Chapter 25

Rusty Ulrich

Disease Report #5

August 1, 2003

Hepatitis A: The Yellow Belly Disease

History

According to the Center for Disease Control, there have been numerous outbreaks throughout the United States over the last few decades. There have usually been about 1-2 per year.

Description
Hepatitis A is a virus which infects the liver causing inflammation. It is the least serious of all the Hepatitis viruses since it does not lead to a chronic version of the disease. However, during the course of the disease, one’s liver stops functioning to a certain degree. The liver serves to remove toxins from the body so when the liver is not able to function properly then you get a lot of seemingly unrelated symptoms. About 100,000 people in the US are infected with the virus each year. The disease can affect anyone from ages 2 and older.

Signs and Symptoms

The symptoms are most prevalent in adults: jaundice (yellowing of the skin), fatigue, abdominal pain, loss of appetite, nausea, diarrhea and fever. Some patients will have a relapse of symptoms within 6-9 months.

Prognosis

Hepatitis A is not a chronic disease, and only about 0.1% of people die from it according to 1uphealth.com. The upside is that 85% of people recover after three months and 99% recover after six months.

Treatment

The main treatment for this disease is rest. It is best to avoid medications that make the liver work overtime, like tylenol. Alcohol and fatty foods should also be avoided.

Prevention and Control

The disease is transmitted through the blood, feces and other body fluids. The virus can be carried in food and water that is contaminated with blood or fecal matter. So it is best to avoid any food or water that one suspects as not being clean. Good hygiene practices after using the restroom is very important. Also, child care facilities are at great risk since diaper changes are frequent with children. Therefore, washing one’s hands before and after each change is a must.

There is a vaccine available that is administered in two stages. Protection begins four weeks after the first injection and the next one must be done within 6-12 months.

Sources

o Center for Disease Control (viewed 8/12/03): <http://www.cdc.gov/ncidod/diseases/hepatitis/a/index.htm>

o Hepatitis Information Network: 2000 (viewed 8/12/03): <http://www.hepnet.com/hepa.html>

o U.S. National Library of Medicine, National Institutes of Health (viewed 8/12/03): <http://www.nlm.nih.gov/medlineplus/hepatitis.html>

Chapter 25 Aston Sanders

Microbiology 2421

M U M P S

Mumps is a common childhood disease caused by a virus. It can be transmitted through saliva and respiratory secretions. Its portal of entry is the respiratory tract. From there it moves to target the parotid glands which are by the ears and cheeks. After about 3 days the glands begin to swell which is a characteristic of mumps. The virus then reaches the salivary glands through the blood. After ten days the virus can be found in the urine.

Symptoms of the mumps virus include: swelling of the parotid glands, fever and pain during swallowing. Orchitis, swelling of testis, can also occur in males past puberty. This can cause sterility. Ovaries and the pancreas can also swell. Meningitis is another unfortunate side effect of mumps.

Mumps can be diagnosed through ELISA techniques if needed, but most of the time it can be made simply by observation of the parotid glands. Mumps is not treaded with any medicine. It normally runs its course, but the patient will need soft foods and be kept hydrated. Ibuprofen can be used to alleviate pain.

The Measles Mumps and Rubella (MMR) vaccine is administered to everyone now to prevent the disease. Before the vaccine mumps was as common as the chicken pox. But once a person got the virus they have immunity to it.

Jing Yuan

Chapter 25- Periodontal Disease

1) History of Disease:

Description: Periodontal disease is a dental disorder that includes gingivitis and periodontitis, involving inflammation and infection of the ligaments and bones that support the teeth.

Identification: Bad teeth and gum existed since ancient time. Many fairytales describe the unsightly characters using crooked and missing teeth, which exemplifies periodontal disease.

2) Signs, Symptoms and Characteristics:

Signs:

Examination of the mouth and teeth by the dentist shows soft, swollen, red-purple gums. Deposits of plaque and calculus may be visible at the base of the teeth, with enlarged pockets in the gums. The gums are usually painless or mildly tender, unless a tooth abscess is also present. Teeth may be loose and gums may be receded. Dental X-rays reveal the loss of supporting bone.

Symptoms:

*swollen gums

*gums appear bright red

*gums appear shiny

*gums bleed easily

*blood on toothbrush even with gentle brushing of the teeth

*gums may be tender when touched but are painless otherwise

*breath odor

*loose teeth

Characteristics:
Periodontal disease is an inflammation or infection of the gums. Infection and inflammation spreads from the gums to the ligaments and bone that support the teeth. Loss of support causes the teeth to become loose and eventually fall out. Periodontal disease is the primary cause of tooth loss in adults. This disorder is uncommon in childhood but increases during adolescence.

3) Progress and Prognosis

Plaque and tartar (calculus) accumulate at the base of the teeth. Inflammation causes a pocket to develop between the gums and the teeth, which fills with plaque and tartar. Soft tissue swelling traps the plaque in the pocket. Continued inflammation eventually causes destruction of the tissues and bone surrounding the tooth. Because plaque contains bacteria, infection is likely and a tooth abscess may also develop, which increases the rate of bone destruction.

