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Prevention of Waterborne Illness

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121. Pneumonia, Community-Acquired (Diagnosis)

, the clinical signs and symptoms of CAP are not sufficiently specific to reliably differentiate the exact etiologic agent. [ ] Therefore, additional testing remains necessary to identify the pathogen and to optimize therapy in CAP. Workup Standard diagnostic studies for CAP include the following: Chest radiography Sputum Gram stain and/or culture Blood cultures Other laboratory tests Depending on the perceived severity of illness and suspected etiology, additional workup may be warranted, including (...) of respiratory specimens, blood, and pleural fluid; PCR of respiratory samples; or antigen tests should be used to target therapy whenever possible. Inpatient CAP therapy usually consists of intravenous antibiotics followed by transition to an oral course of therapy. [ , , , ] Patients who are severely ill or who are unable to tolerate or absorb oral medications may require a longer duration of parenteral therapy before switching to an oral antibiotic. [ ] Mild to moderately ill patients with CAP may

2014 eMedicine.com

122. Amebic Meningoencephalitis (Diagnosis)

amoebae as agents of human infection. J Infect Dis . 2009 Apr 15. 199(8):1104-6. . Centers for Disease Control and Prevention (CDC). Investigational drug available directly from CDC for the treatment of infections with free-living amebae. MMWR Morb Mortal Wkly Rep . 2013 Aug 23. 62 (33):666. . Linam WM, Ahmed M, Cope JR, Chu C, Visvesvara GS, da Silva AJ, et al. Successful treatment of an adolescent with Naegleria fowleri primary amebic meningoencephalitis. Pediatrics . 2015 Mar. 135 (3):e744-8 (...) water. Clin Infect Dis . 2012 Nov. 55(9):e79-85. . Naegleria fowleri — Primary Amebic Meningoencephalitis (PAM) — Amebic Encephalitis. Centers for Disease Control and Prevention. Available at . September 24, 2015; Accessed: September 6, 2016. Kemble SK, Lynfield R, Devries AS, Drehner DM, Pomputius WF 3rd, Beach MJ. Fatal Naegleria fowleri Infection Acquired in Minnesota: Possible Expanded Range of a Deadly Thermophilic Organism. Clin Infect Dis . 2012 Mar. 54(6):805-9. . Schuster FL, Yagi S, Gavali

2014 eMedicine Pediatrics

123. Cyclosporiasis (Follow-up)

Cyclosporiasis (Follow-up) Cyclosporiasis Follow-up: Deterrence/Prevention, Prognosis, Patient Education 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTk2OTc4LWZvbGxvd3Vw processing > Cyclosporiasis Follow-up (...) Updated: Aug 08, 2017 Author: Shipra Gupta, MD; Chief Editor: Russell W Steele, MD Share Email Print Feedback Close Sections Sections Cyclosporiasis Follow-up Deterrence/Prevention As with other types of travelers' diarrhea, cyclosporiasis is preventable when traveling by avoiding untreated water and unpeeled fruits and vegetables, all of which can be contaminated. When caring for hospitalized patients infected with Cyclospora species, contact precautions should be instituted with thorough handwashing

2014 eMedicine Pediatrics

124. 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 Pediatrics

125. Naegleria (Follow-up)

in 95% or more of patients. In patients who do survive, careful attention to the prevention of seizures and control of intracranial pressure is critical. Other measures include prevention of secondary bacterial infections (especially intravenous catheter–related infections and urinary tract infections in patients with Foley catheters), prevention of decubitus ulcers, and prevention of aspiration in patients with coma or seizures. Previous Next: Inpatient & Outpatient Medications See the list below (...) : Therapy for PAM requires hospitalization. Survivors may need seizure medications. Previous Next: Transfer See the list below: The rapidity of progression in PAM usually precludes transferring the patient long distances; however, treating patients in a medical facility with an intensive care unit and neurosurgical and infectious disease support is best whenever possible. Previous Next: Deterrence/Prevention See the list below: N fowleri is ubiquitous and is present in warm freshwater and soil

