Archive | March 2019

QUOTE FOR THE WEEKEND:

“As pointed out in Dr. Chomel’s (2008) article on emerging parasitic zoonoses, emerging infectious diseases are dominated by zoonoses and the majority of these infections originate in wildlife. While protozoa are more likely to account for emerging parasitic infections, there are clear examples of metazoan infections as emerging or re-emerging diseases.”

PMS U.S. National Library of Medicine National Institutes of Health

Part II Continuation of Zoonotic Disease/Bioterrism

Bioterrorism Diseases-

List of diseases that may be used in a bioterrorism event, divided into categories depending on the ease of spread and the severity of illness or death they cause. Including Anthrax, Plague, Brucellosis, and Q fever.

These high-priority agents include organisms or toxins that pose the highest risk to the public and national security:

  • Anthrax (Bacillus anthracis)
  • Botulism (Clostridium botulinum toxin)
  • Plague (Yersinia pestis)
  • Smallpox (variola major)
  • Tularemia (Francisella tularensis)
  • Viral hemorrhagic fevers (filoviruses [e.g., Ebola, Marburg] and arenaviruses [e.g., Lassa, Machupo])

1-Anthrax-Anthrax is caused by the spore-forming bacterium Bacillus anthracis. It most commonly occurs in wild and domestic lower vertebrates (cattle, sheep, goats, camels, antelopes, and other herbivores), but it can also occur in humans when they are exposed to infected animals or tissue from infected animals.

Domestic and wild animals such as cattle, sheep, goats, antelope, and deer can become infected when they breathe in or ingest spores in contaminated soil, plants, or water. In areas where domestic animals have had anthrax in the past, routine vaccination can help prevent outbreaks.

People get infected with anthrax when spores get into the body. When anthrax spores get inside the body, they can be “activated.” When they become active, the bacteria can multiply, spread out in the body, produce toxins (poisons), and cause severe illness.

This can happen when people breathe in spores, eat food or drink water that is contaminated with spores, or get spores in a cut or scrape in the skin. It is very uncommon for people in the United States to get infected with anthrax.

2-Botulism-Botulism is a rare, but very serious condition caused by toxin produced by bacteria called Clostridium botulinum. The toxins that this bacterium produces are among the most poisonous substances known to humans.Three forms of naturally occurring botulism affecting humans exist: foodborne, wound, and intestinal. All forms of botulism result from absorption of botulinum toxin into the bloodstream. The toxin does not penetrate intact skin. Inhalational botulism is a man-made form of disease that results from inhaling aerosolized botulinum toxin.  You can reduce your risk of getting natural botulism by carefully handling your food – especially your home-canned foods, oil-infused garlic or herbs. Never give honey to babies under 12 months of age since it may contain spores of Clostridium botulinum. Honey is safe for persons 1 year and older. To date, botulism has not been used as a terror weapon. There is no vaccine available to protect the general public against botulism.

The poison produced by botulism bacteria is extremely strong and highly lethal. The poison is also easy to produce and transport. A large outbreak of botulism would create a major disruption of normal activity.  Attempts to use botulism as a weapon go back at least to World War II. Since the 1970s, a number of nations have developed – or are believed to be developing – the capability to use botulism as a weapon. A Japanese religious cult tried to release botulism poison into the air at several locations in the Tokyo area, at least three times, between 1990 and 1995.  They used the spread of fleas infected with botulism.

3-Plague-it’s a disease caused by Yersinia pestis (Y. pestis), a bacterium found in rodents and their fleas in many areas around the world.  People get bubonic plague from infected animals. The bacteria are spread by bites from infected fleas, bites or scratches from infected animals, or direct contact with infected animal carcasses.

People get pneumonic plague by inhaling droplets that contain plague bacteria. The droplets are released into the air when infected people – or animals – cough. However, if plague were to be used as a weapon, the bacteria could be released into the air on purpose.

You can get it from people by inhaling droplets released into the air when infected people cough.   No vaccine is now available for plague, although efforts are underway to develop one. When people are exposed to infected people or animals, antibiotics can be used to prevent the illness – if the treatment is started right away.  Plague bacteria released into the air will survive less than one hour. They are destroyed by sunlight, heat and drying.