Removal of dental-plaque from inflamed gums may be uncomfortable. Bleeding and tenderness of the gums should reduce within 1 or 2 weeks after treatment. Good oral hygiene must be maintained lifelong or the disorder may recur.

4) Treatment:

The goal of treatment is to reduce inflammation, and to correct the conditions. Dental irritants such as rough surfaces of teeth should be repaired. It is important to have the teeth cleaned thoroughly. This may involve use of various instruments or devices to loosen and remove deposits from the teeth. Home oral hygiene is necessary after professional tooth cleaning to limit further destruction. Professional tooth cleaning is often recommended more frequently than the standard twice a year. Surgical treatment may be necessary. Deep pockets may need to be opened and cleaned. Loose teeth may need to be supported. Extraction (removal) of a tooth may be necessary for advanced periodontal disease so destruction doesn't spread to adjacent teeth.

5) Prevention and Control:

Good oral hygiene, including thorough tooth brushing and flossing, and regular professional dental cleaning, is the best means of prevention. The prevention and treatment of gingivitis reduces the risk of development of periodontal disease.

Hepatitis E

Hepatitis E is a viral disease that is a branch off of Hepatitis A and or Hepatitis B. Symptoms include malaise, anorexia, abdominal pain, arthralgia, and fever. The disease has approximately a two to nine week incubation period. The cause is partially unknown. It is said to be found in contaminated drinking water. It is able to be passed from person to person though fluids, fecal to oral and, it can also be passed person to person through water. It is said for it to be transmitted through food. No method is availably for foods to be tested for Hepatitis E as though it were coming from an animal.

Epidemics have been reported in Asia and North and East Africa. No epidemics have been reported in the U.S. The disease is mild and usually runs it’s course in about two weeks. It is said to have zero to one percent fatality usually only in pregnant women.

Luckily, like it’s kin diseases Hepatitis A, B, and C. It causes no liver damage and is in most developing countries with poor cleansing methods of water. Only one cases was reported in the U.S.

Rusty Ulrich

Disease Report #4

July 31, 2003

Pinworm Infestation

(Enterobiasis, Oxyuriasis)

History

There is no significant history of pinworm infestation based on my limited research.

Description
Pinworms are caused by a microorganism called Enterobius vermicularis. It can be seen with the unaided eye and appears white and very small. The worms themselves live in the large intestines. The female leaves the anus at night to lay eggs between the buttocks causing intense itching. The itching causes the infected person to scratch and get the eggs on their hands where they can later be spread to others. The eggs enter the digestive tract through the mouth and hatch in the small intestines and eventually make their way to the large intestines.

Pinworms are very common among children especially in densely populated urban areas. One article indicated that the incidence is over 20% of the US children.

Signs and Symptoms

For the most part, there are no symptoms of pinworm infestation aside from the intense itching associated with the female laying its eggs in the perianal area. However, the skin around the anus can become irritated after a lot of scratching causing pain, discomfort, possible loss of sleep and irritability. Vaginitis in small girls has been linked to pinworms.

Typically, the pinworms are diagnosed by visually inspecting the perianal area of the patient approximately 1-2 hours after going to sleep when the anal sphincter is relaxed. The female worms are approximately one centimeter long.

Prognosis

Pinworms are easy to treat, but re-infestation is very likely. But the treatment process can be done many times until the worms do not return.

Treatment

Pyrantel pamoate, Mebendazole, Pyrvinium pamoate and piperazine are all effective medications for killing the mature worms. Treatment will not kill the eggs which can survive for up to three weeks. So repeating the treatment two weeks after the first dose is suggested to kill newly hatched worms from any left over eggs. Without the follow up dose, infestation is extremely likely. One can also use various topical treatments to keep the itching down to a minimum.

Prevention and Control

While the entire family is being treated, washing hands before eating and after using the restroom is imperative. Bed sheets should be washed at least twice weekly. Also, toilet seats should be cleaned daily. It is also important to refrain from scratching around the infected area.

Sources

o American Academy of Family Physicians (viewed 8/12/03): <http://familydoctor.org/handouts/139.html>

o Ohio State University website (viewed 8/12/03): <http://www.biosci.ohio-state.edu/~parasite/enterobius.html>

o Center for Disease Control (viewed 8/12/03): <http://www.cdc.gov/ncidod/dpd/parasites/pinworm/factsht_pinworm.htm>

CHAPTER 25 Aston Sanders

Microbiology 2421

T A P E W O R M I N F E S T A T I O N

As far as I can tell, tapeworms have been around for a long time. They have a three step life cycle. First the adult releases cysticercus, eggs, through the feces. Second, the eggs are ingested in an intermediate host such as a cow, pig or fish. There they mature into larvae in the muscles of the host. Third, the larvae, lodged in the muscles of undercooked meat, are eaten by humans. They migrate to the intestine where they mature into adults.

