MEASLES

 DEFINITION

• Measles is a childhood infection caused by a virus. 
• Also called rubeola, measles can be serious and even fatal for small children

SYMPTOMS 

Measles signs and symptoms appear 10 to 14 days after exposure to the virus.

• Fever
• Dry cough
• Runny nose
• Sore throat
• Inflamed eyes (conjunctivitis)
• Tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek — also called Koplik's spots
• A skin rash made up of large, flat blotches that often flow into one another

The infection occurs in sequential stages over a period of two to three weeks.

• Infection and incubation - For the first 10 to 14 days after you're infected, the measles virus incubates. You have no signs or symptoms of measles during this time.

• Nonspecific signs and symptoms - Measles typically begins with a mild to moderate fever, often accompanied by a persistent cough, runny nose, inflamed eyes (conjunctivitis) and sore throat. This relatively mild illness may last two or three days.

• Acute illness and rash - The rash consists of small red spots, some of which are slightly raised. Spots and bumps in tight clusters give the skin a splotchy red appearance. The face breaks out first, particularly behind the ears and along the hairline.

• Communicable period -  A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days.

CAUSES

1. The cause of measles is a virus that replicates in the nose and throat of an infected child or adult.
2. When someone with measles coughs, sneezes or talks, infected droplets spray into the air, where other people can inhale them. 
3. You can contract the virus by putting your fingers in your mouth or nose or rubbing your eyes after touching the infected surface.

RISK FACTOR

• Being unvaccinated - If you haven't received the vaccine for measles, you're much more likely to develop the disease.
• Traveling internationally - If you travel to developing countries, where measles is more common, you're at higher risk of catching the disease.
• Having a vitamin A deficiency - If you don't have enough vitamin A in your diet, you're more likely to contract measles and to have more-severe symptoms.

TREATMENT

No treatment can get rid of an established measles infection. However, some measures can be taken to protect vulnerable individuals who have been exposed to the virus.

• Post-exposure vaccination - Nonimmunized people, including infants, may be given the measles vaccination within 72 hours of exposure to the measles virus to provide protection against the disease. If measles still develops, the illness usually has milder symptoms and lasts for a shorter time.

• Immune serum globulin - Pregnant women, infants and people with weakened immune systems who are exposed to the virus may receive an injection of proteins (antibodies) called immune serum globulin. When given within six days of exposure to the virus, these antibodies can prevent measles or make symptoms less severe.

PREVENTION 

• Isolation
• Vaccinate
• Promoting and preserving herd immunity.
• Preventing a resurgence of measles.

reference  : measles 

Sexually transmitted diseases (STD)

DEFINITION

• Sexual transmitted disease spread by sex between couples who have been infected, such as chlamydia, syphilis, and gonorrhea.
• It can be transmitted during sexual intercourse through vaginal, or oral (mouth).
• In Malaysia, sexual transmitted disease cases increased from year to year, especially among adolescents aged 16 to 24 years.
• Among the reasons for the increase in cases is early exposure to sex and free sex at a young age.

SIGNS AND SYMPTOMS

You should see a doctor if you experience symptoms such as itching, swelling, mucus production, pain and redness in the vagina or penis.

CHLAMYDIA

• Chlamydia infection usually does not give any does not give any indication of the female patients, but patients may experience symptoms such as non-specific inflammation of the bladder, mucus from the vagina or abdomen pain divided.
• Men also often complain of pain , swelling, mucus from the urethra and epididymis swollen veins.
• This disease can remain infective symptoms disappear after a few days.

GENITAL WARTS

- There are warts that are white or white spots in the vagina and genital area or anus.

- The majority of patients did not complain of any symptoms.

- It's difficult for doctors to make a proper diagnosis of the disease.

GENITAL HERPES

- Such as warts, herpes usually does not cause symptoms.

- Those who show signs of the disease may complain of fever, itching, 'hot' and swelling in the genital area.

