Cholera

By: feedmeee3

"When your stomach is a rolling, and your cleaning out your colon, diarrhea…diarrhea!"

While Americans are able to joke about experiencing diarrhea after consuming spicy or foreign food, diarrheal diseases remain to be the leading cause of preventable deaths for those in developing countries. Although diarrheal diseases are most common to children under the age of five in developing countries, anyone can be affected. Diarrheal diseases are prone to people in poverty since these diseases are associated with individuals who live in areas of inadequate sanitation and hygiene, no safe water treatment. During the 1800s, Cholera, a particular diarrheal illness was once prevalent in the United States, but was quickly resolved with our water and sewage system. While the United States was able to control and diminish this disease, Cholera epidemics occur all around the world today. Centers for Disease Control and Prevention (CDC) estimated 3-5 million cases and over 100,000 deaths that occur each year due to Cholera. Here we will discuss what exactly Cholera is, how an individual can obtain this diarrheal illness, the affects on the human body, and how the world plans on put an end to Cholera epidemics.

Cholera is an acute diarrheal illness caused by infection of the intestine with the comma shaped bacterium Vibrio cholera. It is transmitted by water or food that has been contaminated with the feces containing this bacterium, not by person-to-person contact. Once the bacterium is in the small intestine, it secretes a Cholera Toxin that causes the large intestine to secrete and lose large amounts of water and salt (Silva and Benitez et al. 2016). This leads to the symptoms of this disease, which include watery diarrhea, vomiting, cramping, abdominal pains and etc. If untreated, severe dehydration can rapidly lead to death in hours! Since Cholera symptoms are similar to symptoms of other bacterium, diagnosis and detection is based on a stool sample to see if the bacterium Vibrio cholera is present.

The reason why this bacterium, Vibrio cholera is still around today is due to evolution. Vibrio cholera evolved to effectively withstand diverse physical, chemical, and biological stresses such as extreme temperatures and pH levels and other harsh conditions in both aquatic environment and small intestine of humans (Silva and Benitez et al. 2016). Silva and Benitez et al. (2016) also propose that Vibrio cholera have the ability to switch from motile to non-motile allowing them to successfully survive and colonize in the small intestines of humans as well as in aquatic environments outside the human body. In other words, certain environmental cues will trigger Vibrio cholera to transition their mobility from being sessile (non-motile) to motile and vice versa. This could easily relate to migrating birds. Birds migrate to areas (environments) that supply them everything they need to survive, which would be sufficient amounts of food, water and good living conditions. When their environment no longer supplies these necessities, they migrate until they find another suitable area where they will then stay put, until they need to search for a new home. Since the intestinal gut provides a nutritious environment, it is thought that Vibrio Cholera would like to stay in the small intestine so they transition to non-motile form and cling to the walls of the small intestine. Why leave, when they have everything they need to survive and thrive!

Because nutritional balance is such an important necessity for growing infants, when infected by Cholera, infants are more prone to death. While diarrhea causes dehydration and loss of nutrition and electrolytes, the body loses the energy to grow and protect itself. According to the World Health Organization (WHO), Cholera is the leading cause of malnutrition in children in developing countries. Majority of Cholera deaths are children under the age of five, but Cholera can affect any individual in any age group. To prevent Cholera epidemics to those in developing countries, WHO Cholera groups as well as health experts in the area do their best to provide access to safe drinking water and food, as well as promoting better sanitation practices and hygiene. To resolve deaths of children under the age of five, mothers in developing countries are advised to breastfeed their children for till six months. Reason being, being breastfed allows infants to be 6.1 times less likely to die of diarrhea than infants who are not breastfed. Breast milk contains both immune (specific) and non-immune (nonspecific) antimicrobial factors as well as the necessary vitamins and minerals. In other words, mothers’ breast milk contains everything an infant needs to be a strong, healthy six month infant. According to WHO, by promoting exclusive breast feeding for the first six months through hospital policies, counseling, education, mass media, and mother support groups, this could decrease all-cause mortality in children under five by 13 percent! On top of being preventable, Cholera is also treatable. WHO also states that 80% of cases are be successfully treated with oral rehydration. There is also vaccines that help prevent Cholera, although does not guarantee 100% protection.

Every fifteen seconds, a child dies from bad water and sanitation.. According to WHO, 65% of infant deaths due to cholera and related illnesses in developing countries could be prevented with clean drinking water and sanitation. Hygiene education to create a locally sustainable solution to the global water and sanitation issue is another crucial aspect of the prevention of cholera. Even if we are not directly affected by it, Cholera is still a very active disease that is affecting the whole world.

