LASSA FEVER - Key facts, symptoms and prevention

   Key facts

• Lassa fever is an acute viral haemorrhagic illness of 2-21 days duration that occurs in West Africa.
• The Lassa virus is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces.
• Person-to-person infections and laboratory transmission can also occur, particularly in hospitals lacking adequate infection prevention and control measures.
• Lassa fever is known to be endemic in Benin, Ghana, Guinea, Liberia, Mali, Sierra Leone, and Nigeria, but probably exists in other West African countries as well.
• The overall case-fatality rate is 1%. Observed case-fatality rate among patients hospitalized with severe cases of Lassa fever is 15%.
• Early supportive care with rehydration and symptomatic treatment improves survival.                                          

Lassa fever or Lassa hemorrhagic fever (LHF) is an acute viral hemorrhagic fever caused by the Lassa virus and first described in 1969 in the town of Lassa, in Borno State, Nigeria. Lassa fever is a member of the arenaviridae virus family. Similar to Ebola, clinical cases of the disease had been known for over a decade but had not been connected with a viral pathogen. The infection is endemic in West African countries, and causes 300,000–500,000 cases annually, with approximately 5,000 deaths. Outbreaks of the disease have been observed in Nigeria, Liberia, Sierra Leone, Guinea, and the Central African Republic, but it is believed that human infections also exist in Democratic Republic of the Congo, Mali, and Senegal. The primary animal host of the Lassa virus is the Natal Multimammate Mouse (Mastomys natalensis), an animal indigenous to most of Sub-Saharan Africa. The virus is probably transmitted by contact with the feces or urine of animals accessing grain stores in residences. 

Lassa fever is a viral hemorrhagic fever in West Africa. Studies show up to half a million cases of Lassa fever per year in West Africa, with about 5,000 resulting in death. Results Lassa virus was detected in 25 of 60 (42%) patients in northern and central Edo. The Lassa Virus affects adults and children alike; no matter your age you can be at risk for Lassa.

Like other hemorrhagic fevers, Lassa fever can be transmitted directly from one human to another. It can be contracted by an airborne route or with direct contact with infected human blood, urine, or semen. Transmission through breast milk has also been observed.

Symptoms

In 80% of cases, the disease is inapparent, but in the remaining 20%, it takes a complicated course. It is estimated that the virus is responsible for about 5,000 deaths annually. The fever accounts for up to one third of deaths in hospitals within the affected regions and 10 to 16% of total cases.

After an incubation period of six to twenty-one days, an acute illness with multiorgan involvement develops. Non-specific symptoms include fever, facial swelling, and muscle fatigue, as well as conjunctivitis and mucosal bleeding. The other symptoms arising from the affected organs are:

·         Gastrointestinal tract

·         Nausea

·         Vomiting (bloody)

·         Diarrhea (bloody)

·         Stomach ache

·         Constipation

·        (difficulty swallowing)

·         Hepatitis

·         Cardiovascular system

·         Pericarditis

·         Hypertension

·         Hypotension

·         Respiratory tract

·         Cough

·         Chest pain

·         Dyspnoea

·         Pharyngitis

·         Nervous system

·         Encephalitis

·         Meningitis

·         Unilateral or bilateral hearing deficit

·         Seizures

Clinically, Lassa fever infections are difficult to distinguish from other viral hemorrhagic fevers such as Ebola and Marburg, and from more common febrile illnesses such as malaria.

Diagnosis 

There is a range of laboratory investigations that are performed to diagnose the disease and assess its course and complications. ELISA test for antigen and IgM antibodies gives 88% sensitivity and 90% specificity for the presence of the infection. Other laboratory findings in Lassa fever include lymphopenia (low white blood cell count), thrombocytopenia(low platelets), and elevated aspartate amino transferase (AST) levels in the blood. Lassa fever can also be found in cerebrospinal fluid. In West Africa, where Lassa is most prevalent, it is difficult for doctors to diagnose due to the absence of proper equipment to perform tests. In cases with abdominal pain, diagnoses in endemic countries are often made for other illnesses, such as appendicitis and intussusceptions, delaying treatment with Ribavirin.