2014 eMedicine Pediatrics

126. Intestinal Protozoal Diseases (Follow-up)

2005. 35:1339-47. . Karanis P, Kourenti C, Smith H. Waterborne transmission of protozoan parasites: a worldwide review of outbreaks and lessons learnt. J Water Health . Mar 2007. 5:1-38. . Hunter PR, Thompson RC. The zoonotic transmission of Giardia and Cryptosporidium. Int j Parasitol . Oct 2005. 35:1181-90. . Fleming CA, Caron D, Gunn JE, Barry MA. A foodborne outbreak of Cyclospora cayetanensis at a wedding: clinical features and risk factors for illness. Arch Intern Med . 1998 May 25. 158(10 (...) and in unusual cases in immunocompetent hosts, hospitalization is required, and intravenous solutions are indicated to correct electrolyte imbalance. Outpatient medications: Oral antiprotozoal therapy is usually administered at home. Previous Next: Deterrence/Prevention Standard hospital precautions are used for all hospitalized patients. Additional control precautions are implemented for children with gastroenteritis, especially for patients using diapers or who have incontinence. This includes use of gowns

2014 eMedicine Pediatrics

127. Hematopoietic Stem Cell Transplantation (Follow-up)

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

128. Leptospirosis (Follow-up)

the last trimester of pregnancy and have had high-risk exposure should present promptly for treatment to prevent in utero infection. Newborns of ill mothers can also be treated. Leptospires may be shed in breastmilk for an unknown duration. Travelers and participants in "adventure racing" or other freshwater sports who may be hiking and may otherwise be exposed to fresh water, soil, mud, and vegetation are at higher risk, especially those older than 60 years or those who are immunosuppressed (...) and vector-borne diseases: a regional analysis. Bull World Health Organ . 2000. 78(9):1136-47. . . National Research Council. Advancing the Science of Climate Change . Washington, DC: The National Academies Press; 2010. CDC. From the Centers for Disease Control and Prevention. Update: outbreak of acute febrile illness among athletes participating in Eco-Challenge-Sabah 2000--Borneo, Malaysia, 2000. JAMA . 2001 Feb 14. 285(6):728-30. . CDC. Update: leptospirosis and unexplained acute febrile illness among

2014 eMedicine Pediatrics

129. Amebic Meningoencephalitis (Treatment)

Amebic Meningoencephalitis (Treatment) Amebic Meningoencephalitis Treatment & Management: Approach Considerations, Prevention, Consultations 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTk2MjI3LXRyZWF0bWVudA (...) like an overwhelming acute bacterial meningitis unresponsive to routine antibacterial agents. Next: Prevention Measures to prevent PAM and GAE include the following: The clinician should routinely discuss with individuals the risks of exposure to free-living amoebae in warm, typically stagnant, freshwater Some have advocated the avoidance of diving and jumping into these waters Advise individuals to consider the use of nose plugs for unavoidable exposures Advise individuals to verify adequate

2014 eMedicine Pediatrics

130. Leptospirosis in Humans (Diagnosis)

disease. [ ] Women who become ill during the last trimester of pregnancy and have had high-risk exposure should present promptly for treatment to prevent in utero infection. Newborns of ill mothers can also be treated. Leptospires may be shed in breastmilk for an unknown duration. Travelers and participants in "adventure racing" or other freshwater sports who may be hiking and may otherwise be exposed to fresh water, soil, mud, and vegetation are at higher risk, especially those older than 60 years (...) , Lindsay SW, Confalonieri UE, Patz JA. Climate change and vector-borne diseases: a regional analysis. Bull World Health Organ . 2000. 78(9):1136-47. . . National Research Council. Advancing the Science of Climate Change . Washington, DC: The National Academies Press; 2010. CDC. From the Centers for Disease Control and Prevention. Update: outbreak of acute febrile illness among athletes participating in Eco-Challenge-Sabah 2000--Borneo, Malaysia, 2000. JAMA . 2001 Feb 14. 285(6):728-30. . CDC. Update

