Emerging Illneses

Severe Acute Respiratory Syndrome (SARS)

Severe acute respiratory syndrome (SARS) is a contagious and sometimes fatal respiratory illness. SARS first appeared in November 2002 in southern Chinas Guangdong province, and within one month the province reported 300 cases. Within a few months, SARS spread worldwide, carried by unsuspecting travellers. Quickly spread throughout Asia, North America, and Europe.

Most of the U.S. cases of severe acute respiratory syndrome (SARS) occurred among travellers returning to the United States from other parts of the world with SARS. There have been very few cases as a result of spread to close contacts such as family members and health-care workers. By April 2003 there were 3,000 cases of SARS reported and more than 100 deaths worldwide.

SARS showed how quickly infection can spread in a highly mobile and interconnected world. The SARS epidemic also demonstrated that international cooperation among health experts can effectively contain the spread of the disease. The SARS epidemic had faded away by the end of summer 2003. Since 2004, known instances of SARS transmission have fallen to zero worldwide.

Causes

SARS is caused by a strain of coronavirus, the same family of viruses that causes the common cold. Until now, these viruses have never been particularly dangerous in humans, although they can cause severe disease in animals. For that reason, scientists originally thought that the SARS virus might have crossed from animals to humans.

Symptoms

SARS typically begins with flu-like signs and symptoms fever, chills, muscle/ body aches and occasionally diarrhea, headache, an overall feeling of discomfort. After about a week, signs and symptoms include:Fever of 100.4 F (38 C) or higherDry coughShortness of breath

How SARS spreadsMost respiratory illnesses, including SARS, spread through droplets that enter the air when someone with the disease coughs, sneezes or talks. Most experts think SARS spreads mainly through face-to-face contact, but the virus also may be spread on contaminated objects such as doorknobs, telephones and elevator buttons.

Risk factors

In general, people at greatest risk of SARS have had direct, close contact with someone who's infected, such as family members and health care workers.

ComplicationsMost people with SARS develop pneumonia. Breathing problems can become so severe that a mechanical respirator is required. SARS is fatal in some cases, often due to respiratory failure.People older than the age of 60 especially those with underlying conditions such as diabetes or hepatitis are at highest risk of serious complications.

Tests and diagnosisSeveral laboratory tests can be used to detect the SARS-associated coronavirus in blood, stool, and nasal secretions. Testing also can detect SARS-CoV antibodies produced after infection. Finally, viral culture has been used to detect SARS-CoV.

PreventionResearchers are working on several types of vaccines for SARS, but none has been tested in humans. If SARS infections resume, follow these safety guidelines if you're caring for an infected person:Wash your hands.Clean your hands frequently with soap and hot water or use an alcohol-based hand rub containing at least 60 percent alcohol.Wear disposable gloves.If you have contact with the person's body fluids or feces, wear disposable gloves. Throw the gloves away immediately after use and wash your hands thoroughly.

PreventionWear a surgical mask(N 95).When you're in the same room as a person with SARS, cover your mouth and nose with a surgical mask. Wearing eye glasses also may offer some protection.Wash personal items.Use soap and hot water to wash the utensils, towels, bedding and clothing of someone with SARS.Disinfect surfaces.Use a household disinfectant to clean any surfaces that may have been contaminated with sweat, saliva, mucus, vomit, stool or urine. Wear disposable gloves while you clean and throw the gloves away when you're done.

Follow all precautions for at least 10 days after the person's signs and symptoms have disappeared. Keep children home from school if they develop a fever or respiratory symptoms within 10 days of being exposed to someone with SARS. Children can return to school if signs and symptoms go away after three days.

Middle East Respiratory Syndrome (MERS)

is viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a coronaviruscalled MERS-CoV. Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness.

Middle East Respiratory Syndrome (MERS)

Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness.

About 30% of people confirmed to have MERS-CoV infection have died.incubation period is 2-14 days.

MERS in the U.S.On May 2, 2014, the first U.S. imported case of MERS was confirmed in a traveler from Saudi Arabia to the U.S.On May 11, 2014, a second U.S. imported case of MERS was confirmed in a traveler also from Saudi Arabia.