Research has been done in the last few years by a team of specialists in order to diagnose the Lassa fever on a molecular level.

Prognosis

About 15%-20% of hospitalized Lassa fever patients will die from the illness. It is estimated that the overall mortality rate is 1%, however during epidemics mortality can climb as high as 50%. The mortality rate is greater than 80% when it occurs in pregnant women during their third trimester; fetal death also occurs in nearly all those cases. Abortion decreases the risk of death to the mother.

Prevention

Control of the Mastomys rodent population is impractical, so measures are limited to keeping rodents out of homes and food supplies, as well as maintaining effective personal hygiene. Gloves, masks, laboratory coats, and goggles are advised while in contact with an infected person.

·    In health-care settings, staff should always apply standard infection prevention and control precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.

·     Health-care workers caring for patients with suspected or confirmed Lassa fever should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding. When in close contact (within 1 metre) of patients with Lassa fever, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

·     Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Lassa virus infection should be handled by trained staff and processed in suitably equipped laboratories under maximum biological containment conditions.

Treatment

There is currently no vaccine that protects against Lassa fever.

All persons suspected of Lassa fever infection should be admitted to isolation facilities and their body fluids and excreta properly disposed of.

Early and aggressive treatment using Ribavirin was pioneered by Joe McCormick in 1979. After extensive testing, it was determined that early administration is critical to success. Additionally, Ribavirin is almost twice as effective when given intravenously as when taken by mouth. Ribavirin is a prodrug which appears to interfere with viral replication by inhibiting RNA-dependent nucleic acid synthesis, although the precise mechanism of action is disputed. The drug is relatively inexpensive, but the cost of the drug is still very high for many of those in West African states. Fluid replacement, blood transfusion and fighting hypotension are usually required. Intravenous interferon therapy has also been used.

When Lassa fever infects pregnant women late in their third trimester, it is necessary to induce delivery for the mother to have a good chance of survival. This is because the virus has an affinity for the placenta and other highly vascular tissues. The fetus has only a one in ten chance of survival no matter what course of action is taken; hence focus is always on saving the life of the mother. Following delivery, women should receive the same treatment as other Lassa fever patients.

            

COURTESY FROM: World Health Organization and Wikipedia 

THANKS FOR READING :)

EGG SAFETY IN THE HOME

Eggs are a healthy, nutritious part of many diet, but they are a raw food and should be stored and handled like raw meat and chicken, to reduce the risk of illness.

Most eggs are safe; however cracked and dirty eggs can be a source of harmful bacteria such as Salmonella.

You can enjoy eggs safely by using clean/uncracked eggs, handling them correctly and storing eggs and raw egg products in the refrigerator.

Salmonella 

Salmonella can affect anyone, but there is a greater risk of food poisoning for children under two years, pregnant women, people over 70 and people with lower immune system function. That's because:

- immune systems are weaker

- the stomach may have less acid to protect against bugs

- the impact of symptoms can be more severe and

- recovery takes longer.

Symptoms of Salmonella food poisoning include headache, fever, stomach cramps, diarrhoea, nausea and vomiting which can last days or weeks. The effects of this stomach bug can range from mild to severe.

Three rules to remember

The three key rules to remember when handling eggs are:

1. Don't use cracked and/or dirty eggs

2. Wash your hands after handling eggs

3. Refrigerate raw egg products

The flipside – cooking eggs

Cooking kills most harmful bugs that may be present such as Salmonella. 

When egg whites are cooked until completely firm and the yolk begins to thicken, foods containing eggs such as cakes, quiches and biscuits are usually safe.

Keeping your own chickens

If you keep your own chickens, follow these safety tips:

collect the eggs twice a day, especially in warmer weather to reduce the risk of bacteria growing

throw away any dirty, cracked or broken eggs,and any eggs which may have been in the nest for an extended period of time

do not wash dirty eggs

store the eggs in clean containers in the refrigerator, separately from ready to eat foods

always use the oldest eggs first.