Stay tune for part III continuation of Bioterrism tomorrow!

 

 

QUOTE FOR FRIDAY:

“Several hundred infectious diseases are classified as zoonotic diseases as they are caused by bacteria, virus, fungi or parasites that can be transmitted from animals to humans.”

PMC  US National Library of Medicine National Institutes of Health (nim.nih.gov)

Part I To all animal lovers we do have to be concern with zoonotic diseases!

A further 33 diseases have featured in the World Health Organization’s Disease Outbreak News since its inception in 1996. Of the “big eight”now, six are known zoonotic diseases (diseases from animals) – and the remaining two hepatitis C and Chikungunya are assumed to be so, although the animal reservoir remains undiscovered. Whatever the explanation, hepatitis C (1989), West Nile virus (1999), SARS (2003), Chikungunya (2005), swine flu (2009), MERS (2012), Ebola (2014) and Zika (2015) have all since had their time in the media spotlight.

Since then, emerging diseases have been appearing at an accelerating rate. Part of the explanation for this may simply be that we are much better at detecting them now. On the other hand, population pressure, climate change and ecological degradation may be contributing to a situation where zoonosis – the movement of a disease from a vertebrate animal to a human host – is more common.

A zoonosis (zoonotic disease or zoonoses -plural) is an infectious disease that is transmitted between species from animals to humans (or from humans to animals).

Illnesses Associated with Animal Contact:

1-Rabies Rabies is a disease that affects the nervous system of mammals. It is caused by a virus and is typically spread by an infected animal biting another animal or person. Rabies is a fatal disease; it cannot be treated once symptoms appear. Luckily, rabies can be effectively prevented by vaccination.

2-Blastomycosis (Blastomyces dermatitidisBlastomycosis is a rare fungal infection usually acquired by inhaling the spores of a fungus (Blastomyces dermatitidis) that can be found in wood and soil.  Blastomycosis occurs most often in people living in Ontario, Manitoba, and the south-central, south-eastern, and mid-western United States. In Minnesota, blastomycosis is most common in St. Louis, Itasca, Cass, Beltrami, Washington, and Chisago counties.   The time between exposure to the spores and when symptoms develop varies widely, ranging from 21 to 100 days. The signs and symptoms of blastomycosis vary among individuals. About 50% of infections are asymptomatic (person does not develop any symptoms or disease) or are mild and resolve without treatment.  Some patients develop a chronic lung infection or the disease can spread to other areas of the body (skin, bones, genitourinary system, or central nervous system).

3-Psittacosis (Chlamydophila psittaci, Chlamydia psittaci)
Infection with Chlamydophila psittaci (formerly known as Chlamydia psittaci) is cause of systemic illness in companion birds (birds kept by humans as pets) and poultry. This illness is often referred to as avian chlamydiosis (also known as psittacosis, ornithosis, and parrot fever) in birds.

C. psittaci infection can be transmitted from infected birds to humans. The disease resulting from C. psittaci infection in humans is called psittacosis (also known as parrot disease, parrot fever, and chlamydiosis). Most infections are typically acquired from exposure to pet psittacine (parrots, macaws, parakeets) birds.

Infection with C. psittaci usually occurs when a person inhales organisms that have been aerosolized from dried feces or respiratory tract secretions of infected birds. Other means of exposure include mouth-to-beak contact and handling infected birds’ plumage and tissues.

Psittacosis can result in serious health problems including fatal pneumonia. Diagnosis of psittacosis can be difficult. Antibiotic treatment is recommended.

4-Trichinosis (Trichinella spiralisPeople can become infected with Trichinosis from eating raw or undercooked meat that contains the roundworm larvae. It is most commonly found in wild game meat (such as bear, wild feline, fox, dog, wolf, horse, seal, and walrus) and less commonly, pork. After the meat with the parasite larvae is eaten, the larvae grow into worms in the intestines, which reproduce and make larvae that go into the bloodstream and travel to the skeletal muscle and embed.A few days after eating the roundworm larvae they mature and begin reproducing; during this time symptoms can include nausea, vomiting, diarrhea, fever, fatigue, and abdominal pain. As the larvae go into the bloodstream and embed in the muscle; symptoms can include headaches, fevers, chills, weakness, cough, muscle pain, achy joints, pain/swelling around the face and eyes, light sensitivity, pink eye, itchy skin, extreme thirst, and sometimes incoordination and heart/lung problems. Symptoms can last a few months, to many months in severe cases. The severity depends on how many larvae were ingested.