Countries with Lab-Confirmed MERS Cases

Countries in or near the Arabian Peninsula with CasesSaudi ArabiaUnited Arab Emirates (UAE)QatarOmanJordanKuwaitYemenLebanonIran

Countries with Travel-associated Cases

United Kingdom (UK)FranceTunisiaItalyMalaysiaPhilippinesGreeceEgyptUnited States of America (USA)NetherlandsAlgeria

Symptoms & Complications

Most people confirmed to have MERS-CoV infection have had severe acute respiratory illness with symptoms of:fevercoughshortness of breath

Some people also had gastrointestinal symptoms including diarrhea and nausea/vomiting. For many people with MERS, more severe complications followed, such as pneumonia and kidney failure. About 30% of people with MERS died.

Prevention

Currently, there is no vaccine to prevent MERS-CoV infection.

CDC routinely advises that people help protect themselves from respiratory illnesses by taking everyday preventive actions:

Prevention

Wash your hands often with soap and water for 20 seconds, and help young children do the same. If soap and water are not available, use an alcohol-based hand sanitizer.

Cover your nose and mouth with a tissue when you cough or sneeze, then throw the tissue in the trash.

Prevention

Avoid touching your eyes, nose and mouth with unwashed hands.

Avoid personal contact, such as kissing, or sharing cups or eating utensils, with sick people.

Clean and disinfect frequently touched surfaces such as toys and doorknobs.

Treatment

There is no specific antiviral treatment recommended for MERS-CoV infection.

Individuals with MERS can seek medical care to help relieve symptoms.

For severe cases, current treatment includes care to support vital organ functions.

Bird flu (avian influenza)

Bird flu is caused by a type of influenza virus that rarely infects humans. But when bird flu does strike humans, it's often deadly. More than half the people who become infected with bird flu die of the disease.

In recent years, outbreaks of bird flu have occurred in Asia, Africa and parts of Europe. Most people who have developed symptoms of bird flu have had close contact with sick birds. In a few cases, bird flu has passed from one person to another.

Health officials worry that a global outbreak could occur if a bird flu virus mutates into a form that transmits more easily from person to person. Researchers are working on vaccines to help protect people from bird flu.

A summary of bird flu in China in the past two months

DateLocationEventResultNote2008/11Jiangsu ProvinceH5N1 bird flu killed millions of chickens. Dead chickens were bleached and sold to Shanghai, Shandong and HenanChinese authorities denied the breakout26 have died of bird flu in China since 20032008/12/9Hong KongBird flu breakout in poultry farmsChinese authorities denied breakout in China, and pressured Hong Kong not to reveal the source of the chickens2008/12/30ShenzhenTwo-month-old infant was diagnosed with H9N2 bird fluHospitalized2008/12/24Beijing19-year-old female was diagnosed with H5N1 bird fluPatient died on Jan. 5, 2009

A summary of bird flu in China in the past two months

DateLocationEventResultNote2009/1/5Jinan City, Shandong27-year-old female was diagnosed with H5N1 bird fluPatient died on Jan. 17, 20092009/1/8Qiandongnan, Guizhou16-year-old male was diagnosed with H5N1 bird fluPatient died on Jan. 20, 2009Was transferred to a hospital in Hunan Province

2009/1/14ShanxiTwo-year-old girl was diagnosed with H5N1 bird fluHospitalized2009/1/6ShanxiThe girls mother died of severe pneumonia symptoms before the girl was hospitalizedSuspected to have died of H5N1, but no check-up was available to confirm

Avian Influenza A (H7N9) Virus

first reported in China in March 2013.No evidence of sustained person-to-person spread of H7N9 has been foundThe first case outside of China was in Malaysia and was reported on February 12, 2014.World Health Organization (WHO) reported 132 human H7N9 infections, with 44 deaths.

There are three types of influenza viruses: A, B and C. Human influenza A and B viruses cause seasonal epidemics, generally between October and May,

Wild aquatic birds are the natural hosts for all known influenza type A viruses - particularly certain wild ducks, geese, swans, gulls, shorebirds.Influenza type A viruses can infect people, birds, pigs, horses, dogs, marine mammals, and other animals.

