This document provides an overview of viral hemorrhagic fever (VHF) and focuses on yellow fever. It classifies VHFs and describes their pathogenesis. Yellow fever is caused by a flavivirus transmitted by mosquitoes. It presents with fever, bleeding, liver and kidney damage. Diagnosis involves blood tests showing low platelets and clotting factors. Treatment focuses on supportive care; vaccines can prevent yellow fever.
The document summarizes information about Ebola virus hemorrhagic fever and Lassa virus hemorrhagic fever. It describes the etiology, epidemiology, signs and symptoms, diagnosis, treatment and prevention of the two viral hemorrhagic fevers. Ebola virus causes a severe multisystem disease in humans characterized by fever, headache and bleeding. Lassa fever is endemic in West Africa and transmitted from rodents to humans, causing fever, bleeding and organ dysfunction. Treatment involves supportive care and the antiviral drug ribavirin.
Enteroviruses are a genus of picornaviruses that mainly replicate in the gut. There are at least 71 serotypes divided into 5 groups: polioviruses, coxsackie A viruses, coxsackie B viruses, echoviruses, and newly identified enteroviruses. Enterovirus infections can range from subclinical to abortive infections with minor illness to major illness with paralysis. Prevention is focused on vaccination with oral or intramuscular poliovirus vaccines. While poliovirus has been largely eradicated, surveillance continues to monitor outbreaks and achieve global eradication.
This presentation is on basic virology on Enterovirus diseases. Viruses includes Coxsackie virus, entero virus 71, rota virus, polio virus. Slides are suitable for medical students and medical graduate.
The lecture gives concise review about the main four groups of viruses causing hemorrhagic fever i.e. Flavivirues, Filoviruses, Arenaviruses and Bunyaviruses.
This document provides an overview of viral hemorrhagic fevers (VHFs). It discusses the etiology, epidemiology, pathogenesis, clinical features and treatment of various VHFs. The major viral families that cause VHF are Arenaviridae, Bunyaviridae, Filoviridae, and Flaviviridae. Common VHFs covered include Lassa fever, Ebola, yellow fever, dengue, Crimean-Congo hemorrhagic fever and hantavirus pulmonary syndrome. The document examines the mechanisms of pathogenesis for Ebola and Lassa virus, including increased vascular permeability, immunosuppression and cytokine storm.
Parvoviruses are the smallest DNA viruses, including human parvovirus B19. B19 is pathogenic in humans, infecting erythroid progenitor cells and causing fifth disease in children characterized by a rash. It can also cause aplastic crisis, hydrops fetalis in fetuses, and chronic anemia in immunocompromised patients. Diagnosis involves detecting IgG and IgM antibodies by ELISA or PCR to detect the virus. There is no treatment, though a vaccine is in clinical trials.
This document provides an overview of infectious diseases and pathogens. It begins by outlining the categories of infectious agents, including viruses, bacteria, fungi, parasites and more. It then discusses the transmission and dissemination of microbes, how they overcome host barriers and spread locally or systemically. The document also examines the mechanisms by which microbes cause disease, including direct cell death, toxin/enzyme release, and inducing host immune responses. Specific examples are provided for viral injury mechanisms like cytopathic effects.
Enteroviruses are a genus of picornaviruses that replicate in the gut. There are at least 71 serotypes including polioviruses, coxsackie A and B viruses, echoviruses, and newer enteroviruses. They are single stranded RNA viruses with icosahedral symmetry that are stable in acid pH. Poliovirus was first identified in 1909 and causes the disease poliomyelitis, which can result in paralysis. The Sabin oral polio vaccine uses live attenuated poliovirus grown in monkey kidney cells to induce long lasting immunity after multiple doses.
The document summarizes information about Ebola virus hemorrhagic fever and Lassa virus hemorrhagic fever. It describes the etiology, epidemiology, signs and symptoms, diagnosis, treatment and prevention of the two viral hemorrhagic fevers. Ebola virus causes a severe multisystem disease in humans characterized by fever, headache and bleeding. Lassa fever is endemic in West Africa and transmitted from rodents to humans, causing fever, bleeding and organ dysfunction. Treatment involves supportive care and the antiviral drug ribavirin.
Enteroviruses are a genus of picornaviruses that mainly replicate in the gut. There are at least 71 serotypes divided into 5 groups: polioviruses, coxsackie A viruses, coxsackie B viruses, echoviruses, and newly identified enteroviruses. Enterovirus infections can range from subclinical to abortive infections with minor illness to major illness with paralysis. Prevention is focused on vaccination with oral or intramuscular poliovirus vaccines. While poliovirus has been largely eradicated, surveillance continues to monitor outbreaks and achieve global eradication.
This presentation is on basic virology on Enterovirus diseases. Viruses includes Coxsackie virus, entero virus 71, rota virus, polio virus. Slides are suitable for medical students and medical graduate.
The lecture gives concise review about the main four groups of viruses causing hemorrhagic fever i.e. Flavivirues, Filoviruses, Arenaviruses and Bunyaviruses.
This document provides an overview of viral hemorrhagic fevers (VHFs). It discusses the etiology, epidemiology, pathogenesis, clinical features and treatment of various VHFs. The major viral families that cause VHF are Arenaviridae, Bunyaviridae, Filoviridae, and Flaviviridae. Common VHFs covered include Lassa fever, Ebola, yellow fever, dengue, Crimean-Congo hemorrhagic fever and hantavirus pulmonary syndrome. The document examines the mechanisms of pathogenesis for Ebola and Lassa virus, including increased vascular permeability, immunosuppression and cytokine storm.
Parvoviruses are the smallest DNA viruses, including human parvovirus B19. B19 is pathogenic in humans, infecting erythroid progenitor cells and causing fifth disease in children characterized by a rash. It can also cause aplastic crisis, hydrops fetalis in fetuses, and chronic anemia in immunocompromised patients. Diagnosis involves detecting IgG and IgM antibodies by ELISA or PCR to detect the virus. There is no treatment, though a vaccine is in clinical trials.
This document provides an overview of infectious diseases and pathogens. It begins by outlining the categories of infectious agents, including viruses, bacteria, fungi, parasites and more. It then discusses the transmission and dissemination of microbes, how they overcome host barriers and spread locally or systemically. The document also examines the mechanisms by which microbes cause disease, including direct cell death, toxin/enzyme release, and inducing host immune responses. Specific examples are provided for viral injury mechanisms like cytopathic effects.
