health

Whooping Cough

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Definition

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Whooping cough is a highly contagious and potentially fatal bacterial
infection of the upper respiratory tract.

Description

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Whooping cough, or pertussis, is a potentially severe upper respiratory
infection characterized by spells of intense coughing that end in a
whooping sound when the person is finally able to catch their breath.
It can affect people in any age group, but is most common (and most serious)
in infants and young children. The organism that causes whooping
cough affects only humans; it is not spread by animals.
The early symptoms ofwhooping cough resemble those of the common
cold—runny nose, sneezing, general unwell feeling—and the disease is
often mistaken for an ordinary cold. After about a week of cold-like symptoms,
however, the patient develops episodes of severe coughing that can
bring up thick phlegm (mucus) from the throat. The coughing may be
intense and spasmotic enough to cause vomiting or cause the patient to
turn red or blue in the face. At the end of the coughing attack, the patient
may make a whooping or crowing sound as they gasp to take in their next
breath of air.

Demographics

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At one time whooping cough was a leading cause of death in infants
and toddlers, causing 3,000 to 5,000 deaths in the United States
every year. Even though vaccines against whooping cough have been
available since the 1940s, the disease is still one of the leading causes
of vaccine-preventable deaths worldwide. The World Health Organization
(WHO) estimates that there are between 30 and 50 million
cases of pertussis each year around the world, and 300,000 deaths.
Ninety percent of cases of whooping cough occur in the developing
world. Widespread vaccination against the disease, however, has
lowered the death rate in the United States to fewer than thirty cases
per year.
In the United States, cases of whooping cough tend to cluster in
cycles, with peaks every three to four years. Outbreaks of whooping
cough are seasonal, with most cases occurring between June and September.
On average there are about 2.7 cases of whooping cough per
100,000 in the general population in North America.
Most people who get whooping cough in the United States are
unimmunized children or older teenagers and adults whose full immunity
has faded. The classic symptoms of whooping cough are not often
seen in this latter group, who are likely to have cough for more than
three weeks. According to the Centers for Disease Control and Prevention
(CDC), 29 percent of patients with whooping cough are younger
than one year; 12 percent are aged one to four years; 10 percent are aged
five to nine years; 29 percent are aged ten to nineteen years; and 20 percent
are older than twenty years.
As far as is known, males and females are equally affected by the disease.
Caucasians appear to be more likely to get whooping cough than
either African Americans or Native Americans.

Causes and Symptoms

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Whooping cough is caused by a bacterium known as Bordetella
pertussis, an organism that appears to live only in humans.
The organism is spread primarily by droplets in the coughing
of infected individuals. When someone breathes in some of
these droplets, the bacterium attaches itself to the tissues
that line the throat and upper respiratory tract and multiplies.
The patient usually begins to feel sick within three to twelve
days after being infected.

The symptoms of whooping cough depend on the stage of the illness:

Early phase (lasts one to two weeks). The patient appears to have
an ordinary cold, with runny nose, sneezing, and nasal congestion.
There may be low-grade fever and runny eyes. The disease is most likely
to be spread to others at this stage.
Coughing stage (one to two weeks). The patient has spells of intense
coughing that may last for several minutes and end in a whooping sound
as the child struggles for breath. Infants younger than six months do
not usually make the whooping sound but may become completely exhausted.
The child may turn red in the face and vomit at the end of the coughing spell.
Adults with whooping cough may get headaches during this stage.
The coughing is usually worse at night. In some cases the patient develops
pinpoint-sized red marks in the upper chest or the whites of the eyes caused
by the breaking of tiny blood vessels during the coughing spells.
These little marks are called petechiae.
Recovery stage (one to two weeks). The child begins to feel better
but continues to cough occasionally

Diagnosis

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In most cases the doctor will make the diagnosis on the basis of the patient’s
physical symptoms, a history of exposure to others with whooping cough,
and the patient’s record of immunization against whooping cough. The
doctor may take a blood test to see whether the patient has a higher than
normal number of lymphocyte white blood cells or order a chest x ray to see
whether the patient has developed pneumonia, but neither of these tests is
specific for whooping cough. Tomake the diagnosis definite, the doctor can
take a sample of fluid fromthe patient’s nose or throat on a cotton swab and
send it to a laboratory for analysis.

Treatment

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Treatment of whooping cough depends partly on the patient’s age and
partly on the severity of the disease. Infants younger than six months
often need hospitalization so that they can be given oxygen, have mucus
removed from their airway, and fed intravenously if necessary. Very
young infants are at greatest risk of ear infections, seizures, or other complications
of whooping cough.
Older children, teenagers, and adults should stay home from school or
work in order not to give the disease to other people. They should rest in
bed if at all possible. In most cases the doctor will prescribe an antibiotic
medication, usually for two or three weeks. Antibiotics can shorten the
duration of the illness and also shorten the length of time that the patient
is contagious. In some cases the doctor will prescribe antibiotics for other
members of the patient’s family to reduce their risk of getting the disease.
Over-the counter cough medicines are not usually very helpful in
relieving the sore throat and coughing spells of whooping cough. A coolmist
vaporizer and drinking lots of fluids are usually more effective.

Prognosis

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Older children, adolescents, and adults usually recover from whooping
cough in five to six weeks without any lasting effects. Infants who have
not been immunized against whooping cough and older adults with heart
problems or lung disease are at greatest risk of developing pneumonia or
other complications of whooping cough. About two-thirds of infants
who develop whooping cough will need hospital treatment; the average
length of stay for a baby with whooping cough in 2004 was seven days.
Of the deaths caused by whooping cough in the United States in the
early 2000s, 99 percent were in infants.

Prevention

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The best protection against whooping cough is immunization. Since the
1940s, the vaccine that protects against pertussis has been combined with
vaccines against diphtheria and tetanus in a single vaccine. The American
Academy of Pediatrics (AAP) recommends a total of five doses of the
combined vaccine in children between the ages of two months and six
years. Neither the vaccine nor getting the disease confers permanent
immunity against whooping cough, however; the effectiveness of the vaccine
fades away in three to five years after the last shot.
Because an increasing number of cases of whooping cough are being
diagnosed in teenagers, in 2005 the AAP recommended that all teenagers
receive an additional booster shot of vaccine. This measure is intended to
protect younger children as well as the adolescents, because the evidence
indicates that many cases of whooping cough in infants are caused by the
infection being transmitted to them by older family members. For adults
less than sxity-five years of age, one booster of whooping cough vaccine
should be given combined with the once every ten years tetanus/
diphtheria booster. This is especially important in prospective parents
and grandparents and those health care workers who work in pediatrics.

The Future

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Whooping cough is likely to be a major public health problem even in
developed countries for the foreseeable future because of some people’s
opposition to vaccination. In the 1970s there were a number of lawsuits
filed by people who felt that they had been injured by the diphtheria/
tetanus/pertussis vaccine. While it was not clear in many of these cases
that the person’s health problems were caused by the vaccine, Congress
passed a law in 1986 that requires doctors to give a child’s parents an
information sheet about a vaccine before giving the child the shot. The
doctor is also required to report any side effects of the vaccination to a
national reporting system.
Vaccines licensed for use in the United States must go through a
three-stage process of clinical trials that often takes ten years or even
longer before the new vaccine is approved. A newer form of the
diphtheria/tetanus/pertussis vaccine was developed in 1991 and replaced
the older vaccine completely by 2002. It is reported to have lowered the
rate of side effects from vaccination in the United States by 90 percent.

Whiplash

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Definition

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Whiplash is a general term for injuries to the neck caused by stretching of
the spine and the soft tissues in the neck when the head is moved sharply
forward and then snapped back. It is not a formal medical term; doctors
are more likely to use phrases like “cervical sprain” to describe whiplash.

Description

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Whiplash injuries most commonly occur when a person is in a car or
amusement park ride and is struck from behind. The impact pushes the
car forward, which in turn throws the occupant’s head forward suddenly
and then sharply backward, causing overstrain on the muscles or tearing
of other soft tissues in the neck and shoulders. Some people feel pain at
the time of the accident, while others may not feel the effect of the whiplash
injury until several days later. Symptoms may range from soreness
or stiffness in the neck and shoulders for a few days to severe pain and
disability from injuries to the vertebrae in the neck.

Demographics

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Whiplash injuries are quite common in the United States and Canada,
particularly those related to auto accidents. The National Highway
Traffic Safety Administration (NHTSA) estimates that there are between
750,000 and 900,000 whiplash injuries related to automobile travel each
year in the United States; about 40 percent of these are caused by rearimpact
collisions. They are among the most frequently reported injuries
in insurance claims, amounting to about $8.5 billion in insurance payouts
each year.
Females tend to be at greater risk of whiplash injury than males
regardless of whether they are driving the car or riding as a passenger.
Apart from gender, drivers are more likely to get a whiplash injury than
a front-seat passenger, possibly because drivers are more likely to move
forward to try to control the car when hit from behind whereas passengers
are more likely to be leaning further back in their seats. Passengers
in the rear seats of a car have a slightly lower risk of whiplash injury than
drivers or front-seat passengers.

