Hepatitis is a general term meaning inflammation of the liver and can be caused by a variety of different viruses such as hepatitis

A, B, C, D and E. HEPATITIS A one of the oldest diseases known to humankind, is a self-limited disease which results in fulminant hepatitis and death in only a small proportion of patients

Hepatitis A

CAUSATIVE AGENT HAV or hepatitis A virus o a nonenveloped, positive stranded RNA Virus. o first identified by electron microscopy in 1973, classified within the genus hepatovirus of the picornavirus family SIGNS AND SYMPTOMS Jaundice Abdominal pain Diarrhea Loss of appetite Fatigue Nausea and vomiting Fever Dark urine

for their daily tasks. Rest when you need to. You may feel tired and sick for a few months. Find ways to cope with nausea. Nausea can make it difficult to eat. Find ways to make food more appealing. Eat small snacks throughout the day, rather than three large meals. If you're having trouble eating enough calories, avoid low-calorie foods and choose high-calorie foods. For instance, drink fruit juice or milk, rather than water. Give your liver a rest. Your liver may have difficulty processing medications and alcohol if you have hepatitis A. Review your medications, including overthe-counter drugs, with your doctor. Your doctor may recommend stopping or changing some of your medications. Stop drinking alcohol while you have signs or symptoms of hepatitis A infection.

MODE OF TRANSMISSION HAV is transmitted from person-to-person via the faecal-oral route. Humans are the only reservoir of hepatitis A virus, which is transmitted from faeces of infected patients, either by person-to-person contact or by consumption of contaminated food or water. TREATMENT As no specific treatment exists for hepatitis A, prevention is the most effective approach against the disease. Hepatitis A treatment usually focuses on coping with signs and symptoms of hepatitis A infection. For instance: o Expect to have less energy. Many people with hepatitis A infection feel tired and have less energy

PREVENTION Improved sanitation, food safety and immunization are the most effective ways to combat hepatitis A. The spread of hepatitis A can be reduced by: o adequate supplies of safe drinking water o proper disposal of sewage within communities o personal hygiene practices such as regular handwashing with safe water. o Several hepatitis A vaccines are available internationally. All are similar in terms of how well they protect people from the virus and their sideeffects. No vaccine is licensed for children younger than one year of age. TEST Clinically and biochemically, acute hepatitis due to HAV cannot be distinguished from that due to the other hepatitis viruses >serologic tests are necessary for a virus-specific diagnosis Diagnosis of hepatitis is made by biochemical assessment of liver function (laboratory evaluation of: urine bilirubin and

urobilinogen, total and direct serum bilirubin, ALT and/or AST, alkaline phosphatase, prothrombin time, total protein, serum albumin, IgG, IgA, IgM, complete blood count) finding anti-HAV IgM in the serum of patients detection of virus and/or antigen in the faeces Hepatitis B is a liver disease that results from infection with the Hepatitis B virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis B is usually spread when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected

o o

Hepatitis B

detection of HBsAg in a patient shown to be negative within the last 24 months detection of HBsAg and high levels of specific IgM to hepatitis B core antigen (IgM HBcAg) in the absence of prior evidence of HBV infection detection of HBV DNA and high levels of specific IgM to hepatitis B core antigen (IgM HBcAg) in the absence of prior evidence of HBV infection.

CAUSATIVE AGENT (HBV) HEPATITIS B VIRUS o found in certain body fluids of infected people SIGNS AND SYMPTOMS Jaundice Abdominal pain Fever Dark urine MODE TEST Fatigue Nausea or vomiting Loss of appetite Joint pain

TREATMENT There are no medicines for treating acute hepatitis B infection after you get it. If you have a mild case, your healthcare provider probably will prescribe rest, plenty of fluids, and a nutritious diet. While your body fights hepatitis B, you should avoid any medicinesover-the-counter or prescribedthat could damage your liver. You also should avoid alcohol during your recovery period, as alcohol may also damage your liver. PREVENTION The hepatitis B vaccine is the mainstay of hepatitis B prevention. WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours. The birth dose should be followed by 2 or 3 doses to complete the primary series. In most cases, 1 of the following 2 options is considered appropriate: o a 3-dose schedule of hepatitis B vaccine, with the first dose (monovalent) being given at birth and the second and third (monovalent or combined vaccine) given at the same time as the first and third doses of DTP vaccine; or 4 doses, where a monovalent birth dose is followed by 3 monovalent or combined vaccine doses, usually given with other routine infant vaccines.

OF TRANSMISSION Sex with an infected partner Contact with the blood of an infected person Sharing of needles, syringes, razors, or toothbrushes with an infected person Mother-to-child transmission during childbirth HBV infection is confirmed by the detection of hepatitis B surface antigen (HBsAg) or of HBV DNA in serum. Serology determines whether infections are newly acquired or reflect chronic carriage. >Serology for newly acquired infections requires one of the following:

Hepatitis C is caused by the hepatitis C virus that was discovered in 1989. Humans are the only reservoir of hepatitis C virus. The infection is mainly acquired through contact through broken skin with infectious blood (often through sharing contaminated equipment among injecting drug users). The risk of mother-to-child transmission is around 35%, but in cases of simultaneous HIV infection it may reach 15%. Sexual transmission seems to be infrequent. After 1991, blood transfusions and blood products became much safer than before, as routine HCV tests started to become widely available.

