Dengue fever

• Dengue fever is a painful, debilitating mosquito-borne disease

caused by any one of four closely related dengue viruses.
• Dengue fever is transmitted by the bite of an Aedes mosquito
infected with a dengue virus.
• The mosquito becomes infected when it bites a person with
dengue virus in their blood.
• It can’t be spread directly from one person to another person.
It occurs in tropical and subtropical areas of the world.
• Millions of cases of dengue infection occur worldwide each
year. Dengue fever is most common in Southeast Asia and the
western Pacific islands, but the disease has been increasing
rapidly in Latin America and the Caribbean.
Symptoms

Many people, especially children and teens, may experience no

signs or symptoms during a mild case of dengue fever. When
symptoms do occur, they usually begin four to seven days after
you are bitten by an infected mosquito.
Dengue fever causes a high fever 104 F degrees and at least two
of the following symptoms:
• Headache
• Muscle, bone and joint pain
• Nausea
• Vomiting
• Pain behind the eyes
• Swollen glands
• Rash
Most people recover within a week or so. In some cases, symptoms worsen and can
become life-threatening. Blood vessels often become damaged and leaky. And the
number of clot-forming cells (platelets) in your bloodstream drops. This can cause a
severe form of dengue fever, called dengue hemorrhagic fever, severe dengue or
dengue shock syndrome.
Signs and symptoms of dengue hemorrhagic fever or severe dengue a life-
threatening emergency
include:
• Severe abdominal pain
• Persistent vomiting
• Bleeding from your gums or nose
• Blood in your urine, stools or vomit
• Bleeding under the skin, which might look like bruising
• Difficult or rapid breathing
• Cold or clammy skin (shock)
• Fatigue
• Irritability or restlessness
Diagnosing Dengue Fever

• Doctors can diagnose dengue infection with a blood test to

check for the virus or antibodies to it. If you become sick after
traveling to a tropical area, let your doctor know. This will
allow your doctor to evaluate the possibility that your
symptoms were caused by a dengue infection.
Treatment for Dengue Fever

• There is no specific medicine to treat dengue infection. If you

think you may have dengue fever, you should use pain
relievers with acetaminophen and avoid medicines with
aspirin, which could worsen bleeding.
• You should also rest, drink plenty of fluids, and see your
doctor. If you start to feel worse in the first 24 hours after your
fever goes down, you should get to a hospital immediately to
be checked for complications.
To protect yourself:

• Stay away from heavily populated residential areas, if possible.

• Use mosquito repellents, even indoors.
• When outdoors, wear long-sleeved shirts and long pants
tucked into socks.
• When indoors, use air conditioning if available.
• Make sure window and door screens are secure and free of
holes. If sleeping areas are not screened or air conditioned,
use mosquito nets.
• If you have symptoms of dengue, speak to your doctor.
• To reduce the mosquito population, get rid of places where
mosquitoes can breed. These include old tires, cans, or flower
pots that collect rain. Regularly change the water in outdoor
bird baths and pets' water dishes.
• One dengue fever vaccine, Dengvaxia, is currently approved
for use in those ages 9 to 45 who live in areas with a high
incidence of dengue fever. The vaccine is given in three doses
over the course of 12 months. Dengvaxia prevents dengue
infections slightly more than half the time.
• The vaccine is approved only for older children because
younger vaccinated children appear to be at increased risk of
severe dengue fever and hospitalization two years after
receiving the vaccine.
• The World Health Organization stresses that the vaccine is not
an effective tool, on its own, to reduce dengue fever in areas
where the illness is common. Controlling the mosquito
population and human exposure is still the most critical part of
prevention efforts.
• So for now, if you're living or traveling in an area where
dengue fever is known to be, the best way to avoid dengue
fever is to avoid being bitten by mosquitoes that carry the
disease.
Meningitis
• Meningitis (Greek meninx, membrane, and -itis, inflammation)
is an inflammation of the brain or spinal cord meninges
(membranes).
• There are many causes of meningitis, some of which can be
treated with antimicrobial agents.
• A variety of Gram-positive and Gram-negative bacteria cause
meningitis, including Streptococcus pneumoniae, Neisseria
meningitidis, Haemophilus influenza serotype b, group B
streptococci (S. agalactiae), Listeria monocytogenes,
Mycobacterium tuberculosis, Nocardia asteroides,
Staphylococcus aureus, and S. epidermidis. However, three
organisms tend to be associated with meningitis more
frequently than others: S. pneumoniae, N. meningitidis, and H.
influenza serotype b.
• The usual symptoms of meningitis include an initial respiratory
illness or sore throat interrupted by one or more of the
meningeal syndromes: vomiting, headache, lethargy,
confusion, and stiff neck and back. Once bacterial meningitis is
suspected, antibiotics are administered immediately. In fact,
antibiotics (penicillin, chloramphenicol, cefotaxime,
ceftriaxone, ofloxacin) are often administered prophylactically
to patient
• Control of N. meningitidis infection is with vaccination and
antibiotics. Two meningococcal conjugate vaccines are
currently available: the MCV4-D and the MCV4
Chlamydial pneumonia
• Chlamydial pneumonia is caused by Chlamydophila
pneumoniae. The Gram-negative chlamydiae are obligate
intracellular parasites.