Causes and Symptoms

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Although most whiplash injuries are caused by rear-end auto collisions,
they can also be caused by:

Amusement park rides, particularly roller coasters and bumper-car
rides
Falling from a horse, bicycle, or motorcycle
Railroad and airplane accidents
Contact injuries in sports like football, wrestling, or judo
Being hit on the head by a falling object
Being shaken or hit on the head by an abusive parent or other attacker

Doctors donot agree, however, on exactlywhat causes the pain of whiplash
in terms of the structures of thehumanneck. Somethink that whiplash injury is
caused by hyperextension of the neck, which is themedical term for stretching
the neck beyond its normal range ofmotion.Other doctors think that the biological
cause of whiplash injuries is damage to nerve endings in the neck.
There is no clear relationship between an automobile’s speed at the time of
an accident and a passenger’s risk of a whiplash injury; people have reported
whiplash injuries when their car was traveling at no more than 15 miles
per hour (24 kilometers per hour).

Some doctors use a four-level scale for assessing the symptoms of a whiplash injury.
The scale was first drawn up by a task force in Quebec in 1995.

Level 1: Soreness or stiffness in the neck but there are no
physical signs that can be detected by a doctor.
Level 2: The patient complains of pain and the doctor finds
a decreased range of motion in the neck.
Level 3: The person has pain moving from the neck into
the shoulders and arms plus such symptoms as insomnia, weakness,
headache, blurred vision, or ringing in the ears.
Level 4: In addition to the patient’s symptoms, the doctor
can detect dislocations or fractures of the bones in the neck,
or injury to the spinal cord.

Diagnosis

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People with only mild whiplash injuries may simply treat themselves at
home (see sidebar). While it is not always necessary to see a doctor for
whiplash, people who notice tingling or numbness in their arms or legs,
loss of function in their limbs, severe pain when trying to move the neck,
pain moving from the neck into the shoulders, headache, or dizziness
should see their doctor or go to a hospital emergency department as soon
as possible.
Doctors diagnose the seriousness of whiplash injuries by gently
moving the patient’s head to see how far the neck can move in different
directions. They will also press on different parts of the neck to see
whether there are any localized sore spots. X rays and other imaging
studies may be ordered to check for bone fractures or other signs of serious
injury to soft tissues.

Treatment

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Treatment for mild whiplash injuries may involve massage therapy and
heat application in addition to treatment at home with bed rest, ice, and
mild pain relievers. Within three to four days of the injury, the patient
will be asked to start range-of-motion exercises to keep the neck flexible.
These exercises usually involve gently rolling the head from side to side
or bending the neck backward and forward. If the pain persists for several
months, the doctor may recommend physical therapy to strengthen the
neck muscles. The doctor may also inject a local anesthetic to reduce
muscle spasms before the patient begins the range-of-motion exercises.
Cervical (neck) collars are not used as often now as they were some
years ago. The reason for this change is that wearing a collar for several
weeks or months causes the muscles in the neck to lose their strength.
People who have trouble sleeping because of whiplash pain, however,
may be given a cervical collar to wear while they are sleeping.
Some people are helped by alternative and complementary treatments
for whiplash injuries. The approaches that have been found
helpful include acupuncture, massage therapy, and chiropractic.

Prognosis

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Most people feel better within a few days or weeks after a whiplash
injury. Severe damage to the bones in the neck or to the spinal cord,
however, can result in permanent disability and chronic pain. There is
a 40 percent chance of having some symptoms as long as three months
after a whiplash injury, and an 18 percent chance that the symptoms will
last for as long as two years, but there is no reliable way to predict a specific
individual’s risk of falling into one of these two groups.

Prevention

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Head restraints have been mandated in new passenger cars manufactured
in the United States since 1969. The effectiveness of these restraints in
preventing whiplash injuries is debated by specialists who study the
effects of whiplash injuries on the human body, however. One problem
is that people do not always adjust their head restraint to the proper
height for the size of their head and neck. The head restraint should be
adjusted so that the middle of the headrest is even with the upper tips of
the ears.
Another problem is that the stiffness of a car seat affects the likelihood
of a whiplash injury as much as the quality of the head restraint and
its proper adjustment. Safety engineers are still working on designing
better head restraints, including some that adjust their position automatically
when the driver moves the seat forward or backward.

The Future

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Some causes of whiplash injury, such as abusive or criminal attacks or
accidents involving public transportation, would be difficult to prevent
entirely. The risk of sports injuries to the neck can be lowered somewhat
by redesigning shoulder pads and other protective equipment and by
teaching athletes to minimize their risk of neck injuries. Better automobile
design might help also, but even the best-designed seat or head
restraint will not be effective if drivers and passengers fail to wear seat
belts and adjust their head restraints correctly.

West Nile Fever

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Definition

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West Nile fever is a viral infection that can result in inflammation of the
brain, called encephalitis (en-seh-fuh-LYE-tis). The virus that causes it
spreads to humans by way of infected mosquitoes.

What Is West Nile Fever?

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West Nile fever (WNF) is caused by West Nile virus (WNV), which is part
of the flavivirus family. First discovered in Africa, WNV can infect animals
and humans, although animals (mainly birds, but also horses, cats,
and bats) are the primary hosts for the virus.
Most of the time, people with WNF become only mildly ill. In some
cases, however, WNF can develop into a life-threatening disease. If the
virus passes into the brain, the infection can cause serious inflammation
and complications affecting the nervous system. Of those infected, people
50 years of age or older have the greatest risk of developing severe disease.

Do Many People Contract West Nile Fever?

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WNF is found most frequently in Africa, the Middle East, Western
Europe, and Asia. It was not found in the Western Hemisphere until
1999, when the first case appeared in the United States. Between 1999
and 2008, presence of the virus was documented in 39 states and the
District of Columbia. In 2007, the Centers for Disease Control (CDC)
reported a total of 3,630 WNF cases in the United States. WNF tends
to occur more often in the summer and early fall, but the vast majority
of cases likely go unreported because they cause only mild illness,
if any. Of the 3,630 total in 2007, 124 (3 percent) resulted in death
from the disease. Those numbers represented a decrease compared
with 2006, when the CDC reported 4,269 cases and 177 deaths. Some
experts believed that the U.S. population was starting to develop immunity
to the virus.

Is West Nile fever Contagious?

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Generally, a person cannot contract WNF from another infected person
or from an infected animal, although transmission of the virus through a
blood transfusion has been confirmed in some cases. Likewise, infected
people cannot spread the virus to animals. Scientists think that the virus
is transmitted almost exclusively by the bite of an infected mosquito. The
chances of becoming ill with WNF actually are very small. Of all the
mosquitoes in any area where infected mosquitoes have been found, less
than 1 percent carry the virus.
The transmission cycle begins when a mosquito bites an infected
bird and takes in blood that contains WNV. If the mosquito then bites
a human, it can transmit the virus to that person. Scientists have found
no evidence that humans can contract the disease by handling live or
dead birds or any other animal that has been infected with the virus. Still,
experts recommend that people never handle a dead animal with bare
hands, instead always using disposable gloves and placing the dead animal
in a plastic bag when discarding it.

How Do People Know They Have West Nile Fever?

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The first symptoms of WNV infection are usually fever, headache, and
body aches, sometimes accompanied by a rash and swollen lymph nodes.
Serious cases of the disease may cause more severe symptoms, including
high fever, stiff neck, muscle weakness, convulsions, confusion,
paralysis, and coma. Very severe cases can result in death, but this is
rare. Symptoms usually begin 3 to 15 days after infection.

How Is West Nile fever Diagnosed and Treated?

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If WNF is suspected, the first step for the physician is take a history,
which means asking a person about prior health, when symptoms began,
and recent travels and activities. This may help determine if the person
might have been exposed to an infected mosquito. A blood test can
confirm the presence of the virus.
For mild cases of WNF, no specific treatment exists. A doctor
usually recommends rest and over-the-counter medications, such as
acetaminophen, to ease fever and aches. Severe cases of WNF may
require hospitalization and more specialized care, such as intravenous
(in-tra-VEE-nus) fluids (fluids given directly into a vein) to prevent or treat
dehydration in someone who is too sick to drink or who is vomiting. A
person who is having trouble breathing may be put on a ventilator.
How long WNV illness lasts depends on the severity of the infection.
If a person has a mild infection, symptoms often go away in about a week.
Recovery from serious infection may take several weeks to months. Most
people who are infected with WNV do not become very sick. Only about
1 percent of all infected people become severely ill. Of these severe cases,
up to 15 percent are fatal. Elderly people have the highest risk of developing
serious complications from the disease.

West Nile Invades New York

In the summer of 1999, dead birds began appearing all over the New
York City metropolitan area. Public health offi cials were called in to
fi nd out why. Th ey soon learned that the deaths were linked to the
virus that causes West Nile fever, an infection that is spread by mosquitoes.
Before 1999, West Nile fever had never been seen in the Western
Hemisphere.

Can West Nile Fever Be Prevented?

