Tuesday, 2 January 2018

smileband health issues


Taeniasis is a parasitic infection of the small intestine caused by tapeworm Taenia species. Most people have no or mild symptoms. Tapeworms can cause digestive problems including:
  • abdominal pain
  • weight loss
Infected individuals may notice the passing of tapeworm segments through the anus and in the feces.
Individuals infected with Taenia species can spread tapeworm eggs through their feces to themselves or to others, resulting in cysticercosis, underscoring the importance of identifying and treating Taenia infections.
There was only 1 case of taeniasis reported in Arizona in 2015.
Arizona 5 year median: 1 cases
Transmission
Humans become infected with Taenia species by eating undercooked or raw pork or beef containing Taenia cysticerci.
Incubation period is 2 to 3 months.                                                        Lab Tests & Specimen Info
Test*
Specimen
Microscopic identification
(stool specimens should be
collected on 3 different days)
Stool

 Isolation Precautions
Proper enteric precautions when handling patient feces. Good handwashing should be practiced by the patient and providers. Public Health Actions
If an individual is found to be a carrier of Taenia, their household contacts are at an increased risk for cysticercosis so treatment of the carrier and testing of the household contacts might be advised.

Smileband health issues


Malaria is a parasitic infection that is passed to humans by infected mosquitos. Individuals may be asymptomatic, have mild symptoms or severe disease. Symptoms of uncomplicated malaria usually begin with a cold stage where the patient feels cold and shivers followed by a hot stage where the patient has a fever, headache, vomiting and possibly seizures. A final sweating stage is where a patient has extreme fatigue and sweating. The whole cycle usually takes 6-10 hours.
 
Severe disease includes organ failure or abnormalities in the patient's blood or metabolism.
 
Areas that are endemic for malaria include central Africa, parts of South America, and parts of Southeast Asia.
 
Arizona 5 year median: 25 cases
 
Transmission
Transmission occurs when an infected mosquito bites an individual. Transmission can also occur from blood transfusions or organ transplantation from an infected individual.
 
Incubation period can range from 7 to 30 days.    
Test*
Specimen
Microscopic 
examination
Whole Blood
PCR 
(PCR tests is most useful
in confirming the species
of malarial parasite after
microscopy has been completed)
Whole Blood
Serology IFA 
(Serology tests detect past
exposure not current infections)
Serum,
Plasma

 Isolation Precautions
Malaria cannot be transmitted person to person. 
Standard precautions are recommended in healthcare settings. 
Prevention for Patients
The best way to prevent infection is to avoid being bitten by mosquitos. Methods include:
  • Wearing long pants and long-sleeved shirts
  • Using insect repellent
  • Using screens in windows or doors
Chemoprophylaxis may be recommended depending the individual's level of risk.  Public Health Actions
Pregnant women should be advised to take extra precautions to avoid mosquitos because malaria infection during pregnancy increases the risk of maternal death, miscarriage, stillbirth, low birth weight, and neonatal death.
Malaria infection in infants and young children can be rapidly fatal. When possible, infants and young children should not travel to areas with risk of malaria.
Individuals who lived or traveled to areas with risk of malaria transmission should be advised to not donated blood for at least 6 months after returning from those areas.
Public health will conduct an epidemiological investigation on a case or suspect case.

Smileband health issues


Loa loa infection is a parasitic infection that is caused by the parasitic worm Loa Loa. Many infected individuals will be asymptomatic but some will have loiasis which is a itchy, non-painful swellings of the body. The swelling can occur anywhere on the body but are most likely to occur near the joints. Some individuals will develop an eye worm that crawls across the surface of the eye.
 
The parasite is generally found in certain rain forests in West and Central Africa.
 
Transmission
Transmission occurs when an individual is bitten by an infected deer fly.   Isolation Precautions
Standard precautions are recommended in healthcare settings.
Prevention for Patients
Prevention methods include:
  • wearing long pants and long-sleeved shirts
If you are going to an affected areas for a long period of time you may be able to reduce your risk of infection by taking DEC. Please consult your provider for more information.