• Symptoms include fever, a productive cough (respiratory

secretion brought up by coughing), sore throat,
hoarseness(voice change), and pain on swallowing
• C. pneumoniae is primarily a human pathogen directly
transmitted from human to human by droplet (respiratory)
secretions.
• Diagnosis of chlamydial pneumonia is based on symptoms and
an immunofluorescence test.
• Tetracycline and erythromycin are routinely used for
treatment.
Diphtheria
• Diphtheria (Greek diphthera, membrane, and -ia, condition) is
an acute, contagious disease caused by the Gram-positive
bacterium Corynebacterium diphtheriae
• Typical symptoms of diphtheria include a thick nasal discharge
containing both mucus and pus, pharyngitis(sore throat),
fever, cough, paralysis, and death
• Diagnosis is made by observation of the pseudomembrane in
the throat and by bacterial culture.
• penicillin and erythromycin are used to treat the infection.
Prevention is by active immunization with DTaP (diphtheria
and tetanus toxoids, and acellular B. pertussis vaccine). DTaP is
recommended for immunization of children at two, four, six,
and eighteen months of age, with booster vaccinations given
at twelve and eighteen years.
Legionnaires' Disease
• is a form of atypical pneumonia,The bacterium responsible for the outbreak
was Legionella pneumophila
• Infection with L. pneumophila and other Legionella spp. results from the
airborne spread of bacteria from an environmental reservoir to the human
respiratory system
• Symptoms start 2 to 14 days after exposure and include a high fever,
nonproductive cough, headache, and severe bronchopneumonia
(inflammation of the lungs).
• Diagnosis depends on isolation of the bacterium, documentation of a rise in
antibody titer over time, or the presence of Legionella antigens in the urine as
detected by a rapid test kit.
• Treatment begins with supportive measures and the administration of
erythromycin or rifampin. Death occurs in 5 to 30% of symptomatic cases.
• Prevention of Legionnaires' disease depends on the identification and
elimination of the environmental source of L. pneumophila. Chlorination,
ozonation, the heating of water, and the cleaning of water-containing devices
can help control the multiplication and spread of L. pneumophila.
Tuberculosis
• TB is caused by M. bovisand M. africanum, in addition to M.
tuberculosis
• The incubation period is about 4 to 12 weeks, and the disease
develops slowly.
• The symptoms of TB are fever, fatigue, and weight loss. A cough,
which is characteristic of pulmonary involvement, may result in
expectoration of bloody sputum
• TB must be treated with antimicrobial therapy. Several drugs are
administered simultaneously (e.g., isoniazid [INH], plus rifampin,
ethambutol, and pyrazinamide).
• These drugs are administered for 6 to 9 months.
• X rays and bacterial isolation are completed to confirm the
diagnosis. Other laboratory tests include microscopy of the acid-
fast bacterium and commercially available DNA probes.
Cholera
• Cholera is an acute diarrheal disease caused by infection of
the intestine with the Gram-negative, comma-shaped
bacterium Vibrio cholerae.
• The infection is usually mild or without symptoms in most
healthy adults but can be severe.
• The disease is characterized by profuse watery diarrhea,
vomiting, and leg cramps. These symptoms result from rapid
loss of body fluids leading to dehydration and shock. Death
can occur within hours when persons with rapid fluid loss are
left untreated.
• Treatment is by oral rehydration therapy with NaCl plus
glucose to stimulate water uptake by the intestine; antibiotics
may also be given. The most reliable control methods are
based on proper sanitation, especially of water supplies. The
mortality rate without treatment is often over 50%, but with
treatment and supportive care, it is less than 1%
Lyme disease
• Lyme disease (LD, Lyme borreliosis) was first observed among
people of Old Lyme, Connecticut, in 1975. Between 2007 and
2010, an average of approximately 27,000 confirmed cases of
Lyme disease were reported annually, with 94% of these
located in only 12 states.
• The spirochetes responsible for this disease comprise at least
three species. Borrelia burgdorferi appears to be the primary
cause of Lyme disease in the United States, whereas B. garinii,