Hepatitis C

Because other hepatitis viruses and alcohol use are associated with faster progression of the disease, health experts advise people with hepatitis C to avoid drinking alcohol and to be vaccinated against hepatitis A and hepatitis B viruses. Hepatitis C antibody testing: Enzyme immunoassays (EIAs), rapid diagnostic tests (RDTs), and point-of-care tests (POCTs) Recombinant immunoblot assay Qualitative and quantitative assays for HCV RNA (based on polymerase chain reaction [PCR] or transmission-mediated amplification [TMA]) HCV genotyping Serologic testing (essential mixed cryoglobulinemia is a common finding) is a serious liver disease caused by a virus. It is uncommon in the United States, and only occurs among people who are infected with the Hepatitis B virus

TEST

CAUSATIVE AGENT (HCV) HEPATITIS C VIRUS o This virus causes chronic (long-term) infection SIGNS AND SYMPTOMS Dark urine Jaundice Abdominal pain - Fatigue - Loss of appetite - Nausea or vomiting

Hepatitis D

MODE OF TRANSMISSION You can get hepatitis C from infected blood or body fluids. Today, the most common way people get infected is by needle-sharing during intravenous drug use. Most new infections occur among intravenous drug users. In addition, an infected pregnant woman can infect her unborn baby. Humans are the only reservoir of hepatitis C virus. TREATMENT Two medicines are used to treat hepatitis C: interferon ribavirin Most health experts advise using both drugs together. The response to treatment varies from person to person. THERE IS NO VACCINE AVAILABLE FOR HEPATITIS C.

ETIOLOGIC AGENT Hepatitis D is caused by Hepatitis D Virus, which is found only in people who carry the hepatitis B virus. TESTS AND EXAMS Anti-delta agent antibody Liver Biopsy Liver enzymes (blood test) MODE OF TRANSMISSION Infected blood and needles Sexually transmitted Vertical transmission

SIGNS AND SYMPTOMS Abdominal pain Fatigue Jaundice Joint pain COMPLICATIONS scarring of the liver (cirrhosis) liver disease liver cancer

Dark-colored urine Loss of appetite Nausea Vomiting

Loss of appetite Dark Urine

DIAGNOSIS microscopically examining a stool Blood test TREATMENT There are no medicines for treating a hepatitis E infection after a person gets it. Rest Plenty of fluid Nutritious diet Is the name that had been given to a form of viral hepatitis that seemed to be unexplained by the viruses that cause Hepatitis A-E. It has been debated whether this form of hepatitis is caused by a separate virus or by a variant of one of the other hepatitis viruses.

TREATMENT Currently there are no known treatments for acute or chronic hepatitis D. Antiviral medications do not seem to be very effective in treating hepatitis D. You may be given large doses of the medication called alpha interferon for up to 12 months. is a contagious, acute inflammatory disease of the liver. It does not develop into a chronic disease. is an enterically transmitted virus usually presenting as an acute self-limiting disease. However, mortality increases dramatically from around 1% to 20% in pregnant women.

HEPATITIS F

Hepatitis E

ETIOLOGIC AGENT Hepatitis E is caused by the hepatitis E virus, which is found in the stool of an infected person. MODE OF TRANSMISSION Contaminated water Contaminated food Fecal-oral transmission - Fatigue - Nausea and Vomiting - Fever

ETIOLOGIC AGENT Round 27-37 nm Virus-Like Particles (VLP) were seen. They contain a double stranded DNA with 20 bk. Similar agent was also detected from stools of human patients. MODE OF TRANSMISSION Fecal-oral transmission Contaminated Food Contaminated Water

SIGNS AND SYMPTOMS Jaundice Abdominal Pain Diarrhea

SYMPTOMS Fever Jaundice Pain in the Abdomen

TREATMENT There is no specific treatment for any form of acute hepatitis The patient needs o bed rest o balance diet o nutritious foods o avoid alcoholic beverages First described early in 1996 Hepatitis G is another potential viral cause of hepatitis. The Hepatitis G virus, has been identified and is probably spread by blood and sexual contact. Hepatitis G is a newly discovered form of liver inflammation caused by hepatitis G virus (HGV), a distant relative of the hepatitis C virus.

