Hantavirus and hantavirus pulmonary syndrome (HPS) .facts
- Hantaviruses are RNA viruses transmitted to humans by rodents (rodent-borne).
- Hantavirus pulmonary syndrome, also referred to as HPS, is a disease in which, in the late stage of infection with a hantavirus subtype.
- Early symptoms of hantavirus infections (fatigue, fever, muscle aches) are not caused by anything specific.
- Signs and symptoms of HPS as it spreads thoroughout the body include;
- lung congestion,
- fluid accumulation in the lungs, and
- shortness of breath.
- In addition, some hantaviruses can cause hemorrhagic fever with renal syndrome (HFRS) as the disease progresses.
- Health officials first identified hantavirus in an outbreak in 1993 in the "Four Corners" area of the southwestern United States. Hantavirus is spread to humans by particles of;
- rodent urine,
- feces,
- saliva, and
- airborne particles containing these excretions.
- The 2012 outbreak of hantavirus at Yosemite National Park was due to deer mice that transferd the virus to humans.
- So far, the transmission of hantavirus in the US has not transferred from human-to-human contact.
- Hantavirus is not contagious in North America.
- In South America, some investigators suggest hantavirus there may be contagious.
- It takes about one to five weeks (incubation period) for the signs and symptoms of hantavirus pulmonary syndrome begin.
- About 38% of hantavirus infections are fatal (mortality rate).
- Lung capillaries leak fluid into the lung tissue, which causes hantavirus.
- Doctors usually diagnose HPS infections based on hantavirus lung symptoms are associated with rodents or probable contact with rodent-contaminated airborne dust, and chest X-rays provide additional evidence, but definitive diagnosis is usually done at a specialized lab or the U.S. Centers for Disease Control and Prevention (CDC).
- There is no specific treatment, vaccine, or cure for hantavirus pulmonary syndrome.
- Usually, treatment is in an intensive care facility and often require respiratory support (intubation and mechanical ventilation).
- Special doctors usually care for people with hantavirus infections.
- Risk factors are any association with rodents and their airborne body excretions.
- If a person with HPS survives, there are usually no long-term complications.
- Prevention of HPS centers on avoiding rodent contamination.
- There is no vaccine available to prevent hantavirus infection or pulmonary syndrome.
- There is no cure for hantavirus pulmonary syndrome.
Symptoms of Hantavirus
Flu-like Symptoms
The flu (influenza) is a viral disease of the respiratory tract. Characteristic symptoms are
- fever,
- chills,
- cough,
- malaise, and
- headache.
Other symptoms can occur, like
- nausea and vomiting,
- muscle or body aches,
- tiredness and fatigue,
- appetite loss,
- sore throat, and
- diarrhea.
What is hantavirus and pulmonary syndrome (HPS)?
The term hantavirus represents several groups of RNA-containing viruses (that are members of the virus family of Bunyaviridae) that are carried by rodents and can cause severe respiratory infections termed hantavirus pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS).
HPS is found mainly in the Americas (Canada, U.S., Argentina, Brazil, Chile, Panama, and others) while hemrrhatic fever with renal syndrome (HFRS) is found mainly in Russia, China, and Korea but may be found in Scandinavia and Western Europe and occasionally in other areas.
Like HPS, HFRS results from hantaviruses that are transmitted by
- rodent urine,
- rodent droppings, or
- saliva (rodent bite), by direct contact with
- the animals
- by aerosolized dust contaminated with rodent urine or feces to human skin breaks or to mucous membranes of the mouth, nose, or eyes.
- The vast majority of HPS and HFRS infections do not transfer from person to person.
The goal of this article is to discuss HPS; however, much of what is presented about HPS applies to HFRS -- the main difference is that the predominant symptoms in the late stages of disease vary somewhat between the two diseases (lung fluid and shortness of breath in HPS and low blood pressure, fever, and kidney failure in HFRS).
HPS is a disease caused by hantavirus that results in human lungs filling with fluid (pulmonary edema) and causing death in about 38% of all infected patients.
SLIDESHOW
Viral Infection Types, Treatment, and PreventionWhat are the early symptoms and signs of HPS?
The symptoms and signs of HPS fall into early and late stages.
Early HPS signs and symptoms begin about one to five weeks after the person contacts hantavirus associated with rodent urine, feces, or saliva. The early symptoms are flu-like, last about four to 10 days, and include
- ffatigue,
- fever, and
- muscle aches, especially large muscles in the legs, back, and hips).
Almost every infected person develops these symptoms. Other symptoms of HPS that may occur in about half of infected patients include
Early symptoms of can cause diagnostic confusion. In 2018, Kiley Lane, a 27-year-old mother who lived in New Mexico, was diagnosed as having the flu but her symptoms got worse. She was diagnosed with having hantavirus about a month after her flu diagnosis and died about one month later of the disease.
Late symptoms of HPS occur about four to 10 days after the early symptoms and include;
- coughing,
- chest pain, and
- shortness of breath that can become severe.
Some infected people may develop hemorrhagic fever and kidney failure that may require dialysis (HFRS or hemorrhagic fever with renal syndrome).
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More Health News »What are the causes and risk factors for HPS?
HPS syndrome causes
The cause of HPS is infection of the patient by hantavirus. Currently, about 14 subtypes of hantaviruses have been identified. Many subtypes have been named
- Sin Nombre
- Black Creek hantavirus
- Seoul virus
- New York hantavirus
Some researchers and doctytors simply them under the term of "New World hantaviruses." The Sin Nombre subtype has caused the majority of current HPS disease.
Hantavirus apparently damages cells that compose blood vessel capillaries, causing them to leak fluids. This fluid leak, if it is profound in the lungs, causes the life-threatening pulmonary syndrome.
Hantaviruses live their lifecycle in rodents but apparently do no harm; the viruses multiply and shed in the rodent's urine, feces, and saliva. A recent study in California suggested about 15% of all deer mice examined tested positive for hantavirus. Although the deer mouse has been the source of most HPSinfections, many other rodents may carry a different hantavirus subtype virus (for example, the white-footed mouse, the cotton rat, and the rice rat).
HPS risk factors
The major risk factor for HPS is association with
- Rodent infestation.
- Rodent saliva.
- Rodent urine.
- Feces or with dust, dirt.
- Surfaces contaminated with such rodent excretions, either by direct contact or by aerosol.
- Barns, sheds, homes, or buildings easily entered by rodents (for example, deer mouse or Peromyscus maniculatus) are potential places for hantaviruses to come in contact with humans.
- Rural areas that have forests and fields that can support a large rodent population are areas that increase the risk of exposure to hantavirus.
- Camping and hiking in areas known to have a high rodent population and occupying areas where rodents may seek shelter increase one's risk.
- Working in areas that may be shelter for rodents (for example, crawl spaces, vacated buildings, construction sites) may also have increased risk of hantavirus syndrome.
- The risk is higher in people who work in areas known to have produced hantavirus pulmonary syndrome infections.
IMAGES
HantavirusIs hantavirus contagious, and how long is it before symptoms begin?
Is hantavirus contagious?
There is no evidence that HPS is not contagious from person to person contact in the US. The virus spreads from rodents to humans. Although outbreaks seem like there is person-to-person transfer, outbreaks are usually noted among groups of people exposed to the same infected rodent population while those with hantavirus infections do not transfer them to other uninfected individuals.
How long is hantaviris contagious?
- As of January 2017 in the US, hantavirus has affected about 800 people.
- South America, an estimated 16-35 days was the contagious period for a rare few patients who investigators considered to have exhibited person-to-person transfer with a type of hanta virus termed Andes virus.
- While this is the situation in North America, there are reports that in 1996, mild infections with hantaviruses were transmissible in an outbreak in Argentina.
- Small outbreaks are reported each year; for example, Texas had its first person diagnosed with hantavirus in 2015.
What is the incubation period for hantavirus?
- According to the CDC, in North America, the incubation period (time from initial exposure to the virus and development of the first symptoms) is between one to five weeks after initial exposure to infected rodent urine, droppings, or saliva.
- In South American outbreaks, researchers estimate that the incubation period varies from about 12-27 days.
What exams and tests diagnose HPS?
A test considered to diagnose HPS, is a positive serological test result, which is evidence of viral antigen in tissue by immunohistochemistry, or the presence of amplifiable viral RNA sequences in blood or tissue, with compatible history of HPS, is considered diagnostic for HPS.
What is the treatment for HPS?
- Unfortunately, hantavirus infections can lead to HPS. According to the CDC, hantavirus infections according have a mortality rate of about 38%.
- At this time, there is no definitive treatment for HPS other than early recognition of HPS and subsequent medical support (usually consisting of symptomatic medical treatment and respiratory support or mechanical ventilation).
- The CDC suggests that early treatment in an intensive care unit may allow the patient to survive severe HPS.
- Experimentally, doctors have administered the antiviral medication ribavirin (Rebetol, Copegus), but there are no clear data currently that establish that the drug is effective against HPS; however, its use against HFRS early in the disease suggests ribavirin can decrease illness and deaths.
- There is no vaccine available to protect against any hantaviruses to date.
Consequently, most patients diagnosed with HPS are usually cared for in the intensive care unit by specialists trained in critical care, and usually, in consultation with an infectious-disease doctor. Because the lungs are the most compromised organ in these infections, a lung doctor (pulmonologist) also is usually consulted. Moreover, specialists from the CDC are often involved to help locate the outbreak source and to help healthcare personnel at the outbreak site prevent further infections.
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What are the complications of HPS?
The major complication of HPS is death from respiratory failure. Those who survive may take a few weeks to recover fully. Those patients who survive do not have chronic infections nor do they experience other chronic problems or complications.
Can you die from HPS?
The prognosis of HPS is fair to poor because currently, about 62% of patients recover, while about 38% will die. The prognosis may be better if the patient gets his/her diagnosis early and given support in an intensive care unit in a hospital. However, the early diagnosis of HPS is difficult; some patients did not know they had been exposed to rodents that carried hantavirus.
Can you prevent HPS?
There are no vaccines available to protect against any hantavirus types. The CDC recommends elimination or reduction of contact with any rodents (for example, at home, worksites, campsites, barns, sheds) by reducing rodent access or rodent-proofing. Sealing up gaps and holes, placing traps, and keeping areas as clean and food free as possible will help. If a person must come in contact with rodents or areas where they live, precautions such as gloves and masks may reduce the chances for infection; disinfectant treatment of possible contaminated surfaces may also help prevent the disease.
Do not attempt to use a vacuum or use a broom to remove rodent urine or feces; this action may increase the risk of HPS by generating an aerosol. The risk of HPS can be reduced by inactivating hantaviruses in the environment by using a household detergent and 1½ cups of bleach per gallon of water to wipe or spray the potentially infected area and while minimizing contact by wearing gloves and a mask. Take similar precautions with rodents caught in traps.
When was hantavirus pulmonary syndrome first discovered?
- In 1993, health officials noted the first recognized outbreak of HPS in the "Four Corners" area of the U.S., where the states of Arizona, New Mexico, Colorado, and Utah meet. Two otherwise healthy young people, a Navajo Indian and his fiancée, suddenly became short of breath and died. This unusual situation triggered a review of deaths in the four states that resulted in identification of five other young people who recently died with similar breathing problems. During the next few weeks, health care providers treated additional people in the same geographic area with similar pulmonary syndromes.
- Tissues from affected patients were sent to the CDC, where researchers searched for causes and found a link among the patients: infection with a previously unknown type of hantavirus. Since other known hantaviruses (in Asia and Europe) were known to be transmitted to people by rodents, the researchers started trapping rodents from June to August 1993 to determine if the virus was associated with the animals.
- In November 1993, a rodent (a deer mouse) trapped by CDC researchers in a house where a person who developed the pulmonary syndrome lived yielded the previously unknown virus. In addition, army researchers soon isolated the same virus from an infected patient who also had exposures to mice. This new hantavirus was first termed Muerto Canyon virus, then Sin Nombre virus (SNV), and eventually simply hantavirus.
- The disease caused by this virus was termed hantavirus pulmonary syndrome (HPS).
- Further investigations suggested that other people had died from this infection in the past, as autopsy tissue contained the virus.
- When health researchers studied Navajo Indian medical traditions, the Navajo medical culture apparently recognized the disease and had associated it with mice.
- The outbreak in 1993 probably occurred because environmental factors led to favorable survival and proliferation of mice. The mouse population was about tenfold greater in 1993 than in 1992 in the Four Corners area.
- A large, more recent outbreak of HPS occurred at Yosemite National Park, California, in 2012. The outbreak was linked to deer mouse dropping contamination in campsites (tent-cabins) used by tourists.
- This zoonotic (animal-to-person) transmission probably happened with a rodent infestation augmented by favorable nesting conditions like woodpiles in or near the campsites. At least three deaths occurred, and seven other infected people recovered.
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Viral Infection Types, Treatment, and Prevention
What Is a Virus?
Viruses are small particles of genetic material (either DNA or RNA) that are surrounded by a protein coat. Some viruses also have a fatty "envelope" covering. They are incapable of reproducing on their own. Viruses depend on the organisms they infect (hosts) for their very survival. Viruses get a bad rap, but they also perform many important functions for humans, plants, animals, and the environment. For example, some viruses protect the host against other infections. Viruses also participate in the process of evolution by transferring genes among different species. In biomedical research, scientists use viruses to insert new genes into cells.
When most people hear the word "virus," they think of disease-causing (pathogenic) viruses such as the common cold, influenza, chickenpox, human immunodeficiency virus (HIV), and others. Viruses can affect many areas in the body, including the reproductive, respiratory, and gastrointestinal systems. They can also affect the liver, brain, and skin. Research reveals that that viruses are implicated in many cancers as well.
What Is a Viral Infection?
A viral infection is a proliferation of a harmful virus inside the body. Viruses cannot reproduce without the assistance of a host. Viruses infect a host by introducing their genetic material into the cells and hijacking the cell’s internal machinery to make more virus particles. With an active viral infection, a virus makes copies of itself and bursts the host cell (killing it) to set the newly-formed virus particles free. In other cases, virus particles “bud” off the host cell over a period of time before killing the host cell. Either way, new virus particles are then free to infect other cells. Symptoms of the viral illness occur as a result of cell damage, tissue destruction, and the associated immune response.
Certain viruses -- like the ones that cause chickenpox and cold sores -- may be inactive or “latent” after the initial infection. For example, you may have a cold sore that erupts and then heals. The cold sore virus remains in your cells in a dormant state. At a later date, a trigger, such as stress, sunlight, or something else, may reactivate the virus and lead to new symptoms. The virus makes more copies of itself, releases new virus particles, and kills more host cells.
How Long Are Viral Infections Contagious?
Contagiousness refers to the ability of a virus to be transmitted from one person (or host) to another. Viral infections are contagious for varying periods of time depending on the virus. An incubation period refers to the time between exposure to a virus (or other pathogen) and the emergence of symptoms. The contagious period of a virus is not necessarily the same as the incubation period.
Bacteria vs. Virus
Viruses and bacteria are two types of potentially disease-causing (pathogenic) particles. Viruses are much smaller than bacteria and can’t reproduce without the assistance of a host. Bacteria are capable of reproducing on their own. The symptoms of viral and bacterial illnesses are sometimes similar. A doctor can determine the underlying cause of an illness based on the patient’s symptoms and other factors. Lab tests may help clarify whether an illness is due to a virus, bacteria, or other infectious agent or disease process.
Virus Transmission
Viruses can be transmitted in a variety of ways. Some viruses can spread through touch, saliva, or even the air. Other viruses can be transmitted through sexual contact or by sharing contaminated needles. Insects including ticks and mosquitoes can act as "vectors," transmitting a virus from one host to another. Contaminated food and water are other potential sources of viral infection.
Respiratory Viral Infections
Respiratory viral infections affect the lungs, nose, and throat. These viruses are most commonly spread by inhaling droplets containing virus particles. Examples include:
- Rhinovirus is the virus that most often causes the common cold, but there are more than 200 different viruses that can cause colds. Cold symptoms like coughing, sneezing, mild headache, and sore throat typically last for up to 2 weeks.
- Seasonal influenza is an illness that affects about 5% to 20% of the population in the US every year. More than 200,000 people per year are hospitalized annually in the US due to complications of the flu. Flu symptoms are more severe than cold symptoms and often include body aches and severe fatigue. The flu also tends to come on more suddenly than a cold.
- Respiratory Syncytial Virus (RSV) is an infection that can cause both upper respiratory infections (like colds) and lower respiratory infections (like pneumonia and bronchiolitis). It can be very severe in infants, small children, and elderly adults.
Frequent hand-washing, covering the nose and mouth when coughing or sneezing, and avoiding contact with infected individuals can all reduce the spread of respiratory infections. Disinfecting hard surfaces and not touching the eyes, nose, and mouth can help reduce transmission as well.
Viral Skin Infections
Viral skin infections can range from mild to severe and often produce a rash. Examples of viral skin infections include:
- Molluscum contagiosum causes small, flesh-colored bumps most often in children ages 1 to 10 years old; however, people of any age can acquire the virus. The bumps usually disappear without treatment, usually in 6 to 12 months.
- Herpes simplex virus-1 (HSV-1) is the common virus that causes cold sores. It’s transmitted through saliva by kissing or sharing food or drink with an infected individual. Sometimes, HSV-1 causes genital herpes. An estimated 85% of people in the US have HSV-1 by the time they are in their 60s.
- Varicella-zoster virus (VZV) causes itchy, oozing blisters, fatigue, and high fever characteristic of chickenpox. The chickenpox vaccine is 98% effective at preventing infection. People who have had chickenpox (or in extremely rare instances, people who have received the chickenpox vaccine) are at risk for developing shingles, an illness caused by the same virus. Shingles can occur at any age, but it occurs most often in people age 60 or older.
The best way to avoid viral skin infections is to avoid skin-to-skin contact (especially areas that have a rash or sores) with an infected individual. Some viral skin infections, such as varicella-zoster virus, are also transmitted by an airborne route. Communal showers, swimming pools, and contaminated towels can also potentially harbor certain viruses.
