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Amebiasis (amebic dysentery) |
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What is amebiasis?
Amebiasis is an intestinal illness caused by a microscopic parasite called Entamoeba histolytica. Approximately 1000 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.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 day care 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.
| (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 the recent cases in Florida, 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 2-5 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. Nose swabs are not a good way to diagnose 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.
| (arthropod-borne encephalitis, eastern equine encephalitis, |
| Arboviral Infections St. Louis encephalitis, California encephalitis, Powassan encephalitis, |
| West Nile encephalitis) |
What is arboviral infections?
Arboviral (short for arthropod-borne) infections are caused by any of a 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 the disease and only a small number of the mosquitoes will actually be carrying the virus at any one time. Occasionally, migrating birds have the ability to carry viruses from one area of the country to another; but humans 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 resolve with no complications. Severe infections are marked by a rapid onset, headache, high fever, disorientation, coma, tremors, convulsions, paralysis or death.
When do symptoms appear?
Symptoms usually occur five 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 might provide immunity to that specific virus and perhaps to related viruses. What is the treatment for an infection due to an arbovirus? The physician will usually attempt to relieve the symptoms of the illness, but there is no specific treatment available for arbovirus infections.
How can arboviral infections be prevented?
Insect repellents can be used by persons spending time outdoors in mosquito-or tick-infested areas. Homes can be screened to prevent entry of mosquitoes. Communities or municipalities may establish a mosquito surveillance or control program to reduce mosquito populations by applying pesticides and draining swampy areas.
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 tranfusion 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 8 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?
Standardized treatments for babesiosis have not been developed. However, some drugs used in the treatment of malaria have been found to be effective in some patients with babesiosis.
What can be done to prevent babesiosis?
When in tick-infested habitat special precautions to prevent tick bites should be taken, such as wearing light-colored clothing (for easy tick discovery) and tucking pants into socks and shirt into pants. Consider the use of repellents. 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.
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.
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 tranfusion 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 8 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?
Standardized treatments for babesiosis have not been developed. However, some drugs used in the treatment of malaria have been found to be effective in some patients with babesiosis.
What can be done to prevent babesiosis?
When in tick-infested habitat special precautions to prevent tick bites should be taken, such as wearing light-colored clothing (for easy tick discovery) and tucking pants into socks and shirt into pants. Consider the use of repellents. 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.
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.
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 and viruses). 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. Botulism in infants under one year of age has been associated with the intake of contaminated honey. Wound botulism occurs when Clostridium botulinum spores contaminate a wound and produce toxin.
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?
A person must eat contaminated food that has not been properly canned, cooked or reheated after the bacteria have produced the toxin. Person to person spread does not occur.
What are the symptoms?
Food-borne and infant 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, food-borne and wound 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. Currently antitoxin is not usually given in cases of infant botulism.
If I develop symptoms, what do I do?
If you should develop any of the symptoms above, please contact your physician or your local hospital immediately for evaluation. Please keep any contaminated food for testing.
Can botulism be prevented?
All canned and preserved foods should be properly processed and prepared. Bulging containers should not be opened and foods with an unusual smell should not be eaten or even tasted. Canned food with bulging lids should be thrown away. Identified sources of infant botulism, such as honey, should not be fed to infants.
What is brucellosis?
Brucellosis is a bacterial disease that may affect various organs of the body.
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 livestock.
How is brucellosis spread?
The bacteria that causes 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.
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.
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.
What is the treatment for brucellosis?
Tetracycline or tetracycline plus streptomycin is the treatment of choice. Early diagnosis leading to prompt treatment is essential to prevent chronic infection.
What can be done to prevent the spread of brucellosis?
The use of pasteurized milk and prevention of contact with infected cattle, sheep or goats will reduce the risk of infection.
What is campylobacteriosis?
Campylobacteriosis is a bacterial infection that affects the intestinal tract and, rarely, the bloodstream. It is probably the most common cause of bacterial diarrhea in New York State. Most cases are seen in the summer months and occur as single cases. Outbreaks are uncommon.