HEPATITIS G

ETIOLOGIC AGENT caused by Hepatitis G Virus is a single stranded RNA virus belonging to the Flaviviridae family. MODES OF TRANSMISSION infected blood or blood products sexually transmitted from mother-to-newborn child at birth (vertical) SIGNS AND SYMPTOMS Almost no cases have symptoms like the other Hepatitis viruses. In most cases it doesn't cause symptoms similar to those caused by the other types of hepatitis, although some of the infected persons might present some flu-like symptoms. TREATMENT There is currently no recommended tx for Hepatitis G. Rest Avoid alcohol - balanced diet

Anthrax is a serious, sometimes deadly disease caused by infection with anthrax bacteria. These bacteria produce spores that can spread the infection. Anthrax in humans is rare unless the spores are spread on purpose. It became a concern in the United States in 2001, when 22 cases occurred as a result of bioterrorism. Most of those cases affected postal workers and media employees who were exposed to spores when handling mail. Most cases of anthrax occur in livestock, such as cattle, horses, sheep, and goats. Anthrax spores in the soil can infect animals who eat plants growing in the soil. People can be exposed to spores in infected animal products or meat. This is not much of a concern in North America, because livestock are vaccinated against anthrax. But people can get anthrax from handling animal skins or products made out of animal skins from parts of the world where anthrax is more common

ANTHRAX

WHAT CAUSES ANTHRAX? Anthrax is caused by Bacillus anthracis bacteria. Cutaneous (skin) anthrax . This can occur when spores enter your body through a break in the skin. Half of the cases in the 2001 U.S. terrorist attacks were this type. WHAT ARE THE SYMPTOMS? With cutaneous anthrax, symptoms usually appear 5 to 7 days after exposure to spores, though it may take longer. The first symptom may be a small, raised bump that might itch. The bump becomes a painless, fluid-filled blister and later forms a black center of dying tissue. Swollen lymph nodes, headache, and fever also may occur. RESERVOIR The natural reservoirs of anthrax are domesticated herbivores, especially cattle, sheep, and goats.

HOW IS IT TREATED? Antibiotics are used to treat all types of anthrax. Anyone who is infected needs to be treated with antibiotics as soon as possible. Starting treatment before symptoms begin may make the illness less severe and prevent death. Treatment may also include supportive care in the hospital. Anyone who has been exposed to anthrax spores but is not infected should be treated with antibiotics and a few doses of the vaccine to prevent infection. Not everyone who has been exposed to anthrax will get sick. But because there's no way to know who will get sick and who won't, anyone who is directly exposed will get treatment. If you think that you have been exposed, call your local law enforcement agency and your doctor right away. Don't take antibiotics without talking to your doctor first. CLINICAL LABORATORY TESTING To obtain samples of anthrax and test them in a routine clinical microbiology laboratory, the following steps are needed to confirm the presence of anthrax: Gather samples -- Swabs are taken of the nasal passages and any skin lesions of persons possibly exposed to anthrax. Samples of sputum, blood and spinal fluid may also be taken from persons who have symptoms. Swabs may be taken of surfaces where the patients may have been exposed. Initial cultue -- The samples are transported to the laboratory and plated out, placed on a medium that will support the growth of anthrax, and incubated at the appropriate temperature. This step takes 6-24 hours, depending on the purity of the sample and the concentration of bacteria in it. Gram Stain test -- Bacteria from the culture are placed on a glass microscope slide, stained by the Gram procedure, and then examined under the microscope for their shape and color. If the bacteria are anthrax, they should be rod-shaped and "Gram-positive" (blue). This test takes 10-15 minutes. Repeat culture -- The bacteria from the initial culture are replated on a medium that will support the growth of

anthrax, and incubated at the appropriate temperature. This step takes 24-48 hours.. The aim is to grow up larger quantities of the bacteria for biochemical testing. Biochemical testing -- In the laboratory, specific chemicals are added to the bacteria to identify them definitivel as anthrax. This step takes 2-3 hours.

LEPROSY Leprosy is a chronic infection caused by the Mycobacterium leprae bacteria. It can affect the skin and the nerves of the hands and feet, as well as the eyes and the lining of the nose. In some cases, leprosy can also affect other organs, such as the kidneys and testicles in men. If left untreated, leprosy can cause deformities of the hands and feet, blindness and kidney failure. Leprosy is also called Hansens disease. Leprosy progresses very slowly. Most people who have leprosy do not develop symptoms for at least a year after being infected by the bacteria. In most cases, it takes 5 to 7 years for symptoms to develop. DEPENDING ON THE TYPE OF LEPROSY, SYMPTOMS MAY INCLUDE: Skin sores or lesions that do not heal after several months. Lesions are flat or slightly elevated and light in color or slightly red. Skin lumps and bumps that can be disfiguring. Numbness of the skin because of damage to the nerves under the skin. Muscle weakness WHAT ARE THE CAUSES & RISK FACTORS? Most cases of leprosy are from long-term contact with someone who has the disease. Doctors believe that leprosy might be passed from person to person by breathing in droplets that get into the air when infected people cough or sneeze. Most people who come in contact with the

Mycobacterium leprae do not develop leprosy. However, people whose immune systems are weakened from chronic disease (such as diabetes, HIV, AIDS or heart disease) may be more likely to develop leprosy because their immune systems are not strong enough to fight the bacteria. Children are more likely to develop leprosy than adults.