and B. afzelii appear to cause the disease in Europe.
• B. burgdorferi is transmitted to humans by the bite of infected
black-legged (or deer) ticks (Ixodes scapularis)
• Clinically, Lyme disease is a complex illness with three major stages.
The initial, localized stage occurs a week to 10 days after an infectious
tick bite. The illness sometimes begins with erythema migrans, an
expanding, ring-shaped skin lesion with a red outer border and partial
central clearing.This is accompanied by flulike symptoms (malaise and
fatigue, headache, fever, and chills). However, often the tick bite is
unnoticed, or the skin lesion is missed due to skin coloration or its
obscure location, such as on the scalp. Thus treatment, which is
effective at this stage, may not be started because the illness is
assumed to be "just the flu." The second, disseminated stage may
appear weeks or months after the initial infection. It consists of several
symptoms such as neurological abnormalities, heart inflammation, and
bouts of arthritis (usually in the major joints such as the elbows or
knees). the late stage may appear years later. Infected individuals may
develop neuron demyelination with symptoms resembling Alzheimers'
disease and multiple sclerosis. Behavioral changes can also occur.
• Laboratory diagnosis of LD is based on (1) serological testing
(Lyme ELISA or Western blot) for IgM or IgG antibodies to the
pathogen, (2) detection of Borrelia DNA in patient specimens
(especially synovial fluid) after amplification by PCR, and (3)
recovery of the spirochete from patient specimens, although
cultures are laborious with modest success. Treatment with
amoxicillin or tetracycline early in the illness results in prompt
recovery and prevents arthritis and other complications. If
nervous system involvement is suspected, ceftriaxone is used.
Tetanus
• Tetanus (Greek tetanos, to stretch) is caused by Clostridium
tetani, an anaerobic, Gram-positive, endospore-forming rod.
• The spores of C. tetani are commonly found in hospital
environments, in soil and dust, and in the feces of many farm
animals and humans. Transmission to humans is associated
with skin wounds. Any break in the skin can allow C. tetani
spores to enter.
• Prevention of tetanus involves the use of the tetanus toxoid. The
toxoid, which incorporates an adjuvant (aluminum salts) to
increase its immunizing potency, is given routinely with
diphtheria toxoid and acellular B. pertussis vaccine. An initial dose
is normally administered at 2 months after birth, a second dose 4
months later, a third dose 6 months later, a fourth dose at 18
months, and booster doses given between the ages of four to six
years, again at around age twelve, and every 10 years afterward.
• The case fatality rate in generalized tetanus ranges from 30 to
90% because tetanus treatment is not very effective. Therefore
prevention is all important and depends on (1) active
immunization with toxoid, (2) proper care of wounds
contaminated with soil, (3) prophylactic(medicine used to prevent
disease) use of antitoxin, and (4) administration of penicillin.
Anthrax
• Anthrax (Greek anthrax, coal) is a highly infectious animal
disease caused by the Gram-positive, endospore-forming
Bacillus anthracis. B. anthracis is found worldwide and can be
transmitted to humans by direct contact with infected animals
(cattle, goats, sheep) or their products, especially hides.
• There are three forms of anthrax disease. When the bacterium
enters through a cut or abrasion of the skin, cutaneous
anthrax results. Inhaling spores may result in pulmonary
anthrax, also known as woolsorter's disease. If spores reach
the gastrointestinal tract, gastrointestinal anthrax may result.
• Treatment of anthrax is with ciprofloxacin, penicillin, or
doxycycline (the same antibiotics may be used for all three
forms of anthrax) and is successful only if begun before a
critical concentration of toxin has accumulated. Although
antibiotics may kill the bacterium or suppress its growth, the
exotoxin can still eventually kill the patient. Vaccination of
animals, primarily cattle, is an important control measure.
However, people with a high occupational risk, such as those
who handle infected animals or their products, including hides
and wool, should be immunized.