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Guinea worm disease is a parasitic disease caused by Dracunculus medinensis. Individual who are infected are generally asymptomatic for approximately one year. A few days before the worm comes out of the skin, an individual might have fever, swelling, and pain in the area. The worm then starts to come out of the skin, generally in the legs or feet of the individual. this process can take up to a couple of weeks to be completed and is very painful. A secondary infection can also occur at this site.
Guinea worm disease is only found in Chad, Ethiopia, Mali, and South Sudan.
Transmission
Transmission occurs from drinking infected water.
Lab Tests & Specimen Info No laboratory tests used.
Isolation Precautions Standard precautions are recommended in healthcare settings.
Prevention for Patients Only drinking safe water
Bore-hole wells, dug wells, springs with protective walls around them, and running water such as rivers are all safe drinking water
Filters can be used in areas where safe drinking water is not readily available
Cysticercosis is a parasitic tissue infection that is caused by the larval cysts of Taenia solium. The cysts can infect the brain, muscle, or other issues.
Cysts in the brain:
can cause neurocysticercosis
can cause seizures and headaches
may cause stroke or death
Cysts in the muscles:
can cause lumps under the skin
35 cases of cysticercosis were reported in Arizona in the last 10 years and almost half of those cases had international travel.
Arizona 5 year median: 2 cases
Transmission
Transmission occurs by ingestion of the eggs of the tapeworm Taenia solium through direct fecal-oral contact or by consuming food contaminated with the tapeworm eggs. Isolation Precautions
Standard precautions are recommended in healthcare settings.
Prevention for Patients
Wash hands with soap and warm water after using the toilet, changing diapers, and before handling food.
Wash and peel all raw vegetables and fruits before eating.
Use good water and water safety practices while traveling in developing countries.
Public Health Actions Public health will conduct an epidemiological investigation on a case or suspect case.
If an individual is a carrier of the tapeworm Taenia solium, his/her household contacts are at an increased risk for cysticercosis. Treatment of the carrier and testing of the household con
Babesiosis is caused by a microscopic parasite that is spread by Ixodes scapularis ticks. Many people who are infected do not have any symptoms. The transmission of this disease occurs usually in the Northeast and upper Midwest regions of the United States.
From 2005 to 2015 in Arizona there have been 6 cases of Babesiosis. 5 out of the 6 cases had recent travel to Northeast or upper Midwest states which is where transmission primarily occurs.
Arizona 5 year median: 0 cases
Transmission
Bites from infected Ixodes scapularis ticks (deer ticks) are the main route of transmissions. Transmission can also occur through blood transfusions and very rarely from mother to child.
Incubation period ranges from 1 to 5 weeks following the tick bite.
Lab Tests & Specimen Info
Test*
Specimen
Microscopic examination (In symptomatic patients with acute infections the parasite can be detected in blood smears)
Blood
PCR
Whole blood
IgG/IgM Serology
Serum (acute and convalescent)
Isolation Precautions
Babesiosis is not a contagious disease.
Standard precautions are recommended in healthcare settings.
Prevention for Patients Avoid exposure to tick habitats:
Avoid areas with overgrown grasses or brush.
Wear long pants, long-sleeved shirts and socks when outdoors.
Apply insect repellents to skin and clothing.
Check body for ticks after being outdoors.
Public Health Actions Individuals with a known history of Babesia infections are deferred indefinitely from donating blood.
Public health will conduct an epidemiological investigation on a case or suspect case.
Amebiasis is caused by the parasite Entamoeba histolytica. Amebiasis is most commonly seen in people who have traveled to or immigrated from tropical places that have poor sanitary conditions. Symptoms include diarrhea, abdominal pain and cramping and typically occur 2-4 weeks after exposure.
Arizona 5 year median: 17 cases
Transmission
Transmission occurs through ingestion of contaminated food or water. Transmission can also occur sexually through oral-anal contact.
Incubation period can vary from a few days to months or years, but most typically it is 2-4 weeks. Lab Tests & Specimen Info
Test*
Specimen
Microscopic examination
Stool
IgG Serology, ELISA (Only use serology test on symptomatic individuals)
Serum
PCR
Stool, Liver aspirate
*Some tests may only be available through public health. Please contact your local public health for more information on these tests.
Isolation Precautions Good personal hygiene practices are encouraged, including handwashing. A person can infect another person as long as cysts are still passing (months-years).
For hospitalized patients, enteric precautions should be used in the handling of feces and contaminated clothing and bed linens.
Prevention for Patients If a patient is traveling to a country with poor sanitary conditions they should avoid:
drinks with ice cubes
fresh fruit or vegetables that were not peeled by themselves
milk, cheese, or dairy products that have not been pasteurized
food or drinks sold by street vendors
Individuals who are food handlers or who provide direct care to hospitalized or institutionalized patients should be excluded from work until they complete treatment.
Public Health Actions Public health will conduct an epidemiological investigation on a case or suspect case. Household or other contacts should be tested and treated if positive.
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.
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.
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
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).
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.
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.
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.
