Cardiac Arrest

Cardiac Arrest is defined as the failure and stopping of the pumping action of the heart. A heart attack can lead to cardiac arrest by triggering an unstable heart rhythm. In many cases, sudden cardiac arrest may be the first indication of heart problems. If there is no response, the rescuer turns the person on his back and uses the "look, listen, and feel" approach to determine whether breathing has stopped: looking to see whether the chest moves up and down, listening for sounds of breathing, and feeling for air movement over the person's mouth. This generally involves administration of cardiopulmonary resuscitation (CPR), shock treatment to your chest to reset your heart's rhythm (defibrillation) and advanced life support. Restoring circulation as fast as possible improves your chances of survival.
Cardiac arrest is the sudden, abrupt loss of heart function.Cardiac arrest refers to a sudden, profound disturbance in the heart 's rhythm that causes the heart to stop beating completely or slow to the point where the life is unsustainable. Cardiac arrest is not the same as a heart attack. The resulting lack of blood supply results in cell death from oxygen starvation.Cerebral hypoxia, or lack of oxygen supply to the brain, causes victims to lose consciousness and to stop breathing , which in turn causes the heart to stop Sudden cardiac arrest usually results from a severely abnormal heart rhythm that interferes with the pumping action of your heart and causes the immediate cessation of blood flow from the heart to the rest of your body.
During a heart attack, there may be disturbances in the heart rhythm. Sometimes a person can be revived during the first several minutes after suffering cardiac arrest. However, the more time that passes, the less likely it is that the person can be revived and, if revived, the more likely it is that he will have brain damage. The victim may or may not have diagnosed heart disease. It's also called sudden cardiac arrest or unexpected cardiac arrest. A heart attack, on the other hand, occurs when a sudden blockage in the coronary artery prevents blood flow to part of your heart muscle, causing dysfunction in the affected part and possible tissue death. Experts generally recommend that people make lifestyle changes to prevent the conditions that could trigger cardiac arrest, including atherosclerosis , which is the leading cause of coronary artery disease. Lifestyle changes may include losing weight , reducing LDL cholesterol levels, eating a heart - healthy diet and getting adequate exercise. A heart attack , yet who have extensive muscle damage, may be at risk for sudden cardiac death due to the heart's inability to pump enough blood. If the person is not breathing, the rescuer checks for airway blockage by looking into the mouth and throat for any visible objects.

Causes of Cardiac Arrest

The common Causes of Cardiac Arrest :

• Dramatic slowing of heart rate due to failure of its pacemaker or severe heart block (interference with electrical conduction)
• Choking or drowning
• Electrocution
• Sudden loss of blood pressure
• Sudden stopping of the heart and collapse (cardiac arrest)
• Death of heart tissue (myocardial infarction or heart attack)
• Ventricular fibrillation – a rapid, irregular heart rhythm preventing any circulation of blood (most common cause of sudden cardiac arrest)

Symptoms of Cardiac Arrest

Some are common Symptoms of Cardiac Arrest :

• Chest pain
• Weakness
• Lasts for a more than a few minutes or comes and goes
• Back pain or upper abdominal pain
• May feel like pressure, squeezing, fullness
• Unexplained shortness of breath
• Loss of consciousness
• Cold sweat
• Nausea
• Pounding in the chest
• Feeling faint

Treatment of Cardiac Arrest

• Rapid defibrillation using an automated external defibrillator (AED), found in many large public places and in commercial airplanes
• Treatment of specific problems like heart attack, stroke, or trauma by specialized medical teams
• CPR combines artificial respiration, which supplies oxygen to the lungs, with chest compressions, which circulate oxygen to the brain and other vital organs by forcing blood out of the heart.

Heart Diseases

Introduction - Heart disease is the name given to a whole collection of heart conditions that affect people on a daily basis and a term that people across the world are most certainly familiar with. To really understand what heart disease is all about, you need to know what each of the conditions are, and what they do to your body if you are unlucky enough to suffer from one of them.
It’s a killer disease that affects a vast portion of the world population, but few people know the facts related to heart disease. Heart disease is actually an umbrella term for many different types of afflictions affecting the heart and below we have listed a few conditions that affect the heart; however, this does not represent the full scope of the many specific medical conditions that make up heart disease.

What is Heart Disease? - Coronary Heart Disease

Coronary heart disease is the build up of atheromatous plaque (inflamed tissue) within the arteries that pump blood into the heart; this can build up over time and restrict the flow of blood to the heart causing heart failure. If this does not happen then there is also the possibility that the plaques can rupture causing blood to clot and restrict blood flowing to the heart. The disease progresses over time, and symptoms are often non-existent until the condition manifests itself in the form of a heart attack.
When the plaque builds up to a point where the blood flow to the heart is reduced or cut off, serious consequences can result. Those with an advanced case of coronary heart disease may experience frequent and painful chest pains, due to a symptom known as ‘angina’. The best way of preventing a case of coronary heart disease involves engaging in an active lifestyle, watching what you eat and avoid smoking.
What is Heart Disease?- Ischemic (or ischaemic) heart disease
Those who suffer from Ischemic heart disease experience a decreased flow of blood to the heart. Angina may also occur when a case of Ischemic heart disease is present. Just like Coronary Heart Disease this type of heart disease is very serious and can be prevented by maintaining a healthy lifestyle.
‘Ischaemia’   means an "inadequate blood supply". The only supply of blood to the heart muscle is through the coronary arteries, so any obstruction in the coronary arteries will reduce the supply of blood to the heart muscle.
Atherosclerosis is one of the most common cause of ischemic heart disease and may even exist when the artery lumens appear normal by angiography.
Possible consequences of Ischemic heart disease can be:
v Temporary damage and pain (ischemia)
v Permanent heart muscle damage, heart muscle does not grow back (acute myocardial infarction /infarct)
v Loss of muscle activity (acute heart failure)
v Long term loss of heart muscle activity (chronic heart failure)
v Cardiac arrhythmias: irregular heartbeat which can be fatal. Most death is due to arrhythmias, usually tachyarrhythmias.
v Other structural damage to the heart including damaged heart valves, actual perforation of the heart and a thin walled fibrous floppy heart.

