CHOLERA

Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholera.

Cholera was prevalent in the U.S. in the 1800s, before modern water and sewage treatment systems eliminated its spread by contaminated water. Only about 10 cases of cholera are reported each year in the U.S. and half of these are acquired abroad. Rarely, contaminated seafood has caused cholera outbreaks in the U.S. However, cholera outbreaks are still a serious problem in other parts of the world. At least 150,000 cases are reported to the World Health Organization each year.

The disease is most common in places with poor sanitation, crowding, war, and famine. Common locations include parts of Africa, south Asia, and Latin America. If you are traveling to one of those areas, knowing the following cholera facts can help protect you and your family.

Cholera Causes

Vibrio cholera, the bacterium that causes cholera, is usually found in food or water contaminated by feces from a person with the infection. Common sources include:

• Municipal water supplies
• Ice made from municipal water
• Foods and drinks sold by street vendors
• Vegetables grown with water containing human wastes
• Raw or under cooked fish and seafood caught in waters polluted with sewage

When a person consumes the contaminated food or water, the bacteria release a toxin in the intestines that produces severe diarrhea.

It is not likely you will catch cholera just from casual contact with an infected person.

Cholera Symptoms

Symptoms of cholera can begin as soon as a few hours or as long as five days after infection. Often, symptoms are mild. But sometimes they are very serious. About one in 20 people infected have severe watery diarrhea accompanied by vomiting, which can quickly lead to dehydration. Although many infected people may have minimal or no symptoms, they can still contribute to spread of the infection.

Signs and symptoms of dehydration include:

• Rapid heart rate
• Loss of skin elasticity (the ability to return to original position quickly if pinched)
• Dry mucous membranes, including the inside of the mouth, throat, nose, and eyelids
• Low blood pressure
• Thirst
• Muscle cramps

If not treated, dehydration can lead to shock and death in a matter of hours.

Cholera Treatment and Prevention

Although there is a vaccine against cholera, the CDC and World Health Organization don't normally recommend it, because it may not protect up to half of the people who receive it and it lasts only a few months. However, you can protect yourself and your family by using only water that has been boiled, water that has been chemically disinfected, or bottled water. Be sure to use the bottled, boiled, or chemically disinfected water for the following purposes:

• Drinking
• Preparing food or drinks
• Making ice
• Brushing your teeth
• Washing your face and hands
• Washing dishes and utensils that you use to eat or prepare food
• Washing fruits and vegetables

To disinfect your own water, boil it for one minute (or 3 minutes at higher elevations) or filter it and use a commercial chemical disinfectant. You should also avoid raw foods, including the following:

• Unpeeled fruits and vegetables
• Unpasteurized milk and milk products
• Raw or under cooked meat or shellfish
• Fish caught in tropical reefs, which may be contaminated

If you develop severe, watery diarrhea and vomiting -- particularly after eating raw shellfish or traveling to a country where cholera is epidemic -- seek medical help immediately. Cholera is highly treatable, but because dehydration can happen quickly, it's important to get cholera treatment right away.

Hydration is the mainstay of treatment for cholera. Depending on how severe the diarrhea is, treatment will consist of oral or intravenous solutions to replace lost fluids. Antibiotics, which kill the bacteria, are not part of emergency treatment for mild cases. But they can reduce the duration of diarrhea by half and also reduce the excretion of the bacteria, thus helping to prevent the spread of the disease.

CANCER

Cancer is an umbrella term for a large group of diseases caused when abnormal cells divide rapidly, and spread to other tissue and organs. Cancer is one of the leading causes of death in the world.

Cancer Growth and Metastasis

In a healthy body, the trillions of cells it’s made of grow and divide, as the body needs them to function daily. Healthy cells have a specific life cycle, reproducing and dying off in a way that is determined by the type of cell. New cells take the place of old or damaged cells as they die. Cancer disrupts this process and leads to abnormal growth in cells. It’s caused by changes or mutations in DNA.

DNA exists in the individual genes of every cell. It has instructions that tell the cell what functions to perform and how to grow and divide. Mutations occur frequently in DNA, but usually cells correct these mistakes. When a mistake is not corrected, a cell can become cancerous.

Mutations can cause cells that should be replaced to survive instead of die, and new cells to form when they’re not needed. These extra cells can divide uncontrollably, causing growths called tumors to form. Tumors can cause a variety of health problems, depending on where they grow in the body.

But not all tumors are cancerous. Benign tumors are noncancerous and do not spread to nearby tissues. Sometimes, they can grow large and cause problems when they press against neighboring organs and tissue. Malignant tumors are cancerous and can invade other parts of the body.