Foodborne Viral Infections
Viruses are one of the most common causes of food poisoning. The symptoms of these infections vary depending on the virus involved.
- Hepatitis A is a virus that affects the liver for a few weeks up to several months. Symptoms may include yellow skin, nausea, diarrhea, and vomiting. Up to 15% of infected individuals experience recurrent illness within 6 months of infection.
- Norovirus has been reported to be responsible for outbreaks of severe gastrointestinal illness that happen on cruise ships, but it causes disease in many situations and locations. About 20 million people in the U.S. become sick from these highly contagious viruses every year.
- Rotavirus causes severe, watery diarrhea that can lead to dehydration. Anyone can get rotavirus, but the illness occurs most often in babies and young children.
Rotaviruses and noroviruses are responsible for many (but not all) cases of viral gastroenteritis, which causes inflammation of the stomach and intestines. People may use the terms “stomach virus” or “stomach flu” to refer to viral gastroenteritis, which causes nausea, vomiting, diarrhea, and abdominal pain.
It’s not pleasant to think about it, but foodborne viral illnesses are transmitted via the fecal-oral route. This means that a person gets the virus by ingesting virus particles that were shed through the feces of an infected person. Someone with this type of virus who doesn’t wash their hands after using the restroom can transfer the virus to others by shaking hands, preparing food, or touching hard surfaces. Contaminated water is another potential source of infection.
Sexually Transmitted Viral Infections
Sexually transmitted viral infections spread through contact with bodily fluids. Some sexually transmitted infections can also be transmitted via the blood (blood-borne transmission).
- Human papillomavirus (HPV) is the most common sexually-transmitted infection in the US. There are many different types of HPV. Some cause genital warts while others increase the risk of cervical cancer. Vaccination can protect against cancer-causing strains of HPV.
- Hepatitis B is a virus that causes inflammation in the liver. It’s transmitted through contaminated blood and bodily fluids. Some people with the virus don’t have any symptoms while others feel like they have the flu. The hepatitis B vaccine is more than 90% effective at preventing infection.
- Genital herpes is a common sexually-transmitted infection caused by herpes simplex virus-2 (HSV-2). Herpes simplex virus-1 (HSV-1), the virus responsible for cold sores, can also sometimes cause genital herpes. There’s no cure for genital herpes. Painful sores often recur during outbreaks. Antiviral medications can decrease both the number and length of outbreaks.
- Human immunodeficiency virus (HIV) is a virus that affects certain types of T cells of the immune system. Progression of the infection decreases the body’s ability to fight disease and infection, leading to acquired immune deficiency syndrome (AIDS). HIV is transmitted by coming into contact with blood or bodily fluids of an infected person.
People can reduce the risk of getting a sexually-transmitted viral infection by abstaining from sex or only having sex while in a monogamous relationship with someone who does not have a sexually-transmitted infection. Using a condom decreases, but doesn’t entirely eliminate, the risk of acquiring a sexually-transmitted infection. Minimizing the number of sexual partners and avoiding intravenous drug use are other ways to reduce the risk of acquiring sexually-transmitted and bloodborne viral infections.
Other Viral Infections
Viruses are abundant in the world and cause many other infections ranging from mild to life-threatening.
- Epstein-Barr virus (EBV) is a type of herpes virus that’s associated with fever, fatigue, swollen lymph nodes, and an enlarged spleen. EBV is a very common virus that causes mononucleosis ("mono"). More than 90% of adults have been infected with this “kissing disease” that is spread primarily through saliva.
- West Nile virus (WNV) is a virus that’s most commonly transmitted by infected mosquitos. Most people (70% to 80%) with WNV don’t have any symptoms while others develop a fever, headache, and other symptoms. Less than 1% of people with WNV develop inflammation of the brain (encephalitis) or inflammation of the tissue surrounding the brain and spinal cord (meningitis).
- Viral meningitis is an inflammation of the lining of the brain and spinal cord that causes headache, fever, stiff neck, and other symptoms. Many viruses can cause viral meningitis, but a group of viruses called enteroviruses are most often to blame.
Antiviral Medication and Other Treatment
Many viral infections resolve on their own without treatment. Other times, treatment of viral infections focuses on symptom relief, not fighting the virus. For example, cold medicine helps alleviate the pain and congestion associated with the cold, but it doesn’t act directly on the cold virus.
There are some medications that work directly on viruses. These are called antiviral medications. They work by inhibiting the production of virus particles. Some interfere with the production of viral DNA. Others prevent viruses from entering host cells. There are other ways in which these medications work. In general, antiviral medications are most effective when they’re taken early on in the course of an initial viral infection or a recurrent outbreak. Different kinds of antiviral medications may be used to treat chickenpox, shingles, herpes simplex virus-1 (HSV-1), herpes simplex virus-2 (HSV-2), HIV, hepatitis B, hepatitis C, and influenza.
Viruses and Cancer
Viruses insert themselves into host cell DNA in order to make more virus particles. Cancer is a disease that occurs as the result of mutations or alterations to DNA. Because viruses affect the DNA of host cells, viruses are known to contribute to several different types of cancer. Viruses known to increase the risk of cancer include:
- Epstein-Barr virus (EBV) for nasopharyngeal cancer, Burkitt lymphoma, Hodgkin’s lymphoma, and stomach cancer
- Hepatitis B and hepatitis C for liver cancer
- Human immunodeficiency virus (HIV) for Kaposi sarcoma, invasive cervical cancer, lymphomas, and other cancers
- Human T-lymphotrophic virus-1 (HTLV-1) for T-cell leukemia/lymphoma (ATL)
- Human papilloma virus (HPV) for cervical cancer
- Merkel cell polyomavirus (MCV) for a rare skin cancer called Merkel cell carcinoma
Viral Illness Prevention
Vaccines can reduce the risk of acquiring some viral illnesses. Vaccines are available to help protect against the flu, hepatitis A, hepatitis B, chickenpox, herpes zoster (shingles), cancer-causing strains of human papillomavirus (HPV), measles/mumps/rubella (MMR), polio, rabies, rotavirus, and other viruses.
Vaccines vary in effectiveness and in the number of doses required to confer protection. Some vaccines require booster shots to maintain immunity.
Bacterial Infections 101: Types, Symptoms, and Treatments
What are Bacteria?
Bacteria are microscopic, single-cell organisms that live almost everywhere. Bacteria live in every climate and location on earth. Some are airborne while others live in water or soil. Bacteria live on and inside plants, animals, and people. The word "bacteria" has a negative connotation, but bacteria actually perform many vital functions for organisms and in the environment. For example, plants need bacteria in the soil in order to grow.
The vast majority of bacteria are harmless to people and some strains are even beneficial. In the human gastrointestinal tract, good bacteria aid in digestion and produce vitamins. They also help with immunity, making the body less hospitable to bad bacteria and other harmful pathogens. When considering all the strains of bacteria that exist, relatively few are capable of making people sick.
What Is a Bacterial Infection?
A bacterial infection is a proliferation of a harmful strain of bacteria on or inside the body. Bacteria can infect any area of the body. Pneumonia, meningitis, and food poisoning are just a few illnesses that may be caused by harmful bacteria. Bacteria come in three basic shapes: rod-shaped (bacilli), spherical (cocci), or helical (spirilla). Bacteria may also be classified as gram-positive or gram-negative. Gram-positive bacteria have a thick cell wall while gram-negative bacteria do not. Gram staining, bacterial culture with antibiotic sensitivity determination, and other tests are used to identify bacterial strains and help determine the appropriate course of treatment.
Bacteria vs. Virus
Bacteria and viruses are different types of pathogens, organisms that can cause disease. Bacteria are larger than viruses and are capable of reproducing on their own. Viruses are much smaller than bacteria and cannot reproduce on their own. Instead, viruses reproduce by infecting a host and using the host's DNA repair and replication systems to make copies of itself.
The symptoms of a bacterial or viral infection depend on the area of the body that is affected. Sometimes the symptoms of the two can be very similar. For example, runny nose, cough, headache, and fatigue can occur with the common cold (virus) and with a sinus infection (bacteria). A doctor may use the presence of other symptoms (such as fever or body aches), the length of the illness, and certain lab tests to determine if an illness is due to a virus, bacteria, or some other pathogen or disease process.
Bacterial Skin Infections
Bacterial skin infections are usually caused by gram-positive strains of Staphylococcus and Streptococcus or other organisms. Common bacterial skin infections include:
- Cellulitis causes a painful, red infection that is usually warm to the touch. Cellulitis occurs most often on the legs, but it can appear anywhere on the body.
- Folliculitis is an infection of the hair follicles that causes red, swollen bumps that look like pimples. Improperly treated pools or hot tubs can harbor bacteria that cause folliculitis.
- Impetigo causes oozing sores, usually in preschool-aged children. The bullous form of impetigo causes large blisters while the non-bullous form has a yellow, crusted appearance.
- Boils are deep skin infections that start in hair follicles. Boils are firm, red, tender bumps that progress until pus accumulates underneath the skin.
Bacterial skin infections are treated with oral or topical antibiotics depending on the strain causing the infection.
Foodborne Bacterial Infections
Bacterial infections are one cause of foodborne illness. Nausea, vomiting, diarrhea, fever, chills, and abdominal pain are common symptoms of food poisoning. Raw meat, fish, eggs, poultry, and unpasteurized dairy may harbor harmful bacteria that can cause illness. Unsanitary food preparation and handling can also encourage bacterial growth. Bacteria that cause food poisoning include:
- Campylobacter jejuni (C. jejuni) is a diarrheal illness often accompanied by cramps and fever.
- Clostridium botulinum (C. botulinum) is a potentially life-threatening bacterium that produces powerful neurotoxins.
- Escherichia coli (E. coli) O157:H7 is a diarrheal (often bloody) illness that may be accompanied by nausea, vomiting, fever, and abdominal cramps.
- Listeria monocytogenes (L. monocytogenes) causes fever, muscle aches, and diarrhea. Pregnant women, elderly individuals, infants, and those with weakened immune systems are most at risk for acquiring this infection.
- Salmonella causes fever, diarrhea, and abdominal cramps. Symptoms typically last between 4 and 7 days.
- Vibrio causes diarrhea when ingested, but it can also cause severe skin infections when it comes in contact with an open wound.
Sexually Transmitted Bacterial Infections
Many sexually transmitted diseases (STDs) are caused by harmful bacteria. Sometimes, these infections aren't associated with any symptoms but can still cause serious damage to the reproductive system. Common STDs caused by bacterial infections include:
- Chlamydia is an infection in men and women caused by an organism called Chlamydia trachomatis. Chlamydia increases the risk of pelvic inflammatory disease (PID) in women.
- Gonorrhea, also known as "clap" and "the drip," is caused by Neisseria gonorrhoeae. Men and women can be infected. Gonorrhea also increases the risk of pelvic inflammatory disease (PID) in women.
- Syphilis can affect men and women and is caused by the bacteria Treponema pallidum. Untreated, syphilis is potentially very dangerous and can even be fatal.
- Bacterial vaginosis, which causes an overgrowth of pathogenic bacteria in the vagina (the CDC does not consider this a STD; see second text reference).
Other Bacterial Infections
Harmful bacteria can affect almost any area of the body. Other types of bacterial infections include:
- Bacterial meningitis is a severe infection of the meninges, the lining of the brain.
- Otitis media is the official name for an infection or inflammation of the middle ear. Both bacteria and viruses can cause ear infections, which commonly occur in babies and small children.
- Urinary tract infection (UTI) is a bacterial infection of the bladder, urethra, kidneys, or ureters.
- Respiratory tract infections include sore throat, bronchitis, sinusitis, and pneumonia. Bacteria or viruses may be responsible for respiratory tract infections. Tuberculosis is a type of bacterial lower respiratory tract infection.
Antibiotics
Antibiotics are medications that fight bacterial infections. They work by disrupting the processes necessary for bacterial cell growth and proliferation. It's important to take antibiotics exactly as prescribed. Failure to do so could make a bacterial infection worse. Antibiotics don't treat viruses, but they're sometimes prescribed in viral illnesses to help prevent a "secondary bacterial infection." Secondary infections occur when someone is in a weakened or compromised state due to an existing illness.
Antibiotic Resistance
Overuse and misuse of antibiotics has led to a rise in antibiotic resistance. Antibiotic resistance occurs when bacteria are no longer sensitive to a medication that should eliminate an infection. Antibiotic-resistant bacterial infections are potentially very dangerous and increase the risk of death. About 2 million people in the U.S. suffer from antibiotic resistant infections each year and 23,000 die due to the condition. The CDC estimates 14,000 deaths alone are due to Clostridium difficile (C. difficile) infections that occur because of antibiotic suppression of other bacteria allow C.difficile to proliferate. Most deaths due to antibiotic resistant infections occur in hospitalized patients and those who are in nursing homes.
Good Bacteria and Probiotics
Beneficial bacteria live in the human gastrointestinal (GI) tract and play an important role in digestion and immunity. Most people know it's smart to eat yogurt after completing a course of antibiotics to repopulate the GI tract with helpful bacteria that were wiped out from the antibiotics.
Some studies have shown probiotics can shorten the duration of infectious diarrhea. They may also reduce the risk of developing diarrheal illness due to antibiotic use. Probiotics seem to reduce gas, bloating, and abdominal pain associated with irritable bowel syndrome (IBS). Ongoing research seeks to determine the types and dosages of bacteria that are most beneficial to human health.
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What Is a Staph Infection? Symptoms, Pictures
What Is Staphylococcus?
Staphylococcus is a type of bacteria that can cause many types of infections in your body. Commonly referred to as Staph (pronounced "staff"), it is common bacteria found on most people's skin, and often it does not cause disease. More than 30 types of Staphylococci bacteria cause infections, but the most common type of Staph infection is caused by Staphylococcus aureus. If the bacteria gains access to the body, either through a wound on the skin or via the respiratory tract, it can cause serious infections.
Who Is at Risk for Staph Infections?
While anyone can get a Staph infection, some conditions put people at higher risk including:
- Newborns
- Women who are breastfeeding
- Diabetes
- Vascular or lung disease
- Cancer
- Weakened immune system
- Those who inject drugs or medications
- Skin injuries or disorders
- Surgical incisions
- Use of intravenous catheters
What Are the Signs and Symptoms of a Staph Infection?
Symptoms of staphylococcal disease of the skin include pus-filled abscesses (also called boils or furuncles). Pain, swelling, and redness in the area of the infection is common, along with drainage of pus. If the staph infection is in the blood (called bacteremia or sepsis) symptoms can include fever, chills, and low blood pressure (hypotension).
What Types of Diseases Are Caused by Staph?
Staphylococcus causes many different types of infections. Most of the infections cause localized inflammation or pockets of infection known as abscesses. Superficial skin infections such as impetigo (a crusting of the skin) or cellulitis (an infection of the skin layers) are the most common. Breastfeeding women can get a staph infection of the breast called mastitis, which can release bacteria into the mother's milk. Staph bacteria in the lungs can cause pneumonia. When a Staph infection gets into the bone it can cause osteomyelitis. Staph infection in the blood can also infect the heart or heart valves (endocarditis). If the Staph infection gets into the bloodstream it can spread to other organs and cause severe and life-threatening infections (bacteremia or sepsis). Sepsis can lead to shock or multi-organ failure, which can rapidly lead to death.
What Is Antibiotic-Resistant Staph aureus?
Methicillin-resistant Staphylococcus aureus, or MRSA, is a type of staph resistant to antibiotics, including methicillin, penicillin, amoxicillin, and oxacillin. MRSA is considered a type of "superbug," because it has become resistant to antibiotics commonly used to treat it. MRSA has been found to cause illness in hospitals, nursing homes, prisons and other health facilities called (health-care-associated MRSA or HA-MRSA). It has also caused infections outside of healthcare facilities, called community-associated MRSA (CA-MRSA).
What Are Complications of Staph Infections?
Skin infections with Staph bacteria can cause a serious condition called scalded skin syndrome, which is seen more often in children, but can occur in adults as well. The infection causes a breakdown of the upper layers of the skin, which blisters and sloughs off (just like a severe burn). When the infection covers a large surface area of the body, the result can be fatal. Scalded skin syndrome is treated with intravenous antibiotics and fluids to prevent dehydration.
What Is Staph Food Poisoning?
People can get Staph food poisoning by eating foods contaminated with the Staphylococcus aureus (S. aureus) bacterium. The bacterium releases a toxin into the foods, causing a rapid onset of severe nausea and vomiting. It may also cause fever. Foods most associated with Staphylococcus food poisoning are eggs, meats, poultry, salads (egg, tuna, chicken, potato, macaroni), cream-filled baked goods, and dairy products.
How Are Staph Infections Diagnosed?
A doctor may diagnose a minor staphylococcal skin infection by examination of the skin and lab tests are not usually needed. Serious Staph infections of the blood, pneumonia, or endocarditis (inflammation of the inner chambers of the heart) usually require cultures (samples of blood, pus, or tissues grown in the lab to confirm the presence of the Staphylococcus bacterium). Once the Staph bacteria is confirmed, another test called a sensitivity test can be run to see which antibiotics will kill the bacteria.
What Does Staphylococcus aureus Bacteria Look Like?
Under the power of a highly magnified microscope, Staphylococcus aureus appears as small, round organisms arranged in clusters (like clusters of grapes). There are thread-like connections between the round bacterium made of "biofilm." This biofilm helps protect the bacteria and increases its chances of causing infections.
How Are Staph Infections Treated?
Treatment for Staph infections depends on the location and severity of the infection. Minor skin infections can be treated with topical antibiotic ointments, or oral antibiotics. Abscesses are generally treated with incision and drainage or surgery. More severe infections in large areas of the skin, other body organs, or the bloodstream are generally treated with intravenous antibiotics. MRSA infections may be resistant to many antibiotics.
Can Staph Infections Be Prevented?
