INFECTIOUS DISEASES

Q FEVER
Q fever (Query fever) is an infectious disease that spreads from animals to humans. Q fever is caused
by a microbe called "Coxiella burnetii."
Transmission:
breathe in the Q fever microbe (Most common transmission through air)
contact with dust or mole
Drinking infected milk
through skin contact
Person to person transmission occurs rarely

What are the symptoms of Q fever?
People can have Q fever without knowing it or mistake it for mild flu. Often, it is impossible to tell
without laboratory tests.
Sometimes, Q fever strikes as a sudden illness, affecting a large number of people in the same
workplace. Common signs and symptoms resemble a serious case of the flu:
Sudden onset of high fever
fatigue
muscle pain
chills and sweating
headache
general feeling of sickness and loss of appetite
slight, dry cough because of a lung inflammation known as pneumonitis.
Most symptoms disappear after 7-10 days.
people can feel generally ill with loss of appetite for several weeks.
A SMALL PERCENTAGE of patients develop hepatitis or liver disease and jaundice, a yellowing of the
skin and darkening of the urine, caused by a malfunctioning of the liver.
Other rare clinical syndromes including endocarditis, an inflammation of the lining of the heart
cavity, have been reported.
Test: Antibodies
Treatment: tetracycline (doxycycline) is often used to treat Q fever

Who can get it:
Some of the occupations at increased risk for Q fever include the following:
farmers, ranchers, and farm workers in contact with cattle, sheep, and goats,
stockyard workers, truck drivers, personnel who service the trucks, and visitors to animal auctions,
meat packers, rendering plant workers, hide and wool handlers,
hunters and trappers,
laboratory animal researchers and support staff,
workers who care for pets and livestock--veterinary personnel, pet shop workers and zoo
attendants, and
certain groups of medical and health care personnel who have contact with blood, sputum or
tissue from infected patients.
The risk of infection from the workplace can be reduced by:
vaccination of workers,
personal precautions, and workplace hygiene.

SCABIES:
What is scabies?
Scabies is a skin disease caused by a tiny insect called an "itch mite" which burrows itself under
the skin to lay its eggs.
Scabies causes severe itching and is often called the "itch".
What are the signs and symptoms of Scabies?
Intense itching, mostly at night;
Looks like small, red, slightly raised spots (a pimple-like rash) or streaks in the skin;
May have tiny blisters;
Common areas are between fingers, on wrists or belt lines and in the folds of the skin, but may
appear anywhere on the body.
How do you get Scabies?
You can get scabies by being in direct, prolonged skin-to-skin contact with a person who has
scabies.
It can be passed easily to sexual or household contacts of a person who has scabies.
Scabies can also be spread by wearing that person's clothing or by sleeping in that person's bed,
but this is less common.
Why is it important to treat Scabies?
To stop the itching because scratching can lead to other infections.
So you don't pass scabies on to other people.
How do you get rid of scabies?
Don't try to diagnose scabies by yourself. See a doctor to get a lotion or cream to help treat
scabies.
Follow the directions on the bottle carefully because the lotion or cream contains poison.
If you have scabs or crusts from scratching, have a bath or shower first; this will soften them
and let the medicine get under the skin. Wait 15 minutes until the skin is cool and dry before
applying the lotion or cream.
Cover your entire body from the neck down with the lotion or cream.
Pay special attention to the areas that mites like to live in: between fingers and toes, in the belly
button, armpits and in the skin around the waist and genital area when applying the lotion.
Dress in freshly washed, clean clothes.
Leave the lotion or cream on for 8 to 12 hours (overnight is a good time).
Then take a bath or shower with warm water (not hot!) and wash well. Put on freshly-cleaned
clothes.
See the doctor in about seven days. If you need another treatment, you will be told at that time.
All other household members and sexual contacts should be treated at the same time to
prevent re-infestation.
Care of Clothing and Linens:
The mite that causes scabies can live in clothing and bedding for three days.
You can treat linen and clothes as follows:
o Use hot water to wash all clothing, bed linens, towels and washcloths that have been used
or worn within one week before the treatment.
o Dry clothes, blankets, towels, etc. in the dryer at the hottest setting for 15 minutes.
o Place stuffed animals and items that cannot be washed in a sealed plastic bag for 3 days.
SCARLET FEVER
What is scarlet fever?
Scarlet fever, also called scarlatina, is caused by Group A streptococcus (group A strep), a
bacterium commonly found in the throat and on the skin. These bacteria also cause strep throat.
Scarlet fever often appears as a rash and is accompanied by a high fever and a strawberry-like
appearance of the tongue. The illness is most common among children aged 5 to 18 years, but adults
can also become infected.
How do people get scarlet fever?
Scarlet fever bacteria are transferred from person to person through contact with the droplets of an
infected persons cough and sneeze. If you touch your eyes, nose or mouth after coming into contact
with these fluids, you may be at risk for contracting scarlet fever.
What are the symptoms and consequences of scarlet fever?
Symptoms of scarlet fever include a very red, sore throat; a fever of 38.3 C (101 F) or higher; a red
rash with a sandpaper-like feel; swollen glands in the neck; and a whitish coating on the surface of
the tongue, giving it a strawberry-like appearance because the normal bumps on the tongue look
bigger. Symptoms of scarlet fever usually begin one to four days after exposure to the bacteria.
Approximately one to four days after the onset of illness, the characteristic skin rash will appear. The
rash usually lasts for two to seven days after which the skin may peel.
Other less common symptoms include headache, nausea, vomiting, and body aches.
Complications as a result of untreated scarlet fever are rare and include rheumatic heart disease and
kidney damage, also known as post-streptococcal glomerulonephritis.
How can scarlet fever be prevented?
It is important for infected individuals and those around them to wash their hands often and to avoid
sharing eating utensils, linens, towels, or other personal items that could come into contact with
bodily fluids. There is no vaccine to prevent scarlet fever or strep throat.
What is the treatment for scarlet fever?
Scarlet fever is treated with prescription antibiotics, which fight bacterial infections. It is important to
follow your doctors dosage instructions and to never share any prescription medications.
Patients are usually no longer infectious 24 hours after starting antibiotics; however, the full course
of antibiotics should be taken.







