Smileband health topics

Vancomycin-resistant Enterococci are bacteria that are resistant to an antibiotic that is usually used to treat enterococci. Enterococci are found normally in the human intestine and female genital tract as well as the environment. Most VRE infections occur in hospital settings.

 

VRE can cause infections in the urinary tract, bloodstream or in wounds associated with catheters or surgical procedures. These infections can lead to more severe issues such as bacteremia.

 

Transmission

Transmission occurs from person to person. Individuals who have had contact with someone with VRE or with a contaminated object and then have contact with another individual can pass the VRE.

Lab Tests & Specimen Info

Test*	Specimen
Culture	Specimen from any site
Susceptibility testing	Isolate

 Isolation Precautions

Standard and contact precautions are recommended in healthcare settings. 

Prevention for Patients

• Maintain good hand and body hygiene. Wash hands often, and clean body regularly, especially after exercise.
• Keep cuts, scrapes, and wounds clean and covered until healed.
• Avoid sharing personal items such as towels and razors.
• Seek care early if there are signs of infection.

Smileband health topics

Typhoid fever is a life-threatening illness caused by the bacterium Salmonella typhi. Salmonella typhi lives only in humans. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. A small number of persons, called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed S. typhi in their feces (stool).

Often characterized by:

• insidious onset of sustained fever
• headache
• malaise
• anorexia
• relative bradycardia
• constipation or diarrhea
• nonproductive cough

However, many mild and atypical infections occur.

In Arizona, there is a range of 5 to 15 cases of typhoid fever reported every year. In 2015, all cases had international travel or travel outside of Arizona.

Arizona 5 year median: 7 cases

Transmission

Transmission occurs when an individual consumes water or food that has been contaminated. Transmission through sexual contact, particularly among men who have sex with men, has been rarely documented. Isolation Precautions

Standard precautions are recommended in healthcare settings. 

Prevention for Patients

• If traveling to a country where typhoid is common, consider getting vaccinated against typhoid.
• Avoid eating undercooked or raw meats and seafood and drinking unfiltered or untreated water.

Public Health Actions
Public health will conduct case investigation to determine the source, identify contacts, and transmission setting. 

Cases or contacts should be excluded from working as a food handler, caring for children in or attending a child care establishment, or caring for patients or residents in a healthcare institution. 

Public health will facilitate forwarding specimens to the Arizona State Public Health Laboratory. 

Smileband health topics

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. It is the second most commonly reported infectious disease in Arizona and the United States.

 

Over the last five years, counts and rates of reported gonococcal infections have significantly increased in the state of Arizona. The number of reported infections increased 133.5% from 3,249 in 2010 to 7,585 in 2014.

 

Transmission

Gonorrhea is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread perinatally from mother to baby during childbirth.

Lab Tests & Specimen Info

Test*	Specimen
PCR	Genital Swab, Urine
IgG/IgM Serology	Serum, Whole Blood
Culture	Genital Swab, Urine
Gram Stain	Genital Swab

 Isolation Precautions

Infected individuals should be advised to refrain from sexual activity for at least 7 days after being fully treated. 

Standard precautions are recommended in healthcare settings.

Prevention for Patients
There are several ways to prevent sexually transmitted infection:

• Condoms
• Monogamous relationships
• Abstinence

Expedited partner therapy (EPT) is an available option in Arizona in order to treat partners.

Pregnant females should be screened during  Public Health Actions

Public health monitors gonorrhea case counts and trends statewide.  Due to the high morbidity in Arizona, case investigations may only occur in more severe cases (I.e. co-infection or reinfection).

Public Health in Arizona has developed a plan for addressing the possibility of gonorrhea antimicrobial resistance.  Public health recommends following the CDC recommended treatment guidelines to avoid further antimicrobial resistance development.

