smileband health issues

Hand, foot, and mouth disease is a common viral illness that is caused by Coxsackievirus A16 and usually affects infants and children younger than 5 years old.

Symptoms can include:

• fever
• reduced appetite
• sore throat
• malaise
• painful sores in the mouth
• skin rash with red spots and/or blisters on the palms of the hands and soles of the feet

Complications are rare but viral meningitis, encephalitis, and fingernail and toenail loss can occur.

Transmission 
Transmission may occur from close contact with the infected individual, contact with feces, or contact with contaminated objects or surfaces. Transmission may also occur through the air via coughing or sneezing.

It is possible to get infected with the viruses that cause hand, foot, and mouth disease if you swallow recreational water, such as water in swimming pools. However, this is not very common.

The incubation period is 3 to 6 days.

Lab Tests & Specimen Info 

Test*	Specimen
Culture	Blood, CSF, Rectal Swab, NP Swab, Throat Swab, Stool, Urine
IgG/IgM Serology (a positive test alone does NOT necessarily indicate a current or recent infection due to passive exposure to infected hosts)	Serum, Plasma

  Isolation Precautions 

Standard precautions are recommended in healthcare settings.

Prevention for Patients 
A person can lower their risk of being infected by:

• Washing hands often with soap and water, especially after changing diapers and using the toilet.
• Cleaning and disinfecting frequently touched surfaces and soiled items, including toys.
• Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people with hand, foot, and mouth disease.

Public Health Actions 
Individuals are most contagious while the fever and sore throat are present.

Individuals with fever should be excluded from school or childcare until they are fever-free for 24-hours without the use of a fever-reducing medication.

Smileband health issues

Fifth disease, also called erythema infectiosum, is a mild rash illness caused by parvovirus B19. It is more common in children than adults.

Symptoms may include:

• fever
• runny nose
• headache
• "slapped cheek" rash on the face
• rash on rest of body
• polyarthropathy syndrome.

Some adults may only have painful joints and no other symptoms. The joint pain usually lasts 1 to 3 weeks, but it can last for months or longer.

Generally, there are not serious complications but those with weakened immune systems may have chronic anemia which could require medical treatment.

Transmission 
Transmission occurs through contact with respiratory secretions from an infected individual.

Transmission can also occur through blood or blood products. A pregnant woman who is infected with parvovirus B19 can pass the virus to her baby.

The incubation period is 4 to 14 days.

Lab Tests & Specimen Info
Healthcare providers can often diagnose fifth disease just by seeing "slapped cheek" rash on a patient's face.

Test*	Specimen
PCR	Whole Blood
IgG/IgM Serology (IgM antibodies are detectable 2 weeks after exposure, IgG antibodies are usually created 18 to 24 days after exposure)

 Isolation Precautions

Standard and droplet precaution are recommended in healthcare settings.

Prevention for Patients 
There is no vaccine or medicine that can prevent parvovirus B19 infection. Patients can reduce risk of being infected or infecting others by:

• washing hands often with soap and water
• covering mouth and nose when coughing or sneezing
• not touching eyes, nose, or mouth
• avoiding close contact with people who are sick
• staying home when sick

Public Health Actions 
People are most contagious when it seems like "just a cold" and before the rash or joint pain and swelling. After the rash people are not likely to be contagious, so then it is usually safe to return to work or school.

Individuals with fevers should be excluded from school or childcare until they have been fever-free for 24-hours without the use of a fever reducing medication.

smileband health issues

Creutzfeldt-Jakob Disease (CJD) is a human prion disease that is a rapidly progressive neurodegenerative disorder that is universally fatal. There are three categories of CJD: Classical (sporadic or spontaneous), Familial, and Iatrogenic. Sporadic CJD is the most common form found in Arizona.

In Arizona in the last 10 years there have been 65 cases of CJD reported.

Arizona 5 year median: 8 cases

Transmission

Sporadic CJD occurs sporadically and there is no recognizable pattern of transmission. Familial CJD is thought to develop because of an inherited mutation of the prion protein gene. Iatrogenic CJD occurs as a result of exposure to infectious prions during a medical procedure. Corneal implants, Dura mater grafts, Brain surgery, and growth or Gonadotropic hormones made from human pituitary glands have all been implicated in iatrogenic CJD cases.             Isolation Precautions
Creutzfeldt-Jakob disease is not a communicable disease. Standard precautions are recommended in healthcare settings. 

