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.

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MALARIA - SYMPTOMS, TREATMENT AND PREVENTION

Malaria is caused by a parasite called Plasmodium. There are 5 species of Plasmodiumwhich infect humans:

Plasmodium vivax

Plasmodium falciparum

Plasmodium malariae

Plasmodium ovale

Plasmodium knowlesi which is less common.

Of these, Plasmodium falciparum infection is the most severe and can cause death in up to 10% of cases. It can be rapidly fatal. Pregnant women and children are especially at risk. Other types of malaria are less severe, but still may cause death.

Malaria is a notifiable disease.

How malaria is spread

The parasite is transmitted to humans by the bite of infected female Anopheles species mosquitoes.

The parasites multiply in the liver and the bloodstream of the infected person. The parasite may be taken up by another mosquito when it bites an infected person. The mosquito is then infected for the duration of its life and can infect other humans when it bites them.

Occasionally malaria is transmitted by blood transfusion. For this reason, people who have travelled to countries where malaria occurs may be deferred from giving blood for a short period. Malaria can also be transmitted from a mother to her fetus.

Malaria occurs in most tropical and sub-tropical areas of the world, including:

Africa

Central and South America

Asia (including southeast Asia)

Papua New Guinea

western Pacific islands.

Over a million people living in these countries die from malaria each year. Many thousands of tourists also get malaria during their travels to countries where malaria is present. Tourists often get severe illness because they have had no previous exposure to malaria and have no resistance to the disease.

SIGNS AND SYMPTOMS

In humans, the parasites live mostly in the red blood cells, but a very serious complication of Plasmodium falciparum malaria is infection of the brain.

Symptoms of malaria may include:

fever, which may come and go, or may be constant

chills

profuse sweating

malaise (feeling of unwellness)

muscle and joint pain

headache

confusion

nausea

loss of appetite

diarrhoea

abdominal pain

cough.

Diagnosis

Diagnosis is made by a blood test – sometimes it is necessary to repeat the test a number of times, as the parasites can be difficult to detect.

Incubation period

(time between becoming infected and developing symptoms)

Varies with the type:

P. falciparum: 9 to 14 days

P . vivax: 12 to18 days but some strains may have an incubation period of 8 to 10 months or longer

P. ovale: 12 to 18 days

P. malariae: 18 to 40 days.

These periods are approximate and may be longer if the person has been taking drugs taken to prevent infection.

Infectious period

(time during which an infected person can infect others)

Direct person-to-person spread does not occur.

A person remains infectious as long as the parasites are present in the blood. This may be several years if adequate treatment is not given. Parasites disappear from the blood within a few days of commencing appropriate treatment. Mosquitoes remain infected for life.

TREATMENT

Specific antimalarial treatment is available and must always be started as soon as malaria is diagnosed. There is increasing resistance to currently available drugs and treatment should be carried out by an infectious diseases specialist or other expert in the field.

PREVENTION

Exclusion from childcare, preschool, school or work is not necessary but cases should avoid being bitten by mosquitoes while they are unwell

there is no vaccine to prevent human infection by this parasite

personal protection and the environmental management of mosquitoes are important in preventing illness. See Fight the Bite for tips to on how to protect yourself.

Travel in countries where there is malaria?

Extensive international programs are undertaken in malarious countries to try to control this disease. For travellers, the following advice is given:

see a travel medicine expert before you go to get specific advice for the places you will be visiting

always take malaria prophylaxis drugs exactly as prescribed and take the full course. Be aware of their potential side effects

protect yourself from mosquito bites. Travel medical centres have good information on how to do this

be aware that no preventive measures are 100% effective, so always seek medical attention immediately if you develop a fever while travelling in, or after return from, a country where malaria occurs

always give your doctor the information about your travel if you become sick.

BREAST CANCER, CAUSES, SYMPTOMS & TREATMENT PART 2

Tests that examine the breasts are used to detect (find) and diagnose breast cancer.

A doctor should be seen if changes in the breast are noticed. The following tests and procedures may be used:

·         Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

·         Clinical breast exam (CBE): An exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual.

·         Mammogram : An x-ray of the breast.

Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called asonogram. The picture can be printed to be looked at later.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.