What is Heart Disease? - Cardiovascular Heart Disease

Cardiovascular disease - is a term that represents a number of different types of heart disease. These types of heart disease often affect the blood vessels of the heart. With over 71.3 million citizens of the United States alone affected by a form of cardiovascular disease, it is a common type of illness that can also be avoided by staying healthy.
Pulmonary heart disease - is a very serious form of heart disease. If there is a change in the structure of the right ventricle located in the heart, due to respiratory problems. The affect this has on the right ventricle is great; it can cause increased pressure in the right ventricle, which will eventually lead to the right ventricle stretching through dilation or additional muscle growth in the ventricle to help add strength to the contractions needed for the increase in pressure.
This will add a lot of strain to the heart and will eventually lead to heart failure, and in some cases swelling in the legs.

What is Heart Disease? - Hypertensive Heart Disease

Hypertensive heart disease is related to hypertension, which is commonly known as high blood pressure and affects a large group of people worldwide.
High blood pressure means the heart has produced an elevated amount of pressure to pump the blood around the body, this can, overtime cause a strain on the heart leading to heart failure or an aortic arterial aneurysm.
An aortic arterial aneurysm is the bulging of a blood vessel in the artery, which will increase to the point that it bursts causing severe pain, and without immediate medical assistance, death.
If found early then surgical intervention can take place and an artificial tube sewn into the aorta and the aneurysm closed so it wont rupture causing a massive internal hemorrhage. This surgery is very invasive so the medical profession will not carry out the surgery unless it is deemed necessary. When arterial hypertension is occurring within the heart, the disease takes over, causing fatigue, an irregular pulse, and a swelling of the feet. The condition can lead to cases of congestive heart failure, and it is a leading cause of death in western society. 

What is Heart Disease? - V alvular Heart Disease
There are valves in the heart which assist the bloods journey through the labyrinth of channels that keep the heart functioning. Sometimes there are problems with these valves thus impeding the flow of blood.
The valves in the heart are the tricuspid valve and pulmonic valve, which are both found in the right side of the heart and the mitral valve and aortic valve, which are found in the left side of the heart.
There are a great number of medical conditions that affect the valves in different ways but they all generally involve one or more of the valves being too narrow, wide or loose causing regurgitation of the blood.

What is Heart Disease? - Summary

Now that you know more about the different types of heart disease, you’ll be better able to draw parallels when it comes to acting in a preventative matter and keeping a healthy heart.
By knowing all that you can about:
v coronary heart disease,
v ischaemic heart disease,
v cardiovascular disease,
v pulmonary heart disease
v valvular heart disease
v hypertensive heart disease,
you’ll be better suited than most when it comes to staying healthy, recognizing symptoms and avoiding a visit to the  A & E of your nearest hospital .
As you can see the causes and affects vary greatly, and it is due to this that we need to be diligent and understand heart disease better, after all it is one of the biggest killers of the present day.

Respiratory Failure

Respiratory failure is nearly any condition that affects breathing function or the lungs themselves and can result in failure of the lungs to function properly. The main tasks of the lungs and chest are to get oxygen from the air that is inhaled into the bloodstream, and, at the same to time, to eliminate carbon dioxide (C02) from the blood through air that is breathed out. In respiratory failure, the level of oxygen in the blood becomes dangerously low, and/or the level of C02 becomes dangerously high. There are two ways in which this can happen. Either the process by which oxygen and C02 are exchanged between the blood and the air spaces of the lungs (a process called "gas exchange") breaks down, or the movement of air in and out of the lungs (ventilation) does not take place properly.
Respiratory failure often is divided into two main types. One of them, called hypoxemic respiratory failure, occurs when something interferes with normal gas exchange. Too little oxygen gets into the blood (hypoxemia), and all organs and tissues in the body suffer as a result. One common type of hypoxemic failure, occurring in both adults and prematurely born infants, is respiratory distress syndrome, a condition in which fluid or tissue changes prevent oxygen from passing out of the air sacs of the lungs into the circulating blood. Hypoxemia also may result from spending time at high altitudes (where there is less oxygen in the air); various forms of lung disease that separate oxygen from blood in the lungs; severe anemia ("low blood"); and blood vessel disorders that shunt blood away from the lungs, thus precluding the lungs from picking up oxygen.

The other main type of respiratory failure is ventilatory failure, occurring when, for any reason, breathing is not strong enough to rid the body of C02. Then CO2 builds up in the blood (hypercapnia). Ventilatory failure can result when the respiratory center in the brainstem fails to drive breathing; when muscle disease keeps the chest wall from expanding when breathing in; or when a patient has chronic obstructive lung disease that makes it very difficult to exhale air with its C02. Many of the specific diseases and conditions that cause respiratory failure cause both too little oxygen in the blood (hypoxemia) and abnormal ventilation.
Several different abnormalities of breathing function can cause respiratory failure. The major categories, with specific examples of each, are:

Obstruction of the airways. Examples are chronic bronchitis with heavy secretions; emphysema; cystic fibrosis; asthma (a condition in which it is very hard to get air in and out through narrowed breathing tubes).

