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Prevention of Waterborne Illness

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41. The “Ride” To Eliminating Malaria In Haiti

who pays attention to global health knows the terrible scourge that is malaria. Nearly half of the world’s population is at risk for getting the disease, with the vast majority living in countries that are poor and ill-equipped to respond. It’s not an overstatement to say that a mosquito, which carries and spreads malaria, is the most lethal “animal” on earth. In 2015, for example, there were 214 million new cases and 438,000 deaths worldwide. By those standards, the raw number of cases in Haiti (...) . It even has an official name: Malaria Zero supports the leadership of the Ministries of Public Health in Haiti and the Dominican Republic in their malaria elimination efforts, and is led by the U.S. Centers for Disease Control and Prevention (CDC), and includes the Pan American Health Organization, The Carter Center, the Clinton Health Access Initiative, the London School of Hygiene & Tropical Medicine, Tulane University School of Public Health and Tropical Medicine and the CDC Foundation. One other

2016 CDC Our Global Voices

42. Leptospirosis

Leptospirosis Leptospirosis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Leptospirosis Leptospirosis Aka: Leptospirosis (...) , Leptospira , Leptospira interrogans , Leptospira biflexa , Weil's Disease From Related Chapters II. Epidemiology Worldwide: Common United States: 100-200/year (underestimated) Hawaii accounts for 50% of cases III. Pathophysiology Fresh-waterborne (Leptospira interrogans, Leptospira biflexa and 14 other species) Transmission Passed via infected animals urine Rats (most common) Livestock (e.g. horses, cattle, sheeps, goats) Dogs (often asymptomatic) Leptospira remains viable for months in water and soil

2018 FP Notebook

43. Water Disinfection

Disinfection , Waterborne Illness Prevention , Prevention of Waterborne Illness , Water Filtration , Halogenation II. Methods: Boiling Water sterilized at onset of boiling III. Methods: Pasteurization Cleans, but does not sterilize water Six log reduction in organisms Protocols Heat at 185 degrees F for 20 seconds Heat at 145 degrees F for 30 minutes IV. Methods: Filtration Pore size dependent Agent dependent <.2 micron < 1 micron particles (as small as .0004 micron) Avoid sediment Clogs filters, harbors (...) Water Disinfection Water Disinfection Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Water Disinfection Water Disinfection Aka: Water

2018 FP Notebook

44. Family Practice Notebook Updates 2017

prevents bowel atrophy (surgery, derm, endo, dm) Assess patients for systemic illness, , Assess for (probe to bone test, ESR, XRay changes) of diabetes may typically be managed outpatient (urology, ) Frequently misdiagnosed as Examination is unreliable may be only presenting symptom (cv, cad) Immediate angiography for refractory with , acute , hemodynamic instability, sustained VT/VF (id, fever, ) and have been recommended to replace Criteria in the diagnosis of (derm, acne) Topical and oral in acne (...) not miss in the adolescent with vague hip or Delayed diagnosis risks longterm including and premature hip degeneration (id, immunize, prevent) is safe, effective and prevents serious illness and refusal puts entire communities at risk For every 1000 cases, 50 will develop , 1 will develop and 2 will die Congenital ( ) affected 20,000 U.S. newborns in 1964-5, prior to Rubella (with risk) occurs in up to 10% of males with (psych, sleep) Non-pharmacologic measures are preferred ( is very effective

2018 FP Notebook

45. Cyclospora

Studies (from Trip Database) Ontology: Cyclosporiasis (C0343398) Definition (MSH) Infection with parasitic protozoa of the genus CYCLOSPORA. It is distributed globally and causes a diarrheal illness. Transmission is waterborne. Concepts Disease or Syndrome ( T047 ) MSH ICD9 007.5 ICD10 SnomedCT 240372001 LNC LA10449-9 English Cyclosporiasis , cyclosporiasis , cyclosporiasis (diagnosis) , Cyclosporiasis [Disease/Finding] , Cyclosporiases , Cyclosporiasis (disorder) Dutch cyclosporiase , Cyclosporiasis (...) Cyclospora Cyclospora Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cyclospora Cyclospora Aka: Cyclospora , Cyclosporiasis

2018 FP Notebook

46. Cyclospora

Studies (from Trip Database) Ontology: Cyclosporiasis (C0343398) Definition (MSH) Infection with parasitic protozoa of the genus CYCLOSPORA. It is distributed globally and causes a diarrheal illness. Transmission is waterborne. Concepts Disease or Syndrome ( T047 ) MSH ICD9 007.5 ICD10 SnomedCT 240372001 LNC LA10449-9 English Cyclosporiasis , cyclosporiasis , cyclosporiasis (diagnosis) , Cyclosporiasis [Disease/Finding] , Cyclosporiases , Cyclosporiasis (disorder) Dutch cyclosporiase , Cyclosporiasis (...) Cyclospora Cyclospora Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cyclospora Cyclospora Aka: Cyclospora , Cyclosporiasis