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No vaccine is available for WNF, so the best way to prevent the spread of the
virus is to prevent mosquito bites. To do so, experts recommend that people
avoid being outside at times when mosquitoes are most active (dawn, dusk,
and early evening), that they wear long sleeves and long pants, and that they
use insect repellent when outside. When using repellent, everyone, especially
children, should carefully follow the instructions on the package.
In the United States, health officials have often traced WNV to areas
where dead birds have been found. By tracking the disease and looking
for patterns of infection, public health officials are better able to prevent
future outbreaks. Experts advise people to contact the local or state
health department if a dead bird is found in an area where WNV has been
reported; a representative will collect the bird for testing.

Xeroderma Pigmentosum

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Definition

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Xeroderma pigmentosum, or XP, is a rare condition in which skin
cells are not able to repair damage caused by exposure to the ultraviolet
portion of sunlight. It was first described in 1874 by two Austrian dermatologists,
Ferdinand von Hebra (1816–1880) and Moritz Kaposi
(1837–1902). Dr. Kaposi gave the disorder its name, which means
“dry discolored skin,” in 1882. XP was not understood to be caused
by genetic mutations until 1968, however.

Description

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Xeroderma pigmentosum is a rare skin disorder caused by mutations in
any of eight different genes that govern the ability of skin cells to repair
damage to DNA (the genetic material inside a cell) caused by exposure
to sunlight. In a normal person, exposure to the ultraviolet radiation in
sunlight causes damage to the DNA of the cells in the upper layer of the
skin. This damage is fixed by a mechanism known as nucleotide excision
repair, or NER. In patients with XP, however, the enzymes that carry out
NER are either reduced in effectiveness or missing entirely. When the
damage to the cell’s DNA cannot be repaired, the DNA itself may
mutate, leading to the death of skin cells or to skin cancer. The average
child with XP develops the first signs of skin cancer around age eight.

Xeroderma pigmentosa progresses in three stages:

Stage 1. The child’s skin is healthy at birth but around six months
of age the skin develops reddish, scaly patches with heavy freckling
or sunburn after even short exposure to sunlight. At first only the
face and other areas exposed to direct sun are affected, but gradually
the skin changesappear on the neck, lower legs, and even the chest.
Stage 2. The skin develops irregular patches of lightened or
darkened skin with spidery patterns of blood vessels appearing
underneath. The skin also becomes much thinner.
Stage 3. This stage begins when the child is four to five years old.
Skin cancers and scaly patches known as solar keratoses appear.

About 80 percent of patients with XP develop eye problems related
to sun exposure. The eyes may become bloodshot and painfully
sensitive to light. Both cancerous and noncancerous growths may
appear near the eyes. In a few cases the eyelids may shrink or
even disappear entirely.
Between 20 and 30 percent of patients with XP develop symptoms
affecting the nervous system in late childhood or early adolescence.
These symptoms range from the loss of tendon reflexes and poor
coordination to hearing loss and mental retardation. The child’s
growth may also slow down. These neurologic symptoms
tend to get worse over time.

Demographics

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The frequency of xeroderma pigmentosum varies from country to country.
In the United States, it is estimated to affect between one person in 250,000
and onein 1,000,000. In Japan, however, XP is much more common, striking
one person in every 22,000. It is also more common in the Middle East
and North Africa than in Europe or North America. The reason for these
geographical differences is not yet known for certain but is thought to be
associated with the high rates of marriages within extended families in
some of these countries.
In all countries, XP affects men and women equally. Within the
United States, it affects all races and ethnic groups equally.

Causes and Symptoms

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The cause of xeroderma pigmentosum is a mutation in any of eight genes
(on eight different chromosomes) known to affect the production of the
enzymes responsible for the repair of DNA in sunlight-damaged skin
cells. There are eight subtypes of XP that vary somewhat in the severity
of symptoms depending on which of the eight genes has been affected
by a mutation. The most common subtype, known as XPA, is also the
type most likely to be associated with neurologic symptoms.
A child must inherit a defective gene from both parents in order to
develop XP. A person who has only one copy of the gene mutation is
called a carrier. When both parents are carriers of a recessive gene mutation,
there is a 25 percent chance that a child will inherit two mutations
and develop XP.

in addition to the symptoms that have already been described, children
with xeroderma pigmentosum may also have:

Raw patches of broken skin oozing tissue fluid
Premature aging of the lips, eyes, mouth, and tongue
Cancer developing on the tip of the tongue
Limited growth of body hair on the chest and legs
Increased vulnerability to infectious diseases

Diagnosis

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The diagnosis of xeroderma pigmentosa is usually made during the
baby’s first or second year of life, often following a history of severe and
long-lasting sunburn following only brief exposure to sunlight, or heavy
freckling on the baby’s face. There is usually no family history of the disorder.
The doctor will, however, ask the parents about a family history of
intermarriage among relatives in the extended families on both sides, as
kinship marriages are a risk factor for genetic disorders.
The doctor will examine the baby for signs of eye problems,
including clouding of the cornea (the transparent covering of the front
of the eyeball that admits light) and skin tumors growing near the eyes.
The baby’s reflexes and coordination may also be tested. The diagnosis
of XP can be confirmed by genetic testing or by tests on skin cells that
evaluate whether the cells are unusually sensitive to ultraviolet light. These
tests can be performed only in highly specialized laboratories, however.
XP can be diagnosed before birth by amniocentesis or by chorionic
villus sampling (CVS). CVS is a test in which the doctor takes a small
sample of tissue from the placenta, the organ that forms inside the uterus
during pregnancy and links the mother’s blood supply with the baby’s
blood supply. The tissue sample can then be analyzed for evidence of a
genetic disorder.

Treatment

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There is no cure for xeroderma pigmentosum. In addition, any damage
that occurs to the skin from sun exposure is permanent and irreversible.
The main goals of treatment are therefore to protect the patient from sun
exposure and monitor the development of symptoms affecting the eyes
and nervous system.

Avoiding sun exposure includes:

Wearing protective clothing (long-sleeved shirts and full-length
pants, shirts with collars, tightly-woven fabrics that don’t let light
through); wide-brimmed hats; and eyewear specifically made to
screen out ultraviolet rays.
Applying sunscreens of SPF 30 or higher to all exposed areas of skin.
Avoiding going outdoors during daylight hours as much as possible.
Limiting outdoor activities to nighttime only.
Avoiding the use of halogen or fluorescent bulbs indoors; these
give off enough ultraviolet radiation to affect people with XP.
Applying special film that blocks ultraviolet rays to house and car
windows.

Monitoring patients with xeroderma pigmentosum includes:

Regular visits to a dermatologist—at least every three to five
months—to check for changes in the skin or early signs of skin
cancer.
Yearly testing of the patient’s nervous system.
Frequent visits to an ophthalmologist (eye specialist) to check for
clouding of the cornea, tumors near the eye, or other problems.

Skin cancers are usually removed by surgery as soon as they
appear. Solar keratoses are treated with a cream containing a drug
called 5-fluorouracil.

Prognosis

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The prognosis of xeroderma pigmentosum depends on the subtype that
the patient belongs to; however, all patients with XP have over a thousand
times greater risk of developing skin cancer than people without the
disorder. Those with subtype XPA typically develop skin cancer before
they are ten years old. Only 40 percent of people with XP live into their
twenties. A small percentage of patients with milder symptoms live into
middle age. In general, XP reduces a patient’s life expectancy by at least
thirty years.

Prevention

2010-12-10T04:22:00.001-08:00

Parents of a child with XP have a 25 percent chance of having another
child with the disorder in later pregnancies. They should consult a
genetic counselor before considering having other children. In addition,
people who have a relative with XP should consider having a genetic test
before starting a family.

The Future

2010-12-10T04:21:00.000-08:00

Researchers are trying to better understand the gene mutations responsible
for XP and to see whether there are any other genes associated with
the condition that have not yet been identified. Treatments being investigated
in 2008 included the use of a drug called isotretinoin in preventing
skin cancer in patients with XP and a lotion called T4N5
liposome lotion in protecting against skin damage caused by ultraviolet
radiation.

Zoonoses

2010-12-10T04:19:00.000-08:00

Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses Zoonoses

Definition

2010-12-10T04:18:00.000-08:00

Zoonoses (zoh-ah-NO-seez) are infections that humans contract from
animals.

What Are Zoonoses?

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Zoonoses are infections caused by parasites, bacteria, or viruses that
pass from animals to humans. Most people contract zoonotic (zoh-uh-
NAH-tik) infections from pets, farm animals, and animals with which
they are in contact. Alternatively, there may be an intermediate between
the animal and the human, such as food or water. Wild animals and
insects can be the source of disease, too, particularly for diseases spread
by the bite of a tick, mosquito, or fly. Animals such as wild rodents, raccoons,
and bats also can carry diseases that may be harmful to humans.
Zoonoses can either cause minor or serious illness. In some cases, the
organisms involved infected humans, but the people do not become ill.

Disease-causing Organism____Animal or Insect Carrier ____Human Disease

Bartonella hensalae______________Cats_____________Cat scratch disease
bacteria

Chlamydia psittaci_______________Birds_____________Psittacosis
bacteria

Borrelia burgdorferi_____________Ticks, deer, and mice___Lyme disease
bacteria

Are Zoonoses Contagious?