Some cancer cells can also migrate through the bloodstream or lymphatic system to distant areas of the body. This process is called metastasis. Cancers that have metastasized are considered more advanced than those that have not. Metastatic cancers tend to be harder to treat and more fatal.

TYPES OF CANCER.

Cancers are named for the area in which they begin and the type of cell they are made of, even if they spread to other parts of the body. For example, a cancer that begins in the lungs and spreads to the liver is still called lung cancer. There are also several clinical terms used for certain general types of cancer:

1. Carcinoma is a cancer that starts in the skin or the tissues that line other organs.

2. Sarcoma is a cancer of connective tissues such as bones, muscles, cartilage, and blood vessels.

3. Leukemia is a cancer of bone marrow, which creates blood cells.

4. Lymphoma and myeloma are cancers of the immune system.

RISK FACTORS AND TREATMENT

The direct cause of cancer is changes (or mutations) to the DNA in your cells. Genetic mutations can be inherited. They can also occur after birth as a result of environmental forces. Some of these forces include:

1. Exposure to cancer-causing chemicals, called carcinogens

2. Exposure to radiation

3. Unprotected exposure to the sun

4. Certain viruses, such as human papilloma virus (HPV)

5. Smoking

6. Lifestyle choices, such as type of diet and level of physical activity.

Cancer risk tends to increase with age. Some existing health conditions that cause inflammation may also increase your risk of cancer. An example is ulcerative colitis, a chronic inflammatory bowel disease.

Knowing the factors that contribute to cancer can help you live a lifestyle that decreases your cancer risks. According to experts, these are the seven best ways to prevent cancer:

1. Stop using tobacco and avoid secondhand smoke.

2. Eat a healthy, balanced diet.

- Limit your intake of processed meats.

- Consider adopting a “Mediterranean diet” that focuses mainly on plant-based foods, lean proteins, and healthy fats.

- Avoid alcohol, or drink in moderation. Moderate drinking is defined as one drink a day for women of all ages and men older than 65, and up to two drinks a day for men 65 years of age and younger.

3. Keep a healthy weight and stay active by getting at least 30 minutes of physical activity every day.

4. Stay protected from the sun.

- Cover up with clothing, sunglasses, and a hat, and apply sunscreen frequently.

- Avoid the sun between 10 a.m. and 4 p.m. This is when the sun’s rays are at their strongest.

- Stay in the shade as much as possible when you’re outside.

- Avoid tanning beds and sunlight, which can damage your skin just as much as the sun.

5. Get vaccinated against viral infections that can lead to cancer, such as hepatitis B and HPV.

6. Don’t engage in risky behaviors. Practice safe sex and don’t share needles when using drugs or prescription medications. Only get tattoos at licensed parlors.

7. See your doctor regularly so they can screen you for various types of cancer. This increases your chances of catching any possible cancers as early as possible.

Cancer treatment has different objectives, depending on the type of cancer and how advanced it is. These objectives include:

- Finding a cure: This is not possible for all cancers and situations.

- Providing primary treatment: Killing the cancer cells in your body.

- Providing adjuvant treatment: Killing cancer cells that remain after primary treatment to reduce your risk of the cancer coming back.

- Providing palliative treatment: Relieving health symptoms associated with cancer, such as trouble breathing and pain.

The most common types of treatment are:

Surgery

Surgically removes as much of the cancer as possible.

Chemotherapy

Uses medications that are toxic to cells to kill rapidly-dividing cancer cells.

Radiation Therapy

Uses powerful, focused beams of radiation inside (brachytherapy) or outside (external beam radiation) your body to kill cancer cells.

Stem Cell (Bone Marrow) Transplant

Repairs diseased bone marrow with healthy stem cells. Stem cells are undifferentiated cells that can have a variety of functions. These transplants allow doctors to use higher doses of chemotherapy to treat the cancer.

Immunotherapy (Biological Therapy)

Uses antibodies to help your body’s immune system recognize cancer so it can fight it off.

Hormone Therapy

Removes or blocks hormones that fuel certain cancers to stop cancer cells from growing.

Targeted Drug Therapy

Uses drugs to interfere with certain molecules that help cancer cells grow and survive.

Clinical Trials

Investigates new ways to treat cancer.