- Sometimes the skin may blister and form ulcers cause pain during urination.

GONORRHEA

• Is an infection that involves both men and women.
• It can infect the genital area, anus, colon or throat .
• Approximately 90% of patients will complain release mucus and pus from genital pain during

SYPHILIS

• The initial symptoms are patient will complain of sores on the penis and vagina.
• These sores may be painless and will go away without treatment.
• Then, the patient may experiences fever, chills, and muscles aches.

HIV

- Patients may complain of fever and muscle pain a few months after being infected with the HIV virus, but the majority do not have any symptoms.
- Only a blood test can determine if you are infected with HIV or not.
- The blood test may have to be repeated if found to be negative.
- Eventually, the patient's immune system will be reduce and he will be difficult to fight the disease.

DIAGNOSIS

- Most sexually transmitted diseases through complaints and patient history.

- This is followed by a blood test, urine, and other tests.

- The test results are are confidential between patient and doctor.

- The doctor will take the test sweep at the vaginal or penile shaft (using a cotton bud)  and will be sent to lab.

TREATMENT

• Sexually transmitted diseases can be treated with antibiotics while antiviral drugs can be used for herpes in the genital area. 
• Genital warts are usually heal on their own without treatment .
• Most patients will require the doctor to remove warts is cosmetic reasons .
• Among the agents for treatment include liquid nitrogen to freeze the wart .
• In all cases of sexually transmitted diseases , sexual partners must also be treated even if the patient did not show any symptoms.
• This reduces the risk of infection to others . 

Below is a brief but treatments specific for venereal diseases 

Chlamydia - treated with antibiotics for a few days to few weeks

Gonorrhea - antibiotics are usually given for once

HIV - So far no treatment for AIDS, but there are medications that can reduce the HIV in the body and helps maintain the immune system as long as possible.

Syphilis - Can be treated early with antibiotics for 2 weeks. It can also be treated during the final stages of the diseases. But complications to the heart and nervous system can not be treated.

PREVENTION

• Please refrain from sex and be faithful to your partner is the most effective treatment and practical.
• The use of condoms is also effective to avoid sexually transmitted diseases.
• You are encourage to regularly undergo a medical examination and to know your partner before marriage.

Reference : STD

Leprosy

DEFINITION

• Leprosy is a disease that has been known since biblical times. 
• This infectious disease causes skin sores, nerve damage, and muscle weakness that gets worse over time.

CAUSE

• Leprosy is caused by the bacterium Mycobacterium leprae. 
• It is not very contagious
• It has a long incubation period (time before symptoms appear), which makes it hard to know where or when someone caught the disease. 
• Children are more likely than adults to get the disease.

Leprosy has two common forms:  tuberculoid and lepromatous.

• Both forms produce sores on the skin
• The lepromatous form is most severe. 
• It causes large lumps and bumps (nodules).
• Effective medications exist. Isolating people with this disease in "leper colonies" is not needed.

• Drug-resistant Mycobacterium leprae and an increased numbers of cases worldwide have led to global concern about this disease.

Symptoms

• Skin lesions that are lighter than your normal skin color
• Lesions have decreased sensation to touch, heat, or pain
• Lesions do not heal after several weeks to months
• Muscle weakness
• Numbness or lack of feeling in the hands, arms, feet, and leg

Exam and Test

• Lepromin skin test can be used to tell the two different forms of leprosy apart, but it is not used to diagnose the disease
• Skin lesion biopsy
• Skin scraping examination

Prevention

• Prevention consists of avoiding close physical contact with untreated people. 
• People on long-term medication become noninfectious (they do not transmit the organism that causes the disease).