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Most of these infections do not spread from person to person or do so
only in rare instances. Usually they spread from animals to humans in the
following ways:

Bite of an infected insect
Contact with an animal’s feces or urine, either through the mouth
(perhaps by touching a contaminated object and then touching the
mouth) or by breathing in dust from dried feces
Bite or scratch of an infected animal
Consumption of the meat of an infected animal

What Are Examples of Zoonoses?

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Cat scratch disease A cat carrying Bartonella henselae (bar-tuh-
NEH-luh HEN-suh-lay), the bacterium responsible for cat scratch disease,
usually does not have symptoms, but if the bacteria are passed to a
human through a scratch or bite, the person may experience skin sores,
swollen and sore lymph nodes, extreme tiredness, headaches, and fever.
Doctors may prescribe antibiotics to treat the infection.

Psittacosis People who have contact with birds may be at risk for psittacosis
(sih-tuh-KO-sis), also known as parrot fever. If a person inhales
bird feces or urine particles while cleaning a bird’s cage, the person may
develop symptoms of pneumonia (nu-MO-nyah, inflammation of the
lung), such as fever, coughing, or chest pain. Medical professionals use
antibiotics to treat psittacosis.

Rabies A virus that is carried in the saliva of infected animals can cause
rabies when transmitted through a bite or, less commonly, through contact
with saliva. Rabies in the United States is most often associated with raccoons,
followed by bats and skunks, but any bite produced by an animal, whether
domestic, stray, or wild, should be reported immediately to a local animal
control agency. Symptoms include fever, difficulty swallowing, delirium,
seizures, and coma. If treatment does not begin very soon after the bite,
death can result. Treatment includes intensive care in a hospital. A series of
vaccinations started at the time of a bite from a possibly infected animal
can prevent the person from developing the disease.
In 2006, the Centers for Disease Control and Prevention (CDC)
reported that tests of more than 113,000 animals in 49 states, the
District of Columbia, and Puerto Rico resulted in 6,940 cases of rabies
in animals and three human cases. Only one state, Hawaii, was free of
rabies. Rabies is much more common in many other countries, especially
developing ones.

Plague Plague (PLAYG) is a bacterial infection caused by Yersinia pestis
(yer-SIN-e-uh PES-tis). People can contract plague through the bite of a
flea that has become infected through contact with an infected rodent,
such as a rat. The disease causes such symptoms as fever and swollen
lymph nodes. In some cases the infection spreads through the blood and
can infect the lungs. If this happens, plague can spread from person to
person through coughing or sneezing. Plague was the cause of epidemics
in Europe and Asia during the Middle Ages, and it is still seen in the
21st century in many developing countries. It occurs in many developed
countries too, including the United States, although not as many cases
occur. The disease can be fatal if it is not treated with antibiotics.

Hantavirus Rodents, such as mice and rats, may carry hantavirus
(HAN-tuh-vy-rus), which can spread to humans when they inhale
particles from rodent feces, saliva, or urine. People infected with hantavirus
can develop hantavirus pulmonary (PUL-mo-nar-ee) syndrome (HPS),
which causes such symptoms as fever, headaches, muscle aches, nausea
(NAW-zee-uh), vomiting, diarrhea (dye-uh-REE-uh), abdominal pain,
and chills. In severe cases a person may experience shortness of breath and
the lungs may fill with fluid. No cure is available for hantavirus infection,
but people who have HPS typically are hospitalized in an intensive care
unit, where they receive oxygen and other types of supportive care.

Lyme disease Borrelia burgdorferi (buh-REEL-e-uh burg-DOR-feree)
bacteria inside an infected tick can cause Lyme (LIME) disease in
humans after a tick attaches to the skin and feeds on a person’s blood.
Ticks pick up the bacterium by feeding on the blood of infected deer
and mice, which serve as reservoirs for the organism. Lyme disease can
produce a number of symptoms, such as extreme tiredness, muscle aches,
and swollen painful joints. Patients often describe the symptoms as being
flu-like and pay a visit to the doctor’s office because no one else they know
has the flu. At the site of the tick bite, some (but not all) people develop
a bull’s-eye rash, a red rash surrounded by rings that resembles a bull’s-eye
target. A person with Lyme disease usually is treated with antibiotics.

Toxoplasmosis Eating contaminated meat or having contact with
the feces of an infected cat can put a person at risk for toxoplasmosis
(tox-o-plaz-MO-sis). This zoonosis is caused by a parasite and can produce
such symptoms as swollen lymph nodes, muscle aches, headaches,
and sore throat in a healthy person, and life-threatening brain infections in
people with weakened immune systems, especially those who have HIV/
AIDS*. If a pregnant woman becomes infected with the parasite, she can
transmit the infection to her unborn baby, which can lead to a number of
health problems in the child. Doctors treat those people who have severe
forms of the disease, as well as pregnant women, with antibiotics.

Trichinosis If people eat meat (especially pork products, such as sausage
or ham, or the meat of wild carnivorous animals) infected with the
eggs of Trichinella (trih-kih-NEH-luh) worms, the people can contract
trichinosis (trih-kih-NO-sis), also known as trichinellosis. Trichinosis is a
disease that produces such symptoms as diarrhea, vomiting, and abdominal
pain. It can cause nerve and muscle damage and heart and lung problems.
Medication treats this condition.

How Are Zoonoses Treated?

2010-12-10T03:52:00.000-08:00

The treatment of a zoonotic infection depends on the specific disease, but
many are treated with prescription medications, such as antibiotics.

How Are Zoonoses Prevented?

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Because household pets may carry zoonotic organisms, pet owners should
keep their animals healthy and vaccinated to avoid infection. Some other
ways people can protect against zoonoses include the following:

Have pets regularly examined by a veterinarian
Avoid contact with stray, unfamiliar, or wild animals
Clean litter boxes daily and animal cages frequently to prevent the
growth of bacteria and parasites
Have someone who does not have a weakened immune system and
is not pregnant empty pet litter boxes, bathe pets, clean pet cages,
and pick up pet feces
Cook meat until it is no longer pink inside and the juices run clear
Wash hands with soap and warm water after handling animals and
before eating
Clear brush and other areas around the house where rodents might
live
Avoid storing food or trash in an area where it could attract
animals
Wear long sleeves and long pants when outdoors, especially in
wooded areas, to discourage tick and mosquito bites
Use insect and mosquito repellent
Examine the body and pets for ticks after spending time outside in
areas where ticks are found

Yeast Infection, Vaginal

2010-12-10T03:49:00.000-08:00

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Definition

2010-12-10T03:48:00.000-08:00

The vaginal yeast infection candidiasis (kan-di-DY-a-sis) results from
an overabundance of a certain kind of fungus in the genital area. Its
symptoms include an itching or burning sensation in the genital area and
often a white discharge from the vagina. Genital candidiasis occurs much
more frequently in women, but it also occurs in men.

What Is Candidiasis?

2010-12-10T03:47:00.002-08:00

The fungus that causes most vaginal yeast infection is usually Candida
albicans (KAN-di-da AL-bi-kanz). It is naturally present in the vagina (va-
JY-na), the gastrointestinal* tract, and the mouth. It is part of the vaginal
and gastrointestinal flora. In the vagina and in the gastrointestinal tract,
the Candida organisms usually remains in balance with various bacteria
that are also found in these naturally moist areas (meaning that the presence
of bacteria and other components of the flora helps to keep Candida
growth in check). All of these microorganisms are competitors for the same
resources, and a reduction in the level of one becomes an opportunity for
another to flourish. When this ecological balance is disrupted, Candida
growth may become Candida overgrowth (candidiasis). Vaginal candidiasis
will develop quickly when this excessive growth occurs in the vaginal
area. (When Candida infection involves the mouth, it is called thrush.
When it involves babies’ diaper area, it is called candidal diaper rash.)
Candida fungus cells can multiply too much when a person is taking
an antibiotic, which may destroy too many of the bacteria that usually
keep the fungus in check. Other situations that may cause the fungus
to grow out of control are the use of birth control pills, pregnancy, and
the use of drugs that suppress the immune system. When a woman
becomes immunocompromised (has an immunodeficiency disease such
as AIDS, or is taking an immunosuppressant medication—for example,
in preparation for organ transplantation) she will also be more likely to
develop a vaginal yeast infection. Sugar causes yeasts to multiply. Women
with diabetes have higher blood sugar levels, and their vaginal secretions
contain more glucose. Thus, a woman with diabetes is more likely to
develop a vaginal yeast infection.
Estimates indicate that about 75 percent of women have a yeast infection
at least once in their lifetime. Half of them have the infection more
than once.

What Are the Symptoms of Candidiasis?

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The most common symptom of vaginal yeast infection is an itching
sensation in and around the vagina and/or vulva. The itching may be
accompanied by a burning sensation and sharp, or even severe, pain.
A vaginal discharge is not always present, but when it occurs it typically
has a whitish appearance and a texture like that of cottage cheese. The
area around the vagina also may itch or feel irritated. In yeast infections
in men, the head of the penis becomes inflamed or shows a rash.

How Is Candidiasis Diagnosed and Treated?