Enteroviruses are a genus of picornaviruses that replicate in the gut. There are at least 71 serotypes including polioviruses, coxsackie A and B viruses, echoviruses, and newer enteroviruses. They are single stranded RNA viruses with icosahedral symmetry that are stable in acid pH. Poliovirus was first identified in 1909 and causes the disease poliomyelitis, which can result in paralysis. The Sabin oral polio vaccine uses live attenuated poliovirus grown in monkey kidney cells to induce long lasting immunity after multiple doses.
this is a very serious hemorrhagic virus even if, it is very rare in our settings , we should be aware of it and sometime include it in our differential of renal failure with hemorrhagic fever or cardiopulmonary stuffs.
Coxsackievirus is an enterovirus that causes hand, foot, and mouth disease. It is transmitted through fecal-oral contact or respiratory droplets. Symptoms include fever and blister-like lesions on the hands, feet, and in the mouth. While most cases resolve on their own, complications can occasionally occur involving the heart or brain. Treatment focuses on relieving symptoms, and prevention emphasizes good hygiene and handwashing.
This document summarizes retroviruses and HIV. It discusses the discovery and classification of retroviruses. The structure of retroviruses includes a spherical capsid containing two copies of RNA and viral enzymes. The retrovirus lifecycle includes early reverse transcription of RNA to DNA and later integration into the host genome and assembly of new virions. HIV causes AIDS and was isolated in 1983. It is a global pandemic transmitted sexually or through blood. Treatment includes antiretroviral drugs that target reverse transcriptase, protease, entry, and integration. Prevention focuses on safe sex practices, mother-to-child transmission prevention, and pre-exposure prophylaxis.
Haemophilus influenzae is a Gram-negative coccobacillus that commonly infects the human respiratory tract and can cause serious invasive disease. The most virulent strain is type b, which most commonly causes meningitis in young children. Symptoms of H. influenzae infection vary depending on the site of infection but may include fever, respiratory distress, and neurological dysfunction. Treatment involves antibiotics like ceftriaxone. Routine vaccination against H. influenzae has dramatically reduced the incidence of invasive disease in countries where it is part of the standard childhood vaccine schedule.
The document provides information on the Ebola virus. It discusses that Ebola virus disease first appeared in 1976 in simultaneous outbreaks in Sudan and Zaire. It belongs to the filovirus family and species Zaire ebolavirus which caused the 2014 West African outbreak. The virus infects and kills its host efficiently by attacking the lymph nodes and bloodstream. While there is no proven cure, several vaccine candidates and antiviral treatments are being studied.
This document discusses tick-borne encephalitis (TBE), a viral infection transmitted through tick bites that affects the central nervous system. TBE is caused by the tick-borne encephalitis virus, which is endemic in parts of Europe and Asia. It describes the virus's subtypes, epidemiology, transmission cycle involving ticks and small rodents, clinical signs and symptoms including meningitis and encephalitis, diagnosis through serology or PCR, supportive treatment, and prevention through tick avoidance and the use of vaccines available in Europe.
COVID-19 is certainly a newly emerged zoonosis, not yet understood properly thus cases need utmost care in its handling in both in human and animals.
More observations and studies can only elucidate the origin, intermediate host and definitive host (till date humans) and maintenance host of SARS CoV-2.
For control of emerging and re-emerging zoonoses potentiating one health environmental approach for understanding disease drivers and control strategies are essential elements.
A detailed description of HIV covering virology, morphology, pathogenesis, clinical stages and manifestations, laboratory diagnosis, and diagnostic strategy, and therapeutic options and prevention.
Viral haemorrhagic fevers (vhf) plus questions.Shaikhani.
Viral haemorrhagic fevers are caused by several viruses and occur mostly in rural parts of Africa. Lassa fever is widespread in West Africa with an overall mortality of around 15% for hospitalized cases. Ebola outbreaks occur about once per year in countries like Congo, Uganda, and Sudan. While most have mild symptoms, all can present with fever, body aches, and bleeding. Transmission is through contact with infected individuals, animals, or insect bites. Treatment involves isolation and supportive care, with ribavirin used for Lassa fever and South American haemorrhagic fevers.
Mumps is a contagious viral disease that is transmitted through saliva and causes swelling of the salivary glands. Symptoms include fever, fatigue, and swelling of the parotid glands near the ears. While most people recover within 2 weeks with rest and over-the-counter pain medication, rare complications can include meningitis, encephalitis, hearing loss, and sterility in males. Vaccination with 2 doses of the MMR vaccine provides effective protection against mumps.
This document discusses arboviruses, which are viruses transmitted by arthropods like mosquitoes and ticks. It defines arboviruses and provides their classification. The major families of arboviruses are Togaviridae, Flaviviridae, Bunyaviridae, Reoviridae, and Arenaviridae. Some important arboviruses and the diseases they cause include dengue, yellow fever, Japanese encephalitis, West Nile virus and chikungunya. Diagnosis involves virus isolation, antigen detection, genome detection and serology. Major vectors are mosquitoes and ticks.
Arboviruses are viruses transmitted by arthropods like mosquitoes and ticks. They cause diseases in both animals and humans. There are two main transmission cycles - man-arthropod-man and animal-arthropod-man. Some major arboviruses include dengue, yellow fever, Japanese encephalitis, West Nile virus and chikungunya. They can cause febrile illnesses, encephalitis or hemorrhagic fevers. Diagnosis involves virus isolation or serological tests. There are vaccines available for only a few arboviruses like yellow fever and Japanese encephalitis. Treatment is generally supportive care.
This document provides information on HIV/AIDS, including its history, epidemiology, definition, characteristics, transmission, pathogenesis, clinical manifestations by system, opportunistic infections, diagnosis, and treatment. Some key points are:
- HIV was first identified in the 1980s and has since infected over 38 million people worldwide. India has the third largest epidemic with over 2 million cases.
- Advanced HIV is defined as CD4 count <350 or WHO stage 3/4 disease. AIDS is defined as CD4 <200 or WHO stage 4 disease.
- HIV is transmitted sexually, through blood/blood products, or mother-to-child. It primarily targets CD4 cells and causes immunosuppression.
- Clinical
This document provides an overview of the syllabus for a course on virology and mycology. It discusses several topics that will be covered in the course, including different types of fungi and fungal infections, classification of viruses, RNA viruses like influenza and HIV, DNA viruses like herpes and hepatitis, and advanced PCR techniques for viral identification. Specific units will cover mycology, fungal infections, introduction to virology, RNA viruses, DNA viruses, and next generation PCR applications. The Epstein-Barr virus is mentioned as a topic that will be discussed.