References : LEPROSY

BLACK DEATH

The Black Death of 1348 to 1350

KEY FACT 

• In Medieval England, the Black Death was to kill 1.5 million people out of an estimated total of 4 million people between 1348 and 1350. 
• No medical knowledge existed in Medieval England to cope with the disease. After 1350, it was to strike England another six times by the end of the century. 
• Understandably, peasants were terrified at the news that the Black Death might be approaching their village or town.
• The Black Death is the name given to a deadly plague (often called bubonic plague, but is more likely to be pneumonic plague) which was rampant during the Fourteenth Century.
•  It was believed to have arrived from Asia in late 1348 and caused more than one epidemic in that century - though its impact on English society from 1348 to 1350 was terrible. 
• No amount of medical knowledge could help England when the plague struck. It was also to have a major impact on England’s social structure which lead to the Peasants Revolt of 1381.
• Up until recently the Black Death was thought to have been caused by fleas carried by rats that were very common in towns and cities. 
• When the fleas bit into their victims, it was thought they were literally injecting them with the disease.
• However evidence produced by forensic scientists and archaeologists in 2014 from human remains in the north of the City of London suggests that fleas could not actually have been responsible for an infection that spread so fast - it had to be airborne.
• Once the disease reached the lungs of the malnourished, it was then spread to the wider population through sneezes and coughs.
• Whatever the cause of the infection, death was often very quick for the weaker victims. By Spring 1349 the Black Death had killed six out of every ten Londoners.

The symptoms of the Black Death were terrible and swift:

1. Painful swellings (buboes) of the lymph nodes
2. These swellings, or buboes, would appear in the armpits, legs, neck, or groin
3. A bubo was at first a red color. The bubo then turned a dark purple color, or black
4. Other symptoms of the Black Death included:
5. a very high fever
6. delirium
7. the victim begins to vomit
8. muscular pains
9. bleeding in the lungs
10. mental disorientation
11. The plague also produced in the victim an intense desire to sleep, which, if yielded to, quickly proved fatal
12. A victim would die quickly - victims only lived between 2 -4 days after contracting the deadly disease

Why did the plague spread quickly?

• In towns and cities people lived very close together and they knew nothing about contagious diseases. 
• If they did, they would have avoided close contact with others (staying at least a metre apart) if they themselves were ill or if others around them were ill. 
• They would also have been careful to cover their mouth and nose when coughing or sneezing. 
• Additionally, the disposal of bodies was very crude and helped to spread the disease still further as those who handled the dead bodies did not protect themselves in any way.
• Lack of medical knowledge meant that people tried anything to help them escape the disease. One of the more extreme was the flagellants. 
• These people wanted to show their love of God by whipping themselves, hoping that God would forgive them their sins and that they would be spared the Black Death.
• The Black Death had a huge impact on society. 
• Fields went unploughed as the men who usually did this were victims of the disease. Harvests would not have been brought in as the manpower did not exist.
• Animals would have been lost as the people in a village would not have been around to tend them.
• Therefore whole villages would have faced starvation. 
• Towns and cities would have faced food shortages as the villages that surrounded them could not provide them with enough food. 
• Those lords who lost their manpower to the disease, turned to sheep farming as this required less people to work on the land. 
• Grain farming became less popular – this, again, kept towns and cities short of such basics as bread. 
• One consequence of the Black Death was inflation – the price of food went up creating more hardship for the poor. In some parts of England, food prices went up by four times.

How did peasants respond?

• Those who survived the Black Death believed that there was something special about them – almost as if God had protected them. Therefore, they took the opportunity offered by the disease to improve their lifestyle.
• Feudal law stated that peasants could only leave their village if they had their lord’s permission. 
• Now many lords were short of desperately needed labour for the land that they owned. 
• After the Black Death, lords actively encouraged peasants to leave the village where they lived to come to work for them. When peasants did this, the lord refused to return them to their original village.
• Peasants could demand higher wages as they knew that a lord was desperate to get in his harvest.
• So the government faced the prospect of peasants leaving their villages to find a better ‘deal’ from a lord thus upsetting the whole idea of the Feudal System which had been introduced to tie peasants to the land. 
• Ironically, this movement by the peasants was encouraged by the lords who were meant to benefit from the Feudal System.
• To curb peasants roaming around the countryside looking for better pay, the government introduced the Statute of Labourers in 1351 that stated:
• No peasants could be paid more than the wages paid in 1346. No lord or master should offer more wages than paid in 1346. 
• No peasants could leave the village they belonged to.
• Though some peasants decided to ignore the statute, many knew that disobedience would lead to serious punishment. 
• This created great anger amongst the peasants which was to boil over in 1381 with the Peasants Revolt. 
• Hence, it can be argued that the Black Death was to lead to the Peasants Revolt.