Citations

Cholera. (2015, July). Retrieved February 12, 2016, from http://www.who.int/mediacentre/factsheets/fs107/en/

Cholera- Vibrio cholerae infection. (2014 October/November). Retrieved November/December, 2014, from http://www.cdc.gov/cholera/index.htm

Silva AJ, Benitez JA (2016) Vibrio cholerae Biofilms and Cholera Pathogenesis. PLoS Negl Trop Dis 10(2): e0004330. doi:10.1371/journal.pntd.0004330

Shingles (Herpes zoster)

By: The Patient

Shingles is a nerve pain that usually becomes painful blistering rash on the skin. Shingles is caused by zoster virus, the same virus that causes chickenpox.

Shingles is reactivation of the chickenpox virus. When you have chickenpox as a young child the virus stays inactive, it becomes a dormant in certain nerves in the body. Shingles occur after the virus becomes active again years later. The virus is activated when stress, aging, certain diseases and medicine weakens the immune system. Shingles can develop in any age group but usually develops in people who are 60 years and older and had chickenpox before they were one year old. Statistic has shown that one in three people will have shingles. Symptoms can happen in stages before any rash appear, usually it starts with one-sided pain, tingling or burning sensation, itching, flu like symptoms and headache. When rash appears it looks like red patches on the skin or small blisters that can stay on the skin for 2 to 3 weeks. The rash is usually around the spine, belly area and chest area but it can also be around face, eyes, mouth, ears and neck. Sometimes the blisters can leave permanent scars and nerve pain can be long-term. Shingles is treated with antiviral and pain medications. If detected in early stage shingles can be treated with antiviral medication to help with rash and pain relief. Shingles cannot be passed on unless a person is in direct contact with liquid from the blisters and didn’t have chickenpox as young child or chickenpox vaccine.

Shingle vaccine is recommended for people 60 and older, younger than that will need a prescription from the doctor.

Work Cited:

PubMedHealth. (2015, November 19). Shingles. Retrieved February 09, 2016, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001861/

WebMD. (2014, September 11). Shingles. Retrieved February 10, 2016, from http://www.webmd.com/skin-problems-and-treatments/shingles/shingles-topic-overview

Cdc. (2015, August 05). Prevent Shingles. Retrieved February 10, 2016, from http://www.cdc.gov/features/shingles/

Dental Caries

By: Seahawks Gal

Most people do not know what the word caries means. Dental Caries is another word for tooth decay or cavities. In the United States children between the ages of 6-19, with untreated dental caries was 16.2% during the years 2005-2008, and for adults over the age of 19 with untreated dental caries that were untreated were 23.7%. Dental Caries is a currently huge problem in the United States. Many people have a lack of knowledge, along with not caring or taking proper care of their teeth. Dental caries is one of the most common diseases seen in the human body second to the common cold. There must be more education taught to try and prevent this problem. 

Dental caries is a clinical term for tooth decay. Dental caries starts as buildup of plaque that is formed by tiny bacteria and food particles built up on the tooth surface. Bacteria adhere to the tooth surface in a biofilm called dental plaque. The two main types of bacteria responsible for most tooth decay is Streptococcus Mutans and Lactobacillus. A professor at a University says "Teeth become susceptible to decay when the enamel is softened.”(Academic Onefile) Although there are different types of bacteria that cause tooth decay there are several ways to both treat it and prevent it.

I didn’t realize how serious of a problem tooth decay was in this country until I went to school for dental assisting ten years ago. After working in both pediatric dentistry as well as oral surgery I have seen some of the worst cases both in children as well as adults. I have also seen firsthand how quickly tooth decay can develop and how bad it can get in a short amount of time. Dental caries is a topic that more people need to be aware of and more education needs to be provided about it.

Statistics show that only 56.8% of women and 49% of men actually follow the ADA recommended guidelines and brush their teeth twice a day, along with flossing once a day and using fluoridated mouth wash. I have seen severe dental decay in children as young as 10 months and if not taken care of and prevented this can lead to a life time of dental problems. “Among 4-year-olds in 2005, approximately 37 percent of children had at least one decayed baby tooth. On average, there were 1.84 decayed, missing or filled baby teeth, of which 84 percent comprised of untreated dental decay.”

Tooth Decay-Treatment Overview

Starting at the age of about one when a child gets their first teeth it is vital to start good oral hygiene. Children should be seen by a Pedodontist as soon as they get their first tooth and continue to see a dentist every six months for regular checkups, cleaning and x rays. At the child’s first dental appointment their dentist will cover proper nutrition, proper brushing technique, oral habits as well as any concerns the parent may have. (Your Child's First Visit to the Dentist) Children should also have help with brushing until about the age of eight or when they can write cursive because before that they lack the ability to reach all areas that need to be brushed properly. (“What Is Good Oral Hygiene?") It is essential that parents make it a priority to teach their children good dental habits when they are young, so they are able to continue with good oral hygiene throughout their adult lives.