Measles is caused by a highly contagious RNA virus from the paramyxoviridae family. It is transmitted through respiratory droplets and direct contact. Despite an effective vaccine, measles causes 350,000 childhood deaths annually in developing countries due to poor immunization coverage. The virus infects respiratory epithelium and spreads to reticuloendothelial cells, causing systemic symptoms over three phases - prodromal, enanthematous with pathognomonic Koplik's spots, and exanthematous with a maculopapular rash. Complications include pneumonia, encephalitis and death. Diagnosis is clinical but can be confirmed with IgM antibodies or virus isolation. Treatment is supportive and prevention is through universal
Ebola virus is suspected to be zoonotic, transmitted from bats and primates to humans through contact with bodily fluids. It infects macrophages, causing them to release cytokines that produce symptoms like fever and vascular problems. This leads to small blood clots, disruption of coagulation, bleeding, and multi-organ failure. The incubation period is 2-21 days on average. Laboratory diagnosis involves non-specific tests like leukopenia and elevated liver enzymes, as well as specific tests detecting the virus's RNA, proteins, or antibodies.
This document discusses viral hemorrhagic fever (VHF), specifically Lassa fever. It defines VHF and notes that Lassa fever, caused by the Lassa virus, is endemic in parts of West Africa. The virus is transmitted from rodents to humans and then through human contact. Symptoms can range from mild to severe. Diagnosis involves ELISA, PCR and immunohistochemistry. Treatment for Lassa fever involves supportive care and the antiviral drug ribavirin. Prevention focuses on avoiding contact with rodents, proper food storage, hygiene and use of PPE during potential human exposures.
This Part 1 of 'Monsoon Illnesses affecting Lungs' covers an overview of leptospirosis, malaria and dengue. It base on Harrison's Textbook of Internal Medicine, 18th edition.
this is a very serious hemorrhagic virus even if, it is very rare in our settings , we should be aware of it and sometime include it in our differential of renal failure with hemorrhagic fever or cardiopulmonary stuffs.
Coxsackievirus is an enterovirus that causes hand, foot, and mouth disease. It is transmitted through fecal-oral contact or respiratory droplets. Symptoms include fever and blister-like lesions on the hands, feet, and in the mouth. While most cases resolve on their own, complications can occasionally occur involving the heart or brain. Treatment focuses on relieving symptoms, and prevention emphasizes good hygiene and handwashing.
This document summarizes retroviruses and HIV. It discusses the discovery and classification of retroviruses. The structure of retroviruses includes a spherical capsid containing two copies of RNA and viral enzymes. The retrovirus lifecycle includes early reverse transcription of RNA to DNA and later integration into the host genome and assembly of new virions. HIV causes AIDS and was isolated in 1983. It is a global pandemic transmitted sexually or through blood. Treatment includes antiretroviral drugs that target reverse transcriptase, protease, entry, and integration. Prevention focuses on safe sex practices, mother-to-child transmission prevention, and pre-exposure prophylaxis.
Haemophilus influenzae is a Gram-negative coccobacillus that commonly infects the human respiratory tract and can cause serious invasive disease. The most virulent strain is type b, which most commonly causes meningitis in young children. Symptoms of H. influenzae infection vary depending on the site of infection but may include fever, respiratory distress, and neurological dysfunction. Treatment involves antibiotics like ceftriaxone. Routine vaccination against H. influenzae has dramatically reduced the incidence of invasive disease in countries where it is part of the standard childhood vaccine schedule.
The document provides information on the Ebola virus. It discusses that Ebola virus disease first appeared in 1976 in simultaneous outbreaks in Sudan and Zaire. It belongs to the filovirus family and species Zaire ebolavirus which caused the 2014 West African outbreak. The virus infects and kills its host efficiently by attacking the lymph nodes and bloodstream. While there is no proven cure, several vaccine candidates and antiviral treatments are being studied.
This document discusses tick-borne encephalitis (TBE), a viral infection transmitted through tick bites that affects the central nervous system. TBE is caused by the tick-borne encephalitis virus, which is endemic in parts of Europe and Asia. It describes the virus's subtypes, epidemiology, transmission cycle involving ticks and small rodents, clinical signs and symptoms including meningitis and encephalitis, diagnosis through serology or PCR, supportive treatment, and prevention through tick avoidance and the use of vaccines available in Europe.
COVID-19 is certainly a newly emerged zoonosis, not yet understood properly thus cases need utmost care in its handling in both in human and animals.
More observations and studies can only elucidate the origin, intermediate host and definitive host (till date humans) and maintenance host of SARS CoV-2.
For control of emerging and re-emerging zoonoses potentiating one health environmental approach for understanding disease drivers and control strategies are essential elements.
A detailed description of HIV covering virology, morphology, pathogenesis, clinical stages and manifestations, laboratory diagnosis, and diagnostic strategy, and therapeutic options and prevention.
Viral haemorrhagic fevers (vhf) plus questions.Shaikhani.
Viral haemorrhagic fevers are caused by several viruses and occur mostly in rural parts of Africa. Lassa fever is widespread in West Africa with an overall mortality of around 15% for hospitalized cases. Ebola outbreaks occur about once per year in countries like Congo, Uganda, and Sudan. While most have mild symptoms, all can present with fever, body aches, and bleeding. Transmission is through contact with infected individuals, animals, or insect bites. Treatment involves isolation and supportive care, with ribavirin used for Lassa fever and South American haemorrhagic fevers.
Mumps is a contagious viral disease that is transmitted through saliva and causes swelling of the salivary glands. Symptoms include fever, fatigue, and swelling of the parotid glands near the ears. While most people recover within 2 weeks with rest and over-the-counter pain medication, rare complications can include meningitis, encephalitis, hearing loss, and sterility in males. Vaccination with 2 doses of the MMR vaccine provides effective protection against mumps.
This document discusses arboviruses, which are viruses transmitted by arthropods like mosquitoes and ticks. It defines arboviruses and provides their classification. The major families of arboviruses are Togaviridae, Flaviviridae, Bunyaviridae, Reoviridae, and Arenaviridae. Some important arboviruses and the diseases they cause include dengue, yellow fever, Japanese encephalitis, West Nile virus and chikungunya. Diagnosis involves virus isolation, antigen detection, genome detection and serology. Major vectors are mosquitoes and ticks.
Arboviruses are viruses transmitted by arthropods like mosquitoes and ticks. They cause diseases in both animals and humans. There are two main transmission cycles - man-arthropod-man and animal-arthropod-man. Some major arboviruses include dengue, yellow fever, Japanese encephalitis, West Nile virus and chikungunya. They can cause febrile illnesses, encephalitis or hemorrhagic fevers. Diagnosis involves virus isolation or serological tests. There are vaccines available for only a few arboviruses like yellow fever and Japanese encephalitis. Treatment is generally supportive care.
