Winter Vomiting Bug (Norovirus)

Norovirus, sometimes referred to as the winter vomiting bug, is the most common cause of gastroenteritis.

Symptoms

Diarrhea, vomiting, stomach pain, headache

Usual onset

12 to 48 hours after exposure

Duration

1 to 3 days

Causes

Norovirus

Diagnostic method

Based on symptoms

Sypmtoms

Norovirus infection is characterized by nausea, vomiting, watery diarrhea, abdominal pain, and in some cases, loss of taste. A person usually develops symptoms of gastroenteritis 12 to 48 hours after being exposed to norovirus.

General lethargy, weakness, muscle aches, headaches, and low-grade fevers may occur. The disease is usually self-limiting, and severe illness is rare. Although having norovirus can be unpleasant, it is not usually dangerous and most who contract it make a full recovery within two to three days.

Transmission

Noroviruses are transmitted directly from person to person (62–84% of all reported outbreaks) and indirectly via contaminated water and food.

Shellfish and salad ingredients are the foods most often implicated in norovirus outbreaks. Ingestion of shellfish that have not been sufficiently heated under 75 °C (167 °F) poses a high risk for norovirus infection. Foods other than shellfish may be contaminated by infected food handlers. Many norovirus outbreaks have been traced to food that was handled by one infected person.

Preventiom

1.) Wash your hands thoroughly. If you think you may have come into contact with the virus, you must wash your hands thoroughly to avoid the spread of infection.

2.) Use bleach to clean surfaces. Chlorine bleach is an effective cleaning agent that kills norovirus. Increase the concentration or buy a new bottle of chlorine bleach if the bleach you have has been open for more than a month.

3.) Wash your food before eating or cooking it. Wash all food items such as meats, fruits and vegetables thoroughly before consumption or for use in cooking. This is important as norovirus has the tendency to survive even at temperatures well above 140 degrees Fahrenheit.

4.) For areas exposed to feces or vomit contamination there are special cleaning procedures that you should try to follow. This is because the vomit or feces of a person contaminated with norovirus can easily cause you to become infected.

5.) Cook your food thoroughly before eating it. Seafood and shellfish should be cooked thoroughly before eating it. Quick steaming your food will generally not kill the virus, as it can survive the steaming process. Instead, bake or boil your food at temperatures higher than 140 F (60 C) if you are concerned about its origins.

How to avoid leukaemia in children

Avoiding Potential Risk Factors

Keep your child away from high doses of radiation.

Studies show that people exposed to a high dose of radiation are at risk for leukemia. A classic example is the Hiroshima bombing survivors. Their exposure to atomic bomb radiation increased their chances of getting leukemia dramatically.

Even low doses of radiation in x-rays, CT scans, or radiotherapy increase chances of developing leukemia. Therefore, you should avoid repeated exposure to these tests and treatments as much as possible.
Health care professionals must be responsible in avoiding unnecessary radiation exposure for patients.

Avoid exposing your child to benzene.

Benzene is a chemical base for producing other chemicals such as gasoline, lubricants, and pesticides. It carries a sweet odor that can be absorbed easily once inhaled. It can also penetrate the skin upon exposure.

Rates of leukemia, specifically AML, are higher in people exposed to benzene.
Chronic exposure causes sufficient amounts of benzene to wreak havoc in the body. Avoid working in places with repeated exposure to benzene such as gasoline stations and cigarette factories.

New safety regulations have prompted lessening of benzene content in products such as gasoline. Still, it is best to lessen frequenting gasoline stations and crude oil mills.

Refrain from smoking or using tobacco around your child.

Smoking induces benzene exposure because benzene is emitted in cigarette smoke. Other radioactive chemicals are also found in cigarettes.

Second-hand smoking exposes a person to benzene as well.
The best advice for smokers is to quit smoking now and save other’s lives too. For non-smokers, avoid cigarette smoke at all cost.

Beware of the risks associated with certain types of chemotherapy.

Children treated with chemo for other forms of cancer have a higher risk of developing a secondary cancer like Acute Myeloid Leukemia which develops within 5-10 years of treatment.

Alkylating agents are mostly the culprit for secondary cancer caused by chemotherapy. This drug attaches a disruptive alkyl group that damages the DNA of cells.

There is an increased incidence of leukemia with this group of drugs.
It is advisable to discuss the treatment plan carefully with a doctor when undergoing chemotherapy.