Untreated tooth decay can lead to a lot of more serious problems. A simple cavity that may just need a filling, if left un treated can lead to needing a root canal which involves removing the nerves from the tooth just like you would in trying to kill a tree. This process is one option to try and save the tooth. Another option is a crown placed over the tooth, or even extraction of the tooth. Also if dental caries is left untreated it can lead to the tooth becoming infected which can spread to other parts of the body through the blood stream. As we can see dental decay is nothing to mess around with as it can be very serious.

As we can see tooth decay also known as dental Caries is a very serious problem. This is a problem that affects people all over the world on a day to day basis. Dental decay can be easily prevented with the use of good oral hygiene. If a person does develop dental decay they need to make sure it is properly taken care of as soon as possible to avoid further problems. Simple steps can be taken to keep your teeth looking and feeling their best. With the proper knowledge and resources there should be no excuse for so many people to be living with dental decay which is both unattractive as well a painful and dangerous.

Work Cited

Aarow Peter, Raheb Joseph, Miller Margret. “Brief oral health promotion intervention among parents of young children to reduce early childhood dental decay.” BMC Public Health. 20 March. 2014. Academic Onefile . Web. 08 Feb. 2016

Edelstein Burton. “New approach needed to reduce caries in children” Public Health Reports. July-August 1997.Web. Academic Onefile. 08. Feb 2016

"Foods and Drinks Best for Your Teeth." WebMD. WebMD, n.d. Web. 09 Feb. 2016.

Journal of family health care. “Early Nutrition and Dental Health” June. 2009. Pavilion Publishing and Media Ltd. Web. Acedemic Onefile. 09. Feb. 2016.

"Tooth Decay-Treatment Overview." WebMD. WebMD, 10 Dec. 2014. Web. 10 Feb. 2016.

"Your Child's First Visit to the Dentist." WebMD. WebMD, 04 Jan. 2014. Web. 09 Feb. 2016.

"What Is Good Oral Hygiene?" Oral Hygiene Basics. N.p., n.d. Feb. 10 Feb. 2016.

ZIKA: Balancing Fear with Facts

By: OCR-Mama

You have heard about Zika virus. You have seen the heart-wrenching images of babies born with microcephaly or an abnormally small head. The World Health Organization is talking about it. The Centers for Disease Control and Prevention is talking about it. Your grandma is calling you to talk about it. Zika is spreading rapidly and can have dire health effects. Even as I write this new stories are popping up by the minute, but what are the facts about Zika? What is the real risk for you as a pregnant mom in the US? Before you finish your gestation in a DEET-filled cave, let’s look at what is known and unknown about Zika.

What is Zika virus and how do you get it?


Zika virus disease or ZIKV or Zika fever is caused by a mosquito-borne virus that was first identified in 1947 in a caged rhesus monkey in Africa. In humans the first cases were identified in 1952. In 2013 and 2014 French Polynesia had a ZIKV outbreak with an uptick in central nervous system malformations including microcephaly.

In 2015 a Zika virus outbreak swept through Brazil. 2016 has seen no end to the outbreak and Zika continues to spread through the Americas. So although this disease is not new, the areas of the world that have been impacted by the Zika virus are expanding and the effects on these naive populations are getting attention.

Mosquitos carry the virus and infect the human by acting as a vector for transmission. Mosquitos are excellent vectors because they break through the top layer of skin or epidermis and get into the dermis below. They do this because blood is their meal, but this also allows the virus to make it’s way into the host’s blood. The skin, like a suit of armor, protects against most dangers but a poisonous needle piercing through a chink can cause grave harm.

The cells of the dermis called dendritic cells and fibroblasts have receptors that allow Zika to enter the cell and replicate. The virus has other factors contributing to the rapid spread in areas with many mosquitos. A mosquito can pick up Zika from an infected person and then pass it along to another person. Meaning, a mosquito can become a carrier by biting someone who is sick.

Transmission is no longer thought to be limited to the work of mosquitos either. There is growing evidence that Zika virus disease can be transmitted sexually and remains in semen longer than it has cleared from the blood in an infected person. So if your partner has travelled to a region with Zika it is wise to use condoms or abstain until he has been cleared from the disease whether or not symptoms occur. This route of transmission, however, is much less likely than from a mosquito. So while unlikely to be an issue, better safe than sorry.

Not all mosquitoes carry the Zika virus. In fact, transmission is mainly by Aedes mosquitoes which are most commonly found in tropical environments. For US women concerns about contracting Zika are mainly around travel to area that have cases of Zika and sexual contact with partners that have experienced Zika virus disease. The CDC and WHO are actively tracking the disease and issuing travel guidelines for pregnant women or women who may become pregnant. Currently no locally-acquired cases of this disease have presented in the US, but travel-related cases have. Tracking of the disease and its spread are ongoing and if you have travel plans check with these sources for the latest recommendations.