All known subtypes of influenza A viruses can infect birds, except subtype H17N10 which has only been found in bats. Only two influenza A virus subtypes (i.e., H1N1, and H3N2) are currently in general circulation among people. Some subtypes are found in other infected animal species. For example, H7N7 and H3N8 virus infections can cause illness in horses, andH3N8 virus infection can also cause illness in dogs.

Classified into two categories (low pathogenic and highly pathogenic)refer to their ability to cause severe disease, based upon molecular characteristics of the virus and mortality in birds under experimental conditions.

Classified into two categories (low pathogenic and highly pathogenic)Infection of poultry with low pathogenic avian influenza A (LPAI) viruses may cause no disease or mild illness (such as ruffled feathers and a drop in egg production) and may not be detected. Infection of poultry with highly pathogenic avian influenza A (HPAI) viruses can cause severe disease with high mortality.

Influenza type A viruses are divided into subtypes on the basis of two proteins on the surface of the virushemagglutinin (HA) and neuraminidase (NA).For example, an H7N2 virus designates an influenza A virus subtype that has an HA 7 protein and an NA 2 protein. Similarly an H5N1 virus has an HA 5 protein and an NA 1 protein. There are 17 known HA subtypes and 10 known NA subtypes. Many different combinations of HA and NA proteins are possible.

Three prominent subtypes of avian influenza A viruses that are known to infect both birds and people are:Influenza A H5Nine potential subtypes of H5 viruses are known (H5N1, H5N2, H5N3, H5N4, H5N5, H5N6, H5N7, H5N8, and H5N9). Most H5 viruses identified worldwide in wild birds and poultry are LPAI viruses. Sporadic H5 virus infection of humans, such as with highly pathogenic avian influenza A (H5N1) viruses currently circulating among poultry in Asia and the Middle East have been reported in 15 countries, often resulting in severe pneumonia with approximately 60% mortality worldwide.

Influenza A H7

Nine potential subtypes of H7 viruses are known (H7N1, H7N2, H7N3, H7N4, H7N5, H7N6, H7N7, H7N8, and H7N9). Most H7 viruses identified worldwide in wild birds and poultry are LPAI viruses.

H7 virus infection in humans is uncommon, but has been documented in persons who have direct contact with infected birds, especially during outbreaks of H7 virus among poultry. Illness in humans may include conjunctivitis and/or upper respiratory tract symptoms.

Influenza A H9

Nine potential subtypes of H9 are known (H9N1, H9N2, H9N3, H9N4, H9N5, H9N6, H9N7, H9N8, and H9N9); all H9 viruses identified worldwide in wild birds and poultry are LPAI viruses. H9N2 virus has been detected in bird populations in Asia, Europe, the Middle East and Africa. Rare, sporadic H9N2 virus infections of humans have been reported to cause generally mild upper respiratory tract illness.

SymptomsSigns and symptoms of bird flu typically begin within two to five days of infection. In most cases, they resemble those of conventional influenza, including:CoughFeverSore throatMuscle achesSome people also experience nausea, vomiting or diarrhea. And in a few cases, a mild eye infection (conjunctivitis) is the only indication of the disease.

When to seek medical adviceSee your doctor immediately if you develop a fever, cough and body aches, and have recently travelled to a part of the world where bird flu occurs. Be sure to let your doctor know if you visited any farms or open-air markets.

CausesBird flu occurs naturally in wild waterfowl and can spread into domestic poultry, such as chickens, turkeys, ducks and geese. The disease is transmitted via contact with an infected bird's feces, or secretions from its nose, mouth or eyes.

Open-air markets, where eggs and birds are sold in crowded and unsanitary conditions, are hotbeds of infection and can spread the disease into the wider community.According to the Food and Drug Administration, bird flu cannot be transmitted by eating properly cooked poultry meat or eggs from infected birds. Poultry meat is safe to eat if it's been cooked to an internal temperature of 165 F (74 C). Eggs should be cooked until the yolk and white are firm.