Is this a new disease?
No. Campylobacteriosis has probably been in existence for many years but has only recently been recognized as a common infection as a result of improved laboratory methods.
Who gets campylobacteriosis?
Anyone can get campylobacter infection.
How is the germ spread?
Campylobacter are generally spread by consumption of contaminated food or water and, occasionally, by contact with infected people or animals.
What are the symptoms of campylobacteriosis?
Campylobacteriosis may cause mild or severe diarrhea, often with fever and traces of blood in the stool.
How soon after exposure do symptoms appear?
The symptoms generally appear two to five days after the exposure.
Where are the campylobacter germs found?
Many animals including swine, cattle, dogs and birds (particularly poultry) carry the germ in their intestines. These sources in turn may contaminate meat products (particularly poultry) , water supplies, milk and other items in the food chain.
For how long can a person carry the campylobacter germ?
Generally, infected people will continue to pass the germ in their feces for a few days to a week or more. Certain antibiotics may shorten the carrier phase.
Do infected people need to be isolated or excluded from school or work?
Since the organism is passed in the feces, only people with active diarrhea who are unable to control their bowel habits (infants and young children for example) should be isolated. Most infected people may return to work or school when their stools become formed provided that they carefully wash their hands after toilet visits. Food handlers, children in day care and health care workers must obtain the approval of the local or state health department before returning to their routine activities.
What is the treatment for campylobacteriosis?
Most people infected with Campylobacter will recover on their own or require fluids to prevent dehydration. Antibiotics are occasionally used to treat severe cases or to shorten the carrier phase, which may be important for food handlers, children in day care and health care workers. Since relapses occasionally occur, some physicians might treat mild cases with antibiotics to prevent a recurrence of symptoms.
How can campylobacteriosis be prevented?
- Always treat raw poultry, beef and pork as if they are contaminated and handle accordingly:
- Wrap fresh meats in plastic bags at the market to prevent blood from dripping on other foods.
- Refrigerate foods promptly; minimize holding at room temperature.
- Cutting boards and counters used for preparation should be washed immediately after use to prevent cross contamination with other foods.
- Avoid eating raw or undercooked meats.
- Ensure that the correct internal cooking temperature is reached particularly when using a microwave.
- Avoid eating raw eggs or undercooking foods containing raw eggs.
- Avoid using raw milk.
- Encourage careful handwashing before and after food preparation.
- Make sure children, particularly those who handle pets, wash their hands carefully.
What is chancroid?
Chancroid is a sexually transmitted disease (STD) caused by a bacterium. It is common in tropical countries but rare in other parts of the world.
Who gets chancroid?
Any sexually active person can be infected with chancroid. It is more commonly seen in men than in women, particularly uncircumcised males.
How is chancroid spread?
Chancroid is spread by sexual contact with an infected individual. The bacteria are more likely to invade the sexual organs at the point of a pre-existing injury, such as a small cut or scratch. The likelihood of transmission is greater if a person is very active sexually and does not practice personal hygiene.
What are the symptoms of chancroid?
The first sign of infection is usually the appearance of one or more sores or raised bumps on the genital organs. Sores are surrounded by a narrow red border which soon becomes filled with pus and eventually ruptures, leaving a painful open sore. In 50 percent of untreated cases, the chancroid bacteria infect the lymph glands in the groin. Within five to 10 days of the appearance of primary sores, the glands on one side (sometimes both sides) of the groin become enlarged, hard and painful. A rounded painful swelling results which may eventually rupture.
How soon do symptoms appear?
Symptoms usually appear four to seven days after exposure.
When and for how long is a person able to spread chancroid?
Chancroid is contagious as long as the infected person has any open sores. The open sores contain bacteria and any contact with these sores can result in infection.
What complications can result from chancroid?
Untreated chancroid often results in ulcers occurring on the genitals. Sometimes the ulcers persist for weeks or months.
Does past infection with chancroid make a person immune?
No. Reinfection can readily occur immediately after cure. There is no evidence of natural resistance.