Alternative Medicine

Used to decrease symptoms of cancer and side effects of cancer treatment, such as nausea, fatigue, and pain. Alternative medicine includes:

- acupuncture

- hypnosis

- massage

- yoga

- meditation

- relaxation techniques

ASTHMA

Asthma is an inflammatory disease of the lungs. It makes breathing difficult and brings on attacks of coughing, wheezing, tightness in the chest and shortness of breath. According to the Centers for Disease Control and Prevention (CDC), approximately 25 million Americans suffer from asthma. It’s the most common chronic condition among American children. About one in every 10 children has asthma.

To understand asthma, you need to understand a little about what happens when you breathe. Normally, with every breath you take, air goes through your nose and down into your throat, eventually making it to your lungs. There are lots of small air passages in your lungs that help deliver oxygen from the air into your bloodstream. Asthma symptoms occur when the lining of these air passages swell and the muscles around them tighten. Mucus then fills the airways, further reducing the amount of air that can pass through. These conditions then bring on an asthma “attack” — the coughing and tightness typical of asthma.

TYPES OF ASTHMA

Asthma is sometimes referred to as bronchial asthma since it affects the bronchi in the lungs. A distinction is made between childhood asthma and adult-onset asthma, when symptoms don’t appear until at least age 20. Other types of asthma are described below.

Allergic Asthma (Extrinsic Asthma)

Allergic asthma is triggered by allergens like:

- pet dander

- food preservatives

- mold

- pollen

Allergic asthma is more likely to be seasonal because it often goes hand-in-hand with season allergies.

Non-Allergic Asthma (Intrinsic Asthma)

Irritants in the air not related to allergies trigger this type of asthma. This includes:

- burning wood and cigarette smoke

- air pollution

- air fresheners

- household cleaning products

- perfumes

Cough-Variant Asthma (CVA)

Cough-variant asthma doesn’t have classic asthma symptoms of wheezing and shortness of breath. CVA is characterized by a persistent, dry cough. Cough-variant asthma can lead to full-blown asthma that includes the other more common symptoms.

Exercise-Induced Asthma (EIA)

Exercise-induced asthma affects people during or after physical activity. EIA can occur in people who are not sensitive to other asthma triggers such as dust, pollen, and pet dander.

Nocturnal Asthma

This type of asthma is characterized by asthma symptoms that worsen at night. Triggers such as heartburn, pet dander, and dust mites can cause bring on symptoms while sleeping.

Occupational Asthma

Occupational asthma is a type of asthma induced by triggers in the workplace. These include:

- dust

- dyes

- gases

- fumes

- animal proteins

- rubber latex

These irritants can exist in a wide range of industries including farming, textiles, woodworking, and many manufacturing companies.

Long-Term Outlook

Unfortunately, there is no cure for asthma. On the other hand, there are many effective treatments that can control asthma symptoms. Lifestyle changes and medications can provide the help that an asthma sufferer needs to live a healthy, symptom-free life. The key is to become educated. The more you know about your type of asthma, what triggers your symptoms, and what works for you, the better your quality of life will be.

DIABETES

 Diabetes is a common group of chronic metabolic diseases that cause high blood sugar (glucose) levels in the body due to defects in insulin production and/or function. Insulin is a hormone released by the pancreas when we eat food. Insulin allows sugar to go from the blood into the cells. If the cells of the body are not using insulin well, or if the body is unable to make any or enough insulin, sugar builds up in the blood.

Symptoms include excessive thirst, hunger, and urination; fatigue; slow-healing sores or cuts; and blurry vision.

If diabetes develops quickly, as happens with type 1 diabetes, people may also experience quick weight loss. If diabetes develops slowly, as in type 2 diabetes, people may not be diagnosed until symptoms of longer-term problems appear, such as a heart attack or pain, numbness, and tingling in the feet.

Long-term complications of diabetes can include kidney failure, nerve damage, and blindness.

TYPES OF DIABETES

Diabetes is categorized into categories:

Type 1 Diabetes

This type of diabetes is categorized as an autoimmune disease and occurs when the body’s misdirected immune system attacks and destroys insulin-producing beta cells in the pancreas. Although genetic or environmental triggers are suspected, the exact cause of type 1 diabetes is not completely understood. 

Type 1 accounts for only five to 10 percent of diabetes cases in the United States, and while it can occur at any age, most patients are diagnosed as children or young adults. People with type 1 diabetes must take insulin daily to manage their condition.