This document provides information on HIV/AIDS, including its history, epidemiology, definition, characteristics, transmission, pathogenesis, clinical manifestations by system, opportunistic infections, diagnosis, and treatment. Some key points are:
- HIV was first identified in the 1980s and has since infected over 38 million people worldwide. India has the third largest epidemic with over 2 million cases.
- Advanced HIV is defined as CD4 count <350 or WHO stage 3/4 disease. AIDS is defined as CD4 <200 or WHO stage 4 disease.
- HIV is transmitted sexually, through blood/blood products, or mother-to-child. It primarily targets CD4 cells and causes immunosuppression.
- Clinical
This document provides an overview of the syllabus for a course on virology and mycology. It discusses several topics that will be covered in the course, including different types of fungi and fungal infections, classification of viruses, RNA viruses like influenza and HIV, DNA viruses like herpes and hepatitis, and advanced PCR techniques for viral identification. Specific units will cover mycology, fungal infections, introduction to virology, RNA viruses, DNA viruses, and next generation PCR applications. The Epstein-Barr virus is mentioned as a topic that will be discussed.
Measles is caused by a highly contagious RNA virus from the paramyxoviridae family. It is transmitted through respiratory droplets and direct contact. Despite an effective vaccine, measles causes 350,000 childhood deaths annually in developing countries due to poor immunization coverage. The virus infects respiratory epithelium and spreads to reticuloendothelial cells, causing systemic symptoms over three phases - prodromal, enanthematous with pathognomonic Koplik's spots, and exanthematous with a maculopapular rash. Complications include pneumonia, encephalitis and death. Diagnosis is clinical but can be confirmed with IgM antibodies or virus isolation. Treatment is supportive and prevention is through universal
Ebola virus is suspected to be zoonotic, transmitted from bats and primates to humans through contact with bodily fluids. It infects macrophages, causing them to release cytokines that produce symptoms like fever and vascular problems. This leads to small blood clots, disruption of coagulation, bleeding, and multi-organ failure. The incubation period is 2-21 days on average. Laboratory diagnosis involves non-specific tests like leukopenia and elevated liver enzymes, as well as specific tests detecting the virus's RNA, proteins, or antibodies.
This document discusses viral hemorrhagic fever (VHF), specifically Lassa fever. It defines VHF and notes that Lassa fever, caused by the Lassa virus, is endemic in parts of West Africa. The virus is transmitted from rodents to humans and then through human contact. Symptoms can range from mild to severe. Diagnosis involves ELISA, PCR and immunohistochemistry. Treatment for Lassa fever involves supportive care and the antiviral drug ribavirin. Prevention focuses on avoiding contact with rodents, proper food storage, hygiene and use of PPE during potential human exposures.
This Part 1 of 'Monsoon Illnesses affecting Lungs' covers an overview of leptospirosis, malaria and dengue. It base on Harrison's Textbook of Internal Medicine, 18th edition.
The document discusses definitions, epidemiology, etiology, risk factors, and scoring systems related to sepsis. It defines sepsis as a life-threatening organ dysfunction caused by a dysregulated response to infection. Sepsis exists on a continuum of severity, ranging from infection to septic shock, which can lead to multiple organ dysfunction syndrome and death. The Sequential Organ Failure Assessment (SOFA) score and quick SOFA (qSOFA) score are used to assess organ dysfunction and predict mortality in sepsis patients.
This document discusses the management of severe viral pneumonia in the ICU. It begins with an introduction that outlines the major concerns of viral pneumonia for intensivists due to high mortality and morbidity rates. It then discusses the various viruses that can cause respiratory infections in the ICU such as influenza, RSV, adenovirus, SARS-CoV, and others. The pathophysiology, clinical presentation, diagnostic tools including imaging and labs, and treatment approaches including antiviral therapy, corticosteroids, oxygenation and ventilation are summarized. Non-invasive ventilation is discussed as a first-line treatment for acute respiratory failure but criteria for NIV failure requiring intubation are also provided.
Ophthalmic eye care presentation, medical residency training, health care and malaria, Vision and malaria, malaria blindness, complications of malaria, ocular malaria
The document discusses the investigation and management of eosinophilia in returned travelers and migrants from tropical regions. Eosinophilia in this population is most commonly caused by helminth infections, which can have serious consequences if left untreated. The document provides guidance on evaluating asymptomatic eosinophilia based on travel history, recommends initial screening tests, and reviews common clinical presentations that may accompany eosinophilia.
Typhoid fever is a severe illness caused by the bacteria Salmonella typhi. It is characterized by prolonged fever and can invade the liver, spleen, and other organs if untreated. It occurs primarily in developing countries with poor sanitation. Persons are infected by consuming food or water contaminated by the feces or urine of infected individuals. Diagnosis involves isolating the bacteria from blood or bone marrow cultures. Antibiotics are the primary treatment and help reduce complications if started early. Vaccines can help prevent infection but hygiene practices are also important for those in endemic areas.
1) Sepsis is a life-threatening condition caused by the body's response to infection. It can lead to tissue damage, organ failure, and death. Common signs include changes in mental status, decreased urine output, and low blood pressure.
2) Risk factors include advanced age, immunosuppression, hospitalization, and underlying illnesses. The most common pathogens are bacteria, though fungi and viruses can also cause sepsis.
3) Early identification of sepsis is important. The qSOFA and NEWS scores use simple clinical measures to help identify patients with sepsis.
Mary Mallon was a cook who was the first identified healthy carrier of typhoid fever. In 1906, she worked for a family where several members contracted typhoid. An investigation found Mallon to be the source, though she did not show symptoms. She was quarantined from 1907 to 1910. After her release, she obtained work under an alias as a cook and infected over 20 people. She was then permanently isolated from 1915 until her death in 1938. Typhoid fever remains endemic in parts of Asia and Africa, with over 16 million cases estimated annually. Diagnosis involves blood and stool cultures while treatment is usually with antibiotics like ciprofloxacin or azithromycin. Complications can include intestinal perforation or
This document discusses meningitis and encephalitis. It defines meningitis as an infection of the meninges and encephalitis as an inflammation of the brain parenchyma. It outlines the different types of meningitis and common causative organisms. It describes the clinical features, investigations, complications, prognosis and treatment for both conditions. The goals of physical therapy for patients with these inflammatory central nervous system disorders are also mentioned.
This document provides an overview of malaria, including:
- Malaria is caused by Plasmodium parasites and infects approximately 650 million people annually, killing over 1 million mostly young children in Africa.
- The life cycle involves sporozoites infecting the liver followed by merozoites infecting red blood cells and multiplying, periodically breaking out to infect new cells.