There are three major types of tapeworms that affect humans the most categorized by their intermediate host: the beef, pork, and fish species. Taenia saginata the beef adult can reach 6m (18ft) or longer and can live fore at least 25 years within the intestinal tract of a human. The pork adult, Taenia solium have similar symptoms, but the pork tapeworm can produce the larval stage in humans instead of using an intermediate hosts. The eggs and larvae, called cysterci, migrate to organs and mature. This condition is called neurocysticercosis. The third type of worm is Diphyllobothrium latum, the fish tapeworm. It exists in pike, perch, trout and salmon.

The symptoms include abdominal pain and release of eggs and segments through the anus. Tapeworm can be diagnosed by examining the feces for eggs or segments of tapeworm. Oral medications are available for treatment. The leading medicine is niclosamide, but praziquantel and albendazole can also be used. The US government has created laws to prevent tapeworm outbreaks by regulating the feed of the animals. Other prevention methods can be taken by practicing good hygiene and cooking meat thoroughly.

Yersenia Gastroenteritis

Yersinia is responsible for the plague. During the 6th century AD, the plague took over the world over a 50-year period causing 100 million deaths. The "black death" It also took over Europe for about a five-year period. Once tested the disease is composed of Gram negative, bipolar staining coccobacilli. Plague is a disease that is primarily carried among rat populations and transmitted by infected fleas.

Two distinct forms of plague occur in human populations: Bubonic plague occurs within a week of being bitten by an infected flea. You get a red swollen bump and an infected lymph node. Seventy five percent of the people that get this die. Pneumonic plague occurs under crowded conditions when one person breathes in the infected cell from another person. This one has a shorter incubation period and has a ninety percent chance of death.

The only cure for this particular disease is control of the rat population and certain vaccines are available for those in high risk of yersenia Gastroenteritis.

Vibrio Gastroenteritis

History of Disease

Vibrio gastroenteritis is caused by the bacterium, Vibrio parahaemolyticus, which is the same family as the bacteria that cause cholera. It lives in saltwater and requires 2% or more sodium chloride for optimum growth [Tortora, 2002]. V. parahaemolyticus naturally inhabits coastal waters in the United States and Canada, and it is present in higher concentrations during the summer [CDC, 2000].

Signs and Symptoms

V. parahaemolyticus, when ingested, causes watery diarrhea often causing abdominal cramping, nausea, vomiting, fever, and chills. Usually, these symptoms occur within 24 hours of ingestion. Most people become infected by eating raw or undercooked oysters or crustaceans [CDC, 2000].

Progress and Prognosis

The illness is generally self-limited and lasts three days. Severe disease is rare and occurs more commonly in persons with weakened immune systems [CDC, 2000]. In those people suffering from liver disease, the mortality rate from septicemia may exceed 50% [Tortora, 2002].

Treatment

According to the Centers for Disease Control (CDC), treatment is not necessary in most cases of Vibrio gastroenteritis. Patients are urged to drink plenty of liquids to replace lost fluids. Even though there is no evidence that antibiotic treatment decreases the severity or length of the illness, they may be prescribed in a severe or prolonged illness. The antibiotics of choice are tetracycline, ampicillin, or ciprofloxicin [CDC, 2000].

Prevention and Control

Most infections caused by Vibrio gastroenteritis can be prevented by thoroughly cooking seafood, especially oysters. For instance, restaurants usually pasteurize raw oysters. Additionally, the CDC mentioned that when an outbreak is traced to an oyster bed, health officials recommend closing the oyster bed until conditions are less favorable for the bacterium, V. parahaemolyticus.

References

Centers for Disease Control (CDC): Division of Bacterial and Mycotic Diseases. “Vibrio parahaemolyticus.” www.cdc.gov.ncidod/dbmd/diseaseinfo. (March 29, 2000). [August 4, 2003].

Tortora, Gerard J., et. al. Microbiology: An Introduction. 7^th Edition. Benjamin Cummings, San Francisco, CA. 2002. pp. 696-697.

Microbial Diseases of the Digestive Tract

Hydatid Disease

Description: a tissue zoonotic infection caused by the ingestion of the Echinococcus granulosus tapeworm found in carnivorous animal feces especially dogs’ and wolfs’, where the adult helminths reside in the animal’s small bowels. The definitive hosts are wild and domestic canines, which become infected when it eats contaminated animal carcasses. The infection is generally found in third world regions and seldom found in the U.S. Cyst formation begins at the liver and can spread to the spleen, lungs, kidneys, and brain. Infection can also form in the bones and muscle. The preferred sites on the human host are the liver and brain. Because of the slow development rate, the disease can remain unevaluated for years, which is why mostly adults on average of 35 years of age are diagnosed with the pathogen.

Occurrences: not prevalent in the U.S., more common in South America, South Africa, New Zealand, Australia and Ice Land. But because of the current ease of world travel there is now an increase of occurrences in the U.S. Still, the rate remains at about 1 in a million cases, except in Alaska, which has an endemic region, and therefore has at least 1 infection per 100,000 inhabitants. Areas involved with sheep herding are mainly at great risk because of the large number of dogs used, and sheep are the intermediate host.