Prevention for Patients

Iatrogenic CJD can be prevented by correct sterilization of surgical equipment.

Public Health Actions

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

smileband health issues

Trichinosis is caused by roundworms of the genus Trichinella. First symptoms are gastrointestinal, occurring 1-2 days after exposure to undercooked meat, including:

• nausea
• diarrhea
• vomiting
• abdominal pain

Later symptoms occur within 2 weeks after exposure, including:

• muscle pain
• fever
• swelling of the face
• weakness
• fatigue
• cough
• diarrhea
• constipation.

In Arizona, over the last 10 years, there have been 2 cases reported.

Arizona 5 year median: 0 cases

Transmission

Human infection occurs when ingesting meat containing Trichinella cysts.

The incubation period is usually less than 1 month.

Lab Tests & Specimen Info

Test*	Specimen
Serology ELISA (IgG antibodies can be detected 12 to 60 days post-infection)	Serum
Immunoassay EIA (IgG antibodies can be detected 12 to 60 days post-infection)	Serum

 Isolation Precautions

Infection does not occur person-to-person.

Prevention for Patients

• Cook meat to safe temperatures. Wash hands after handling raw meat. Freeze pork less than 6 inches thick for 20 days at 5°F (-15°C) to kill any worms. 

Smileband health issues

Schistosomiasis is a parasitic infection that is caused by the Schistosoma specieces that are found in freshwater snails. Schistosomiasis is found in southern and sub-Saharan Africa, Brazil, Suriname, Venezuela, Dominican Republic, Guadeloupe, Martiique, Saint Lucia, areas of the Nile River valley including Egypt, Indonesia, parts of China, Cambodia, Laos, and parts of Central and West Africa.

Symptoms include rahs, fever, chills, cough and muscle aches. Chonic schistosomiasis infections can lead to abdominal pain, enlarged liver, blood in the stool or urine and issues passing urine. Chronic infections als increase the risk of bladder cancer.

Transmission

Transmission occurs when the larvae penertrated the skin.

Incubation period can range from 4 to 12 weeks depending on the species.

Lab Tests & Specimen Info

Test*	Specimen
Microscopic examination	Stool, Urine

 Isolation Precautions

Standard precautions are recommended in healthcare settings. 

Prevention for Patients
Avoid swimming in freshwater in countries that are endemic for schistosomiasis.

Drink safe water

• Boil water for 1 minute
• Filter water
• Iodine treatment alone will not guarantee that the water is safe

Smileband health issues

Overview

A fever is a temporary increase in your body temperature, often due to an illness. Having a fever is a sign that something out of the ordinary is going on in your body.

For an adult, a fever may be uncomfortable, but usually isn't a cause for concern unless it reaches 103 F (39.4 C) or higher. For infants and toddlers, a slightly elevated temperature may indicate a serious infection. Fevers generally go away within a few days. A number of over-the-counter medications lower a fever, but sometimes it's better left untreated. Fever seems to play a key role in helping your body fight off a number of infections.

Symptoms

You have a fever when your temperature rises above its normal range. What's normal for you may be a little higher or lower than the average normal temperature of 98.6 F (37 C).

Depending on what's causing your fever, additional fever signs and symptoms may include:

• Sweating
• Chills and shivering
• Headache
• Muscle aches
• Loss of appetite
• Irritability
• Dehydration
• General weakness

Children between the ages of 6 months and 5 years might experience febrile seizures. About a third of the children who have one febrile seizure will have another one, most commonly within the next 12 months.

Taking a temperature

To check your or your child's temperature, you can choose from several types of thermometers, including oral, rectal, ear (tympanic) and forehead (temporal artery) thermometers.

Although it's not the most accurate way to take a temperature, you can use an oral thermometer for an armpit (axillary) reading:

1. Place the thermometer in the armpit and cross your arms or your child's arms over the chest.
2. Wait four to five minutes. The axillary temperature is slightly lower than an oral temperature.
3. If you call your doctor, report the actual number on the thermometer and where on the body you took the temperature.

