Giardiasis

INFECTIOUS NON - INFLAMMATORY DIARRHEAS

GIARDIASIS
Giardiasis, a disease that affects the gastrointestinal tract, is caused by a microscopic parasite called Giardia lamblia. The parasite attaches to the mucosa of the small intestine in humans, which sabotages the body absorb fats and carbohydrates in food digestion. Giardia is a major cause of diarrhea in the United States, and is transmitted by contaminated water. It can survive the normal amount of chlorine used to purify the water supply of the Community, and can live more than two months in cold water. As little as 10 microscopic parasites in a glass of water can cause a severe case of giardiasis in a human being who drinks it.

Travellers are the largest group at risk of giardiasis infection, especially those traveling to developing countries. Giardiasis is common among hikers and campers, people who swim in public pools, children attending day care, and gay men. Others are high-risk close contacts of infected people and those with contact with infected animals.

INCUBATION PERIOD

Symptoms usually begin 1-2 weeks (an average of seven days) after a person is infected. In healthy people, symptoms can last from 2-6 weeks. Although symptoms may last longer, medications can help reduce the duration of symptoms.

TRANSMISSION

Giardiasis is caused by ingestion of infected cysts. There are several modes of communication including bilateral disease, water and sexually transmitted diseases. Bilateral transfer of the majority of infections with Giardia and is generally associated with poor hygiene and sanitation. transmission of water is common in the United States Giardia outbreaks, often associated with ingestion of unfiltered water (polluted). Sex of disease transmission occurs through fecal-oral contamination. Moreover, changing diapers, and hand washing is a low risk factors for transmission of infected children. Finally, Giardia outbreaks of epidemics has been developed for food contamination by infected food handlers.

CLINICAL MANIFESTATIONS

It is estimated that between 1% and 20% of the U.S. population has giardiasis, and this figure could be 20% or more in developing countries where giardiasis is a major cause of infantile diarrhea epidemic. But more than two-thirds of those infected may have no signs or symptoms of the disease, although the living parasite in their intestines. When the parasite causes symptoms, the illness usually begins with severe watery diarrhea without blood or mucus. Giardiasis affects the body's ability to absorb fat from the diet, so the diarrhea contains unabsorbed fats. This means that the diarrhea floats, is shiny and smells terrible.

DIAGNOSIS

It can diagnosed by parasite antigen detection in stool and /or multiple freshly collected samples of stool ,use to identify cyst by concentration methods ( oval with four nuclei ) or trophozoites ( pear shaped ,flattened parasites with two nuclei and four pairs of flagella ).

TREATMENT

Giardiasis is the most common treatment of metronidazole (Flagyl) is 5-10 days. Giardia does not suffocate with over 85% of the time, but often cause gastrointestinal side effects such as nausea, metallic taste and dizziness and headache. Although its efficacy, metronidazole is not FDA approved for the treatment of giardiasis United States. Only approved drug for the treatment of giardiasis in the United States and furazolidone (Furoxone) is 7-10 days. And broadly as effective as metronidazole. Tinidazole is available outside the U.S. is highly effective in treating Giardiasis (90%). It can also be administered as a single dose and is well tolerated. Quinacrina is a highly effective treatment for giardiasis, but is no longer available in U.S. paromomycin and albendazole are equally effective than other treatments.

Sometimes the treatment fail to eliminate Giardia. In this case, drugs may be altered or longer or higher dose may be used. Combination therapy may also be effective (e.g, quinacrina and metronidazole).

Skin and soft tissue infection

 

SKIN AND SOFT TISSUE INFECTION .

 

Skin infections are common and can be caused by a wide range of organisms, including bacteria, fungi, viruses, protozoa, bacteria, mycoplasma and rickettsia. They range from acute to chronic and mild to life threatening. Because the skin has a limited repertoire of responding to insults, clinical manifestations of a skin infection similar to those caused by other substances or mechanisms, for example, allergic reactions such as toxic epidermal necrolysis toxic epidermal , or autoimmune skin diseases such as pemphigus.