2010-12-10T03:46:00.000-08:00

The diagnosis of vaginal yeast infection is usually a simple matter of
microscopic examination. A scraping or swab of the infected area, or a
small sample of the vaginal discharge, is placed on a microscope slide.
The treatment is antifungal drugs that are applied to the affected area or
taken by mouth.
An individual who notices a vaginal yeast infection for the first time
should see her doctor, who can then diagnose it properly before she
begins treatment. Health professionals recommend that anyone with a
vaginal yeast infection should also have her partner examined for infection.
Women who have had previous vaginal yeast infections are often
familiar enough with the infection to diagnose it themselves and begin
treatment with over-the-counter creams.

How Can Candidiasis Be Prevented?

2010-12-10T03:44:00.000-08:00

The following measures can help prevent a vaginal yeast infection:

Wearing cotton underwear
Avoiding tight-fitting underwear made of synthetic fiber such as
nylon
Avoiding the daily use of panty hose
Using white, non-perfumed toilet paper
Keeping the genital area clean
Using a towel (not a blow dryer) to dry the genital area
Removing a wet bathing suit as soon as possible after swimming
Avoiding douches and feminine hygiene sprays
Using sanitary pads or tampons that are free of perfume

Fungal Infections

2010-12-09T16:40:00.002-08:00

Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections Fungal Infections

Definition

2010-12-09T16:40:00.001-08:00

Fungal (FUNG-gul) infections are caused by fungi (FUNG-eye) that can
grow on the skin, nails, and hair and within internal organs.

What Are Fungal Infections?

2010-12-09T16:38:00.002-08:00

Fungal infections are caused by fungi, tiny microbes found in soil,
air, and water, as well as on plants, animals, and people. Fungi feed on
other organisms, living or dead, and play an important role in helping
dead plants and animals decay. There are at least 100,000 species of
fungi. The most familiar types of fungi are the mushrooms, the fuzzy
white or blue-green mold that grows on forgotten foods in the back of
the refrigerator, and the mildew on the shower curtain. Fungi grow best
in warm, moist areas such as a steamy bathroom or the spaces between
the toes.
Relatively few species of fungi cause fungal infections, also called
mycoses (my-KO-seez), in humans. Fungal infections are of two basic
types: superficial infections and systemic infections. Superficial infections
affect the surface of the body, the skin, the nails, and the hair. They most
often occur in moist areas, such as between the toes, in the crotch, or in
the mouth.
Systemic infections take hold inside the body, in individual organs or
throughout the body, and can cause severe or even fatal illness. System
infections are most likely to develop in people who have weak or suppressed
immune systems, such as the following:

People with leukemia (cancer of the blood cells), Hodgkin’s disease,
or other kinds of lymphomas (cancers of the immune system)
People receiving chemotherapy or radiation treatment
People with AIDS
People who have uncontrolled diabetes
People who have received an organ transplant
People who are taking any type of drug that suppresses the immune
system. For example, in September 2008, the U. S. Food and Drug
Administration began an investigation into the risk of increased
fatal fungal infections in people taking immunosuppressant drugs
for rheumatoid arthritis.

In these people, the infections can cause chronic* disease and, in some
cases, death.

What Are the Common Signs and Symptoms of Fungal Infections?

2010-12-09T16:38:00.001-08:00

Superficial fungal infections, such as jock itch, vaginal yeast infection,
athlete’s foot, and ringworm, typically are annoying but not
very serious. Their symptoms generally include itchy, dry, red, scaly, or
irritated skin. Systemic fungal infections often begin in the lungs and
take time to develop. Severe infections occur in people whose immune
systems have been weakened, allowing the infection to spread beyond
the lungs to other organs. Symptoms of systemic fungal infections
depend on which organs become infected and may include respiratory
problems, extreme tiredness, coughing, weight loss, fever, night
sweats, and headache.

What Are Some Specific Fungal Infections?

2010-12-09T16:36:00.000-08:00

Tinea (TIH-nee-uh) is a general term given to a group of superficial fungal
infections that affect the nails, feet (athlete’s foot), groin area (jock itch),
scalp, or skin (ringworm). Trichophyton and Microsporum fungi cause these
related infections. Ringworm is identified by a red, scaly patch on the skin
that looks like an expanding ring around a clearing center. Symptoms of
athlete’s foot include redness and cracking of the skin between the toes,
and infected nails on the hands or feet usually look white and appear to
be crumbling.
Candidiasis (kan-dih-DYE-uh-sis) is a superficial fungal infection
caused by various strains of Candida (CAN-dih-duh) fungi. Candida is a
yeast-like fungus often found in the mouth and the lining of the intestinal
tract of healthy people. In people with weak immune systems, however, it
can grow out of control, leading to an infection. A Candida infection of
the mouth and throat is known as oropharyngeal (or-oh-fair-in-JEE-ul)
candidiasis (OPC) or thrush, and infection of the vagina is known as
vulvovaginal (vul-vo-VAH-jih-nul) candidiasis (VVC) or vaginal yeast
infection. OPC can affect newborns, people with AIDS or diabetes, and
other people with weak immune systems. Its symptoms include white,
thick patches on the tongue, mouth, and throat. Candida infection commonly
occurs in newborns in the form of thrush or diaper rash. VVC is
associated with vaginal burning or itching and a thick, cheese-like discharge.
In certain situations, Candida can enter the bloodstream and
spread to internal organs. These cases are seen most frequently in hospitalized
patients who have weak immune systems and have received powerful
antibiotics for other conditions.
Aspergillosis (as-per-jih-LO-sis) is the name for a variety of systemic
infections caused by Aspergillus (as-per-JIH-lus) fungi. If it is inhaled
through the mouth or nose, the fungus can cause a mild allergic reaction
or a more serious infection of the sinuses and lungs. Symptoms of
aspergillosis vary and may include fever, cough, chest pain, and wheezing.
In severe cases, typically seen in people with weak immune systems,
the infection can spread to other organs, including the brain, skin, and
bones.
Blastomycosis (blas-toh-my-KO-sis) is a systemic infection caused by
the Blastomyces dermatitidis fungus commonly found in soil in the southeast,
midwest, and south-central United States. The disease’s symptoms
resemble those of the flu: joint and muscle pain, a cough that brings
up sputum, fever, chills, and chest pain. If it progresses, it can lead to
chronic pulmonary infection, causing permanent lung damage, or widespread
disease that affects the bones, skin, and genital and urinary tracts.
Blastomycosis leads to death in about 5 percent of patients.
Coccidioidomycosis (kok-sih-dee-oyd-o-my-KO-sis) is a systemic
infection caused by Coccidioides immitis, a fungus found in soil in the
southwestern United States, in Mexico, and in South America. Most
people with coccidioidomycosis have no symptoms, but 40 percent of
patients experience a flu-like illness, with fever, rash, muscle aches, and
cough. Also known as valley fever, the infection can cause pneumonia
or widespread disease affecting the skin, bones, and meninges, which are
the membranes covering the brain and spinal cord.
Cryptococcosis (krip-toh-kah-KO-sis) is a systemic infection caused
by the fungus Cryptococcus neoformans, usually found in soil or bird
droppings. Typically, the fungus enters the body through the mouth or
nostrils when someone inhales fungi spores, and symptoms of a lung
infection, such as cough and chest pain, may develop. Although infection
with Cryptococcus usually produces no symptoms or only mild symptoms
in healthy people, the infection may spread in people who have weak
immune systems. If it spreads to the central nervous system, it can cause
inflammation of the meninges. This complication is especially common
among people with AIDS.
Histoplasmosis (his-toh-plaz-MO-sis) is usually a mild systemic infection
caused by Histoplasma capsulatum. This fungus is found in the eastern
and central United States in soil that contains bird and bat feces. When
the soil is disturbed, the fungal spores may be inhaled. Histoplasmosis can
cause flu-like symptoms, including body aches, fever, and cough. Most
people who become infected do not experience symptoms, but as with
other fungal infections, people with weak immune systems are at risk
for severe disease. In those cases, the infection affects the lungs and may
spread to the liver, spleen, bones, and brain.
Mucormycosis (mu-cor-my-KO-sis) is caused by a fungus found on
decaying plants. Most people do not get sick from exposure to this fungus.
However, people with weakened immune systems or uncontrolled
diabetes are susceptible to becoming sick. Mucormycosis often starts with
a sinus infection. Infection then spreads to the brain and sometimes to
the lungs, skin, digestive system, and kidneys. The death rate for this
fungal infection ranges from 30 to 70 percent, depending on where the
infection is located.
Sporotrichosis (spo-ro-trih-KO-sis) is a skin infection caused by the
Sporothrix schenckii fungus, which is found in soil, thorny plants, hay,
sphagnum (SFAG-num) moss, and other plant materials. It enters the
skin through a small cut or puncture, such as a thorn might make. Soon,
small reddish bumps resembling boils form around the cut and often
ulcerate. In some cases, infection can spread to other parts of the body,
such as the lungs or joints.

How Common Are Fungal Infections?