avoid contact with body fluids and the rashes of people who have leprosy. DESCRIPTION Acute febrile infection of the tonsil, throat, nose, larynx, or a wound marked by a patch or patches of grayish membrane from which the diphtheria bacillus is readily cultured. Nasal diphtheria is commonly marked by one sided nasal discharge and excoriated nostrils. Non-respiratory or cutaneous diphtheria appears as localized punched out ulcers. POSITIVE ETIOLOGIC AGENT Corynebacterium diphtheria (Klebs-Loeffler bacillus) SIGNS AND SYMPTOMS The symptoms of respiratory diphtheria usually begin after a two- to five-day incubation period. Symptoms of respiratory diphtheria may include the following: Fever - Malaise Hoarseness - Difficulty in swallowing Difficulty in breathing - Sore throat RESERVOIR Infected humans are the usual reservoir and carriers MODE OF TRANSMISSION Droplet Airborne Direct contact Contaminated fomite

DIPHTHERIA

WHAT ARE THE COMPLICATIONS? If left untreated, leprosy can cause permanent damage to the nerves in the fingers, toes, hands and feet. This may affect a persons ability to feel pain and temperature in these areas of the body. When you cant feel your fingers or toes, you may accidentally burn, cut or hurt yourself. If leprosy damages the lining of the nose, it can cause frequent nosebleeds and constant stuffiness. If leprosy damages your eyes, it can lead to glaucoma and even blindness. Lepromatous leprosy can reduce the amount of the male hormone testosterone and sperm counts in men, which can lead to erectile dysfunction and infertility. In more severe cases, leprosy can also damage the kidneys, which can lead to kidney failure. RESERVOIR Humans are generally considered to be the only natural reservoir of leprosy. HOW IS IT TREATED? Leprosy is treated with antibiotics. Antibiotics can kill all the Mycobacterium leprae bacteria in your body, but they cant reverse nerve damage or deformities caused by leprosy. This is why early treatment is important. You may need to take antibiotics for 6 months or longer, depending on how severe your infection is. HOW IS IT PREVENTED? Even though the risk of catching leprosy is very low, you can still reduce your risk. The best way to prevent leprosy is to

TREATMENT Using diphtheria antitoxin to neutralize the toxin produced by the bacteria Using antibiotics to kill and eliminate diphtheria bacteria

IDENTIFICATION OF MICROORGANISM Gram-positive bacillus with club-shaped swelling at each end BIOCHEMICAL TEST Catalase: All CORYNEBACTERIUM species are catalase positive Gas gangrene(clostridial myonecrosis) is a severe form of gangrene and is so named from the high amounts of carbon dioxide and hydrogen gas produced by the infection usually caused by Clostridium perfringens. It can also be from Group A Streptococcus. Staphylococcus aureus and Vibrio vulnificus can cause similar infections.

GAS GANGRENE

ETIOLOGIC AGENT: Clostridium perfringens IDENTIFICATION: Large Gram-positive bacilli with stubby ends Capsulated Non motile Anaerobic Grown quickly on selective media Can be identified by Nagler reaction RESERVOIR AND MODE OF TRANSMISSION Soil is the primary reservoir. Humans become infected when soil containing clostridial pores enters an open wound. Person-to-person transmission does not occur. RISK FACTORS Trauma or recent surgical wound Arthrosclerosis Diabetes Colon Cancer

SIGNS AND SYMPTOMS Symptoms usually begin suddenly and rapidly worsen. Moderate to severe pain around a skin injury Progressive swelling around a skin injury Moderate to high fever Initial pallor, later dusky progressing to dark red or purple Vesicle formation Signs and Symptoms, cont. Blisters filled with brown-red fluid Drainage from the tissues, foul-smelling serosanguineous discharge Tachycardia Diaphoresis Subcutaneous emphysema MEDICATIONS Antibiotics o Pen G + Clindamycin o Augmentin o Imipenem o Unasyn Analgesics Hyperbaric oxygen BIOCHEMICAL TESTS Cl. perfringnes characterized by: o It ferments many carbohydrates with acid & gas o It acidified litmus milk with stormy clot production o Nagler reaction is positive OVERVIEW OF DISEASE Botulism is, in humans, a rare and sometimes fatal paralytic illness. There are three major types of botulism that differ in how they are acquired: food-borne, wound, and infant botulism.

BOTULISM

Food borne botulism is an intoxication caused by consuming food contaminated with the botulinum toxin; it is not passed on from person to person when the skin is intact. Never taste-test food that may have gone bad. Wound botulism is due to Clostridium bacteria infecting a wound and releasing the neurotoxin. In infant botulism, the baby consumes spores of the bacteria which then grow in the baby's intestine and release the neurotoxin.

