“Many germs, such as bacteria, viruses and fungi can cause pneumonia. Understanding the cause of pneumonia is important because pneumonia treatment depends on its cause.”

American Lung Association

“Flu (influenza) is a contagious respiratory illness caused by influenza viruses that can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. … RSV (respiratory syncytial virus) is a common respiratory virus that usually causes mild, cold-like symptoms.”

Cleveland Clinic

“According to the National Cancer Institute, more than 268,600 women in the United States will be diagnosed with breast cancer and nearly 42,000 will die of the disease in 2019.  Breast cancer is the most common type of non-skin cancer in women in the United States.”

First Part of risk factors:

Those that we cannot change:

Gender

Women account for more than 99 percent of all breast cancer cases.

Age

After gender, age is the most influential risk factor for developing breast cancer. Women younger than age 40 account for only 4.7 percent of invasive breast cancer diagnoses and only 3.6 percent of in situ breast cancer diagnoses. Over 70 percent of all breast cancer diagnoses are made in women who are 50 or older.

You may have heard the statistic that one in eight women in the United States will develop breast cancer. This does not mean that a woman of any age has a one-in-eight chance of developing breast cancer. This statistic conveys a woman’s lifetime risk. This means that if a woman lives until age 85, she has a risk of one in eight of developing breast cancer sometime during her lifetime.

Race

After age 40, Caucasian women are more likely to be diagnosed with breast cancer than African-American women. However, African-American women are more likely than white women to die of breast cancer. Women of Asian, Hispanic or American Indian descent are at lower risk than Caucasian or African-American women for developing breast cancer.

Personal History

If a woman has had cancer in one breast, she is at increased risk of developing cancer in the other breast.

Family History

Women with a relative who has had breast cancer are at higher risk of developing breast cancer themselves, particularly if it is a first-degree relative, such as a mother, sister or daughter.

That risk is further increased if a woman has multiple first-degree relatives who have had breast cancer, or if she has a first-degree relative who developed breast cancer at a young age or in both breasts.

Patients with family members who have had breast and/or ovarian cancer may choose to see a qualified genetic counselor from the UCSF Cancer Genetics and Prevention Program at Mount Zion. These counselors are available to evaluate a person’s likelihood of carrying a gene mutation and to discuss the possibility of genetic testing.

Genetic Risk Factors

Women who have certain inherited gene mutations (including BRCA1 and BRCA2) have a significantly increased risk of breast cancer and account for about 5 percent to 10 percent of breast cancer cases. In most women, the normally functioning BRCA1 and BRCA2 genes help to prevent breast cancer by controlling cell growth. However, these genes are no longer able to control cell growth properly unmutated.

Since these genes are passed down from your parents, it is possible to carry a gene mutation from the mother or father’s side of the family. A female who carries either the BRCA1 or BRCA2 gene mutation has up to an 85 percent chance of developing breast cancer by the age of 70. However, in men the BRCA2 gene mutation is reported to increase risk of breast cancer more than the BRCA1 gene mutation. Males who carry the BRCA2 gene mutation have a suggested 6 percent chance of developing breast cancer during a lifetime.

A prevalence of the BRCA1 and BRCA2 gene mutations has been observed in the Ashkenazi Jewish (Jews with European or Central European ancestry) population. Having one or more relatives with breast or ovarian cancer, and being of Ashkenazi Jewish descent, puts a person at greater risk for carrying a BRCA gene mutation.

Radiation

Exposure to high doses of chest radiation, such as for medical therapy for Hodgkin’s lymphoma, particularly during childhood, can greatly increase a woman’s risk of developing breast cancer.

Researchers have found that the age at which radiation was received is inversely related to the acquired risk. Thus, women who received radiation after their menopausal years incurred very little risk.

“1 out of 8 women will develope breast cancer in their lifetime.”

National Breast Cancer Foundation, Inc.

