June 08 Lyme Disease
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Official Nh Dhhs Health Alert
THIS IS AN OFFICIAL NH DHHS HEALTH ALERT Distributed by the NH Health Alert Network [email protected] May 18, 2018, 1300 EDT (1:00 PM EDT) NH-HAN 20180518 Tickborne Diseases in New Hampshire Key Points and Recommendations: 1. Blacklegged ticks transmit at least five different infections in New Hampshire (NH): Lyme disease, Anaplasma, Babesia, Powassan virus, and Borrelia miyamotoi. 2. NH has one of the highest rates of Lyme disease in the nation, and 50-60% of blacklegged ticks sampled from across NH have been found to be infected with Borrelia burgdorferi, the bacterium that causes Lyme disease. 3. NH has experienced a significant increase in human cases of anaplasmosis, with cases more than doubling from 2016 to 2017. The reason for the increase is unknown at this time. 4. The number of new cases of babesiosis also increased in 2017; because Babesia can be transmitted through blood transfusions in addition to tick bites, providers should ask patients with suspected babesiosis whether they have donated blood or received a blood transfusion. 5. Powassan is a newer tickborne disease which has been identified in three NH residents during past seasons in 2013, 2016 and 2017. While uncommon, Powassan can cause a debilitating neurological illness, so providers should maintain an index of suspicion for patients presenting with an unexplained meningoencephalitis. 6. Borrelia miyamotoi infection usually presents with a nonspecific febrile illness similar to other tickborne diseases like anaplasmosis, and has recently been identified in one NH resident. Tests for Lyme disease do not reliably detect Borrelia miyamotoi, so providers should consider specific testing for Borrelia miyamotoi (see Attachment 1) and other pathogens if testing for Lyme disease is negative but a tickborne disease is still suspected. -
Are You Suprised ?
B DAMB 721 Microbiology Final Exam B 100 points December 11, 2006 Your name (Print Clearly): _____________________________________________ I. Matching: The questions below consist of headings followed by a list of phrases. For each phrase select the heading that best describes that phrase. The headings may be used once, more than once or not at all. Mark the answer in Part 2 of your answer sheet. 1. capsid 7. CD4 2. Chlamydia pneumoniae 8. Enterococcus faecalis 3. oncogenic 9. hyaluronidase 4. pyruvate 10. interferon 5. Koplik’s spot 11. hydrophilic viruses 6. congenital Treponema pallidum 12. Streptococcus pyogenes 1. “spreading factor” produced by members of the staphylococci, streptococci and clostridia 2. viral protein coat 3. central intermediate in bacterial fermentation 4. persistant endodontic infections 5. a cause of atypical pneumonia 6. nonspecific defense against viral infection 7. has a rudimentary life cycle 8. HIV receptor 9. Hutchinson’s Triad 10. measles 11. resistant to disinfection 12. β-hemolytic, bacitracin sensitive, cause of suppurative pharyngitis 2 Matching (Continued): The questions below consist of diseases followed by a list of etiologic agents. Match each disease with the etiologic agent. Continue using Part 2 of your answer sheet. 1. dysentery 6. Legionnaire’s 2. botulism 7. gas gangrene 3. cholera 8. tuberculosis 4. diphtheria 9. necrotizing fascitis 5. enteric fever 10. pneumoniae/meningitis 13. Clostridium botulinum 14. Vibrio cholera 15. Mycobacterium bovis 16. Shigella species 17. Streptococcus pneumoniae 18. Clostridium perfringens 19. Salmonella typhi 20. Streptococcus pyogenes 3 II. Multiple Choice: Choose the ONE BEST answer. Mark the correct answer on Part 1 of the answer sheet. -
Kellie ID Emergencies.Pptx