ETIOLOGIC AGENT Clostridium botulinum SIGNS AND SYMPTOMS Classical botulism: Nausea Vomiting Dysphagia (difficulty in swallowing) Diplopia (double vision) Dilated/fixed pupils Extremely dry mouth unrelieved by drinking fluids RESERVOIR It is most commonly found in soil and agricultural products. Spores have been found in marine sediments and the intestinal tracts of animals, including fish. MODE OF TRANSMISSION classical botulism is acquired by ingestion of inadequately cooked food or processed or refrigerated foods in which toxin has formed, particularly canned and alkaline foods wound botulism are due to ground-in soil or gravel Infant botulism arises from ingestion of spores rather than pre-formed toxin. Sources of spores include foods such as honey and dust

TREATMENT For cases of foodborne botulism, doctors sometimes clear out the digestive system by inducing vomiting and giving medications to induce bowel movements. Enemas (an injection of fluid into the large intestine) may also be used because they encourage you to empty your bowels. Antitoxin debridement (wound) Botulism Immune Globulin Intravenous-Human (BIG-IV or BabyBIG). METHOD OF DIAGNOSIS Diagnosis is made by culture of C. botulinum or demonstration of specific toxin in serum, gastric aspirate, faeces, implicated food or wounds. Electromyography may be useful in corroborating the clinical diagnosis. IDENTIFICATION OF MICROORGANISM Clostridium botulinum is a spore-forming anaerobic bacillus. Several serotypes exist, however types A, B and E cause most human disease. OVERVIEW Rabies is an acute viral encephalomyelitis caused by the rabies virus, a rhabidovirus of genus lyssavirus. It is fatal once sign and sypmtoms appear. ETIOLOGIC AGENT Rabies virus (a rhabdovirus) SIGNS AND SYMPTOMS (MAN) Sense of apprehension Headache Fever Sensory change near site of animal bite

RABIES

Spasms of muscles or deglutition on attempts to swallow Fear of water/hydriphobia Paralysis Delirium and convulsion

IDENTIFICATION OF MICROORGANISM Virus BIOCHEMICAL TESTS Rabies virus RNA can be enzymatically amplified as DNA copies. Rabies RNA can be copied into a DNA molecule using reverse transcriptase (RT). The DNA copy of rabies can then be amplified using polymerase chain reaction (PCR). This technique can confirm dFA results and can detect rabies virus in saliva and skin biopsy samples. Whooping cough is a highly contagious bacterial infection of the lungs and airways. The medical term for whooping cough is pertussis. The condition usually begins with a persistent dry and irritating cough that progresses to intense bouts of coughing. These are followed by a distinctive 'whooping' noise, which is how the condition gets its name.

RESERVIOR All mammals are susceptible to rabies and therefore are possible reservoirs. MODES OF TRANSMISSION Rabies is transmitted by the virus-laden saliva of an infected animal introduced via a bite or scratch, or by contamination of mucous membranes or broken skin. TREATMENT The most important immediate treatment includes: Washing the wound with copious amounts of soap and water. Apply 1% quaternary ammonium compounds after all traces of soap have been removed. Apply antirabies serum by careful instillation into the wound and by infiltration around the wound. Administer serum systemically. Postpone suturing the wound. Institute antitetanus procedures Start administration of vaccine pending autopsy of animal involved in the bite. Stop treatment if animal is normal. If rabies symptoms ensue give extensive supportive care (treat symptoms as they appear): o Tracheostomy to prevent hypoxia o Careful tracheal suctioning o Use of supplemental oxygen o Relieve intracranial pressure by insertion of a CSF reservoir connected to the lateral ventricle (cavity in the forebrain, one in each cerebral hemisphere) o Control focal seizures with anticonvulsant therapy

WHOOPING COUGH

CAUSATIVE AGENT Bordetella pertussis. These bacteria attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system. The bacteria release toxins, which damage the cilia and cause inflammation (swelling). SIGNS AND SYMPTOMS First stage (Catarrhal stage): lasting 1-2 weeks: o Loss of appetite o Slight fever o Watery, running nose and eyes o Fatigue o Sneezing o Irritating cough (particularly at night Second stage (Paroxysmal stage): usually lasting 1-6 weeks, but can continue for up to 10 weeks:

o o

Severe coughing spasms A high-pitched "whooping" sound when inhaling after a coughing spasm (the whoop sound may not occur with young infants) Vomiting or turning blue due to severe coughing or choking on mucous

Syphilis is a sexually transmitted disease caused by the spirochete bacterium Treponema pallidum. The primary route of transmission is through sexual contact. It may also be transmitted from mother to foetus during pregnancy or at birth, resulting in congenital syphilis. The incubation period is from 10 days to 3 months.

SYPHILIS

Third stage (Convalescent stage): may last for months: o droplets or by direct contact with infected throat or nasal discharges. Coughing and sneezing are the most common modes of transmission. o Once infection with the whooping cough bacteria has occurred, the time until symptoms appear (incubation period) is usually between five to 10 days, though it can be as long as 21 days.