- Clinical symptoms are caused by the rupture of infected red blood cells, including fevers, anemia, hepatosplenomegaly, and in severe cases cerebral malaria or placental malaria in pregnant women. Treatment involves antimalarial drugs.
This document provides information on approaching and evaluating patients with potential infectious diseases. It discusses taking an exposure and social history, performing a physical exam focusing on vital signs, lymph nodes, skin, and foreign bodies. Diagnostic testing options are outlined including lab tests, imaging, and pathogen-specific tests. Empirical antibiotic therapy is recommended for common infections like pneumonia based on presentation. Community-acquired pneumonia causes are discussed. Hospital-acquired pneumonia treatment typically involves antibiotics until culture results are available. Infective endocarditis typically involves bacterial vegetation on heart valves.
This document discusses extrapulmonary tuberculosis (EPT), which is tuberculosis that affects structures other than the lungs. EPT can affect many different organs and systems, including lymphatic, pleural, bones/joints, meninges, and gastrointestinal tract. The diagnosis of EPT can be challenging as it may not involve the lungs. Imaging tests, biopsy, and microbiological examination of affected tissues or fluids are used to diagnose EPT in different locations. Proper treatment is important to prevent complications and spread of infection.
Hemolytic uremic syndrome (HUS) is a disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal injury, most commonly caused by toxin-producing strains of E. coli. The toxins produced by these bacteria damage endothelial cells in the kidneys and other organs, leading to platelet aggregation and thrombosis. This causes fragmentation of red blood cells and kidney dysfunction. HUS diagnosis is based on laboratory findings of hemolytic anemia, low platelet count, and kidney involvement. Treatment is largely supportive through dialysis, blood transfusions, and controlling blood pressure and electrolyte abnormalities. Most patients recover renal function, but some are left with chronic kidney disease.
Malaria is a life-threatening disease caused by parasites that are transmitted via mosquito bites. The most common malaria parasites that infect humans are Plasmodium falciparum, vivax, ovale, malariae, and knowlesi. Malaria symptoms include fever, headache, fatigue, and in severe cases can lead to organ damage or death. Diagnosis involves examining blood smears under a microscope for parasites. Treatment depends on the parasite species and disease severity, with artemisinin-based combination therapies recommended by the WHO. Prevention focuses on avoiding mosquito bites through protective clothing, bed nets, and insect repellents.
This document provides a summary of key information about primary care approaches to treating HIV patients, including:
1) It discusses the history and epidemiology of HIV, modes of transmission, clinical presentations to different specialists, treatment with HAART, and baseline evaluations prior to treatment initiation.
2) Primary care providers should offer ART to patients with CD4 counts <200 or symptoms, consider treatment for counts 200-350, and can defer for asymptomatic patients with counts >350 and low viral loads.
3) When initiating ART, providers should evaluate readiness, ensure adherence, perform baseline testing, and select preferred first-line regimens consisting of 2 NRTIs combined with an NNRTI or PI.
Sarcoidosis and IgG4-related diseases are inflammatory conditions characterized by granuloma formation. Sarcoidosis is a multisystem disorder involving lungs in over 90% of cases and skin, eyes, and liver in about a third of patients each. It is thought to be triggered by an infectious or environmental agent in a genetically susceptible host. IgG4-related disease is a fibroinflammatory condition that can affect virtually any organ, forming tumefactive lesions. Treatment for both conditions typically involves corticosteroids, with immunosuppressants used for chronic or resistant cases.
This document provides information on fever of unknown origin (FUO). It defines FUO as a fever over 38.3°C for at least 3 weeks without a confirmed diagnosis after tests and visits. Common causes include infections, cancers, and autoimmune disorders. The evaluation involves medical history, exam, lab tests, imaging and biopsies to identify infectious, inflammatory or malignant sources. Treatment focuses on the underlying cause rather than empiric antibiotics or steroids. Some cases remain undiagnosed, but most adult patients have a good prognosis in these situations.
This document discusses acute rheumatic fever, which is an inflammatory disease that can occur after a streptococcal throat infection. Some key points:
1. It is caused by an autoimmune reaction to a streptococcal infection and can damage the heart valves, joints, and brain. Untreated, it can lead to rheumatic heart disease.
2. It was first described in the 1500s and the link between strep throat and heart damage was established in the 1800s. Diagnostic criteria were developed in 1944.
3. It remains a major health problem in developing countries where the incidence is higher, though it has declined in developed nations with improved hygiene and access to antibiotics.
This document discusses social capital and its relationship to health. It defines social capital as the networks between people in a society that enable it to function, including trust, shared identities and norms. There are two types: cognitive social capital involving perceptions of trust, and structural involving social networks. Social capital is associated with better health through improved access to health information through social networks, receiving informal healthcare from others, and groups advocating for public health resources. However, social capital is difficult to measure uniformly and its relationship to health can run in both directions.
The document provides details about performing and interpreting a urinalysis. It begins with an introduction stating that urinalysis evaluates kidney and urinary tract health through physical, chemical, and microscopic analysis of a urine sample. It then outlines the indications for testing, sample collection procedures, and methods for macroscopic and chemical analysis including using urine dipsticks to test for various substances. The document discusses the clinical significance of findings for each component and limitations of the dipstick method. In summary, the document provides guidance on correctly performing and interpreting the results of a urinalysis to obtain clinically useful information.
This document discusses evidence-based medicine (EBM) and its importance for family physicians. It defines EBM as integrating individual clinical expertise with the best available clinical research evidence to make decisions about patient care. The five steps of the EBM process are outlined as asking questions, accessing evidence, appraising the evidence, applying to practice, and auditing performance. While EBM has advantages like improving quality of care, there are also challenges for family physicians in applying it due to limitations of evidence and time constraints. EBM must be implemented thoughtfully while balancing different types of evidence and the realities of family medicine.
This document provides an overview of trachoma, including its epidemiology, etiology, pathogenesis, clinical features, classification, diagnosis, and prevention and treatment. Trachoma is caused by Chlamydia trachomatis and is the leading infectious cause of preventable blindness worldwide, primarily affecting poor, rural areas with limited access to clean water and sanitation. The WHO's SAFE strategy of surgery, antibiotics, facial cleanliness, and environmental improvement is the recommended approach to control and eliminate trachoma as a public health problem.
This document provides an overview of Caesarean delivery (CD), including its history, indications, types, procedures, complications, and postoperative care. CD is a surgical procedure to deliver babies through incisions in the abdominal wall and uterus. It can be elective or emergency, and indications include fetal distress, abnormal presentation, and maternal conditions. The procedure involves making incisions, delivering the baby, delivering the placenta, and closing incisions. Postoperative care focuses on monitoring for complications like bleeding, infections, and injuries to maternal or neonatal organs. Regional anesthesia like spinal or epidural is preferred over general anesthesia.