4/24/11 ID Alert! recognizing rapidly fatal infections Susan M. Kellie, MD, MPH Professor of Medicine Division of Infectious Diseases, UNMSOM Hospital Epidemiologist UNMHSC and NMVAHCS Fever and…. Rash and altered mental status Rash Muscle pain Lymphadenopathy Hypotension Shortness of breath Recent travel Abdominal pain and diarrhea Case 1. The cross-country trucker A 30 year-old trucker driving from Oklahoma to California is hospitalized in Deming with fever and headache He is treated with broad-spectrum antibiotics, but deteriorates with obtundation, low platelet count, and a centrifugal petechial rash and is transferred to UNMH 1 4/24/11 What is your diagnosis? What is the differential diagnosis of fever and headache with petechial rash? (in the US) Tickborne rickettsioses ◦ RMSF Bacteria ◦ Neisseria meningitidis Key diagnosis in this case: “doxycycline deficiency” Key vector-borne rickettsioses treated with doxycycline: RMSF-case-fatality 5-10% ◦ Fever, nausea, vomiting, myalgia, anorexia and headache ◦ Maculopapular rash progresses to petechial after 2-4 days of fever ◦ Occasionally without rash Human granulocytotropic anaplasmosis (HGA): case-fatality<1% Human monocytotropic ehrlichiosis (HME): case fatality 2-3% 2 4/24/11 Lab clues in rickettsioses The total white blood cell (WBC) count is typicallynormal in patients with RMSF, but increased numbers of immature bands are generally observed. Thrombocytopenia, mild elevations in hepatic transaminases, and hyponatremia might be observed with RMSF whereas leukopenia -
Compendium of Measures to Control Chlamydia Psittaci Infection Among
Compendium of Measures to Control Chlamydia psittaci Infection Among Humans (Psittacosis) and Pet Birds (Avian Chlamydiosis), 2017 Author(s): Gary Balsamo, DVM, MPH&TMCo-chair Angela M. Maxted, DVM, MS, PhD, Dipl ACVPM Joanne W. Midla, VMD, MPH, Dipl ACVPM Julia M. Murphy, DVM, MS, Dipl ACVPMCo-chair Ron Wohrle, DVM Thomas M. Edling, DVM, MSpVM, MPH (Pet Industry Joint Advisory Council) Pilar H. Fish, DVM (American Association of Zoo Veterinarians) Keven Flammer, DVM, Dipl ABVP (Avian) (Association of Avian Veterinarians) Denise Hyde, PharmD, RP Preeta K. Kutty, MD, MPH Miwako Kobayashi, MD, MPH Bettina Helm, DVM, MPH Brit Oiulfstad, DVM, MPH (Council of State and Territorial Epidemiologists) Branson W. Ritchie, DVM, MS, PhD, Dipl ABVP, Dipl ECZM (Avian) Mary Grace Stobierski, DVM, MPH, Dipl ACVPM (American Veterinary Medical Association Council on Public Health and Regulatory Veterinary Medicine) Karen Ehnert, and DVM, MPVM, Dipl ACVPM (American Veterinary Medical Association Council on Public Health and Regulatory Veterinary Medicine) Thomas N. Tully JrDVM, MS, Dipl ABVP (Avian), Dipl ECZM (Avian) (Association of Avian Veterinarians) Source: Journal of Avian Medicine and Surgery, 31(3):262-282. Published By: Association of Avian Veterinarians https://doi.org/10.1647/217-265 URL: http://www.bioone.org/doi/full/10.1647/217-265 BioOne (www.bioone.org) is a nonprofit, online aggregation of core research in the biological, ecological, and environmental sciences. BioOne provides a sustainable online platform for over 170 journals and books published by nonprofit societies, associations, museums, institutions, and presses. Your use of this PDF, the BioOne Web site, and all posted and associated content indicates your acceptance of BioOne’s Terms of Use, available at www.bioone.org/page/terms_of_use. -
Cutaneous Melioidosis Dermatology Section
DOI: 10.7860/JCDR/2016/18823.8463 Case Report Cutaneous Melioidosis Dermatology Section BASAVAPRABHU ACHAPPA1, DEEPAK MADI2, K. VIDYALAKSHMI3 ABSTRACT Melioidosis is an emerging infection in India. It usually presents as pneumonia. Melioidosis presenting as cutaneous lesions is uncommon. We present a case of cutaneous melioidosis from Southern India. Cutaneous melioidosis can present as an ulcer, pustule or as crusted erythematous lesions. A 22-year-old gentleman known case of diabetes mellitus was admitted in our hospital with an ulcer over the left thigh. Discharge from the ulcer grew Burkholderia pseudomallei. He was successfully treated with ceftazidime. Melioidosis must be considered in the differential diagnosis of nodular or ulcerative cutaneous lesion in a diabetic patient. Keywords: B. pseudomallei, Diabetes Mellitus, Skin ulcer CASE REPORT melioidosis is a rare entity. Cutaneous melioidosis may be primary A 22-year-old gentleman was admitted in our hospital with (presenting symptom is skin infection) or secondary (melioidosis complaints of an ulcer over the left thigh of seven days duration. at other sites in the body with incidental skin involvement) [3]. History of fever was present for four days. He also complained of There is limited published data from India documenting cutaneous pain in the thigh. The patient initially noticed a nodule on the left melioidosis. thigh which eventually progressed to form a discharging ulcer. He B. pseudomallei reside in soil and water [4]. Inoculation, inhalation was a known case of diabetes mellitus (type 1) on insulin. Clinical or ingestion of infected food or water are the modes of transmission examination revealed a 5cm× 5cm ulcer on the left thigh with [5]. -