Smileband health topics

Relapsing fever is a systemic spirochetal disease in which periods of fever lasting 2–7 days alternate with afebrile periods of 4–14 days; the number of relapses varies from 1 to 10 without treatment. Febrile periods are often associated with shaking chills, sweats, headache, muscle and joint pain, and can be associated with a rash. Photophobia, eye pain, dizziness, dry cough, nausea, vomiting, or lack of appetite can also occur. Each febrile period terminates by a crisis (abrupt symptom change). Symptoms can be more severe without treatment.

 

TBRF occurs in the western U.S. and is usually linked to sleeping in rustic, rodent-infested cabins in mountainous areas and high elevations.

 

Arizona 5 year median: 1 cases

 

Transmission

Transmission occurs when an individual is bitten by an infected tick. Transmission can also occur mother to child in pregnant women.

Incubation period is 2 to 18 days.  Isolation Precautions

Tick-borne relapsing fever is not directly transmitted person-to-person. 

Standard precautions are recommended in healthcare settings. 

Prevention for Patients

• Avoid sleeping in rodent infested buildings
• Inspect buildings on a regular basis for rodent activity
• Eliminate rodent nesting areas
• Use proper food and waste handling practices that eliminate food sources for rodents
• Rodent–proof cabin/buildings by sealing holes in foundation and walls and use screens to prevent rodent entry

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

Smileband health topics

Salmonellosis is a bacterial infection that is caused by Salmonella species. The most common species seen in the United States are Salmonella serotype Typhimurium and Salmonella serotype Enteritidis.

 

The illness can have variable severity and is commonly manifested by:

• diarrhea (sometimes bloody)
• abdominal pain
• nausea
• vomiting

Asymptomatic infections may occur and the organism may cause extraintestinal infections.

In Arizona, there is usually a range from 600 to 1000 cases of Salmonellosis (excluding S. Typhi and S. Paratyphi) reported yearly.

 

Arizona 5 year median: 1,010 cases

 

Transmission
Salmonella is transmitted through contaminated food or water, or contact with infected animals. Salmonella is also transmitted person-to-person by the fecal-oral route.

Animals may be a source of Salmonella infection for humans. Salmonella may also be found in the feces of some pets, especially those with diarrhea. Reptiles, such as turtles, lizards, and snakes, and amphibians, such as frogs, are particularly likely to harbor Salmonella. Many chicks and young birds carry Salmonella in their feces. Lab Tests & Specimen Info

Test*	Specimen
Culture (All positive Salmonella samples are automatically forwarded to the State Public Health Laboratory for further serotyping.)	Stool

Immunoassay tests are not recommended.

Isolation Precautions
Enteric precautions are recommended in healthcare settings. 

Prevention for Patients 

• If served undercooked meat, poultry or eggs in a restaurant, send it back to the kitchen for further cooking.
• Wash hands, kitchen work surfaces, and utensils with soap and water immediately after they have been in contact with raw meat or poultry.
• Be particularly careful with foods prepared for infants, the elderly, and the immunocompromised.
• Wash hands with soap after handling reptiles, birds, or baby chicks, and after contact with pet feces.
• Avoid direct or even indirect contact between reptiles (turtles, iguanas, other lizards, snakes) and infants or immunocompromised persons.
• Don't work with raw poultry or meat, and an infant (e.g., feed, change diaper) at the same time.
• Mother's milk is the safest food for young infants. Breastfeeding prevents salmonellosis and many other health problems.

Public Health Actions
Public health will conduct an epidemiologic investigation to determine the source, risk factors, and transmission settings.

Smileband health topics

The 'Croydon Cat Ripper' appears to have struck again after a black cat was found dead with the killer's tell-tale signs - its head and tail were removed. A £10,000 reward is now being offered for information that leads to the 'low life scum's' capture.

Snarl, a local animal rescue and rehabilitation shelter, have seen the mutilation of the cat-killer's victims more than 400 times.

The serial killer has also murdered squirrels, foxes and rabbits since 2014

It is understood by Snarl that the killer is a white man in his 40s, around 5ft 9in tall, who is likely to be from Croydon, due to the ease in which he moves around the area. When Tony Jenkins, founder of Snarl, presented the latest fatality to a vet he recoiled at the sight, along with its missing head and tail its body had been sliced open. 

