Health & Fitness

Stopping the Spread of Infectious Disease

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Infectious diseases are sometimes forgotten, but never gone. Here’s a refresher on the simple steps you should be taking to keep yourself healthy.

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Cholera. Typhoid. Whooping cough. Yellow fever. Dengue fever. Polio. Influenza. Bubonic plague. Menengitis. Hepititis. Ebola. These are words that once struck fear and panic in communities across the world.

Thanks to modern technology and incredible advances in medicine, many of these diseases are relatively rare. But make no mistake, they are all still here. And occasionally we are given reason to remember that fact.

The potential for infection is everywhere, says Dr. Robert Geller, infectious disease specialist at FHN. And it’s not just limited to colds, flu and other common contagious illnesses.

“I tell my patients to think about what happens when you go to a restaurant,” he says. “The waiter hands you a menu. You have no idea who has held it before or whether it has been cleaned recently. After you give your order, the waiter takes the menus and places a basket of bread on the table. You reach for the bread with the same hand that held that filthy menu.”

If someone with a communicable infectious disease touched the menu or coughed/sneezed on it, you may well be infected.

“I recommend carrying a small bottle of antibacterial gel to use after handling menus and other questionable items,” Geller adds. “My grandchildren call it ‘Grandpa’s goo.’”

Diseases Spread by Insects and Animals

Bacteria- and virus-based diseases aren’t the only concerns. Insects can carry a multitude of diseases from Lyme disease to West Nile to seemingly obscure, archaic ones such as the bubonic plague. The plague killed nearly half of the population of Europe in the 1300s to 1400s, but it was around in 700 A.D. in the Middle East, killing an estimated 25 million. Travelers on the Silk Highway carried it to China where it continued to decimate the population in two more pandemics.

And most recently, in spring 2019, residents of Los Angeles, Calif., feared an outbreak of the bubonic plague amongst the homeless population caused by piles of uncollected garbage and rats creating unsanitary conditions.

Here in the Midwest, residents are concerned about other insect-borne diseases.

“People worry about West Nile virus,” Geller says. “So far this year, no birds have been found to be carrying the virus, but they did find an infected nest of mosquitoes in southern Illinois. Last year, there were 176 diagnosed cases of West Nile, most of them diagnosed in July through September.”

To safeguard against West Nile, Geller suggests common-sense defense techniques: spray clothing with any product designated to ward against West Nile and let it dry. Avoid areas where mosquitoes are prevalent. Eliminate standing water that lingers for more than a week.

When it comes to Lyme disease, people have every right to be concerned about ticks.

“People say they never go where deer are present,” Geller says. “The truth is, white-footed mice are far more likely to pass on ticks with Lyme disease. If you have an older house with a moldy, dirty basement, you are more at risk than from an occasional deer.”

Doing a total body check after hiking, fishing, camping and other outdoor activities is important, Geller says.

“Lyme disease ticks have to be on the body for 24 to 36 hours in order to pass on the disease,” he explains. “First they bite and suck blood, then the blood absorbs the virus, which is then returned to the human body. A thorough check immediately after being outdoors pretty much eliminates the possibility of getting Lyme.”

Diseases Spread Amongst Humans

Diseases that can be passed hand-to-hand include hepatitis, E. coli, staph infections, bacterial food poisoning and Methicillin-resistant Staphylococcus aureus (MRSA). Protecting the population from these diseases is becoming more challenging due to the rising number of strains that are becoming immune to antibiotics. Allergic reactions to antibiotics are another issue, as is the number of people who distrust vaccinations.

Meningitis and hepatitis are uncommon in the United States but can become quite serious for those affected.

Meningitis is an infectious process that causes inflammation of the fluid that surrounds the brain.

“Predictably, the first symptom of meningitis is usually a headache,” says Dr. Addie Spier, an infectious disease physician with Mercyhealth. “Patients may also experience fever, chills, nausea and vomiting, stiff neck, and sensitivity to light.”

Viruses are the most common cause of meningitis, Spier adds. There are several specific viruses that can cause meningitis. Enteroviruses are the most common, accounting for 55 to 90 percent of meningitis cases. Enteroviruses spread via contact with someone sick with the disease through their coughing, sneezing or contact with their eyes, nose, mouth or fecal material. This is why hand washing is so important, Spier explains.

“One of the most important causes of bacterial meningitis is Neisseria meningitis,” she says. “It can be rapidly fatal, which is why it’s good that vaccines exist to prevent this serious infection.”

Children ages 11 to 12 should receive a meningitis vaccine and booster covering the most common strains of Neisseria meningitis. College-age students should also receive a meningitis B vaccine, Spier advises.

Rest and pain medications are used to treat viral meningitis, Spier adds.

“The exception is herpes meningitis, which is treated with high doses of IV acyclovir,” she says. “Bacterial meningitis is treated with IV antibiotics, typically for two weeks.”

A Closer Look at Hepatitis

Viral hepatitis describes a group of viruses that are named with letters and cause inflammation of the liver. In terms of global prevalence, they are not very common in the United States.