Signs/symptoms/characteristics: fever, abdominal pain, itching, cough and chest pain occur depending on the sight of infection. Swelling, inflammation, and neurological infection warning signs including headaches and seizures can also take place. Sensations of sharp needle sticks are felt as a result of skin infection, and or a feeling of weak muscles from larval influx or brain injury.

Progress/prognosis: larvae filled cyst formation at the liver spreads to other regions of the body. Renal flow blockage, cranial pressure, and obstruction of bile flow, and breathing difficulties become life threatening. Cyst rupture will further proliferate infection.

Treatment: there are several drugs that can be used to control the infection on animals. The effectiveness on people is not always reliable, and occasionally, surgical removal of cyst is necessary.

Prevention/control: washing hands with soap and water after petting pets is especially important. The pet may inadvertently contaminate its coat when rolling in the grass. Children are especially susceptible to this mode of transmission. Keep dirty hands away from the face. Avoid handling wild or stray animals. Lastly, treat pets with de-wormer on a regular basis as prescribed by veterinarian, and do not allow them to roam and or gain access to dead animals.

http://cancerweb.ncl.ac.uk/cgi-bin/omd?query=Hydatid+disease&action=Search+OMD

http://www.emedicine.com/med/byname/hydatid-cysts.htm

http://www.dpi.qld.gov.au/health/3893.html

http://www.dpd.cdc.gov/dpdx/HTML/Echinococcosis.htm

Maria Nguyen

Biol 2421

Hepatitis C

Hepatitis C is an inflammation of the liver caused by the hepatitis C virus. It is the most common chronic blood-borne infection in the United States. Hepatitis C has been referred to as a “Silent Epidemic,” since it usually progresses slowly over many years. Most people who are infected with hepatitis C are not aware of any noticeable symptoms for as long as one to two decades after they are infected. In fact, by the time symptoms appear, the virus has probably already begun to damage the liver. Liver failure from chronic hepatitis C is one of the most common causes of liver transplant in the United States.

Once the hepatitis C virus infects a person’s blood, it enters the cells in the liver and begins to reproduce itself rapidly. Some people in the acute stage may experience extreme tiredness, weakness, loss of appetite, and jaundice. They may also complain of abdominal discomfort, which may be a sign that the liver is inflamed and tender. With or without symptoms, initial damage to the liver cells can take place soon after infection, within 2 to 8 weeks, manifested by elevation of alanine aminotransferase in the blood.

If you think you nay be at risk for hepatitis C, it is very important that you visit your doctor as soon as possible to receive a proper diagnosis and to learn about treatment options. The goals of hepatitis C treatment are to clear the virus from the blood and slow the progression of the disease. Even if the virus is not cleared, treatment can help prevent further liver damage.

Molly Huynh

Microbiology 2421

Disease Report T/TH 8-10

July 28, 2003

E. Coli Gastroenteritis

Certain strains of E. coli can be pathogenic. The cells are normally harmless and are found in the intestinal tract of humans. “They also produce toxins that cause gastrointestinal disturbances, collectively termed E. coli gastroenteritis.” The disease can cause severe diarrhea and can be treated by oral rehydration. If a patient needs a more potent treatment, antimicrobial drugs can be taken. Eating something that is under cooked can be very dangerous. E. coli can be ingested and my cause blood in the urine and lead to kidney failure, in children. Because this is such a common disease, scientists are developing a better method of detecting the disease. This new method will be less time consuming than culturing in laboratories.

Amber Smith Dental Caries: Chapter 25

Teeth are unlike any other exterior surface of the body. Due to their

makeup, accumulations may form with mass amounts of microorganisms. This

accumulation, called dental plaque, is involved in the formation of dental

caries, or tooth decay. The most important cariogenic (caries-causing)

bacterium is Streptococcus mutans, a gram-positive coccus. Symptoms of

dental caries can be build up on the tooth, or severe pain in the tooth,

gums or jaw.

The growth of caries depends on the attachment of S. mutans to the tooth.

Dextran is produced, which is a gummy polysaccharide of glucose molecules. A

large accumulation of dextran and bacteria start to form dental plaque on

the teeth. The bacteria favor areas of the teeth such as between teeth,

where it is hard to clean. Dental plaque can produce acid resulting in

softening of the enamel. Enamel low in fluoride will be more susceptible to

the acid and it?s effects. That is why fluoride is part of toothpaste and

water, and has significantly lowered the incidence of tooth decay. If the

bacteria work its way through the enamel, they can penetrate into the tooth,

causing major damage. The decay of the tooth will eventually lead to the

pulp, which connects with the tissues of the jaw and contains the blood

supply and nerve cells. Once this is reached, a root canal must be done to

remove the infected tooth and tissue and start antibiotic therapy. Treatment

for less serious tooth decay, such as plaque build up, relies on the dentist

to work on the teeth. Further than that, as stated previously, dental caries

usually require some sort of procedure to remove the tooth or some part of

it.

While tooth decay is a common problem these days, it was very uncommon up

until about the seventeenth century. What sparked this problem seems to

relate to the introduction of sugar, or sucrose, into our diet. The best

preventions of dental caries are lower intakes of sucrose, using fluoride,

and a basic dental regiment of brushing, flossing and professional cleaning

regularly.