There is no vaccine currently available to prevent Staphylococcus aureus. Preventing Staph remains the best defense against contracting an infection. Ways to help manage risk factors for contracting Staph and MRSA are discussed on the following slides.
Staph Prevention Tip #1
Cover all skin Staph infections with clean, dry bandages. This is especially important if the wounds are producing pus and draining, because the pus may contain MRSA, which can spread to others.
Staph Prevention Tip #2
Proper hygiene is important. Wash hands diligently, avoid close contact with infected individuals, and carefully clean all skin scrapes, cuts, and wounds to reduce the chances of them becoming infected with Staph. If you have Staph, make sure all people in close contact with you wash their hands frequently, especially if they change your bandages or touch the infected wound.
Staph Prevention Tip #3
Do not share personal items that may have come in contact with the infected wound. Items such as towels, razors, bed linens, or clothing should not be shared. Wash all bedding and clothing in hot water, and dry in a hot dryer to help kill Staph bacteria.
Staph Prevention Tip #4
Handle and prepare food safely to help decrease the risk of Staphylococcal food poisoning:
- Wash hands thoroughly with soap and water before handling and preparing food.
- If you have wounds, skin infections, or a nose or eye infection, do not prepare or serve food to others.
- Clean and sanitize kitchens and all dining areas.
- Keep hot foods hot (over 140 F) and cold foods cold (40 F or under).
- Refrigerate any food that is to be stored as soon as possible.
Staph Prevention Tip #5
The risk of developing toxic shock syndrome (a rare, life-threatening illness caused by toxins secreted by Staph bacteria and associated with tampon use, especially when tampons are not changed frequently) in menstruating women can be reduced by:
- Changing tampons every 4 to 8 hours
- Using low-absorbency tampons
- Alternating tampon use with sanitary pads
Staph Prevention Tip #6
If you have a Staph or MRSA infection, tell your doctor or any health care provider you visit so they can take the proper protective precautions.
Staph Infection Prognosis
When mild and promptly treated with antibiotics, the prognosis for recovery from a Staph infection is excellent. However, a MRSA infection can have an entirely different outlook. MRSA infections, when mild and found in otherwise healthy individuals have a relatively good prognosis. MRSA infections in chronically or severely ill people, the elderly, newborns, or other people with compromised immune systems may be life-threatening or fatal.
Staph Infection At A Glance
- Staphylococcus, is bacteria that can cause many types of infections.
- Staphylococcus can cause diseases such as abscesses, impetigo, food poisoning, cellulitis, mastitis, scalded skin syndrome, and toxic shock syndrome.
- MRSA, or methicillin-resistant Staphylococcus aureus, is a type of Staph infection resistant to many different antibiotics.
- Staph infections are treated with topical, oral, or intravenous antibiotics, depending upon the type and severity of the infection.
MRSA Infection: Causes, Symptoms, and Treatment
What is MRSA?
Methicillin-resistant Staphylococcus aureus (MRSA) are shown in this scanning electron microscope picture. Strains of these bacteria (commonly termed "staph") may cause infection in almost any part or organ system in humans. MRSA strains are further characterized as superbugs because MRSA strains are resistant to many different antibiotics
Symptoms of a MRSA Skin Infection
Initially, MRSA infections in the skin resemble minor skin infections; they appear as a red bump, pimple, or boil on the skin that may be painful, swollen, or warm to the touch. Occasionally, these infections may open and have pus drain from the area. Although most MRSA skin infections are mild, some progress and spread further into the skin and to other areas or organ systems.
Is It MRSA, a Spider Bite, or Something Different?
Bug bites, insect bites, spider bites, rashes, and stings are often difficult to distinguish from MRSA infections because they have similar appearances or symptoms. However, if the person never viewed a spider or other entity causing the lesion, there is a good chance the skin lesion may be caused by MRSA, especially if the lesion area spreads or does not start getting better after about two to three days of treatment with common antibiotics.
MRSA Skin Infection and Cellulitis
Often, the first indication of MRSA infection is a spread of the infection into the surrounding skin, producing skin that is pink or reddish and often is warm, tender, and swollen. Such an infected skin area is termed cellulitis and represents infection spread into deeper skin layers. Cellulitis can rapidly advance (over a few hours) in some individuals.
MRSA Skin Infection: Abscess
MRSA may be somewhat contained by the body by attempting to wall off the invading bacteria by making a pocket of pus surrounded by cells trying to kill or stop the MRSA from advancing. This deeper skin infection is termed an abscess and can spread like cellulitis in some instances. Abscesses usually require drainage (sometimes done with warm compresses, sometimes with a needle, while others require surgical drainage) and antibiotics; your doctor should be consulted as you should not attempt to treat MRSA infections by yourself.
How Do People Catch MRSA?
MRSA is easily spread to other individuals by people with the organisms on their skin. Usually, either skin-to-skin contact or contact with towels, razors, or even doorknobs or benches can transfer MRSA to another person. Some people, termed carriers, have MRSA strains on their body but have no symptoms; however, these people can still transfer MRSA to others by direct and indirect contact (towels or clothing that carriers have used).
Who Can Get MRSA?
Some individuals are at higher risk to get MRSA than others. People who have a chronic medical condition (for example, cancer, HIV, or any immune depression), the elderly, individuals in hospitals, or those who have had recent surgery are at higher risk for MRSA infections.
How Safe Are Hospitals?
Hospitals used to have a reputation as an area to get MRSA infections. However, in recent years, with guidelines established and followed by hospital staff, visitors, and patients, there have been far fewer MRSA infections occurring in hospitals. Simple changes in hygiene policies and utilization of more strict hand-washing procedures have made a positive impact in reducing MRSA infections in hospitals and other institutions like nursing homes and even in community areas such as athletic facilities.
Can Healthy People Get MRSA?
MRSA can easily infect healthy people. Outbreaks have been documented at many areas where people are crowded together (for example, gyms, dormitories, barracks, prisons, and day-care centers). The type of MRSA obtained by healthy people outside of health-care facilities is often termed community-associated or community-acquired MRSA (usually termed CA-MRSA) by many clinicians.
MRSA in Dogs and Cats
MRSA can be transferred to pets such as cat or dogs (the animals may have no symptoms like human MRSA carriers) and, unfortunately, may reinfect the pet owners or other people. Only CA-MRSA strains have been documented to do this with pets.
MRSA on the Beach
MRSA strains survive fairly well for some time on objects handled or worn by carriers or infected individuals. MRSA has been found even in sand and beach water on occasion. How MRSA arrived there is unclear, but the practice of good hygiene (covering skin scrapes, frequent hand washing, and showering with soap after going to the beach or engaging in another water activity) is the best way to reduce the chance of getting a MRSA infection from objects in the environment.
How Is MRSA Diagnosed?
Definitive diagnosis of MRSA is not difficult. However, it may take a few days because, after S. aureus is cultured from an infected site, the bacteria then need to be tested against antibiotics to determine not only what the bacteria are resistant to but also what antibiotic(s) might be effective.
How Is MRSA Treated?
A doctor should guide treatment of MRSA infections. Most treatment methods depend on the severity of the infection and the resistance pattern of the bacteria. Some minor sores or small abscesses may need only warm compresses for pus drainage (if present) and cleaning and coverage with a small bandage. Many clinicians will prescribe an oral antibiotic that some MRSA are usually sensitive to (for example, sulfamethoxazole and trimethoprim [Bactrim], linezolid [Zyvox], or clindamycin [Cleocin T]). More invasive or severe infections might respond to oral antibiotics, but many clinicians may choose to treat such infections with IV drugs such as vancomycin (Vancocin), possibly along with a second IV antibiotic. Most severe infections are treated in consultation with an infectious disease specialist.
MRSA Skin Infection and Home Care
If you are diagnosed with MRSA and sent home with antibiotics, you are strongly advised to take all of the antibiotics prescribed, even if you feel fine, to prevent the infection from reoccurring. Following your doctor's advice about warm compresses and wound care is also important to help you recover. In addition, you need to be careful to dispose of or disinfect items you contact to prevent passing MRSA to others.
MRSA Complications
MRSA infections (especially those associated with health-care facilities) can be dangerous; they can spread rapidly to other body areas and organs and cause serious organ damage or death. At their peak, reports indicated there were about 19,000 deaths in a year due to MRSA, but recently, this rate has decreased because of good hospital practices according to the CDC.
How to Avoid MRSA
Avoiding or reducing the chance of getting infected with a MRSA strain of S. aureus is fairly easy -- the cardinal rule is frequent hand washing with soap and water. Using an alcohol-containing hand sanitizer can also reduce infection risk. Avoid skin-to-skin contact with others if possible. Don't share towels and never touch bandages or wounds on other people, especially if they are hospitalized. Again, hand washing and showering with soap and water is the key to reducing MRSA (and other) infections. Disinfecting surfaces and other items also reduces the chances for infection.
Hepatitis C, Hep B, Hep A: Symptoms, Causes, Treatment
What Is Hepatitis?
Inflammation of the liver of any cause is referred to as hepatitis. It may be caused by viruses, drugs, or alcohol, although the most common cause is viruses, termed viral hepatitis. There are several types of viral hepatitis, the most common of which are hepatitis A, B, and C. You may hear about an outbreak of hepatitis A due to contaminated food, for example.
Symptoms of Hepatitis
Very frequently the onset of hepatitis, the acute phase, is not associated with symptoms or signs, but when they do occur they are usually general and include fatigue, nausea, decreased appetite, mild fever, or mild abdominal pain. Later signs more specific for liver disease may occur, specifically, yellowing of the skin and eyes (jaundice) and darkening of the urine. If the infection becomes chronic as is the case with hepatitis B and C, that is, infection lasting longer than months, the symptoms and signs of chronic liver disease may begin. At this point, the liver often is badly damaged.
What Happens with Hepatitis A?
Viral diseases generally are contagious. Hepatitis A is highly contagious. It usually is spread from person to person via a fecal-oral route, meaning via fecal contamination of food. It usually is a mild hepatitis, and many people do not know they are infected. The virus is eliminated by the body rapidly, and it does not cause long-term damage. Good hand washing hygiene helps prevent hepatitis A.
How Does Hepatitis A Spread?
Hepatitis A is spread from person to person via fecal contamination because the virus is present in the stool. It is spread via contaminated food or water by an infected person who gets small amounts of stool on his or her hands, does not wash his or her hands, and passes the stool onto food that is eaten by others. An example of this is outbreaks of hepatitis A in daycare centers for young children when employees don't wash their hands after changing diapers, and they then pass the viruses to the next child they feed. In addition, fecal contamination of water in which shellfish live can contaminate the shellfish, and the shellfish can pass the virus to people who eat the shellfish raw.
Who Is at Risk for Hepatitis A?
Travelers to countries with high infection rates and the inhabitants of those countries are at higher risk for developing hepatitis A. The Centers for Disease Control issues travel advisories that identify the countries with outbreaks or endemic hepatitis A. Eating raw or uncooked foods increases the risk for hepatitis A.
What Happens with Hepatitis B?
A majority of adults who contract hepatitis B have none to mild symptoms, and then the virus resolves spontaneously; however, about 5% of people are not able to eliminate the hepatitis B virus and develop chronic infection. If a chronically infected mother gives birth, 90% of the time her infant will be infected and develop chronic hepatitis B, usually for life. This may give rise to serious complications of liver disease later in life such as liver damage, liver failure, and liver cancer.
How Does Hepatitis B Spread?
Persons infected with hepatitis B can pass the virus to others through blood or body fluids. In the U.S., the most common way of becoming infected is through unprotected sex, although sharing an infected person's needles to inject illicit drugs also is quite common. Less common ways are by contaminated razors or toothbrushes. As previously mentioned, hepatitis B is passed from infected mother to infant in over 90% of cases.
Who Is at Risk for Hepatitis B?
Although unprotected sex is the most common way of becoming infected with hepatitis B, infection is more likely for people who have multiple sex partners. Shared needles also are an important means of spreading hepatitis B. Other risk factors are being a health care worker, but infection usually is related to needle sticks. There also is a risk of becoming infected by living with someone who has chronic hepatitis B, in part due to sexual transmission.
What Happens with Hepatitis C?
Is hepatitis C a virus? Yes. With acute hepatitis C, the virus is eliminated in 25% of people. The rest of the people become chronically infected and later may develop serious complications such as liver failure and liver cancer. There is treatment, however, for hepatitis C that usually can prevent the complications.
How Does Hepatitis C Spread?
Hepatitis C is transmitted primarily by infected blood, for example by sharing needles when injecting illicit drugs. The virus is spread much less commonly with tattoos or body piercing with a contaminated needle. Mothers pass the virus to their infants at birth, and the infant becomes chronically infected. The risk of spreading hepatitis C with unprotected sex is small, but having multiple sex partners, HIV, or rough sex increases the risk.
Who Is at Risk for Hepatitis C?
It only takes one exposure to hepatitis C to become chronically infected, so people who have injected illegal drugs even one time or many years previously could have chronic hepatitis C, and not know it since there are often no symptoms. People with blood transfusions prior to 1992 - when they started testing blood for transfusion for hepatitis C - also may have become chronically infected.
How Is Hepatitis Diagnosed?
Chronic hepatitis slowly attacks the liver over many years without causing symptoms. If the infection is not diagnosed and treated, many people will develop damaged livers. If suspected, viral hepatitis of all types can be diagnosed easily by blood tests.
Who Should Be Tested for Hepatitis?
It is important to test people with symptoms or exposure to hepatitis as well as people at high risk such as illicit drug users and people with multiple sex partners. There is a high prevalence of chronic hepatitis individuals of Asian heritage, and they also should be tested. It is estimated the 10% of Asians living in the U.S. have chronic hepatitis that probably has been present from birth.
What If You Test Positive for Hepatitis?
If testing discloses that you have viral hepatitis there are steps to prevent your passing the viruses to family and friends. Washing the hands helps prevent transmission of hepatitis A. Not sharing needles, razors, nail clippers, or toothbrushes also will reduce transmission of viral hepatitis. Everyone should be vaccinated against hepatitis B.
Hepatitis A Treatment
No treatment is needed for hepatitis A since the infection almost always resolves on its own. Nausea is common, though transient, and it is important to stay hydrated. It is recommended that strenuous exercise be avoided until the acute illness is over.
Chronic Hepatitis B Treatment
For hepatitis B, treatment is aimed at controlling the virus and preventing damage to the liver. Antiviral medications are available that will benefit most people, but the medications need to be chosen carefully, and the treatment needs to be monitored in order to assure successful treatment and to prevent or treat medication-related side effects. For some individuals, the risks of treatment may not be justified.
Chronic Hepatitis C Treatment
Treatment of chronic hepatitis C has evolved, rendering many earlier drugs obsolete. The drugs currently used include pegylated interferon, ribavirin, elbasvir, grazoprevir, ledipasvir, sofosbuvir, paritaprevir, ritonavir, ombitasvir, dasabuvir, simeprevir, daclatasvir. These are always used in various combinations, never alone. Interferon is given by injection while the other medications are pills. Studies have shown that combinations of these drugs can cure all but a small proportion of patients; however, serious side effects of treatment can occur.
Treatment options need to be discussed with a knowledgeable physician, as the appropriate combination is dependent upon multiple factors. These include genotype (there are 6), prior treatment and results, drug intolerances, presence of compensated liver disease or uncompensated cirrhosis, presence of HIV co-infection, other complicating conditions and liver transplantation.
Monitoring Chronic Hepatitis
Monitoring of the progression of liver disease and its treatment are the cornerstones of managing hepatitis B and C. Doctors regularly follow blood tests to determine how well the liver is functioning. Ultrasound examinations and CT scans can determine if there are complications such as cirrhosis or liver cancer that can be treated more effectively if found early. Some people will not need treatment.
Liver function tests and imaging can also help identify problems like hepatic steatosis (hepatic lipidosis), hepatic encephalopathy (hepatic coma), hepatic cysts, hepatic adenoma, hepatic hemangioma, diffuse hepatic steatosis, hepatic lesions, hepatic fibrosis, and fulminant hepatic failure.
Imaging helps doctors see the hepatic portal vein, hepatic portal system, hepatic vein, hepatic artery (common hepatic artery), hepatic duct (common hepatic duct), and hepatic lobes.
Complications: Cirrhosis
Cirrhosis is the most common complication of chronic hepatitis. Cirrhosis can be detected with simple tests, but the liver biopsy is the best way to diagnose it. Cirrhosis occurs as the liver is destroyed and it is associated with liver failure, a life-threatening condition. The signs of cirrhosis include retention of fluid (swelling of the abdomen or lower extremities, fatigue, nausea, and weight loss. Later, confusion and jaundice occur due to the accumulation of chemicals normally removed by a healthy liver.
Complications: Liver Cancer
The major cause of liver cancer is hepatitis B and C, and can develop silently as the liver becomes cirrhotic. Blood tests, ultrasound examinations, CT and MRI scans can identify the cancers (seen here in green). Biopsy of the liver is needed to definitely make a diagnosis of cancer. If the cancers are found early, a small proportion of patients can be cured.
Liver Transplant
The liver serves many functions including the manufacture and removal of chemicals that allow cells to function normally, digestion of food, elimination of toxic chemicals, and the production of many proteins that the body needs. Thus, if a large portion of the liver is damaged, the liver cannot perform these critical functions; it is impossible to live without a liver. If the liver fails, a liver transplant may be the only hope, but it is not easy to find a healthy liver to transplant.
Hepatitis A and B Vaccines
Vaccines can protect against hepatitis A and B. The Centers for Disease Control recommends hepatitis A vaccination for children 12 to 23 months of age and for adults who travel or work in locations with a higher prevalence of hepatitis A infection. Vaccination for hepatitis A also should be given to people with hepatitis B and C. If the mother has chronic hepatitis B, the infant should receive the hepatitis B vaccine as well as hepatitis B immune globulin to prevent the development of chronic hepatitis B. There is no vaccine for hepatitis C.