Eating out – are you at risk?

If purchasing food from a restaurant or takeaway for people who are at greater risk, check whether raw or pasteurised egg is used in any of the dishes. Manufactured products from a supermarket or retail outlet will show on the label if pasteurised egg is used.

Myths and facts about eggs

Sometimes it's hard to tell the difference between fact and fiction when it comes to eggs. See our Myths and facts about eggs page to help you to better understand eggs.

FOOD POISON

FOOD POISONING - SYMPTOMS, TREATMENT AND PREVENTION

Food poisoning is an illness caused by eating contaminated food. The most common sources of contamination are bacteria or toxic substances produced by bacteria. Some viruses and fungi can also cause food poisoning.

Food poisoning is a notifiable disease.

How food poisoning occurs

Bacteria may contaminate food as a result of farming or other production methods or poor preparation, handling or storage of food. Contaminated food may not look, smell or taste any different from food that is safe.

SIGNS AND SYMPTOMS

Typical symptoms are a sudden onset of:

nausea

vomiting

stomach cramps

diarrhoea. 

The illness usually lasts from less than 24 hours to several days depending on the cause. Occasional severe cases last longer and may require hospitalisation.

While single cases of food poisoning undoubtedly occur, they are difficult to detect and frequently go unreported. Food poisoning is usually recognised as a typical illness occurring in a group of people shortly after eating a common food.

Diagnosis

Detection of large numbers of certain bacteria in suspect food samples and detection of the same bacteria in samples of faeces from affected people confirm the diagnosis of food poisoning.

Incubation period

(time between becoming infected and developing symptoms)

Varies depending on the cause, but usually from a few hours to a few days. Although many ill people blame a food they ate before they got ill, experience indicates that this food is usually not the cause of the illness.

Infectious period

(time during which an infected person can infect others)

Depends on what has caused the illness. Not all causes of food poisoning are able to be spread from person-to-person, but some are.

TREATMENT

Treatment varies depending on what is the cause of the food poisoning. Usually these illnesses do not require antibiotic treatment.

PREVENTION

If the cause is not known, it should be assumed that it may be possible to spread from person-to-person, or for an infected person to contaminate food and indirectly infect others. Therefore:

Exclude from childcare, preschool, school or work until there has been no diarrhoea or vomiting for 24 hours. If working as a food handler in a food business, the exclusion period should be until there has been no diarrhoea or vomiting for 48 hours

follow good hand washing and keeping areas clean procedures

good food handling procedures should always be followed

do not allow people affected by food poisoning to prepare food for others until there has been no diarrhea or vomiting for 24 hours

people who have diarrhoea should not use public swimming pools until there has been no diarrhoea for at least 24 hours

babies and small children who are not toilet trained should wear tight fitting waterproof pants or swimming nappies in swimming pools and changed regularly in the change room. When faecal accidents occur, swimming pools should be properly disinfected.

http://careyegbon.blogspot.com/2014/07/causes-of-kidney-pain.html

YOU ARE NEVER TOO OLD TO EXERCISE

A lot of people when they get into their middle-aged years if they are out of shape may be inclined to think that getting fit is a lost cause. They imagine in order to get into shape again requires many hours a week on the treadmill or long distance running. Actually, nothing could be farther from the truth. First of all it is never too late for anyone to start a fitness routine. And secondly the most effective training methods shouldn't take a person more than a few minutes a week to complete.

Exercise at a high intensity level interspersed with periods of moderate rest is known as high intensity interval training (HIIT). If you are middle-aged and out of shape you might think that this type of intense activity will be too much for you to handle. Certainly you must take the approach that you can only give your body as much as it can handle, but normally your body will tell you when it's had enough. Letting your doctor know that you are about to undertake an intense training program should put your mind at ease as your body's abilities to handle it.

Test after test have shown that exercise after 40 will provide multiple benefits. Lowering your existing heart rate and maximizing oxygen uptake are only a couple of ways that exercise can help people at middle-age. But the one wonderful benefit I would like to address here is how intense exercise will help naturally boost human growth hormone levels. This is vital for healthy aging and maintaining the vigorous lifestyle well into old age.