Do not drink alcohol during pregnancy.

Some studies have found that mothers who drink alcohol during pregnancy may increase the risk of leukemia developing in their unborn child.

Keeping Your Child Healthy

Feed your child a healthy diet.

Encouraging children to make healthier choices will make their bodies strong and are less likely to develop cancer. According to MD Anderson Cancer Center you may try the following alternatives to help your children eat healthy.

Add different fruits and vegetables to your kid’s meal.
Prepare ready to eat fruits and vegetables for snacks.
Puree vegetables and add as sauces over pastas.

Encourage your child to be more active.

Exercise keeps the body in good shape as well as improves overall immunity. Make sure to get your kids at least 60 minutes of physical activity.

Limit TV and video games.
Encourage bike or walking early morning.
Sign up kids for classes such as basketball clinics or dance lessons.

Make sure your child is getting adequate sleep.

The body recuperates best during sleep. Repair of damaged cells commence during this time to restore good health. Adequate sleep will ensure a healthy body and a well-oiled immune system, which is important to combat illnesses.
In general, children need a lot of sleep. one to three year olds need 12 to 14 hours, four to six year olds need 10 to 12 hours, seven to twelve year olds need 10 to 11 hours and teenagers need 8 to 9.

Recognizing the Symptoms Early On

Look for signs of fatigue.

Fatigue is the most common symptom. Paleness of the face and skin and difficult of breathing with mild exertion may accompany fatigue. These symptoms indicate that the red blood cells do not carry sufficient amounts of oxygen to the rest of the body. The lungs, other vital organs, and muscles compensate for less oxygen by working more diligently. This is a very taxing process to sustain and causes general feeling of fatigue.

Be aware of persistent fever.

Fever actually protects the body from harmful processes within. The constant fighting of the body against leukemia cells trigger persistent fever.

Ask your child if they are experiencing bone pain.

The bone marrow is the soft tissue core inside the bone. Bone pain is a result of the saturation of bone marrows with leukemia cells.

Look for easy bruising and bleeding.

Easy bruising , frequent bleeding of gums and nose, pinpoint red spots in the skin. These are symptoms of low amounts of normal platelet in the body.

Feel for soft, small lumps under the skin.

Soft, small lumps may be found in any part of the body. The lumps are by-products of leukemic cells seeping under the affected area.

Watch out for a loss of appetite.

The spleen is the graveyard for dead blood cells. Leukemia increase the death rate of blood cells and congest the spleen. Consequently, the spleen becomes enlarged. The close proximity of the spleen to the stomach plays a role in loss of appetite. The enlarged spleen presses on the stomach to mimic a feeling of fullness. This explains the loss of appetite.

Keep track of any weight loss.

Chronic battle of the body against leukemia triggers a cascade of inflammatory cells. One inflammatory cell is named tumor necrosis factor (cachectin). Cachectin is responsible for weight loss.

Be aware if your child is experiencing night sweats.

Fever is a response of the body against harmful leukemia cells. Chronic fever alters the ability of the brain to regulate body temperature. The brain’s faulty regulatory process perceives the normal body temperature to be too hot and uses night sweating as a means of releasing heat.

Look for lumps in the groin, underarms, and neck.

The lumps signify swelling of the lymph glands. The lymph glands are the policemen of the body. They detain unwanted bacteria, virus, and foreign substance such as cancer cells and prime them for removal. In this case, lymph glands trap leukemia cells and try to eliminate them.

Identify any pains or aches on the left side of the abdomen.

The spleen becomes too stretched and enlarged that pain is produced. This is often complained in the left side of the abdomen where the spleen is usually located.

Treating Leukemia

Put your child through chemotherapy.

According to the American Cancer Society, the main treatment for childhood leukemia is chemotherapy. For children who have higher risk for leukemia, chemotherapy is given along with stem cell transplant.

Chemotherapy can only potentially treat ALL and AML cases. Chemotherapy is most successful in ALL where 50% of cases are cured. CML and CLL do not respond well to chemotherapeutic drugs.

The main drawback of chemotherapy drugs is that it kills both normal and cancer cells. There may also be setbacks when cancer cells recur despite treatment. The main medications used in chemotherapy are cytarabine and anthracycline.

Cytarabine works by disturbing the DNA synthesis of healthy and cancer cells. Therefore, new cell production is put to a halt. Anthracycline damages DNA proteins and disrupts DNA synthesis of healthy and leukemia cells.