Thrush
Thrush is a yeast infection of the mucus membrane lining the mouth and tongue.
Causes
The body normally hosts a variety of germs ,including bacteria and fungi. Some of these are useful to
the body, some produce no harm or benefit, and some can cause harmful infections.
Thrush occurs when a fungus called Candida (part of normal flora) overgrows in your mouth. A small
amount of this fungus lives in your mouth most of the time. It is usually kept in check by your
immune system and other germs that also normally live in your mouth.
However, when your immune system is weak or when the other normal bacteria die, the fungus can
overgrow. The following factors can increase your chances of getting thrush:
The following factors can increase your chances of getting thrush:
Being in poor health
Being very old or very young
Having an HIV infection or AIDS
Long-term use or high dose antibiotics
Receiving chemotherapy or drugs that weaken the immune system
Taking steroid medications
Thrush is commonly seen in infants. It is not considered abnormal in infants unless it lasts longer than
a couple of weeks.
Candida can also cause yeast infections in the vagina.
People who have diabetes and have high blood sugar levels are more likely to get thrush in the
mouth (oral thrush), because the extra sugar in your saliva acts like food for Candida.
Taking high doses of antibiotics or taking antibiotics for a long time also increases the risk of oral
thrush. Antibiotics kill some of the healthy bacteria that help keep Candida from growing too much.
People with poorly fitting dentures are also more likely to get thrush.
Symptoms
Thrush appears as whitish, velvety sores in the mouth and on the tongue. Underneath the whitish
material, there is red tissue that may bleed easily. The sores can slowly increase in number and size.
Exams and Tests
Your doctor or dentist can almost always diagnose thrush by looking at your mouth and tongue. The
sores have a distinct appearance.
If the diagnosis is not clear, one of the following tests may be performed to look for Candida:
Culture of mouth lesions
Microscopic examination of mouth scrapings
Treatment
For thrush in infants, treatment is often NOT needed. It usually gets better on its own within 2 weeks.
If you develop a mild case of thrush after taking antibiotics, eating yogurt or taking over-the-counter
acidophilus capsules can help.
Use a soft toothbrush and rinse your mouth with a diluted 3% hydrogen peroxide solution several
times a day.
Good control of blood sugar levels in persons with diabetes may clear a thrush infection.
Your doctor may prescribe an antifungal mouthwash (nystatin) or lozenges (clotrimazole) to suck on
if you have a severe case of thrush or a weakened immune system. These products are usually used
for 5 to 10 days. If they don't work, other medication may be prescribed.
You may need stronger medications, such as fluconazole (Diflucan) or itraconazole (Sporanox) if:
You have a weakened immune system due to HIV or some medicines
The infection is moderate to severe
The infection spreads through your body
Outlook (Prognosis)
Thrush in infants may be painful, but it is rarely serious. Because of discomfort, it can interfere with
eating. If it does not get better on its own within 2 weeks, call your pediatrician.
In adults, thrush that occurs in the mouth can be cured. However, the long-term outlook depends on
your immune system and the cause of the immune problem.
Possible Complications
If you have a weakened immune system, Candida can spread throughout your body, causing a
widespread (invasive) infection. This might affect your:
Brain (meningitis)
Esophagus (esophagitis)
Eyes (endophthalmitis)
Heart (endocarditis)
Joints (arthritis)
When to Contact a Medical Professional
Call your doctor if:
Your infant has had thrush-like sores in the mouth for at least 2 weeks.
Your infant is eating poorly due to the sores.
You are a teen or adult with thrush-like sores.
You have pain or difficulty swallowing.
You have symptoms of thrush and you are HIV positive, receiving chemotherapy, or you take
medications to suppress your immune system.
Prevention
If you get thrush often, your doctor may recommend taking antifungal medication on a regular basis
to avoid repeat infections.
If an infant with thrush is breastfeeding, talk to your doctor about ways to prevent future infections,
such as an antifungal medication. Sterilize or throw out any pacifiers. For bottle-fed babies with
thrush, throw out the nipples and buy new ones as the baby's mouth begins to clear.
To prevent the spread of HIV infection, follow safe sex practices and use precautions when working
with blood products.