Type 2 Diabetes

This type of diabetes most often develops gradually with age and is characterized by insulin resistance in the body. For reasons not yet totally understood, the cells of the body stop being able to use insulin effectively. Because of this resistance, the body’s fat, liver, and muscle cells are unable to take in and store glucose, which is used for energy. The glucose remains in the blood. The abnormal buildup of glucose (blood sugar), called hyperglycemia, impairs body functions. Type 2 diabetes occurs most often in people who are overweight and sedentary, two things thought to lead to insulin resistance. Family history and genetics play a major role in type 2 diabetes.

Gestational Diabetes

Gestational diabetes is defined as blood-sugar elevation during pregnancy; it is known to affect about three to eight percent of women. Left undiagnosed or untreated, it can lead to problems such as high birth weight and breathing problems for the baby. All pregnant women are tested for gestational diabetes at between 24 and 28 weeks of pregnancy, as this is when this problem usually develops. Gestational diabetes usually resolves in the mother after the baby is born, but statistics show that women who have gestational diabetes have a much greater chance of developing type 2 diabetes within five to 10 years.

Prediabetes

Although prediabetes is not technically diabetes, some experts now consider it to be the first step to type 2 diabetes. This condition is marked by blood sugar levels that are too high to be considered normal but are not yet high enough to be in the range of a typical diabetes diagnosis. Prediabetes increases not only your risk of developing diabetes but also your risk of heart disease and stroke.

STROKE

According to the Centers for Disease Control and Prevention (CDC), stroke is the fourth-leading cause of death in the United States. Brain tissue loses oxygen and food when a blood vessel in the brain ruptures and bleeds or if the blood supply to the brain is blocked. Brain cells and tissue begin to die within minutes, which causes a stroke.

What Are Symptoms of Stroke?

Stroke symptoms happen in body parts that the brain controls. Symptoms include:

- paralysis

- numbness or weakness in the arms, face, or leg, especially on -- one side of the body

- difficulty speaking or understanding speech

- confusion

- slurring speech

- trouble seeing in one or both eyes, with vision blackened or - blurred or double vision

- trouble walking

- loss of balance or coordination

- dizziness

- severe, sudden headache with an unknown cause

Fast treatment is key to preventing brain damage, long-term disability, and death from a stroke.

Causes and Types of Strokes

A stroke caused by a blocked artery is called an ischemic stroke. A stroke caused by a burst or leaking blood vessel is known as a hemorrhagic stroke. Another type of stroke is a transient ischemic attack (TIA or mini-stroke).

According to the CDC, most strokes are ischemic strokes. In this type of stroke, the arteries supplying blood to the brain narrow or get blocked. These blockages are often caused by blood clots or blood flow that’s severely reduced. The two most common types of ischemic strokes are thrombotic and embolic. A thrombotic stroke happens when a blood clot forms in one of the arteries supplying blood to the brain. Embolic stroke is when a blood clot or other debris forms in another part of the body — often the heart — and goes through the blood and gets stuck in brain arteries, also causing a blood clot.

A hemorrhagic stroke happens when an artery in the brain suddenly breaks open or leaks blood. That leaking blood puts excess pressure in the skull and swells the brain, damaging brain cells and tissues. This stroke is often caused by high blood pressure and aneurysms. The two types of hemorrhagic strokes are subarachnoid and intracerebral. Intracerebral is the most common type of hemorrhagic stroke. It happens when the tissues surrounding the brain fill with blood after an artery bursts. Less common is the subarachnoid hemorrhage, which is bleeding in the area between the brain and tissues that cover it.

Known as a TIA or a mini-stroke, a transient ischemic attack is when blood flow to the brain is blocked for under five minutes. Symptoms may be temporary and disappear after a few minutes. A TIA is often caused by a blood clot and is a warning of a future stroke. Don’t ignore a TIA. Seek the same treatment you would for a major stroke.

Risk Factors for Stroke

Certain risk factors make you more susceptible to stroke. The more risk factors you have, the more likely you are to have a stroke. One risk factor is an unhealthy diet. This means your diet is high in salt, saturated fats, trans fat and cholesterol. All of these are linked to stroke.

Inactivity can also raise your risk for stroke. The CDC recommends that adults get 2.5 hours of aerobic exercise every week. That can mean a brisk walk a few times a week.

The risk for stroke also increases if you drink too much alcohol. According to the Mayo Clinic, alcohol consumption should be in moderation. This means no more than one drink per day for women and no more than two for men. More than that may raise blood pressure levels and triglyceride levels, which can harden your arteries. Using tobacco also raises your risk since it can damage your blood vessels and heart. The same goes for smoking because your blood pressure rises when you use nicotine.