This document outlines the management of early pregnancy loss by Dr. Mohammed Lukman Abolaji. It begins with definitions of key terms like miscarriage, threatened abortion, and blighted ovum. It then discusses the epidemiology, risk factors, and potential causes of early pregnancy loss. The document covers approaches to diagnosis using ultrasound and HCG levels. It outlines treatment options for early pregnancy loss including expectant, medical, and surgical management. Post-abortion care and potential complications are also summarized. The role of family physicians in caring for patients experiencing early pregnancy loss is emphasized.
The document outlines several key principles of family medicine according to various experts and organizations. It discusses that family medicine is the specialty focused on comprehensive primary care for patients and their families. Some of the core principles mentioned include that the family physician acts as a skilled clinician, values the patient-physician relationship, provides community-based care, and coordinates care as a resource to their practice population. The principles aim to emphasize whole-person care, prevention, and management of common medical issues.
The document discusses sexual dysfunction and the sexual response cycle. It defines sexual dysfunction, outlines the typical sexual response cycle and phases of arousal, orgasm and resolution. It describes various dysfunctions like reduced libido, arousal issues, premature ejaculation and anorgasmia. Causes include psychological, relationship, medical and medication factors. Evaluation involves history, exam and sometimes labs. Treatment focuses on addressing underlying causes, education, counseling/therapy, and sometimes medications.
Stroke; the role of family physcian [autosaved]mohammedlukman
The document discusses the tertiary management of stroke by family physicians. It covers rehabilitation methods like walking aids, gait training, repetitive task training, and muscle strength training to help patients regain mobility. It also addresses managing cognitive issues post-stroke through cognitive rehabilitation, and treating visual problems through screening and management. The overall role of family physicians is in providing long-term care, managing complications, and coordinating the multidisciplinary rehabilitation process.
This document provides an overview of syncope by Dr. Mohammed Lukman Abolaji. It defines syncope and discusses the pathophysiology, including how a loss of cerebral blood flow can cause loss of consciousness. It outlines the most common causes or etiologies of syncope including reflex or neurally mediated syncope, orthostatic hypotension, and cardiac syncope. It emphasizes that obtaining a thorough history and physical examination is important for evaluating syncope and determining its underlying cause in 50-85% of patients.
This document provides guidance on effectively breaking bad news to patients. It begins with introducing the SPIKES protocol, a six-step approach to breaking bad news. The six steps are: setting, perception, invitation, knowledge, emotion, and subsequent. Each step is then defined and best practices are outlined. Examples of bad news, why it should be done properly, what makes it difficult, and other models are also discussed. The document concludes with dos and don'ts, considerations for language barriers, and references.
The document provides an overview of neonatal tetanus, including its history, epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, treatment, and prevention. Some key points:
- Neonatal tetanus is caused by Clostridium tetani bacteria entering the body through a wound, usually the umbilical stump of a newborn.
- It kills approximately 500,000 infants annually, mainly in developing countries.
- Symptoms include difficulty feeding, crying, stiffness, and painful muscle spasms.
- Treatment involves wound cleaning, tetanus immunoglobulin, antibiotics, muscle relaxants, and supportive care like mechanical ventilation.
- Prevention relies on
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
4. INTRODUCTION
Viral hemorrhagic fevers (VHFs) are a group of
febrile illnesses caused by RNA viruses from
several viral families.
These highly infectious viruses lead to a
potentially lethal disease syndrome characterized
by
o Fever, malaise, vomiting
o Mucosal and gastrointestinal (GI) bleeding
5. VHF
VHFs are of particular public health importance
because they:
Spread within a hospital setting
Have a high case-fatality rate
Are difficult to recognize and detect rapidly
Have no effective treatment
Have a potential usage for bioterrorism
Drain the healthcare system following an
outbreak
6. Virus Family Disease (Virus)
Natural
Distribution
Usual Source of Human
Infection
Incubation (Days)
Arenaviridae
Arenavirus Lassa fever Africa Rodent 5-16
Argentine HF (Junin) South America Rodent 7-14
Bolivian HF (Machupo) South America Rodent 9-15
Brazilian HF (Sabia) South America Rodent 7-14
Venezuelan HF (Guanarito) South America Rodent 7-14
Bunyaviridae
Phlebovirus Rift Valley fever Africa Mosquito 2-5
Nairovirus Crimean-Congo HF
Europe, Asia,
Africa
Tick 3-12
Hantavirus
Hemorrhagic fever with renal
syndrome, Hantavirus pulmonary
syndrome
Asia, Europe,
worldwide
Rodent 9-35
Filoviridae
Filovirus Marburg and Ebola Africa Fruit bat 2-216
Flaviviridae
Flavivirus Yellow fever
Tropical Africa,
South America
Mosquito 3-6
Dengue HF
Asia, Americas,
Africa
Mosquito 5-7
7. Pathogenesis
The primary defect in patients with viral
hemorrhagic fever (VHF) is that of increased
vascular permeability.
Hemorrhagic fever viruses have an affinity for the
vascular system, leading initially to signs such as
flushing, conjunctival injection, and petechial
hemorrhages, usually associated with fever and
myalgias.
Later, frank mucous membrane hemorrhage may
occur, with accompanying hypotension, shock,
and circulatory collapse.
The relative severity of the clinical presentation
may vary depending on the virus in question,
amount, and route of exposure.
8.
9. VHF
Hemorrhagic complications are multifactorial and
are related to hepatic damage, consumptive
coagulopathy and primary marrow injury to
megakaryocytes.
Multisystem organ failure affecting the
hematopoietic, neurologic, and pulmonary
systems often accompanies the vascular
involvement.
Case-fatality rates of patients with VHF vary from
less than 10% to 90%.
Complications from VHF infection include
retinitis, orchitis, hepatitis, transverse myelitis,
and uveitis
10. YELLOW FEVER
Yellow fever is the prototype of the Flavivirus genus of
the family Flaviviridae.
Yellow fever circulates zoonotically as 5 genotypes:
type IA in West and Central Africa,
type IB in South America,
type II in West Africa,
type III in East Central Africa
type IV in East Africa.
Types IA and IB virus are capable of urban
transmission between human beings by Aedes
aegypti.
11. YELLOW FEVER
Yellow fever is transmitted by tree-hole breeding
mosquitoes (Haemagogus and Aedes species) during
the tropical wet season and early dry season.