What is the treatment for Trichinosis?

A mild case may not be noticed. Trichinosis is treated with anti-parasitic drugs, and can be fatal if severe cases are not treated. There is no treatment once the larvae embed in the muscles, pain relievers can help.

5-Cat Scratch Disease-CSD (Bartonella henselae)

Generally people who get CSD are bitten, scratched, or licked by a cat before they get sick.  Fleas are responsible for transmitting B. henselae between cats.  Because kittens are more likely to be infected than adult cats, they are more likely to transmit cat scratch disease to humans.  Cats are the natural reservoir for the bacteria that causes CSD, and generally do not show any signs of illness. Therefore it is impossible to know which cats can spread CSD to you.  It is believed that transmission to humans occurs through contamination of bites or scratches with flea excrement.             There is no human-to-human transmission of CSD.

The duration of illness caused by B. henselae is usually 2 to 4 months with spontaneous recovery. TREATMENT-Supportive treatment & Antibiotics may be used for severely ill patients to speed recovery

6-Histoplasmosis (Histoplasma capsulatum)-it is an infection caused by a fungus called Histoplasma. The fungus lives in the environment, particularly in soil that contains large amounts of bird or bat droppings. In the United States, Histoplasma mainly lives in the central and eastern states, especially areas around the Ohio and Mississippi River valleys. The fungus also lives in parts of Central and South America, Africa, Asia, and Australia.

People can get histoplasmosis after breathing in the microscopic fungal spores from the air. Although most people who breathe in the spores don’t get sick, those who do may have a fever, cough, and fatigue. Many people who get histoplasmosis will get better on their own without medication, but in some people, such as those who have weakened immune systems, the infection can become severe.

6-Coccidiomycosis (Valley Fever)-Valley fever, also called coccidioidomycosis, is an infection caused by the fungus Coccidioides. The fungus is known to live in the soil in the southwestern United States and parts of Mexico and Central and South America. The fungus was also recently found in south-central Washington. People can get Valley fever by breathing in the microscopic fungal spores from the air, although most people who breathe in the spores don’t get sick. Usually, people who get sick with Valley fever will get better on their own within weeks to months, but some people will need antifungal medication.

7-Intestinal Illness Acquired From Animals
Including E. coli , Cryptosporidium parvum, Campylobacter, and Salmonella.

People usually get intestinal illnesses (foodborne illnesses like E. coli O157:H7, Campylobacter, Salmonella, Cryptosporidium) from food and water. But, you can also get any of these from contact with animals or their environments.

In recent years, intestinal diseases associated with places where the public has contact with farm animals (e.g., petting zoos, state or county fairs, educational farms) have been identified with increasing frequency. Minnesota is no exception to this trend.

Keeping Backyard Poultry-An increasing number of people around the country are choosing to keep poultry, such as chickens or ducks, as part of a greener, healthier lifestyle. While you enjoy the benefits of backyard chickens and other poultry, it is important to consider the risk of illnesses, especially in children, that can result from handling live poultry or anything in the area where they are kept.

Staying safe at pet zoos or animal fairs-From mid-June to Labor Day is fair season in Minnesota. Each year, fairs across the state provide opportunities to eat deep fried delicacies and interact with livestock and poultry. But these interactions aren’t without risk — animals can carry germs that can make people sick. The risk can be minimized with careful handwashing and taking a few simple precautions.

Spotlight on particular home animal pets:

8-Salmonella- Some Reptiles and Amphibians-They can make cool pets, but they can also be a source of illness. Reptiles (e.g., Iguanas, turtles, snakes) and amphibians (e.g., frogs and toads) carry Salmonella.

Always wash hands after handling reptiles and/or amphibians.   Reptiles and amphibians should not be kept as pets in households with young children (i.e. less than 5 years old) or other high risk individuals, including pregnant women, older persons and the immune-compromised.  Reptiles and amphibians should not be kept in child care centers, schools, or other facilities with children younger than 5 years old.

