malaria, mumps, measles, meningitis

8/2/2019 Malaria, Mumps, Measles, Meningitis

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Malaria is caused by a parasite that ispassed from one human to another by the

bite of infected Anopheles mosquitoes. After infection, the parasites (called

sporozoites) travel through the bloodstreamto the liver, where they mature and release

another form, the merozoites. The parasites enter the bloodstream and

infect red blood cells.


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The parasites multiply inside the red

blood cells, which then break openwithin 48 to 72 hours, infecting more redblood cells. The first symptoms usually

occur 10 days to 4 weeks after infection,

though they can appear as early as 8days or as long as a year after infection.The symptoms occur in cycles of 48 to 72

hours.


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Most symptoms are caused by:

The release of merozoites into thebloodstream

Anemia resulting from the destruction ofthe red blood cells

Large amounts of free hemoglobin beingreleased into circulation after red bloodcells break open


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Malaria can also be transmitted from a

mother to her unborn baby(congenitally) and by blood transfusions.

Malaria can be carried by mosquitoes in

temperate climates, but the parasitedisappears over the winter.


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There are four types of common malaria

parasites. Quartan malaria;

Falciparum malaria- , affects more red bloodcells than the other types and is much more

serious. Biduoterian fever;

Blackwater fever;

Tertian malaria;

Recently, a fifth type, Plasmodium

knowlesi, has been causing malaria in

Malaysia and areas of southeast Asia.


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Anemia

Bloody stools

Chills

Coma

Convulsion

Fever

Headache

Jaundice

Muscle pain

Nausea

Sweating

Vomiting


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During a physical examination,the doctor may find an enlarged

liver or enlarged spleen.Malaria blood smears taken at 6

to 12 hour intervals confirm the

diagnosis.A complete blood count (CBC)

will identify anemia if it is present.


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Malaria, especially Falciparum

malaria, is a medical emergency thatrequires a hospital stay.

Chloroquine is often used as an anti-malarial medication. However,

chloroquine-resistant infections are

common in some parts of the world.


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Possible treatments for chloroquine-

resistant infections include:

The combination of quinidineor quinine plus doxycycline, tetracycline,or clindamycin

Atovaquone plus proguanil (Malarone)

Mefloquine or artesunate

The combination of pyrimethamine andsulfadoxine (Fansidar)

Medical care, including fluids through avein (IV) and other medications andbreathing (respiratory) support may be

needed.


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Brain infection (cerebritis)

Destruction of blood cells (hemolyticanemia)

Kidney failure Liver failure

Meningitis

Respiratory failure from fluid in the lungs(pulmonary edema)

Rupture of the spleen leading to massiveinternal bleeding (hemorrhage)


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Most people who live in areas wheremalaria is common have gottensome immunity to the disease. Visitors willnot have immunity, and should takepreventive medications.

It is important to see your health careprovider well before your trip, becausetreatment may need to begin as long as 2weeks before travel to the area, andcontinue for a month after you leave thearea. In 2006, the CDC reported that mosttravelers from the U.S. who contractedmalaria failed to take the right precautions.


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The types of anti-malarial medications

prescribed will depend on the area youvisit. According to the CDC, travelers toSouth America, Africa, the Indiansubcontinent,Asia, and the South Pacificshould take one of the following drugs: mefloquine,

doxycycline,

chloroquine, hydroxychloroquine,

or Malarone.

Even pregnant women should takepreventive medications because the risk tothe fetus from the medication is less thanthe risk of catching this infection.


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Avoid mosquito bites by wearing

protective clothing over the arms and

legs, using screens on windows, andusing insect repellent.

malaria.FLV


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Measles is a very contagious(easily spread) illness caused bya virus.


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The infection is spread by contact

with droplets from the nose,mouth, or throat of an infectedperson.

Sneezing and coughing can putcontaminated droplets into the

air.


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Rash

Usually appears 3 - 5days after the firstsigns of being sick

May last 4 - 7 days

Usually starts on thehead and spreads toother areas, movingdown the body

Rash may appear asflat, discolored areas(macules) and solid,

red, raised areas(papules) that later

join together

Itchy

Redness andirritation of the eyes(conjunctivitis)

Runny nose

Sore throat

Tiny white spots

inside the mouth(Koplik's spots)


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There is no specific treatment forthe measles.

The following may relievesymptoms:

Acetaminophen (Tylenol)

Bed rest Humidified air


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Some children may need vitamin A

supplements. Vitamin A reduces the risk of death and

complications in children in lessdeveloped countries, where children

may not be getting enough vitamin A.