Sign your child up for a stem cell transplant.

A healthy donor’s stem cell can be transplanted into a leukemia patient by way of the bone marrow. In this way, new multipotent stem cells encourage the growth of new, healthy blood cells.
Bone marrow is the only stem cell transplant source without controversy. Other stem cell sources (such as embryos) are met with mixed opinions in the medical field.

Put your child on a neutropenic diet.

This is a special type of diet which aims to protect the patient from foods that harbor bacteria and potentially cause infection. The blood cells of patients are not well-equipped to ward off infection efficiently. Some basic tips to follow for neutropenic diet are:

• Avoid fresh fruits and raw vegetables. Bacteria may be present in the skin and leaves. Fruits that can be peeled off such as banana, grapefruit, and oranges are safe to eat. Cooked vegetables, canned fruits and vegetables, and juices are safe for consumption.
• Always cook the meat and fish well-done. This ensures that no potential threat such as Salmonella can infect a patient.
• Consume only pasteurized dairy products. Pasteurization is the gold standard of eliminating harmful substances in dairy products.
• Avoid salad bars, deli counters, and sashimi counters. Opt for cooked food all the time.
• Make sure that water is safe for drinking. Distilled, boiled, reverse osmosis or filtered water is advisable.

Tuberculosis

Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections do not have symptoms, in which case it is known as latent tuberculosis.

About 10% of latent infections progress to active disease which, if left untreated, kills about half of those affected.

The classic symptoms of active TB are a chronic cough with blood-containing sputum, fever, night sweats, and weight loss.

Symptoms

Chronic cough, fever, blood in the sputum, weight loss

Causes

Mycobacterium tuberculosis

Risk factors

Smoking, HIV/AIDS

Diagnostic method

CXR, culture, tuberculin skin test

Differential diagnosis

Necrotizing pneumonia, histoplasmosis, sarcoidosis, coccidioidomycosis

Treatment

Antibiotics

Frequency

25% of people (latent TB)

Deaths

1.6 million (2017)

How to prevent Tuberculosis

Avoid exposing yourself to people with active TB.

Obviously the most important precaution you can take to prevent TB is to avoid being around people with active TB, which is highly contagious, especially if you have already tested positive for latent TB. More specifically:

In particular, it is important to avoid spending time with TB patients in warm, stuffy rooms.
If you are forced to be around TB patients, for example if you work in a care facility where TB is currently being treated, you will need to take protective measures, such as wearing a face mask, to avoid breathing in the TB bacteria.

If a friend or family member has active TB, you can help to rid them of the disease and lessen your own risk of contracting it by ensuring that they strictly follow treatment instructions.

Know if you are “at-risk”.

Certain groups of people are considered to be more at-risk of developing TB than others. If you are a member of ones of these groups, you need to be more vigilant about protecting yourself from TB exposure.
Some of the main at-risk groups are as follows:

• People with weakened immune system, such as those with HIV or AIDs.

• People who live with or care for someone with active TB, such as a close relative or a doctor/nurse.

• Healthcare and social workers who serve high-risk patients, such as people who are homeless.

• People born where TB is common, including children, and anyone who has immigrated within the last five years from areas that have a high TB rate.

• People who live in crowded, confined spaces such as prisons, nursing homes, or homeless shelters.

• People who abuse drugs and alcohol, or have little or no access to proper health care.

• People who live in or travel to countries where active TB is common, such as countries in Latin America, Africa and parts of Asia .

Lead a healthy lifestyle

People who are in poor health are more susceptible to the TB virus, as their disease resistance is lower than in healthy people. Therefore, it is important to do your best to lead a healthy lifestyle.

Eat a healthy, balanced diet with plenty of fruit, vegetables, whole grains and lean meat. Avoid fatty, sugary and processed foods.
Exercise often, at least three to four times a week.

Try to incorporate some good cardiovascular exercise into your workouts, such as running, swimming or rowing.

Cut down on alcohol consumption and avoid smoking or taking drugs.

Get plenty of good quality sleep, ideally between seven and eight hours a night.

Maintain good personal hygiene and try to spend as much time as possible outdoors, in the fresh air.

Get the BCG vaccination to prevent TB.

The BCG (Bacille Calmette-Guerin) vaccine is used in many countries to help prevent the spread of TB, especially among small children. However, the vaccine is not commonly used in the US, where infection rates are low and the disease is highly treatable.