What is the treatment for chancroid?
Chancroid may be successfully treated with certain antibiotics. Lesions and ulcers can be expected to heal within two weeks.
How can the spread of chancroid be prevented?
- Limit the number of your sex partners.
- Use a condom.
- Carefully wash the genitals after sexual relations.
- If you think you are infected, avoid any sexual contact and visit your local STD clinic, a hospital or your doctor. Notify all sexual contacts immediately so they can obtain examination and treatment.
| Chlamydia trachomatis genital infection |
What is Chlamydia?
Chlamydia is a bacterial infection that is spread through sexual contact with an infected person. Chlamydia is one of the most common sexually transmitted diseases (STD); more than 50 million cases occur worldwide and approximately 3 million cases occur in the United States annually.
Who gets Chlamydia?
Any sexually active person can be infected with Chlamydia. Most often, Chlamydia occurs in adolescents and young adults (ages 15-24) who have new or multiple sex partners and who do not consistently use condoms or other barrier contraception.
How is Chlamydia spread?
Chlamydia is spread through sexual contact. This includes penis to vagina or penis to rectum contact. It can also be passed from the mother to her newborn during birth.
What are the symptoms of Chlamydia?
Because approximately 75% of women and 50% of men have no symptoms, most people infected with Chlamydia are not aware of their infections and may not seek health care. If males have symptoms, they may include urethritis (itching and/or burning on urination) and discharge from the penis in small or moderate amounts. If females have symptoms, they may include vaginal discharge and painful urination.
When and for how long is a person able to spread Chlamydia?
From the time a person is infected with Chlamydia, he or she can spread the disease. A person can continue to spread the infection until properly treated.
Does past infection with Chlamydia make a person immune?
Past infection with Chlamydia does not make a person immune to Chlamydia.
What is the treatment for Chlamydia?
Chlamydia is treated with antibiotics. The recommended antibiotic treatment is doxycycline taken twice a day for seven days or azrithromycin taken in one single dose. Other alternative medications may be used but are not as effective as azrithromycin & doxycycline. Persons being treated for Chlamydia should not have sexual intercourse for seven days after single dose therapy (azrithromycin) or until completion of all seven days of antibiotics (doxycycline) . Patients can be re-infected if their sex partners are not treated.
What happens if Chlamydia goes untreated?
If a person is not treated for Chlamydia, complications may occur. Women frequently develop pelvic inflammatory disease (PID) . PID can cause infertility (not being able to get pregnant) , chronic pelvic pain, tubal pregnancies, and the continued spread of the disease. In men, untreated Chlamydia can cause urethral infection and complications such as swollen and tender testicles. Chlamydia infection during pregnancy may result in premature rupture of membranes, preterm delivery and possible tubal pregnancy in a small percent of women. In addition, Chlamydia can cause conjunctival (eye) and pneumonic (lung) infection in the newborn. Persons with a Chlamydia infection have an increased chance of getting other infections such as gonorrhea or HIV.
What can be done to prevent the spread of Chlamydia?
Limit your number of sex partners. Use a male or female condom. If you think you are infected or have been exposed, avoid any sexual contact and visit a local sexually transmitted disease (STD) clinic, a hospital or your doctor. Either bring your sex partners with you when you are treated or notify them immediately so they can obtain examination and treatment.
What is chickenpox?
Chickenpox is a highly communicable disease caused by the varicella virus, a member of the herpes virus family. In temperate climates, chickenpox occurs most frequently in winter and early spring.
Who gets chickenpox?
Chickenpox is common in the United States. Virtually everyone who is not vaccinated acquires chickenpox by adulthood. Cases are expected to decline as vaccine coverage levels increase.
How is chickenpox spread?
Chickenpox is transmitted to others by direct person-to-person contact, by droplet or airborne spread of discharges from an infected person s nose and throat or indirectly by contact with articles freshly soiled by discharges from the infected person s lesions. The scabs themselves are not considered infectious.
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 inapparent infections occasionally occur in children. The disease is usually more serious in adults than in children.