Protecting Your Liver
If you have chronic hepatitis, you should prevent further damage to your liver, for example, by not drinking alcohol. Since some medications and supplements can damage the liver, before taking them you should discuss it with your doctor. Regular appointments for follow-up are important. Early progression of the disease or complications are likely to change treatment.
Fatty Liver Disease: Nonalcoholic and Alcoholic Causes and Treatments
More Widespread Than You Realize
Fatty liver could be the most common disease you've never heard of. At least 1 out of 4 people have it, which is more people than diabetes and arthritis combined. And lots of those who have it may not know they have it -- or even what it is. Most times, this liver disease is mild, but it can lead to more serious health problems. Yet you can often control or reverse fatty liver with smart changes to your lifestyle.
What Is It?
When too much fat builds up in your liver, that's fatty liver disease. There are two basic types: nonalcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease, also called alcoholic steatohepatitis. Sometimes, the extra fat can trigger changes that stop your liver from working well. Since your liver filters toxins out of your blood, that could make you very sick.
Nonalcoholic Fatty Liver Disease
The most common type of fatty liver disease is usually harmless. But some people develop a more severe version called nonalcoholic steatohepatitis (NASH). That's when your liver gets swollen, which can lead to cirrhosis (scars on the liver that don't heal) and a greater chance of liver cancer and heart disease. Experts think NASH is about to become the leading reason for liver transplants.
Who Does NAFLD Affect?
Experts don't fully understand why some people get it and others don't. But you're more likely to if you're overweight or obese; have diabetes, high cholesterol and triglycerides, high blood pressure, or hepatitis C and other liver infections; or take certain medications, including steroids or drugs for cancer or heart problems. Most people with this type of fatty liver are middle-aged. But the disease can happen to anyone, even kids.
Alcoholic Fatty Liver Disease
People who drink a lot -- more than one drink a day for women and two for men -- get this type. Being obese or a woman raises your chances, too. So can problems that you're born with in your genes. This can be the first stage of more serious problems. If you keep drinking, you could go on to have alcoholic hepatitis, cirrhosis, liver failure, and higher odds of liver cancer.
Symptoms
Most of the time, there are none. That's why so many people who have it don't realize they do. But some people may feel pain or pressure in the middle or right side of their belly, or be very tired. And sometimes, fatty liver and related problems can make you lose your appetite and lose weight.
Diagnosis
Because it often has no symptoms, doctors can miss fatty liver disease. Typical lab tests may not catch it either.
Special blood tests can check how well your liver works. Your doctor may want to do an ultrasound or CT scan to see how your liver looks. You might need a biopsy: The doctor will use a needle to get a very small sample of your liver to check it for signs of disease.
Treatment
While there's no medicine for fatty liver disease, there's a lot you can do on your own to control it -- or even make it go away. Most important is to change the things about your lifestyle that led to the condition.
Lose Weight
Obesity is the main cause of NAFLD. So if you're heavy, talk with your doctor to come up with a plan to work off some weight based on healthy eating (with fewer calories) and being more active. A pound or two a week is good -- lose too fast, and you can actually make fatty liver disease worse. Dropping just 3% to 5% of your body weight can help.
Exercise
Even if it's hard for you to exercise enough to help you lose weight, moderate activity -- brisk walking for 150 minutes every week -- can get rid of some of the fat in your liver.
Don't Drink
When you have alcoholic fatty liver disease, the most important thing to do is stop drinking. It may not be easy, but the benefits are big, especially if you catch it early -- you may be able to completely reverse the damage. If you think you have a problem with alcohol, talk to your doctor.
Cutting out alcohol can help with nonalcoholic fatty liver disease, too.
Take Care of Your Health
Get treatment for related medical conditions, like diabetes and high cholesterol. Ask your doctor if you can stop taking medications that might cause fatty liver disease or switch to different ones. See your doctor (or a liver expert, called a hepatologist) regularly to keep on top of any changes you might need to make to your treatment plan over time.
Be Kind to Your Liver
You may need shots for hepatitis A, hepatitis B, the flu, and pneumococcal disease to protect your liver and keep you healthy. Also, tell your doctor before you start taking any new medicine, vitamin, or supplement. Even over-the-counter drugs can be hard on your liver.
Prevention
The same healthy habits that treat fatty liver can lower your chances of getting it. Exercise regularly. Eat a nutritious diet, with good-for-you fats and lots of veggies, fruits, and whole grains. Limit your alcohol. Work with your doctor to manage your health, and follow directions for any medication you take.
Here's a nice bonus: These strategies also help you avoid other problems, like obesity, diabetes, and heart disease.
Liver Health: 14 Best and Worst Foods for Your Liver
Oatmeal
Food with lots of fiber can help your liver work at its best. Want one that's a great way to start your day? Try oatmeal. Research shows it can help you shed some extra pounds and belly fat, which is a good way to keep away liver disease.
Stay Away From Fatty Foods
French fries and burgers are a poor choice to keep your liver healthy. Eat too many foods that are high in saturated fat and it can make it harder for your liver to do its job. Over time it may lead to inflammation, which in turn could cause scarring of the liver that's known as cirrhosis. So next time you're in the drive-thru line, think about ordering a healthier option.
Broccoli
Add lots of veggies to your diet if you want to keep your liver healthy. Broccoli can be part of this strategy. Some studies suggest this crunchy food can help protect you from nonalcoholic fatty liver disease. If steamed broccoli sounds a little too blah, shred it into a slaw and toss it with sliced almonds, dried cranberries, and a tangy vinaigrette. It's also delicious roasted with garlic and a splash of balsamic vinegar.
Coffee
If you can't make it through the day without it, you'll be glad to hear that it may have some benefits for your liver. Studies show that drinking two to three cups a day can protect your liver from damage caused by too much alcohol or an unhealthy diet. Some research suggests it may lower your risk of liver cancer.
Ease Up on Sugar
Too much of the sweet stuff can take a toll on your liver. That's because part of its job is to convert sugar into fat. If you overdo it, your liver makes too much fat, which ends up hanging around where it doesn't belong. In the long run, you could get a condition like fatty liver disease. So do your liver a favor and make sweets an occasional treat.
Green Tea
It's brimming with a type of antioxidant called catechins. Research suggests it may protect against some forms of cancer, including liver. You'll get more catechins if you brew tea yourself and drink it hot. Iced tea and ready-to-drink green teas have much lower levels.
Water
One of the best things you can do for your liver is keep a healthy weight. Get in the habit of drinking water instead of sweetened drinks like sodas or sports drinks. You'd be amazed at how many calories it will save you each day.
Almonds
Nuts -- especially these -- are good sources of vitamin E, a nutrient that research suggests may help protect against fatty liver disease. Almonds are good for your heart, too, so grab a handful the next time you feel like snacking. Or try them in salads, where they add a nice crunch.
Put a Cap on Salt
Your body needs some salt -- just not nearly as much as you probably get. Early research suggests a diet high in sodium may lead to fibrosis, which is the first stage of liver scarring. There are some easy things you can do to cut back. Avoid processed foods like bacon or deli meats. Choose fresh instead of canned veggies. And keep temptation at arm's length by taking your salt shaker off the table.
Spinach
Leafy greens have a powerful antioxidant called glutathione, which can help keep your liver working right. And spinach couldn't be easier to prepare. It makes a great base for a dinner salad, and it's also delicious sauteed with garlic and olive oil. When it's wilted, top it with a dusting of fresh parmesan.
Blueberries
They've got nutrients in them called polyphenols that may help protect you against nonalcoholic fatty liver disease, which often goes hand in hand with obesity and high cholesterol. If blueberries aren't your thing, other foods rich in polyphenols include dark chocolate, olives, and plums.
Be Moderate With Alcohol
Drinking too much can wreak havoc on your liver. Over time it can lead to cirrhosis. Even occasional binge drinking -- four drinks in one sitting for women and five for men -- can be harmful, too. Try to limit yourself to one drink a day if you're a woman or two a day if you're a man.
Herbs and Spices
Want to protect your liver and your heart at the same time? Sprinkle on some oregano, sage, or rosemary. They're a good source of healthy polyphenols. An extra benefit: they help you cut back on salt in many recipes. Cinnamon, curry powder, and cumin are good ones to try, too.
Limit Packaged Snack Foods
Next time you feel the call of the vending machine, reach for a healthy snack instead. The problem with chips and baked goods is that they're usually loaded with sugar, salt, and fat. Cutting back is a relatively easy diet tweak with a little planning. One good strategy: Bring a stash of healthy snacks with you to work. Try an apple with a single-serve packet of nut butter, or sugar snap peas with a mini-cup of hummus.
Hepatitis: Surprising Things That Can Damage Your Liver
Sugar
Too much sugar isn't just bad for your teeth. It can harm your liver, too. The organ uses one type of sugar, called fructose, to make fat. Too much refined sugar and high-fructose corn syrup causes a fatty buildup that can lead to liver disease. Some studies show that sugar can be as damaging to the liver as alcohol, even if you're not overweight. It's one more reason to limit foods with added sugars, such as soda, pastries, and candy.
Herbal Supplements
Even if the label says "natural," it may not be OK for you. For instance, some people take an herb called kava kava for menopause symptoms or to help them relax. But studies show that it can keep the liver from working right. That can lead to hepatitis and liver failure. Some countries have banned or restricted the herb, but it's still available in the U.S. You should always talk to your doctor before you take any herbs to make sure they're safe.
Extra Pounds
The extra fat can build up in your liver cells and lead to non-alcoholic fatty liver disease (NAFLD). As a result, your liver may swell. Over time, it can harden and scar liver tissue (doctors call this cirrhosis). You are more likely to get NAFLD if you are overweight or obese, middle-aged, or have diabetes. You may be able to turn things around. Diet and exercise can stop the disease.
Too Much Vitamin A From Supplements
Your body needs vitamin A, and it's fine to get it from plants such as fresh fruits and vegetables, especially those that are red, orange, and yellow. But if you take supplements that have high doses of vitamin A, that can be a problem for your liver. Check with your doctor before you take any extra vitamin A because you probably don't need it.
Soft Drinks
Research shows that people who drink a lot of soft drinks are more likely to have non-alcoholic fatty liver disease (NAFLD). Studies don't prove that the drinks were the cause. But if you down a lot of sodas and have been meaning to cut back, this could be a good reason to switch what you sip.
Acetaminophen
You've got a sore back, or a headache, or a cold, and you reach for a pain reliever. Be sure to take the right amount! If you accidentally take too much of anything that has acetaminophen -- for instance, a pill for your headache and something else for your cold, and both have acetaminophen in it -- it can harm your liver. Check the dose and how much is OK to take in one day. Stick to those limits, and you should be fine.
Trans Fats
Trans fats are a man-made fat in some packaged foods and baked goods. (You'll see them listed as "partially hydrogenated" ingredients). A diet high in trans fats makes you more likely to gain weight. That's not good for your liver. Check the ingredients list. Even if it says "0" grams of trans fat, it may still have a small amount, and that adds up.
Mistakes Happen
A doctor or nurse gets nicked by a needle they've used on a patient. Or people injecting illegal drugs share a needle. The needle isn't the problem. It's what's on it. Hepatitis C can spread through blood. Even if it only happened once, or you're at high risk for other reasons (like if you have HIV or your mom had hepatitis C while pregnant with you), you should get tested. So should everyone born from 1945 through 1965.
Less Alcohol Than You May Think
You probably already know that drinking too much is bad for your liver. But you might not realize that "too much" can happen without you being an alcoholic or addicted to alcohol. It's easy to drink more than you think. Many glasses can hold a lot more than one standard serving, which is 5 ounces of wine (that's a little more than half a cup), 12 ounces of regular beer, or 1.5 ounces of liquor. If you drink, be sure to keep it moderate -- that's one drink a day for women and up to 2 per day for men.
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Hepatitis: How Do You Get Hepatitis A, B, and C?
What Is Hepatitis?
Hepatitis means inflammation of the liver. It can be caused by several viruses. The main types in the United States are A, B, and C. Type A symptoms are often similar to a stomach virus. But most cases resolve within a month. Hepatitis B and C can cause sudden illness. However, they can lead to liver cancer or a chronic infection that can lead to serious liver damage called cirrhosis.
Hepatitis A Transmission
It is easier to contract hepatitis A than hepatitis B and hepatitis C. It is possible to contract hepatitis A by being in close contact with an infected person. The virus is spread via the fecal-oral route of transmission. This involves eating food or consuming a beverage that contains fecal matter of an infected person. This can happen when people do not thoroughly wash their hands after using the restroom and prepare food or drinks. It is possible to contract hepatitis A through sexual contact. Hepatitis B and hepatitis C are spread by having contact with semen, blood, or other body fluids of an infected person.
Water and Produce
It is possible to contract hepatitis A by eating uncooked, contaminated fruits and vegetables. Drinking water in developing countries may also be contaminated with the virus. Get in the habit of washing fresh fruit and vegetables thoroughly before eating them. If you are visiting a developing country, do not drink the tap water. Drink bottled water instead. Avoid ice as well. It is possible to be vaccinated against hepatitis A and hepatitis B. There is no vaccine available for hepatitis C.
Undercooked and Raw Shellfish
Shellfish are animals that filter the water from their surroundings. Because of this, they can become contaminated with hepatitis A virus if they are grown in polluted waters. To be safe, cook shellfish thoroughly before eating it. Undercooked shellfish like oysters, mussels, and clams may harbor and transmit hepatitis A. You may prefer the taste of raw oysters, but cooked shellfish really is safer. Protect your health and skip the raw oyster bar.
Hand Washing
Hepatitis A is a hearty virus that is capable of being viable outside of the body for up to several months. It is critical to practice good hygiene to reduce your risk of contracting hepatitis A. Wash your hands thoroughly after using the restroom. Carry hand sanitizer with you and use it frequently throughout the day if washing with soap and water is not available. It is especially important to wash your hands before eating or preparing food. Avoid touching faucets, toilet flush handles, and door handles in public restrooms. Flush the toilet with your foot and use a paper towel to turn on and off the faucet and to open the door to minimize your risk of coming into contact with germs.
Contact with Blood
It is possible to contract hepatitis C virus ("hep C") and hepatitis B from having contact with the body fluids and blood of an infected person. An infected mother may pass the infection to her baby during childbirth. Sex partners may contract the virus from each other. Dental instruments contaminated with infected blood may transmit hepatitis, but sterilization makes this highly unlikely. It is much less likely to contract hep C and hepatitis B from a blood transfusion because the blood supply in the U.S. is screened. However, the risk of contracting these viruses from blood transfusion is not zero. It is estimated that there is about a 1 in 205,000 chance of contracting hepatitis B from a blood transfusion and a 1 in 2 million chance of contracting hepatitis C from a blood transfusion.
Body Art
If you are considering getting a body piercing or tattoo, make sure you choose the shop wisely. Tattoos and body piercing are risk factors for contracting hepatitis C virus and hepatitis B. Ask the staff at the facility how they sterilize the equipment between clients. All tools should be heat-sterilized to kill blood-borne infections after every client. Observe the staff closely. Make sure they wear gloves while piercing or tattooing, and they should wash their hands thoroughly after every client. Staff should put on a new pair of gloves before attending to the next customer.
Nail and Hair Salons
Any time you are exposed to the blood of another person, there is a risk of contracting hepatitis C virus and hepatitis B. The nail salon and hair salon both offer small potential sources of exposure through shared grooming items. Make sure the nail and hair salons you go to thoroughly sterilize and disinfect tools between clients. If you are still concerned, consider bringing your own razors, nail files, nail clippers, and other tools to the shop.
Sex Partners
Having a sex partner who has hepatitis C virus or hepatitis B is a major contributor to new infections. Hepatitis B and C viruses can reside in the vaginal fluid, blood, or semen of an infected person. Abstinence is the only surefire way to avoid contracting hepatitis from an infected person. There is a vaccine for hepatitis B. Use latex condoms and/or dental dams every time you have sex to help reduce the risk of being exposed to hepatitis C and hepatitis B viruses. These measures will also help protect you against HIV-infected partners.
Keep Personal Items Personal
Any tools or implements that may have a bit of blood on them from infected people are potential sources of hepatitis B or C transmission. Toothbrushes, nail clippers, razors, needles, and washcloths may all contain trace amounts of blood that can transmit infection. Keep personal items such as these to yourself and never use personal items that belong to others.
Organ Transplantation
All donated blood, organs, and tissues in the U.S. are screened for hepatitis C virus, HIV, and other pathogens prior to being given to recipients. Screening greatly decreases the risk of recipients becoming infected with hepatitis C virus and other blood-to-blood transmitted infections, but it does not eliminate the risk entirely. People who received donated blood or organs prior to 1992 were at increased risk of contracting hepatitis C infection from the donated tissue because that was when widespread screening for the virus was instituted.
Kidney Disease Link
People who have kidney disease and undergo dialysis, especially long-term, are more likely to be infected with hepatitis B and hepatitis C. One study found that having chronic hepatitis C infection was associated with a 43 percent increase in the incidence of chronic kidney disease. The chronic HCV-infected who also have chronic kidney disease are also more likely to develop end-stage renal disease and have higher all-cause mortality when undergoing dialysis.
Baby Boomers
People born in the baby boom generation between 1945 to 1965 are 5 times more likely to have HCV infection than other adults. Although anyone of any age can contract hepatitis C, approximately 75 percent of people who have it were born during the baby boom. Transmission of the virus was highest from the 1960s to the 1980s. Many people may have become infected from medical procedures before precautions to guard against transmission of blood-borne pathogens were in place. Others may have been infected by receiving blood transfusions before adequate screening was in place. Intravenous drug use and needle sharing is another potential source of infection. The majority of people who have hepatitis C do not know that they have it. People often live with chronic infection for many years without exhibiting symptoms. This is dangerous because HCV-related risks include increased incidence of liver disease, liver cancer, and the need for liver transplantation. The earlier that HCV infection is diagnosed and treated, the better. The U.S. Preventive Services Task Force recommends that all baby boomers be screened at least once for HCV.