2010-12-09T16:35:00.002-08:00

Superficial fungal infections, such as athlete’s foot and candidiasis, are
common. Systemic infections, by contrast, are rare, appearing in less than
one to two people in every 100,000 in the United States, according to
the Centers for Disease Control and Prevention. They are more common
in certain populations, such as people with AIDS or those who have had
organ transplants.
With the so-called endemic mycoses, rates of disease are higher in
specific geographic areas. For example, coccidioidomycosis occurs in about
15 of every 100,000 people in parts of the southwestern United States
(with 10 to 50 percent of the population testing positive for exposure to
the fungus). In areas where histoplasmosis is found, up to 80 percent of the
population test positive for exposure to Histoplasma capsulatum, but the
disease develops only in people with weak immune systems.

Are Fungal Infections Contagious?

2010-12-09T16:35:00.001-08:00

Some fungal infections, such as candidiasis and ringworm, can spread
from person to person through contact with the infected area. Most infections,
however, develop from fungi found naturally on the human body
or in the environment. Many fungi that cause systemic respiratory disease
are found in soil or in the droppings of animals or birds. Usually they are
inhaled after the soil or droppings are disturbed, sending dust and fungal
spores into the air.

How Do Doctors Make the Diagnosis?

2010-12-09T16:34:00.003-08:00

Most superficial fungal infections are diagnosed based on their appearance
and location. A doctor may also take a skin scraping to examine
under the microscope or to culture in a laboratory. Some fungi glow
with a particular color under ultraviolet light, so a doctor may make the
diagnosis by shining such a light on the affected area. Systemic infections
can be diagnosed by collecting a sample of blood, urine, cerebrospinal
fluid, or sputum to culture.

Can Fungal Infections Be Treated?

2010-12-09T16:34:00.001-08:00

Most superficial fungal infections are treated at home with antifungal
creams or shampoos for one to two weeks. Oral (taken by mouth) antifungal
medication also may be prescribed, if necessary. Some cases of fungal
infection are more persistent and may need to be treated with medicine
for two to four weeks or even longer. Systemic illnesses often require hospitalization
so that the patient can receive intravenous antifungal drugs
and supportive care.

Can Fungal Infections Be Prevented?

2010-12-09T16:33:00.000-08:00

Preventing fungal infections can be difficult, because fungi are everywhere.
In general, people who are otherwise healthy rarely contract systemic
fungal infections. Practicing good hygiene, keeping the skin dry,
and changing socks and underwear every day can help prevent superficial
skin infections.

Flat Feet

2010-12-09T16:31:00.000-08:00

Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet Flat Feet

Definition

2010-12-09T16:30:00.002-08:00

Flat feet have flat inner arches and soles that completely touch the ground
when the person is standing.

What Are Flat Feet?

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Flat feet can happen at any age, and babies are born with them. Babies
have fatty pads in the soles of the foot and in front of the heel, which fills
the arch and gives feet their flat appearance. By three years of age, when
children are walking properly, their feet no longer have a flat look. When
children are between three to six years of age, the muscles of their feet
become stronger, the fat disappears, and an arch develops. If the arches have
not appeared by about age five or six—as happens with approximately one
in every 10 children—a child is likely to have flat feet through adulthood.
Adults may have flat feet but still have good muscle tone and no pain.
If feet are extremely flat, a doctor may recommend orthotics (arch supports)
and a firm shoe to enable the person to walk without foot strain. Upwards
of 75 percent of Americans have foot pain at some time, and flat feet may
be the cause.

What Makes Feet Flat?

2010-12-09T16:29:00.000-08:00

For some people, flat feet are the result of congenital bone malformation,
evident if the doctor takes x-rays. For others, flat feet develop later. Each
day as people walk, they take 8,000 to 10,000 steps on pavement, floor,
tile, and other surfaces. With each step a person takes, gravity-induced
pressure puts three to four times the body’s weight on each foot. Over
the years, the imbalance on the muscles of the feet may cause a disorder
in the natural arch, weakening the posterior tibial tendon of the foot.
Excessive weight or pounding stress may cause the longitudinal (lonj-i-
TOO-di-nal) arch (which runs the length of the foot) or the metatarsal
(met-a-TAR-sal) arch (which runs perpendicular to the longitudinal arch,
from one side of the foot to the other) to fall, or flatten.
Other causes of flat feet are shoes that do not fit well, obesity, rickets,
and metabolic disorders that may cause the arch muscles to weaken. In
older adults, decreased exercise and increased weight can cause mechanical
disturbances in the foot.

What Is Bad about Flat Feet?

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Flat feet in themselves are not a problem. However, running on flat feet is
almost like running on gelatin. Flat feet turn inward (pronation), causing
legs to turn inward, and contribute to such overuse injuries as shin
splints and back problems. Flat feet can also produce heel spurs.

Correcting Flat Feet

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Reducing pronation can help to prevent further problems. Experts recommend
the following:

Wearing shoes with arch support
Wearing shoes that are motion controlled
Avoiding shoes with lots of cushioning and little support
Avoiding uneven running surfaces such as golf courses and trails.
Surgery is rarely recommended for flat feet alone.

Filariasis

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Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis FilariasisFilariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis Filariasis

Definition

2010-12-09T16:25:00.001-08:00

Filariasis (fih-luh-RYE-uh-sis) is a tropical disease caused by tiny worms

What Is Filariasis?

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Filariasis is caused by different species of microscopic parasitic roundworms
that are passed to people through the bites of insects, most commonly
mosquitoes. Several strains of these worms, known as filariae (fih-LAIRe-
e), can infect humans, including Wuchereria bancrofti (voo-ker-E-re-ah
ban-CROFT-e). There are also different types of filariasis itself, including
cutaneous or skin-related, body cavity, and lymphatic infections. In the
cutaneous disease, the worms live in the layers of the skin; in body cavity
filiariasis, they inhabit certain body openings and surrounding tissue; and
in the lymphatic form of infection, they invade the vessels of the lymphatic
system and the lymph nodes.
Lymphatic filariasis, which can progress to a condition called elephantiasis,
is the most serious form of the disease. It begins when an
infected female mosquito injects worm larvae into a person’s blood while
feeding. The larvae travel to the lymphatic vessels, where they grow into
adult worms. As adults, the worms can survive and reproduce for up to
seven years. The gradual buildup of worms in the vessels hinders the
lymphatic system’s ability to fight infection and causes lymph fluid to
collect—typically in the arms, legs, breasts, and male genitals—leading to
swelling and disfigurement.

How Common Is the Infection?

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Filariasis is most common in tropical and subtropical regions, including
parts of Africa, the western Pacific, Asia (especially India), and Central
and South America. In these areas, in the early 2000s, the number of cases
of filariasis continued to rise. It was estimated that more than 120 million
people worldwide had the lymphatic form of illness, and approximately
40 million of them were disabled or disfigured by the disease. Although
contracting filariasis is not a risk in the United States, some immigrants
may have it, and people who travel to other countries can contract the
disease as well. For example, missionaries and Peace Corps volunteers are
considered to be at risk.

Is Filariasis Contagious?

2010-12-09T16:23:00.001-08:00

The disease does not spread from direct person-to-person contact. Instead,
it is transmitted by the bite of a mosquito. When one of these insects bites
someone who is infected, it takes in the parasites along with its meal of
blood. The mosquito then can pass those parasites on to the next person it
bites. Usually, someone must be bitten many times, typically over a long
period, to develop symptoms of filariasis.

What Are the Signs and Symptoms of the Disease?

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The lymphatic form of filariasis usually produces fever, swollen or painful
lymph nodes in the neck and groin, pain in the testicles, and swelling
in the limbs or genitals. Males and the male urinary and genital systems
are particularly likely to be affected. In elephantiasis, a severe form of
chronic lymphatic filariasis, the blocked flow of lymph causes one or
both legs to swell significantly. Over time, the skin on the leg can also
change, taking on a rough texture so that it resembles the skin of an
elephant. Although elephantiasis is unusual, up to half of all men with
lymphatic filariasis may show serious symptoms, such as swelling of the
scrotum. In some cases people may have no obvious symptoms, but they
still may have serious damage to the kidneys and lymphatic system.

Making the Diagnosis
Knowing that the person lives in or has spent time in a country where
filariasis poses a risk can help a doctor diagnose the disease. The doctor
may also take skin and blood samples from the patient to look for signs
of the parasite.

What Is the Treatment for Filariasis?

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Ideally, treatment begins as soon as possible after the patient becomes
infected. Prompt treatment may not be possible, however, because the
disease can be difficult to detect in its early stages. When the diagnosis is
made, treatment may include:

medication to kill the young worms in the bloodstream and stop the
parasite’s life cycle (although the medicine cannot kill adult worms)
exercising and moving swollen limbs to improve lymph flow
bed rest and compression bandages to treat swelling
medications to lessen swelling and discomfort
hospitalization and intravenous(IV) antibiotics for secondary
infections that might appear because the damaged lymphatic system
is less able to assist in defending the body against infectious agents
surgical treatment for deformities, such as enlarged limbs and scrotum,
sometimes with several procedures and skin grafts to correct
cases of disfigurement

How Long Does the Disease Last and What Are the Complications?