How soon do symptoms appear?
Symptoms commonly appear 14-16 days (range of 10-21 days) after exposure to someone with chickenpox or herpes zoster (shingles).
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 onset of rash until all lesions have crusted. People who are immunocompromised may be contagious for a longer period of time.
Does past infection with chickenpox make a person immune?
Chickenpox generally results in lifelong immunity. However, this infection may remain hidden and recur years later as shingles in a proportion of older adults and sometimes in children.
What are the complications associated with chickenpox?
Newborn children (less than one month old) whose mothers are not immune and patients with leukemia may suffer severe, prolonged or fatal chickenpox. Immunocompromised patients, including those on immunosuppressive drugs, may have an increased risk of developing a severe form of chickenpox or shingles. Reye s syndrome has been a potentially serious complication associated with clinical chickenpox involving those children who have been treated with aspirin. Aspirin or aspirin-containing products should never be given to a child with chickenpox.
Is there a vaccine for chickenpox?
A vaccine to protect children against chickenpox was first licensed in March 1995. It has been recommended for persons over 12 months of age. To protect high-risk newborns and immunocompromised patients from exposure, a shot of varicella zoster immune globulin (VZIG) is effective in modifying or preventing disease if given within 96 hours after exposure to a case of chickenpox. Older children and adults who have previously had chickenpox do not need to be vaccinated. Contact your doctor or local health department for further information about the chickenpox vaccine.
What can a person or community do to prevent the spread of chickenpox?
The best method to prevent further spread of chickenpox is for people infected with the disease to remain home and avoid exposing others who are susceptible. If they develop symptoms, they should remain home until one week after the skin eruption began or until the lesions become dry and crusted. Pay particular attention to avoiding unnecessary exposure of nonimmune newborns and immunocompromised people to chickenpox.
Is there a treatment for chickenpox?
In 1992, acyclovir was approved by the U. S. Food and Drug Administration for treatment of chickenpox in healthy children. However, because chickenpox tends to be mild in healthy children, most physicians do not feel that it is necessary to prescribe acyclovir.
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. Antibiot-ics, 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%) 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.
| (crip-toe-spor-id-i-ho-sis) Information for People with Weakened Immune Systems |
What is cryptosporidiosis?
Cryptosporidiosis is an intestinal illness caused by a microscopic parasite called Cryptosporidium. Approximately 400-500 cases are reported in New York State each year.
Is cryptosporidiosis a new disease?
Although Cryptosporidium is not new, it was not recognized as a cause of human disease until 1976. Cryptosporidiosis was added to the list of reportable diseases in New York State in February 1994.
What are the symptoms of cryptosporidiosis?
The most common symptom is diarrhea, which is usually watery. It is often accompanied by abdominal cramping. Nausea, vomiting, fever, headache and loss of appetite may also occur. Some people infected with Cryptosporidium may not become ill.
Who is susceptible to cryptosporidiosis and how long does the illness last?
All people are presumed susceptible to infection with Cryptosporidium. In healthy individuals with normal immune systems, signs and symptoms generally persist for two weeks or less. However, immunocompromised persons (those with weak immune systems) may have severe and long lasting illness. Some examples of immunocompromised people are those receiving cancer chemotherapy, kidney dialysis or steroid therapy, people with HIV/AIDS and patients with Crohns disease.
How long after exposure do symptoms appear?
The incubation period may range from one to 12 days with an average of seven days.
How is the disease contracted?
Cryptosporidium is shed in the feces of infected humans and animals. People become infected by ingesting the organism. Cryptosporidium can be spread by person-to-person or animal-to-person contact and by drinking contaminated water. Infected individuals can shed the organism in their stool for several weeks after they recover from the illness. Because cryptosporidiosis is transmitted by the fecal-oral route, the greatest potential to transmit the organism comes from infected people who have diarrhea, people with poor personal hygiene and diapered children.
Does past infection with cryptosporidium make a person immune?
Some immunity appears to follow infection but the degree to which a previously infected person is immune to subsequent Cryptosporidium infection is unclear. Exposure to a large dose of the parasite could result in recurrent illness.