At-Risk Professionals
Health-care professionals like surgeons, dentists, infusion nurses, and other medical workers who may suffer needlestick injuries and come into contact with blood are at increased risk of contracting hepatitis C virus. Any health-care professional who suffers a needlestick or other exposure to a patient's blood should be tested for hepatitis C and watch for symptoms of acute hepatitis C infection like fatigue, fever, clay-colored stool, abdominal pain, joint pain, jaundice, nausea, vomiting, dark urine, and loss of appetite. Approximately 75 to 85 percent of people who are infected with HCV go on to develop chronic hepatitis C infection. Several blood tests are available to detect HCV infection. Some of these tests check for antibodies (anti-HCV). Some blood tests check for the presence of HCV genetic material. Some blood tests check for the amount of virus in the body (viral load).
HIV Infection
HIV and HCV are both blood-borne infections that are spread by blood-to-blood contact. Approximately 25 percent of people who are infected with HIV are co-infected with hepatitis C. HIV and hepatitis C co-infection is present in approximately 50 to 90 percent of HIV-infected injection drug users. People who have both infections are more likely to progress to liver damage compared to those who just have HCV infection. Infection with HCV affects the way that HIV is managed, too. It is recommended that everyone who has HIV should be screened for HCV infection.
Hepatitis C (Hep C) Symptoms and Treatment
What Is Hepatitis C (Hep C, HCV)?
Hepatitis C (HCV) is a virus that causes inflammation of the liver. Hepatitis means inflammation of the liver. It is a member of the family of viruses that include hepatitis A and hepatitis B. The viruses behave differently and have different modes of transmission. Hepatitis C can cause serious liver damage, liver failure, liver cancer, and even death.
How Common Is Hepatitis C?
About 2.7-3.9 million people in the U.S. currently live with chronic hepatitis C infection. 75%-85% of people infected with hepatitis C are infected with chronic hepatitis C. The virus is most common in baby boomers who represent 75% of infected adults. The rates of hepatitis C were the highest in the 1970s and 1980s, the time when many baby boomers were likely infected. Many people who have hepatitis C don't know they have it because the virus may not produce symptoms until decades after infection.
Hepatitis C in Children
Hepatitis C is less common in children, but there are approximately 23,000-46,000 children in the U.S. with hepatitis C. Most children are infected by hepatitis C at birth. A child has a 1 in 20 chance of being infected if the mother has hepatitis C. Adolescents can be infected with hepatitis C by exposing themselves to IV drug use, sharing needles, and high-risk sexual behaviors. Up to 40% of hepatitis C cases in children will go away on their own by age 2, if the virus is transmitted at birth.
How Do You Get Hepatitis C?
Hepatitis C is a blood-borne illness, meaning it is transmitted via contact with infected blood. Usually the virus enters the body through a puncture wound on the skin.
Is Hepatitis C Contagious?
Yes, hepatitis C is contagious. The most common way hepatitis C is transmitted is via injection drug use. Sharing needles with someone who is infected can transmit hepatitis C. Health care professionals may contract the virus via needlestick injury. Prior to 1992, the U.S. blood supply was not screened the way it is today, so some people contracted hepatitis C from infected blood transfusions. Rarely, babies born to hepatitis C-infected mothers acquire the virus. Hepatitis C can also be spread by having sex with an infected person or sharing personal items (a razor or toothbrush) with someone who has the virus, but these cases are rare.
Hepatitis C (Hep C) Symptoms
About 70% to 80% of people with the hepatitis C virus do not have any symptoms, especially in the early stages. In these people, symptoms may develop years, even decades later, when liver damage occurs. Others develop symptoms between 2 weeks to 6 months after infection. The average time to develop symptoms is 6 to 7 weeks after acquiring the virus. A person who has hepatitis C infection, but isn't exhibiting any symptoms can still pass the virus on to others. Hepatitis C symptoms may include:
- Mild-to-severe fever
- Fatigue
- Abdominal pain
- Loss of appetite
- Nausea
- Vomiting
- Joint pain
- Dark urine
- Clay-colored stool
- Yellowing of the skin (jaundice)
Acute vs. Chronic Hepatitis C Infection
Acute hepatitis C infection refers to symptoms that appear within 6 months of newly acquiring the virus. About 20% to 30% of those who acquire hepatitis C experience acute illness. After this, the body either clears the virus or goes on to develop chronic infection.
Chronic hepatitis C infection refers to long-lasting infection. The majority of people who have acute hepatitis C infection (75% to 85%) go on to develop the chronic form of the illness.
How Is Hepatitis C Diagnosed?
Hepatitis C infection is diagnosed with several blood tests. The hepatitis C antibody test checks for antibodies (immune particles) that fight the virus. A "non-reactive" result means that antibodies to the virus are not detected. A "reactive" result means antibodies to the virus are present, but the test is unable to indicate whether the infection is current or from the past. Another blood test to assess the presence of hepatitis C genetic material (HCV RNA test) is available. The results of this test can help doctors determine whether hepatitis C infection is current or not. Additional blood tests can be used to determine the amount of virus in the body, known as a titer.
When someone has confirmed hepatitis C infection, the doctor will order more tests to assess the degree of liver damage. A liver biopsy may be performed. There are several different strains of the hepatitis C virus that respond to different treatments. For this reason, the doctor will order a test to determine the genotype(s) of the hepatitis C infection to help determine the course of treatment.
Who Should Get Tested for Hepatitis C?
- Current or former drug users who use needles
- Healthcare workers exposed to blood or bodily fluids
- People with a sex partner infected with chronic hepatitis C
- People who had their blood filtered by a machine for a long time
- People who received a blood transfusion or organ transplant from a donor before July 1992
- People with HIV
- People born between 1945 and 1965
Potential Hepatitis C Complications
Chronic hepatitis C infection is a long-lasting illness with potentially serious complications. About 75% to 85% of those with acute hepatitis C infection go on to develop chronic hepatitis C. Of those in the chronic illness group, more than two-thirds will develop liver disease. Up to 20% will develop cirrhosis, or scarring of the liver, within 20 to 30 years. Cirrhosis affects liver function and causes elevated blood liver enzymes. Up to 5% of people with chronic hepatitis C infection will die from liver cancer or cirrhosis. Chronic hepatitis C infection is the most common reason for liver transplantation in the U.S.
Hepatitis C (Hep C) Treatment
Treatment for hepatitis C is available. The course of treatment depends on whether the infection is acute or chronic, the strain (genotype) of the virus, the amount of the virus in the body (viral load), the degree of liver damage, response to previous treatment, and the health of the patient. Hepatitis C treatment is highly individualized, so it's important to be under the care of a doctor with expertise in this area. The goal of treatment is to achieve sustained virologic response (SVR), which means there is no detectable virus in the blood 6 months after treatment. While it's not a cure, achieving SVR is the next best thing. Many people with hepatitis C can achieve SVR with treatment.
Medications That Treat Hepatitis C
- Interferon (Infergen, Roferon, Intron A)
- Peglyated interferon (Pegasys, Pegintron)
- Ribavirin (CoPegus, Rebetol)
- Boceprevir (Victrelis)
- Telaprevir (Incivek)
- Simprevir (Olysio)
- Sofosbuvir (Sovaldi)
- Ledipasvir/sofosbuvir (Harvoni)
- Ombitasvir/paritaprevir/ritonavir tablets; dasabuvir tablets (Viekira Pak)
- Ombitasvir/paritaprevir/ritonavir (Technivie)
- Daclatasvir (Daklinza)
Your doctor can choose the best treatment for your individual circumstances.
Hepatitis C and Liver Transplantation
Some people with advanced hepatitis C and severe liver damage undergo a liver transplant, but that doesn't eradicate the infection. Patients with an active infection at the time of the transplant will develop hepatitis C in the new liver. Sometimes the infection recurs even when patients are on antiviral treatment. Those who have achieved sustained virologic response (SVR) - meaning no detectable virus in the blood 6 months after treatment - have a very low risk of developing hepatitis C infection in the new liver.
Is Hepatitis C Curable?
About 15% to 25% of people who are infected with the hepatitis C infection clear the virus on their own. Scientists are still trying to determine why hepatitis C goes away in some patients, while others go on to develop symptoms. There is no cure for an active or chronic hepatitis C infection, but sustained virologic response (SVR) is the next best thing. Hepatitis C infection rarely recurs in those who have achieved SVR.
Hepatitis C Vaccine
There is currently no vaccine for hepatitis C. Research is ongoing to develop a vaccine against the virus. There are vaccines for hepatitis A and hepatitis B.
How to Prevent Hepatitis C Infection
Hepatitis C is a blood-borne infection. To reduce the risk of infection, avoid sharing personal items (toothbrushes and razors) with others. Do not use injected drugs. If you do use injected drugs, never share needles and equipment with others. Getting tattoos and body piercings can put you at risk. Use condoms during sex. Health care workers should take precautions to avoid needle-sticks and properly dispose of needles and other materials that come into contact with blood. Speak to your doctor about your risk factors and follow recommended screening standards for hepatitis C.
How to Prevent Giving Hepatitis C
If you have hepatitis C, these common precautions should be followed to prevent spreading or giving hepatitis C to others:
- Cover cuts and blisters
- Properly dispose of any used bandages, tissues, tampons, or anything else containing your blood
- Wash your hands or any objects that have come in contact with your blood
- Clean spilled blood on surfaces with household bleach and water
- Don’t share personal items that have your blood on it
- Do not breastfeed if your nipples becomes cracked and bleed
- Do not donate blood, sperm, or organs
What Are HIV & AIDS? Symptoms, Treatment, and Prevention
What Is HIV, the Virus That Causes AIDS?
HIV is short for human immunodeficiency virus. The virus attacks and suppresses the immune system, making those who have it more susceptible to infections and cancer. AIDS stands for acquired immunodeficiency syndrome (a disease where the body’s cellular immunity is severely damaged and thus lowers your resistance to infection and/or malignancy). HIV is the virus that causes AIDS. While there is no cure for the disease, there are medications that slow down its progression. People who have HIV can take measures to decrease the risk of transmitting the virus to others.
Where Did HIV/AIDS Come from?
HIV is a virus that likely originated in monkeys and apes in Africa. One theory says that HIV started as a virus that infected these animals. The virus later changed into a form that was able to infect humans. The disease may have started infecting humans more than 100 years ago. There was an HIV pandemic in Congo in the 1920s. The virus then made its way to the population of Haiti in the 1960s. It later emerged in the United States and other countries first and became very prevalent (world-wide) in the 1980s.
What Does HIV Do to the Immune System?
HIV attacks white blood cells, or T cells, in the immune system. It attacks a certain kind of white blood cell called a CD4-positive T cell. The virus replicates, making copies of itself, and infects greater numbers of T cells. As more T cells are damaged by the virus, the levels of healthy T cells decrease and a person is susceptible to infections and certain kinds of cancers. When enough T cells are infected by the virus, AIDS develops.
How Does HIV Spread?
HIV spreads through contact with infected bodily fluids. Sex and sharing needles are the two main ways HIV is transmitted. Body fluids that may contain and transmit HIV include pre-ejaculate, semen, blood, vaginal fluid, breast milk, and rectal mucus. The fluid from an infected person much come into contact with a mucous membrane, the bloodstream, or a cut or injured area of another person to transmit the virus.
Can HIV Be Spread Through Casual Contact?
It is not possible to get HIV from an infected person with whom you have casual contact. You can’t get HIV from hugging, shaking hands, a toilet seat, a drinking fountain, or by eating food prepared by a person who is HIV-positive. You cannot get HIV from a bug bite. You cannot contract the virus from tears, saliva, sweat, or closed-mouth kissing. HIV dies quickly when it is on surfaces outside of the human body.
Does HIV Cause Early Symptoms?
The majority of people who have contracted HIV do not know it when they first become infected. However, some people get flu-like symptoms within 2 to 4 weeks of infection. The early symptoms of HIV may include fever, headache, fatigue, swollen lymph nodes, and a sore throat. Today, testing can detect HIV infection much earlier than testing could in the past. If you are experiencing flu-like symptoms and have engaged in behavior that may have put you at risk of contracting HIV, see your doctor and be tested.
What Are the Symptoms of AIDS?
HIV infection follows three stages, the last of which is the most severe and causes full-blown AIDS. The first stage is the acute infection stage. Many people who first acquire HIV do not experience any symptoms. The ones who do may suffer from flu-like symptoms. The second stage of HIV is called clinical latency. This means the virus is inactive, dormant, and reproduces at a much slower rate than it did in the acute phase. This stage may last for up to one decade, but in some people it may progress faster. The third stages of HIV infection is full-blown AIDS. In this stage, people have very low T-cell counts and compromised immune systems that make them susceptible to infections and certain kinds of cancer. Early detection and treatment of HIV can help prevent the development of full-blown AIDS.
Who Is at Risk for HIV?
Anyone can get HIV at any age, but certain populations are more at risk than others. Men who have sex with other men and people who inject drugs are at high risk of contracting HIV. Infected mothers who are pregnant may pass the virus on to the fetus in utero. Infected moms may also pass the HIV virus on to their babies in breast milk. A man who is infected may pass the virus on to a woman. Approximately 1.1 million people in the United States were living with HIV as of 2014. About 1 in 7 people who have HIV do not know they have it.
Who Should Be Tested for HIV?
The Centers for Disease Control and Prevention (CDC) recommends all people between the ages of 13 and 64 get tested for HIV at least once as a part of routine health care. People at high risk of contracting HIV should be tested at least once a year. High risk groups include men who have sex with men, people who inject drugs, those who have sexually-transmitted infections, and those who have multiple sex partners. Several different types of tests are available to detect HIV. At-home tests are available that may provide results in as soon as 20 or 30 minutes. If you test negative for HIV but have recently engaged in high-risk behavior, get retested 3 months later because it can take that long for the body to make HIV antibodies.
What Are HIV/AIDS Treatments?
HIV/AIDS used to be a much deadlier infection prior to the development of drugs that help slow progression of the disease. If you are diagnosed with HIV, see your doctor for treatment as soon as possible. Antiretroviral therapy (ART) involves taking two or more drugs from several classes. These medications stop HIV from replicating or prevent the virus from infecting new T cells. These drug cocktails are tailored to the individual by the doctor. People who are infected with HIV and adhere to their treatment plan have the same life expectancy as those who are not infected.
Do Alternative Treatments Work for HIV?
There is no cure for HIV. Antiretroviral therapy increases the chance that people living with HIV will have a normal life expectancy. No alternative treatments or folk remedies are proven to treat or cure HIV. However, many people with HIV may use yoga, acupuncture, massage, meditation, and visualization as adjunctive or supportive methods adjusts to standard treatment. These therapies may help reduce stress and help alleviate some of the symptoms associated with HIV/AIDS. Some people use herbal medicine, too. Check with your doctor before incorporating complementary and alternative therapies into your treatment regimen, especially regarding herbs. Some herbs may interfere with the activity of certain medications.
What Are Self-Care Strategies for Managing HIV?
People who have HIV are an increased risk of infections and other conditions. It is important to take care of yourself.
- Eat a wide variety of fruit, vegetables, lean meat, fish, and dairy products. Minimize your intake of sugar and salt.
- Aim to get at least 30 minutes of physical activity per day, as long as your doctor has said that it is safe for you to exercise.
- Get adequate sleep and rest.
- Spend time with friends and family. Social support is important for your body and mind.
- See your doctor for routine checkups.
- Seek the help of a therapist if you suffer from depression or anxiety.
- Take your medications, including HIV medications, as prescribed. If you are experiencing side effects, see your doctor. He or she can adjust your regimen, if needed. Newer HIV drugs are generally better tolerated than older medications.
Do I Have to Disclose That I Have HIV?
In general, you should tell people who may be impacted by your HIV status about your illness. Your doctor should know to optimize your care. You may want to tell close friends and family about your condition. You may want to disclose that you have HIV to others who have it, such as those in a support group. Sex partners and people you share needles with need to know if you are HIV positive. They are at risk of contracting the virus from you. Some states have laws that make it a crime not to disclose your HIV-positive status to sex partners or needle-sharing partners before you have sex or inject drugs. Employers are not allowed to discriminate based on HIV status.
Can You Prevent HIV?
Practicing sexual abstinence and avoiding high-risk behavior are is the only sure-fire ways to maximally reduce risk or to prevent contracting HIV. If you are going to have sex, use a condom every time (reduces but does not eliminate risk of HIV infection). Limit the number of sexual partners you have to decrease your risk of exposure. You are less likely to be infected with HIV from having oral sex than from having vaginal sex or anal sex. If you are at very high risk of contracting HIV, ask your doctor about medications that may substantially reduce your risk of getting the virus. If you engage in high-risk behavior, prophylactic medication is available to decrease the risk of contracting HIV. If you do inject drugs, always use clean, sterile needles. Avoid sharing needles. People at risk for getting HIV should be tested at least once per year, maybe even more frequently.
HIV Prevention for High-Risk Groups
In the 1990s, HIV infection was the #1 cause of death for those between the ages of 25 to 44. In 2014, HIV was the 8th leading cause of death in those aged 25 to 34 years old and the 9th leading cause of death in those 35 to 44 years of age. Better diagnosis and treatment and increased public awareness are responsible for reduced death rates. There are even newer medications designed to decrease the risk of contracting HIV in those who are exposed. For people who are at high risk of HIV, taking a medication combo known as PrEP decreases the risk of infection. People who have been exposed to HIV can take antiretroviral medication, or post-exposure prophylaxis (PEP), to decrease the risk of infection. These medications must be started within 72 hours of the suspected exposure and must be taken for 28 days. They do not guarantee you will not become infected with HIV, but they reduce the risk.
Get Tested and Get Help
There is no cure for HIV, but there are effective treatments that can increase life expectancy. Early diagnosis and treatment of the virus is important to achieve the best possible outcomes. Get tested for HIV, especially if you engage in high-risk behavior. AIDS.gov provides a listing of many government resources for those living with HIV, including locations for testing. The CDC provides similar resources at gettested.cdc.gov or 800-CDC-INFO (800-232-4636).