 

Skin infections can cause superficial skin structures (for example hair follicles), the external intruder (eg, bites or chips) or hematogenously (foe example , an infection spread by gonococci). Therefore, the approach to identify a specific cause of skin infection mandates attention to detail, and the history, physical examination, laboratory tests and other diagnostic methods. The good news is that you can see signs of infection and also visually assess response to treatment. Thus, if empirical therapy fails, a more powerful diagnostic approach can arise.

Normal skin is heavily colonized by bacterial flora. The most common are the different pathogenic Gram-positive bacteria such as Staphylococcus epidermidis (coagulase negative). Skin infections and soft tissue are usually caused by Staphylococcus aureus (S. aureus) and Streptococcus pyogenes. This article discusses the common and some not so common bacterial skin infections, including the impetigo, folliculitis, furncles and jewelry, cellulitis and erysipelas, gangrenous cellulitis, staphylococcal skin syndrome and burned scarlet. Impetigo and ecthyma are bacterial infections of the skin often caused by S. aureus and / or a group of Streptococcus.

 

Mild impetigo topical antibiotics and local, while widespread or severe one and in ecthyma systemic antibiotics like, cloxacillin, erythromycin, cephalexin, or azithromycin should be used. Folliculitis, furunculosis and anthrax infections by S. folliculocentric aureus varies with the depth and extent of ovarian follicles (t) and the surrounding tissue. These conditions can be treated by local or systemic antibiotics like cloxacillin, cephalexin, erythromycin, amoxicillin / clavulanic acid or vancomycin. Staphylococcal scalded skin syndrome is a toxin mediated exfoliative skin disease caused by S. Phase II aureus group. Intravenous antibiotics such as penicillinase-resistant anti-staphylococcal methicillin, cloxacillin, cephalosporins or erythromycin are necessary.

 

Erysipelas and cellulitis are acute infections of the skin and subcutaneous tissue caused most frequently group beta-hemolytic streptococci (erysipelas) or S. aureus requiring systemic antibiotics like oral or intravenous penicillin, erythromycin, cephalexin, cloxacillin, vacomycin, minocycline, or ciprofloxacin, depending on the severity of the case suspect organism and culture / sensitivity results. Cellulite is characterized by necrosis, gangrene, infection of the skin and underlying subcutaneous tissue due to various pathogens occur in a different position. Ampicillin, gentamicin, and either metronidazole or clindamycin intravenously with standard doses recommended for treatment.

Necrotizing soft tissue infections infection is a rare but very serious bacterial infection that can destroy the muscles, skin and underlying tissues. Necrotizing refers to something that causes tissue death. Many types of bacteria can cause this type of infection. A severe form and often fatal necrotizing infections of soft tissues caused by Streptococcus pyogenes, which is sometimes called "flesh-eating bacteria." Necrotizing soft tissue infections infection develops when bacteria enter the body, usually through small cut or scratch. Bacteria begins to grow and release harmful substances (toxins) which kills bacteria, interfering with blood flow to the tissues, breaking material in tissues, which rapidly spread the bacteria, leading to widespread effects, such as shocks .

 

The first sign of infection may be a small red, painful spot or bump on the skin. This quickly turned into a bronze medal, very painful or purple patch that grows rapidly. The centre may become black and die. The skin can break open and oozing fluid. The wound may quickly grow in less than an hour. Symptoms may include malaise, fever, sweats, chills, nausea, dizziness, profound weakness, and, finally, shock. Without treatment, death comes quickly.

 

 

 

Diseases spread - Diseases control - Prevention of infectious disease

INFECTION ,INFECTIOUS DISEASES SPREAD ,  PREVENTION AND CONTROL 

ROUTES OF TRANSMISSION 


Infectious or contagious diseases are all caused by some infectious agents - such as bacteria, viruses, fungi or parasites. Some infectious diseases can be transmitted from  one person to next. Some is transmitted by the bites of insects and animals. Others are acquired from eating contaminated food or water or other environmental exposures.