What are the symptoms of Zika virus disease?

If Zika virus disease occurs symptoms are likely to begin around a couple days after exposure and symptoms are generally mild, lasting 2-7 days. These symptoms include fever, skin rash, discomfort, headache, joint and muscle pain, and eye redness. Most people infected with Zika virus will have no lasting harm from the disease. If a woman is pregnant when the Zika virus is contracted, however, the virus may cause severe brain damage to the unborn and is linked to a condition called microcephaly. The relationship between Zika virus and microcephaly is not fully understood by scientists.

How is Zika virus disease treated?

Symptoms of Zika virus can be eased with rest, drinking plenty of water, and taking pain relievers like ibuprofen. No antiviral medications are recommended at this time for Zika and no vaccination is available. If you are pregnant and suspect you have Zika virus talk to your doctor about what tests are available. Blood, urine, and saliva tests may be used to find viral RNA and the CDC has released an algorithm for testing. Ultrasound may be used to look for calcifications in the fetal skull and microcephaly. Recommended testing is still controversial and not widely available. The reality is that if you haven’t travelled to a region currently affected by Zika or live in that region then you aren’t considered to be at risk for Zika.

What is microcephaly and does Zika cause it?


Microcephaly is a condition that literally means small head. The head grows in a developing fetus because the brain is growing. In microcephaly the brain is not growing normally and this can be linked to a range of serious difficulties. Many causes of microcephaly are known such as infections like rubella, toxoplasmosis, and cytomegalovirus. Malnutrition or toxic exposures in development like alcohol can also cause microcephaly. ZIKV genetic material has been found in the brain tissue samples of a fetus with microcephaly whose mother was exposed to ZIKV during her pregnancy and experienced symptoms of ZIKA fever in her 13th week of pregnancy. ZIKV genetic material has also been found through amniocentesis. It is not proven that Zika causes microcephaly, but researchers think that the virus may target and replicate in the developing brain of a fetus. Zika doesn’t seem to cause lasting harm in other organs or tissues but stays and replicates in the brain stem.

The best prevention for ZIKV is to not get bit by a mosquito. Consider guidelines and consult with your doctor about travel plans. Look at the EPA’s recommendation for mosquito repellants and follow the directions carefully if you are expecting exposure. If you do they are safe to use during pregnancy. Wearing long pants and shirts can help as well. Standing water is prime breeding ground for mosquitos and can become a safety risk so care should be taken to prevent this. So the ZIKV media frenzy may be inducing worries in your pregnant mind, but fear is a beast that thrives on attention. Arm yourself with facts and be well.

References:

Akpan, Nsikan (January 29, 2016  updated February 1, 2016) How does Zika virus shrink a baby’s brain and other FAQs.  PBS NewsHour. Retreived from: http://www.pbs.org/newshour/updates/zika-virus-faqs-ultrasound-detection/

Centers for Disease Control and Prevention. (February 12, 2016).

Facts about Microcephaly (article). Retreived from: http://www.cdc.gov/ncbddd/birthdefects/microcephaly.html

Centers for Disease Control and Prevention. (January 29, 2016).

Possible Association Between Zika Virus Infection and Microcephaly — Brazil, 2015

(Morbidity and Mortality Weekly Report).   Retreived from: http://www.cdc.gov/mmwr/volumes/65/wr/mm6503e2.htm

Mlakar, J M.D., Korva, M Ph.D., Tul, N M.D., Ph.D., Popović, M M.D., Ph.D., Poljšak-Prijatelj,  M Ph.D., Mraz, J  M.Sc.,... Avšič Županc, T Ph.D. (February 10, 2016) Zika Virus Associated with Microcephaly.  The New England Journal of Medicine.  DOI: 10.1056/NEJMoa1600651

McNeiL, D.G. Jr., Saint Louis, C. & St. Fleur, N.  ( February 16, 2016).  Short Answers to Hard Questions about Zika Virus. The New York Times. Retreived at: http://www.nytimes.com/interactive/2016/health/what-is-zika-virus.html?_r=0

World Health Organization.  (February 2016).  Zika Virus (fact sheet). Retreived from: http://www.who.int/mediacentre/factsheets/zika/en/

USE THIS CC VIDEO: https://commons.wikimedia.org/wiki/File:Zika_virus_video_osmosis.webm

And this image: http://d3hjf51r9j54j7.cloudfront.net/wp-content/uploads/sites/5/2013/01/pregnant-worried.jpg