HIV AIDS Facts: Symptoms and Treatments
Having HIV Means You Have AIDS
MYTH. The last stage of HIV (human immunodeficiency virus) infection is AIDS (acquired immune deficiency syndrome). Once you get an HIV infection, you have it for life, but it does not progress to AIDS in all people. With antiretroviral therapy treatment (ART) many people can live a normal life expectancy with HIV infection.
It's Difficult to Get HIV From Casual Contact
FACT. HIV is not spread from casual contact, air, water, sharing dishes, toilet seats, or saliva. The virus cannot live for long periods outside the body. HIV is spread through bodily fluids including blood, semen, and breast milk and it is possible to spread the disease by having unprotected sex, and sharing needles. Less commonly, HIV can be passed on through breast milk, blood transfusions (this is rare because the blood supply in the U.S. is carefully screened), and being stuck with an HIV-contaminated needle or object.
You Only Have A Few Years To Live
MYTH. At the start of the AIDS epidemic, the life expectancy was only a couple of years, however, that is no longer the case. New medications and treatments have extended the lives of people with HIV and many can live a normal life span. With early intervention you may be able to prevent HIV from becoming AIDS.
You'll Know You Have HIV Because of Your Symptoms
MYTH. Not everyone has symptoms when first infected with HIV. Many people have flu-like symptoms, called “acute retroviral syndrome” (ARS) or “primary HIV infection,” within 2 to 4 weeks of being infected with HIV. Symptoms may include fever, swollen glands, sore throat, rash, fatigue, muscle and joint aches, and headache. Symptoms may last a few days to a few weeks. However, these symptoms resemble many other infections and the only way to know for sure if you are infected with HIV is to get tested.
HIV Can Be Cured
MYTH. There is no drug that can cure HIV infection, but there are treatments that can help control the virus and protect your immune system, and possibly prevent HIV from becoming AIDS. Right now there are five different "classes" of HIV drugs, and current recommendations are for patients to take three different antiretroviral drugs from two different classes.
Anyone Can Get HIV
FACT. The Centers for Disease Control (CDC) estimates 1.1 million people age 13 and older are infected with HIV, and 44,000 people are newly infected in 2014. Anyone can be infected with HIV. In 2010, men who have sex with men accounted for 67% of new infections, and women accounted for 19% of new infections. The incidence of HIV among African-Americans is about 8 times as high as in whites.
Sex Is Safe When Both Partners Have HIV
MYTH. Even if both partners are HIV-positive and symptom-free, one may still carry another sexually transmitted infection (STI). In addition, you and your partner may have different variations (strains) of the HIV virus. Using condoms and dentals dams is always safer. Latex condoms protect the best against HIV infection; lambskin condoms do not provide any protection as the virus can pass through them.
You Can Have a Baby if You Are HIV-Positive
FACT. Pregnant women who are HIV positive can pass the HIV virus to their babies. It can happen during pregnancy, during vaginal childbirth, or while breastfeeding. However, if the mother receives treatment with antiretroviral drugs during pregnancy, has a C-section delivery, and avoids breastfeeding, she can greatly reduce the risk of passing the infection on to her baby.
Other HIV-Related Infections are Unavoidable
MYTH. People with HIV are vulnerable to what is called opportunistic infections. These include tuberculosis, pneumonia, septicemia (blood poisoning), candidiasis, herpes, cytomegalovirus, and some HIV-associated cancers such as Kaposi's sarcoma, lymphoma, and squamous cell carcinoma. Antiretroviral therapy treatment can greatly reduce your risk for getting these opportunistic infections by increasing your CD4 cells. Other infections can be prevented with medications.
No Insurance Means Not Getting Lifesaving Drugs
MYTH. If you don't have insurance, there are several programs that can help you get the care you need to treat your HIV/AIDS. These include:
- Ryan White HIV/AIDS Program
- Medicaid
- Medicare
- Programs that help pay for medications: Ryan White AIDS Drug Assistance Program (ADAP); patient assistance programs; and clinical trials.
A Timeline of the HIV/AIDS Pandemic
AIDS Timeline
The first cases of AIDS were reported in 1981, and since then, more than 25 million people worldwide have died from the illness. Currently, more than 33 million people around the world are living with HIV, an estimated 1.1 million in the U.S. How did all of this start?
Circa 1900: From Monkeys to Humans
There are several theories as to how the HIV virus – the virus that causes AIDS – developed in humans. The most widely accepted theory is that humans contracted the virus by hunting certain species of chimpanzees that carried the virus, and then eating them or getting their blood in an open wound.
1981: First Cases Recognized
In 1981, the Centers for Disease Control (CDC) reported on five young, previously healthy homosexual men infected with a rare yeast-like fungus called Pneumocystis carinii pneumonia (PCP). It is a type of opportunistic infection, seen in patients with compromised immune systems (such as people undergoing chemotherapy, or organ transplant recipients). PCP is the most common opportunistic infection in people with AIDS. In addition, the same year the CDC reported a cluster of cases of a rare and aggressive type of skin cancer, Kaposi's sarcoma (KS) among gay men in New York and California. By the end of the year, 270 cases of severe immune deficiency among gay men have been reported, and 121 of those died.
1982
In September of 1982, the CDC called the disease AIDS (acquired immune deficiency syndrome), and defined it as, “a disease at least moderately predictive of a defect in cell-mediated immunity, occurring in a person with no known case for diminished resistance to that disease.” The first American AIDS clinic is founded in San Francisco, and Gay Men's Health Crisis is founded in New York City.
1983
By 1983, the CDC had established the National AIDS Hotline, and cases of AIDS were reported in female partners of males with AIDS. In September, the CDC identified major routes of transmission of HIV, ruling out casual contact, food, water, air, or surfaces. By the end of the year a New York doctor is threatened with eviction for treating AIDS patients, and the first AIDS discrimination lawsuit is filed.
1983
Also in 1983, Dr. Robert Gallo of the National Institutes of Health (NIH) proposes that a retrovirus is the likely cause of AIDS. In France, Professor Luc Montagnier of the Pasteur Institute reports discovery of a retrovirus called Lymphadenopathy Associated Virus (LAV) that might be the cause of AIDS.
1984
In June 1984 Dr. Gallo and Professor Montagnier jointly announce that Gallo's HTLV-III retrovirus and Montagnier's Lymphadenopathy Associated Virus (LAV) are likely identical and the cause of AIDS. The Department of Health and Human Services (HHS) announces a blood test to detect HTLV-III has been developed.
1985
1985 brings AIDS into the forefront, as actor Rock Hudson dies of AIDS-related illness, leaving a large sum to establish the American Foundation for AIDS Research (AmFAR), chaired by founder Elizabeth Taylor. The case of Ryan White, a teenager who contracted AIDS through a blood transfusion to treat his hemophilia, makes headlines when he is denied entry to his school. He goes on to become a spokesman against discrimination of people with AIDS.
1985
The U.S. Food and Drug Administration (FDA) licenses the first commercial blood test for HIV, called ELISA, in 1985. The HHS and the World Health Organization (WHO) holds the first International AIDS conference in Atlanta, GA, and the U.S. Congress allocates $70 million towards AIDS research.
1986
1986 marks President Ronald Reagan's first public mention of AIDS, with a vow to Congress to make AIDS a priority. The same year sees the debut of the first panel of the AIDS quilt created by AIDS activist Cleve Jones, and the Surgeon General of the U.S., C. Everett Koop, issues a report urging parents and schools to start open discussions about AIDS and education on condom use.
1987
The FDA approves the Western blot blood test kit, a more specific test for HIV antibodies, in 1987, and they also declare HIV prevention as a new indication for male condoms. President Reagan establishes a Presidential Commission on AIDS, and the AIDS Memorial Quilt is displayed for the first time with 1,920 panels at the National Mall in Washington, DC.
1987
Also in 1987, pianist Liberace dies of AIDS-related illness. The FDA approves the first antiretroviral drug, zidovudine (AZT), and the organization ACT UP is formed and immediately protests the high cost and lack of access to the new drug. The U.S. adds HIV to its immigration exclusion list, and prohibits people with the virus form entering the country.
1988
Elizabeth Glaser, an HIV-positive mother of 2 HIV-positive children, establishes the Pediatric AIDS Foundation in 1988. ACT UP protests the FDA's drug approval process, leading to a new policy that speeds up drug approvals. The World Health Organization (WHO) declares December 1st to be the first World AIDS Day.
1989
The number of reported AIDS cases reaches 100,000 in 1989. The National Commission on AIDS, established by Congress, meets for the first time in September, and the head of the National Institute of Allergy and Infectious Diseases (NIAID) allows people with HIV who do not qualify for clinical trials to receive experimental treatments. Photographer Robert Mapplethorpe dies of AIDS-related complications.
1991-1992
In 1991, the Red Ribbon Project creates a symbol of compassion for people with AIDS. The same year, NBA star Magic Johnson announces he is HIV-positive, and Freddie Mercury, lead singer of the rock band Queen, dies of pneumonia resulting from AIDS. By 1992, AIDS is the leading cause of death in U.S. men aged 25 to 44.
1993
Tom Hanks stars as an attorney with AIDS in "Philadelphia," the first major Hollywood film on AIDS, and the play Angels in America wins both the Tony Award for Best Play and the Pulitzer Prize for Drama.
1994
By 1994, AIDS has become the leading cause of death for all Americans age 25 to 44. The U.S. Public Health Service recommends giving the drug AZT to pregnant women to reduce the risk of transmitting HIV to their baby. MTV's The Real World features Pedro Zamora, an openly gay man living with HIV. He dies after the season finale at age 22.
1996-1997
For the first time since the beginning of the epidemic, the number of new cases of AIDS diagnosed in the U.S. declines. Highly active antiretroviral therapy (HAART), the AIDS drug "cocktail," is announced in 1996 and by 1997 it becomes the new standard of HIV treatment.
1998-2000
In 1998, the CDC finds 49% of U.S. AIDS-related deaths are among African Americans, and Congress funds the Minority AIDS Initiative. By 1999, the World Health Organization (WHO_ reported that HIV/AIDS was the 4th leading cause of deaths worldwide, estimating 33 million people were living with HIV, and 14 million had died of AIDS. In 2000, the Joint United Nations Programme on HIV/AIDS and the WHO announced a joint initiative to collaborate with major pharmaceutical companies to reduce prices for HIV/AIDS drugs in developing countries.
2001-2002
The first National Black HIV/AIDS Awareness Day is marked on February 7, 2001. In 2002, governments, civil and private organizations come together to establish the Global Fund to Fight AIDS. Young people are being increasingly diagnosed with HIV/AIDS – worldwide 10 million teenagers and young adults aged 15 to 24 are living with HIV.
2003-2005
In 2003, the CDC estimated that 27,000 of the 40,000 new cases of HIV/AIDS in the U.S. were a result of transmission of the virus from persons who did not know they were infected. The U.S. Food and Drug Administration in 2004 approves a rapid HIV diagnostic kit that provides results in 20 minutes. Also in 2004 the President's Emergency Program for AIDS Relief (PEPFAR), U.S. Government initiative to help save the lives of those suffering from HIV/AIDS around the world, receives $350 million in funding from Congress.
2006-2007
June 5, 2006 marks 25 years since the first AIDS cases were reported and by 2007, the CDC reports over 565,000 deaths from AIDS since the beginning of the epidemic. The projected life expectancy for a person diagnosed with HIV is 24.2 years, with a lifetime cost per person for HIV care of $618,900.
2008
The CDC releases new estimates for HIV infections, which are higher than previously thought (56,300 new infections per year versus 40,000), a reflection of a newer, more accurate system of recording rates.
2008
In 2008, Luc Montagnier and Francoise Barre-Sinoussi are awarded the Nobel Prize in Medicine for their discovery of the HIV virus. The ban on HIV-positive people entering the U.S. is lifted, and people with HIV/AIDS are permitted to enter the country on a case-by-cases basis.
2009
UNAIDS reports that the spread of HIV peaked in 1996 with 3.5 million new infections, and the number of AIDS-related deaths peaked in 2004 at 2.2 million. Since the beginning of the epidemic, 25 million people have died of AIDS-related causes. On the positive side, new HIV infections worldwide dropped by 17%.
2009-2010
The 100th new antiretroviral drug is approved in 2009. In 2010 the HIV travel and immigration ban is finally lifted. That same year, the WHO, UNAIDS, and UNICEF publish a report that shows an estimated 5.25 million people received antiretroviral therapy that year, with an estimated 1.2 million of those starting treatment that year – the biggest recorded annual increase.
Hope for Tomorrow
Scientists are continuing to work on an HIV vaccine. A study conducted in Thailand in 2009 shows promise that a vaccine may provide some protection from the virus. Clinical trials of the vaccine are expected to begin in South Africa in 2015. Another area of study is microbicides, which are gels, films, or suppositories that can kill viruses and bacteria. Several studies of vaginal microbicides have shown positive results and further clinical trials are underway.
Ebola Virus: Outbreaks, Epidemics, and Symptoms
What Is Ebola Virus?
Ebola is a viral hemorrhagic (bleeding) illness that has a high fatality rate. The virus was discovered in 1976 near the Ebola River in the present-day Democratic Republic of Congo. There are five strains of the Ebola virus -- Tai Forest, Sudan, Bundibugyo, Zaire, and Reston. Four of the strains (Reston is the exception) are responsible for outbreaks in humans. The Ebola virus is harbored by fruit bats, gorillas, monkeys, forest antelope, chimpanzees, and porcupines. Humans can contract the virus by coming into close contact with the body or bodily fluids (including blood) of an infected animal. Once the virus spreads to a human, person-to-person transmission is possible.
Ebola Outbreaks
Since 1976, outbreaks have occurred sporadically in Zaire, Sudan, Democratic Republic of Congo, Gabon, and Uganda. The largest outbreak by far began in March 2014 and lasted into April 2016. It affected Guinea, Liberia, Sierra Leone, Senegal, and Nigeria. This West Africa Ebola outbreak resulted in 28,652 reported cases and 11,325 deaths. Visit the Centers for Disease Control (CDC) website for the latest outbreak statistics.
How Is Ebola Transmitted?
In between human outbreaks, Ebola is believed to be harbored in animals that act as a “reservoir” for the virus. When a human contracts Ebola by handling an infected animal, person-to-person transmission can then lead to an outbreak. Ebola can be transmitted directly or indirectly. Direct transmission refers to the virus passing from an infected person to another person via sexual contact or by infected body fluids (blood, tears, feces, urine, vomit, for example) through contact with mucous membranes or broken skin. Indirect transmission refers to a person picking up a virus from a contaminated object, such as infected surgical equipment or a needle.
What Are the Signs and Symptoms of Ebola?
The signs and symptoms of Ebola virus are divided into two stages. First comes the "dry" phase, which varies from person to person. It frequently includes fever greater than 101°F, intense weakness, severe headache, joint/muscle pain, and sore throat. It may also include vomiting, diarrhea, abdominal pain, rash, and internal bleeding.
Some people with the illness go on to develop symptoms associated with the "wet" phase. These include bleeding from the eyes, nose, ears, and rectum. Lab tests may reveal abnormal liver and kidney function. Levels of white blood cells and platelets may be elevated. The incubation period of Ebola, defined as the period of time from exposure to the virus until the onset of symptoms, is 21 days. The average time from exposure to symptom development is about 8 – 10 days; bleeding is usually a later symptom that signifies severe infection.
Is Ebola Airborne?
In lab conditions, the Ebola virus has been shown to spread through the air. However, in real-world living conditions and in hospital settings, there is no evidence that Ebola can be transmitted through the air. While there are fears that Ebola could mutate and become more easily transmissible, the director of the CDC, Dr. Tom Frieden, stated that there has been little change in the Ebola virus in the past 40 years. He also said that there is no evidence that Ebola has undergone any changes that would make it easier to spread from person to person.
What Is the Fatality Rate of Ebola?
Every Ebola outbreak is different. Historically, the larger Ebola outbreaks have had a fatality rate of 25% to almost 90%. The Democratic Republic of the Congo Ministry of Health reports that the DRC outbreak has shown a 67% fatality rate from Aug. 2018 to Sept. 2019.
Is There Any Treatment for Ebola?
There is no cure for Ebola. New therapies are being investigated. Treatment for Ebola consists of supportive care which often includes administering intravenous (IV) fluids and monitoring and maintaining appropriate electrolyte, oxygen, and blood pressure levels. Prevention and treatment of other infections that may develop in the Ebola-infected patient is important as well.
Is There an Ebola Vaccine?
More than two decades in the making, a vaccine for Ebola was approved in Europe in late 2019. While now approved in Europe, the Ebola vaccine known as Ervebo has been approved by the US FDA in December of 2019. Vaccines to stop the spread of Ebola have already been administered three times in Africa, according to the World Health Organization, starting in 2015 when more than 16,000 volunteers were vaccinated. They were used again in May-July 2016 in Equateur Province, and again in the eastern region of Kivu in the Democratic Republic of the Congo in 2018-19.
Another investigational vaccine is expected to be used in 2019 for the DRC outbreak. This vaccine requires a second booster 56 days after the first dose, and is designed to work against the Zaire ebolavirus type.
Other Potential Treatments for Ebola
Although none have been approved by the FDA yet, four Ebola treatments have been attempted during the 2018 DRC outbreak on an investigational basis. These are ZMapp, REGN-EB3, mAb114, and remdesivir. The trial of two of the experimental drugs was halted early when the other two showed greater survival rates in Ebola patients. REGN-EB3 and mAb114 therapy made survival rates “much higher” according to the CDC.
Although their investigational trials ended early, both ZMapp, an antibody cocktail experimental therapy for Ebola, and remdesivir have been proven effective in the laboratory in summer 2019. These drug therapies were successful in 2014 during the West Africa Ebola outbreak. The ZMapp therapy consists of three monoclonal antibodies that are designed to treat existing Ebola infection. Monoclonal antibodies work by binding to proteins in the virus and “targeting” them for destruction by the immune system. Research continues into these therapeutic approaches.