“In the United States, for equine encephalitides for which vaccines are available include eastern equine encephalomyelitis (EEE), western equine encephalomyelitis (WEE), Venezuelan equine encephalomyelitis (VEE) and West Nile Virus encephalomyelitis. The availability of licensed vaccine products combined with an inability to completely eliminate risk of exposure justifies immunization against EEE and WEE as core prophylaxis for all horses residing in or traveling to North America and any other geographic areas where EEE and/or WEE is endemic.  Adult horses previously vaccinated against EEE/WEE: Annual revaccination must be completed prior to vector season in the spring. In animals of high risk or with limited immunity, more frequent vaccination or appropriately timed vaccination is recommended in order to induce protective immunity during periods of likely exposure.”

American Association of  Equine Practioners

“Know there’s no cure for Eastern equine encephalitis, or EEE, but there is a vaccine for the mosquito-borne illness. It’s just not commercially available for humans.The United States military developed it in the 1980s as part of a vaccine program to protect military personnel from dangerous pathogens, says Sam Telford, an epidemiologist at Tufts University.”

Common Health

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Eastern equine encephalitis virus (EEEV) is a zoonotic alphavirus and arbovirus, and was first recognized in horses in 1831 in Massachusetts. The first confirmed human cases were identified in New England in 1938. EEEV is present today in North, Central and South America, and the Caribbean. In rare cases, those that contract the virus will develop the serious neuroinvasive disease, Eastern equine encephalitis (EEE). From 2009 to 2018, between three (3) and fifteen (15) cases of EEE were reported annually in the U.S. EEE may also be commonly referred to as Triple E or sleeping sickness. EEEV is a vector-borne disease that is transmitted to humans through the bite of an infected mosquito. Culiseta melanura is the primary vector among birds, but this mosquito species does not typically feed on humans. It is believed that EEEV is mainly transmitted to humans and horses by bridge vectors that have contracted the virus by feeding on infected birds. Bridge vector species of mosquitoes may include Coquillettidia pertubans, Aedes sollicitans, and Ochlerotatus canadensis. The risk of contracting the EEE virus is highest during the summer months, and those who live and work near wetland and swamp areas are at higher risk of infection. EEEV is only spread to humans via mosquito bite, and cannot be transmitted directly by other humans or horses. There is an EEEV vaccine available for horses, and owners are encouraged to discuss vaccination with their veterinarian.

A Global View of Eastern Equine Encephalitis

EEE affects areas throughout North and South America, with outbreaks occurring mainly in the eastern coastal areas of the United States and Canada, the Caribbean, and Argentina.

Know Your Mosquitoes

In the U.S., Culiseta melanura is the mosquito responsible for the spread of EEEV in the mosquito-bird-mosquito cycle. Known as the black-tailed mosquito, Cs. melanura can be found in swamps from the Great Lakes and Maine to southern Florida and southeastern Texas. It is distinguished by its unusually long, curved dark-scaled proboscis. This mosquito is also unique because it overwinters as larvae, as opposed to most mosquito species that overwinter as adults or eggs.

EEEV is mainly transmitted to humans by bridge vectors that contract the virus by feeding on infected birds. Bridge vectors may include Aedes, Coquillettidia, and Culex species.

Aedes mosquitoes have distinct black and white markings on their body and legs. They bite during the daytime only, with the highest levels of activity occur in the early morning and evening hours. Members of the Aedes genus are known vectors of EEE, Zika virus, dengue, yellow fever, West Nile virus, and chikungunya.

Coquillettidia mosquitoes have slender bodies and long legs. They are commonly found in humid, low-lying areas that have warm summer and lots of vegetation. In addition to acting as vectors for EEE, Coquillettidia mosquitoes are also known to transmit West Nile virus to humans.

Culex mosquitoes are brown with whitish markings on the abdomen. They typically bite at dusk and at night, and are known to vector several diseases including EEE, West Nile virus, Japanese encephalitis, St. Louis encephalitis, and avian malaria.