Sunday 26 April 2015

MEASLES

Measles, also known as morbilli, rubeola, or red measles, is a highly contagious infection caused by the measles virus.Initial signs and symptoms typically include fever, often greater than 40 °C , cough, runny nose, and red eyes.Two or three days after the start of symptoms small white spots may form inside the mouth, known as Koplik's spots. A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms.


SIGNS AND SYMPTOMS

The classic signs and symptoms of measles include four-day fevers and the three C's cough, coryza head cold)(fever), and conjunctivitis red eyes along with fever and rashes.Fever is common and typically lasts for about one week; the fever seen with measles is often as high as 40 °C.Koplik's spots seen inside the mouth are pathognomonic diagnostic for measles, but are temporary and therefore rarely seen.[10] Recognizing these spots before a person reaches their maximum infectiousness can help physicians reduce the spread of the disease.

CAUSE

Measles is caused by the measles virus, a single-stranded, negative-sense, enveloped RNA virus of the genus Morbillivirus within the family Paramyxoviridae.The virus was first isolated in 1954 by Nobel Laureate John F. Enders and Thomas Peebles, who were careful to point out that the isolations were made from patients who had Koplik's spots.



TREATMENT

There is no specific treatment for measles. Most people with uncomplicated measles will recover with rest and supportive treatment. It is, however, important to seek medical advice if the patient becomes sicker, as they may be developing complications.

Some people will develop pneumonia as a consequence of infection with the measles virus. Other complications include ear infections, bronchitis either viral bronchitis or secondary bacterial bronchitis, and brain inflammation.Brain inflammation from measles has a mortality rate of 15%. While there is no specific treatment for brain inflammation from measles, antibiotics are required for bacterial pneumonia, sinusitis, and bronchitis that can follow measles.





TUBERCULOSIS

Tuberculosis is a widespread and in many cases fatal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis.Tuberculosis typically attacks the lungs, but can also affect other parts of the body. It is spread through the air when people who have an active TB infection cough, sneeze, or otherwise transmit respiratory fluids through the air.Most infections do not have symptoms, known as latent tuberculosis. About one in ten latent infections eventually progresses to active disease which, if left untreated, kills more than 50% of those so infected.


Signs and Symptoms

Extrapulmonary TB occurs when tuberculosis develops outside of the lungs, although extrapulmonary TB may coexist with pulmonary TB, as well.

General signs and symptoms include fever, chills, night sweats, loss of appetite, weight loss, and fatigue.Significant nail clubbing may also occur.


CAUSES

The main cause of TB is Mycobacterium tuberculosis, a small, aerobic, nonmotile bacillus.The high lipid content of this pathogen accounts for many of its unique clinical characteristics.It divides every 16 to 20 hours, which is an extremely slow rate compared with other bacteria, which usually divide in less than an hour. Mycobacteria have an outer membrane lipid bilayer.If a Gram stain is performed, MTB either stains very weakly Gram positive or does not retain dye as a result of the high lipid and mycolic acid content of its cell wall.MTB can withstand weak disinfectants and survive in a dry state for weeks. In nature, the bacterium can grow only within the cells of a host organism, but M. tuberculosis can be cultured in the laboratory.


TRANSMISSION


When people with active pulmonary TB cough, sneeze, speak, sing, or spit, they expel infectious aerosol droplets 0.5 to 5.0 µm in diameter. A single sneeze can release up to 40,000 droplets.Each one of these droplets may transmit the disease, since the infectious dose of tuberculosis is very small (the inhalation of fewer than 10 bacteria may cause an infection.


PREVENTION


Tuberculosis prevention and control efforts primarily rely on the vaccination of infants and the detection and appropriate treatment of active cases.The World Health Organization has achieved some success with improved treatment regimens, and a small decrease in case numbers.

VACCINES

The only available vaccine as of 2011 is bacillus Calmette-Guérin.In children it decreases the risk of getting the infection by 20% and the risk of infection turning into disease by nearly 60%.



SALMONELLA


 There are only two species of Salmonella, Salmonella bongori and Salmonella enterica, of which there are around six subspecies and innumerable serovars. The genus Escherichia, which includes the species E.coli belongs to the same family.

Salmonellae are found worldwide in both cold-blooded and warm-blooded animals, and in the environment. They cause illnesses such as typhoid fever, paratyphoid fever, and food poisoning.


Detection, culture and growth conditions

Most subspecies of Salmonella produce hydrogen sulfide,which can readily be detected by growing them on media containing ferrous sulfate, such as is used in the triple sugar iron test TSI.Most isolates exist in two phases: a motile phase I and a nonmotile phase II. Cultures that are nonmotile upon primary culture may be switched to the motile phase using a Cragie tube.