Priscilla Maya Clostridium Perfringens Gastroenteritis

Clostridium perfringens gastroenteritis is the focus of my paper today. I will
discuss some of the diseases' background, where the disease is most likely found, some
of the symptoms, ways to prevent the disease, and treatment options.
"Clostridium perfringens is a Gram-positive bacterial pathogen that has the
capability of forming an endospore. The dormant spores can change to potentially
harmful vegetative cells if exposed to cooking temperatures and allowed to stand at
temperature between 41 degrees Fahrenheit and 120 degrees Fahrenheit, especially in the
temperature range from 70*F and 120*F." The disease is most likely to be found in such places as "soil, sediment, in the intestines of domestic and feral animals, and humans,
areas near sewage, and raw food. The bacteria Clostridium perfringens thrives in
certain foods like "meats, stews, soups, gravies, milk, seafood, potato salad, and macaroni and cheese." This food borne illness also resides in such places as "hospitals, nursing
homes, school cafeterias, and prisons."

The population most at risk for contracted the disease include the young and elderly.

"Clostridium perfringens gastroenteritis can result after 8 to 22 hours of
consuming food contaminated with large numbers of the vegetative form of Cl.
pefringens. Symptoms felt by the ill include; "abdominal cramps, pain, diarrhea, and
flatulence." These symptoms usually last only a day. It is for this reason the illness is also known as the "24-hour flu."

One way to prevent the illness is by cooking foods at
140*F or higher and "bed rest with convenient access to toilet or bedpan is a
desirable treatment."

References:

Gastroenteritis. The Merck Manuel. 1995-2003. http://www.merck.com/pubs/mmanual/section3/chapter28/28a.htm.

Preventing Foodborne Illness Associated with
Clostridium perfringens. EDIS.

http://edis.ifas.ufl.edu/BODY_FS101.

Cynthia Sanchez

M-W 8:00-10:00

Helicobacter pylori Peptic Ulcer

It was generally thought that stress, spicy foods, acid, and other behavioral factors contributed to the formation of a peptic ulcer. A peptic ulcer is a sore or hole in the lining of the stomach or duodenum. Previously patients were given long term medications for ulcers, however it could only heal temporarily but it could not heal the infection. Even though acidity was reduced ulcers particularly those caused by H. pylori reoccurred. However, in 1982 two Australian physicians, Robin Warren and Barry Marshall were the first to link Helicobacter pylori and ulcers. H. pylorus is a spiral shaped bacteria that is generally found in the mucous layer or epithelial lining of the stomach. This bacterium can cause up to 90% of duodenal ulcers and up to 80% of peptic ulcers.

H. pylori can cause chronic active or chronic persistent atrophic gastritis. The general symptoms are a gnawing or burning pain in the stomach which occurs when the stomach is empty, between meals, and in the early morning hours. The pain can last up to minutes or hours and is usually relieved by eating or taking antacids. Less common symptoms experienced are nausea, vomiting, loss of appetite, and bleeding. The method of infection is not known but it is believed to be transmitted by fecal-oral or oral-oral routes. Contaminated water sources and less common contaminated endoscopes could be reservoirs for H. pylori. There are several methods to discover whether H. pylorus is the cause of peptic ulcers. Serological tests are used to measure the bacterium’s IgG antibodies. A breath test can also be used which can measure 13C or 14C labeled urea to drink. The bacterium is effective in metabolizing urea releasing carbon and measuring Co2 levels. The last resort is an upper esophagogastroduodenal endoscopy which tests a biopsy of the stomach or duodenum.

The current treatment used lasts up to 10-14 days with the use of one or more antibiotics. The antibiotics used are Amoxicillin, Tetracycline, Metronidazole, Clarithromycin plus Ranitidine bismuth citrate, bismuth sub salicylate, or a proton pump inhibitor. By using the H2 blocker and the proton pump inhibitors it can alleviate ulcer related symptoms, inflammation of the stomach lining, and enhance the efficacy of antibiotics against the bacterium. Antibiotics used in triple therapy and for longer periods of time are more effective than double therapy and short term use in curing peptic ulcers.

Since the cause of the development of H. pylori is not yet known recommendations for prevention have not yet developed. In general washing hands, eating properly prepared foods and drinking water from safe sources are all recommended to prevent possible infection of the bacterium.

