Smileband health issues

A study of more than 10,000 young people found that e-cigarettes act as a gateway to the real thing, making those that use them 2.5 times more likely to start smoking cigarettes.  The e-liquid in e-cigarettes contains nicotine, and some teenagers showed signs of addiction within one months of starting to use the devices. 

Cigarettes have fallen relatively out of favor with teenagers, but this research follows recent National Institute of Drug Abuse findings that vaping is increasingly popular with the age group, many of whom are not sure what exactly they are smoking.  

The study authors found that all cigarette alternatives raised the odds that the teenagers would later try cigarettes too, suggesting that changes to policy are needed to discourage young people from taking up any for of smoking. Other alternatives, including hookahs, non-cigarette combustible tobacco such as cigarillos or smokeless tobacco, trigger conventional smoking just as quickly.

The study of teenagers is the first time scientists have compared the trendy products simultaneously with subsequent cigarette use, and follows other recent research that has shown the direct health risks of e-cigarettes. 

Studying the effect of e-cigarettes on the behavior of teenagers is crucial because, as the study points out, 90 percent of adults who smoke tried their first cigarette before they were 18.  

At the outset of teen the study, none of the 12- to 17-year-old male and female participants had smoked a cigarette. The researchers followed up with them 12 months later. 

Study author and University of California, San Francisco dentistry professor Dr Benjamin Chaffee said: 'We estimated that 'ever use' of e-cigarettes was associated with 2.53 times greater odds of subsequent cigarette use.'

He added: 'Among youths who had never smoked a cigarette at baseline, adjusted odds of any cigarette use initiation were approximately double for ever users of e-cigarettes, hookah, non-cigarette combustible tobacco and smokeless tobacco compared with never users.

'Odds of past 30-day cigarette use at follow-up were also approximately double for ever users of e-cigarettes, hookah, non-cigarette combustible tobacco and smokeless tobacco compared with never users.'

Dr Chaffee, of the Center for Tobacco Control Research and Education at the University of California, San Francisco, added that the use of more than one product increased the risk even more.

He said non-cigarette tobacco use among teenagers increased between 2011 and 2015, as e-cigarettes and hookahs became increasingly popular. 

Smileband health issues

Overview

Legionnaires' disease is a severe form of pneumonia — lung inflammation usually caused by infection. Legionnaires' disease is caused by a bacterium known as legionella.

You can't catch legionnaires' disease from person-to-person contact. Instead, most people get legionnaires' disease from inhaling the bacteria. Older adults, smokers and people with weakened immune systems are particularly susceptible to legionnaires' disease. 

Symptoms

Legionnaires' disease usually develops two to 10 days after exposure to legionella bacteria. It frequently begins with the following signs and symptoms:

• Headache
• Muscle pain
• Chills
• Fever that may be 104 F (40 C) or higher

By the second or third day, you'll develop other signs and symptoms that may include:

• Cough, which may bring up mucus and sometimes blood
• Shortness of breath
• Chest pain
• Gastrointestinal symptoms, such as nausea, vomiting and diarrhea
• Confusion or other mental changes

Although legionnaires' disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.

A mild form of legionnaires' disease — known as Pontiac fever — may produce signs and symptoms including a fever, chills, headache and muscle aches. Pontiac fever doesn't infect your lungs, and symptoms usually clear within two to five days.

Smileband health issues

Legionellosis is a respiratory disease caused by Legionella bacteria. If the bacteria cause pneumonia, the condition is called Legionnaires' disease. If the bacteria cause a less serious infection that presents like a mild case of flu, the condition is called Pontiac fever.

Both Legionnaires’ disease and Pontiac fever are initially characterized by:

• anorexia
• malaise
• myalgia
• headache

Within a day, there is usually a rapidly rising fever and chills. Fevers commonly reach 39˚C-40.5˚C (102˚F-105˚F). A nonproductive cough, abdominal pain, and diarrhea are common symptoms. In Legionnaires’ disease, a chest x-ray may show patchy or focal areas of consolidation that may progress to bilateral involvement and ultimately to respiratory failure.