Weak breathing. This can be caused by drugs or alcohol, which depress the respiratory center; extreme obesity; or sleep apnea, where patients stop breathing for long periods while sleeping.

Muscle weakness. This can be caused by a muscle disease called myasthenia; muscular dystrophy; polio; a stroke that paralyzes the respiratory muscles; injury of the spinal cord; or Lou Gehrig's disease.

Lung diseases, including severe pneumonia. Pulmonary edema, or fluid in the lungs, can be the source of respiratory failure. Also, it can often be a result of heart disease; respiratory distress syndrome; pulmonary fibrosis and other scarring diseases of the lung; radiation exposure; burn injury when smoke is inhaled; and widespread lung cancer.

An abnormal chest wall (a condition that can be caused by scoliosis or severe injury of the chest wall).

A majority of patients with respiratory failure are short of breath. Both low oxygen and high carbon dioxide can impair mental functions. Patients may become confused and disoriented and find it impossible to carry out their normal activities or do their work. Marked C02 excess can cause headaches and, in time, a semi-conscious state, or even coma. Low blood oxygen causes the skin to take on a bluish tinge. It also can cause an abnormal heart rhythm (arrhythmia). Physical examination may show a patient who is breathing rapidly, is restless, and has a rapid pulse. Lung disease may cause abnormal sounds heard when listening to the chest with a stethoscope: wheezing in asthma, "crackles" in obstructive lung disease. A patient with ventilatory failure is prone to gasp for breath, and may use the neck muscles to help expand the chest.
The symptoms and signs of respiratory failure are not specific. Rather, they depend on what is causing the failure and on the patient's condition before it developed. Good general health and some degree of "reserve" lung function will help see a patient through an episode of respiratory failure. The key diagnostic determination is to measure the amount of oxygen, carbon dioxide, and acid in the blood at regular intervals. A sudden low oxygen level in the lung tissue may cause the arteries of the lungs to narrow. This, in turn, causes the resistance in these vessels to increase, which can be measured using a special catheter. A high blood level of C02 may cause increased pressure in the fluid surrounding the brain and spinal cord; this, too, can be measured.
Nearly all patients are given oxygen as the first treatment. Then the underlying cause of respiratory failure must be treated. For example, antibiotics are used to fight a lung infection, or, for an asthmatic patient, a drug to open up the airways is commonly prescribed.

A patient whose breathing remains very poor will require a ventilator to aid breathing. A plastic tube is placed through the nose or mouth into the windpipe and is attached to a machine that forces air into the lungs. This can be a lifesaving treatment and should be continued until the patient's own lungs can take over the work of breathing. It is very important to use no more pressure than is necessary to provide sufficient oxygen; otherwise ventilation may cause further lung damage. Drugs are given to keep the patient calm, and the amount of fluid in the body is carefully adjusted so that the heart and lungs can function as normally as possible. Steroids, which combat inflammation, may sometimes be helpful but they can cause complications, including weakening the breathing muscles.

The respiratory therapist has a number of methods available to help patients overcome respiratory failure. They include:

Suctioning the lungs through a small plastic tube passed through the nose, in order to remove secretions from the airways that the patient cannot cough up.

Postural drainage, in which the patient is propped up at an angle or tilted to help secretions drain out of the lungs. The therapist may clap the patient on the chest or back to loosen the secretions, or a vibrator may be used for the same purpose.

Breathing exercises often are prescribed after the patient recovers. They make the patient feel better and help to strengthen the muscles that aid breathing. One useful method is for the patient to suck on a tube attached to a clear plastic hosing containing a ball so as to keep the ball lifted. Regular deep breathing exercises are simpler and often just as helpful. Another technique is to have the patient breathe out against pursed lips to increase pressure in the airways and keep them from collapsing.
The outlook for patients with respiratory failure depends chiefly on its cause. If the underlying disease can be effectively treated, with the patient's breathing supported in the meantime, the outlook is usually good.

Care is needed not to expose the patient to polluting substances in the atmosphere while recovering from respiratory failure; this could tip the balance against recovery. When respiratory failure develops slowly, pressure may build up in the lung's blood vessels, a condition called pulmonary hypertension. This condition may damage the vessels, worsen hypoxemia, and cause the heart to fail. If it is not possible to provide enough oxygen to the body, complications involving either the brain or the heart may prove fatal.

If the kidneys fail or the diseased lungs become infected, the prognosis is worse. In some cases, the primary disease causing the lungs to fail is irreversible. The patient, family, and physician together then must decide whether to prolong life by ventilator support. Occasionally, lung transplantation is a possibility, but it is a highly complex procedure and is not widely available

Because respiratory failure is not a disease itself, but the end result of many lung disorders, the best prevention is to treat any lung disease promptly and effectively. It is also important to make sure that any patient who has had lung disease is promptly treated for any respiratory infection (even of the upper respiratory tract). Patients with lung problems should also avoid exposure to pollutants, as much as is possible. Once respiratory failure is present, it is best for a patient to receive treatment in an intensive care unit, where specialized personnel and all the needed equipment are available. Close supervision of treatment, especially mechanical ventilation, will help minimize complications that would compound the problem.
A common form of lung disease in which breathing, and therefore gas exchange, is labored and increasingly difficult.

Gas exchange
The process by which oxygen is extracted from inhaled air into the bloodstream, and, at the same time, carbon dioxide is eliminated from the blood and exhaled.