Salmonella-Chicks and Ducklings:
Those cute little chicks and ducklings can be a great attraction for children this time of year, but they can also be a source of illness, so it’s important for those who handle them to take steps to prevent infection.

stayed tune for part II on Bioterrism Disease

 

QUOTE FOR THURSDAY:

“TB disease in the United States is most common among people who travel to or who were born in countries with high rates of TB.

  • In 2017, a total of 70.1% of reported TB cases in the United States occurred among non-U.S.-born persons.
  • The case rate among non-U.S.–born persons (14.7 cases per 100,000 persons) was approximately 15 times higher than among U.S.-born persons (1.0 cases per 100,000 persons).
  • The percentage of U.S. TB cases among non-U.S.–born persons who have been in the United States for 10 years or longer are about equal to those who have been in the United States less than 10 years.”

CDC Center for Disease Control and Prevention

Part III Understanding how tuberculosis is spread and controlled in the health care setting.

How does PTB develop? TB bacilli enters the body and lodges in the lungs (TB Infection). In the lungs, they multiply and slowly eat the cells and the body begins to experience symptoms (TB Disease)  A person who develops a TB disease, when remain untreated, can then begin to infect others. In some cases, the TB germ migrates to other body organs and begin to destroy them, thus the advent of extra-pulmonary (outside) cases of Tuberculosis like TB of the meninges, bones, etc. A TB disease that remains untreated leads to death.

Airborne to prevent the transmission of highly contagious or virulent infections spread by small airborne droplets (smaller than 5 microns) examples know or suspected TB, chicken pox.

Airborne Precautions: spread of microbes on small droplet nuclei through the air ( 5 microns); which transmit 3 feet in air. (ie) TB, Mumps; Pertussis; Influenza; SARS. Private room / or cohort clients, and mask worn if within 3 feet.

TB can be transmitted in just about any setting. It can be spread in places such as homes or worksites. However, TB is most likely to be transmitted in health care settings when health care workers and patients come in contact with persons who have unsuspected TB disease, who are not receiving adequate treatment, and who have not been isolated from others. All health-care settings need an infection-control program designed to ensure the following:

  • Prompt detection of TB disease;
  • Airborne precautions; and
  • Treatment of people who have suspected or confirmed tuberculosis (TB) disease.

Overview of TB Infection-Control Measures

The TB infection-control program should be based on the following three-level hierarchy of control measures:

  1. Administrative controls
  2. Environmental controls
  3. Use of respiratory protective equipment

Administrative Controls

The first and most important level of the hierarchy, administrative controls, are management measures that are intended to reduce the risk or exposure to persons with infectious TB.  These control measures consist of the following activities:

  • Assigning someone the responsibility for TB infection control in the health care setting;
  • Conducting a TB risk assessment of the setting;
  • Developing and implementing a written TB infection-control plan;
  • Ensuring the availability of recommended laboratory processing, testing, and reporting of results;
  • Implementing effective work practices for managing patients who may have TB disease;
  • Ensuring proper cleaning, sterilization, or disinfection of equipment that might be contaminated (e.g., endoscopes);
  • Educating, training, and counseling health care workers, patients, and visitors about TB infection and disease;
  • Testing and evaluating workers who are at risk for exposure to TB disease;
  • Applying epidemiology-based prevention principles, including the use of setting-related TB infection-control data;
  • Using posters and signs to remind patients and staff of proper cough etiquette (covering mouth when coughing) and respiratory hygiene; and
  • Coordinating efforts between local or state health departments and high-risk health-care and congregate settings.

Environmental Controls

The second level of the hierarchy is the use of environmental controls to prevent the spread and reduce the concentration of infectious droplet nuclei.  This includes two types of environmental control.

  • Primary environmental controls consist of controlling the source of infection by using local exhaust ventilation (e.g., hoods, tents, or booths) and diluting and removing contaminated air by using general ventilation.
  • Secondary environmental controls consist of controlling the airflow to prevent contamination of air in areas adjacent to the source airborne infection isolation (AII) rooms; and cleaning the air by using high efficiency particulate air (HEPA) filtration, or ultraviolet germicidal irradiation.