Risk factorsThe greatest risk factor for bird flu seems to be contact with sick birds or with surfaces contaminated by their feathers, saliva or droppings. The World Health Organization (WHO) has confirmed a handful of cases of limited human-to-human transmission of bird flu. But unless the virus begins to spread more easily among people, infected birds or associated material presents the greatest hazard.

Risk factorsThe pattern of human transmission remains mysterious. Young children seem especially vulnerable to the virus, although some experts note that children are more likely to have contact with sick birds or to play on ground contaminated with droppings. What's more, people of all ages have contracted and died of bird flu. At this point, too few people have been infected to know all the possible risk factors for bird flu.

ComplicationsPeople with bird flu may develop life-threatening complications, including:PneumoniaCollapsed lungRespiratory failureKidney dysfunctionHeart problems

ComplicationsAlthough bird flu kills more than half the people it infects, the number of fatalities is still low because so few people have had bird flu. According to the World Health Organization, a few hundred people have died of bird flu since 2003.In contrast, the Centers for Disease Control and Prevention estimates that seasonal influenza is responsible for tens of thousands of deaths each year in the United States alone.

If you suspect that you have bird flu, you need to see your family physician. If you are very ill, you may need to be hospitalized.

What to expect from your doctorIn addition to listening to your description of symptoms, your doctor will perform a physical exam. He or she may also take a sample of fluid from your throat or nose. To be useful, these samples must be taken within the first few days after symptoms appear.

Laboratory testsSamples of fluids from your nose or throat can be tested for the presence of a flu virus. In the past, these types of tests could take hours or even weeks to complete. When more-rapid tests became available, they couldn't distinguish between bird flu and other types of influenza. The Food and Drug Administration recently approved a type of test that can identify bird flu viruses in less than an hour.

Imaging testsX-rays may be useful in assessing the condition of your lungs, which can help determine the proper diagnosis and the best treatment options for your signs and symptoms.

Treatments and drugs

Many influenza viruses have become resistant to the effects of a category of antiviral drugs that includes amantadine and rimantadine. Health officials recommend the use of oseltamivir (Tamiflu) and possibly zanamivir (Relenza) instead.

These drugs must be taken within two days after the appearance of symptoms,

Prevention

Bird flu vaccine The Food and Drug Administration has approved one vaccine to prevent infection with one strain of H5N1 bird flu virus. This vaccine isn't available to the public, but the U.S. government is stockpiling it and will distribute it in the event of an outbreak.

Prevention

Bird flu vaccine Researchers continue to work on other types of bird flu vaccines. One of the stumbling blocks is that most vaccines need chicken eggs for their development and production. Bird flu viruses are lethal to chicken eggs.

Recommendations for travelersIf you're travelling to Southeast Asia or to any region with bird flu outbreaks, consider these public health recommendations:

Avoid domesticated birds.If possible, avoid rural areas, small farms and open-air markets.

Recommendations for travelersWash your hands.This is one of the simplest and best ways to prevent infections of all kinds. When you're traveling, alcohol-based hand sanitizers containing at least 60 percent alcohol are an excellent choice. They are effective, easy to use, don't require water and they're safe for children.Ask about a flu shot.Before traveling, ask your doctor about a flu shot. It won't protect you specifically from bird flu, but it may help reduce the risk of simultaneous infection with bird and human flu viruses.

Poultry and egg products Because heat destroys avian viruses, WHO officials don't consider cooked poultry a health threat. Even so, it's best to take precautions when handling and preparing poultry, which is often contaminated with salmonella or other harmful bacteria.

Poultry and egg products Avoid cross-contamination.Carefully wash cutting boards, utensils and all surfaces that have come into contact with raw poultry in hot, soapy water.Cook thoroughly.Cook chicken until the juices run clear, and it reaches a minimum internal temperature of 165 F (74 C).Steer clear of raw eggs.Because eggshells are often contaminated with bird droppings, avoid mayonnaise, ice cream, and any other foods containing raw or undercooked eggs.