Hypoxemia
An abnormally low amount of oxygen in the blood, the major consequence of respiratory failure, when the lungs no longer are able to perform their chief function of gas exchange.

Pulmonary fibrosis
An end result of many forms of lung disease (especially chronic inflammatory conditions). Normal lung tissue is converted to scarred, "fibrotic" tissue that cannot carry out gas exchange.

Cough

A cough is a forceful release of air from the lungs that can be heard. Coughing protects the respiratory system by clearing it of irritants and secretions.

Cough - Description

While people can generally cough voluntarily, a cough is usually a reflex triggered when an irritant stimulates one or more of the cough receptors found at different points in the respiratory system. These receptors then send a message to the cough center in the brain, which in turn tells the body to cough. A cough begins with a deep breath in, at which point the opening between the vocal cords at the upper part of the larynx (glottis) shuts, trapping the air in the lungs. As the diaphragm and other muscles involved in breathing press against the lungs, the glottis suddenly opens, producing an explosive outflow of air at speeds greater than 100 mi (160 km) per hour.

In normal situations, most people cough once or twice an hour during the day to clear the airway of irritants. However, when the level of irritants in the air is high or when the respiratory system becomes infected, coughing may become frequent and prolonged. It may interfere with exercise or sleep, and it may also cause distress if accompanied by dizziness, chest pain, or breathlessness. In the majority cases, frequent coughing lasts one to two weeks and tapers off as the irritant or infection subsides. If a cough lasts more than three weeks it is considered a chronic cough, and physicians will try to determine a cause beyond an acute infection or irritant.

Coughs are generally described as either dry or productive. A dry cough does not bring up a mixture of mucus, irritants, and other substances from the lungs (sputum), while a productive cough does. In the case of a bacterial infection, the sputum brought up in a productive cough may be greenish, gray, or brown. In the case of an allergy or viral infection it may be clear or white. In the most serious conditions, the sputum may contain blood.

Cough - Causes and Symptoms

In the majority of cases, coughs are caused by respiratory infections, including:

colds or influenza, the most common causes of coughs

bronchitis, an inflammation of the mucous membranes of the bronchial tubes

croup, a viral inflammation of the larynx, windpipe, and bronchial passages that produces a bark-like cough in children

whooping cough, a bacterial infection accompanied by the high-pitched cough for which it is named

pneumonia, a potentially serious bacterial infection that produces discolored or bloody mucus

tuberculosis, another serious bacterial infection that produces bloody sputum

fungal infections, such as aspergillosis, histoplasmosis, and cryptococcoses.

Environmental pollutants, such as cigarette smoke, dust, or smog, can also cause a cough. In the case of cigarette smokers, the nicotine present in the smoke paralyzes the hairs (cilia) that regularly flush mucus from the respiratory system. The mucus then builds up, forcing the body to removed it by coughing. Post-nasal drip, the irritating trickle of mucus from the nasal passages into the throat caused by allergies or sinusitis, can also result in a cough. Some chronic conditions, such as asthma, chronic bronchitis, emphysema, and cystic fibrosis, are characterized in part by a cough. A condition in which stomach acid backs up into the esophagus (gastroesophageal reflux) can cause coughing, especially when a person is lying down. A cough can also be a side-effect of medications that are administered via an inhaler. It can also be a side-effect of beta-blockers and ACE inhibitors, which are drugs used for treating high blood pressure.

Cough - Diagnosis

To determine the cause of a cough, a physician should take an exact medical history and perform an exam. Information regarding the duration of the cough, what other symptoms may accompany it, and what environmental factors may influence it aid the doctor in his or her diagnosis. The appearance of the sputum will also help determine what type of infection, if any, may be involved. The doctor may even observe the sputum microscopically for the presence of bacteria and white blood cells. Chest x rays may help indicate the presence and extent of such infections as pneumonia or tuberculosis. If these actions are not enough to determine the cause of the cough, a bronchoscopy or laryngoscopy may be ordered. These tests use slender tubular instruments to inspect the interior of the bronchi and larynx.

Cough - Treatment

Treatment of a cough generally involves addressing the condition causing it. An acute infection such as pneumonia may require antibiotics, an asthma-induced cough may be treated with the use of bronchodialators, or an antihistamine may be administered in the case of an allergy. Physicians prefer not to suppress a productive cough, since it aids the body in clearing respiratory system of infective agents and irritants. However, cough medicines may be given if the patient cannot rest because of the cough or if the cough is not productive, as is the case with most coughs associated with colds or flu. The two types of drugs used to treat coughs are antitussives and expectorants.

Antitussives

Antitussives are drugs that suppress a cough. Narcotics--primarily codeine--are used as antitussives and work by depressing the cough center in the brain. However, they can cause such side effects as drowsiness, nausea, and constipation. Dextromethorphan, the primary ingredient in many over-the-counter cough remedies, also depresses the brain's cough center, but without the side effects associated with narcotics. Demulcents relieve coughing by coating irritated passageways.

Expectorants

Expectorants are drugs that make mucus easier to cough up by thinning it. Guaifenesin and terpin hydrate are the primary ingredients in most over-the-counter expectorants. However, some studies have shown that in acute infections, simply increasing fluid intake has the same thinning effect as taking expectorants.

Cough - Alternative treatment

Coughs due to bacterial or viral upper respiratory infections may be effectively treated with botanical and homeopathic therapies. The choice of remedy will vary and be specific to the type of cough the patient has. Some combination over-the-counter herbal and homeopathic cough formulas can be very effective for cough relief. Lingering coughs or coughing up blood should be treated by a trained practitioner.