A contagious  (infectious ) disease can be transmitted from one source. Definition of transmission plays an important role in understanding the biology of an infectious agent, and in the fight against the disease it causes. Transmission can be through several mechanisms. Respiratory diseases and meningitis are often acquired through contact with aerosol droplets spread by sneezing, coughing, talking, kissing or even sing. Gastrointestinal diseases are often acquired through contaminated food and water. Sexually transmitted diseases are acquired through contact with bodily fluids, generally as a result of sexual activity. Some contaminants can be spread through contact with an infected person, inanimate object (known as a vector liabilities) as a coin passed from one person to another, while others penetrate the skin diseases directly. 

Transmission of infectious or contagious   diseases may also include a vector. Vectors may be mechanical or biological. A mechanical vector contains an infectious agent outside the body and sends it passively. There is an example of mechanical vector is a fly that landed on the cow manure, pollution of the annexes for the bacteria in the stool, and then landed in the food before consumption. The pathogen  never enters the body of the flies.

In contrast, biological vectors of pathogens in their body and deliver pathogens actively in new hosts , usually a bite. Biological vectors are often responsible for serious blood diseases such as malaria, viral encephalitis, Chagas disease, Lyme disease and African sleeping sickness. Biological vectors are usually but not exclusively, arthropods such as mosquitoes, ticks, fleas and lice. Vectors are often necessary in the life cycle of a pathogen. A common strategy to fight against the infectious disease vectors is to interrupt the life cycle of a pathogen by killing the vector.

The relationship between virulence and transmission is complex and has important implications for long-term evolution of a pathogen. Since it takes several generations for a microbe and a host of new species co-evolution, an emerging pathogen may hit its first victims particularly difficult. It usually occurs in the first wave of a new disease mortality rates are higher. If a disease is rapidly fatal, the host may die before the microbe can be that way to another host. However, this cost could be overwhelmed by short-term benefit of higher infectiousness if transmission is linked to virulence, as in the case of cholera (the explosive diarrhea helps bacteria to find new hosts) or many infections respiratory (sneezing and coughing for creating infectious aerosols).

PREVENTION AND CONTROL 

Methods of prevention of infection depends on the source and route of transmission. 

• Eradication of reservoir : There is no provision in the tank to an unusual disease to humans are the only natural reservoir of infection, it may be possible to eliminate the disease through intensive screening, treatment and vaccination. What has been done in cases of smallpox there. If an animal or a complete eradication of the reservoir environment is unlikely, but local control methods can reduce the risk of human infection (eg kill rodents to control fever, leptospirosis and other diseases) .
• For arthropode - vector - borne infections :  Destroys the carrier (which can be quite certain cases). Act to avoid biting (eg, insect repellent spray, mosquito nets).
• For food borne infection : Improve food handling and preparation is less contamination during processing, transportation or preparation. naturally present in foods can kill the body preparation and cooking. Improve supervision and regulation of food and better health education for the public need.
• For faeco-oral infections :  Improvement in  water supply  and sanitation. About 30%  ( thirty percent ) of the world's  population  have  no access to adequate safe drinking water ,and over half  have no adequate sanitation.
• For blood borne infections : Prevention of blood transfusion and handling of contaminated medical equipment which is use during transfusion .And routine testing of donated blood for infectious disease or infection even in most developed countries.
• For infections spread by airborne and direct contact:  In some respiratory infections which is caused by some air-borne infectious agents or microorganisms and some infections which is spread by direct contact ,we can control it by isolating the patients. Isolation is so useful but it is impractical in patients .In  severe immunodeficient patients ,it could be useful to protect them from infectious agents which is responsible for infection.