Use a rectal thermometer for infants:

1. Place a dab of petroleum jelly on the bulb.
2. Lay your baby on his or her tummy.
3. Carefully insert the bulb 1/2 to 1 inch (1.3 to 2.5 centimeters) into your baby's rectum.
4. Hold the bulb and your baby still for three minutes.
5. Don't let go of the thermometer while it's inside your baby. If your baby squirms, the thermometer could go deeper and cause an injury.

When to see a doctor

Fevers by themselves may not be a cause for alarm — or a reason to call a doctor. Yet there are some circumstances when you should seek medical advice for your baby, your child or yourself.

Infants

An unexplained fever is greater cause for concern in infants and in children than in adults. Call your baby's doctor if your child is:

• Younger than age 3 months and has a rectal temperature of 100.4 F (38 C) or higher.
• Between ages 3 and 6 months and has a rectal temperature up to 102 F (38.9 C) and seems unusually irritable, lethargic or uncomfortable or has a temperature higher than 102 F (38.9 C).
• Between ages 6 and 24 months and has a rectal temperature higher than 102 F (38.9 C) that lasts longer than one day but shows no other symptoms. If your child also has other signs and symptoms, such as a cold, cough or diarrhea, you might call your child's doctor sooner based on severity.

Children

There's probably no cause for alarm if your child has a fever but is responsive — making eye contact with you and responding to your facial expressions and to your voice — and is drinking fluids and playing.

Call your child's doctor if your child:

• Is listless or irritable, vomits repeatedly,has a severe headache or stomachache, or has any other symptoms causing significant discomfort.
• Has a fever after being left in a hot car.Seek medical care immediately.
• Has a fever that lasts longer than three days.
• Appears listless and has poor eye contact with you.

Ask your child's doctor for guidance in special circumstances, such as a child with immune system problems or with a pre-existing illness.

Adults

Call your doctor if your temperature is 103 F (39.4 C) or higher. Seek immediate medical attention if any of these signs or symptoms accompanies a fever:

• Severe headache
• Unusual skin rash, especially if the rash rapidly worsens
• Unusual sensitivity to bright light
• Stiff neck and pain when you bend your head forward
• Mental confusion
• Persistent vomiting
• Difficulty breathing or chest pain
• Abdominal pain or pain when urinating
• Convulsions or seizures

smileband general news

Storm Eleanor smashed into Britain on Tuesday night with hurricane-force winds topping 97mph and torrential rain triggering 'danger to life' warnings across the country.   Gusts of nearly 100mph were recorded near Connaught airport in Mayo, Southern Ireland, while the highest recorded winds in Britain hit Aberdaron in west Wales reaching 76mph.

Poor weather conditions meant Irish Sea ferry crossings from Holyhead in Anglesey were cancelled while yellow and amber warnings have been issues across Britain. The amber wind warning, valid from 19:30 until 04:00, is in place for much of Northern Ireland.  

Experts warn this coupled with high tides, could cause large waves, leading to debris on sea fronts. Disruption could also be caused to transport and power supplies. 

Forecasters say there is a chance of injuries and danger to life, as well as minor property damage and disruption to power and other services.

Many areas – including Cambridgeshire and along the Thames – face flooding until tomorrow, with the Environment Agency issuing 61 flood warnings across the country. It comes as a woman is fighting for her life in hospital after being caught by a freak wave while walking at the Lizard in Cornwall on New Year’s Day.

On the same weekend, photographer James Pearce caught a man balanced on rocks surrounded by dangerous waves at Godrevy Lighthouse near St Ives. Moments later, just after the man had moved on, the rocks were submerged by the rising tide. The Met Office said: ‘Public transport may be disrupted or cancelled and some bridges are likely to be closed. Power cuts and disruption to other services – mobile phones for example – may also occur, while injuries from flying debris are possible.

‘Combined with a period of high tides, it is likely that some western coastal communities will be affected by large waves and spray, and again there is a chance that injuries and danger to life could occur from large waves, or beach material being thrown.’

The Environment Agency warned that strong winds and waves could bring coastal flooding until tomorrow.

Flood duty manager Neil Davies said: ‘We urge people to ... take extreme care on coastal paths and promenades, and don’t put yourself in unnecessary danger trying to take “storm selfies”.’

Forecasters expect a return to ‘much colder’ conditions over the weekend with a risk of frost and ice, particularly in the north. 

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.