RESERVIOR Humans are the only type of reservoir for T. pallidum or syphilis . Syphilis cannot be spread by a non-living reservoir, such as toilet seats, swimming pools, or eating utensils. SIGNS AND SYMPTOMS The signs and symptoms of syphilis vary depending on which of the four stages it presents (primary, secondary, latent, and tertiary). The primary stage: People with primary syphilis will develop one or more sores. The sores resemble large round bug bites and are often hard and painless. They occur on the genitals or in or around the mouth somewhere between 10-90 days (average three weeks) after exposure. Even without treatment they heal without a scar within six weeks. Secondary syphilis: may last one to three months and begins within six weeks to six months after exposure o Painless rash over the body or on the palms of the hands and soles of the feet o Flu-like illness with swollen glands o White patches on the tongue, mouth or genitals o Fever, fatigue, rash, aches and pains, and loss of app o Latent syphilis with little or no symptoms. Tertiary syphilis: If the infection isn't treated, 1030 years after infection began, it may then progress to a stage characterized by severe problems with the heart, brain, and nerves that can result in paralysis, blindness,

RESERVOIR Humans are reservoir of these bacteria MODE OF TRANSMISSION The whooping cough bacteria are spread from person to person in airborne droplets or by direct contact with infected throat or nasal discharges. Coughing and sneezing are the most common modes of transmission. TREATMENT Antibiotics are used in the treatment of whooping cough. The recommended antimicrobial agents for treatment o of pertussis are azithromycin, clarithromycin and erythromycin. BIOCHEMICAL TESTS Respiratory secretions- nose and throat swabs may be taken to confirm the diagnosis. A chest x-ray Blood tests

dementia, deafness, impotence, and even death if it's not treated. DIAGNOSTIC METHODS The demonstration of spirochetes in the exudate from primary chancres or from the mucous membrane lesions of secondary syphilis, using dark field microscopy or immunofluorescence. Using a combination of treponemal and non-treponemal serological tests(blood test). Treponemal tests measure specific treponemal antibodies in serum. These include Treponema pallidum particle agglutination, enzyme immunoassay and fluorescent Treponemal antibody absorption tests. Non-treponemal tests such as rapid plasma reagin (RPR) and venereal diseases test measure antibodies that are produced in response to syphilis and also to a relatively large number of other conditions TREATMENT: Penicillin is the drug of choice to treat syphilis. Ceftriaxone is given to those allergic to penicillin . One dose of long-acting penicillin is given to those in primary and secondary stages. While those in the latent and tertiary stages, three doses are given. A follow-up exam and a blood test for cure should be done at 6 and 12 months after the antibiotics are given (and may be done at 24 months after latent syphilis) to be sure the infection is cured. PREVENTION: Practicing safe sex is always a method that can be used to help prevent the spread of syphilis. Routine blood tests to check for it especially if pregnant If an individual has any suspicion that he or she may have a sexually transmitted disease, it is imperative that they seek

immediate medical attention before possibly infecting another individual.

DISEASE OVERVIEW Tetanus is a serious bacterial disease that affects the nervous system, leading to painful muscle contractions, particularly of the jaw and neck muscles; hence commonly known as lockjaw. CAUSATIVE AGENT Tetanus is caused by the bacterium clostridium tetani. RESERVOIR Their reservoir is the intestines of horses and other animals, including humans. Moreover, clostridium tetani is widely distributed in cultivated soil. MODE OF TRANSMISSION Tetanus is not directly transmitted from person to person. Spores may be introduced through contaminated puncture wounds, lacerations, burns or contaminated injected street drugs. SIGNS & SYMPTOMS Difficulty in swallowing Spasms of the jaw muscles Stiffness of muscles in the neck and abdomen Excessive sweating Headache Restlessness

TETANUS

BIOCHEMICAL TEST/ DIAGNOSIS There are currently no blood tests for diagnosing tetanus. The diagnosis is based on the presentation of tetanus symptoms and does not depend upon isolation of the bacterium, which is recovered from the wound in only 30% of cases and can be isolated from patients without tetanus. IDENTIFICATION Clostridium tetani is a Gram-positive, spore-forming, rodshaped bacterium. TREATMENT Tetanus immunoglobulin Equine antitoxin Antibiotics Sedatives Specific drug examples include metronidazole, diazepam, etc. Tetanus toxoid should be administered for vaccination.

Tuberculin skin test o Detect exposure to mycobacteria o Results in 48-72 hours

TREATMENT If TB is in an inactive state, an antibiotic called isoniazid (INH) is prescribed for six to twelve months. Active TB is treated with INH as well as drugs such as o Rifampin o Ethambutol o Pyrazinamide Vitamin C helps destroy drug-resistant tuberculosis RESERVOIR Humans OVERVIEW Cholera is an infection of the small intestine caused by the bacterium Vibrio cholerae. The main symptoms are watery diarrhea and vomiting. Transmission occurs primarily by drinking water or eating that has been contaminated by the feces(waste product) of an infected person, including one with no apparent symptoms. The severity of the diarrhea and vomiting can lead to rapid dehydration and electrolyte imbalance, and death in some cases. The primary treatment is oral rehydration therapy, typically with oral rehydration solution, to replace water and electrolytes. If this is not tolerated or does not provide improvement fast enough, intravenous fluids can also be used. Antibacterial drugs are beneficial in those with severe disease to shorten its duration and severity. Worldwide, it affects 35 million people and causes 100,000130,000 deaths a year as of 2010. Cholera was one of the earliest infections to be studied by epidemiological methods. ETHIOLOGIC AGENTS Vibrio cholera

CHOLERA

Tuberculosis is an infection caused by the rod-shaped, non spore-forming, aerobic bacterium Mycobacterium tuberculosis.