Biopsy : The removal of cells or tissues so they can be viewed under a microscope by apathologist to check for signs of cancer. If a lump in the breast is found, the doctor may need to remove a small piece of the lump. Four types of biopsies are as follows:

 Excisional biopsy : The removal of an entire lump of tissue.

  Incisional biopsy : The removal of part of a lump or a sample of tissue

  Core biopsy : The removal of tissue using a wide needle.

Fine-needle aspiration (FNA) biopsy : The removal of tissue or fluid, using a thin needle.

If cancer is found, tests are done to study the cancer cells.

• Decisions about the best treatment are based on the results of these tests. The tests give information about:
  ·         how quickly the cancer may grow.
  ·         how likely it is that the cancer will spread through the body.
  ·         how well certain treatments might work.
  ·         how likely the cancer is to recur (come back).
  Tests include the following:
  · Estrogen and progesterone receptor test : A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more estrogen and progesterone receptors than normal, the cancer may grow more quickly. The test results show whether treatment to block estrogen and progesterone may stop the cancer from growing.
  ·         Human epidermal growth factor type 2 receptor (HER2/neu) test: A laboratory test to measure how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs that target the HER2/neu protein, such as trastuzumab andlapatinib.
  ·         Multigene tests: Tests in which samples of tissue are studied to look at the activity of many genes at the same time. These tests may help predict whether cancer will spread to other parts of the body or recur (come back).
  o    Oncotype DX: This test helps predict whether stage I or stage II breast cancer that isestrogen receptor positive and node-negative will spread to other parts of the body. If the risk of the cancer spreading is high, chemotherapy may be given to lower the risk.
  o    MammaPrint: This test helps predict whether stage I or stage II breast cancer that is node-negative will spread to other parts of the body. If the risk of the cancer spreading is high, chemotherapy may be given to lower the risk.
  There are three ways that cancer spreads in the body.
  Cancer can spread through tissue, the lymph system, and the blood:
  ·         Tissue. The cancer spreads from where it began by growing into nearby areas.
  ·         Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  ·         Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
  Cancer may spread from where it began to other parts of the body.
  When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
  ·         Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
  ·         Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
  
  
  The metastatic tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bone, the cancer cells in the bone are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
  ·         There are different types of treatment for patients with breast cancer.
  ·         Six types of standard treatment are used:
  o    Surgery
  o    Sentinel lymph node biopsy followed by surgery
  o    Radiation therapy
  o    Chemotherapy
  o    Hormone therapy
  o    Targeted therapy
  ·         New types of treatment are being tested in clinical trials.
  o    High-dose chemotherapy with stem cell transplant
  ·         Patients may want to think about taking part in a clinical trial.
  ·         Patients can enter clinical trials before, during, or after starting their cancer treatment.
  ·         Follow-up tests may be needed
  
  

BREAST CANCER, SYMPTOM AND CAUSES Part1

DEFINITION

Breast cancer is cancer that forms in the cells of the breasts.

After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. Breast cancer can occur in both men and women, but it's far more common in women.

Public support for breast cancer awareness and research funding has helped improve the diagnosis and treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths has been declining, thanks to a number of factors such as earlier detection, new treatments and a better understanding of the disease.

SIGNS AND SYMPTOMS OF BREAST CANCER MAY INCLUDE:

·         A breast lump or thickening that feels different from the surrounding tissue

·         Bloody discharge from the nipple

·         Change in the size or shape of a breast

·         Changes to the skin over the breast, such as dimpling

·         Inverted nipple

·         Peeling, scaling or flaking of the nipple or breast skin

·         Redness or pitting of the skin over your breast, like the skin of an orange

When to see a doctor

If you find a lump or other change in your breast — even if a recent mammogram was normal — make an appointment with your doctor.

It's not clear what causes breast cancer. Doctors know that breast cancer occurs when some breast cells begin growing abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. The cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body.

Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma). Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells within the breast.

Researchers have identified things that can increase your risk of breast cancer. But it's not clear why some people who have no risk factors develop cancer, yet other people with risk factors never do. It's likely that breast cancer is caused by a complex interaction of your genetic makeup and your environment.

INHERITED BREAST CANCER

Doctors estimate that only 5 to 10 percent of breast cancers are linked to gene mutations passed through generations of a family. A number of inherited mutated genes that can increase the likelihood of breast cancer have been identified. The most common are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2), both of which increase the risk of both breast and ovarian cancer.

