Find Out How You Measure Up Against Meningitis

Meningitis, or inflammation of the meningeal layers that cover the brain and spinal cord, may result from many causes. Due to these multiple means of exposure, meningitis can be contracted both in the United States and abroad. Learn the risk factors for this disease to decide whether you require vaccination.

How could I be exposed?   

There are five types of meningitis: bacterial, viral, fungal, parasitic, and non-infectious, each of which involves a different point of exposure. These diseases also vary in severity and have different treatments.

Bacterial meningitis, or meningococcal meningitis, is the most common and serious form of the disease. It can cause brain damage and is fatal in 50% of untreated cases. Various bacteria may cause meningitis. In the United States, the most common are Haemophilus influenzae, Streptococcus pneumoniae, group B Streptococcus, Listeria monocytogenes, and especially Neisseria meningitidis. The latter is also common in sub-Saharan Africa. These bacteria are transferred between individuals through respiratory or throat secretions. Therefore, common points of exposure include kissing, coughing or sneezing, and living in close quarters where eating and drinking utensils are shared. Travelers, especially those visiting the “meningitis belt” (Senegal to Ethiopia) of sub-Saharan Africa, or those making a pilgrimage to Mecca, face increased risk.

While the other types of meningitis are less common, they do continue to affect individuals and bear mention. Viral meningitis is the second most common type of the disease and is most often caused by enteroviruses, which are contracted through feces and may be spread through mucus or saliva. Fungal meningitis results when an inhaled fungus spreads through the blood to the spinal cord. This means of exposure is uncommon, and fungal meningitis cannot be passed between individuals, though it can severely compromise already weak immune systems, including those of individuals infected by HIV. The rare parasitic meningitis results from exposure to the amoeba Naegleria fowleri, which enters the body through the nose when people swim in freshwater such as lakes, rivers, and hot springs. Finally, non-infectious meningitis may be the by-product of certain cancers, lupus, head injury, or brain surgery. Parasitic and non-infectious meningitis also cannot be spread between individuals.

What symptoms should I be aware of?

There are several characteristic symptoms of meningitis common to the disease, regardless of the type of exposure. Meningitis often first presents itself as the sudden onset of fever, headache, and stiff neck. The typical symptoms that develop within three to seven days after exposure include:

• Nausea
• Vomiting
• Photophobia, a.k.a. increased sensitivity to light 
• Altered mental status, or confusion

Anyone with these symptoms should see a doctor immediately for antibiotic or antifungal treatment. Other drug regimens may also be undertaken, depending on the type of meningitis. However, for most individuals, vaccination is the most proactive of treatments.

Should I be vaccinated?

Administration of the meningitis vaccine can come in two forms: the meningococcal polysaccharide vaccine (MPSV4) and the meningococcal conjugate vaccine (MCV4). All adolescents should receive MCV4 at the age of 11 or 12. A booster dose should also be given at around age 16, because adolescents aged 16-21 have the highest rates of disease. The vaccine and booster are particularly important for entering college freshmen and military recruits, who will live in a dormitory or close quarters. Adults living in similar situations, or those traveling to countries in which the disease is common, should also seek out vaccination at a certified travel clinic.

The Hazardous Stages of Typhoid Fever and How To Stop It

Typhoid, also known as Typhoid Fever, is a very common worldwide bacterial disease that is transmitted when one ingests food or water that has been contaminated with feces from another infected person.  This disease, which is commonly referred to by many different names such as slow fever, gastric fever, nervous fever and more, has fallen immensely in terms of impact due to the development of sanitary techniques since the 20^th century.  Although Typhoid defines as “resembling typhus” and stems from the same neuropsychiatric symptoms, they are both distinctly different diseases caused by different types of bacteria. 

Untreated Typhoid Fever is categorized into four distinct and individual stages that each last around one week.  The patient during these four individual courses becomes increasingly exhausted and stretched, which leads them to lose an extreme amount of weight.  During the first week of Typhoid, the infected patient’s temperature rises slowly and steadily while suffering from malaise, headaches, and coughs.  One can also experience abdominal pains and bloody noses.  There is also a decrease in the number of circulating white blood cells.  In the second week of Typhoid, the infected person lies face down for extended periods of time with an extremely high fever reaching around 104 degrees F.  The contaminated patient also falls prey to bouts of delirium, which at times can range from calm to agitation.  These periods of delirium give Typhoid its moniker of “nervous fever”.  In about a third of the patients, red spots appear around the abdomen and the lower chest. Constipation is frequent in this stage as is diarrhea.  The liver and spleen also undergo tenderness and enlargement. 