2010-12-09T16:20:00.000-08:00

Filariasis can last a lifetime, and without treatment it can worsen. The disease
can lead to permanent disfigurement and damage to the lymphatic
system and kidneys, secondary infections, hardening and thickening of
the skin, and sexual and psychological problems. In countries in which
the disease is common, a serious social stigma often accompanies it,
meaning that people in these countries look down on individuals who
have symptoms of the disease.

Can Filariasis Be Prevented?

2010-12-09T16:19:00.000-08:00

There is no vaccine to prevent filariasis, but controlling the populations of
blood-sucking insects, especially mosquitoes, can limit the spread of the
disease. In some areas where filariasis is common, people are treated yearly
with preventive medicine to kill any immature worms in their blood. To
protect themselves, people can also do the following:

Stay inside as much as possible from dusk to dawn, when mosquitoes
are most active.
Sleep under mosquito netting.
Place screens in all windows.
Use insecticides around living areas.
Apply insect repellent to exposed skin.

Fifth Disease

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Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease Fifth Disease

Definition

2010-12-09T16:16:00.000-08:00

Fifth disease, also known as erythema infectiosum (air-uh-THEE-muh infek-
she-O-sum), is a common viral infection of infants and young children
that causes a characteristic slapped-cheek rash.

What Is Fifth Disease?

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Fifth disease, sometimes called slapped-cheek disease, is an infection
caused by the virus human parvovirus B19. Its most characteristic feature
is a bright red rash that begins on the face, making the cheeks look as if
they have been slapped. After a few days, the rash may spread down the
body and onto the arms and legs. As it spreads, the rash takes on a pink,
lacy appearance.
Most people with fifth disease have mild symptoms and do not become
seriously ill; some may not have any symptoms at all. However, the disease
can be serious for people with certain blood disorders, such as sickle-cell
disease, because parvovirus B19 can temporarily cause or worsen existing
anemia. For most people, temporary anemia is not a problem, but for
those who already have anemia, the condition can become severe, causing
paleness, fatigue, and a fast pulse. People with weakened immune systems,
such as those who have AIDS, cancer, or who have had an organ transplant,
can also develop severe anemia as a result of fifth disease.
Parvoviruses can infect animals, but these are not the same strains
that affect humans. Therefore, a person cannot catch fifth disease from a
dog or cat, and a pet cannot catch it from an infected person.

How Common Is Fifth Disease?

2010-12-09T16:15:00.001-08:00

Fifth disease occurs most commonly in children between the ages of 5
and 15 years, but adults can also get it. It often occurs in outbreaks (for
example, among classmates at school or children in a child-care center) in
the winter and spring, but people can get it throughout the year.
Fifth disease spreads quickly. At home, up to half of family members
exposed to someone with fifth disease become infected. If an outbreak
occurs in school, up to 60 percent of students may get the virus.
A person with fifth disease can spread the infection in the early part of
the illness, before the rash develops. By the time the rash appears (about
a week after being exposed to the virus), a person likely is no longer
contagious. Once someone is infected with parvovirus B19, that person
develops immunity to it and will not usually become infected again.
Parvovirus B19 passes from one person to another through nose and
mouth fluids, such as mucus and saliva. Any direct contact with the fluids
of an infected person, whether through a cough or sneeze or by sharing
drinking glasses or utensils, can spread the infection.
Fifth disease can also be passed from pregnant women to their unborn
babies. Most of the time, the baby is not harmed. Occasionally the
infection can cause severe anemia in the baby and lead to miscarriage,
especially if the baby was infected in the first half of pregnancy.

What Happens When People Get Fifth Disease?

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Signs and symptoms
The first symptoms of fifth disease are similar
to those of a common cold and include low fever, a runny or stuffy nose,
sore throat, cough, headache, diarrhea, and fatigue. During this early
period fifth disease is most contagious. After a few days, especially in children,
the slapped-cheek rash usually first appears on the face, and it soon
begins to involve the rest of the body in a pink, lacy-looking pattern. Not
everyone with fifth disease develops this rash, but it is much more likely to
appear in children under 10 years of age. For some people the rash fades
and reappears if triggered by heat, exercise, stress, or exposure to the sun.
Sometimes the rash itches, and adults in particular may experience pain
and swelling of the joints in the hands, or the wrists, knees, or ankles.

Diagnosis In children,
doctors can usually diagnose fifth disease simply
by looking for the telltale rash on the face and body. In cases in which
there is no rash, blood tests can confirm the presence of parvovirus B19.

Treatment Most people with fifth disease do not require treatment.
Antibiotics do not help because the illness is caused by a virus rather
than bacteria. Symptoms such as fever or joint pain may be treated with
acetaminophen.
The rash clears up on its own, often within one to three weeks. Joint
pain and swelling can take longer to go away, sometimes up to several
months. People with joint pain may need to rest and restrict their activities
until they feel better.
People with blood disorders or immune deficiencies who develop
severe anemia as a result of fifth disease may require blood transfusion*
and other specialized medical care.

Complications
The vast majority of people who are infected with
parvovirus B19 recover completely without any complications. Severe
anemia, the complication most often associated with fifth disease, usually
affects people with weakened immune systems or blood disorders
and, rarely, unborn babies who were infected during the first half of
pregnancy.
In healthy people, parvovirus B19 infection can sometimes affect the
ability of the bone marrow (the soft tissue inside bones where blood cells
are made) to make new red blood cells, but this effect is usually temporary
and does not cause significant anemia or other problems.

Can Fifth Disease Be Prevented?

2010-12-09T16:12:00.001-08:00

There is no vaccine to prevent fifth disease. The best way to prevent the
spread of infection is to practice good hygiene, including frequent hand
washing and not sharing drinking glasses and eating utensils. Because the
disease is most contagious before the telltale rash appears, it is difficult
to keep the infection from spreading among family members or young
children in school or day care. By the time the rash appears and the illness
is diagnosed, the person is usually no longer contagious.

Fibrocystic Breast Disorder

2010-12-09T16:10:00.002-08:00

Definition

2010-12-09T16:10:00.001-08:00

Fibrocystic (fy-bro-SIS-tik) breast disorder is the general term used to
describe noncancerous changes in the breast, such as the formation of
fluid-filled sacs called cysts.

When Is a Breast Lump Not Breast Cancer?

2010-12-09T16:09:00.002-08:00

It is estimated that more than half of all women experience the breast
changes that are known as fibrocystic breast disorder at some time during
their lives. The symptoms vary from person to person. Some women have
no symptoms at all. Others notice a lump that feels like a smooth grape
under the skin. These lumps, or cysts, are sometimes painful or tender to
the touch.

What Causes Fibrocystic Breast Disorder?

2010-12-09T16:09:00.001-08:00

The breast is made up of fatty tissue filled with pockets called lobes, each
of which contains many smaller pockets called lobules. After a woman
gives birth, these lobules produce milk. As a woman goes through her
menstrual cycle, the body releases hormones that cause the pockets in
the breast to enlarge and hold extra fluid. At the end of the cycle, this
swelling disappears, but fluid can sometimes get trapped in these openings.
Over time, cysts can form.
Fibrocystic breast disorder usually affects women between the ages of
30 and 50. The lumps often are especially noticeable before and during
menstruation. When a woman reaches her 50s or 60s and stops menstruating,
these symptoms usually disappear as well.

How Does the Doctor Know if the Lumps Are Not Cancer?

2010-12-09T16:05:00.000-08:00

A doctor starts with a physical examination and mammogram, or x-ray
of the breast, because benign breast lumps often look and feel different
from cancerous ones. If the lump turns out to be a cyst, the doctor may
use a small needle to drain the fluid. If the fluid is bloody or appears
unusual in any way, it may be sent to the laboratory for analysis. In most
cases, no other treatment is needed.
If the lump is solid, a biopsy (BY-op-see) is performed. During this
procedure, some or all of the tissue is removed and examined under a
microscope for the abnormal cell shapes and growth patterns that indicate
cancer. Researchers have investigated whether there is a connection
between fibrocystic breast disorder and a woman’s risk for breast cancer
without reaching a conclusion as of the early 2000s.

Fever

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Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever

Definition

2010-12-08T08:59:00.001-08:00

Fever is an abnormally elevated body temperature that usually occurs
during an infection, inflammation, or some other kind of illness. Fever
is not a disease itself, but it is one of the most common signs of illness,
especially among children.

How Is Body Temperature Controlled?

2010-12-08T08:57:00.000-08:00

The body adjusts its temperature in much the same way that the thermostat
in a house works. With a thermostat, people set the temperature
they want, and the heating or cooling system clicks on until the inside
of the house reaches the right temperature. After that, the heater or air
conditioner clicks on and off automatically to keep the temperature in the
house hovering around the desired temperature.
The body’s thermostat is located in the hypothalamus (hy-po-THALa-
mus), a small part of the brain that also helps to regulate hunger, thirst,
awareness of pleasure, and awareness of pain. The thermostat region of the
hypothalamus, called the thermoregulatory (ther-mo-REG-u-la-tor-ee)
center, normally keeps the body’s temperature hovering at around 98.6
degrees Fahrenheit (F) (36.8 degrees Centigrade [C]).
Like a house, the body has sensors that tell the thermostat if the temperature
inside is rising or falling. In the body, these sensors are cells
located in the skin and in the brain itself. If the sensors report that the
body’s temperature is rising, the body’s cooling system clicks on, telling
the cells to burn less fuel and produce less heat. The blood vessels expand
to let heat escape from the skin (the evaporating sweat draws heat away
from blood vessels), sweat pours out to cool the body as it evaporates,
and the brain may get a bright idea: “Let’s go into the shade and have a
cold drink.”