And what makes this hormone so important? The growth hormone, also known as Somatotropin is beneficial not only for bodybuilders, as we've heard so much about, but for everyone as they get into their middle years and over. These hormones act as a liaison as they pass messages to various endocrine glands using the blood as a carrier. The signals they send are the main way that new tissue growth is built. As we age, old tissue is constantly lost, and if it is not replaced by new tissue we gradually deteriorate through old age.

Increasing the growth hormone gives other medical benefits. To name a few they lower bad cholesterol levels and raise good cholesterol levels, reduce fat tissue, make it possible to increase lean muscle mass and give us more energy to exercise longer. Anything we can do to increase these levels should be a high priority.

The necessity of getting into intense training begins shortly after we start the aging process. We probably aren't aware of this, but when we reach our mid-20s to 30 years old we begin a process called somatopause. This is where our production of human growth hormone begins to decrease quite dramatically, and this is where the aging process begins. Maintaining your HGH levels take on a great importance as it addresses the issues of muscle loss and a trophy. But tests have shown that just because you miss this early window doesn't mean you can't make up for it in your midlife or even elderly years. Never assume that you're too old, as it's been well documented that you're never too old to begin intense exercising.

Endorphins are an important regulator of pain, but also pleasure.  Most people produce them through exercise, but certain foods, especially chocolate can produce a similar effect.  Read more about it on our website.  Rich Carroll is a writer and health advocate now living in Chicago.

By Rich Carroll  

TELEVISION VS EXERCISE - WHICH PAY MORE?

One of the most common reasons people have for not being able to exercise on a regular basis is that they do not have enough time during the day. Does this sound familiar? Maybe you have been guilty of telling yourself this is the reason why you are unable to workout on a consistent schedule. If so, try not to feel too bad and get down on yourself because you are far from being the only one using this excuse.

This is not an attempt to downplay the daily schedule of individuals who avoid regular exercise due to having a jam-packed day with work, chores, kids, along with other time-zappers that arise. There are millions of reasons why exercising on a consistent basis takes a backseat to other day-to-day activities.

First off, if you are content with the lack of exercise and have no desire to change your ways, then by all means stop reading this article because you are definitely wasting your time. However, if you truly want to lose weight and get fit, in addition to eating in a more healthy manner, you will have to find a way to start exercising on a regular basis.

Here's something you should really take to heart. If you have time to watch television, you have time to exercise. Simple and straight to the point.

In actuality, if you have time for any type of leisure activity such as reading a book/newspaper, using the computer for non-work related things (like social media), and particularly watching movies/television, these are specific moments you will want to consider to change or at least alter a bit in order to accommodate exercise regularly.

As the idea for this article popped into my head, I thought about my past experiences with "leisure time" activities and how I was accustomed to spend my time away from work. The number one leisure activity for me was that darn television.

That's when I asked myself some simple questions to test how important this television time was to me. See if you can answer these same 3 questions which may open your eyes and get you to rethink the role the TV plays in your leisure time.

1) What did you watch 3 weeks ago at 9pm on a Tuesday night?

2) What was the plot of your favorite tv show in the first week of October last year?

3) OK, OK, something a bit more recent. What is your favorite memory of your television viewing from last week?

After taking a moment to really think carefully about these questions, you may have found out an interesting revelation just as I did when I thought about these same three. My answers were 1) Have no idea, possibly an Ancient Aliens show or some movie on a cable station 2) My favorite show is Big Bang Theory so I know it was funny, but I don't remember specifics 3) Nothing stands out, except a Redbox movie rental Non-Stop. But will I really remember that 2 months or a year from now?

Did you have difficulties coming up with accurate, memorable answers to these questions?

Sure watching television is an enjoyable way to spend the evening after a long day of work, chores, and kids. Naturally after an exhausting jam-packed day, it's refreshing to jump in bed and simply not have to move anything other than your eyes at the images on the screen.