Swine flu (H1N1 flu)

H1N1Flu (commonly known as swine flu) is a seriouis flu disease caused by an influenza virus and has been declared by theWHO as a world-wide pandemic(214 countries as of 2010). The current pandemic (which was noticed in mid 2009) has killed an 18,000 people world-wide.

H1N1 Flu -virus is spread through droplets in the air when people suffering from H1N1 infection cough and sneeze. The H1N1 virus has shown that it is highly infectious which is why it has spread so far despite the efforts of governments around the world to protect their citizens from the disease.

At Risk Populationspregnant women;infants, and young children particularly under age 2;people of any age with certain chronic health conditions (including asthma or lung disease, heart disease, diabetes, kidney disease or some neurological conditions);people with severely compromised immune systems which includes many people who have HIV/AIDS.

Well as you can see from the picture above, the symptoms of H1N1 flu can include:+ fever, + cough, + cold, + headache, + bodyache,+ diarhoea and or vomiting, + breathing difficulty,+ drowsyness and or / altered conciousness

What makes one flu virus different from another?

There are two main types of flu influenza A and influenza B. Influenza A is more common and generally more serious than influenza B.

What makes one flu virus different from another?

Influenza A viruses come in assorted strains, each named for the place and date of its identification. Formally, the 2009 pandemic flu virus is named A/California/7/2009 (H1N1), because its first documented appearance was in residents of California during 2009. The number 7 tells which laboratory identified the virus. H1N1 indicates the viral serotype; it's a kind of shorthand for characteristics that allow the virus to enter your cells.Flu viruses evolve quickly, which is the reason viruses of the same serotype, such as H1N1, aren't all the same.

Is it possible to catch 2009 H1N1 from pigs?

No. The 2009 pandemic virus, now considered a seasonal flu virus, is a human-adapted virus that does not spread among pigs. People occasionally catch swine viruses when they have close contact with pigs, but someone infected with a swine virus typically can't spread it to other people.

What is the connection between 2009 H1N1 flu and swine flu?

The 2009 pandemic flu is a human infection. Swine flu is an infection in pigs. The distinction may be confusing because other H1N1 viruses also occur in both species.

The swine H1N1 virus and the 2009 human H1N1 virus share a notorious ancestor the virus that caused a devastating global pandemic in 1918 and 1919. That virus infected humans and pigs at the same time, but it quickly made separate adaptations to each species. The human-adapted virus was deadlier than its swine counterpart.

Once it infects a pig, a bird flu virus may cross with a swine flu virus.

It's also possible for bird and human-adapted flu viruses to meet up in swine.

Why was H1N1 flu considered a serious threat in 2009?

Any outbreak of a flu-like illness outside the normal flu season should be taken seriously. If the cause turns out to be a completely new flu virus as it did in 2009 virtually everyone is at high risk of infection; you can't be immune unless you've been vaccinated or exposed to the virus before.

Why was H1N1 flu considered a serious threat in 2009?

So a red flag appeared in April 2009, when two children from neighboring California counties developed a flu-like illness well after the peak of the flu season. By the time experts at the Centers for Disease Control and Prevention (CDC) determined that the cause was a previously unknown "novel" influenza virus, the infection had already spread from its apparent site of origin in southern Mexico to several areas in the United States and Canada.

How can we best protect ourselves?

covering your mouth and nose while coughing and sneezing.

Its just good manners for me to keep the germs that are troubling me to myself

What else can I do to protect myself, my family and my co-workers?

Besides getting vaccinated, you can:Wash your hands with soap and water frequently. Alcohol sanitizers also may be helpful.Avoid close contact with anyone who has cold or flu symptoms.Stay home if you're ill, and encourage others to do the same.

Hand, Foot, & Mouth Disease (HFMD)

Hand, foot, and mouth disease (HFMD)is a common viral illness of infants and children. The disease causes fever and blister-like eruptions in the mouth and/or a skin rash. HFMD is often confused with foot-and-mouth (also called hoof-and-mouth) disease, a disease of cattle, sheep, and swine; however, the two diseases are not relatedthey are caused by different viruses. Humans do not get the animal disease, and animals do not get the human disease.