2016 FP Notebook

47. World Health Organization Estimates of the Global and Regional Disease Burden of 22 Foodborne Bacterial, Protozoal, and Viral Diseases, 2010: A Data Synthesis. (PubMed)

to contaminated food, we then applied proportions of infections that were estimated to be foodborne from a global expert elicitation. Waterborne transmission of disease was not included. We estimate that 29% (95% UI 23-36%) of cases caused by diseases in our study, or 582 million (95% UI 401-922 million), were transmitted by contaminated food, resulting in 25.2 million (95% UI 17.5-37.0 million) DALYs. Norovirus was the leading cause of foodborne illness causing 125 million (95% UI 70-251 million) cases (...) World Health Organization Estimates of the Global and Regional Disease Burden of 22 Foodborne Bacterial, Protozoal, and Viral Diseases, 2010: A Data Synthesis. Foodborne diseases are important worldwide, resulting in considerable morbidity and mortality. To our knowledge, we present the first global and regional estimates of the disease burden of the most important foodborne bacterial, protozoal, and viral diseases.We synthesized data on the number of foodborne illnesses, sequelae, deaths

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2015 PLoS medicine

48. A Model Aquatic Health Code for Healthy Pools

for Healthy Pools Posted on June 18, 2015 by Child on slide. Photo from Creatas Images. Since 1978, the number of illness outbreaks associated with recreational water has increased significantly. Many of these illnesses can be prevented by proper maintenance, water treatment, and updated disease prevention practices. At the request of local and state health departments, and the aquatics industry, CDC led a national effort to develop the Model Aquatic Health Code (MAHC). The MAHC is a free resource based (...) on science and best practices. Government agencies can use the MAHC to make swimming healthier and safer and reduce risk for drowning, pool-chemical injuries, and outbreaks of waterborne disease. Aquatics industry leaders don’t have to wait for a government agency to adopt the MAHC. They can implement key MAHC elements now to start improving health and safety at their facilities. The MAHC includes voluntary guidelines for Public swimming pools Pools, hot tubs, and spas in hotels, apartment complexes

2015 CDC Your Health - Your Environment Blog

49. Malaria prophylaxis

Committee on Malaria Prevention (ACMP) [ ]. This CKS topic does not cover the treatment of acute malaria or additional travel risks such as other vector borne infections, injury, foodborne, waterborne or sexually transmitted infections. There are separate CKS topics on and . The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact or primary health care. How up-to-date is this topic? How up-to-date is this topic? Changes Changes (...) treatment. A patient information leaflet on emergency standby medication is available as part of the Public Health England publication . Advise travelling companions to read the leaflet as well in case the person becomes ill and need assistance in following advice. Basis for recommendation Basis for recommendation The recommendations on standby emergency medication are based on the clinical guidelines Guidelines for malaria prevention in travellers from the UK 2017 [ ] and expert opinion in review

2012 NICE Clinical Knowledge Summaries

50. Adenoviruses (Follow-up)

reservoirs and fomites includes proper disinfection of tonometry and ophthalmologic instruments according to local infection control and manufacturer guidelines. Proper use and monitoring of open, multiple-use ophthalmic solutions (and timely discarding of these) according to local infection control and manufacturer guidelines is essential. Chlorination of swimming pools Adequate chlorination of swimming pools may prevent waterborne outbreaks. Adenovirus is relatively hardy and survives long periods (...) intensive care unit. J Pediatr . 2005 Apr. 146(4):523-7. . Kajon AE, Moseley JM, Metzgar D, Huong HS, Wadleigh A, Ryan MA. Molecular epidemiology of adenovirus type 4 infections in US military recruits in the postvaccination era (1997-2003). J Infect Dis . 2007 Jul 1. 196(1):67-75. . Russell KL, Hawksworth AW, Ryan MA et al. Vaccine-preventable adenoviral respiratory illness in US military recruits,1999-2004. Vaccine . April 2006. 15:2835-42. . Wirsing von König CH, Rott H, Bogaerts H, Schmitt HJ