Large vaccination campaigns and A aegypti control
programs have decreased the incidence of yellow
fever worldwide.
Nonetheless, yellow fever has reemerged across
Africa and South America, despite the availability of
an effective live-attenuated 17D vaccine.
The populations at highest risk for the illness are
those in countries that lack the funding and
infrastructure to support a widespread vaccination
program.
Flaviviruses, including those that cause yellow fever,
also have a potential use as biologic weapons. [9]
13. EPIDEMIOLOGY
An estimated 200,000 cases of yellow fever occur
annually, with 30,000 deaths per year.
Accurate incidence reporting is limited by the
occurrence of asymptomatic disease, underreporting
of the disease, and lack of diagnostic capabilities in
endemic areas.
90% of reported cases occur in Africa, where Aaegypti
is rampant.
Transmission occurs in largely unvaccinated
populations of sub-Saharan Africa.
The countries at greatest risk lie within a band from
15° north to 10° south of the equator. [This region
includes 32 countries in sub-Saharan Africa.
15. VIROLOGY
Yellow fever virus is a positive-sense, single-
stranded, ribonucleic acid (RNA) ̶ enveloped
flavivirus with a diameter of about 50-60 nm.
The virus is transmitted via the saliva of an
infected mosquito.
Local replication of the virus takes place in the
skin and regional lymph nodes.
Viremia and dissemination follows.
17. PATHOPHYSIOLOGY
The virus gains entrance through receptor-
mediated endocytosis. RNA synthesis occurs in
the cytoplasm and protein synthesis takes place
in the endoplasmic reticulum.
Virions are released through the cell membrane.
The infection quickly disseminates to the kidneys,
lymph nodes, spleen, and bone marrow.
Renal failure occurs as renal tubules undergo
fatty change and eosinophilic degeneration, likely
due to direct viral effect, hypotension, and hepatic
involvement.
18. PATHOPHYSIOLOGY
The liver is the most important organ affected in
yellow fever. The disease was labeled "yellow"
based on the profound jaundice observed in
affected individuals.
Hepatocellular damage is characterized by
lobular steatosis, necrosis, and apoptosis with
subsequent formation of Councilman bodies
(degenerative eosinophilic hepatocytes).
]
19. PATHOPHYSIOLOGY
The kidneys also undergo significant pathologic
changes. Albuminuria and renal insufficiency evolve
secondary to the prerenal component of yellow fever;
consequently, acute tubular necrosis develops in
advanced disease.
Hemorrhage and erosion of the gastric mucosa lead
to hematemesis, popularly known as black vomit.
Fatty infiltration of the myocardium, including the
conduction system, can lead to myocarditis and
arrhythmias.
20. PATHOPHYSIOLOGY
Central nervous system (CNS) findings can be
attributed to cerebral edema and hemorrhages
compounded on metabolic disturbances.
The bleeding diathesis of this disease is
secondary to reduced hepatic synthesis of
clotting factors, thrombocytopenia, and platelet
dysfunction.
The terminal event of shock can be attributed to
a combination of direct parenchymal damage and
a systemic inflammatory response.
21. PATHOPHYSIOLOGY
Finally, circulatory shock develops secondary to
cytokine storm, with evidence of increased levels
of
interleukin (IL)-6,
IL-1 receptor antagonist,
interferon-inducible protein-10, and
tumor necrosis factor (TNF)–alpha.
• Viral antigens are found diffusely in kidneys,
myocardium, and hepatocytes.
• In individuals who survive yellow fever, the
recovery is complete, with no residual fibrosis.
22. CLINICAL PRESENTATION
After an incubation period of 3-6 days,
most individuals with yellow fever have a mild, self-
limiting illness consisting of fever, headache, myalgia,
and malaise.
More serious illness develops in 15% of cases and
presents with the abrupt onset of general malaise,
fever, chills, headache, lower back pain, nausea, and
dizziness. .
This stage is marked by vomiting, abdominal pain,
renal failure, and hemorrhage.
Physical findings include pulse-fever dissociation
(Faget sign), conjunctival injection, and facial flushing
Petechiae, ecchymoses, epistaxis, and bleeding from
gums and venipuncture sites can progress to melena,
hematemesis, and metrorrhagia.
23. CLINICAL PRESENTATION
Other physical findings, such as scleral icterus,
jaundice, epigastric tenderness, and hepatomegaly,
develop as disease progresses.
Disseminated intravascular coagulation (DIC),
induced by liver dysfunction, leads to consumption of
platelets and clotting factors.
Ischemia primarily affects the kidneys and central
nervous system leading to altered mental status
and/or signs of volume overload (jugular venous
distension, presence of rales, and S3 gallop, or
edema
In late stages of disease, shock and multiorgan
dysfunction syndrome (MODS) dominate the clinical
picture..
Tachypnea and hypoxia with impending respiratory
failure may develop as a consequence of sepsis and
acute respiratory distress syndrome (ARDS).
24. WORK UP
Full blood count
Leukopenia with relative neutropenia
Thrombocytopenia as part of a consumptive
coagulopathy
Initial hemoconcentration
Subsequent hemorrhage and hemodilution resulting
in decreasing complete blood cell counts
Coagulation studies
Reduced fibrinogen and clotting factors II, V, VII, VIII,
IX, and X and the presence of fibrin split products
indicates DIC
Decreased synthesis of clotting factors may result in
an elevated prothrombin time
Prolonged clotting times may be found
25. WORK UP
Chemistries
Elevated ALT ,AST
Elevated creatinine
Hypoglycemia secondary to hepatic dysfunction
Metabolic acidosis
Urinalysis
Elevated urinary protein levels
Elevated urobilinogen levels
26. WORK UP
CXR - pulmonary edema, secondary bacterial pulmonary
infections,
CT intracranial hemorrhage .
ECG -prolongation of PR and QT intervals. Arrhythmias
are commonly due to myocarditis. ST-T wave
abnormalities.
Electrolyte abnormalities
27. WORK UP
Rapid detection methods
Detection of yellow fever antigen using monoclonal
enzyme immunoassay in serum specimens
Detection of viral genome sequences in tissue or in
blood or other body fluid using PCR assay
Serologic testing methods
ELISA. Confirmation is difficult because of cross-
reactivity with other viruses, particularly in Africa,
where multiple flaviviruses exist]
Immunoglobulin M (IgM) antibody-capture enzyme-
linked immunosorbent assay (MAC-ELISA) is used to
detect the specific IgM for yellow fever; a single
positive serum titer is diagnostic.