Illness

The disease usually begins with a fever, poor appetite, malaise (feeling vaguely unwell), and often with a sore throat.One or 2 days after fever onset, painful sores usually develop in the mouth. They begin as small red spots that blister and then often become ulcers. The sores are usually located on the tongue, gums, and inside of the cheeks.

Illness

A non-itchy skin rash develops over 12 days. The rash has flat or raised red spots, sometimes with blisters. The rash is usually located on the palms of the hands and soles of the feet; it may also appear on the buttocks and/or genitalia.A person with HFMD may have only the rash or only the mouth sores.

Cause of Hand, Foot, and Mouth Disease

HFMD is caused by viruses that belong to the enterovirus genus (group). This group of viruses includes polioviruses, coxsackieviruses, echoviruses, and enteroviruses.Coxsackievirus A16 is the most common cause of HFMD in the United States, but other coxsackieviruses have been associated with the illness.Enteroviruses, including enterovirus 71, have also been associated with HFMD and with outbreaks of the disease.

How Hand, Foot, and Mouth Disease Is Spread

Infection is spread from person to person by direct contact with infectious virus. Infectious virus is found in the nose and throat secretions, saliva, blister fluid, and stool of infected persons. The virus is most often spread by persons with unwashed, virus-contaminated hands and by contact with virus-contaminated surfaces.Infected persons are most contagious during the first week of the illness.

How Hand, Foot, and Mouth Disease Is Spread

The viruses that cause HFMD can remain in the body for weeks after a patient's symptoms have gone away. This means that the infected person can still pass the infection to other people even though he/she appears well. Also, some persons who are infected and excreting the virus, including most adults, may have no symptoms.

HFMD is not transmitted to or from pets or other animals.

Factors That Increase the Chance for Infection or Disease

HFMD occurs mainly in children under 10 years old but can also occur in adults. Children are more likely to be at risk for infection and illness because they are less likely than adults to have antibodies to protect them. Such antibodies develop in the body during a persons first exposure to the enteroviruses that cause HFMD.Infection results in immunity to (protection against) the specific virus that caused HFMD. A second case of HFMD may occur following infection with a different member of the enterovirus group.

Diagnosis of Hand, Foot, and Mouth DiseaseHFMD is one of many infections that result in mouth sores. However, health care providers can usually tell the difference between HFMD and other causes of mouth sores by considering the patients age, the symptoms reported by the patient or parent, and the appearance of the rash and sores.Samples from the throat or stool may be sent to a laboratory to test for virus and to find out which enterovirus caused the illness. However, it can take 24 weeks to obtain test results, so health care providers usually do not order tests.

Treatment and Medical Management of Hand, Foot, and Mouth Disease

There is no specific treatment for HFMD.Symptoms can be treated to provide relief from pain from mouth sores and from fever and aches:Pain and fever can be treated with over-the-counter medications (caution: aspirin should not be given to children).Mouthwashes or sprays that numb pain can be used to lessen mouth pain.Fluid intake should be enough to prevent dehydration (lack of body fluids). If moderate-to-severe dehydration develops, it can be treated medically by giving fluids through the veins.

Prevention of Hand, Foot, and Mouth Disease

A specific preventive for HFMD is not available, but the risk of infection can be lowered by following good hygiene practices.Good hygiene practices that can lower the risk of infection includeWashing hands frequently and correctly and especially after changing diapers and after using the toiletCleaning dirty surfaces and soiled items, including toys, first with soap and water and then disinfecting them by cleansing with a solution of chlorine bleach (made by adding 1 tablespoon of bleach to 4 cups of water)Avoiding close contact (kissing, hugging, sharing eating utensils or cups, etc.) with persons with HFMD

Vaccination Recommendations

No vaccine is available to protect against the enteroviruses that cause HFMD.

Complications of Hand, Foot, and Mouth Disease

Complications from the virus infections that cause HFMD are not common, but if they do occur, medical care should be sought.Viral or "aseptic meningitiscan rarely occur with HFMD. Viral meningitis causes fever, headache, stiff neck, or back pain.