How is cryptosporidiosis diagnosed?
The infection is diagnosed by identifying the parasite during a microscopic examination of the stool. When a person with diarrheal illness is suspected of having cryptosporidiosis, the health practitioner should specifically request a Cryptosporidium test, since most laboratories do not yet routinely perform the necessary tests needed to identify this particular microscopic parasite. A cryptosporidium test should specifically be ordered for people with HIV/AIDS or other immunocompromised patients (for example, cancer or transplant patients) who are being treated for diarrhea.
How is cryptosporidiosis treated?
There is no specific treatment for cryptosporidiosis. However, some patients may respond to certain antibiotics. Oral liquids or intravenous fluids are sometimes necessary if dehydration occurs. Anti-diarrheal drugs which reduce the motion of the intestines may provide some temporary improvement. Patients with cryptosporidiosis should obtain nutritional counseling through their health care provider to discuss their diet and how best to minimize the symptoms of their diarrhea.
How can I avoid getting and transmitting cryptosporidiosis?
You can minimize the chances of acquiring and spreading the infection by thoroughly washing your hands after using the toilet, changing diapers or coming into contact with fecal material in any way. Because cattle are a common source of Cryptosporidium, do not drink raw milk and be sure to wash your hands thoroughly after contact with cattle or other farm animals. Avoid drinking untreated and inadequately filtered surface water when camping or when traveling in developing countries. Comply with any water advisory issued by local and state authorities.
Has Cryptosporidium been found in New York State water systems and is it easily detectable?
It is believed that Cryptosporidium has always been present to some degree in water. Recently, it has been found in low numbers in some drinking waters derived from surface water sources (streams, lakes or reservoirs) in New York State and across the nation. No waterborne outbreaks of cryptosporidiosis have been identified in New York State. Only laboratories with specialized testing capabilities can detect the presence of Cryptosporidium cysts in water. Laboratory tests are not very reliable at this time and they cannot tell whether the cyst is alive or dead.
Should immunocompromised persons take extra precautions to minimize their risk of cryptosporidiosis?
Because cryptosporidiosis can be a severe disease in immunocompromised persons, such individuals should discuss the need for extra precautions with their health care provider to minimize their risk of infection. Contaminated drinking water is only one of a number of ways in which cryptosporidiosis can be acquired. Here are some suggested steps to reduce risk of infection:
- Wash hands thoroughly after changing diapers or whenever fecal soiling occurs.
- Avoid sexual practices that may result in hand or mouth exposure to feces, such as oral/anal contact (rimming).
- Avoid direct exposure to cattle and other farm animals. If exposure cannot be avoided, wash your hands thoroughly immediately thereafter.
- Avoid swallowing water when swimming, especially in lakes, ponds or rivers.
- Thoroughly wash all fruits and vegetables. Avoid drinking unpasteurized apple cider.
If an outbreak of waterborne Cryptosporidium is identified (none has been to date in New York) , immunocompromised patients should carefully and consistently comply with all public advisories and notices issued by the local or state health department.
The four items listed below may help immunocompromised patients and their health care providers decide whether to take extra routine precautions with drinking water under normal, nonoutbreak conditions:
- Boiling water for at least one minute with a rolling boil will kill Cryptosporidium.
- Properly drilled and maintained wells that utilize underground water are generally protected from surface contamination and are unlikely to contain Cryptosporidium cysts.
- Unless it is distilled or pasteurized, bottled water may not be any safer than tap water. Those bottling companies using properly designed and operated groundwater sources have a very low likelihood of producing water containing Cryptosporidium cysts. Those companies using surface water sources have the same risk of cryptosporidiosis as tap water from the same source unless additional treatment is undertaken. Current standards for bottled water do not guarantee that the water is Cryptosporidium-free. Bottled water sold in New York must also include on the label whether the water comes from a well, spring or municipal source. A list of bottled waters certified for sale in New York along with their sources can be obtained from the New York State Department of Health at (518) 402-7676.