Respiratory Controls

The third level of the hierarchy is the use of respiratory-protection control. It consists of the use of personal protective equipment in situations that pose a high risk of exposure to TB disease.

Use of respiratory protection equipment can further reduce risk for exposure of health care workers to infectious droplet nuclei that have been expelled into the air from a patient with infectious TB disease. The following measures can be taken to reduce the risk for exposure:

  • Implementing a respiratory protection program;
  • Training health care workers on respiratory protection; and
  • Educating patients on respiratory hygiene and the importance of cough etiquette procedures.

Determining the Infectiousness of TB Patients

The infectiousness of a TB patient is directly related to the number of droplet nuclei carrying M. tuberculosis (tubercle bacilli) that are expelled into the air.  The number of tubercle bacilli expelled by a TB patient depends on the following factors:

  • Presence of a cough
  • Cavity in the lung
  • Acid-fast bacilli on sputum smear
  • TB disease of the lungs, airway, or larynx
  • Patient not covering mouth and nose when coughing
  • Not receiving adequate treatment or having prolonged illness
  • Undergoing cough-inducing procedures
  • Positive sputum cultures

Patients can be considered noninfectious when they meet all of the following three criteria:

  • They have three consecutive negative AFB sputum smears collected in 8- to 24-hour intervals (one should be an early morning specimen);
  • They are compliant with an adequate treatment regimen for two weeks or longer; and
  • Their symptoms have improved clinically (for example, they are coughing less and they no longer have a fever).

QUOTE FOR WEDNESDAY:

“When TB occurs outside your lungs, signs and symptoms vary according to the organs involved. For example, tuberculosis of the spine may give you back pain, and tuberculosis in your kidneys might cause blood in your urine.”
 
MAYO CLINIC

Part II Tuberculosis – The symptoms, how its diagnosed and treatment.

Symptoms of active TB include a cough that contains thick, cloudy, and sometimes bloody mucus from the lungs, called sputum, for more than two weeks, tiredness and weight loss, night sweats and a fever, a rapid heartbeat, swelling of the lymph nodes, and shortness of breath and chest pain.

DIAGNOSIS:

There are numerous ways for a doctor to diagnose a patient with tuberculosis. Doctors can typically find latent, or not active, TB by doing a tuberculin skin test, where TB antigens are injected under the skin. If the patient has TB bacteria within their body, a red bump will appear at the injection spot in two days. A blood test can also be performed to detect if a patient has TB. For doctors to discover pulmonary TB, they will often test a sample of mucus from the lungs to see if the TB bacteria are present there. Other tests may include further testing on sputum, or mucus from the lungs, other blood tests, or a chest X-ray to find pulmonary TB. To diagnose extrapulmonary TB, a doctor may take a sample of tissue, or a biopsy, to test as well as a CT scan or an MRI to get a clear visual of the inside of the patient’s body.

TREATMENT:

In the majority of cases, doctors will combine four antibiotics to treat active TB, and it is essential for patients to take this medicine for a minimum of six months. A majority of patients are cured of the TB bacteria if they take all the required medicine necessary to destroy the infection. If tests performed by a doctor reveal active TB is still present in the body after six months, treatment will continue for another two or three months. In the worst case scenario, if the TB bacteria is still resistant to multiple antibiotics, called multidrug-resistant TB, treatment will be necessary for one year or longer. Patients with latent TB may be treated with one antibiotic they consume daily for nine months or with a combination of antibiotics taken once a week for twelve weeks. Ensuring every dose is taken reduces the risk of a patient with latent TB to develop active TB.

Patients should be aware that if they miss a dose of their medication or if they stop taking it too soon, the treatment may fail or have to continue for an extensive period. Some patients may even have to start their treatment all over again. This can result in the infection becoming worse or even lead to an infection resistant to antibiotics, which is much more difficult to treat.

There is no guaranteed way for an individual to prevent TB from happening to them or a loved one, but there are some helpful tips individuals can implement if they are at risk or around someone with active TB. As previously stated, latent TB is not contagious and extrapulmonary TB is much more challenging to spread compared to active pulmonary TB. One thing everybody can do to stop the spread of this infection is to get vaccinated, whether as a child or as an adult.