Over the last 5 years, Arizona has reported on average 60 cases of legionellosis a year.

 

Arizona 5 year median: 69 cases

 

Transmission

Legionella is transmitted via aerosol inhalation from contaminated water sources or through aspiration. It is not transmissible person-to-person.                                                                                                      Lab Tests & Specimen Info

Test*	Specimen
Culture	Lung Biopsy,  Lung Exudate,  Pleural Fluid,  Transtracheal Aspirate, Sputum, Bronchial Washing
Immunoassay EIA  (this test only  identifies serotype 1)	Urine
DFA	Lung Biopsy,  Lung Exudate, Pleural Fluid, Transtracheal Aspirate, Sputum,  Bronchial Washing
PCR	Bronchial Lavage,  Throat Swab,  NP Swab
IgG/IgM  Serology	Serum

  Isolation Precautions

Standard Precautions are recommended.

If case is healthcare-associated, surveillance efforts for additional cases should be enhanced by the infection control official at the facility.

Prevention for Patients
Prevention includes:

• Maintaining water systems where the bacteria can grow including drinking water systems, hot tubs, decorative fountains, and cooling towers ( or air-conditioning units for large buildings).

Smileband Health issues

Doctors in the UK have warned that it could be the worst outbreak of the bug in 50 years, as official figures revealed cases more than doubled in just one week.

Government statistics show 1,111 people were struck down with flu as temperatures dropped last week - a 156 per cent jump on the previous seven days. Although the number of flu-related deaths recorded in Ireland so far is under ten, 73 people have been hospitalised and the Irish Health Service Executive is urging  people to get vaccinated.

In a statement, the executive said the number of reported cases of flu had increased in the week before Christmas and that flu 'is now actively circulating in Ireland'. 

Director of the HSE's Health Protection Surveillance Centre Dr Kevin Kelleher told RTE the executive has been informed of a 'small number of deaths directly related to influenza (less than ten)' in the last two weeks. 

The executive is urging people, particularly those in high-risk groups, to make sure they are vaccinated.

These include people aged 65 and over; anyone with a chronic illness; all pregnant women as well as people in care homes or long stay facilities.

Meanwhile, figures released by Public Health England show a sharp rise in cases, triggered by a surge in two aggressive subtypes attacking the population simultaneously. The H3N2 subtype triggered two and a half times the normal number of cases in Australia. Britain's flu season tends to mirror what has happened there.

Experts fear the virulent flu strain, which has now reached the UK, could prove as deadly as the Hong Kong flu in 1968, which killed one million people.

Usually, just one subtype, either influenza A or B, is responsible for the majority of cases. It spreads much easier in the cold weather.

But last week 522 cases of influenza A and 546 of influenza B were recorded across England and Wales. Some 43 cases are yet to be identified. 

However, this winter's outbreak shows no signs of slowing down, as flu cases are expected to rocket even further in the coming weeks. 

However, this winter's outbreak shows no signs of slowing down, as flu cases are expected to rocket even further in the coming weeks.  

Cases this year are almost 10 times higher than they were at the same point in 2015, according to the PHE data. Just 132 cases were recorded then.

But in 2015, Government figures suggested that the winter flu played a part in more than 16,000 deaths. Only 577 deaths were recorded in the previous winter. 

The total recorded in week 51 is also double that of last year, when 583 cases, mainly of the H3N2 subtype, were reported. 

The sharp rise in flu is only expected to cause further problems for the NHS, with cases of the winter vomiting bug also continuing to soar.  

Smileband Health issues

Ehrlichiosis is a broad term used for infections caused by Ehrlichia bacterial species. The symptoms commonly seen with these infections include fever, headache, chills, malaise, muscle pain, nausea, vomiting, diarrhea, confusion, rash, and conjunctival injection. Symptoms will vary for individuals.

 

Ehrlichiosis can be a very serious disease if not treated correctly. Individuals who are immunocompromised are more likely to have severe disease.

 

Arizona will typically see 1 to 4 cases of ehrlichiosis reported each year.

 

Arizona 5 year median: 2 cases

 

Transmission

Transmission occurs from the bite of an infected tick. Blood transfusions and organ transplantation are also possible modes of transmission.