- During an outbreak of cryptosporidiosis in Milwaukee in 1993, one study showed that less diarrhea occurred in houses using water filters with a pore size less than 2 microns than in houses using filters with large pore sizes. If home water filters are used, follow the manufacturer s instructions supplied with the unit. The instructions will provide information on filter maintenance needed to prevent clogging and ensure proper filtration. Filters should be certified by the National Sanitation Foundation (NSF) or an equivalent testing agency for cyst removal.
For additional information, contact your health care provider or your local or state health department.
What is Cyclospora?
Cyclospora is a microscopic parasite that can affect the intestinal tract and cause diarrhea. It is an uncommon disease in the United States and is occasionally associated with foreign travel.
Who gets Cyclospora?
Cyclospora infections can occur in people of all ages.
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.
What is Cytomegalovirus, (CMV)?
CMV is a common virus that infects most people at some time during their lives but rarely causes obvious illness. It is a member of the herpes virus family. Other members of the herpes virus family cause chickenpox, infectious mononucleosis, fever blisters (herpes I) and genital herpes (herpes II) . Like other herpes viruses, CMV infection can become dormant for a while and may reactivate at a later time. The virus is carried by people and is not associated with food, water or animals.
Who gets CMV?
Anyone can become infected with CMV. Almost all people have been exposed to CMV by the time they reach adulthood.
How is CMV spread?
Although the virus is not highly communicable, it can be spread from person to person by direct contact. The virus is shed in the urine, , saliva, semen and to a lesser extent in other body fluids. Transmission can also occur from an infected mother to her fetus or newborn and by blood transfusion and organ transplants.
What are the symptoms of CMV infection?
Most children and adults who are infected with CMV do not develop symptoms. Those who develop symptoms may experience an illness resembling infectious mononucleosis and have fever, swollen glands and feel tired. People with a compromised immune system (such as AIDS patients or those receiving chemotherapy) may experience more serious illness involving fever, pneumonia and other symptoms.
Is CMV infection very serious in infants?
Approximately 10 out of every 1000 babies born in the United States will have CMV infection; but nine of these will have no symptoms and one may have significant illness involving nervous system damage or developmental disabilities.
How soon after exposure do symptoms appear?
Although most people never develop symptoms after exposure, the incubation period appears to be between three and 12 weeks.
How long can an infected person carry CMV?
CMV remains in the body throughout a lifetime. Infected people may occasionally shed the virus in urine or saliva. Several studies have found that from 3 to 11 percent of normal adults and up to 50 percent of healthy children shed the virus in either urine or saliva. The virus rapidly dies once outside the body.
How is CMV diagnosed?
There are special laboratory tests to culture the virus but such testing is difficult, expensive and not widely available. Specific blood tests can be helpful to the physician in making a diagnosis or determining if a person has been exposed but the results are sometimes inaccurate.
What is the treatment for CMV infection?
In most cases, there is no treatment. An effective vaccine has not yet been developed.
Should an infected child be excluded from school or day care?
There is no reason to exclude children who have CMV.
What precautions should pregnant women take when performing patient care or child care?
Pregnant women should practice good hygiene and carefully wash their hands after caring for patients or children. This is particularly important when handling diapers or having contact with the child's urine or saliva.
The risk of CMV infection in hospital workers is not greater than it is in others in the community and is probably low because of careful handwashing practices. In day care centers, where handwashing practices may not be as good, there may be a greater risk of infection. In both settings, good hygiene and careful handwashing are the most important control measures. Pregnant women working in child care facilities should minimize direct exposure to saliva and avoid kissing babies or young children on the mouth. Hugging is fine and is not a risk factor.
Routine blood testing during pregnancy for CMV antibody is not generally recommended. Pregnant women should consult their physician on an individual basis regarding this issue.
What can be done to prevent the spread of CMV?
Good handwashing is the best preventive measure. Plastic disposable gloves should be worn when handling linen or underclothes soiled with feces or urine.
| (breakbone fever, dengue hemorrhagic 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.