Many health practitioners advise increasing fluids and breathing in warm, humidified air as ways of loosening chest congestion. Others recommend hot tea flavored with honey as a temporary home remedy for coughs caused by colds or flu. Various vitamins, such as vitamin C, may be helpful in preventing or treating conditions (including colds and flu) that lead to coughs. Avoiding of mucous-producing foods can be effective in healing a cough condition. These mucous-producing foods can vary, based on individual intolerance, but dairy products are a major mucous-producing food for most people.

Cough - Prognosis

Because the majority of coughs are related to the common cold or influenza, most will end in seven to 21 days. The outcome of coughs due to a more serious underlying disease depends on the pathology of that disease.

Cough - Prevention

It is important to identify and treat the underlying disease and origin of the cough. Avoid smoking and coming in direct contact with people experiencing cold or flu symptoms. Wash hands frequently during episodes of upper-respiratory illnesses.

Key Terms

Antitussives
Drugs used to suppress coughing.

Expectorant
Drug used to thin mucus.

Gastroesophageal reflux
Condition in which stomach acid backs up into the esophagus.

Glottis
The opening between the vocal cords at the upper part of the larynx.

Larynx
A part of the respiratory tract between the pharynx and the trachea, having walls of cartilage and muscle and containing the vocal cords.

Sputum
The mixture of mucus, irritants, and other substances expelled from the lungs by coughing.

Five reasons to avoid junk food

Junk food is very common now a day’s especially in young youth. People have stopped eating the traditional curry dishes. As every picture has two sides so is same for the junk food. People like junk food as it is readily available always. People think that junk food digest faster than the usual traditional food. But the junk food has also got drawbacks. Following are the 5 major reasons that why one should avoid the junk food:-

Heart diseases

Junk food results in many heart diseases such as cardiac arrest, atherosclerosis and myocardial infraction. The reason that junk food causes these diseases is that junk food contain excess amount of lipoproteins and cholesterol. The lipoproteins and cholesterol deposit on inner linings of blood vessels. So, this results in formation of plaques. And for this reason heart need to put extra effort to pump the blood through the arteries. Junk food also contains excess amount of sugar and salts which result in increased blood pressure.

Liver failure

Liver failure is also due to same reason. The presence of cholesterol and salts in junk food result in liver failure.

Lack of energy

Junk food contains harmful carbohydrates, cholesterol and fats. So, the body having junk food does not get required nutrients and it lack energy.

Diabetes

Junk food ingredients are also harmful in the way that they damage the pancreas and result in IDDM (Insulin-dependent diabetes mellitus).

Poor concentration

Due to excess of oil and fat in the junk food it makes difficult for the body to digest it. So to digest this all body utilizes more enzymes and blood. Person feels drowsy and has less concentration because major portion of blood is diverted to intestine.

West Nile disease

What is it West Nile disease?

West Nile virus is spread through the bite of an infected mosquito. The mosquito can become infected after biting an infected bird and this can then be transmitted from the bird to humans.

There is no evidence to suggest that West Nile virus can be spread from person to person or animal to person.

Where am I at risk?

The West Nile virus was first discovered in the West Nile area of Uganda in 1937.

It is prevalent in North America, where two thirds of the East coast states have had cases. There has even been a case in California.

There have also been cases in Israel, Africa and Asia and parts of Eastern Europe.

There was a UK case of a bird with the antibodies of the West Nile virus, but there have been no human cases.

What are the symptoms?

The patient can incubate the disease for up to a fortnight after being bitten.

Many of the people who become infected will have either no symptoms or mild flu-like symptoms, which last a couple of days.

These can range from fever, headache and body aches to skin rashes on the trunk of the body and swollen lymph glands.

But more serious cases, less than 1% of those who become infected, can result in severe illness such as West Nile encephalitis or meningitis and sometimes lead to death.

Out of about 1,000 people who became infected in Europe recently there were about 40 deaths.

How do I protect myself?

Scientists have developed a vaccine for the disease and it was due to start human trials in late 2002.

But as yet there is no vaccine for travellers to use so the best way to protect yourself is to avoid being bitten by a mosquito.

The mosquitoes which carry this disease bite at dawn, dusk and early evening, so if you are travelling to an area where the disease is prevalent you should either stay indoors, or wear long sleeved shirts and long-trousers and wear insect repellent.

People travelling with young children should ensure that they use a specially prepared insect repellent, rather than the adult version.

Sars

What is Sars?

Sars stands for Severe Acute Respiratory Syndrome. It is a new illness that emerged in the Far East early in 2003, first in southern China, then spreading to Hong Kong, Vietnam, Singapore, Canada and more than 20 other countries.

It is believed to be caused by a new strain of Corona virus - a family of viruses which has been linked to the common cold.

By the middle of April, it had killed more than 150 people worldwide and infected more than 3,000 more.

What are the symptoms, and how is it treated?

The most obvious symptoms of Sars are breathing problems. Patients develop a high temperature (more than 38 degrees), dry cough, and severe respiratory symptoms follow swiftly.

Some patients need to be put on a ventilator to keep them breathing while their bodies fight the infection. Four in every hundred people who develop Sars do not survive.

Most of those who have died have been older, or had pre-existing health problems which increased their vulnerability - but some younger, healthy people have died.

Patients suspected of having Sars are given a combination of antibiotics and antiviral drugs, which have produced an improvement in some patients, although their precise effectiveness is uncertain.

There is no vaccine for the virus that causes Sars, although a diagnostic test has been developed.