Complications of Hand, Foot, and Mouth Disease

Other more serious diseases, such as encephalitis (swelling of the brain) or a polio-like paralysis, result even more rarely. Encephalitis can be fatal.

There have been reports of fingernail and toenail loss occurring mostly in children within 4 weeks of their having hand, foot, and mouth disease (HFMD).

Trends and Statistics of Hand, Foot, and Mouth Disease

Individual cases and outbreaks of HFMD occur worldwide. In temperate climates, cases occur more often in summer and early autumn.Since 1997, outbreaks of HFMD caused by enterovirus 71 have been reported in Asia and Australia.

Trends and Statistics of Hand, Foot, and Mouth Disease

HFMD caused by coxsackievirus A16 infection is a mild disease. Nearly all patients recover in 7 to 10 days without medical treatment.

HFMD caused by enterovirus 71 has shown a higher incidence of neurologic (nervous system) involvement. And fatal cases of encephalitis (swelling of the brain) caused by enterovirus 71 have occurred during outbreaks.

Legionnaires DiseasePontiac fever and Legionnaires' disease may also be called "legionellosis. Legionellosis is a term for any disease caused byLegionellabacteria.

Causes&Transmission

caused by a type of bacteria calledLegionella. TheLegionellabacteria are found naturally in the environment, usually in water. The bacteria grow best in warm water, like the kind found inHot tubsCooling towersHot water tanksLarge plumbing systemsDecorative fountainsThey do not seem to grow in car or window air-conditioners.

Spread of Disease

People get Legionnaires' disease when they breathe in a mist or vapor (small droplets of water in the air) containing the bacteria. One example might be from breathing in droplets sprayed from a hot tub that has not been properly cleaned and disinfected. The bacteria arenotspread from one person to another person.

Signs&Symptoms

CoughShortness of breathHigh feverMuscle achesHeadachesThese symptoms usually begin 2 to 14 days after being exposed to the bacteria.

Pontiac Fever

A milder infection, also caused byLegionellabacteria, is called Pontiac fever. Thesymptoms of Pontiac feverare similar to those of Legionnaires disease and usually last for 2 to 5 days. Pontiac fever is different from Legionnaires' disease because the patient does not have pneumonia.Symptoms go away on their own without treatment.

Treatment

AntibioticsAntipyretics

Possible ComplicationsLung failureDeath (5-30%)

*****It now seems likely that it evolved from one or more animal viruses into a completely new strain.*When to see a doctor If you think you've been exposed to or have SARS, see your doctor right away. SARS is a serious illness that can lead to death.

********They had fever, cough, and shortness of breath. About 30% of people confirmed to have MERS-CoV infection have died.*(time between when a person is exposed to MERS-CoV and when they start to have symptoms)This virus has spread from ill people to others through close contact, such as caring for or living with an infected person. However, there is no evidence of sustained spreading in community settings.

*So far, all the cases have been linked to countries in and near the Arabian Peninsula.

*The two U.S. cases are not linked.one to Indiana, the other toFlorida. Both cases were among healthcare providers who lived and worked in Saudi Arabia. Both traveled to the U.S. from Saudi Arabia, where they are believed to have been infected. Both were hospitalized in the U.S. and later discharged.*serology testing.Serology testing uses blood samples and is designed to look for antibodies to MERS-CoV that would indicate a person had been previously infected with the virus and developed an immune response.Serology for MERS-CoV includes three separate tests (1) a screening test called ELISA or enzyme-linked immunosorbent assay, (2) a confirmatory test called IFA or Immunofluorescent assay, and (3) a slower, but more definitive confirmatory test called the neutralizing antibody assay.

*Most of the people who died had an underlying medical condition. Some infected people had mild symptoms (such as cold-like symptoms) or no symptoms at all; they recovered.*CDC is discussing with partners the possibility of developing one.*polymerase chain reaction, assays.PCR tests are done with respiratory samples and can quickly indicate if a person has active infection with MERS-CoV.