Necrotizing Fasciitis
INFORMATION ABOUT NECROTIZING FASCIITIS • Information has been circulating on social media/media outlets of an individual who developed an infection after visiting our area. We are taking this issue seriously and are working with the Indiana Department of Health to determine if this infection was caused by bacteria such as Vibrio vulnificus or other reportable disease. Currently, we do not have any information about this individual’s illness. • Necrotizing fasciitis (many times called “flesh eating bacteria” by the media) is caused by more than one type of bacteria. Several bacteria, common in our environment can cause this condition – the most common cause of necrotizing fasciitis is Group A strep. • People do not “catch” necrotizing fasciitis; it is a complication or symptom of a bacterial infection that has not been promptly or properly treated. • Sometimes people call Vibrio vulnificus the “flesh eating bacteria.” Vibrio vulnificus is a naturally occurring bacteria found in warm salty waters such as the Gulf of Mexico and surrounding bays. Concentrations of this bacteria are higher when the water is warmer. • Necrotizing fasciitis and severe infections with Vibrio vulnificus are rare. These infections can be treated with antibiotics and sometimes require surgery to remove damaged tissue. Rapid diagnosis is the key to effective treatment and recovery. • If you are healthy with a strong immune system, your chances of developing or having complications due to this condition are extremely low. HOW TO REDUCE YOUR RISK OF EXPOSURE • The Centers for Disease Control and Prevention (CDC) encourages all people to avoid open bodies of water (such as the Gulf), pools and hot tubs with breaks in the skin. -
Staging of Necrotizing Fasciitis Based on the Evolving Cutaneous Features
ReportBlackwellOxford,IJDInternational0011-905945 UK Publishing Journal LtdLtd,of Dermatology 2006 StagingWang,Case report Wong, of necrotizing and Tay fascitis of necrotizing fasciitis based on the evolving cutaneous features Yi-Shi Wang, MBBS, MRCP, Chin-Ho Wong, MBBS, MRCS, and Yong-Kwang Tay, MBBS, FRCP From the Division of Dermatology, Changi Abstract General Hospital, Department of Plastic Background Necrotizing fasciitis is a severe soft-tissue infection characterized by a fulminant Reconstructive and Aesthetic Surgery, course and high mortality. Early recognition is difficult as the disease is often clinically Singapore General Hospital, Singapore indistinguishable from cellulitis and other soft-tissue infections early in its evolution. Our aim was Correspondence to study the manifestations of the cutaneous signs of necrotizing fasciitis as the disease evolves. Yi-Shi Wang, MBBS, MRCP Methods This was a retrospective study on patients with necrotizing fasciitis at a single Division of Dermatology institution. Their charts were reviewed to document the daily cutaneous changes from the time Changi General Hospital of presentation (day 0) through to day 4 from presentation. 2 Simei Street 3 Singapore 529889 Results Twenty-two patients were identified. At initial assessment (day 0), almost all patients E-mail: [email protected] presented with erythema, tenderness, warm skin, and swelling. Blistering occurred in 41% of patients at presentation whereas late signs such as skin crepitus, necrosis, and anesthesia Presented at the European Academy of were infrequently seen (0–5%). As time elapsed, more patients had blistering (77% had blisters Dermatology and Venereology (EADV) 14th at day 4) and eventually the late signs of necrotizing fasciitis characterized by skin crepitus, Congress, London, October 12 to 16, 2005. -
World Health Orsanization Manila