However, I think now about how many countless "free-time" hours I spent sitting on the couch or laying in bed watching television. Often I would just channel surf until I found something that peaked my interest. Bam, one hour just flew by. That could have been one hour working out burning 700+ calories and making my body healthier and stronger.

This is the decision you will have to come to just as I had to about two years ago. Either change your habits or stay in the same condition you are in. I was sick and tired of being lazy and out of shape and was determined to do something about it especially when I found out I weighed nearly 300 pounds. Now, a year and a half later, I am proud to state that I am 45 pounds lighter and continuing to lose a little more week by week.

Sure I still watch television, but now it's usually after I've worked out for at least an hour as I'm falling asleep after a long, productive day. The choices you make from this point on will help determine the direction your life will take.

Just remember, the next time you use the excuse "I don't have time to exercise" hopefully it's not said after you watched two hours of the Kardashian show or Friends re-runs.

By Gregory L. Gomez, visit his website for more http://healthychoicesinlife.com/healthy-snacks-for-work.

CAUSES OF KIDNEY PAIN

Anyone that is dealing with kidney pain will most likely tell you that they want to know what causes the pain in the first place. There could be times when the pain is not going to be caused by a kidney stone and there could be some very serious complications that need to be addressed. Because of this, it is always a good idea to learn about the different causes of kidney pain.

Urinary tract issues can cause kidney pain. Some individuals will find that there are enlargements in the uterus that can contribute to pain. In some very serious situations there will be times when cancer or tumors will cause this pain. Most individuals will find that they are suffering from this pain because of kidney stones. Others will be suffering from cysts that are found within the kidney and long-term exposure to lead or its salts.

Believe it or not, there are medications that could cause this problem for a lot of people. There are people out there that may be taking medications to help treat glaucoma that they are dealing with. This medication is called Azopt and one of the side effects is kidney pain. Others could suffer from trauma related to the kidneys and this can cause the pain.

Suffering from this kind of pain can be very annoying and it could be related to something very serious. Therefore, it will be important to know about some of the very serious or life threatening conditions that could cause kidney pain. At times some people may deal with this type of pain because of an abscess in or near the kidney. Others may suffer from pain because of blockage that may be in an artery that leads to the kidney. Because the pain can be caused by something very serious it will be important to speak with a health care professional immediately if you believe you are dealing with pain in your kidneys.

If you are preparing to meet a doctor to discuss your symptoms you will find that there are a few questions you are going to be asked. The doctor will ask you how long you have been having pain. It will also be important for you to try to describe the pain. You should let the doctor know if it is constant or if it is sporadic. Where it is located will also be a very important detail the doctor needs to know. Always let the doctor know if you have ever dealt with kidney problems before. The doctor will need to know if you had an infection before the kidney pain began. Other symptoms as well as medications that you are taking should also be discussed with your doctor.

In the end, you need to understand that kidney pain can be the result of some very serious complications. Therefore, it will be very important for you to seek treatment as soon as possible. You could end up facing kidney failure if you do not seek treatment. Possible infections or cancer could also spread if you do not seek treatment immediately.

THANK YOU FOR READING..

By Mike G Jansen 

PILLOW THAT RELIEVE NECK PAIN

The back and neck are among the most vulnerable parts of the body to pain and thus the main reason people go to massage centers to get therapy to ease sore muscles. More than 80% of the globe's population suffers from back and neck problems at some point of their lives. While there are many over-the-counter drugs available to treat pain, this type of treatment will not save your pennies.

What is Back and Neck Therapy?

A type of physical treatment and rehabilitation focuses on the body structures that support the spine, namely the back and the neck. With countless causes, neck and back pain can progressively worsen if left untreated. Therapy inhibits the need for surgical intervention. With several sessions of back and neck therapy, acute pain can be managed.

Back and neck therapy:

1. Strengthens and stretches back muscles

2. Promotes muscle healing and relaxation

3. Reduces pain

4. Restores joint mobility

5. Manages exacerbation

Back and neck therapy can take the form of physical massage (therapy delivered by hand), cervical and lumbar exercise (patient-specific exercise), or the use of devices(electrical stimulation and heat and cold application).