Mr Jenkins, when speaking to AFP, said: 'It was the classic head and tail removal: clean cuts on both, with a bit of additional mutilation to the stomach area,

'We've had cats matching that exact same thing in all sorts of different areas,

'Lowlife scum.'

The shelter started a hunt for the cat-killer after a series of deaths kept cropping up on social media in the Croydon area.

Mr Jenkins and his co-founder Boudicca Rising began investigating the suspicious demise of these poor creatures. After consulting vets, pet owners and local residents they pieced together a map and timeline of the killings. 

Scotland Yard police headquarters and the Royal Society for the Prevention of Cruelty to Animals, Britain's biggest animal welfare charity, both started inquiries after receiving information from Mr Jenkins.

According to Mr Jenkins the cats died from blunt force trauma and the possibility that the killer was another animal was quickly ruled out.

Smileband health topics

British researchers have made a breakthrough that means hospital scanners costing millions and weighing up to three tons could be shrunk down to the size of laptop computers. MRI scanners are vital in a huge range of applications - from detecting brain tumours to tears in ligaments in the knee.

But they are too bulky to be used during surgery, for example. University of York scientists say the breakthrough paves the way to miniaturising the machines – and using them in ‘real time’ during operations.

It could soon transform our ability to diagnose and treat diseases including cancer, diabetes and dementia.

The research is in the early stages, but the team say the breakthrough is comparable to the leap the from computers used 40 years ago to those of the present day.

Professor Simon Duckett from the Centre for Hyperpolarisation in Magnetic Resonance at the University of York said: ‘What we think we have the potential to achieve with MRI what could be compared to improvements in computing power and performance over the last 40 years.

‘While they are a vital diagnostic tool, current hospital scanners could be compared to the abacus, the recent development of more sensitive scanners takes us to Alan Turing’s computer and we are now attempting to create something scalable and low-cost that would bring us to the tablet or smartphone’. This changes the direction the molecules spin in the human body – polarising them to all spin in the same direction.

When molecules are spinning the same way, they can be picked up by the scanner using radio waves.

The new research uses a technique that polarises glucose – and this allows much cheaper, weaker magnets to carry out the same activity.

Professor Duckett said: ‘In theory, it would provide an imaging technique that could be used in an operating theatre.’

‘For example, when a surgeon extracts a brain tumour from a patient they aim to remove all the cancerous tissue while at the same time removing as little healthy tissue as possible. This technique could allow them to accurately visualise cancerous tissue at a far greater depth there and then.’

Dr Peter Rayner, Research Associate at the University of York, said: ‘Our method reflects one of the most significant advances in magnetic resonance in the last decade.’

Smileband general news

Sex robots could make men not women obsolete, according to a top mathematician.  Dr Cathy O'Neil from Harvard University claims females of the future could get spoiled by 'dashing menbots' who also do the dishes.

It's a basic human need to want someone to love and have sex with but most women also look for someone who does their fair share of chores around the house.

The mathematician says it is 'entirely possible' that robots will outperform men and women of the future could choose to live with menbots instead. There are around five makers of sex robots worldwide, with prices ranging from around £4,000 ($5,400) to more than £11,600 ($15,700) for a 'deluxe' model.

The market for sexbots is currently 95 per cent male dominated but that could all be about to change.

'I think it’s the men who should be worried. It’s entirely possible that robots can outperform them', said Dr Cathy O'Neil who has a PhD in mathematics from Harvard University.

'In the #MeToo age, I feel like raising standards is quite reasonable. It’s called for, in fact', she said, writing for Bloomberg. 

Contrary to what the name suggests, not everyone will use their doll purely for sex.

And these robots could be good at doing the dishes and other household chores, Dr O'Neil said. 

Despite the dangers of hackers turning sex robots into killers she believes that would not make them more of a threat than real men.