2014 eMedicine.com

51. Campylobacter Infections (Overview)

Updated: Aug 24, 2018 Author: Mahmud H Javid, MBBS; Chief Editor: Michael Stuart Bronze, MD Share Email Print Feedback Close Sections Sections Campylobacter Infections Overview Background Campylobacter infections are among the most common bacterial infections in humans. They produce both diarrheal and systemic illnesses. In industrialized regions, enteric Campylobacter infections produce an inflammatory, sometimes bloody, diarrhea or dysentery syndrome. Campylobacter jejuni (see image below (...) for H pylori . Next: Pathophysiology The known routes of Campylobacter transmission include fecal-oral, person-to-person sexual contact, unpasteurized raw milk and poultry ingestion, and waterborne (ie, through contaminated water supplies). Exposure to sick pets, especially puppies, has also been associated with Campylobacter outbreaks. Transmission of Campylobacter organisms to humans usually occurs via infected animals and their food products. Most human infections result from the consumption

2014 eMedicine.com

52. Shigella Infection (Follow-up)

of infected people as food handlers and measures to decrease contamination of food by house flies People with diarrhea due to this waterborne pathogen should not use recreational water venues for 2 weeks after symptoms resolve. Improvements in worker hygiene during vegetable and fruit picking and packing may prevent shigellosis caused by contaminated produce. Appropriate case reporting to health authorities is essential to take effective measures to prevent further transmission. Next: Complications See (...) Shigella Infection (Follow-up) Shigella Infection Follow-up: Deterrence/Prevention, Complications, Prognosis Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTY4NzczLWZvbGxvd3Vw processing > Shigella Infection

2014 eMedicine Pediatrics

53. Giardiasis (Diagnosis)

common in children than in adults. [ , ] G intestinalis can cause asymptomatic colonization or acute or chronic diarrheal illness. The organism has been found in as many as 80% of raw water supplies from lakes, streams, and ponds and in as many as 15% of filtered water samples. [ , ] It is a common cause of chronic diarrhea and growth retardation in children in developing countries. Giardiasis usually represents a zoonosis with cross-infectivity between animals and humans. Giardia intestinalis has (...) of genes implicated in the apoptotic cascade and the formation of reactive oxygen species. Panaro et al demonstrated that Giardia trophozoites induce cell apoptosis by activation of both intrinsic and extrinsic apoptotic pathways, down-regulation of the antiapoptotic protein Bcl-2, and up-regulation of the proapoptotic Bax. These findings suggest a possible role for caspase-dependent apoptosis in the pathogenesis of giardiasis. [ ] Giardia can also prevent the formation of nitric oxide, a compound

2014 eMedicine Pediatrics

54. Hematopoietic Stem Cell Transplantation (Diagnosis)

undergoing bone marrow transplantation. Among the most important have been in selecting hematopoietic stem cell donors and the tissue source, optimizing transplantation conditioning, reducing the morbidity and mortality from transplantation conditioning, and preventing and treating graft versus host disease. [ ] Patient education For patient education information, see the . Previous Next: Indications for HSCT Interpretation of the results of trials is always complicated by the problem of patient (...) -Blackfan anemia Osteopetrosis Inborn errors of metabolism Autoimmune disorders *Uncommon in children; common reasons for transplantation in adults Previous Next: Prognosis Transplantation-related mortality and morbidity rates have considerably decreased because of improved conditioning regimens, human leukocyte antigen (HLA) typing, supportive care, and prevention and treatment of serious infections. Currently, overall and event-free survival rates are based on the individual's disease pathology

2014 eMedicine Pediatrics

55. Fascioliasis (Diagnosis)

Singh Arora, MD; Chief Editor: Russell W Steele, MD Share Email Print Feedback Close Sections Sections Fascioliasis Overview Background Fascioliasis is a waterborne and foodborne zoonotic disease caused by two parasites of class Trematoda, genus Fasciola ; namely F. hepatica and F . [ ] giganticaHumans are incidental hosts and become infected by ingesting contaminated watercress or water. The illness occurs worldwide, particularly in regions with intensive sheep or cattle production. Incidence (...) in preserved human stool samples. Am J Trop Med Hyg . 2009 Jul. 81(1):156-62. . Fascioliasis. DPDx: Centers for Disease Control and Prevention. Available at . Accessed: March 10, 2015. Ai L, Dong SJ, Zhang WY, et al. Specific PCR-based assays for the identification of Fasciola species: their development, evaluation and potential usefulness in prevalence surveys. Ann Trop Med Parasitol . 2010 Jan. 104(1):65-72. . Le TH, Nguyen KT, Nguyen NT, Doan HT, Le XT, Hoang CT, et al. Development and evaluation

2014 eMedicine Pediatrics

56. Cryptosporidiosis (Follow-up)

, suppresses diarrhea in chronic cryptosporidiosis. Previous Next: Fluid and electrolyte loss Replacement of fluids and electrolytes is the critically important first step in the management of cryptosporidiosis, particularly in patients with large diarrheal losses. Fluids should include sodium, potassium, bicarbonate, and glucose. Oral rehydration is the preferred mode, but severely ill patients may require parenteral fluids. Biliary involvement Biliary involvement in cryptosporidiosis requires specific (...) interventions. Acalculous cholecystitis should be treated with cholecystectomy. Patients with sclerosing cholangitis can usually be treated with endoscopic retrograde cholangiopancreatography (ERCP), although sphincterotomy may result in temporary relief. In selected cases, recurrence may be prevented by placing a stent. Previous Next: Prevention of Cryptosporidiosis Water purification is the most important public health measure in the prevention of cryptosporidiosis. [ , ] Because chlorination has little