*If you are caring for or living with a person confirmed to have, or being evaluated for, MERS-CoV infection*Avoid contact with camelsDo not drink raw camel milk or raw camel urineDo not eat undercooked meat, particularly camel meat

******Most of these infections are believed to result from exposure to infected poultry or contaminated environments, as H7N9 viruses have also been found in poultry in China.with about one-third resulting in deathcontrol measures taken by Chinese authorities - like closing live bird markets - and the change in weather.***In humans, LPAI (H7N2, H7N3, H7N7) virus infections have caused mild to moderate illness.HPAI (H7N3, H7N7) virus infections have caused mild to severe and fatal illness.On April 1, 2013,the first known human cases of infection with avian influenza H7N9 viruses were reported. These were associated with severe respiratory illness and death.

*********What you can do You may want to write a list that includes:Detailed descriptions of the symptomsRecord of recent travel to an area where bird flu is prevalentInformation about past medical problemsInformation about the medical problems of parents or siblingsQuestions you want to ask the doctor****something that may prove logistically difficult on a worldwide scale, even if there were enough to go around. Because they're in short supply, it's not entirely clear how flu drugs would be allocated if there were a widespread epidemic.*It's intended to help protect adults ages 18 to 64 and could be used early in such an outbreak to provide limited protection until another vaccine designed to protect against the specific form of the virus causing the outbreak is developed and produced.

*****hollandaise sauce, ********In pigs, a direct descendant of the 1918 swine flu virus still causes a disease called classical swine flu. In humans, the 1918 H1N1 virus caused seasonal flu epidemics until 1957, when a new pandemic flu virus temporarily pushed the H1N1 virus out of the picture. In 1968, another pandemic virus H3N2 emerged, replacing the 1957 pandemic virus. Then, in the late 1970s, human H1N1 returned fortunately, without the lethal consequences it had in 1918. For the next 41 years, the revived H1N1 and the 1968 H3N2 viruses were relatively stable, both surviving as seasonal flu viruses.

**All this mingling of viruses adds variety to the flu virus gene pool in swine and the more variety there is, the greater the chance that some new combination of genes will cross into humans and become the next pandemic virus. A similar process, most likely, created the 2009 pandemic virus.

*Also, past experience with new flu viruses has shown that they cause more severe illness and death than do recurring seasonal flu viruses sometimes, substantially more, as was the case in 1918.

*It took only a few weeks to appear on every continent.If I get the seasonal flu shot in the fall, will I be safe from H1N1 flu?Yes. The seasonal flu shot targets three influenza viruses from previous years' flu epidemics. The targeted viruses change each year, based on recommendations from virologists, immunologists and public health experts. The 2009 H1N1 flu virus is one of the three targets of the 2010-2011 seasonal flu shot. *That holds true any airborne disease TB and other viral infections like the common cold spread this way too.**********Everyone who has not already been infected with an enterovirus that causes HFMD is at risk of infection, but not everyone who is infected with an enterovirus becomes ill with HFMD.

*****The condition is usually mild and clears without treatment; however, some patients may need to be hospitalized for a short time.

*At this time, it is not known whether the reported nail loss is or is not a result of the infection. However, in the reports reviewed, the nail loss has been temporary and nail growth resumed without medical treatment.

**Enterovirus Type 71.. The Institut Pasteur inCambodiahas discovered Enterovirus Type 71 in about two-thirds of patients it tested after a mystery disease killed more than 60 children in the country, said the head of the institutes virology unit.

Several major outbreaks of enterovirus 71 (EV71) have been reported since 1974 (1,2). Countries of the Asia Pacific Rim particularly have been recently affected by large outbreaks of EV71-associated hand-foot-and-mouth disease (HFMD). Most patients with HFMD experience a mild disease course, but recent reports on the outbreak of EV71 infection in various countries, including Taiwan, Peoples Republic of China, and Malaysia, indicate that some EV71-infected persons have severe neurologic complications or systemic disease*Legionnaires' disease can have symptoms like many other forms of pneumonia, so it can be hard to diagnose at first.Signs of Legionnaires' diseasecan include*Healthy people usually get better after being sick with Legionnaires disease, but hospitalization is often required. Pontiac fever goes away without specific treatment. Antibiotics provide no benefit for a patient with Pontiac fever.

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