'Given the baseline murder rate for human sexual partners, it’s hard to get too worried. Plus, if they can understand female anatomy — I mean, really understand it — maybe it’s worth the risk', Dr O'Neil said.

The Harvard mathemetician suggested that women and men may coexist but not cohabitate. As a result she believes this could make us stronger as a community.

'We’ll come together, online or in person, and be more respectful, more relaxed, less edgy. It’s worth a try. So bring on the sex robots', she said. 

Smileband health topics

What is cherubism?

Cherubism is a rare genetic condition that affects the bones of your lower jaw and sometimes upper jaw. The bones are replaced with cyst-like tissue growths that are not as dense. This makes the cheeks look round and swollen, but it is usually painless. 

About 200 cases of cherubism have been reported worldwide. The condition is usually discovered during early childhood, though symptoms may get better after puberty. 

Keep reading to learn more about how this condition presents, what causes it, and more.  Symptoms

The most common symptoms of cherubism are:

• round, swollen-looking cheeks
• a wide jaw
• loose, misplaced, or missing teeth
• eyes that turn slightly upward (in advanced stages)

People with cherubism show no signs of it at birth. It starts to appear in early childhood, usually between the ages of 2 and 5 years. The tissue growths in the jaw grow rapidly until the child is about 7 or 8 years old. At that point, the tissue usually stops growing or grows more slowly for several years.

When someone with cherubism reaches puberty, the effects of the condition usually begin to reverse. For many people, the cheeks and jaw start to return to their typical size and shape in early adulthood. When this happens, normal bone replaces the tissue growths again. 

Many people show little or no outward sign of cherubism by their 30s or 40s. In some rare cases, though, the symptoms last throughout adulthood and don’t reverse. Causes

Cherubism is a genetic disorder. This means there’s a mutation, or permanent change, to the DNA pattern of at least one gene. Mutations can affect a single gene or multiple genes. 

About 80 percent  of people with cherubism have a mutation to the same gene, called SH3BP2. Studies suggest this gene is involved in creating cells that break down bone tissue. That could be why when this particular gene is mutated, it affects bone growth in the jaws.

In the remaining 20 percent of people with cherubism, the cause is most likely a genetic disorder, too. However, it isn't known which gene is affected.

Smileband health topics

Q fever is caused by the bacterium Coxiella burnetii. The organism is very hardy and is resistant to heat, drying, and many disinfectants, so it is able to survive in the environment for long periods. Q fever can result in acute or chronic illness. Symptoms vary greatly between individuals, and about half of the people with Q fever will not show any symptoms. Acute cases of Q fever begin with a sudden onset of one or more of the following:

• high fevers (up to 104°-105°F)
• severe headache
• general discomfort and fatigue
• muscle pain, confusion
• sore throat
• chills, sweats
• dry cough
• nausea
• vomiting
• diarrhea
• stomach pain
• chest pain.

Fever usually lasts for 1 to 2 weeks. Chronic Q fever may result in less than 5% of acutely infected patients, presenting within six weeks of acute infection, up to many years later.

 

Those at highest risk for chronic Q fever are pregnant women, immunosuppressed persons, and patients with pre-existing heart valve defects. Endocarditis is the most common manifestation of chronic Q fever.

 

Over the last 5 years, there have been approximately 8 cases of Q fever reported yearly.

 

Arizona 5 year median: 7 cases

 

Transmission
People usually become infected with Q fever through inhalation of dust contaminated with dried placental material, birth fluids, and excreta of infected herd animals. Other modes of transmission, such as tick bites and human-to-human transmission, are very rare. Consumption of raw or unpasteurized dairy products from infected animals is another method of exposure.

Incubation period is 2 to 3 weeks.

Lab Tests & Specimen Info

Test*	Specimen
IgG/IgM Serology (The convalescent specimen should be taken 2-4 weeks after the acute)	Serum (acute and convalescent)
PCR	Serum