Salmonella can also be detected and subtyped using PCR rom extracted salmonella DNA, various methods are available to extract salmonella DNA from target samples.

Mathematical models of salmonella growth kinetics have been developed for chicken, pork, tomatoes, and melons.Salmonella reproduce asexually with a cell division rate of 20 to 40 minutes under optimal conditions.


Saturday 4 April 2015

LEPROSY

Leprosy is a chronic infection caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis.Initially, infections are without symptoms and typically remain this way for 5 to as long as 20 years

SIGNS AND SYMPTOMS

Skin lesions light or dark patches are the primary external sign.If untreated, leprosy can progress and cause permanent damage to the skin, nerves, limbs, and eyes. Contrary to folklore, leprosy does not cause body parts to fall off, although they can become numb or diseased as a result of secondary infections; these occur as a result of the body's defenses being compromised by the primary disease.Secondary infections, in turn, can result in tissue loss causing fingers and toes to become shortened and deformed, as cartilage is absorbed into the body.

CAUSE

An intracellular, acid-fast bacterium, M. leprae is aerobic and rod-shaped, and is surrounded by the waxy cell membrane coating characteristic of the Mycobacterium genus.

Due to extensive loss of genes necessary for independent growth, M. leprae and M. lepromatosis are obligate intracellular pathogens, and unculturable in the laboratory, a factor that leads to difficulty in definitively identifying the organism under a strict interpretation of Koch's postulates.The use of nonculture-based techniques such as molecular genetics has allowed for alternative establishment of causation.

Leprosy be transmitted to humans by armadillos and may be present in three species of non-human primates.

Two exit routes of M. leprae from the human body often described are the skin and the nasal mucosa, although their relative importance is not clear. Lepromatous cases show large numbers of organisms deep in the dermis, but whether they reach the skin surface in sufficient numbers is doubtful.

PREVENTION/ TREATMENT


Medications can decrease the risk of those living with people with leprosy from acquiring the disease and likely those with whom people with leprosy come into contact outside the home.However, concerns are known of resistance, cost, and disclosure of a person's infection status when doing follow-up of contacts. Therefore, the WHO recommends that people who live in the same household be examined for leprosy and only be treated if symptoms are present.

Multidrug therapy remains highly effective, and people are no longer infectious after the first monthly dose.It is safe and easy to use under field conditions due to its presentation in calendar blister packs.Relapse rates remain low, and no resistance to the combined drugs is seen.

LEPTOSPIROSIS

Leptospirosis is an infection caused by corkscrew-shaped bacteria called Leptospira. Symptoms can range from none to mild such as headaches, muscle pains, and fevers; to severe with bleeding from the lungs or meningitis.If the infection causes the person to turn yellow, have kidney failure and bleeding it is then known as Weil's disease.If it causes lots of bleeding from the lungs it is known as severe pulmonary haemorrhage syndrome.

SIGNS AND SYMPTOMS

 Leptospirosis is a biphasic disease that begins suddenly with fever accompanied by chills, intense headache, severe myalgia muscle ache, abdominal pain, conjunctival suffusion red eye, and occasionally a skin rash.The symptoms appear after an incubation period of 7–12 days. The first phase acute or septicemic phase ends after 3–7 days of illness.The disappearance of symptoms coincides with the appearance of antibodies against Leptospira and the disappearance of the bacteria from the bloodstream. The patient is asymptomatic for 3–4 days until the second phase begins with another episode of fever.The hallmark of the second phase is meningitis inflammation of the membranes covering the brain.


CAUSE


Leptospirosis is caused by spirochaete bacteria belonging to the genus Leptospira. 21 species of Leptospira have been identified.13 species cause disease or have been detected in human cases.

Leptospira are also classified based on their serovar. About 250 pathogenic serovars of Leptospira are recognized. The diverse sugar composition of the lipopolysaccharide on the surface of the spirochete is responsible for the antigenic difference between serovars. Antigenically related serovars are grouped into 24 serogroups, which are identified using the microscopic agglutination test MAT. A given serogroup is often found in more than one species, suggesting that the LPS genes that determine the serovar are exchanged between species


Leptospirosis is transmitted by the urine of an infected animal and is contagious as long as the urine is still moist. Although Leptospira has been detected in reptiles and birds, only mammals are able to transmit the bacteria to humans and other animals.Rats, mice, and moles are important primary hosts but a wide range of other mammals including dogs, deer, rabbits, hedgehogs, cows, sheep, raccoons, opossums, skunks, and certain marine mammals carry and transmit the disease as secondary hosts.