Smileband health issues


Giardiasis is an infection from a protozoanGiardia lamblia that affects primarily the upper small intestine. It can cause acute, self-limited diarrhea, or chronic diarrhea, abdominal cramps, bloating, malabsorption (of fats and fat-soluble vitamins) and weight loss.
 
Giardiasis is the most common intestinal parasite infection that is identified in humans in the United States. There is generally a peak in cases during the early summer through early fall.
 
Arizona 5 year median: 119 cases
 
Transmission
Typically through contaminated food, water or unwashed hands. Some animals (beavers, other domestic animals) are carriers and improper handling of the feces of these animals can cause illness. Lab Tests & Specimen Info
Test*
Specimen
Microscopic
examination
(Multiple stool specimens
may need to be submitted
to help with detection)
Stool
Immunoassay
EIA
(This test should NOT
take the place
of the O+P test)
Stool
IgG/IgM
Serology
(This test should NOT
take the place
of the O+P test)
Serum
 Isolation Precautions
Standard precautions are recommended in healthcare settings. 
Prevention for Patients
  • Good hand washing is essential especially before handling food, before eating and after using the toilet. Do not drink unfiltered or untreated water.
Public Health Actions
Public health will conduct an epidemiologic investigation of each reported case to establish possible source of infection.

Smileband health issues


The gastric sleeve is the fastest growing procedure in the UK and around the world. 
The sleeve is a key hole (laparoscopic) procedure that usually takes between 60 and 75 minutes to complete. It involves cutting along the length of the stomach and removing about 80% of it to leave a thin, banana shaped stomach. The larger part of the stomach (the ‘80%’) is removed altogether.
One of the attractions of the sleeve is that the food you eat enters and leaves the stomach in the same places as it did prior to surgery, unlike with the gastric bypass. 

How a gastric sleeve works

The gastric sleeve works to produce weight loss in two ways. Firstly by restriction as a large portion of the stomach is removed during surgery leaving a 'stomach sleeve' about 20% of the original volume. This means you can only eat a very small amount of food before feeling full.
Secondly by an impact on hormones. Levels of the appetite stimulant ghrelin fall after gastric sleeve surgery, which may explain why patients experience such a marked loss of appetite. Sleeve patients also experience major changes in taste and food preferences, usually away from fatty, sugary foods and this change also contributes to weight loss.   

gastric sleeve surgery right for you?

If you have been struggling with your weight for a long time, you have tried and failed using diets and your body mass index BMI) is above 35, then the sleeve may be a good option for you. Decisions about the best procedure will always vary according to individual patient circumstances and ultimately the choice will be yours. Many patients end up having to decide between the gastric band and the gastric sleeve procedures. We will explain both in detail before and during your consultation.  
We have also recently started offering the new Endoscopic Sleeve Gastroplasty (ESG) procedure. This is a non-surgical alternative to the gastric band and the surgical gastric sleeve. It’s a new, younger procedure that those looking for a lower risk procedure might consider. Of course, the newness of the ESG means results are less predictable than for the band or surgical sleeve

Smileband health issues

Lymphatic filariasis is a parasitic disease that is caused by Wuchereria bancroftiBrugia malayiand Brugia timori. Most individuals will be asymptomatic when they are first infected but the adult parasites damage the lymph system and individuals can go on to develop lymphedema, hydrocele or elephantiasis. These secondary issues are generally permanently dibilitating and communities will sometimes shun individuals because of the disfigurements.
 
The damage to the lymph system can also make these individuals more susceptible to other infections.
 
Transmission
Transmission occurs when an individual is bitten by an infected mosquito.
Lab Tests & Specimen Info
Test*
Specimen
Microscopic
examination
(blood needs to be
collected at night)
Serum

 Isolation Precautions
Standard precautions are recommended in healthcare settings. 
Prevention for Patients
The best way to prevent infection is to avoid being bitten by mosquitos. Methods include:
  • Wearing long pants and long-sleeved shirts
  • Using insect repellent
  • Using screens in windows or doors

Smileband health issues


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 

Smileband helath issues


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

Smileband health issues


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.

Smileband Health issues


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.

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