“Hepatitis A is highly contagious via the oral-fecal route, which means it is spread through contact with feces of an infected person, or by consuming food or drink contaminated by hepatitis A virus particles,” Spier says. “Typically, hepatitis A does not cause chronic liver damage but does cause a short-lived vomiting/diarrheal illness. While there is no specific treatment of hepatitis A, there is a vaccine against hepatitis A which, after two doses, is nearly 100 percent effective.”

Hepatitis B is also highly contagious but is spread when blood, semen or other affected body fluids enter the body of an uninfected person. It can be transmitted from mother to child at birth, through sex with an infected person, by sharing needles with an infected person, by sharing toothbrushes or razors with an infected person, or through direct contact with blood or open sores of an infected person.

“Not everyone who is infected with hepatitis B holds onto the virus and requires treatment,” Spier explains. “The majority of adults clear the infection on their own. Only about 5 to 10 percent of adults go on to develop chronic hepatitis B, which should be evaluated for treatment. Hepatitis B is also preventable by a very effective vaccine given between 6 to 18 months of age. This is very important because chronic hepatitis B, which is preventable through vaccine, can also lead to hepatocellular cancer.”

Spier adds that those who go on to develop chronic hepatitis B should be evaluated by a gastrointestinal or infectious disease specialist to determine if treatment is warranted.

“With hepatitis C, recent advances in treatment and cure have brought an increase in media attention,” Spier continues. “Today, the majority of people who become infected with hep C are exposed through the sharing of needles used to inject drugs. Unlike hep B, 70 to 85 percent of people who are infected develop chronic disease. The majority of these persons have no symptoms associated with their hep C, thus infection may go undetected until serious liver problems develop.”

The CDC recommends hepatitis C testing for everyone born between 1945 and 1965, and for anyone with a history of IV drug use. Since 2011, several new, highly effective drugs to treat hepatitis C have been approved for use by the FDA. As of now, 90 percent of persons infected with chronic hepatitis C can be cured with eight to 12 weeks of oral medications. Unlike hepatitis A and B, there is no vaccine effective in preventing hepatitis C, Spier adds.

Water-Borne Bacterial Diseases

Less common but still of concern are those old, feared water-borne bacterial diseases: cholera and typhoid. The CDC reports that an estimated 3 to 5 million people worldwide are infected with cholera, with up to 130,000 of the cases fatal. About 12.5 million cases of typhoid are recorded annually, most commonly in Southeast Asia, with an estimated 149,000 deaths. Underdeveloped countries are the most likely to produce these diseases because of unsanitary conditions, contaminated water sources and less access to treatment.

However, the CDC also indicates that about 400 reported cases of these diseases are diagnosed in the United States each year. As with any communicable disease worldwide, not all cases are reported, so it’s difficult to put a firm finger on exactly how pervasive these diseases are.

Dr. Vijaya Somaraju, medical director of infectious disease at Beloit Health System, says American cases are primarily imported by travelers or found after massive natural disasters – where flooding and hurricanes have pushed contaminated water into heavily populated regions.

Both diseases can cause diarrheal illness if left untreated, and both can become deadly, via severe dehydration.

The bacteria that is specific for typhoid fever is salmonella typhi, less common in the United States. However, there are several other strains of salmonella that cause food poisoning (salmonellosis).

Cholera, a feco-oral infection, is caused by vibrio cholera, a toxin-producing bacteria. It requires only a small dose of bacteria to cause severe acute diarrheal illness.

“Patients must be constantly rehydrated until the diarrhea runs its course,” Somaraju says. “It is extremely contagious through one-on-one contact with body fluids.”

Somaraju adds that some people are more susceptible for severe cholera or typhoid than others, especially those whose immune systems are weak or compromised by chemotherapy, chronic diseases or other medical reasons.

For anyone planning on traveling to foreign countries, especially those considered underdeveloped, Somaraju suggests drinking only bottled water, or boiling locally obtained water for 20 full minutes before consuming it.

“I know people say it tastes bad,” she says. “Bring water flavorings to cover the flat taste so you are encouraged to drink it.”

Somaraju also recommends that people be careful about eating undercooked foods.

“If you are planning to travel to underdeveloped countries, start planning a few months in advance by scheduling vaccinations for cholera and typhoid at least 6-8 weeks prior to travel,” she says. “This will give you enough time to develop protective immunity that can last for six months to one year. Then, take every precaution to protect yourself from catching one of these diseases.”

Another danger to travelers to Africa is Ebola. As recently as this July, an outbreak of Ebola virus in the Democratic Republic of the Congo caused an international health warning. More than 200 died as a result and the situation is still not resolved.

One more travel tip to help prevent infectious diseases that Somaraju likes to share involves booking a hotel room on the third floor or higher.

“It sounds weird, but mosquitoes don’t usually fly that high up,” she explains. “To avoid being bitten by mosquitoes that can transmit malaria, dengue fever, yellow fever and other infections, staying on the third floor cuts down the possibility of being infected considerably.”

Staying Vigilant

In developed countries such as the United States, it is easy to rely on medical advances and take for granted that these diseases are in abeyance. But it doesn’t take a lot to bring them back to the surface. Natural disasters and other factors can contribute to one or more of these deadly diseases appearing without warning.

Remember to practice common-sense habits, like hand washing. A commitment to sanitation and eliminating conditions that encourage the spread of these diseases will do much to prevent them from appearing and spreading.

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