2014 eMedicine Emergency Medicine

131. Legionnaires Disease (Diagnosis)

, 2018 Author: Burke A Cunha, MD; Chief Editor: Michael Stuart Bronze, MD Share Email Print Feedback Close Sections Sections Legionnaires Disease Overview Background Legionnaires disease (LD) is the pneumonia caused by Legionella pneumophila. LD also refers to a more benign, self-limited, acute febrile illness known as Pontiac fever, which has been linked serologically to L pneumophila, although it presents without pneumonia. (See Pathophysiology and Etiology.) L pneumophila is an important cause (...) is a small, aerobic, waterborne, gram-negative, unencapsulated bacillus that is nonmotile, catalase-positive, and weakly oxidase-positive. It is a fastidious organism and does not grow anaerobically or on standard media. Buffered charcoal yeast extract (CYE) agar is the primary medium used for isolation of the bacterium. (See Workup.) The Legionellaceae family consists of more than 42 species, constituting 64 serogroups. L pneumophila is the most common species, causing up to 90% of the cases

2014 eMedicine Emergency Medicine

132. Gastroenteritis (Diagnosis)

a result of increased awareness, surveillance, and reporting is unclear. Acute gastroenteritis outbreaks have been associated with many modes of transmission, including foodborne, waterborne, person-to-person, animal contact, and environmental. Food and water represent important vehicles for pathogens and are linked to several illnesses that cause gastroenteritis. In 2009 alone, foodborne agents were responsible for 13,497 illnesses from 668 reported outbreaks in the United States. There were 2,259 (...) no difficulty defining their own situation. Although most definitions center on the frequency, consistency, and water content of stools, the author prefers defining diarrhea as stools that take the shape of their container. The severity of illness may vary from mild and inconvenient to severe and life threatening. Appropriate management requires extensive history and assessment and appropriate, general supportive treatment that is often etiology specific. Diarrhea associated with nausea and vomiting

2014 eMedicine Emergency Medicine

133. 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 Emergency Medicine

134. Gastroenteritis (Overview)

a result of increased awareness, surveillance, and reporting is unclear. Acute gastroenteritis outbreaks have been associated with many modes of transmission, including foodborne, waterborne, person-to-person, animal contact, and environmental. Food and water represent important vehicles for pathogens and are linked to several illnesses that cause gastroenteritis. In 2009 alone, foodborne agents were responsible for 13,497 illnesses from 668 reported outbreaks in the United States. There were 2,259 (...) no difficulty defining their own situation. Although most definitions center on the frequency, consistency, and water content of stools, the author prefers defining diarrhea as stools that take the shape of their container. The severity of illness may vary from mild and inconvenient to severe and life threatening. Appropriate management requires extensive history and assessment and appropriate, general supportive treatment that is often etiology specific. Diarrhea associated with nausea and vomiting

2014 eMedicine Emergency Medicine

135. Giardiasis (Overview)

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 been isolated (...) 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 Emergency Medicine

136. Pediatrics, Kawasaki Disease (Overview)

, and pyuria. The American Heart Association (AHA) suggests an algorithm for the diagnosis of incomplete KD in the most recent guideline. [ ] Echocardiography is the study of choice to evaluate for CAAs. Serial echocardiograms should be obtained as follows: At the time of KD diagnosis 1-2 weeks after the onset of the illness 5-6 weeks after the onset of the illness See and for more details. Management The principal goal of treatment is to prevent coronary artery disease. Intravenous immunoglobulin (IVIG (...) immunity. Epidemiologic data suggest, however, that person-to-person transmission of the disease is unlikely. Some authors have proposed a controversial association of KD with recent carpet shampooing, flooding, the use of a humidifier in the room of a child with an antecedent respiratory illness, [ ] and locations near bodies of water. [ ] These data have led to a waterborne vector hypothesis. The overall clinical presentation of patients with KD is similar to that of patients with a viral