reference : black death

YELLOW FEVER

YELLOW FEVER

• Yellow fever virus is found in tropical and subtropical areas in South America and Africa.
• The virus is transmitted to human by the bite of an infected mosquito
• Yellow fever is very rare cause of illness in U.S. travellers.
• There is no specific treatment for yellow fever – care is based on symptoms.

Symptoms

i. The person who infected with yellow fever virus have no illness or only mild illness
ii. The incubation period is typically 3-6 days.
iii. Fever, chills, severe headache, back pain, general body aches, nausea, vomiting, fatigue, and weakness.

How is yellow fever transmitted?

Three transmission cycles for yellow fever have been identified.

1. Sylvatic (jungle) cycle :

•   In tropical rain forest, infected monkeys pass the virus to mosquito that feed on them.
•  These infected mosquitoes then bite humans who enter the rain forest for occupational or recreational activities.

 
    2. Intermediate ( savannah ) cycle :

• In humid or semi-humid regions of Africa
• The virus can be transmitted from monkeys to human, or from human to human by the mosquitoes.

    3. Urban cycle :

• When infected humans introduce the virus into urban areas with large numbers of unvaccinated individual, infected mosquitoes ( aedes aegypti ) transmit the disease from human to human.
• This form of transmission can lead to large epidemics.

Prevention of Yellow Fever

Avoid mosquito bites

• Use insect repellent  - When go outdoors, use an EPA
• Wear proper clothing to reduce mosquito bites – when weather permits, wear long-sleeves, long pants and socks when outdoors. Mosquitoes  may bite through thin clothing, so spraying clothes with repellent containing permethrin or another EPA – registered repellent will give extra protection.
• Be aware of peak mosquito hours 

1. Aedes aegypti one of the mosquitoes that transmits yellow fever virus, feel during the daytime. 
2. Staying in accommodations with screened or air – conditioned rooms,                 particully during peak biting times, will reduce risk of mosquito bites.

Reference: yellow fever

chikungunya

CHIKUNGUNYA

• Chikungunya is viral illness disease transmitted to human by the bite of an infected Aedes Aegypti mosquito

• The name comes from a word in the African Kimakonde language and means “ bent over in pain “. It suffering with severe joint pains.

Symptoms

After an incubation period symptoms of

• Severe joint pain
• Fever ( up to 104 F )
• Chills
• Nausea
• Severe headache
• Vomiting

In particular cases the joints might become swollen and painful to touch.


Recovery Time

• Almost all cases will recover within 3 – 5 days
• Some patients might have Persistant joint pains for months
• Children may display Neurologic symptoms 

Diagnosis   

• Serologic  testing, virus isolation test, IgM testing and genetic ID of virus gene structures.
• Detection of either C or E1 genome indicates positive results, similarly increased antibody also mark presence of chikungunya virus

Treatment

• There is no specific treatment or vaccination for chikungunya.
• Treatment is just symptomatic with rest, fluids, antipyretics and anti-convulsants.

 

REFERENCES : chikungunya 

Difference type of plague

TYPES OF PLAGUE

There are three basic form of plague

1. Bubonic plague

• The most common form of plague is bubonic plague.
• It is usually contracted when an infected rodent or fleas bites you.
• Bubonic plague infects your lymphatic system ( immune system ), causing inflammation
• If untreated, it can move into the blood and cause septicemic plague, or
 to the lungs, causing pneumonic plague.