Ascariasis

The nematode Ascaris lumbricoides cause ascariasis. It infects more than 4 million individuals, most of who are immigrants from developing countries. It is found most
commonly in countries with poor sanitary conditions. Ascaris species is transmitted by fecal-oral spread, primarily from ingestion of products or food contaminated with parasite eggs. Ascaris larvae hatch from swallowed eggs in the intestine, and migrate through the blood to the pulmonary circulation. The larvae then penetrate then
penetrate the alveoli 1-2 weeks later as third-stage larvae and migrate up the tracheobronchial tree. At this point the host swallows the larvae, which then develop into adult worms in the intestine. This disease results in pulmonary disease, which includes cough or wheezing, fever dyspnea, fleeting patchy pulmonary infiltrates, and rarely hemoptysis. Ascariasis may also cause Intestinal disease, which is mostly asymptomatic, with the most common symptom as colicky abdominal pain. Localized pain may suggest complete IO or appendicitis. Migrating worms have also been reported to cause intestinal perforation. Another cause of the bacteria is Biliary tract disease. Migration of a single adult worm may obstruct the biliary tree, leading to biliary colic, cholangitis, or gallstone formation. There are different treatments that can be administered depending on where the worms are located. If pulmonary disease occurs, appropriate bronchodilators and corticosteroid should be used. If Intestinal obstruction occurs, surgery is often the only treatment, especially with high worm loads. To avoid discomfort doctors usually urge patients to avoid spicy and peppery food because these foods may induce migration of the worms in the intestine.

Ergot Poisoning

Ergot poisoning is caused by the fungus Claviceps purpurea. The disease causes ergotism in livestock if hays or grains are infected. Ergot occurs every year on
cereals and grasses, and is more prevalent in rye and triticale. The most common sign of ergot is the dark purple to black sclerotia found replacing the grain in the heads of cereals and grasses just prior to harvest. The ergot disease occurs abundantly during wet seasons. The wet weather and wet soils favor germination of the ergot bodies.

Ergot is toxic to animals, the most susceptible being cattle. Two well known forms of ergotism exist in animals, an acute form characterized by convulsions, and a chronic form characterized by agalactia and lack of mammary gland development, prolonged gestations, and early foal deaths in mares fed heavily contaminated feed. Symptoms of convulsive ergotism include heyperexcitability, belligerence, ataxia or staggering, lying down, convulsions and backward arches of the back. Symptoms of gangrenous
ergotism involve the extremities of the animal including the nose ears tails and limbs. For humans consumption of food contaminated with Ergot can cause vomiting, diarrhea,
hallucinations, and may lead to gangrene in serious cases. As recently as 1951 there was an outbreak of the disease in s small town in France. People who bought fresh bread from a local bakery started experiencing burning sensations in their limbs, began to hallucinate. Many other outbreaks were reported, and the chemical said to cause the hallucinations is actually LSD. Although Ergot can cause many problems it has both medical and recreational uses for many.

Cholera

Kenneth Cattles

Millions of people have been killed by cholera since it emerged out of the filthy water and living conditions of Calcutta India in the early 1800’s. Since then, there have been a total of eight cholera pandemics. The fist cholera pandemic of 1817-1823 spread from India to Southeast Asia, Central Asia, the Middle East and Russia leaving hundreds of thousands of dead in its wake. The recent cholera epidemic in Pohnpei, which was part of the eighth and current pandemic, added some more sad numbers to the tragic statistics of cholera. In this year, since January there have been cholera outbreaks in Peru, southern Africa and the Marshall Islands. An English doctor named John Snow in 1854, using death certificates, was able to trace the spread of cholera in one area of London to the now infamous Broad Street water pump, thereby pointing to sewage-contaminated water as a carrier of something that cause cholera. Also in 1854 an Italian doctor Filippo Pacini was the first to discover the cholera bacteria (Vibrio cholerae) but the Italian medical community, which still subscribed to the miasmatic theory of illness, ignored his discovery. It was in 1883 when Robert Koch discovered the cholera bacteria again.

Cholera is an acute illness characterized by watery diarrhea that is caused by the bacterium Vibro cholerae. It is spread by eating food or drinking water contaminated with the bacteria. Because of an extensive system of sewage and water treatment in the U.S., Canada, Europe, Japan, and Australia, cholera is generally not a concern for visitors and residents of these countries.

In the small intestine, the cholera bacteria rapidly multiply and produce toxins that cause a large volume of water and electrolytes to be secreted into the bowels and then to be abruptly eliminated as watery diarrhea. Vomiting may also occur. Symptoms will appear one and three days after the contaminated food or water has been ingested.

Most cases of cholera are mild, but about 1 in 20 patients experience severe, potentially life-threatening symptoms. Severe cases, fluids can be lost through diarrhea and vomiting at the rate of one quart per hour. This can produce a dangerous state of dehydration unless fluids and electrolytes are rapidly replaced.

The key to treating cholera is in preventing dehydration by replacing the fluids and electrolytes lost through diarrhea and vomiting. The discovery that rehydration could be accomplished orally revolutionized the treatment of the cholera worldwide. The World Health Organization has developed an inexpensive oral replacement fluid containing appropriate amounts of water, sugar, and salts that are used worldwide. Replacing fluids can also be accomplished intravenously. Recovery usually takes 3-6 days.

The best prevention for cholera is to establish good sanitation and waste treatment systems. A cholera vaccine exists that can be given to travelers and residents of areas where cholera is known to be active, but the vaccine is not highly effective. The United States Center for Disease Control and Prevention do not currently recommend cholera vaccination for travelers. Some prevention tips are: Boil it, Cook it, Peel it, Forget it (Raw food), and Stay out of it (polluted water).