2014 eMedicine Emergency Medicine

137. Leptospirosis in Humans (Follow-up)

disease. [ ] Women who become ill during the last trimester of pregnancy and have had high-risk exposure should present promptly for treatment to prevent in utero infection. Newborns of ill mothers can also be treated. Leptospires may be shed in breastmilk for an unknown duration. Travelers and participants in "adventure racing" or other freshwater sports who may be hiking and may otherwise be exposed to fresh water, soil, mud, and vegetation are at higher risk, especially those older than 60 years (...) , Lindsay SW, Confalonieri UE, Patz JA. Climate change and vector-borne diseases: a regional analysis. Bull World Health Organ . 2000. 78(9):1136-47. . . National Research Council. Advancing the Science of Climate Change . Washington, DC: The National Academies Press; 2010. CDC. From the Centers for Disease Control and Prevention. Update: outbreak of acute febrile illness among athletes participating in Eco-Challenge-Sabah 2000--Borneo, Malaysia, 2000. JAMA . 2001 Feb 14. 285(6):728-30. . CDC. Update

2014 eMedicine Emergency Medicine

138. Legionnaires Disease (Follow-up)

, 2018 Author: Burke A Cunha, MD; Chief Editor: Michael Stuart Bronze, MD Share Email Print Feedback Close Sections Sections Legionnaires Disease Overview Background Legionnaires disease (LD) is the pneumonia caused by Legionella pneumophila. LD also refers to a more benign, self-limited, acute febrile illness known as Pontiac fever, which has been linked serologically to L pneumophila, although it presents without pneumonia. (See Pathophysiology and Etiology.) L pneumophila is an important cause (...) is a small, aerobic, waterborne, gram-negative, unencapsulated bacillus that is nonmotile, catalase-positive, and weakly oxidase-positive. It is a fastidious organism and does not grow anaerobically or on standard media. Buffered charcoal yeast extract (CYE) agar is the primary medium used for isolation of the bacterium. (See Workup.) The Legionellaceae family consists of more than 42 species, constituting 64 serogroups. L pneumophila is the most common species, causing up to 90% of the cases

2014 eMedicine Emergency Medicine

139. Vaccination for safe travel to India (PubMed)

rabies. Furthermore diseases spreading through behavior aspects cannot be ruled out hence posing a risk for hepatitis B, HIV/AIDS, hepatitis C as well. Hence, before travel the travelers are advised about the risk of disease in the country or countries they plan to visit and the steps to be taken to prevent illness. Vaccination offers the possibility of avoiding a number of infectious diseases that may be countered abroad. There is no single vaccination schedule that fits all travelers. Each schedule (...) Vaccination for safe travel to India Worldwide more than 900 million international journeys are undertaken every year. India is one of the favorite tourist destinations around the world. International travel exposes travelers to a range of health risks. Traveling to India possess a threat to travelers with waterborne diseases like bacterial diarrhea, hepatitis A and E, and typhoid fever; vector borne diseases like dengue fever, Japanese encephalitis, and malaria; animal contact disease like

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2013 Human vaccines & immunotherapeutics

140. Cysts and Parasite Exam

should only take this on the advice of your doctor. is one of the methods your body uses to help rid itself of the infection. If you slow down or prevent this from happening by taking anti-diarrhoea medication you can prolong the amount of time that you are ill and sometimes make your infection worse. Related Content On This Site Tests: ; Giardia; Cryptosporidium; Entamoeba Histolytica antigen tests Conditions: , , Food and Waterborne Illness Elsewhere On The Web Find Us On Social Media: Footer Menu (...) , if cryptosporidium or giardia is due to contaminated swimming pool water or community water supply, steps will need to be taken to prevent the spread of the infection. The best way is to avoid food and water that is suspected of being contaminated. This is especially true if you travel to developing nations, where ice in a drink or a dinner salad may expose you to parasites. But the clearest mountain stream should also be suspect, it could be contaminated with giardia. You cannot see most parasites, you won't

2012 Lab Tests Online UK

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