REGIONAL OFFICE FOR THE WESTERN PACIFIC of the World Health Orsanization Manila REPORT ON THE SECOND REGIONAL SEMINAR ON VENEREAL DISEASE CONTROL MANILA. PHILIPPINES, 3 - 12 DECEMBER 1968 ., REGIONAL OFfiCE fOR THE WESTERN PACIFIC OF THE WORLD HEALTH ORGANIZATION MANILA ~PORl' ON rrHE SECOND REGIONAL SEMlNAR ON VENEREAL DISEASE CONTROL - Manila. Philippines 3 to 12 Decemher, 1968 WPRO 0144 SECOND RlOOIONAL SEMINAR ON VENEREAL DISEASE CONTBOL Sponsored by the WORLD HEALTH ORGANIZATION RIDIONAL OFFICE FOR THE WESTERN PACIFIC Manila, Philippines 3 to 12 December 1968 FINAL REPORT NOT FOR SALE PRINTED AND DISTRIBUTED by the REGIONAL OFFICE FOR THE WESTERN PACIFIC of the World Health Organization Manila, Philippines August 1969 CONTENTS PREFACE ~ 1. INTRODUCTION: THE CHANGING ENVIRONMENT •••••••••••••••••••••••• 1 2. NATURE AND ~ OF THE PBOBLEM .............................. 2 3. DIAGNOSIS OF VENEREAL DISEASES ....................•..••......•• 6 4.. TREA'D-mNT OF VENEREAL DlSEAS:e:f> ................................................................ .. 11 5.. VENEREAL DISEASE CONTROL .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 17 6. BEHAVIOURAL PA'1"1'ERNS, HEALTH ElXJCATION AND ATTITUDES ........... 33 7 .. roruRE (J(]IJ!I.()OK .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 35 8. SUMMARY AND RECOMMENDATIONS ............•..................•.... 35 9.. RE:P'ERmlCES .. .. . -
Practical Infection Control Guidelines
PRACTICAL INFECTION CONTROL GUIDELINES EDITION ONE CONTENTS INTRODUCTION 4 How to start 5 Four guiding principles 5 SECTION 1: HAND HYGIENE 6 Alcohol-based sanitisers 7 Hand washing 9 Factors that influence the effectiveness of hand hygiene 11 SECTION 2: PERSONAL PROTECTIVE EQUIPMENT 12 Laboratory coats/Scrubs 12 Non-sterile gowns 12 Gloves 13 Face protection 13 Respiratory protection 13 Footwear 14 Footbaths and foot mats 14 Table 1. Selection of appropriate protective equipment relative to risk 14 SECTION 3: ENVIRONMENTAL HYGIENE 15 Combining Cleaning and Disinfection 15 Cleaning 15 Disinfecting 16 Isolation Wards 16 Managing Patients in the isolation ward 17 Disinfectant selection 18 Table 2. Characteristics of selected disinfectants 19 Table 3. Commonly used disinfectants 20 Table 4. Antimicrobial spectrum of selected disinfectants 21 Miscellaneous items 21 SECTION 4: GENERAL PROCEDURES 22 Introduction 22 Cleaning of examination rooms 22 Cleaning of stethoscopes and smart devices 23 Cleaning of otoscopes 23 Cleaning of video-otoscopy units 23 Cleaning of diagnostic equipment (ultrasound machines, radiography machines) 23 Anaesthetic equipment disinfection 24 Cleaning of endoscopes 24 Endoscope disinfection with a liquid chemical agent involves five steps after leak testing 25 SECTION 4: GENERAL PROCEDURES CONTINUED 25 Surgery 25 Surgical Theatre 25 Personal Protective Equipment 25 Hand Hygiene 26 Preoperative-care 26 Skin Preparation 26 Post-operative care 26 Prophylactic antimicrobial use 26 Instrument sterilisation 27 Cold sterilisation using immersion in antiseptic solutions 27 Commonly performed high risk procedures 27 A. Otoscopic examination in a consult room 27 Instrument sterilisation 27 B. Ear flushing 28 Procedures area 28 Animal preparation 28 Personal Protective Equipment 28 Instrument sterilisation 29 C. -
Louisiana Morbidity Report
Louisiana Morbidity Report Office of Public Health - Infectious Disease Epidemiology Section P.O. Box 60630, New Orleans, LA 70160 - Phone: (504) 568-8313 www.dhh.louisiana.gov/LMR Infectious Disease Epidemiology Main Webpage BOBBY JINDAL KATHY KLIEBERT GOVERNOR www.infectiousdisease.dhh.louisiana.gov SECRETARY September - October, 2015 Volume 26, Number 5 Cutaneous Leishmaniasis - An Emerging Imported Infection Louisiana, 2015 Benjamin Munley, MPH; Angie Orellana, MPH; Christine Scott-Waldron, MSPH In the summer of 2015, a total of 3 cases of cutaneous leish- and the species was found to be L. panamensis, one of the 4 main maniasis, all male, were reported to the Department of Health species associated with progression to metastasized mucosal and Hospitals’ (DHH) Louisiana Office of Public Health (OPH). leishmaniasis in some instances. The first 2 cases to be reported