Individuals who are at risk of developing TB or who work with patients who have active TB should always wash and sanitize their hands after they have come into contact with the patient. If an individual is visiting a loved one with TB or taking care of a patient, due to the airborne nature of this infection, uninfected individuals should also keep a healthy distance and wear a mask to prevent them from coming into contact with TB bacteria. Patients who have severe TB should also be quarantined for a time to reduce the risk of spreading the disease as well.

Despite the stigma surrounding this curable disease, with the proper treatment and a bit of patience, individuals infected with tuberculosis can get onto the road to recovery and be healthy sooner rather than later!

Despite the stigma surrounding this curable disease, with the proper treatment and a bit of patience, individuals infected with tuberculosis can get onto the road to recovery and be healthy sooner rather than later!

QUOTE FOR TUESDAY:

“Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection (LTBI) and TB disease. If not treated properly, TB disease can be fatal.”

CDC Centers for Disease Control and Prevention

Part I Tuberculosis What it is and risk factors that prone you in getting TB.

  TB commonly affects lungs.

 

Spreads via coughing and talking near someone so in active TB the patient is put in droplet isolation.  A restricted room and anyone who visits the pt in the room wears a mask.

Tuberculosis is an infectious disease usually caused by Mycobacterium tuberculosis bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body.

Approximately 8.6 million individuals are diagnosed with tuberculosis (TB), and 1.3 million will die of the disease globally, but it is commonly found in the developing world. TB is a highly contagious but treatable infection that predominantly affects the lungs and throat, but can also spread to the kidney, bones, and brain. So what is tuberculosis exactly? Find out what causes this highly contagious infection, who is most at risk for developing it, and how to treat the different kinds and prevent the spreading of this old world disease.

Tuberculosis, commonly abbreviated to TB, is an infection caused by slow-growing bacteria that festers in areas of the body containing an abundant amount of blood and oxygen, hence why it is commonly found in the lungs. TB found in the lungs is known as pulmonary TB and tuberculosis that spreads to other organs is called extrapulmonary TB. TB is highly contagious, but treatment is often effective and can take between six to nine months to treat, or in severe cases, can take up to two years to treat an infected patient. TB can also be either latent or active. Latent TB is when the immune system is defending the body against TB bacteria and keeping it from becoming active, with no visible symptoms. Active TB is when the TB bacteria are growing inside of the body and symptoms have become noticeable in the patient, and it is easy to spread the disease to others= CONTAGIOUS.

Pulmonary TB is contagious, however extrapulmonary TB does not spread as easily as it is usually contained within another part of the body. TB spreads when an individual has active TB breathes out air that has the TB bacteria in it and another individual breathes in the bacteria from the air. Even more bacteria can become airborne when an infected person coughs or laughs as well.

RISK FACTORS IN DEVELOPING TUBERCULOSIS:

1-Those at risk of developing TB are individuals who have HIV or another illness that weakens the immune system, individuals who have close contact with a patient with active TB such as living in the same house as an infected patient, and those caring for a patient with active TB, such as doctors and nurses.

2-Other risk factors include individuals who live or work in crowded places such as prisons, nursing homes, homeless shelters or wherever individuals may have active TB, as well as individuals who abuse drugs and alcohol.

3- Individuals with poor access to health care, where it is commonly seen in the developing world, as well as homeless individuals and migrant farm workers.

4-As well, traveling to places where untreated TB is common puts an individual at risk, such as Latin America, Africa, Asia, Eastern Europe, and Russia. It is important to note individuals who are at a high risk for developing TB should get tested once or twice a year.

5-As well, traveling to places where untreated TB is common puts an individual at risk, such as Latin America, Africa, Asia, Eastern Europe, and Russia. It is important to note individuals who are at a high risk for developing TB should get tested once or twice a year.  So people who make it in the United States via customs with this disease or left here to another country picking up TB bringing it in America passing customs put many at risk and pick up the TB and continue spreading it till treated and healed.  Just like the others who pick it up in or out of America but spread it in the U.S.  There needs to be closer checking on visitors coming in or citizens that leave home and come back in America to be checked for TB.  This will help decrease the amount of people in America with TB by getting diagnosed immediately with treatment.