PREVENTION/ TREATMENT

Effective rat control and avoidance of urine contaminated water sources are essential preventive measures. Human vaccines are available in a few countries, including Cuba and China.Currently, no human vaccine is available in the US. Animal vaccines only cover a few strains of the bacteria. Dog vaccines are effective for at least one year.
Effective antibiotics include penicillin G, ampicillin, amoxicillin and Doxycycline. In more severe cases cefotaxime or ceftriaxone should be preferred.

Glucose and salt solution infusions may be administered; dialysis is used in serious cases. Elevations of serum potassium are common and if the potassium level gets too high special measures must be taken. Serum phosphorus levels may likewise increase to unacceptable levels due to renal failure.



JAPANESE ENCEPHALITIS

Encephaliti is a disease caused by the mosquito-borne Japanese encephalitis virus.The Japanese encephalitis virus is a virus from the family Flaviviridae.

SIGNS AND SYMPTOMS

Severe rigors may mark the onset of this disease in humans. Fever, headache and malaise are other non-specific symptoms of this disease which may last for a period of between 1 and 6 days. Signs which develop during the acute encephalitic stage include neck rigidity, cachexia, hemiparesis, convulsions and a raised body temperature between 38–41 °C 100.4–105.8 °F. Mental retardation developed from this disease usually leads to coma.


PREVENTION

A formalin-inactivated mouse-brain derived vaccine was first produced in Japan in the 1930s and was validated for use in Taiwan in the 1960s and in Thailand in the 1980s. The widespread use of vaccine and urbanization has led to control of the disease in Japan, Korea, Taiwan and Singapore. The high cost of this vaccine, which is grown in live mice, means that poorer countries have not been able to afford to give it as part of a routine immunization program.


TYPHOID FEVER

Typhoid fever, also known simply as typhoid, is a symptomatic bacterial infection due to Salmonella Typhi.Symptoms may vary from mild to severe and usually begin six to thirty days after exposure.Often there is a gradual onset of a high fever over several days.


SIGN & SYMPTOMS

In the first week, the body temperature rises slowly, and fever fluctuations are seen with relative bradycardia Faget sign, malaise, headache, and cough. A bloody nose epistaxis is seen in a quarter of cases, and abdominal pain is also possible. A decrease in the number of circulating white blood cells leukopenia occurs with eosinopenia and relative lymphocytosis; blood cultures are positive for Salmonella typhi or S. paratyphi. The Widal test is negative in the first week.

In the second week of the infection, the patient lies prostrate with high fever in plateau around 40 °C (104 °F) and bradycardia sphygmothermic dissociation or Faget sign, classically with a dicrotic pulse wave. Delirium is frequent, often calm, but sometimes agitated. This delirium gives to typhoid the nickname of "nervous fever". Rose spots appear on the lower chest and abdomen in around a third of patients. Rhonchi are heard in lung bases.
The abdomen is distended and painful in the right lower quadrant, where borborygmi can be heard. Diarrhea can occur in this stage: six to eight stools in a day, green, comparable to pea soup, with a characteristic smell. However, constipation is also frequent. The spleen and liver are enlarged (hepatosplenomegaly) and tender, and liver transaminases are elevated. The Widal test is strongly positive, with antiO and antiH antibodies. Blood cultures are sometimes still positive at this stage.

CAUSES

The bacterium that causes typhoid fever may be spread through poor hygiene habits and public sanitation conditions, and sometimes also by flying insects feeding on feces.

PREVENTION

Two typhoid vaccines are licensed for use for the prevention of typhoid the liveR, oral Ty21a vaccine sold as Vivotif by Crucell Switzerland AG) and the injectable typhoid polysaccharide vaccine (sold as Typhim Vi by Sanofi Pasteur and 'Typherix by GlaxoSmithKline. Both are 50 to 80% protective and are recommended for travellers to areas where typhoid is endemic. Boosters are recommended every five years for the oral vaccine and every two years for the injectable form. An older, killed-whole-cell vaccine is still used in countries where the newer preparations are not available, but this vaccine is no longer recommended for use because it has a higher rate of side effects (mainly pain and inflammation at the site of the injection.

TREATMENT

Antibiotics, such as ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, amoxicillin, and ciprofloxacin, have been commonly used to treat typhoid fever in microbiology.Treatment of the disease with antibiotics reduces the case-fatality rate to about 1%.