were newly acquired, a 17-year- The third case to be reported in the summer of 2015 was from old male and his father, a 49-year-old male. Both had traveled to an Australian resident with an extensive travel history prior to Costa Rica approximately 2 months prior to their initial medical developing the skin lesion, although exact travel history could not consultation, and although they noticed bug bites after the trip, be confirmed. The case presented with a non-healing skin ulcer they did not notice any flies while traveling. It is not known less than 1 cm in diameter on his right leg. The ulcer had been where transmission of the parasite occurred while in Costa Rica, present for 18 months and had not previously been treated. -
Necrotizing Fasciitis Report of 39 Pediatric Cases
STUDY Necrotizing Fasciitis Report of 39 Pediatric Cases Antonio Fustes-Morales, MD; Pedro Gutierrez-Castrellon, MD; Carola Duran-Mckinster, MD; Luz Orozco-Covarrubias, MD; Lourdes Tamayo-Sanchez, MD; Ramon Ruiz-Maldonado, MD Background: Necrotizing fasciitis (NF) is a severe, Results: We examined 39 patients with NF (0.018% of life-threatening soft tissue infection. General features all hospitalized patients). Twenty-one patients (54%) were and risk factors for fatal outcome in children are not boys. Mean age was 4.4 years. Single lesions were seen in well known. 30 (77%) of patients, with 21(54%) in extremities. The most frequent preexisting condition was malnutrition in 14 pa- Objective: To characterize the features of NF in chil- tients (36%). The most frequent initiating factor was vari- dren and the risk factors for fatal outcome. cella in 13 patients (33%). Diagnosis of NF at admission was made in 11 patients (28%). Bacterial isolations in 24 Design: Retrospective, comparative, observational, and patients (62%) were polymicrobial in 17 (71%). Pseudo- longitudinal trial. monas aeruginosa was the most frequently isolated bacte- ria; gram-negative isolates, the most frequently associated Setting: Dermatology department of a tertiary care pe- bacteria. Complications were present in 33 patients (85%), diatric hospital. mortality in 7 (18%), and sequelae in 29 (91%) of 32 sur- viving patients. The significant risk factor related to a fatal Patients: All patients with clinical and/or histopatho- outcome was immunosuppression. logical diagnosis of NF seen from January 1, 1971, through December 31, 2000. Conclusions: Necrotizing fasciitis in children is fre- quently misdiagnosed, and several features differ from those Main Outcome Variables: Incidence, age, sex, num- of NF in adults. -
Reportable Diseases and Conditions by Year 2012-2016
County of San Diego Reportable Diseases and Conditions by Year 2012-2016 July 3, 2017 Disease/Condition and Case Inclusion Criteria (C, P, S)1 2012 2013 2014 2015 2016 Amebiasis2 C 64 34 62 36 5 Anaplasmosis/Ehrlichiosis C,P 1 0 0 0 0 Anthrax C,P 0 0 0 0 0 Babesiosis C,P 0 0 0 0 1 Botulism, Foodborne C 0 0 0 0 1 Botulism, Infant C 0 0 1 1 4 Botulism, Wound C 1 0 0 0 0 Brucellosis C,P 7 1 1 1 4 Campylobacteriosis C,P 728 589 848 649 786 Chicken Pox, Hospitalization or Death C,P 8 2 2 2 3 Chikungunya3 C,P 0 0 7 13 6 Chlamydia C,S 16,538 16,042 15,633 17,396 18,904 Cholera C 0 0 0 0 0 Ciguatera Fish Poisoning C 1 1 0 0 0 Coccidioidomycosis C 159 126 117 168 158 Creutzfeldt-Jakob Disease C,P 0 6 6 7 4 Cryptococcosis C 1 0 1 1 0 Cryptosporidiosis C,P 30 24 36 24 35 Cyclosporiasis C,P 0 0 0 1 1 Cysticercosis C,P 0 2 5 0 1 Dengue Virus Infection C,P 11 12 6 17 23 Diptheria C,P 0 0 0 0 0 Domoic Acid Poisoning C 0 0 0 0 0 Encephalitis, Aseptic/Viral C 12 9 25 27 21 Encephalitis, Bacterial C 0 3 1 6 5 Encephalitis, Fungal C 0 0 0 0 3 Encephalitis, Parasitic C 1 0 0 1 0 Encephalitis, Other and Unknown C 27 32 25 46 42 Giardiasis C,P 242 264 262 314 397 Gonorrhea C,S 2,597 2,865 3,393 3,686 4,992 Haemophilus influenzae , Invasive Disease4 C,P 4 2 3 5 4 Hantavirus Infection C 1 0 0 0 0 Hemolytic Uremic Syndrome5 C,P 3 2 1 1 3 Hepatitis A, Acute C 38 40 15 21 26 Hepatitis B, Acute C 13 12 8 12 3 Hepatitis B, Chronic C,P 847 853 960 863 865 Hepatitis C, Acute6 C,P 4 2 0 2 1 Epidemiology and Immunization Services Branch 619-692-8499 www.sdepi.org Page