Shigellosis

Stephanie Penn

This is another disease which is most common among toddlers, and secondarily, among adults within close contact. It is an infectious disease caused by a Shigella bacterium, resulting in abdominal cramps, fever, and bloody diarrhea within five to seven days of contact. Shigella sonnei is responsible for the majority of shigellosis in the United States, while Shigella dysenteriae type I causes deadly epidemics in developing countries. Shigella bacteria are named for the Japanese scientist, Shiga, who first discovered them over a century ago. Twenty-five thousand cases of Shigellosis are reported yearly in the United States, and almost four hundred and fifty thousand cases are suspected to occur. The bacteria are transmitted from infected feces to someone’s mouth. This can occur through contact with unwashed hands, food contaminated by flies or sewage, contaminated drinking or swimming water, or the hands or diapers of children who aren’t completely toilet-trained. Shigellosis is commonly spread in day care centers. The resulting diarrhea may be severe enough to require hospitalization in the young and elderly. It may be treated with antibiotics like ampicillin, but due to increasing resistance among various forms of Shigella, antibiotics should be avoided whenever possible.

Mary E. Tombiri

Online Research #5

Chapter 25

Staphylococcal Food Poisoning

The staphylococcal bacteria is most commonly thought of as a organism that effects the skin, but it can also cause food poisoning which is what I will focus on in this paper. Alan Greene MD FAAP says this about Staphylococcal Food Poisoning, “This organism is a common cause of skin infections, from impetigo to pimples to boils. This can get into food from handling. Warm food (100 degrees) is the ideal place for the bacteria to grow and produce a toxin. The toxin is not destroyed by cooking”.

The University of Arizona’s College of Agriculture and Life Sciences says that symptoms of Staph Food Poisoning will begin to appear one 1 to 8 hours after the food has been eaten. It says that the illness can last anywhere from 6 to 24 hours. The symptoms include nausea, vomiting, abdominal cramping and exhaustion. Severe cases can take two or more days to recover, but in all cases, the prognosis good.

According to the University of Arizona, the ways in which one can prevent themselves from becoming ill with Staph Food Poisoning, includes: Washing hands thoroughly before handling food. Use gloves if you have a cut on your hand or in the place of thorough hand washing. Thoroughly clean all countertops or places that come in contact with food and food should be kept warm at temperatures of 140 degrees and be refrigerated at 40 degrees.

An important note to be included is that Camille Kotton MD, of the Infectious Disease Division of Massachusetts General Hospital says that this disease is very common in the United States.

Campylobacter gastroenteritis

Michael Neeley

History

Campylobacter infection is a type of gastroenteritis caused by a bacterium known as Campylobacter. All age groups can be affected, but infection is more common in children under five years of age, young adults and the elderly. The elderly typically form more severe symptoms. Symptoms occur two to five days after infection.

Signs and Symptoms

Campylobacter bacteria are found in the feces of many animals and humans. People become infected when Campylobacter bacteria are ingested. Examples of ways a person can get infected include:

· Eating undercooked meat, especially chicken.

· Drinking unpasteurised milk or drinking water contaminated with Campylobacter.

· Eating cooked food, which has been cross-contaminated with Campylobacter bacteria from raw food.

· Handling infected animals and not washing hands afterwards.

· People with Campylobacter bacteria in their feces do not wash their hands properly after going to the toilet. Contaminated hands can then contaminate food, which may be eaten by others, and surfaces that may be touched by others.

· Hands become contaminated when changing the diaper of an infected infant.

Symptoms of infection include nausea and vomiting, stomach cramps, fever, and diarrhea. Sometime diarrhea may contain blood or mucous.

Prognosis

Most symptoms are alleviated within a week of a normal, healthy individual. In 1 in 1000 cases, Guillain-Barre syndrome, an autoimmune disorder characterized by temporary paralysis, has been linked to Campylobacter infections.

Treatment

Antibiotics are usually administered, such as tetracycline, ampicillin, or erythromycin. Resistance to antibiotics has been reported.

Prevention and Control

Prevention is relatively easy. Keep all kitchen and bathroom surfaces clean. Make sure to wash hands thoroughly when handling food, as well as silverware, and dishes. Be especially thorough in cleaning when handling raw meat. Disinfect cutting boards.

References

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Gastroenteritis_campylobacter?OpenDocument

Tortora, Gerald J., et al. Microbiology: An introduction. Pearson Education Inc. 2002.

Chapter 25 : Salmonellosis

John Garcia

Description

Salmonellosis is a disease produced by approximatley 2000 serotypes of Salmonella. These diseases are found worldwide and are usually manifested as a self-limiting gastroenteritis. Their pathogenicity are due to toxin productions and their ability to invade intestinal mucosa. They can infect a variety of animals, having a large animal reservoir with S.typhi being specific to humans. The bacteria itself can be found in water, soil, animal feces, raw meats, poultry, and eggs. Usually limited to the intestinal tract the disease can also spread to blood or bone of the host body. Salmonella is capable of causing typhoid fever, the sypmtoms of which include fever, abdominal pain, headache, malaise, lethargy, skin rash, constipation, and delirium. Salmonella is usually transmitted to humans by food contaminated with animal feces. Salmonella can be found in some pets, and it seems reptiles are a normal carrier.