In the third week of Typhoid, there are a number of different complications that can occur.  One of the complications that can happen is intestinal hemorrhaging, but fortunately this is not usually fatal, although it is very serious and dangerous.  Another complication, intestinal perforation in the distal ileum, also occurs in the intestine.  This specific symptom is very serious and frequently fatal, and can occur almost without warning.  One could also contract Encephalitis, while fever stays very high without much oscillation.  Dehydration succeeds and the patient continues to suffer from intense delirium.  By the end of the third week, the patient usually begins to recover from the condition with the fever decreasing in temperature and delusions cease.

Although simple development of sanitation and hygiene are the best ways of combating the disease, there is a vaccination to prevent Typhoid.  Transmission of Typhoid can only occur from human to human, so it can only spread in environment where human feces or urine comes in contact with water.  So if one is ever going to a developing country, vaccination is necessary, especially since Typhoid is such a dangerous infection.  There are two different types of typhoid vaccinations, one is a live vaccine administered orally and the other is an injectable subunit vaccine.  Boosters are highly recommended every five years. There are also antibiotics that may not completely cure Typhoid, but usually decrease the death rate to a mere 1%. Death rates in untreated patients range from 10 – 30$, so make sure if one ever comes across these symptoms, get it checked. Vaccinations can be administered at your local travel immunization clinic.

Why Rabies is Considered One of the Most Dangerous Viruses and How It’s Combated

Rabies is a zoonotic and viral disease that causes acute encephalitis in warm-blooded animals and is transferable between species, such as dogs and humans, commonly through bites from the infected.  Once contracted with rabies, the virus infects the central nervous system, which inevitably causes disease in the brain and can induce death.  Rabies is particularly fatal in humans if post-exposure prophylaxis it not administered before some of the more severe symptoms begin to occur. 

The Rabies virus travels to the brain by following the peripheral nerves and once infected, one enters an incubation period, which is common amongst viral diseases.  The incubation period usually lasts a few months for humans, and it depends on the distance the virus must travel to ultimately reach the central nervous system.  Unfortunately, after the virus reaches the central nervous and symptoms become prevalent, the infection becomes essentially untreatable and usually kills within days. Rabies annually causes 55,000 deaths worldwide with close to around 95% of these deaths occurring in Africa and Asia.  Another astonishing fact surrounding the rabies infection is that 97% of those who become infected were bitten and contaminated by dogs.  Rabid Dogs (dogs infected with the rabies virus) are very dangerous and aggressive, which leads to attacks.  Dogs that are infected usually appear with black swollen eyes, and they sometimes secrete a white, bubbly liquid from their mouths.  Because of control and vaccination programs in the United States, rabid dog attacks are nowhere near as high as they are in developing countries that lack proper care. However, it is very important to have your dog checked if it seems to behave more bizarrely than usual and is starting to produce any rabies related symptoms.  

  

After the incubation period, which has been documented to last as low as four days to as long as six years, all depending upon the distance of the bite from the central nervous system and the amount of the virus that enters the body.  Those who become contaminated initially begin to show minor symptoms such as headache, fever, or malaise.  Soon, more symptoms begin to arise such as paralysis, anxiety, insomnia, paranoia, and agitation, which then leads in to more severe symptoms: mania, lethargy, uncontrolled emotions, hallucinations, and delirium.   After these unfortunate symptoms occur, the infected patient will eventually slip into a coma where he or she will more than likely die from respiratory insufficiency.  Although survival after the incubation period is rare, there are forms of prevention and treatments for those still in the incubation period.  

In terms of prevention, two French scientists, Louis Pasteur and Emile Roux, created the rabies vaccination in 1885.  Consisting of a sample of the virus that was harvested from rabbit, the vaccination actually weakened the virus even after one had become infected.  Recently, other form of the vaccine such as V-RG (recombinant rabies vaccine), which can be taken orally, have been created and administered throughout the world, greatly preventing the spread of the infection.  If one has already been exposed to the virus, he or she is given post-exposure prophylaxis, which is very effective in combating and preventing rabies after a rabid animal has bitten the patient.  This PEP is made from rabies vaccine and immunoglobulin and is administered several times after infection. Contact your local vaccination clinic today to make an appointment to vaccinate yourself against rabies!

Stay Away from Mosquitoes and Aware of Yellow Fever

Are you looking forward to exotic travels, having finally found that chance to make your way to South America or Africa? Well, while you’re deciding what to pack for your next adventure, be sure to consider taking the vaccine for yellow fever before you leave.

What’s Yellow Fever?          