Impetigo
A highly contagious bacterial infection, impetigo often starts when a small cut or scratch becomes
infected. Though this type of bacterial infection can affect adults, it is much more common in
children.
The symptoms of impetigo are honey-colored, crusty sores that often appear on the face between
the upper lip and nose. The rashes consist of red spots or blisters that rupture, discharge, and
become encrusted. People with impetigo should not scratch the sores because they may
inadvertently spread the infection to other parts of their bodies.
Causes of Impetigo
This skin infection is caused by one of two bacteria, group A streptococcus, which is the bacteria also
responsible for "strep throat," or staphylococcus. If impetigo is caused by streptococcus it will begin
with tiny blisters. These blisters will eventually erupt revealing small, wet patches of red skin.
Gradually, a tan or yellowish brown crust will cover the affected area giving the appearance that it is
coated with honey. If caused by staphylococcus, people will notice larger blisters that appear to
contain a clear fluid. These blisters stay intact for a longer period of time compared to the smaller
ones.
Impetigo usually affects preschool and school-aged children, especially during the summer. This type
of infection has a special preference for skin that has been affected by other skin problems, such as
eczema, poison ivy, or a skin allergy to soap.
Impetigo is highly contagious. Children can spread this skin infection from one area of the body to
another by touching the infected area and then touching other parts of their bodies. The infection
can also spread to other household members through clothing, towels, and bed linens that have
been in contact with the infected person. Classmatesand playmates also hold themselves at high risk
of infection by coming in contact with the infected person or anything that he or she has touched.
Treatment and Prevention
The most important way parents can prevent impetigo is by keeping their childs skin
clean. Osteopathic physicians (DOs) recommend giving your child daily baths or showers with anti-
bacterial soap and warm water. They say to pay special attention to areas of the skin with cuts or
scrapes, as well as rashes on the skin.
If impetigo is not improved after three days, or any new infected areas appear, a physician should be
called immediately. If left unattended, this infection can cause serious problems, such as pain;
swelling; tenderness of the infected areas; discharge of pus; or fever.
If the infected areas are relatively small, DOs suggest trying simple home remedies:
Try to by soaking the infected area in warm water for 15 to 20 minutes
Then scrub the area gently with a washcloth and antibacterial soap
Apply antibiotic ointments
Cover the area with gauze or a loose plastic bandage, if possible.
Preventing Impetigo from Spreading
One of the main issues with impetigo is preventing it from spreading. For instance, when your child
has a runny nose, keep the area between the upper lip and nose clean. The nose is most often the
source of impetigo germs.
Physicians recommend spreading a thin layer of anti-bacterial ointment under the noseas well as
applying it in the nostrils with a Q-tip.
These precautions can help eradicate the "bug" that causes the infection.
Even though impetigo is not life threatening, it could lead to life-threatening situations. However,
this infection is very manageable. With the proper medical attention, it can be easily treated.
Giardiasis
What is giardiasis?
Giardiasis (gee-are-dye-uh-sis) is a diarrheal disease caused by microscopic parasites called Giardia. T
Giardiasis is a common cause of waterborne disease in humans. Giardiasis is sometimes called
"beaver fever" after an outbreak in which hikers at Banff National Park became ill from drinking
stream water contaminated with Giardia from beavers.
What are the symptoms of giardiasis?
Giardia infection may causea variety of intestinal symptoms, including :
diarrhea
bloating, gas or flatulence
greasy stools that tend to float
stomach or abdominal cramps
upset stomach or nausea
fatigue, and
weight loss
Symptoms of giardiasis usually begin seven to 10 days after exposure, but it can also be as little as
three days or as long as 25 days. The symptoms typically last two to six weeks, but may occasionally
last longer.
How is giardiasis spread?
You can become infected by :
ingesting contaminated drinking or recreational water
touching your mouth with contaminated hands,
putting something in your mouth that has come into contact with the droppings of infected animals
or the stool of infected humans,
eating raw or undercooked food that is contaminated,
inadequately washing hands before preparing food, before eating, and after toileting or diapering,
or
exposure to feces of an infected individual through sexual contact.
How is giardiasis diagnosed and treated?
Giardiasis is usually diagnosed by examination of stool samples. Patients may be asked to submit
multiple stool samples because detection of Giardia can be difficult.
Several anti-parasitic medications are available to treat giardiasis. Your health care practitioner will
decide if and what medication is needed for you. Persons with diarrhea should generally drink lots of
liquids to avoid dehydration.
If you think you have giardiasis you should see your doctor for testing, advice and treatment.
How can you prevent giardiasis?
The most important preventative measure is good hygiene.
Practice good hand hygiene. Wash your hands with soap and water :
after using the toilet
after changing diapers
after assisting others with the toilet
after contact with animals
after working in the garden, and
before and after handling food
Avoid swallowing water while swimming in lakes, rivers or pools.
Avoid drinking water from shallow wells, rivers, lakes or streams. Only drink water that you know is
uncontaminated. If you are not sure, treat the water yourself, for example, by boiling for at least five
minutes.
Peel raw vegetables and fruits before eating. Use uncontaminated water to wash fruits and
vegetables.
Giardiasis has been associated with camping and travelling. Campers and travellers should be aware
if giardiasis is common in the area they will be visiting. For more information, consult a travel
medicine clinic to assess personal risk and appropriate preventive measures.
What is fifth disease?
Fifth disease is a very common childhood illness. Adults can get it too. It is sometimes called slapped-
cheek disease because of the rash that some people get on the face. You spread the disease by
coughing and sneezing.
Fifth disease is usually a mild illness that lasts a few weeks. It can be more serious for people
with weak immune systems or blood disorders, such as sickle cell disease. It can also cause
problems for the baby (fetus) of a pregnant woman who gets the illness, although this isn't common.


