ill-defined infiltration of what appears to be an otherwise normal organ or tissue.

Pain is a variable symptom with tumours. It most commonly results from the growing tumour pressing on adjacent nerve tracts. In their early stages all tumours tend to be painless, and those that grow to a large size without interfering with local functions may remain painless. Eventually, however, most malignant tumours cause pain by the direct invasion of nerves or the destruction of bone.

All benign tumours tend to remain localized at the site of origin. Many benign tumours are enclosed by a capsule consisting of connective tissue derived from the structures immediately surrounding the tumour. Well-encapsulated tumours are not anchored to their surrounding tissues. These benign tumours enlarge by a gradual buildup, pushing aside the adjacent tissues without involving them intimately. Malignant tumours, by contrast, do not usually possess a capsule; they invade the surrounding tissues, making surgical removal more difficult or risky.

A benign tumour may undergo malignant transformation, but the cause of such change is unknown. It is also possible for a malignant tumour to remain quiescent, mimicking a benign one clinically, for a long time. The regression of a malignant tumour to benign is unknown.

http://www.britannica.com/EBchecked/topic/608802/tumour