How can I catch it?

The virus appears to be transmitted less easily than conventional influenza - although the resulting illness can become more severe.

It appears to be passed on by "close contact" with an infected person, perhaps carried in large droplets thrown out when the infected person sneezes or coughs.

There has been concern about transmission within passenger aircraft. The latest advice suggests that those at risk of infection would need to be seated within a couple of rows of the infected person, with no evidence of risk to people sitting elsewhere on the plane.

People in the Far East have attempted to protect themselves by wearing face masks - it is uncertain how much genuine protection these offer against the virus.

Should I avoid any particular areas?

The areas worst hit by Sars are Hong Kong, and the Guangdong province of southern China.

In late March 2003, the World Health Organization advised people to restrict non-essential travel to Hong Kong or Guangdong. The UK government agreed with this advice. This was only intended to be temporary advice until outbreaks in these locations were under control.

Travellers should check the websites of the World Health Organization and, in the UK, either the Health Protection Agency or Foreign and Commonwealth Office for the latest advice.

All travellers to areas heavily affected by Sars should be aware of this and take account of the problem in their travel plans. Some countries have been screening passengers arriving from Sars-hit areas for early signs of the illness.

I have some of these symptoms. What should I do?

If you have recently returned from South East Asia and suffer from any of the following symptoms - sudden onset of fever (>38° C), together with respiratory symptoms such as cough, sore throat, shortness of breath or difficulty breathing within 10 days of return

Lyme disease

How would I get Lyme disease?

Lyme disease is caused by a bacteria, called Borrelia burgdorferi, and is transmitted to humans through the bites of a tick.

The ticks are found either on animals such as deer and mice, or they jump onto the human when they brush past them in tall grass, shrubs or low trees.

Where am I most at risk?

America, particularly the forested areas of New England, has the most cases of Lyme disease - here the numbers of those infected run into hundreds of thousands each year.

Russia is also quite badly affected. But there are also cases of Lyme disease in the UK. Doctors usually see a few hundred cases of it each year.

And recent climate changes have been blamed for an increase in the infection.

What are the symptoms?

There are a variety of symptoms linked to Lyme disease. The first is an expanding rash or bruise which starts at the bite mark, usually a week after the person has been bitten.

It can appear as either a single red blotch, or as a "bullseye" shape with a widening ring around its central point.

The mark can feel warm to the touch, but might not itch or cause pain.

After the rash appears sufferers may also start to suffer joint pains, fever, fatigue, stiff neck and facial paralysis or tingling as the bacteria starts to spread around the body.

More serious symptoms can include severe headaches, painful arthritis, joint swelling and heart problems.

Some patients even suffer mental disorders such as short term memory loss and difficulty concentrating.

But if the disease is caught early enough it can be treated with antibiotics, although later stage Lyme does not respond as well.

What should I do to protect myself?

Anyone in an area where Lyme disease is thought to be prevalent should check themselves regularly to ensure that they have not been bitten.

Ticks can attach themselves anywhere on the body, but prefer creases like the armpit, groin or back of the knee.

Walkers should wear light coloured clothing and gardeners' light gloves, so they can see the ticks.

The ticks spread their disease slowly, so the quicker they are spotted the less chance there is of someone becoming infected.

The best way to remove a tick is by tweezers, although you should be careful to pull the tick out directly without jerking or twisting it. Antiseptic should then be put on the wound.

Leishmaniasis

What is it?

Leishmaniasis is a parasitic disease spread through bites from sandflies.

It affects about 12 million people globally, most of them in south or central America, Africa and the Middle East.

There are three sorts of leishmaniasis, which vary in severity.

The most dangerous is "visceral leishmaniasis", which is also known as black fever. This is nearly always fatal if it is left untreated.

It spreads into the spleen, bone marrow and liver and attacks and destroys the immune system.

Another type, "mucocutaneous leishmaniasis", produces disfiguring lesions which destroy the mucous membranes of the nose, mouth and throat.

"Cutaneous leishmaniasis" tends to cause sores on the skin. Some people have had up to 100 and these can vary in size from 2cm to 3cm in diameter.

How can I avoid it?

As the disease is spread by the sandfly the best way to avoid it, is to avoid getting bitten.

The sandfly bites mainly at night so travellers should use a good insect repellent, they should also sleep under insect nets with a very fine mesh.

Leishmaniasis is prevalent in about 90 tropical and subtropical countries around the world.

What do I do if I get it?

Anyone suffering from the symptoms of leishmaniasis, who has just returned from an area in which it is prevalent, should contact their GP immediately.

It is vital that people going to their doctor tell him where they have been travelling so that he can make an accurate diagnosis.

What is the treatment?

The treatment involves a series of about 30 days worth of injections, using a toxic drug to kill the parasite. The patient has to stay in hospital for the duration of their treatment.

Dengue fever

How would I get dengue fever?

Dengue fever is a mosquito-borne infection, which annually affects about 20 million people.

It is also nicknamed "break bone fever".

About 24,000 people worldwide die from dengue each year.

It is now endemic in more than 100 countries in Africa, Southern America, the Eastern Mediterranean, South-east Asia and the Western Pacific.

What are the symptoms?

Dengue fever has symptoms which can be very similar initially to flu.

Most people who get it will suffer from headaches and fever. Some get rashes, aches and pains and their symptoms usually last for two or three days.

An infected person can feel tired for up to three months, but will not usually need treatment.

Could I die?

It particularly affects young children and adults, but is rarely fatal.

But there is one form of the disease, dengue haemorrhagic fever (DHF) that can be a fatal complication.

