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Varicella (chickenpox) is a viral infection that is caused by varicella-zoster virus. Symptoms generally appear 10 to 21 days after exposure to the virus and can include:
high fever
loss of appetite
headache
generalized and pruritic rash
The rash will progress from macules to papules to vesicular lesions before crusting. It will usually take 1 week for the lesions to crust over.
Some individuals in high risk groups can go on to have more severe symptoms such as:
pneumonia
bleeding problems
encephalitis
sepsis
Those high risk groups include infants, pregnant women, and individuals with weakened immune systems.
Individuals are contagious 2 days before blisters appear until all blisters have completed scabbed over.
Over the last 5 years between 300 and 600 cases of varicella are reported in Arizona each year.
Arizona 5 year median: 300 cases
Transmission
Transmission occurs when the virus is spread through the air by the cough or sneezes of an infected individual. Transmission can also occur by touching or breathing in the virus that can come from the blisters.
Incubation period is 10 to 21 days (average of 14 to 16 days).
Impression smears of tissues, Lesion scrapings and swabs
IgG/IgM Serology
Serum
Public Health Actions
Individuals should be excluded from school/child care until all blisters are scabbed over and dry and the individual is fever-free for 24 hours without the use of fever-reducing medications.
Public health will complete an epidemiological investigation for reports of death due to varicella infection.
Yellow fever is an infection caused by the Yellow fever virus. The majority of individuals will have no illness or a mild illness. Symptoms include:
fever
chills
headache
body aches
nausea
vomiting
fatigue
weakness
Approximately 15% of cases will go on to develop a more severe disease which can include high fever, jaundice, bleeding, and eventually shock and multiorgan failure.
Yellow fever virus is generally found in tropical and subtropical areas of South America and Africa.
Arizona has not had a case of yellow fever reported in the last 10 years.
Transmission
Transmission occurs when an individual is bitten by an infected mosquito. It is not transmitted person-to-person. Isolation Precautions
Standard precautions are recommended in healthcare settings.
Prevention for Patients
Vaccination against Yellow fever is the best prevention method for individuals. Avoiding contact with mosquitoes is also another prevention method. Methods include:
Wearing long pants and long-sleeved shirts
Using insect repellent
Using screens in windows or doors
Public Health Actions
Individuals should be advised to avoid further mosquito exposure during the first 5 days after fever onset to help reduce the transmission of the virus to more mosquitos.
Public health will conduct an epidemiological investigation on a case or suspect case.
Lassa fever is an acute viral illness that occurs in west Africa.
For the majority of Lassa fever virus infections, symptoms are mild and are undiagnosed. However, disease may progress to more serious symptoms including:
hemorrhaging (in gums, eyes, or nose, as examples)
respiratory distress
repeated vomiting
facial swelling
pain in the chest, back, and abdomen
shock
Neurological problems have also been described, including hearing loss, tremors, and encephalitis.
Transmission
The reservoir, or host, of Lassa virus is a rodent known as the "multimammate rat". Transmission of Lassa virus to humans occurs most commonly through ingestion or inhalation. Mastomys rodents shed the virus in urine and droppings and direct contact with these materials, through touching soiled objects, eating contaminated food, or exposure to open cuts or sores, can lead to infection.
Contact with the virus may also occur when a person inhales tiny particles in the air contaminated with infected rodent excretions. This aerosol or airborne transmission may occur during cleaning activities, such as sweeping.
Person-to-person transmission may occur after exposure to virus in the blood, tissue, secretions, or excretions of a Lassa virus-infected individual.
Incubation period can range from 1-3 weeks. Isolation Precautions
Standard, droplet, and contact precautions are recommended in healthcare settings.
Single-patient rooms are also preferred.
Prevention for Patients
Primary transmission of the Lassa virus from its host to humans can be prevented by avoiding contact with Mastomys rodents, especially in the geographic regions where outbreaks occur.
Putting food away in rodent-proof containers and keeping the home clean help to discourage rodents from entering homes
Using these rodents as a food source is not recommended
Trapping in and around homes can help reduce rodent populations (however, the wide distribution of Mastomys in Africa makes complete control of this rodent reservoir impractical)
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.
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.
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.
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.
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.
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
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:
Place the thermometer in the armpit and cross your arms or your child's arms over the chest.
Wait four to five minutes. The axillary temperature is slightly lower than an oral temperature.
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:
Place a dab of petroleum jelly on the bulb.
Lay your baby on his or her tummy.
Carefully insert the bulb 1/2 to 1 inch (1.3 to 2.5 centimeters) into your baby's rectum.
Hold the bulb and your baby still for three minutes.
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
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.