Certain risk factors for stroke you can’t control. Stroke risk can be linked to your:

- family history

- sex

- age

- race

- ethnicity

Stroke risk is higher in some families because health issues like high blood pressure can be based on genetic issues. According to the CDC, both women and men can have strokes, but it’s more common in men than in women for most age groups. Age is also a risk factor. You’re more likely to have a stroke the older you are. Asians and non-Hispanic whites are less likely to have a stroke than African-Americans, Hispanics, Alaska natives, and American Indians.

As mentioned above, certain medical conditions are linked to a stroke risk. These include:

- having already had a stroke or a TIA

- high blood pressure

- high cholesterol

- heart disorders such as coronary artery disease

- heart valve defects

- enlarged heart chambers and irregular heartbeats

- sickle cell disease

- diabetes

Diagnosis of Stroke

Several tests can help determine:

- if you had a stroke

- what may have caused it

- what part of the brain is impacted

- if you have bleeding in the brain

These tests can also determine if your symptoms are being caused by something else.

You’ll get a physical exam. The doctor will check your balance and coordination, weakness or numbness in your arms, face, and legs, signs of confusion, and vision.

The doctor will ask you or a family member about your symptoms and what you were doing when they happened. They’ll take your medical history to find out your stroke risk factors. The doctor will ask what medications you take, check your blood pressure, and listen to your heart.

Tests for Stroke

You may go through various tests to further help determine if you’ve had a stroke. Your doctor might call for blood tests. That can determine:

- your blood sugar levels

- if you have an infection

- your platelet levels

- how fast your blood clots

You may undergo magnetic resonance imaging (MRI) and a computerized tomography (CT) scan. The MRI will help see if there is any changed brain tissue or damaged brain cells. A CT scan will provide a detailed and clear picture of your brain and show any bleeding or damage in the brain. It may also show other brain conditions that may be causing your symptoms.

You may get an electrocardiogram (EKG). This simple test records the electrical activity in the heart, measuring its rhythm and recording how fast it beats. It can help find out if you have any heart conditions that may have led to stroke, such as a prior heart attack.

Other tests may include a cerebral angiogram. This offers a detailed look at the arteries in your neck and brain. You may get a carotid ultrasound, which can show fatty deposits (plaque) and whether your carotid arteries have been narrowed or blocked. You also may receive an echocardiogram, which can find sources of clots in your heart that may have traveled to your brain and caused a stroke.

Prevention

You can take measures to prevent stroke by living a healthy lifestyle. That means not smoking and limiting how much alcohol you drink. If you smoke, quitting will lower your risk for stroke. Alcohol consumption can raise your blood pressure, so try to reduce your intake.

Keep your weight at a healthy level. Being obese or overweight increases your stroke risk. Eat a diet that’s healthy and full of fruits and vegetables. Eat foods low in cholesterol, trans fat, and saturated fats. Stay physically active to maintain a healthy weight and help decrease your blood pressure and cholesterol levels.

Be on top of your health. Get your cholesterol and blood pressure checked. Talk to your doctor about modifying your lifestyle and discuss your medication options. Address any heart problems. If you have diabetes, take steps to manage it. Taking all these measures will help put you in optimal shape to prevent stroke.

APPENDICITIS

The suffix "-itis" means inflammation, so appendicitis is inflammation of the appendix. Appendicitis occurs when mucus, stool, or a combination of the two blocks the opening of the appendix that leads to the cecum. Bacteria proliferate in the trapped space and infect the lining of the appendix. If the inflammation and blockage are severe enough, the tissue of the appendix can die and even rupture or burst, leading to a medical emergency.

APPENDICITIS AFFECTED AGES

Anyone can get appendicitis, but it occurs most often in people between the ages of 10 and 30. About 7% of people in the U.S. experience appendicitis during their lifetime. Very young children and elderly people are at higher risk of complications due to appendicitis. Early recognition and prompt treatment of the condition are necessary, especially in vulnerable populations.

MOST FREQUENT COMPLICATIONS OF APPENDICITIS

Delaying the diagnosis and treatment of appendicitis increases the risk of complications. One potential complication -- perforation -- can lead to an accumulation of pus (abscess) around the appendix or an infection that spreads throughout the abdominal lining and that of the pelvis (peritonitis). Surgery should occur as soon as possible after the diagnosis of appendicitis. Longer delays between diagnosis and treatment (surgery) increase the risk of perforation. For example, the risk of perforation 36 hours after appendicitis symptoms first appear is 15% or more.