DHF is often characterised by a high fever, a bleeding and often enlarged liver and in the most severe cases circulatory fever.

How can I avoid it?

Unlike most mosquitoes, the Ades species, which transmits Dengue fever bites during the day.

Travellers in infected areas should protect themselves during the day by wearing long-sleeved shirts and trousers.

Travellers should also use insect repellents and mosquito coils.

There is currently no vaccine for the disease.

What do I do if I get it?

Travellers who get dengue fever are advised to get plenty of rest and to seek medical help if their condition worsens.

But people who have got the disease once should find that they are unlikely to get reinfected within the year.

Abscesses

An abscess is formed when pus accumulates in a tissue, organ, confined space in the body due to an infection. An abscess can form in the brain, lungs, teeth, gums, under arms, GI tract, abdominal wall, ears, tonsils, sinuses, bones, breasts, kidneys, prostate gland, rectum, scrotum, and to almost any part of the body. They may indeed be located externally or internally and may result from injury or a lowered resistance to infection.

The affected area may be swollen, inflamed, hot, red, and tender. The individual may also experience fatigue, weight; loss, anorexia, and alternating bouts of fever and chills. Rupture of the abscess and in severe cases, bacteremia (blood infection) can occur. The material inside an abscess consists of living and dead white blood cells, bacteria, dead tissue, and toxins – all of which can be discarded from the body.

An abscess is said to be acute if it appears suddenly ( in a matter of a few hours or overnight) and is termed chronic is it has been present for a period of days or weeks. Acute abscesses generally respond better to treatment in a matter of days.

Basically, an abscess is a sign that the body is trying to rid itself of impurities. The impurities may be half-starved cells, deficient in nutrients such as sulfur, or toxins that accumulate because of a failure of the normal eliminative processes. Such a situation stems from poor diet and exposure to environmental pollutants, chemicals, or harmful substances. Eating junk food not only clutters the system with food lacking in nutrients, but also prevents the cellular wastes from being eliminated efficiently by causing problems such as constipation and a sluggish liver, spleen, and kidney function.

Water Borne diseases

Water-borne diseases are any illness caused by drinking water contaminated by human or animal faeces, which contain pathogenic microorganisms.
The full picture of water-associated diseases is complex for a number of reasons. Over the past decades, the picture of water-related human health issues has become increasingly comprehensive, with the emergence of new water-related infection diseases and the re-emergence of ones already known. Data are available for some water-, sanitation- and hygiene-related diseases (which include salmonellosis, cholera, shigellosis), but for others such malaria, schistosomiasis or the most modern infections such legionellosis or SARS CoV the analyses remain to be done.
The burden of several disease groups can only partly be attributed to water determinants. Even where water plays an essential role in the ecology of diseases, it may be hard to pinpoint the relative importance of aquatic components of the local ecosystems.

Dimension of the problem

In developing countries four-fifths of all the illnesses are caused by water-borne diseases, with diarrhoea being the leading cause of childhood death.

The global picture of water and health has a strong local dimension with some 1.1 billion people still lacking access to improved drinking water sources and some 2.4 billion to adequate sanitation. Today we have strong evidence that water-, sanitation and hygiene-related diseases account for some 2,213,000 deaths annually and an annual loss of 82,196,000 Disability Adjusted Life Years (DALYs) (R. Bos, Dec. 2004).

WHO estimates indicate that worldwide over 2 billion people are infected with schistosomes and soil transmitted helminthes and 300 million of these suffer serious illness as a result.
Malaria kills over a million people every year, and a large percentage of them are under five as well, mainly in Africa South of the Sahara. In 2001 the estimated global burden of malaria amounted to 42.3 million DALYs, constituting 10 % of Africa’s overall disease burden. Malaria causes at least 396.8 million cases of acute illness each year. Pregnant women are the main adult risk group. As one of the major public health problems in tropical countries, it has been claimed that malaria has reduced economic growth in African countries by 1.3 % each year over the past 30 years (*).

An estimated 246.7 million people worldwide are infected by schistomiasis, and of these 20 million suffer severe consequences of the infection, while 120 million suffer milder symptoms. An estimated 80% of transmission takes place in Africa south of the Sahara (*).

Diarrhoea occurs worldwide and causes 4% of all deaths and 5% of the health loss to disability.

In Bangladesh alone, some 35 million people are exposed, on a daily basis, to elevated levels of arsenic in their drinking water, which will ultimately threaten their health and shorten their life expectancy.

After the Tsunami attack in Asia on Sunday the 26^th of December 2004 people faced the threat of water borne diseases linked to flooding, like Shigellosis, Cholera, Hepatitis A, Leptospirosis, Typhoid Fever, Malaria and Dengue fever.

Source 'Global Water Supply and Sanitation Assessment 2000 Report', section 2.2, WHO 2000

Transmission

Water borne diseases spread by contamination of drinking water systems with the urine and faeces of infected animal or people.

This is likely to occur where public and private drinking water systems get their water from surface waters (rain, creeks, rivers, lakes etc.), which can be contaminated by infected animals or people. Runoff from landfills, septic fields, sewer pipes, residential or industrial developments can also sometimes contaminate surface water.

This has been the cause of many dramatic outbreaks of faecal-oral diseases such as cholera and typhoid. However, there are many other ways in which faecal material can reach the mouth, for instance on the hands or on contaminated food. In general, contaminated food is the single most common way in which people become infected.

The germs in the faeces can cause the diseases by even slight contact and transfer. This contamination may occur due to floodwaters, water runoff from landfills, septic fields, and sewer pipes.