People who don't get enough vitamin A

are more likely to get infections,

including measles.


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Complications of measlesinfection may include:

Bronchitis Encephalitis

Ear infection (otitis media)

Pneumonia


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Routine immunization is highly effectivefor preventing measles. People who are

not immunized, or who have not

received the full immunization are athigh risk for catching the disease.

Taking serum immune globulin 6 days

after being exposed to the virus can

reduce the risk of developing measles,or can make the disease less severe.

measles.FLV


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Mumps is a contagious disease that

leads to painful swelling of the salivary

glands. The salivary glands produce

saliva, a liquid that moistens food andhelps you chew and swallow.


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The mumps are caused by a virus. The virusis spread from person-to-person byrespiratory droplets (for example, when you

sneeze) or by direct contact with items thathave been contaminated with infectedsaliva.

Mumps most commonly occurs in childrenages 2 - 12 who have not been vaccinatedagainst the disease. However, the infectioncan occur at any age. The time betweenbeing exposed to the virus and getting sick(incubation period) is usually 12 - 24 days.


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Mumps may also infect the:

Central nervous system

Pancreas

Testes


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Face pain

Fever

Headache

Sore throat

Swelling of the parotidglands (the largestsalivary glands,located between theear and the jaw)

Swelling of the templesor jaw(temporomandibulararea)

Other symptoms ofthis disease that canoccur in males: Testicle lump

Testicle pain Scrotal swelling


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A physical examination confirms

the presence of the swollen

glands. No testing is usuallyrequired.


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There is no specific treatment for

mumps.

Ice or heat packs applied to the neckarea and acetaminophen (Tylenol)

may help relieve pain.

Do not give aspirin to children with a

viral illness because of the risk of Reyesyndrome.


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You can also relieve

symptoms with: Extra fluids

Soft foods

Warm salt water gargles


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Infection of other organs

may occur,including orchitis.


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MMR immunization (vaccine) protects

against measles, mumps, and rubella.

It should be given to children 12 - 15

months old. The vaccine is givenagain between ages 4 - 6, or between

ages 11 - 12, if it wasn't given before.


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Meningitis is a bacterialinfection of the membranescovering the brain and spinalcord (meninges).


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The most common causes of

meningitis are viral infections that

usually get better without treatment. However, bacterial meningitis

infections are extremely serious, and

may result in death or brain damage,

even if treated.


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Meningitis may also becaused by:

Chemical irritation

Drug allergies

Fungi

Tumors


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Symptoms usuallycome on quickly, andmay include:

Fever and chills

Mental status

changes Nausea and vomiting

Sensitivity to light(photophobia)

Severe headache

Stiff neck(meningismus)

Other symptoms thatcan occur with thisdisease:

Agitation

Bulging fontanelles

Decreasedconsciousness

Poor feeding orirritability in children

Rapid breathing

Unusual posture, withthe head and neckarched backwards(opisthotonos)


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Physical examination will usuallyshow:

Fast heart rate Fever

Mental status changes

Stiff neck


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For any patient who is suspected ofhaving meningitis, it is important to

perform a lumbar puncture ("spinal tap"),in which spinal fluid (known ascerebrospinal fluid, or CSF) is collectedfor testing.

Tests that may be done include: Blood culture

Chest x-ray

CSF examination for cell count, glucose, and

protein CT scan of the head

Gram stain, other special stains, and cultureof CSF


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Doctors prescribe antibiotics forbacterial meningitis. Antibiotics are not

effective in viral meningitis.

Other medications and intravenous fluidswill be used to treat symptoms such as

brain swelling, shock, and seizures.

Some people may need to stay in the

hospital, depending on the severity of

the illness and the treatment needed.


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Brain damage

Buildup of fluid between the skull

and brain (subdural effusion)Hearing loss

Hydrocephalus

Seizures


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Haemophilus vaccine (HiB vaccine) inchildren will help prevent one type ofmeningitis.

The pneumococcal conjugate vaccine is

now a routine childhood immunization andis very effective at preventingpneumococcal meningitis.

Household members and others in close

contact with people who havemeningococcal meningitis should receivepreventive antibiotics to avoid becominginfected themselves.


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The meningococcal vaccination isrecommended for:

Adolescents ages 11 - 12 and adolescentsentering high school (about age 15) whohave not already received the vaccination.

All college freshmen who have not been

vaccinated and are living in dorms. Children age 2 and older who do not have

their spleen or who have other problems withtheir immune system.

Those traveling to countries where diseases

caused by meningococcus are verycommon (ask your doctor).

meningitis.FLV

malaria, mumps, measles, meningitis

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