Signs and Symptoms:

Symptoms include nausea, vomiting, abdominal cramps, diarrhea(sometimes bloody), fever, and headache. Since so many different types of illness can cause these symptoms, salmonella should be diagnosed by laboratory tests which can identify the bacteria in an infected persons stool.

Two common types of salmonella are typhimurium and enteriditis. They have been reported for more than 100 years. A new strain, DT104, has been proven resistant to seven different antibiotics that would normally kill any salmonella strain.

Progress and Prognosis:

Symptoms can occur within 48 hours of contamination but are usually apparent within 24 hours. Very little salmonella bacteria is needed to cause infection, but not everyone is susceptible. Factors such as age, general health, and immune system status all play a role in whether or not someone will be affected.

Acute symptoms may last 1 or 2 days or may be prolonged; salmonellosis usually takes care of itself in 5 to 7 days.

Prevention:

Salmonella is almost always found in animal foods, raw or undercooked eggs, poultry, and meat. For this reason none of these foods should be eaten raw. They should be cooked thoroughly, until they are no longer pink in the middle. Certain desserts such as; tiramisu, homeade ice cream, chocolate mousse, cookie dough, and frostings all contain raw eggs and should be avoided. Unpasteurized milk and juices can also be contaminated with salmonella.

Egg-associated salmonellosis is a health problem in the United States because the bacteria can live inside normal-looking eggs that we buy in a grocery store. Salmonella can grow within the ovaries of healthy hens and contaminates the eggs before the shells are formed.Stricter guidlines were implemented in the 1970's to ensure that the outside of eggshells were cleaned before distribution. Grade A eggs can still be infected with Salmonella and present a danger when raw or uncooked eggs are consumed. Sunny-side-up and poached eggs with soft center still pose a risk of infection.

Cross-contamination is the probably one of the most common and yet avoidable means of transmission of Salmonella. Hands, cutting boards, counters, and knives should be washed completely, preferably with antibacterial soap or steamed, after handling uncooked foods, especially meats.

Treatment:

If the infection is not acute and the patient has a healthy immunce system, the usual treatment is to let the salmonellosis run its course. No antibiotics should be taken unless the patient is a young infant or in a high-risk group and immune system is unable to fight off the infection.

Simple treatments of acetaminophen to reduce fever and relieve cramping are appropriate. Due to diarrhea and vomiting, dehydration is possible and special care should be taken to ensure patient is well hydrated.

Whitney Lowther 8/07/03

Bill 2421- Albin Disease Report Ch 25

Bacillus cereus Gastroenteritis

The term “gastroenteritis” is a general term for infection or irritation of the digestive tract, particularly the stomach and intestine. It can be caused by a variety of organisms, even viruses. Bacterial gastroenteritis is a very common problem, with approximately 8 million doctor visits and 250,000 hospitalizations in the US. Episodes of gastroenteritis usually do not occur at random but in outbreaks. There are several possible organisms that can cause gastroenteritis, including Bacillus cereus. The type of organism causing the illness causes different characteristics in stool samples. For example, if B. cereus was the culprit of the gastroenteritis, the patient would be infected in the small intestine and their stool would be watery, not bloody, pH<5.5, and come out in large amounts. Other organisms might infect the large intestine, and therefore cause different characteristics of the stool. Onset of the disease is also dependent on the type of organism causing the sickness. In the case of B. cereus and similar preformed toxin, symptoms will usually occur within 6 hours of ingestion of the toxin. An infection by B. cereus usually lasts 1-2 days and includes vomiting and abdominal pain, but no fever. There are a large variety of sources from which toxins can be ingested. Each toxin, or group of toxins, usually resides in specific sources. Patients who become ill with B. cereus gastroenteritis almost always obtain the toxin from contaminated fried rice.

Symptoms displayed by all patients with gastroenteritis include dehydration, abdominal pain, Borborygmi (significant increase in peristaltic activity), and possibly malnutrition in chronic cases. To diagnose which toxin is causing a patient’s gastroenteritis, various lab tests are performed on stool samples. Factors such as pH, presence/absence of blood, and presence/absence of leukocytes can determine where the infection is taking place and which organism is causing it. In the case of preformed toxins such as B. cereus, it is best to culture the food eaten by the patient to yield results, as rapid onset of the disease may not allow time for the toxin to exist in the GI tract. Treatment for gastroenteritis is usually supportive in nature, as patients’ diarrhea is usually self-limiting. Rehydration is the most important step in treatment. It is important to start with very small amounts to prevent further vomiting (if present) and gradually increase the amount of fluid taken in at one time. For B. cereus infections, no antibiotics are necessary for treatment, but vancomycin and clindamycin can be administered in severe cases.

Prognosis is excellent with proper management of the gastroenteritis. The most common cause of mortality from gastroenteritis is dehydration, followed by malnutrition/malabsorption. Once malnutrition begins, prognosis becomes more and more grim. The best way to prevent illness from gastroenteritis is to follow proper food preparation and storage techniques.