The following picture shows the faecal-oral routes of diseases transmission.

The only way to break the continued transmission is to improve the people’s hygienic behaviour and to provide them with certain basic needs: drinking water, washing and bathing facilities and sanitation. Malaria transmission is facilitated when large numbers of people sleep outdoors during hot weather, or sleep in houses that have no protection against invading mosquitoes. Malaria mosquitoes, tropical black flies, and bilharzias snails can all be controlled with efficient drainage because they all depend on water to complete their life cycles.

Prevention

Clean water is a pre-requisite for reducing the spread of water-borne diseases. It is well recognised that the prevalence of water-borne diseases can be greatly reduced by provision of clean drinking water and safe disposal of faeces.
Water is disinfected to kill any pathogens that may be present in the water supply and to prevent them from growing again in the distribution systems. Disinfection is then used to prevent the growth of pathogenic organisms and to protect public health and the choice of the disinfect depends upon the individual water quality and water supply system.
Without disinfection, the risk from waterborne disease is increased.
The two most common methods to kill microorganisms in the water supply are: oxidation with chemicals such as chlorine, chlorine dioxide or ozone and irradiation with Ultra-Violet (UV) radiation.

Diseases that are Thriving Thanks to Global Warming

Global climate change is extending the reach of diseases once found only in tropical regions.

Do you think tropical diseases only occur in developing countries? Think again.

The World Health Organization (WHO) says diseases are spreading to temperate regions thanks to global warming.

Warmer temperatures and greater moisture extend the geographic range and season for disease-vector organisms such as insects and rodents. Below are diseases that could have you feeling the sting of global warming.

Malaria

Malaria is spread by the Anopheles mosquito infected with the Plasmodium parasite. Warmer and wetter climates trigger increased mosquito abundance, biting rates, activity level, and accelerated incubation of their parasites. Winter temperatures must drop below 16ºC to prevent a malaria outbreak the following spring.

The U.N. Intergovernmental Panel on Climate Change (IPCC) projects that warmer temperatures will put 65% of the world’s population at risk of infection—an increase of 20%. This news is especially frightening in light of increased resistance to the chloroquine treatment drugs. Malaria has already hit Texas, New Jersey, Michigan, and New York.

Dengue Fever

Dengue fever is spread by the Aedes mosquito infected with the Flavivirus virus. The geographic range of the mosquito is limited by freezing temperatures that kill larvae and eggs, thus limiting transmission to tropical and subtropical regions.

With no vaccine, “breakbone” fever is considered the most serious mosquito-borne viral disease affecting humans.

But studies by the U.S. Environmental Protection Agency (EPA) and U.S. Department of Agriculture predict dengue’s encroachment upon temperate regions due to small increases in temperature.

The mosquito has spread as far north as Chicago and the Netherlands and to higher elevations of the Andes. With no vaccine, “breakbone” fever is considered the most serious mosquito-borne viral disease affecting humans.

Encephalitis

Encephalitis is an arthropod-borne disease present in many forms, including St. Louis, equine, La Crosse, and West Nile. New York experienced outbreaks of both West Nile Virus (WNV) and St. Louis encephalitis in 1999 during its driest and hottest spring and summer in a century.

Those weather patterns favorable to outbreaks—heat and drought followed by heavy downpours—will likely occur more often with global warming. Small stagnant pools of water that accompany drought are big enough to support breeding mosquitoes but not populations of the frogs that prey on them.

Bubonic Plague

Bubonic plague is spread by rodents and their fleas infected with the bacterium Yersinia pestis. A study in the Proceedings of the National Academy of Sciences reports that global warming promotes outbreaks of “black death.”

A 1ºC increase in springtime temperatures is predicted to lead to more than a 50% increase in the prevalence of the bacterium.

A study in the American Journal of Tropical Medicine and Hygiene reports a 60% rise in plague cases in New Mexico following wetter than average winters and springs. Wetter conditions enhance food resources for rodents and promote flea survival and reproduction.

Cholera

Cholera is a waterborne disease present in drinking water and food contaminated with the bacterium, Vibrio cholerae. The WHO links the spread of cholera with increases in sea surface temperature, sea level rise, and El Niño-Southern Oscillation.

The U.S. EPA reports that algal blooms, which can be accompanied by cholera, become more frequent with warming temperatures. Cholera-harboring zooplankton also proliferates in warmer water temperatures.

What you can do

The IPCC warns that global warming will result in human mortality from infectious disease. Unlike the typical U.S. approach of emergency response to epidemics, a preventive approach would preclude unnecessary suffering, infection, and loss of life.

The Centers for Disease Control and Prevention (CDC) provides information on prevention, vaccines, and epidemics. Below are things you can do to reduce your chance of infection.

Get vaccinated for cholera and yellow fever when visiting areas with epidemics.

Prevent exposure to mosquitoes and ticks. You can do this by: wearing long sleeves and pants, and avoiding outdoor activity between dusk and dawn during mosquito season.

Eliminate sources of food and nesting places for rodents and treat your pets for fleas.

Tell your doctor if you work outdoors or have exposure to disease-vector organisms. The symptoms of many diseases are similar to the common flu and are therefore misdiagnosed, especially by doctors in temperate regions who are unfamiliar with the diseases.

Do your part to help stop global warming and support environmental legislation. Stopping global warming will slow the spread of diseases and obviate the need for widespread spraying of dangerous pesticides such as Malathion.

Often policymakers do not take action on environmental issues unless it affects human health so maybe this will be their wake-up call to do something about global warming