Some drugs may be more effective in outbreaks with different strains of Ebola. These are difficult drugs to develop because Ebola virus is an RNA virus, and as such it is always mutating, according to the CDC.
Can Ebola Be Prevented?
Ebola virus infection has never taken place in the United States, according to the CDC. The only people with Ebola infection in the US acquired the disease elsewhere or got the infection from someone who entered the country already infected like two US caregivers.
People in areas known to have cases of Ebola can take the following precautions to minimize the risk of contracting the virus. Meticulous hygiene is necessary. Avoid people and bodily fluids of those known or suspected of having Ebola. Do not have contact with bats and wild animals; do not consume raw or undercooked animals that may have the virus. Only highly specialized, trained professionals with adequate protective gear should administer medical care to Ebola patients and handle the dead bodies of Ebola victims. Should you need medical care while you are in an area known to harbor Ebola, contact your embassy or consulate for a referral for an appropriate facility.
Zika Virus Symptoms, Pregnancy, Treatments, Vaccine
What is the Zika Virus?
The Zika virus is a Flavivirus related to dengue fever, West Nile virus, yellow fever, and Japanese encephalitis viruses. Zika fever, as it is also known, is transmitted to humans through bites from a mosquito infected with the Zika virus. Common Zika infection symptoms include rash, fever, and joint pain as well as inflammation of the conjunctiva of the eyes, leading to redness. Typically the illness is mild and lasts from a few days to a week. Serious illness is rare, but in February 2016 the World Health Organization declared Zika virus infections as a public-health emergency due to severe birth defects associated with Zika infections during pregnancy.
Where Did The Zika Virus Come From?
The Origin of Zika Virus
Zika virus received its name from its place of origin, the Zika Forest of Uganda. In 1947 the Zika virus was isolated and identified in Uganda. Blood tests from patients in 1951-1981 concluded that the Zika virus had spread to other African countries and even Indonesia.
Zika Outside of Africa and Indonesia
In 2007, Zika virus was found on Yap Island in the Indo-Pacific, which was the first documented account of the virus outside of Africa or Indonesia. Zika virus has continued to spread to North and South America. The first confirmed Zika outbreak in Brazil was reported in May 2015. Zika virus has continued to travel spread globally with Zika virus outbreaks now in Puerto Rico, the Caribbean, Mexico, and the United States.
Is There a Zika Virus Vaccine?
As of now, there is no vaccine available to prevent Zika virus infection. The best method of prevention is avoiding mosquito bites. The mosquitoes that transmit Zika virus are most active during the daytime. These mosquitoes transmit other viruses that can cause illness, including dengue and chikungunya virus.
Zika Infection Spread by Mosquitoes
Two species of mosquito, Aedes aegypti and Aedes albopictus are the typical vectors (carriers) of Zika virus. These are the same species of mosquitoes that can carry and spread dengue and chikungunya viruses. Mosquitos lay eggs in or near sources of standing water, in locations such as animal dishes, ponds, tires, buckets, or plant and flower pots. Aedes mosquitos live both indoors and outdoors and bite people most often in the daytime. If the mosquito bites a person infected with Zika, the mosquito becomes infected with Zika virus and can spread the virus when it bites another person.
Zika Prevention: Adults and Mosquito Bites
If you are concerned about preventing Zika virus infection, avoid mosquito bites by the following measures:
- Cover as much skin as possible by wearing long sleeves and long pants.
- When indoors, stay in areas with air conditioning or window and door screens.
- Use a mosquito bed net if your sleeping area is open to the outdoors.
- Treat gear and clothing with permethrin and follow directions for proper use. You can also purchase permethrin-treated products. Do not use permethrin directly on skin.
What Type of Bug Spray Should I Use to Prevent Zika Virus Spread?
Use insect repellents that are U.S. Environmental Protection Agency (EPA)-registered, and use them as directed. It is important that your repellent includes one of the following active ingredients:
- DEET
- Picaridin
- IR3535
- Oil of lemon eucalyptus
- Para-menthane-diol (PMD)
Is Bug Spray Safe During Pregnancy?
Yes. According to the U.S. Centers for Disease Control (CDC), if used correctly EPA-registered insect repellents are safe and effective for pregnant and breast-feeding women. A study in Thailand, consisting of 900 pregnant women, proved that there were no harmful effects to their babies after giving birth when DEET was used during pregnancy.
Zika Prevention: Children, Babies, and Mosquito Bites
Protecting your child from mosquito bites can be done by covering the crib, baby carrier, or stroller with mosquito netting. Dress your child in long sleeves and long pants, keeping skin covered when possible. Do not use insect repellent on a child’s hands, eyes, mouth, or on injured or cut skin.
Is Bug Spray Safe For Babies?
Never use insect repellent on babies younger than 2 months. Alternatively, use bug netting and avoid locations where mosquitos are present. Insect repellent containing DEET may be used on children older than 8 weeks. Products containing picaridin are considered safe once your child is over 2 years old. After your child turns 3, insect repellent containing PMD and oil of lemon eucalyptus are considered safe to use.
Bug Spray Tips for Parents
- Insect repellents should only be used on exposed skin and clothing.
- Wash off repellent at the end of the day with soap and water. Sleeping with repellents on increases the absorption of the chemicals into the skin.
- Apply insect repellent to a child’s face by spraying it onto your hands and then wiping the child’s face.
Zika Virus Spread from Human to Human
Can I Get Zika Virus from Having Sex?
Zika virus can be transmitted by a man to his sex partners. The Zika virus is present in semen longer than in blood. For this reason, physicians recommend the use of condoms to protect uninfected sex partners from getting the virus.
Zika Infection from Mother to Child
A pregnant women can infect her fetus with Zika virus during pregnancy or around the time of birth. As of now, there are no instances of infants acquiring Zika through breastfeeding.
Can I Get Zika from a Blood Transfusions?
Zika virus can be transmitted through blood transfusion. There have been many reports of Zika being transmitted through blood infusions in Brazil. During the Zika outbreak in the French Polynesian, 2.8% of blood donors tested positive for Zika. Do not donate blood if you have been possibly been exposed to possible Zika virus infection.
How Long Does Zika Virus Stay in The Blood Stream?
If infected with Zika it is important to prevent additional mosquito bites. For about a week after infection, the virus is found in the blood of an infected person. If a mosquito bites an infected person during this time, the mosquito becomes infected and can spread Zika virus to another person when it bites again.
Zika Virus: Symptoms and Diagnosis
What are the Symptoms of Zika Infection (Zika Fever)?
Only 1 out of 5 patients people with Zika infection will show symptoms. Zika symptoms include fever, joint pain, rash, and conjunctivitis (reddened eyes). Headaches and muscle pain are other possible symptoms of a Zika virus infection. Symptoms may develop within a few days to a week after infection and last for several days to one week. Severe illness and death are rarely a result of a Zika virus infection.
How is Zika Virus Diagnosed?
Health-care professionals can diagnose patients by completing history and physical exams. It is important to reveal any recent travel to areas where Zika is active. A blood test or urine test can confirm a Zika infection. Blood tests can differentiate Zika from dengue fever or chikungunya virus infections.
Zika Virus and Pregnancy
The Zika virus has an extreme effect on a developing fetus in pregnant women, creating dramatic and often life-threating birth defects. In rare cases, Zika infection may cause fetal death and loss of pregnancy.
Zika and Microcephaly
Zika virus infection during pregnancy can causeis associated with microcephaly, a birth defect in which the baby’s head is unusually small and under-developed. Infants born with microcephaly may display the following symptoms as a result:
- Balance and coordination problems
- Developmental delays
- Trouble swallowing and problems feeding
- Hearing loss
- Hyperactivity
- Seizures
- Speech and vision problems
- Cranial abnormalities
Should Pregnant Women Avoid Travel?
Women who are pregnant or who want to become pregnant should avoid travel to areas with known local Zika virus transmission. If you must travel, discuss the situation with your doctor and take precautions to avoid mosquito bites.
Future Pregnancies and the Zika Virus
Wanting to have a baby but are concerned about Zika virus exposure? Pregnancy planning and safe sex is an essential part of preventing the spread of the Zika virus and its associateds birth defects.
Women Who Live in or Travel to Zika Regions
Women who plan to become pregnant but live in a known Zika virus al region should consult a physician before trying to conceive. Waiting at least 8 weeks to conceive is a recommended precaution for women with Zika exposure.
Men Who Live in or Travel to Zika Regions
Men who have been diagnosed with Zika infections should wait at least 6 months before safely trying to conceive as Zika virus lives longer in sperm cells than it does in the blood stream. Men who have been traveling to a Zika region but with no known infection should wait a precautionary 8 weeks to attempt conception.
Zika Virus Treatment
Treatment for Zika virus is directed at relieving the symptoms of infection. If diagnosed with Zika, get plenty of rest and drink fluids in order to prevent dehydration. Medications such as acetaminophen (Tylenol) can relieve fever and pain. Patients infected with Zika virus should avoid mosquito bites for the first week of the illness in order to prevent the spread of Zika to others.
Medications to Avoid with Zika Fever
Do not take aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen until a dengue fever diagnosis has been ruled out due to a heightened risk of bleeding.
Zika Virus Travel Notices
The CDC is working with individual states to monitor the presence of Zika virus in the United States. Health-care providers are encouraged to report suspected cases of Zika infection to state or local health departments.
Zika virus outbreaks in United States Territories such as the Puerto Rico, the U.S. Virgin Islands, and American Samoa have been reported. Local spread of the Zika virus in some areas of the mainland U.S. where Aedes mosquitos are present is possible.
If traveling to regions with active Zika virus outbreaks, follow the appropriate measure to prevent mosquito bites. If pregnant, avoid traveling to regions with active Zika virus transmission or consult your physician.
Testing for Zika Virus
Better methods for diagnostic testing to identify Zika virus infection are becoming available. Both urine and blood tests are available for patients within two weeks of symptom onset. Individuals who suspect they may have a Zika virus infection should seek immediate medical care and undergo testing.
Individuals looking to conceive should seek medical advice before trying to get pregnant if they or their partner has recently been traveling to known Zika transmission regions. Tests for Zika virus in semen are now available.
Zika Virus Research
Preparations for the first human trials of a Zika vaccine are under way. Researchers are testing the Zika DNA vaccine GLS-5700. Trials will include the assessment of the safety and effectiveness of the Zika vaccine. An effective Zika virus vaccine is needed to stop the Zika virus pandemic.
West Nile Virus Infection: Causes, Symptoms, and Treatment
What Is West Nile Virus?
West Nile virus (WNV) is a microorganism (virus) transmitted by mosquitoes and, more rarely, ticks. It is commonly found in Africa, West Asia, the Middle East, and the Caribbean.
Most humans who contract the virus have been bitten by an infected mosquito, often the common house mosquito (Culex pipiens). This mosquito, found in most U.S. states, is a known vector of WNV. (A “vector” is an animal host that transmits an infectious disease).
This disease can infect humans, birds, mosquitoes, horses, and some other mammals. West Nile virus infection can cause West Nile fever (WNF) and West Nile Neuroinvasive Disease (WNND).
History of West Nile Virus in the U.S.
West Nile virus was discovered in 1937 in the West Nile district of Uganda. West Nile emerged in the United States for the first time in the New York City area in Aug. 1999. There were 62 confirmed human cases and seven deaths during this outbreak, creating widespread concern.
In 2012, the CDC confirmed an outbreak of 1,118 cases of West Nile virus, the highest number of reported cases since the virus was first detected in the U.S. Of those, 56% of patients from 47 states developed neuroinvasive disease. Approximately 75% of the cases were reported from five states (Texas, Mississippi, Louisiana, South Dakota, and Oklahoma), and almost half of all cases were reported from Texas, many in the Dallas area.
According to the CDC, since 1999 more than 50,000 people have been reported with West Nile virus in the U.S. More than 2,300 of those people died. Cases of West Nile infection spiked in 2018, with 25% more cases reported that year than average.
West Nile Virus in the U.S. Today
As of August 2019, every state but Hawaii has reported West Nile virus infections according to the Centers for Disease Control. More than 2,600 cases were reported in 2018, resulting in 167 deaths. More than 1,600 of these cases had potential to infect the nervous system, marking them as more serious and potentially deadly. Indeed, 10% of the patients reported to the CDC with neuroinvasive WNV died in 2018.
How Does West Nile Virus Infect Mosquitoes?
Birds are vectors (intermediate carriers) of the virus. As such they are important to the virus's life cycle and transmission cycle. For female mosquitos that carry WNV, a typical blood meal comes from birds. When mosquitoes feed on the blood of an infected bird, the virus can infect these mosquitoes.
Birds make ideal vectors for WNV. That’s because they can circulate high levels of the infection in their blood. The infected birds themselves may or may not show signs of illness. Crows and Jays are some of the species most likely to die from infection, whereas most other bird species survive.
How Do People Get Infected With West Nile Virus?
Almost all people infected with West Nile virus contract the disease through the bite of an infected mosquito. Mosquitoes become infected when they feed on infected birds, which circulate the virus in their blood. To date, more than 300 different species of bird have been found to carry the virus in the U.S. However, there is no evidence the virus can be spread directly from a bird to a human.
The virus eventually finds its way into the mosquito's salivary glands. During subsequent blood meals, the virus may be injected into humans and animals, where it can multiply and possibly cause illness.
Is West Nile Virus Contagious?
It is important to remember that West Nile virus is not contagious and cannot be transmitted from person to person. A person cannot get the virus, for example, from touching or kissing someone who has the disease. Likewise, a health care worker who has treated someone with the disease cannot spread the infection to others.
Humans are called "dead-end" hosts for the virus, meaning we can be infected but our immune systems prevent the virus from multiplying enough to be passed back to mosquitoes and then to other hosts. Horses can also catch West Nile virus, but are also dead-end hosts and cannot infect humans.
Rare Cases in Which West Nile Virus Is Spread
In a tiny number of cases, WNV has also been spread through these unusual means:
- Blood transfusion
- Organ transplant
- Breastfeeding
- Pregnancy (mother to baby)
- Laboratory exposure
What Are the Risks of West Nile Virus During Pregnancy?
Pregnant mothers have a very low risk of spreading WNV to their newborns. However, only a small number of cases have been studied so far. That means it is not yet possible to determine what percentage of WNV infections during pregnancy result in infection of the fetus or medical problems in newborns. One small study of infected mothers found that all 17 children were born healthy. In fact, there has been only one documented instance of a newborn becoming infected during pregnancy.
Even so, concerns remain that mother-to-child WNV transmission can occur with possible adverse health effects. For this reason, pregnant women should take precautions to reduce their risk for WNV and other mosquito-borne infections by avoiding mosquitoes. They can do this by following three safety precautions:
- Stay away from mosquitos and mosquito-prone areas
- Wear mosquito-protective clothing, including long sleeves
- Use repellents that have DEET. FDA-registered repellents with DEET are deemed safe for pregnant women.
Can You Get West Nile Virus Directly From Birds?
There is no evidence a person can get West Nile virus by handling infected birds, whether the birds are alive or dead. However, it is a good idea in general to avoid skin contact when handling dead animals, including dead birds. Gloves or double plastic bags should be used to remove and dispose of carcasses.
Some states monitor WNV through a dead bird surveillance program. To find out if such monitoring happens in your area, check with your local vector control program.
Eating Infected Birds or Animals
There is no evidence the virus can be transmitted to humans who eat infected birds or animals. In keeping with overall public-health practice, and due to the risk of known food-borne pathogens, you should always follow safety precautions to ensure your meat is fully cooked.
West Nile Virus Illness: Who Is at Risk?
If you live in or visit areas where active cases have been identified, you are at risk of developing West Nile viral infection. But remember—4 out of 5 infected people show no symptoms. Those most at risk of severe symptoms, including neurological disease, are people 50 years of age or older.
Children appear to be at low risk for symptomatic WNV, The American Academy of Pediatrics says. However, they still face some risk.
Is West Nile Virus Seasonal?
The risk of infection is highest during mosquito season, when mosquitos are most active. When temperatures freeze, mosquito season comes to an end in most places.
Cases of West Nile virus infection occur primarily in the late summer or early fall in temperate areas of the world. In southern climates where temperatures are milder, though, the threat of infection may last all year.
Can West Nile Virus Kill?
About 70% to 80% of those infected have no symptoms. About 20% to 30% of infected people develop West Nile fever with mild symptoms, including fever, headache, and body aches, occasionally with a skin rash on the trunk of the body and swollen lymph glands.
A tiny percentage of infected people develop West Nile Neuroinvasive Disease. Symptoms include headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, and paralysis. It can be deadly. About one in 150 people infected with the West Nile virus will develop this more severe form of WNV disease.
How Long Do Symptoms Last?
It usually takes three to 14 days to develop symptoms following an infectious bite. Symptoms will generally last a few days, although even some healthy people report the illness lasting several weeks. When the infection develops into West Nile Neuroinvasive Disease (WNND), serious symptoms can last for months.
Can West Nile Fever Turn Into West Nile Encephalitis?
When someone is infected with West Nile virus (WNV), they will typically have one of three outcomes: no symptoms, West Nile fever, or severe West Nile Neuroinvasive Disease. WNND can cause serious symptoms such as meningitis and encephalitis, but it occurs in less than 1% of those infected. If you develop a high fever with severe headache, consult your doctor immediately or go to an Emergency Department.
How Does West Nile Virus Actually Cause Severe Illness and Death in Humans?
Following transmission by an infected mosquito, West Nile virus can multiply in the blood system and cross the blood-brain barrier to reach the brain. When this happens, it causes West Nile Neuroinvasive Disease. During WNND the virus interferes with normal central nervous system functioning and causes inflammation of brain tissue.
Why some people develop WNND and not others remains unclear. A weak immune response may be responsible, though. Some researchers believe the virus develops into WNND when a person’s immune system fails to adequately control the virus, allowing the infection to develop deeper into the nervous system.