What causes fifth disease?
Fifth disease is caused by a virus called human parvovirus B19. (Only humans can catch and spread
fifth disease. Although there are other parvoviruses that infect animals, you cannot catch these from
your pet or any other animal.)
As a rule, people can spread fifth disease only while they have flu-like symptoms and before they get
a rash. Usually, by the time the rash appears, you can no longer spread the disease to anyone else.
Some people, such as those who have weak immune systems or blood disorders, may be able to
spread the disease for a longer time.
What are the symptoms?
Symptoms usually appear 2 to 3 weeks after exposure to the virus. Early symptoms are similar to the
flurunny nose, sore throat, headacheand may be so mild that you don't notice them.
The rash comes several days later, first on the face and later over the rest of the body. It may be
itchy. The rash usually fades within 5 days. For a few weeks, the rash may come back when you are
out in the sun, get too warm, or are under stress. This doesn't mean the disease is worse.
Some people also get pain in their joints. This can last for several weeks or even months.
Not all people with fifth disease get a rash or feel sick.
How is fifth disease diagnosed?
Your doctor can diagnose fifth disease by doing a physical examination and asking questions about
your medical history. The disease is easier to diagnose if you have the rash.
Tests aren't usually needed, but they may be done in some cases to confirm that you have fifth
disease.
How is it treated?
Fifth disease usually goes away on its own. Antibiotics don't help with fifth disease, because the
illness is caused by a virus, not a bacteria.
Home treatment can help with symptoms until you feel better.