If you have a strong family history of breast cancer or other cancers, blood tests may help identify mutations in BRCA or other genes that are being passed through your family.

Consider asking your doctor for a referral to a genetic counselor, who can review your family health history. A genetic counselor can also discuss the benefits, risks and limitations of genetic testing with you.

A breast cancer risk factor is anything that makes it more likely you'll get breast cancer. But having one or even several breast cancer risk factors doesn't necessarily mean you'll develop breast cancer. Many women who develop breast cancer have no known risk factors other than simply being women.

Factors that are associated with an increased risk of breast cancer include:

·         Being female. Women are much more likely than men are to develop breast cancer.

·         Increasing age. Your risk of breast cancer increases as you age.

·         A personal history of breast cancer. If you've had breast cancer in one breast, you have an increased risk of developing cancer in the other breast.

·         A family history of breast cancer. If your mother, sister or daughter was diagnosed with breast cancer, particularly at a young age, your risk of breast cancer is increased. Still, the majority of people diagnosed with breast cancer have no family history of the disease.

·         Inherited genes that increase cancer risk. Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most common gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers, but they don't make cancer inevitable.

·         Radiation exposure. If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is increased.

·         Obesity. Being obese increases your risk of breast cancer.

·         Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.

·         Beginning menopause at an older age. If you began menopause at an older age, you're more likely to develop breast cancer.

·         Having your first child at an older age. Women who give birth to their first child after age 35 may have an increased risk of breast cancer.

·         Having never been pregnant. Women who have never been pregnant have a greater risk of breast cancer than do women who have had one or more pregnancies.

·         Postmenopausal hormone therapy. Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer. The risk of breast cancer decreases when women stop taking these medications.

·         Drinking alcohol. Drinking alcohol increases the risk of breast cancer.

Women with breast cancer may have appointments with their primary care doctors, as well as several other doctors and other health professionals, including:

·         Breast health specialists

·         Breast surgeons

·         Doctors who specialize in diagnostic tests, such as mammograms (radiologists)

·         Doctors who specialize in treating cancer (oncologists)

·         Doctors who treat cancer with radiation (radiation oncologists)

·         Genetic counselors

·         Plastic surgeons

What you can do to prepare

·         Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.

·         Write down key personal information, including any major stresses or recent life changes.

·         Write down your family history of cancer. Note any family members who have had cancer, including how each member is related to you, the type of cancer, the age at diagnosis and whether each person survived.

·         Make a list of all medications, vitamins or supplements that you're taking.

·         Keep all of your records that relate to your cancer diagnosis and treatment. Organize your records in a binder or folder that you can take to your appointments.

·         Consider taking a family member or friend along.Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.

·         Write down questions to ask your doctor.

Questions to ask your doctor

Your time with your doctor is limited, so preparing a list of questions will help make the most of your time together. List your questions from most important to least important in case time runs out. For breast cancer, some basic questions to ask your doctor include:

·         What type of breast cancer do I have?

·         What is the stage of my cancer?

·         Can you explain my pathology report to me? Can I have a copy for my records?

·         Do I need any more tests?

·         What treatment options are available for me?

·         What are the benefits from each treatment you recommend?

·         What are the side effects of each treatment option?

·         Will treatment cause menopause?

·         How will each treatment affect my daily life? Can I continue working?

·         Is there one treatment you recommend over the others?

·         How do you know that these treatments will benefit me?

·         What would you recommend to a friend or family member in my situation?

·         How quickly do I need to make a decision about cancer treatment?

·         What happens if I don't want cancer treatment?

·         What will cancer treatment cost?

·         Does my insurance plan cover the tests and treatment you're recommending?

·         Should I seek a second opinion? Will my insurance cover it?

·         Are there any brochures or other printed material that I can take with me? What websites or books do you recommend?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions that may occur to you during your appointment.

WHAT TO EXPECT FROM YOUR DOCTOR

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow time later to cover other points you want to address. Your doctor may ask:

·         When did you first begin experiencing symptoms?

·         Have your symptoms been continuous or occasional?

·         How severe are your symptoms?

·         What, if anything, seems to improve your symptoms?

·         What, if anything, appears to worsen your symptoms?