Incubation period is between 5 to 21 days.

Lab Tests & Specimen Info

Test*	Specimen
PCR (this test should be used during the acute phase of the disease)	Whole Blood
Serology (Acute and convalescent specimens should be sent and the convalescent should be collected 2-4 weeks after the acute)	Serum
Microscopic examination (this test should be used during the first week of illness)

 Isolation Precautions

Ehrlichiosis is not a communicable disease. 

Standard precautions are recommended in healthcare settings. 

Prevention for Patients
Reducing contact with ticks:

• use insect repellent
• wear long sleeves and pants
• avoid wooded areas and brushy areas with high grass
• perform thorough tick checks after spending time outdoors

Public Health Actions
If an individual develops ehrlichiosis within a month of receiving a blood transfusion or solid organ donation this case should promptly be reported to public health so an investigation can be completed. 

Smileband Health issues

Brucellosis is an infectious disease caused by bacteria. The main reservoir for Brucella species is animals. The most common species are usually associated with cattle, sheep, goats, pigs, and rarely dogs.

In the acute form of illness (less than 8 weeks from illness onset), nonspecific and "flu-like" symptoms may include:

• fever
• sweats
• malaise
• anorexia
• headache
• myalgia
• back pain

In the undulant form of illness (less than 1 year from illness onset), symptoms may include:

• undulant fevers
• arthritis
• epididymo-orchitis in males

In Arizona the most common risk factor is consumption of unpasteurized milk, milk products or cheese.

Arizona 5 year median: 1 case

Transmission

Contact with tissues, blood, urine, vaginal discharges, aborted fetuses and especially placentas, and by ingestion of raw, unpasteurized milk and dairy products from infected animals.

Airborne infection of animals occurs in pens and stables, and of humans in laboratories and abattoirs.

Brucella is rarely transmitted from person-to-person.

Mothers may transmit the infection to their infants congenitally or through breast-feeding.

Sexual transmission has also been reported.

Although uncommon, transmission may also occur via contaminated tissue transplantation.    

Test*	Specimen
Culture	Whole Blood, Bone Marrow, Spleen, Liver, Abscess Fluid, Joint Fluid
PCR	Whole Blood, Serum, Isolate
IgG/IgM Serology (only detects Brucella abortus)	Serum
Serology BMAT (The convalescent specimen should be  taken 2-4 weeks after the acute)	Serum (acute and convalescent)

  Isolation Precautions

In addition to standard precautions, contact precautions are indicated for patients with draining wounds. 

Since person to person transmission is rare, exclusion or quarantine is not applicable.

Prevention for Patients
Do not eat unpasteurized dairy products. Cook meat thoroughly. People who handle animal tissues should protect themselves using rubber gloves, googles, and gowns or aprons.  Public Health Actions

Alert the laboratory to the possibility of Brucellaand need for special safety procedures.

Public health will conduct an epidemiological investigation on a case or suspect case.

A detailed contact and environmental investigation will be completed if a particular source is considered highly likely to be the cause of illness among groups of people.

All laboratories handling specimens with confirmed Brucella will be contacted and investigated to identify possible contacts to Brucella isolates. 

Smileband Health issues

Police reforms to progress equality for women and ethnic minorities are being blocked by the Freemasons, it has been claimed. Steve White, the Police Federation chairman for England and Wales, said a number of people within his organisation 'suspected' members of the secretive group have been an 'obstacle' to changes.

But the Masons completely deny the claims, saying they uphold 'values in keeping with public service and high morals'. Mr White, who is stepping down from his role, told the guardian: 'What people do in their private lives is a matter for them. When it becomes an issue is when it affects their work.

'There have been occasions when colleagues of mine have suspected that Freemasons have been an obstacle to reform.

'We need to make sure that people are making decisions for the right reasons and there is a need for future continuing cultural reform in the Fed, which should be reflective of the makeup of policing.'

The Masons are shrouded in mystery and many people believe that they serve the interests of its members over the general public. 