2. Pneumonic  plague

• It is because the bacteria multiply in the lungs.
• It is the most serious form of the disease
• When a person with pneumonic plague coughs, the bacteria from their lungs are expelled into the air.
• Other people who breath that air can also develop this highly contagious form of plague, which can lead to an epidermic.

3. Septicemic plague

• It is when the bacteria multiply in the bloodstream
• When both bubonic an pneumonic plague untreated, it can lead to septicemic plague.


http://www.asnom.org/en/423_peste.html

Hawar (plague )

PENGENALAN

• Hawar adalah jangkitan wabak secara semulajadi yang melibatkan tikus berlaku di merata tempat di seluruh dunia.
• Penyakit epidemik akut yang melibatkan tikus dan roden liar berlaku di bahagian tengah, timur dan selatan Afrika, Amerika Selatan, bahagian barat Amerika Utara dan di sebahagian besar Asia.
• Di sesetengah kawasan, kontak antara tikus hutan dan tikus rumah biasa berlaku dan boleh menyebabkan kes jangkitan manusia dan kadang-kala menjadi wabak

AGEN PENYEBAB : 

Yersinia pestis

CARA JANGKITAN

• Jangkitan kutu yang menular dari tikus ke haiwan lain dan manusia.
• Jangkitan manusia ke manusia tidak berlaku kecuali semasa wabak pneumonik, apabila titisan cecair pernafasan daripada pesakit menjangkiti orang lain semasa berdekatan.
• Wabak juga boleh merebak melalui sentuhan dengan objek yang tercemar ( contoh : tisu/tuala) atau cecair atau nanah haiwan yang dijangkiti.

TEMPOH PENGERAMAN 

1hingga 7 hari 

Pelancong adalah berisiko rendah. Walaubagaimanapun perjalanan ke kawasan dimana penyakit biasa berlaku di kawasan luar bandar mempunyai risiko, terutamanya jika berkhemah atau memburu atau jika tersentuh tikus.

TANDA DAN GEJALA

1. Demam
2. batuk
3. Bengkak yang sakit di pangkal peha, leher dan ketiak
4. Muntah

JANGKITAN TERBAHAGI KEPADA TIGA JENIS :-

i) Hawar Bubonik 

- Berpunca dari gigitankutu yang dijangkiti menyebabkan radang pada kelenjar limfa (limfadenetis) dan sekitar kelenjar limfa.

- Ciri utama : bengkak yang sakit dan bernanah.

ii) Hawar Septisemik

- Merebak dari wabak bubonik atau berlaku semasa ketiadaan limfadenitis.

- Jangkitan menular ke dalam aliran darah yang menyebabkan keradangan di selaput otak (meningitis), renjatan endotoksid dan pendarahan yang teruk akibat penggumpulan intravasel tersebar( Disseminated Intravascular Coagulation - DIVC)

iii) Hawar Pneumonik

- jangkitan boleh menular ke paru-paru dan menyebabkan pneumonia yang teruk

- Pesakit boleh merebakkan penyakit melalui titisan cecair pernafasan.

- Individu yang  yang terkena titisan/cecair tersebut boleh mendapatkan jangkitan paru-paru.

PENCEGAHAN

• Elakkan memegang tikus yang hidup atau mati
• Elakkan berada di tempat yang sesak
• Elakkan gigitan kutu dengan menggunakan repelan dan racun serangga
• Elakkan mengendali tikus mati dan laporkan kepada pihak kesihatan jika terjumpa tikus mati
• Jika berhubungan dengan orang yang dijangkiti, elakkan menyentuh cecair tubuh pesakit dan dapatkan rawatan awal
• Simpan dan lupuskan sisa makanan/sampah dengan betul supaya tikus tidak mencerobohi makanan dan tempat tinggal anda.

RUJUKAN : HAWAR