It’s important for travelers to central and western Africa as well as parts of Latin America to be knowledgeable of the risks posed by yellow fever. This illness is transmitted by mosquitoes, which acquire a virus from infected primates or humans and then pass it on to others who are bitten. Yellow fever is marked by three types of transmission cycles, and may be acquired in jungle (sylvan), savannah (intermediate), and city (urban) settings.

How can it affect me?

The majority of individuals infected by the yellow fever virus show no symptoms; but each year, many do suffer signs of the illness following an incubation period of three to six days after infection. Affected individuals often experience a sudden fever, chills, intense headache, back pain, body aches, nausea, vomiting, fatigue, and weakness. Once the virus does develop into the illness, the only course of action is to treat symptoms in order to provide comfort, meanwhile allowing the immune system to fight the fever.

Many patients improve after this “acute” phase, which lasts three to four days; but, 15% of patients go on to develop a more severe hemorrhagic fever after an initial remission period of about 24 hours. The high fever characteristic of the illness returns, and now affects multiple body systems. Yellow fever’s victims quickly develop the jaundice for which the virus is named, and may experience abdominal pain as well as vomiting. Bleeding can occur from the mouth, nose, eyes, or stomach, and appears in the vomit and feces. Kidney function deteriorates, and up to half of all patients who enter this toxic phase expire within two weeks.

How can I protect myself?        

Due to the difficulty of diagnosing yellow fever from its initial symptoms, and the potentially dire effects of disease progression, it is absolutely necessary for at risk travelers to protect themselves against the illness. Mosquito repellent is always recommended, but the best course of action is to get the yellow fever vaccination before embarking! The yellow fever vaccine is safe, affordable, and highly effective. A single dose of the vaccine can provide immunity within 30 days, and remains effective for a lifetime without an additional booster shot!

If you are affected by HIV, have primary immune deficiency, or are engaging in an immunosuppressive therapy, it is not appropriate to receive the yellow fever vaccination. Additionally, the vaccine should not be given to children under six months of age or individuals with allergies to albumin. If you are over 60 years of age, may be pregnant, or are breastfeeding, please consult a doctor before vaccination. In all other circumstances, be sure to visit your closest immunization clinic a month before traveling!

Hepatitis A Virus and Why You Should Get Vaccinated

Hepatitis A is an acute infectious disease of the liver that is caused by the virus of the same name, hepatitis A virus or HAV.  Hepatitis A is an RNA virus that spreads in most cases by the fecal-oral route.  In short, the virus is heavily transmitted from person to person through the ingestion of food or water that has been previously contaminated.  Unfortunately, one who eventually contracts the virus may never know when or how he or she even came in contact with it, which makes the virus completely spontaneous.   Individuals can also become contaminated with the virus through directed contact with an infected person. 

This year alone, tens of millions of people will be contaminated.  The inability to immediately discern whether someone has become infected allows the virus to harbor undetected for a few weeks.  There is a space of time between the initial contraction of the infection and the appearance of its symptoms known as the incubation period that can consist of around two weeks to six.  The incubation period greatly aids the virus’s spread, because someone who has been contaminated infects food or water unknowingly and unwillingly; thereby infecting others who are also unaware of the potential risks.  The incubation period of Hepatitis A usually lasts for around twenty-eight days. 

Because of usually poor hygiene standards, developing countries are much more susceptible to the virus.  A source of water is not always privately consumed or distributed in poorer countries like here in the United States.  This allows for a large group of people to come contact with an infected source, whereas in more developed countries, those contaminated aren’t as likely to spread the disease as easily.  The higher the countries wealth, the lower the likelihood of contracting the virus, but that does not mean those in first world countries are immune from contraction.

Another worrying factor of the Hepatitis A virus is that children are the most likely to become infected; because when one is infected he or she is essentially immune afterwards.  The risk of the virus is directly proportional with the age of the contaminated.  Adults have a much more severe response to the virus and 80% of those infected have symptoms that are compatible with acute hepatitis, whereas children are more likely to have either a asymptomatic or unrecognized infection.  Although it is rare, there have been cases of relapse.  Luckily, there is a vaccination to treat the danger of HAV.  

 

The first successful Hepatitis A vaccine was created by Maurice Hilleman and with a success rate of 95%, the vaccine goes a long way in stifling the virus and its symptoms: fatigue, fever, jaundice, nausea.  There are currently two types of vaccines. One contains the inactivated Hepatitis A virus, and the other a live, attenuated virus.  The injection takes place in the upper arm region and is usually given in two doses.  The vaccine gives immunity to its host for fifteen to twenty-five years.  If you are ever traveling to a developing country, vaccination is greatly recommended, especially if a child is present.  Although mortality for Hepatitis is low, one can never exude too much caution when dealing with such a transmittable virus. Contact the office of a local travel clinic to set up an appointment!