Is There a Pillow that Relieves Pain?

During a back and neck massage, the most common item used by therapists is a pillow. Pillows found in massage and chiropractic centers are not just the ones commonly seen at home, they are therapeutic. These pillows calm, relax and de-stress muscles of the back and neck.

A neck pillow is contoured for the head and neck and is usually made for people with cervical spine problems. This type has a deeper depression designed to provide extra support under the neck.

On the other hand, a back pillow provides lower back support which is very helpful for those who frequently experience regional pain. Sitting for long periods of time without support can generate pain and muscle tension. A back pillow specifically works by supporting the lumbar curve of the spine.

How to Choose the Right Therapeutic Pillow?

It should be mentioned that pillows for the back and neck wear out over time and may need replacing every two years. How long a pillow lasts entirely depends on the material, frequency of use, and handling.

Choose a pillow made from foam or synthetic fibers. Pillows made from these materials are less allergic and are easier to wash. People who have sensitive skin should avoid feather (down)-filled pillows.

For optimum support, look for orthopedic pillows. They are not similar to conventional pillows. Orthopedic pillows are more effective in relieving muscle tension and supporting body joints. However, they are pricier.

Whenever your pillow starts to lose its support and shape, it's time to get a new one.

When finding the right neck pillow, choose one that keeps the neck in a neutral position.

When selecting a back pillow for sitting, choose one that provides lumbar support in particular. This not only gives maximum support and improves posture, but it also absorbs the pulling force of gravity that may hurt the spine.

A donuts pillow is beneficial for people suffering from coccyx (the triangular bone located at the base of the spine) pain. It can be a pillow of choice for pregnant mothers.

There are many types of pillows for the back and neck. These cushion items are not just useful in back and neck therapy centers, but they come in handy anywhere and everywhere - homes, cars, airplanes, etc. A good quality pillow is not necessarily expensive. One has to do some research to select the best pillow that is budget-friendly and can provide the most efficient support.

Written by

Dr. Bhanu Voguri, MD

NO MORE SMELLING SHOES WITH THE FOLLOWING HINTS AND TIPS

Have you ever smelt your shoes or feet at the end of a day and found yourself horrified at the odor?

There are plenty of things that can cause this. Perhaps you have a fungal infection or maybe your shoes are worn out or don't allow for enough air passage.

Thankfully, there are lots of things you can do to make sure your shoes don't stink anymore. Let's review some of the better hints and tips.

First, you must remove the smell that is already there by sprinkling some baking soda into your shoes each night.

Also, check your insoles and make sure they are the type that don't collect odors or make your feet sweat. Cedar insoles are classed as the best. Do also make sure that your insoles are unable to move about, as this could make your feet sweat by rubbing them.

If you can, although this is costly, replace the lining of your shoes with silver. Silver is a fantastic anti-microbial agent.

If your shoes are already stinky, freeze them. Washing your shoes will also be beneficial, but only if they are washable. Baby powder on your feet is also very beneficial. This will prevent your feet from sweating and it also reduces the chances of fungal and bacterial infections.

Naturally, excellent personal hygiene is also very important and you should wash your feet every day. What is perhaps even more important is that you also dry them properly.

You should also always wear socks, particularly in closed shoes. You will otherwise start to rub your skin and make your feet smell. You can always choose to wear no show socks if you don't like the look of socks.

Also, when you go out to buy new shoes (or socks), make sure they are made of a high quality material.

Lastly, throw your shoes away if they are totally worn. It will become increasingly difficult to get rid of the smell and more and more bacteria will take up residence in there.

Clearly, smelly shoes should be a thing of the past.

The above hints and tips should help every time, unless you don't have healthy feet. Get checked out by your medical professional and if you do have a fungal or bacterial infection, they will be able to prescribe you something for that.

You may think that these tips are simple common sense, but many people forget to actually do this.

Marina Smithson lives with her partner in Indianapolis and works for Jays Barely There Socks. She loves blogging about life, love and healthy feet.

visit their site, Smithson, M. D,  http://ezinearticles.com/