TUBERCULOSIS

TRANSMISSION Mycobacterium tuberculosis is spread by small airborne droplets, called droplet nuclei, generated by the o Coughing o Sneezing o Talking o singing of a person with pulmonary or laryngeal tuberculosis. TESTS Sputum smear o To detect acid-fast bacilli o Results in 24 hrs

BIOCHEMICAL TEST Oxidase test test for bacterial colonies were picked with a platinum wire and streaked on filter paper saturated with 0.5% tetramethyl-p phenylenediamine hydrochloric. Rapid appearance of a dark purple color was considered a positive reaction. Arginine dihydrolase test- medium use was Luria-Bertani broth containing 1%(wt/vol) 1-argine (pH6.8). Phenol red powder was added as an indicator. RESERVIOR Humans are considered the primary reservoir and can be asymptomatic carriers. This bacteria are considered hyperinfective immediately upon release from the human body as defined by a significantly lower infectious dose required to cause an infection. Human Aquaticenvironment MODE OF TRANSMISSION Cholera is typically by either contaminated food and water. In the developed world, seafood is the usual cause, while in the developing world I is more often water. Water borne disease Food borne disease Rarely direct contact SIGNS AND SYMPTOMS The primary symptoms of cholera are profuse, painless diarrhea and vomiting of clear fluid. If severe diarrhea is not treated with intravenous rehydration, it can result in the life threatening dehydration and electrolyte imbalances. Typically symptoms of dehydration include low blood pressure, poor skin turgor (wrinkled hands), sunken eyes, and a rapid pulse. Painless diarrhea Vomiting Dehydration

Blood pressure Poor skin turgor (wrinkled hands) Sunken eyes Rapid pulse

TREATMENT fluids electrolyts antibiotics OVERVIEW Salmonella is a genus of rod-shaped, Gram-negative, nonspore-forming, predominantly motileenterobacteria with diameters around 0.7 to 1.5 m, lengths from 2 to 5 m, and flagella that grade in all directions (i.e., peritrichous). They are chemoorganotrophs, obtaining their energy from oxidation and reduction reactions using organic sources, and are facultative anaerobes. Most species produce hydrogen sulfide,[1] which can readily be detected by growing them on media containing ferrous sulfate, such as 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 is closely related to the Escherichia genus and are found worldwide in cold- and warm-blooded animals (including humans), and in the environment. They cause illnesses such as typhoid fever, paratyphoid fever, and foodborne illness. ETHIOLOGIC AGENTS Salmonella typhi BIOCHEMICAL TEST Fermentation of glucose Lysine decarboxylayse H2S production - Negative urease reaction - Negative indole test

SALMONELLA

RESERVIOR Domestic and wild animals including poultry and reptiles act as a reservoir. Cases and convalescent carriers including mild and unrecognized cases can also occurs acts as reservoir. Human and wild animals - Food MODE OF TRANSMISSION Transmission is via person to person or animal to person spread via the fecal oral route. Ingestion of the organisms via contaminated or improperly cooked foods also occurs. This particularly with raw and undercooked eggs and products, raw milk and raw milk products, poultry and poultry products, raw red meats, unwashed salads, fruits and vegetables, grains, seeds and nuts. Food borne transmission Water borne transmission SIGNS AND SYMPTOMS Salmonella infection is usually caused by eating raw or undercooked meat, poultry, eggs or egg products. Most salmonella infections can be classified as gastroenteritis. possible signs and symptoms include : o Nausea -Vomiting o Abdominal pain - Diarrhea o Fever - Chills o Headache - Muscle pains o Blood in the stool TREATMENT Because salmonella infection can be dehydrating, replacement of fluids and electrolytes is the focus of treatment. Severe cases may require hospitalization and fluids delivered into a vein (intravenous). In addition, your doctor may recommended : o Replacement Of Fluids And Electrolytes o Anti-Diarrheals o Antibiotics