According to The Sun, Mike Baker, spokesman for the United Grand Lodge, the governing body for most freemasons in England, said: 'Why would there be a clash?

'It's the same as saying there would be a clash between anyone in a membership organisation and in a public service.

'We are parallel organisations, we fit into these organisations and have high moral principles and values. 

Smileband Health issues

Cryptococcosis is a fungal infection caused by Cryptococcus gattii or Cryptococcus neoformans. The fungus is found in the environment in tropical and sub-tropical areas around the world. Symptoms will depend on where the infection occurs. An infection of the lungs will cause a pneumonia-like illness and can include cough, shortness of breath, chest pain, and fever. Cryptococcal meningitis can occur if the fungus spreads from the lungs to the brain. Symptoms include headache, fever, neck pain, nausea, sensitivity to light and confusion or behavior changes.

Individuals at higher risk include individuals who are immunocompromised, have lung conditions, are 50 years or older, or smoke tobacco.

Transmission

Transmission occurs when individuals breath in the fungus.       Lab Tests & Specimen Info

Test*	Specimen
Culture (this is needed to tell the difference in C. neoformans and C. gattii)	CSF, Sputum, Lung Tissue
Immunoassay	CSF, Sputum, Lung Tissue

 Isolation Precautions

Standard precautions are recommended in healthcare settings. 

Prevention for Patients
There are no formal recommendations for preventing cryptococcosis because you can breath in the spores from the environment.

Smileband Health issues

Ringworm is a fungal infection that can be caused by over 40 different species of fungi from the Trichophyton, Microsporum, and Epidermophyton families. The fungus can cause an itchy, red, circular rash on the body. Ringworm can affect different parts of the body including feet, groin, scalp, beard, hands, toenails or fingernails, and arms or legs.

Ringworm is a very common infection but those who have weakened immune systems may be at high risk for the infection and may have a harder time fighting off the infection. The fungi can live on skin and in the environmnet.

Transmission

Transmission can occur from coming into to contact with a person or animal that has the fungi. Transmission can also occur if you come in contact with the fungi in the environment.

The incubation period is 1 to 3 weeks.                                      Isolation Precautions

Standard precautions are recommended in healthcare settings. 

Prevention for Patients

• Keep your skin clean and dry
• Wear shoes that allow air to circulate freely around your feet
• Don't walk barefoot in locker rooms or public showers
• Don't share clothing, towels, sheets or other personal items
• Wash your hands after touching pets

Smileband Health issues

AFM is one of a number of conditions that can result in neurologic illness with limb weakness. Such illnesses can result from a variety of causes, including viral infections, environmental toxins, genetic disorders and others. Despite extensive laboratory testing, a cause for AFM is unable to be identified.

AFM is characterized by:

• Acute onset of focal limb weakness
• An MRI showing a spinal cord lesion largely restricted to gray matter and spanning one or more spinal segments
• Cerebrospinal fluid (CSF) with pleocytosis (WBC >5 cells/mm3)

In 2015, 16 people from 12 states had confirmed AFM. In 2014, a total of 115 people from 34 states were reported to have confirmed AFM.

Transmission
AFM has numerous suspect etiologies, but a cause for AFM is unable to be identified. Suspected viruses identified in AFM patients include:

• Enteroviruses (polio and non-polio)
• West Nile virus (WNV) and viruses in the same family as WNV, specifically Japanese encephalitis virus and Saint Louis encephalitis virus
• Herpesviruses, such as cytomegalovirus and Epstein-Barr virus
• Adenoviruses

Lab Tests & Specimen Info   Isolation Procedures

Standard precautions are recommended in healthcare settings. 

Prevention for Patients
Persons can help protect themselves from known causes of AFM by:

• Being up to date on all recommended vaccinations, including poliovirus
• Washing hands often with soap and water
• Avoiding close contact with sick people
• Cleaning surfaces with a disinfectant, especially those that a sick person has touched
• Protecting from mosquito-borne viruses such as West Nile virus

Public Health Actions
Public health can provide targeted guidance for the workup and therapies of a suspect AFM case.

Public health will conduct an epidemiological investigation on a case or suspect case.