Treatment for West Nile Virus
The diagnosis of West Nile virus infection is confirmed with a blood or cerebrospinal fluid test. There is no specific treatment for West Nile virus infection. Mild illness does not require therapy other than medication to reduce fever and pain.
When West Nile infects the brain, intensive supportive therapy is needed. Anti-inflammatory medications, intravenous fluids, and intensive medical monitoring may be required in severe cases. There is no specific antibiotic or antidote used to treat this viral infection.
Is There a West Nile Virus Vaccine?
There is no current vaccine to prevent the virus. A vaccine for horses was first introduced in 2005, and four other horse vaccines have been released since then. Several US laboratories are currently using various approaches to research and develop a human vaccine, though to date none have moved past the trial phase of development.
Similar Viruses
West Nile virus is closely related to Japanese encephalitis virus and St. Louis encephalitis virus. These viruses are found in the US in the southeast, west, and Midwest. These are all mosquito-borne viruses, and have a similar life cycle in birds and mosquitoes to WNV. They are even found in some of the same mosquitos that carry WNV.
A major difference is that St. Louis encephalitis is "silent" in birds, generally not killing them, so there is usually no warning before a human case occurs. With West Nile virus (at least the American strain), some birds, particularly jays and crows, become ill or die from the disease and therefore offer an early warning to researchers.
West Nile Virus Prevention: Habitat Control
Limiting mosquito habitats and breeding grounds helps limit your exposure to them. Mosquitoes lay their eggs in standing water. So, dispose of all cans, plastic containers, rubber tires, or any other possible water-holding containers from nearby property.
At least once or twice a week, empty water from flowerpots, pet food and water dishes, bird baths, swimming pool covers, buckets, barrels, and cans. Drain water from pool covers. Check for clogged rain gutters and clean them out, too. By doing so, you will help control the habitats where mosquito larvae grow.
Prevention: Mosquito Avoidance and Control
Here are some steps you can take to protect yourself and your family from mosquito bites:
Insect Repellent
Apply insect repellent to exposed skin. An effective repellent contains 20%-30% DEET (N,N-diethyl-meta-toluamide). Although DEET is approved for children, some caution is warranted. Consider lower DEET concentrations if children will be outdoors for less than two hours. (High DEET concentrations last longer). Use only once per day, and do not treat babies less than 2 months old.
Clothes
When weather permits, wear long-sleeved shirts and long pants whenever you are outdoors. Spray clothing with repellents containing permethrin (not to be applied on skin) or another EPA-registered repellent since mosquitoes may bite through thin clothing.
Other Considerations
- Place mosquito netting over infant carriers when you are outdoors with infants.
- Consider staying indoors at dawn, dusk, and in the early evening, which are peak mosquito biting times.
- Install or repair screens on window and door so that mosquitoes cannot get indoors.
- Remove standing water from your yard. Encourage neighbors to drain standing water sources in their yards, too.
How Communities Can Stop West Nile Virus
There are three major steps a community can take to protect itself from this virus. First, a community can monitor its bird population. This includes surveying sick birds and birds that have died of disease.
Second, the community can watch out for stagnant water, particularly if it is nutrient-laden. Stagnant water allows mosquitoes to lay their eggs.
Third, widespread mosquito-control efforts may be warranted. These include the use of spraying and larvicide. However, even with rigorous surveillance, spraying, and larvicide, the virus may still continue to infect people.
Larvicides and Adulticides
Insecticides are commonly used when whole populations of mosquitoes need to be controlled or eradicated. Mosquito insecticides come in two broad categories: larvicides, used in killing immature mosquitoes, and adulticides, which target adults.
Larvicides
Larvicides are pesticides used to kill immature mosquitoes. They can change the growth and development of mosquito larvae in several ways. They include insect growth regulators, surface films, bacterial insecticides, and organophosphates like Diazinon.
Larvicides are applied directly to water sources that hold mosquito eggs or larvae. When used properly, larvicides can help to reduce the overall mosquito population by limiting the number of new mosquitoes.
Adulticides
Adulticides are products used to kill adult mosquitoes. Adulticides can be applied from handheld sprayers, truck-mounted sprayers, or airplanes. Adulticides, when used properly, can have an immediate impact to reduce the number of adult mosquitoes in an area, with the goal of reducing the number of mosquitoes that can bite people and possibly transmit West Nile virus.
Can You Develop a Natural Immunity?
Most infected people eventually recover. That means they have developed a natural immunity to the infection. It is assumed that immunity from West Nile virus (WNV) will be lifelong. However, it is possible that immunity may wane in later years.
West Nile Virus Facts
When dealing with West Nile virus, mosquito bite prevention is your best bet. Fighting mosquito bites reduces your risk of getting West Nile virus, along with other illnesses that mosquitoes can carry.
Diseases and Conditions: The Most Common Infectious Diseases in the U.S.
Chlamydia
This sexually transmitted disease affects men and women. Most people who have it have mild symptoms or none at all, but you may have discharge or pain when you pee. Your doctor can diagnose it with a urine test or genital swab. Though antibiotics can cure it easily, this "silent" infection speaks loudly if it goes untreated. Complications include pelvic inflammatory disease (PID) in women and prostate gland infections in men.
Influenza A and B
Sudden fever and chills, muscle aches, headache, tiredness, sore throat, congestion. If you have these, you likely have the flu. Between 3% and 11% of people in the U.S. get it each year. It usually clears up within 2 weeks, but you may be tired for a while. For small children, the elderly, and those with weak immune systems, it can be dangerous and even deadly. If you're at risk for complications or very sick, your doctor may give you antiviral medicine. The best way to keep from getting it is to get a flu shot every year.
Staph
There are more than 30 kinds of staph bacteria. Staphylococcus aureus is the most common one. They often live on your skin and sometimes in the lining of your nose. But they can get into your body through a cut or sore. This can cause an infection that can be serious or life-threatening. You can treat most staph infections with antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA) doesn't respond to penicillin-based drugs. It must be treated with different types of antibiotics.
E. Coli
Most strains of the Escherichia coli (E. coli) bacteria are harmless. They live in your gut and help you digest your food. But some can cause urinary tract infections or pneumonia. Others cause belly pain, vomiting, and diarrhea that can be bloody. The usual cause is eating contaminated raw vegetables or undercooked meat, especially ground beef. The illness usually starts 1 to 10 days after you’ve had contact with the bacteria. You'll most likely get better on your own in about a week.
Herpes Simplex 1
Herpes simplex 1 (HSV-1) causes most oral herpes, also called fever blisters or cold sores. It's so common that more than 50% of U.S. adults get it, usually through mouth-to-mouth contact. You can't cure it, but over-the-counter medication relieves symptoms and can shorten healing time. Though herpes simplex 2 (HSV-2) is the more common cause of genital herpes, you can spread HSV-1 to genital areas through oral sex.
Herpes Simplex 2
Herpes simplex 2 (HSV-2) causes most genital herpes, but HSV-1 type can cause it, too. If you have it, you may have a rash or blisters that can ooze or bleed. But most people have either mild symptoms or none at all. But you can still pass it to a partner without knowing you have it. This is partly why it's so common: More than 1 in 6 people ages 14-49 have it. There's no cure, but medicine can prevent or shorten outbreaks and lessen the chances that you'll give it to a partner.
Shigellosis
Anyone can get it, but it most often affects young children. It spreads through contact with contaminated water or food or with an infected person's poop. Because of this, it can happen in daycare centers or public swimming pools. It can cause fever, stomach pain, or diarrhea that can sometimes be bloody -- or there can be no symptoms at all. It often goes away without medication, but the diarrhea can cause dehydration.
Syphilis
Syphilis starts as a sore on your genitals, rectum, or mouth. You can treat it quickly with penicillin. If you don't take care of it, it can progress through phases that range from a full body rash to brain damage. A mother can pass it to her baby through pregnancy or childbirth.
Gonorrhea
Gonorrhea spreads through unprotected vaginal, oral, or anal sex. Common symptoms include discharge from the vagina or penis. It may also hurt when you pee. Women may have pain in their pelvis or belly. You might also have discharge from your eyes or rectum. Your joints could swell and hurt. But you may not notice any symptoms. Antibiotics keep it from leading to infertility and an increased risk of HIV.
Norovirus
There are several causes of food poisoning or "stomach flu." Norovirus is a major one. It's highly contagious. It often spreads through contaminated food, water, surfaces, or objects. You can also get it if you're in close contact with someone who has it. It causes gastroenteritis, or inflammation of the stomach and intestines. This brings on symptoms like diarrhea, vomiting, and belly pain. There's no treatment, but it usually works its way out of your system after a few days. Try to replace the fluids you lose to prevent dehydration.
Salmonella
If you eat raw or undercooked meat, poultry, eggs, or egg products, you're at risk for a salmonella infection. You may not have symptoms, but if you do, they'll feel like the stomach flu. Drink as much water as you can: Diarrhea and vomiting can dehydrate you. This infection often passes before your test results come back.
Pneumonia
Your lungs contain hundreds of millions of tiny air sacs called alveoli. Bacteria, viruses, and fungi can cause an infection that inflames these sacs so that they fill with fluid or pus. This can be mild or serious. If you're elderly, a child, or have a weak immune system, it can be life-threatening. You can have trouble breathing, chest pain, tiredness, and a bad cough. You can treat it with medicine. The tired feeling may last for a long time after you have it.
Hepatitis C
Hepatitis is an inflammation of your liver due to a virus. Most new infections in the U.S. are from type C. You get this type from contact with infected blood, such as with used drug or tattoo needles. Symptoms include fever, tiredness, belly pain, nausea, and jaundice (yellowing of the skin and eyes). But almost half of those who have it don't know it. Antiviral drugs will stop it, but without treatment, it can lead to liver failure, liver cancer, and in some cases, death.
HIV
HIV attacks cells that help your body fight infection. This makes it hard to resist other infections and diseases. You spread it through unprotected sex or contact with infected blood. It can also pass from mother to child during pregnancy or childbirth. There's no cure, but you can live a healthy life with it through antiretroviral therapy (ART). If you don't treat it, late-stage HIV can turn into AIDS.
Common Cold
The common cold sounds minor, but it may not feel that way. This viral infection of your nose and throat can cause a runny or stuffy nose, cough, congestion, and that general run-down feeling. The virus can live in the air and get in your body through your mouth, eyes, or nose. Hand-to-hand contact is another way it spreads. It can also live on objects like doorknobs and toys. You can treat your symptoms, but there's no cure. Just rest, drink fluids, and wash your hands to keep it from spreading to others.
Your Health: Conditions That Affect Men and Women Differently
Heart Attack
The telltale heart attack sign of feeling like there's an elephant sitting on your chest isn't as common in women as it is in men. Many women feel upper back pressure, jaw pain, and are short of breath. Or they may feel nauseated and dizzy instead. Though heart disease is the leading cause of death for both genders in the U.S., women are more likely to die after they have a heart attack.
Multiple Sclerosis
Diseases that affect the immune system are often more severe in men. For example, MS affects many more women than men overall, but when it comes to the progressive form (PPMS), men get it in equal numbers to women. PPMS tends to be harder to diagnose and treat than the relapsing remitting form of MS.
Stroke
Nearly 55,000 more women than men have strokes each year in the U.S. Common symptoms are sudden weakness on one side, loss of speech and balance, and confusion. But women often have additional or different symptoms: fainting, agitation, hallucinations, vomiting, pain, hiccups, and seizures. Women typically have a worse recovery after a stroke, too.
STDs
Women are less likely to have symptoms with sexually transmitted diseases (STDs) like chlamydia and gonorrhea. STDs can also lead to chronic pelvic inflammatory disease in women, causing fertility issues. Men seldom have such complications. The human papillomavirus (HPV) is also the main cause of cervical cancer in women, but it doesn't pose a similar risk for men.
Hair Loss
Men are far more likely to lose hair as they age than women. Some 40% of women will have hair thinning or hair loss, but 85% of men will have thinning hair by age 50. Men tend to lose hair in the same pattern -- their hairline goes farther and farther back. (This is called a receding hairline.) They may also get a bald spot on the crown of their head. Women have either thinning all over or random bald patches.
Acne
Hormones are often to blame for acne. Because women's hormones shift during periods, pregnancy, and throughout menopause, they're more prone to adult acne than men. Treatment can vary based on your sex, too. Doctors tend to prescribe meds that control hormones, like birth control, for women. Creams that you rub onto your skin are more common for men.
Stress
Women are more likely to say they're stressed than men. Both sexes feel anger, crankiness, and muscle tension at near the same rates from stress, but women more often say it causes a headache, upset stomach, or makes them feel like they need to cry. Men are less likely to feel physical symptoms during times of stress than women.
UTIs
Although women tend to get urinary tract infections (UTIs) more often, men's UTIs are more complicated. They have different causes, too. Women most often get them because of bacteria from sex or poop (their urethra is shorter and closer to that area). Men's UTIs are more likely to arise from something that blocks their urine stream, like an enlarged prostate or kidney stones.
Pain
More women live with chronic pain (pain that lasts longer than 6 months and doesn't seem to respond to treatment) than men. Their pain also tends to last longer and be more intense. Doctors are still trying to figure out why, but they think differences in hormones between the sexes may be to blame.
Osteoporosis
Because women are more likely to get osteoporosis, it's often overlooked in men. But men who have this lack of bone density and break a hip are twice as likely to die than women with osteoporosis who break .
Diseases and Conditions: Diseases Making a Comeback
Plague
It's hard to believe, but the Black Death isn't just one for the history books or far-flung places. It's shown up recently in New Mexico, California, and Colorado, though it's still rare. Antibiotics can take care of it, but it can be life-threatening if it's not treated early enough. It's carried by rodents, like squirrels and mice, and the fleas that live on them.
Tuberculosis (TB)
Around the world, TB causes half the deaths it did in 1990. Even so, it still ranks right up there with HIV in terms of lives lost worldwide. And the fight against it is getting a lot harder because the antibiotics used to treat TB don't work on some newer types of it. Researchers are working on ways to cure these.
Syphilis and Chlamydia
Antibiotics don't work as well as they used to on these sexually transmitted diseases (STDs). Syphilis was almost gone from the U.S., but it's back at its highest rate in 20 years. And chlamydia, the most common STD, is getting harder to treat, too. To lower your chances of both, use condoms.
Scarlet Fever
Again, more people are getting this because the bacteria has changed just enough that antibiotics don't work as well against it. Caused by the same bacteria as strep throat, this one's usually mild. It mostly affects kids ages 5 to 15, giving them a rough, red rash that feels like sandpaper. But if it's not treated, it can lead to issues like heart or kidney problems.
Measles
There were eight outbreaks of this disease in the U.S. in 2013, including the largest since 1996 (58 people came down with it). People who aren't vaccinated against it have the highest chances of getting it. You know the measles by the telltale rash: red spots that start on your face and spread down your body. Kids under 5 and adults over 20 are more likely to have serious health problems because of it, like pneumonia or swelling of the brain. In those cases, it can be life-threatening.
Mumps
Most people in the U.S. have been vaccinated against this, but outbreaks still pop up here and there. For example, a 2009 outbreak in the Northeast affected more than 3,000 people. These tend to happen where a bunch of people live close together, like a college dorm. It can cause fever, headache, and tiredness. But the main symptom is pain and swelling in your jaw and cheek in front of your ears. In rare cases, it can also lead to swelling in the brain, breasts, ovaries, and testicles.
Whooping Cough
Also called pertussis, this gives you severe coughing fits. When you try to catch your breath after one of those, you make a whooping sound. More than 48,000 people in the U.S. had it in 2012, the most since 1955. It can last 10 weeks or more and spreads easily from one person to another. It's serious at any age but life-threatening for babies, who often need treatment in a hospital. The best way to prevent it is to get the vaccine.
Legionnaires' Disease
This one may sound like something from an old-time movie, but it seems to be on the rise in recent years. It's a lung infection that comes from breathing in tiny water droplets that have legionella bacteria. It starts with flu-like symptoms, but soon you have a cough that doesn't go away, chest pains, and trouble breathing. Antibiotics can cure it, but it can lead to serious issues if it's not treated, especially for older adults.
Leprosy
Now called Hansen's disease, this illness is caused by bacteria that attack your nerves. And it's not just a disease of the distant past. Each year, about 250,000 people around the world get it (150 to 250 in the U.S.). It can lead to serious issues, like not being able to feel or move your hands and feet. It's actually hard to spread but easy to treat, once you know what it is.
Polio
The only disease we've completely eliminated is smallpox. This one's close, but it still exists in several countries outside the U.S. That's partly because it's not always easy to tell that someone has it. In places where not everyone gets the vaccine, it can spread before doctors have a chance to contain it. Because polio affects your brain, it can be life-threatening or cause long-term problems, like not being able to move parts of your body.
Gout
You might think of the Middle Ages when you think of this type of painful arthritis. But it's been getting more common, and doctors think it has a lot to do with bigger waistlines. Being very overweight can double your chances of it. And high blood pressure doesn't help, either. Gout often starts with serious pain in your big toe, but it can begin in any joint, like your knee or elbow. After a week or so, the pain comes and goes in one joint at a time, usually in your lower leg.
Rickets
Caused by a lack of vitamin D, this leads to soft bones in kids. The uptick in recent years partly comes from two causes: breastfeeding only and fear of skin cancer. Breast milk doesn't have much vitamin D -- mothers can give their babies a supplement -- and concerns about skin cancer can mean kids spend less time outside. That can be a problem because sunlight helps your body make vitamin D. Kids with dark skin are at higher risk because they need even more sunlight to boost their levels.
Scurvy
An old-time sailor's disease that was solved with limes? Not quite. Scurvy is still with us today. It's caused by a serious lack of vitamin C, and it can make your gums bleed and your teeth fall out. It's most common in people who don't eat fruits and vegetables, older adults, alcoholics, and men who live alone -- that's called widower scurvy. It's easily treated with vitamin C supplements.END=GOLDEN AMITABHA MONASTERY=VIETNAMESE BUDDHIST NUN=THICH CHAN TANH.AUSTRALIA,SYDNEY.26/3/2020.
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