2014 eMedicine.com

57. Streptococcus Group A Infections (Diagnosis)

(SPEs) to function as superantigens. Scarlet fever When a fine, diffuse, erythematous rash is present in the setting of acute streptococcal pharyngitis, the illness is called scarlet fever. The rash of scarlet fever is caused by the pyrogenic exotoxins (ie, SPE A, B, C, and F). The rash highly depends on toxin expression; preexisting humoral immunity to the specific SPE toxin prevents the clinical manifestations of scarlet fever. Scarlet fever has apparently become less common and less virulent than (...) by bacterial toxins and enzymes (eg, lipase, hyaluronidase, collagenase, streptokinase), interactions among organisms (synergistic infections), local tissue factors (eg, decreased blood and oxygen supply), and general host factors (eg, immunocompromised state, chronic illness, surgery). As the infection spreads deep along the fascial planes, vascular occlusion, tissue ischemia, and necrosis occur. [ ] Although GAS is often isolated in cases of necrotizing fasciitis, this disease state is frequently

2014 eMedicine.com

58. Cryptosporidiosis (Diagnosis)

in about 4% of stools sent for parasitologic examination. Seroprevalence studies using antibody assays suggest that 25-35% of the population in industrialized countries (including the United States) have had cryptosporidiosis at some time in their life. Cryptosporidium species also cause waterborne outbreaks of diarrhea. In 1993, more than 400,000 cases of diarrheal illness due to Cryptosporidium infection were reported in Milwaukee, Wisconsin. [ ] Waterborne outbreaks continue to be common worldwide (...) , Xiao L, Yoder JS, Centers for Disease Control and Prevention. Cryptosporidiosis surveillance -- United States, 2011-2012. MMWR Suppl . 2015 May 1. 64 (3):1-14. . Chalmers RM, Smith R, Elwin K, Clifton-Hadley FA, Giles M. Epidemiology of anthroponotic and zoonotic human cryptosporidiosis in England and Wales, 2004-2006. Epidemiol Infect . 2011 May. 139(5):700-12. . Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, et al. Foodborne illness acquired in the United States--major

2014 eMedicine.com

59. Cyclospora (Diagnosis)

, Mexico Canada/United States: raspberries, blackberries, mesclun, basil‡; Germany: lettuce imported from Southern France/Southern Italy; Mexico: watercress Waterborne outbreaks United States (Chicago), Nepal 14 cases of cyclosporiasis; tap water in medical dormitory, suspected source was contaminated water storage tank; 12 of 14 developed cyclosporiasis * Community-based studies † Highest in spring and early summer ‡ Fresh produce. Raspberries from Guatemala; blackberries from Guatemala (...) in several countries. [ ] It has also been isolated from wastewater in Tunisia and in Arizona. [ , ] In endemic countries, soil contact is an important risk factor for children younger than 2 years. Oocysts can survive in water for 2 months at 39.2°F (4°C) and for 7 days at 98.6°F (37°C). Heating them at 140°F (60°C) for 60 minutes prevents sporulation. Freezing them at -0.4°F (-18°C) prevents sporulation. Desiccation for 15 minutes ruptures the oocyst wall. They are resistant to chlorine disinfection

2014 eMedicine.com

60. Listeria Monocytogenes (Diagnosis)

> Listeria Monocytogenes Infection (Listeriosis) Updated: Dec 18, 2018 Author: Karen B Weinstein, MD, FACP; Chief Editor: Michael Stuart Bronze, MD Share Email Print Feedback Close Sections Sections Listeria Monocytogenes Infection (Listeriosis) Overview Background Listeria monocytogenes, which causes listeriosis, is an important pathogen in pregnant patients, neonates, elderly individuals, and immunocompromised individuals, although it is an uncommon cause of illness in the general population. Patients (...) , and diarrhea may resemble a gastrointestinal illness. [ ] The microorganism has gained recognition because of its association with epidemic . In 1997, an outbreak of noninvasive gastroenteritis occurred in 2 schools in northern Italy, involving more than 1500 children and adults. [ ] Bacteremia and are more serious manifestations of disease that can affect individuals at high risk. Unless recognized and treated, Listeria infections can result in significant morbidity and mortality. Next: Pathophysiology L

2014 eMedicine.com

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