IDENTIFICATION TEST Traditional Methods -based on colony appearance on chromogenic and other selective agar media is traditionally confirmed using classical biochemical and serological testing. Rapid methods - many rapid confirmation and identification methods have been developed for Salmonella and a large number and have been developed to commercial products. OVERVIEW According to research, the origins of HIV date back to the late nineteenth or early twentieth century in west-central Africa. AIDS and its cause, HIV, were first identified and recognized in the early 1980s. Both the virus and the disease are often referred together as HIV/AIDS. People with HIV have what is called HIV infection. As a result, some will then develop AIDS. The development of numerous opportunistic infections in an AIDS patient can ultimately lead to death. HIV is a retrovirus that infects the vital organs of the human immune system. The disease progresses in the absence of antiretroviral therapy. The rate of disease progression varies widely between individuals and depends on many factors (age of the patient, body's ability to defend against HIV, access to health care, existence of coexisting infections, the infected person's genetic inheritance, resistance to certain strains of HIV). CAUSATIVE AGENT HIV virus o HIV is a retrovirus, in the genus Lentivirus. o They are named retroviruses because they reverse the usual order of transcription. SIGNS AND SYMPTOMS Fever Pharyngitis Depression - Headache - Weight loss - Night sweats

HIV(Human Immunodeficiency Virus)

Oral or genital ulcers GI distress Diarrhea White spots on the tongue or mouth

MODES OF TRANSMISSION Unprotected sex with infected partner Sharing needles with infected person Vertical transmission Infection from blood products RESERVOIRS Infected humans serves as reservoir TREATMENT Currently, there is no vaccine or cure for HIV/AIDS. But treatments have evolved which are much more efficacious they can improve patients' general health and quality of life considerably. Emergency HIV pills. If an individual believes they have been exposed to the virus within the last 72 hours (three days), anti-HIV medication, called PEP (post-exposure prophylaxis) may stop infection. The treatment should be taken as soon as possible after contact with the virus Antiretroviral drugs. HIV is treated with antiretrovirals (ARVs). The treatment fights the HIV infection and slows down the spread of the virus in the body. Generally, patients take a combination of medications called HAART (highly active antiretroviral therapy). Complementary or alternative medicine. Although widely used, alternative/complementary medications, such has herbal ones, have not been proven to be effective or ineffective. According to some limited studies, mineral or vitamin supplements may provide some benefits. Patients are urged to discuss these options with their doctors.

PREVENTION Unprotected sex. Having sex without a condom can put a person at risk of being infected with HIV and other sexually transmitted infections (STIs). HIV can be spread by having unprotected sex (vaginal, oral and anal sex). It can also be caught from sharing sex toys with someone infected with HIV. Drug abuse and needle sharing. Intravenous drug use is an important factor in HIV transmission in developed countries. Sharing needles can expose users to HIV and other viruses, such as hepatitis C. Strategies such as needle-exchange programs are used to reduce the infections caused by drug abuse. Body fluid exposure. Exposure to HIV can be controlled by employing precautions to reduce the risk of exposure to contaminated blood. At all times, health care workers should use barriers (gloves, masks, protective eyewear, shields, and gowns). Frequent and thorough washing of the skin immediately after being contaminated with blood or other bodily fluids can reduce the chance of infection. Pregnancy. Anti-HIV medicines can harm the unborn child. But an effective treatment plan can prevent HIV transmission from mother to baby. Precautions have to be taken to protect the babys health. Delivery through caesarean section may be necessary. Breastfeeding may have to give way to bottle-feeding if the mother is infected. A study by scientists from Columbia University, New York, found that breastfeeding for 6+ months with antiretroviral therapy could help reduce mother-to-child HIV transmission as well as improve chances of infant's survival. Education. Health education is an important factor in reducing risky behavior.

BIOCHEMICAL TEST ELISA Testing o First serological test developed to detect HIV infection. o Antibodies detected in ELISA include those directed against: p24, gp120, gp160 and gp41, detected first in infection and appear in most individuals ELISA tests useful for: 1. Screening blood products. 2. Diagnosing and monitoring patients. 3. Determining prevalence of infection. 4. Research investigations. Truvada o Truvada is made up of HIV drugs from a class called nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), also known as nukes. o The NRTIs block reverse transcriptase, a protein that HIV needs to make more copies of itself. This may slow down HIV disease OTHER SCREENING TESTS Agglutination tests o using latex particles, gelatin particles or microbeads are coated with HIV antigen and will agglutinate in the presence of antibody. Dot-Blot Testing o utilizes paper or nitrocellulose impregnated with antigen, patient serum is filtered through, and antiantibody is added with enzyme label, color change is positive. o A rapid, cost-effective and may become an alternative to standard ELISA and Western blot testing. Western Blot o Most popular confirmatory test. o Utilizes a lysate prepared from HIV virus. o The lysate is electrophoresed to separate out the HIV proteins (antigens).

The paper is cut into strips and reacted with test sera. o After incubation and washing anti-antibody tagged with radioisotope or enzyme is added. o Specific bands form where antibody has reacted with different antigens. o Most critical reagent of test is purest quality HIV antigen. Indirect immunofluorescence o Can be used to detect both virus and antibody to it. o Antibody detected by testing patient serum against antigen applied to a slide, incubated, washed and a fluorescent antibody added. o Virus is detected by fixing patient cells to slide, incubating with antibody. o