ANOTHER COMPLICATION OF APPENDICITIS

Sometimes the inflammation associated with appendicitis interferes with the action of the intestinal muscle and prevents bowel contents from moving. Nausea, vomiting, and abdominal distention can occur when liquid and gas build up in the part of the intestine above the blockage. In these cases, the insertion of a nasogastric tube -- a tube that is inserted into the nose and advanced down the esophagus into the stomach and intestines -- may be necessary to drain the contents that cannot pass.

SYMPTOMS OF APPENDICITIS

One of the first symptoms of appendicitis is abdominal pain that is hard to localize. People with appendicitis typically experience pain in the central part of the abdomen that eventually moves over to the right lower quadrant. Loss of appetite is another early symptom of appendicitis. Nausea and vomiting may occur early in the course of the illness or even later as the result of an intestinal obstruction.

APPENDICITIS DIAGNOSED

Doctors diagnose appendicitis based on the patient's symptoms and findings during physical examination. A person with appendicitis usually experiences moderate-to-severe pain when the doctor gently pushes down on the lower right abdomen. A potential indication of peritonitis is "rebound tenderness," which is a worsening of pain when the doctor removes his hand after pressing down on a tender area of the abdomen.

APPENDICITIS TREATMENT

Surgical removal of the appendix is called an appendectomy. Antibiotics are given to a patient with suspected or confirmed appendicitis both before and after surgery. Appendectomies can be performed laparoscopically, where special surgical tools are advanced into the abdomen via several small incisions. The following is a step-by-step account of an appendectomy.

• APPENDECTOMY: Step 1 of 8.Normal appendix in a female patient undergoing surgery for an infection in her reproductive system. Since there is no known function of the appendix and to prevent diagnostic confusion in the future, the surgeon removes it to prevent potential appendicitis in the future.

• APPENDECTOMY: Step 2 of 8.To remove the appendix, the surgeon separates it from the mesentery, which is the tissue that delivers blood to the area. Electric current delivered by an instrument called a bipolar forceps is used to seal (cauterize) the blood vessels and prevent bleeding.

• APPENDECTOMY: Step 3 of 8.In the next step, the surgeon uses scissors to snip the appendix free from the mesentery. He alternates between electrocautery (to seal blood vessels) and cutting to completely separate the appendix from the surrounding tissues until the only remaining connection is to the colon.

• APPENDECTOMY: Step 4 of 8.In the next step, the surgeon crushes the base of the appendix with a clamp and then moves the clamp slightly towards the end of the appendix, positioning a pre-tied suture at the base of the appendix to tie it off.

• APPENDECTOMY: Step 5 of 8.The surgeon tightens and secures the suture using a fisherman'’s knot, which can be tightened but is incapable of loosening by itself.

• APPENDECTOMY: Step 6 of 8.The surgeon then uses the scissors to cut the suture above the knot.

• APPENDECTOMY: Step 7 of 8.The surgeon cuts the appendix with the same scissors above the knot but below the clamp to prevent contamination.

• APPENDECTOMY: Step 8 of 8.The surgeon and his surgical team complete one final inspection of the area to ensure there is no bleeding.

COMPLICATIONS AND/OR LONG-TERM CONSEQUENCES OF APPENDECTOMYInfection at the surgical sites is the most common complication associated with an appendectomy. Redness and pain may be present with a mild infection. Moderate infections may have more severe symptoms. Antibiotics are used to treat mild-to-moderate postsurgical infections. If an abscess develops, drainage may be necessary.
The appendix plays an uncertain role in adults and older children. Removal of the appendix is not associated with any major long-term health problems. Some studies report an increased risk of certain diseases after an appendectomy. Crohn’s disease, which is an inflammatory intestinal condition, is one such disease.

ZIKA VIRUS

The Zika virus is a Flavivirus related to dengue fever, West Nile virus, yellow fever, and Japanese encephalitis viruses. Zika fever, as it is also known, is transmitted to humans through bites from a mosquito infected with the Zika virus. Common Zika infection symptoms include rash, fever, and joint pain as well as inflammation of the conjunctiva of the eyes, leading to redness.

Typically the illness is mild and lasts from a few days to a week. Serious illness is rare, but in February 2016 the World Health Organization declared Zika virus infections as a public-health emergency due to severe birth defects associated with Zika infections during pregnancy.

THE ORIGIN OF ZIKA VIRUS

Zika virus received its name from its place of origin, the Zika Forest of Uganda. In 1947 the Zika virus was isolated and identified in Uganda. Blood tests from patients in 1951-1981 concluded that the Zika virus had spread to other African countries and even Indonesia.