28. MANAGEMENT
No specific treatment exists for yellow fever;
however, supportive care is critical
vasoactive medications,
fluid resuscitation,
ventilator management, and
treatment of DIC, hemorrhage, secondary
infections, and renal and hepatic dysfunction.
Patient should be isolated with mosquito netting
in areas with potential vector mosquitoes.
29. COMPLICATIONS
Liver failure
Renal failure
Pulmonary edema
Myocarditis
Secondary bacterial infections
Hemorrhage or disseminated intravascular
coagulation
Encephalitis (rare)
Shock or death
Secondary bacterial infections are frequent
complications in patients who survive the critical
period of illness.
30. PROGNOSIS
Yellow fever ranges in severity from a self-limited
infection to life-threatening hemorrhagic fever.
About 15-25% of affected individuals develop a more
severe phase of disease that involves fever, jaundice,
and liver and renal failure.
Case-fatality rates in South America are reportedly
higher than in West Africa.
Mortality is a function of patient susceptibility and of
the virulence of the infecting strain.
The mortality risk in patients who present in the toxic
stage of yellow fever is up to 50%.
Infancy and age older than 50 years is associated
with increased severity of illness and lethality.
31. VACCINATION
Prevention remains the cornerstone to minimizing the
risk of yellow fever.
Single dose of the live attenuated virus (17D) vaccine
lifelong immunity in 95% of patients
A booster dose recommended for the following high-
risk populations after 10 years.
Poor financing remains a problem and a major reason
for low vaccination rates among residents of endemic
areas
32. LASSA FEVER
Lassa fever first appeared in Lassa, Nigeria, in 1969.
It has been found in all countries of West Africa and is
a significant public health problem in endemic areas.
In populations studied, Lassa fever accounts for 5-
14% of hospitalized febrile illnesses.
Its natural reservoir is a small rodent of the genus
Mastomys known as “multimammate rat” whose
virus-containing excreta is the source of transmission.
34. LASSA FEVER
Lassa virus has an unusual potential for human-to-
human spread and has
resulted in many small epidemics in Nigeria, Sierra
Leone, and Liberia.
Medical workers in Africa and the United States have
also contracted the
disease.
Patients with acute Lassa fever have been
transported by international
aircraft, necessitating extensive surveillance among
passengers and crews.
36. LASSA FEVER
Environmental conditions in Nigeria support the
natural reservoirs of Lassa fever virus and cases
of person to person transmission is presently
been reported.
38. CLINICAL SPECTRUM
A spectrum from asymptomatic (80%) to severe
disease, characterized by loss of plasma from small
vessels (capillaryleakage) and bleeding.
Liver involvement is common, including jaundice.
Clinically, these infections can be confused with other
causes of febrile illness and a high index of suspicion
is needful.
39. PRESENTATION
• Incubation Period Lassa Fever 10 (3 – 21)
days
Common symptoms:
Fever, malaise, fatigue and body aches.
Nausea; vomiting; diarrhoea; headache
Diarrhoea; productive cough; proteinuria; low BP
anaemia.
Facial edema; convulsions; mucosal bleeding
(mouth, nose, eyes);
Internal bleeding; confusion; disorientation; coma
and death.
40. CASE DEFINITION
Fever >380C for < 3weeks AND
Absence of signs of local inflammation (ie. the
sickness is systemic) AND
Absence of a clinical response after 48hr of anti-
malaria treatment &/OR a broad spectrum
antibiotic AND
Two major or one major and two minor signs:
41. CASE DEFINITION CRITERIA
MAJOR SIGNS
Bleeding
Swollen neck or face
Conjunctivitis or
subconjunctival
Haemorrhage Spontaneous
abortion
Petechial or haemorrhagic
rash
New onset tinnitus or altered
hearing
Persistent hypotension
Raised transaminases esp.
AST>ALT
Known exposure to a Lassa
fever case
MINOR SIGNS
Headache
Sore throat
Vomiting
Diffuse abdominal pain/
tenderness
Chest/ retrosternal pain
Cough
Diarrhea
Generalized myalgia or
arthralgia
Profuse weakness
Proteinuria
Leucopenia < 4000/L
42. WORK UP
• FBC:-mild Leucopaenia and Lymphopaenia / Mild
thrombocytopaenia
Urinalysis: Proteinuria
Serum: High BUN
High liver transaminases (AST>150 U/L)
Definitive Tests:
IgM ELISA, IgG ** (** occurs late)
Lassa Virus Antigen
RT-PCR (3rd day)
Viral culture (7- 10 days)
Post mortem – Immunohistochemistry on tissue
specimens
43. MANAGEMENT
Isolation and Infection control – barrier nursing
• Ribavirin : shown to reduce mortality 5-10
fold if given intravenously within 6 days of the
clinical illness.
Loading dose: IV 30mg/kg (max. 2g), followed by
15mg/kg 6hrly for 4days (max. 1g), then 7.5mg/kg
(max. 500mg) 8 hrly for 6 days
Dilute Ribavirin in 150mls of 0.9%NS and infuse
slowly.
no convincing evidence that oral rivabirin delays
or prevents Lassa fever
45. COMPLICATIONS
Deafness (1/3 of cases), permanent
Spontaneous abortion
Hypovolemic shock
Respiratory distress resulting from airway
obstruction, pleural effusion, or congestive heart
failure may occur.
10–20% of patients experience late neurologic
involvement characterized by intention tremor of the
tongue and associated speech abnormalities. In
severe cases, there may be intention tremors of the
extremities, seizures, and delirium. The CSF is
normal.
Anuria
Death
46. REFRENCES
Cleri DJ, Ricketti AJ, Porwancher RB, Ramos-
Bonner LS, Vernaleo JR. Viral hemorrhagic
fevers: current status of endemic disease and
strategies for control. Infect Dis Clin North Am.
2006 Jun. 20(2):359-93.
Quaresma JA, Pagliari C, Medeiros DB, Duarte
MI, Vasconcelos PF. Immunity and immune
response, pathology and pathologic changes:
progress and challenges in the immunopathology
of yellow fever. Rev Med Virol. 2013 Sep.
23(5):305-18.
Barnett ED, Wilder-Smith A, Wilson ME. Yellow
fever vaccines and international travelers. Expert
Rev Vaccines. 2008 Jul. 7(5):579-87.
47. REFRENCES
LASSA FEVER OUTBREAK IN NIGERIA Daily
Situation Report No. 11: 19 January, 2016 Nigeria
Centre for Disease
Control(NCDC).http://reliefweb.int/sites/reliefweb.i
nt/files/resources/Lassa11.pdf
Centers for Disease Control. Lassa Fever. Fact
sheet.
http://www.cdc.gov/vhf/lassa/pdf/factsheet.pdf