Therefore, the CDC does not recommend the vaccine as a routine immunization.

In fact, the CDC only recommends the BCG vaccine for U.S. citizens in the following situations:

• When a child has been tested negative for TB but will continue to be exposed to the disease, especially strains that are resistant to treatment.

• When a healthcare worker is continually exposed to tuberculosis, especially strains that are resistant to treatment.

• Before travelling to another country where tuberculosis is prevalent.

How to recognise Tuberculosis symptoms

Notice any unusual coughing.

TB usually infects the lungs, breaking down the tissue there. Our body’s natural response is to remove the irritant by coughing. Figure out how long you’ve been coughing; TB usually lasts for more than 3 weeks and may include such worrisome signs as bloody sputum.

Consider how long you’ve taken over the counter cold/flu medications or antibiotics for a respiratory infection with no relief. TB needs very specific antibacterial drugs, and to start therapy requires screening and confirming TB.

Look for discharge when coughing.

Have you noticed any sputum (sticky discharge) when coughing? If it smells and is dark, it can be any type of bacterial infection. If it’s clear and odorless, it can be a viral infection. Take notice if there’s been any blood when coughing into your hands or tissues.

When TB cavities and nodules form, nearby blood vessels may get destroyed, leading to hemoptysis coughing up blood.
You should always seek expert medical advice when you cough up blood. He or she will be able to advise you on how to proceed.

Pay attention to chest pain.

Chest pain can suggest a wide variety of issues, but when taken together with other symptoms, they can point to TB. If you feel a sharp pain, it can you point to a specific, localized area.

Note particularly if it hurts when you apply pressure to that area, or if it hurts when you breath in and out or when you cough.

TB forms hard cavities and nodules against the lungs/chest wall. When we breath, these hard masses cause damage to the area, leading to inflammation at the site. Pain tends to be sharp, localized to a specific area, and reproducible when we put pressure on it.

Take note of unintentional weight loss and lack of appetite.

The body has a complex response to the Mycobacterium tuberculosis bacteria that results in poor nutrient absorption and altered protein metabolism.

These changes might persist for months without your noticing them.
Look in the mirror and note any changes to your body. If you can see the outline of your bones, this indicates you don’t have enough muscle mass due to lack of protein and fat.
Measure your weight on a scale. Use a previous but recent weight from when you were feeling healthy as a comparison. Weight changes vary, but you should address any drastic changes with your healthcare provider.
Note whether your clothes feel looser
Keep track of how often you’ve been eating and compare it to when you last felt healthy.

Do not ignore fever, chills and night sweats.

Bacteria usually reproduce at around normal body temperature (98.6 F). The brain and immune system respond by raising the body’s temperature to stop the bug from reproducing. The rest of the body detects this change, then attempts to adjust to this new temperature by contracting muscles (shivers), making you feel chills. TB also causes specific inflammatory proteins that aid in fever production to be produced.

Beware of latent TB infection.

A latent TB infection is dormant and not infectious. The bacteria simply resides in body with no harm. Reactivation can occur in those with reduced immunity, as listed above. It can also occur with increased age due to weakening of the immune system. Reactivation sometimes also occurs for other, unknown reasons.

Be able to distinguish TB from other respiratory infections.

There are many other conditions that TB could be mistaken for. You don’t want to wait out a simple cold virus only to find out that you have something more serious on your hands. To differentiate between TB and other conditions, ask yourself the following questions:

• Is there clear mucus liquid dripping from my nose? A cold will cause congestion/inflammation of the nose and lungs that leads to mucus dripping or running out from the nose. TB will not present with a runny nose.
• What is being produced by my coughing? Viral infections and the flu tend to have a dry cough or produce a white mucus. Bacterial infections found in the lower respiratory tract produce brownish sputum. TB, though, typically produces a cough over 3 weeks and can produce a hallmark bloody sputum.
• Am I sneezing? TB does not cause sneezing. This is usually a sign of the cold or flu.
• Do I have a fever? TB can cause a fever of all levels, but those who have the flu typically have fevers of more than 100.4°.

• Do my eyes appear watery/itchy? The cold typically presents with these symptoms, but not TB.

• Do I have a headache? The flu typically presents with headaches.

• Do I have joint and/or body aches? The cold and flu can cause this but it is more severe with the flu.

• Do I have a sore throat?Look inside your throat and see if it appears red, swollen and painful when swallowing. This is seen mainly with cold but can appear with the flu as well.