ZIKA OUTSIDE OF AFRICA AND INDONESIA

In 2007, Zika virus was found on Yap Island in the Indo-Pacific, which was the first documented account of the virus outside of Africa or Indonesia. Zika virus has continued to spread to North and South America. The first confirmed Zika outbreak in Brazil was reported in May 2015. Zika virus has continued to travel spread globally with Zika virus outbreaks now in Puerto Rico, the Caribbean, Mexico, and the United States.

ZIKA VIRUS VACCINE

As of now, there is no vaccine available to prevent Zika virus infection. The best method of prevention is avoiding mosquito bites. The mosquitoes that transmit Zika virus are most active during the daytime. These mosquitoes transmit other viruses that can cause illness, including dengue and chikungunya virus.

ZIKA MODE OF INFECTION

Two species of mosquito, Aedes aegypti and Aedes albopictus are the typical vectors (carriers) of Zika virus. These are the same species of mosquitoes that can carry and spread dengue and chikungunya viruses. Mosquitos lay eggs in or near sources of standing water, in locations such as animal dishes, ponds, tires, buckets, or plant and flower pots. Aedes mosquitos live both indoors and outdoors and bite people most often in the daytime. If the mosquito bites a person infected with Zika, the mosquito becomes infected with Zika virus and can spread the virus when it bites another person.

ZIKA PREVENTION:

Adults and Mosquito Bites

If you are concerned about preventing Zika virus infection, avoid mosquito bites by the following measures:

• Cover as much skin as possible by wearing long sleeves and long pants.

• When indoors, stay in areas with air conditioning or window and door screens.

• Use a mosquito bed net if your sleeping area is open to the outdoors.

• Treat gear and clothing with permethrin and follow directions for proper use. You can also purchase permethrin-treated products. Do not use permethrin directly on skin.

TYPE OF BUG SPRAY USE TO PREVENT ZIKA VIRUS SPREAD

Use insect includes one of the following active ingredients:

• DEET

• Picaridin

• IR3535

• Oil of lemon eucalyptus

• Para-menthane-diol (PMD)

SAFETY OF BUG SPRAY DURING PREGNANCY

Yes. According to the National Agency for Food and Drug Administration and Control (NAFDAC) and U.S. Centers for Disease Control (CDC), if used correctly EPA-registered insect repellents are safe and effective for pregnant and breast-feeding women. A study in Thailand, consisting of 900 pregnant women, proved that there were no harmful effects to their babies after giving birth when DEET was used during pregnancy.

Protecting your child from mosquito bites can be done by covering the crib, baby carrier, or stroller with mosquito netting. Dress your child in long sleeves and long pants, keeping skin covered when possible. Do not use insect repellent on a child’s hands, eyes, mouth, or on injured or cut skin.

SAFETY OF BUG SPRAY FOR BABIES

Never use insect repellent on babies younger than 2 months. Alternatively, use bug netting and avoid locations where mosquitos are present. Insect repellent containing DEET may be used on children older than 8 weeks. Products containing picaridin are considered safe once your child is over 2 years old. After your child turns 3, insect repellent containing PMD and oil of lemon eucalyptus are considered safe to use.

BUG SPRAY TIPS FOR PARENTS

• Insect repellents should only be used on exposed skin and clothing.

• Wash off repellent at the end of the day with soap and water. Sleeping with repellents on increases the absorption of the chemicals into the skin.

• Apply insect repellent to a child’s face by spraying it onto your hands and then wiping the child’s face.

CONTRACTING ZIKA VIRUS SEXUAL INTERCOURSE

Zika virus can be transmitted by a man to his sex partners. The Zika virus is present in semen longer than in blood. For this reason, physicians recommend the use of condoms to protect uninfected sex partners from getting the virus.

ZIKA INFECTION FROM MOTHER TO CHILD

A pregnant women can infect her fetus with Zika virus during pregnancy or around the time of birth. As of now, there are no instances of infants acquiring Zika through breastfeeding.

CONTRACTING ZIKA INFECTION FROM A BLOOD TRANSFUSIONS

Zika virus can be transmitted through blood transfusion. There have been many reports of Zika being transmitted through blood infusions in Nigeria and Brazil. During the Zika outbreak in the French Polynesian, 2.8% of blood donors tested positive for Zika. Do not donate blood if you have been possibly been exposed to possible Zika virus infection.

PERIOD ZIKA VIRUS IN THE BLOOD STREAM

If infected with Zika it is important to prevent additional mosquito bites. For about a week after infection, the virus is found in the blood of an infected person. If a mosquito bites an infected person during this time, the mosquito becomes infected and can spread Zika virus to another person when it bites again.