Use acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) for fever, headache, or
joint pain. Follow all directions on the label. If you give medicine to your baby, follow your doctor's
advice about what amount to give. Do not give ASA to anyone younger than 20 because of the risk
of Reye syndrome .

Get extra rest.

Drink plenty of fluids.
Try not to spread the illness. Wash your hands often, and stay home from school, daycare, or work.
(When the rash appears, you can return.)
If you are pregnant or have a weak immune system or certain blood disorders, see your doctor. You
may need extra checkups, tests, or treatment.

Kwashiorkor
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Kwashiorkor is a form of malnutrition that occurs when there is not enough protein in the diet.
Causes
Kwashiorkor is most common in areas where there is:
Famine
Limited food supply
Low levels of education (when people do not understand how to eat a proper diet)
This disease is more common in very poor countries. It often occurs during a drought or other natural
disaster, or during political unrest. These conditions are responsible for a lack of food, which leads to
malnutrition.
Kwashiorkor is very rare in children in the United States. There are only isolated cases. However, one
government estimate suggests that as many as 50% of elderly people in nursing homes in the United
States do not get enough protein in their diet.
When kwashiorkor does occur in the United States, it is usually a sign of child abuse and severe
neglect.
Symptoms
Changes in skin pigment
Decreased muscle mass
Diarrhea
Failure to gain weight and grow
Fatigue
Hair changes (change in color or texture)
Increased and more severe infections due to damaged immune system
Irritability
Large belly that sticks out (protrudes)
Lethargy or apathy
Loss of muscle mass
Rash (dermatitis)
Shock (late stage)
Swelling (edema)
Exams and Tests
The physical examination may show an enlarged liver (hepatomegaly) and general swelling.
Tests may include:
Arterial blood gas
BUN
Complete blood count (CBC)
Creatinine clearance
Serum creatinine
Serum potassium
Total protein levels
Urinalysis
Treatment
Getting more calories and protein will correct kwashiorkor, if treatment is started early enough.
However, children who have had this condition will never reach their full potential for height and
growth.
Treatment depends on the severity of the condition. People who are in shock need immediate
treatment to restore blood volume and maintain blood pressure.
Calories are given first in the form of carbohydrates, simple sugars, and fats. Proteins are started
after other sources of calories have already provided energy. Vitamin and mineral supplements are
essential.
Since the person will have been without much food for a long period of time, eating can cause
problems, especially if the calories are too high at first. Food must be reintroduced slowly.
Carbohydrates are given first to supply energy, followed by protein foods.
Many malnourished children will develop intolerance to milk sugar (lactose intolerance). They will
need to be given supplements with the enzyme lactase so that they can tolerate milk products.
Outlook (Prognosis)
Getting treatment early generally leads to good results. Treating kwashiorkor in its late stages will
improve the child's general health. However, the child may be left with permanent physical and
mental problems. If treatment is not given or comes too late, this condition is life-threatening.
Possible Complications
Coma
Permanent mental and physical disability
Shock
When to Contact a Medical Professional
Call your health care provider if your child has symptoms of kwashiorkor.
Prevention
To prevent kwashiorkor, make sure the diet has enough carbohydrates, fat (at least 10 percent of
total calories), and protein (12 percent of total calories).
Alternative Names
Protein malnutrition; Protein-calorie malnutrition; Malignant malnutrition