SYMPTOMS OF ZIKA INFECTION (ZIKA FEVER)

Only 1 out of 5 patients people with Zika infection will show symptoms. Zika symptoms include fever, joint pain, rash, and conjunctivitis (reddened eyes). Headaches and muscle pain are other possible symptoms of a Zika virus infection. Symptoms may develop within a few days to a week after infection and last for several days to one week. Severe illness and death are rarely a result of a Zika virus infection.

ZIKA VIRUS DIAGNOSE

Health-care professionals can diagnose patients by completing history and physical exams. It is important to reveal any recent travel to areas where Zika is active. A blood test or urine test can confirm a Zika infection. Blood tests can differentiate Zika from dengue fever or chikungunya virus infections.

ZIKA VIRUS AND PREGNANCY

The Zika virus has an extreme effect on a developing fetus in pregnant women, creating dramatic and often life-threating birth defects. In rare cases, Zika infection may cause fetal death and loss of pregnancy.

ZIKA AND MICROCEPHALY

Zika virus infection during pregnancy can causeis associated with microcephaly, a birth defect in which the baby’s head is unusually small and under-developed. Infants born with microcephaly may display the following symptoms as a result:

• Balance and coordination problems

• Developmental delays

• Trouble swallowing and problems feeding

• Hearing loss

• Hyperactivity

• Seizures

• Speech and vision problems

• Cranial abnormalities

PREGNANT WOMEN SHOULD AVOID TRAVELING

Women who are pregnant or who want to become pregnant should avoid travel to areas with known local Zika virus transmission. If you must travel, discuss the situation with your doctor and take precautions to avoid mosquito bites.

FUTURE PREGNANCIES AND THE ZIKA VIRUS

Wanting to have a baby but are concerned about Zika virus exposure? Pregnancy planning and safe sex is an essential part of preventing the spread of the Zika virus and its associateds birth defects.

WOMEN WHO LIVE IN OR TRAVEL TO ZIKA REGIONS

Women who plan to become pregnant but live in a known Zika virus al region should consult a physician before trying to conceive. Waiting at least 8 weeks to conceive is a recommended precaution for women with Zika exposure.

MEN WHO LIVE IN OR TRAVEL TO ZIKA REGIONS

Men who have been diagnosed with Zika infections should wait at least 6 months before safely trying to conceive as Zika virus lives longer in sperm cells than it does in the blood stream. Men who have been traveling to a Zika region but with no known infection should wait a precautionary 8 weeks to attempt conception.

ZIKA VIRUS TREATMENT

Treatment for Zika virus is directed at relieving the symptoms of infection. If diagnosed with Zika, get plenty of rest and drink fluids in order to prevent dehydration. Medications such as acetaminophen (Tylenol) can relieve fever and pain. Patients infected with Zika virus should avoid mosquito bites for the first week of the illness in order to prevent the spread of Zika to others.

MEDICATIONS TO AVOID WITH ZIKA FEVER

Do not take aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen until a dengue fever diagnosis has been ruled out due to a heightened risk of bleeding.

ZIKA VIRUS TRAVEL NOTICES

The CDC is working with individual states to monitor the presence of Zika virus in the Nigeria and United States. Health-care providers are encouraged to report suspected cases of Zika infection to state or local health departments.

Zika virus outbreaks in United States Territories such as the Puerto Rico, the U.S. Virgin Islands, and American Samoa have been reported. Local spread of the Zika virus in some areas of the mainland U.S. where Aedes mosquitos are present is possible.

If traveling to regions with active Zika virus outbreaks, follow the appropriate measure to prevent mosquito bites. If pregnant, avoid traveling to regions with active Zika virus transmission or consult your physician.

TESTING FOR ZIKA VIRUS

Better methods for diagnostic testing to identify Zika virus infection are becoming available. Both urine and blood tests are available for patients within two weeks of symptom onset. Individuals who suspect they may have a Zika virus infection should seek immediate medical care and undergo testing.

Individuals looking to conceive should seek medical advice before trying to get pregnant if they or their partner has recently been traveling to known Zika transmission regions. Tests for Zika virus in semen are now available.

ZIKA VIRUS RESEARCH

Preparations for the first human trials of a Zika vaccine are under way. Researchers are testing the Zika DNA vaccine GLS-5700. Trials will include the assessment of the safety and effectiveness of the Zika vaccine. An effective Zika virus vaccine is needed to stop the Zika virus pandemic.