Fever
With fever, the thermostat in the brain is reset to a higher temperature.
Instead of keeping the body’s temperature hovering at around
98.6 degrees F, the body’s heating and cooling systems may keep the temperature
at 100 to 102 degrees F or even higher.
Normal temperature varies a bit from person to person and from
morning to evening, making it hard to state precisely where normal ends
and fever begins. In fact, temperature measured at different places in the
body can also be different. Temperature measured at the mouth can be
one whole degree Fahrenheit lower than the actual core body temperature.
For this reason, core body temperature is best measured at the rectum
or at the ear. Most doctors say that a core body temperature at or above
100.4 degrees F (38 degrees C) should be considered a fever. Core body
temperature above 104 degrees F (40 degrees C) is generally considered a
high fever.

Hyperthermia
Sometimes a person’s temperature can rise for a different
reason. Hyperthermia (hy-per-THER-me-a), quite different from fever,
occurs when the heat outside is too much for the body’s cooling system to
handle, making body temperature (and the set point) rise. The most severe
cases of hyperthermia tend to occur in people who cannot sweat as much
as others, such as elderly people or those taking certain medications.

How Does Illness Cause Fever?

2010-12-08T08:55:00.000-08:00

Bacteria and viruses themselves, as well as toxins (poisonous waste products)
produced by some bacteria, cause fever. In some cases, they work
directly on the brain to raise the thermostat. More commonly, they cause
the body’s immune system to produce proteins called cytokines (SY-tokines).
The cytokines help fight the infection, but they also reset the
brain’s thermostat, causing fever.
Any substance that causes fever is called a pyrogen (PY-ro-jen), from
the Greek word for “fire-causer.” If the substance comes from outside the
body, such as a toxin from bacteria, it is called an exogenous (ek-SOJ-enus)
pyrogen. The prefix “exo-” means “outside” in Greek. If the substance
comes from inside the body, such as a cytokine, it is called an endogenous
(en-DOJ-e-nus) pyrogen. The prefix “endo-” means “inside” in Greek.

Sometimes the immune system produces pyrogens even without an
infection. For instance, this may happen if a person has the following:

an autoimmune disease, such as rheumatoid arthritis or lupus
inflammation anywhere in the body
cancer, such as leukemia or lymphoma
received a blood transfusion* that is not compatible with his or her
own blood type
has a reaction to a medication

Who Gets Fever?

2010-12-08T08:53:00.000-08:00

Fever is caused by so many common illnesses, including colds and flu,
that it happens to everyone many times in the course of a lifetime. Young
children are particularly likely to get bacterial and viral infections, such
as strep throat and ear infections, that cause fever. Sometimes minor viral
infections cause high fevers in children, whereas illnesses that are more
serious cause milder fevers. People of all ages get fever.

Helpful fever
Some evidence suggests that an elevated body temperature
can make the immune system more effective and weaken certain
bacteria. However, most of this evidence comes from animals or experiments
on human cells in test tubes. Scientists really do not know whether
fever actually helps people fight off infections. It may be that fever helps
in certain cases but not in others.
Fever often can be helpful in another way. It can be an important sign
that a person is sick. The movements of temperature up and down can
indicate whether a person is getting better or worse.

Harmful fever
Fever often makes an illness more unpleasant. In addition,
a feverish body needs more oxygen, which means that the heart and
lungs have to work harder as the fever rises, which can be a problem for
people who already have heart or lung problems.
Fever can make mental problems worse for elderly people who have
dementia (de-MEN-sha), which is a form of mental confusion and loss
of memory that can develop gradually as people age. High fever also can
cause temporary mental confusion, called delirium (de-LEER-e-um),
even in healthy people.

Febrile convulsion
Children under five years of age can have a different
problem if their temperature rises quickly. They may experience
a kind of seizure called a febrile convulsion (FEB-ryl kon-VUL-shun).
Their muscles may twitch, and they may lose consciousness for several
minutes. Usually, a febrile convulsion needs no treatment and may not
recur. However, febrile convulsions can be frightening. They also can lead
to injury; for example, if a child falls.
Extremely high temperatures of around 107 degrees F or higher can
cause permanent brain damage at any age if they last for a long time.
Temperatures that high usually result from hyperthermia, not from an
illness-related fever.

How Is Fever Diagnosed?

2010-12-08T08:52:00.002-08:00

People with a fever often feel hot, tired, achy, and generally sick. They
sometimes have shaking chills as their temperature rises. Shaking helps
raise the temperature to the feverish level that has been set by the body’s
thermostat. They may sweat heavily when the fever “breaks” (starts to
go away) or if it falls temporarily as part of an up-and-down pattern.
Sweating helps lower the temperature to the new, lower point set by the
thermostat.
Although the classic way of checking for fever at home is to touch the
person’s forehead to see how warm it feels, doing so often does not work.
The only way to tell for sure if a person has a fever is by taking the temperature
with a thermometer. Three kinds of thermometers are available:
digital, mercury, or tympanic.
Digital thermometers, usually used in medical offices and hospitals
as well as at home, are electronic. They can take an oral temperature
when placed under the tongue, a rectal temperature when placed
into the rectum, or an axillary (AK-si-lar-y) temperature when placed
in the armpit. The measured rectal temperature is the closest to what
the core of the body actually feels and thus is considered to be the most
accurate.
Mercury thermometers, which used to be the only kind available, are
made out of glass and contain liquid mercury. They come in oral or rectal
versions. Either kind can be used in the armpit as well. They are cheaper
than digital thermometers, but they take longer to use.
Tympanic (tim-PAN-ik) thermometers are a special kind of digital
thermometer that is placed into the ear. While the other thermometers
take several minutes to give a reading, the tympanic thermometer takes
only a few seconds. However, tympanic thermometers are more expensive
and can be inaccurate if placed improperly in the ear.

When Should a Doctor Be Consulted?

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A doctor should be consulted if a fever is high, lasts longer than a few
days, or is accompanied by other symptoms, such as a rash; pain in the
joints, neck, or ears; unusual sleepiness; or a dazed or very sick feeling.
For babies under about three months of age, a doctor should be consulted
about any fever.
The doctor will try to find and treat the underlying cause of the fever.
Antibiotics can cure many bacterial infections, such as those that cause
many earaches and sore throats. No medications are available to treat
most viral infections.

How Is Fever Treated?

2010-12-08T08:51:00.001-08:00

In a basically healthy adult or older child, there usually is no medical
reason to treat the fever itself unless it is very high. In fact, lowering the
fever with drugs can make it harder to tell if a person is actually getting
better or if the drugs are just keeping the fever down. In younger
children, though, doctors often treat fevers above 100 degrees F, in part
to avoid febrile convulsions. Of course, if a person of any age is very
uncomfortable or unable to sleep, even a low fever can be treated to
provide relief.
Fever can be lowered by drugs called antipyretics (an-ti-py-RET-iks)
that do not require prescriptions. The major ones are acetaminophen
(a-seet-a-MIN-oh-fen), ibuprofen, and aspirin. However, aspirin should
not be given to children or teenagers with a fever. If children have a viral
illness, such as influenza or chickenpox, aspirin makes it likelier that they
may get a rare but dangerous illness called Reye’s syndrome. This possibility
does not exist with their taking acetaminophen or ibuprofen.
Antipyretic medicines are available in pills for adults, chewable tablets
for children, and liquid drops for babies. Acetaminophen also comes in
suppositories (su-POZ-i-tor-eez), waxy pellets that are inserted into the
rectum. They are used for people who cannot take medicine by mouth
for whatever reason.
A lukewarm bath can also help lower a high temperature. However,
cold water or alcohol rubs can do more harm than good by causing the
body to shiver, which just raises body temperature more. In addition to
these treatments, it is important for a person with a fever to drink plenty
of liquids to avoid dehydration. In extreme cases, a person in the hospital
with a very high fever may be wrapped in a special cooling blanket or
immersed in ice water.

How Can Fever Be Prevented?

2010-12-08T08:50:00.001-08:00

Many of the diseases that cause fever can be prevented by vaccination*.
These include influenza, measles, mumps, rubella (German measles),
chickenpox, diphtheria, and typhoid fever. A number of other diseases
that cause widespread fever in poorer nations have been eradicated in the
United States by good sanitation systems and access to clean water. Still
other diseases, such as colds and strep infections, often can be prevented
by washing the hands properly before eating and, if possible, by avoiding
contact with people who already have these infections.

Fetishism

2010-12-08T08:22:00.000-08:00

Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism Fetishism

Definition

2010-12-08T08:21:00.002-08:00

Fetishism involves assigning increased value or power to an inanimate
object or non-sexual body part.

What Is Fetishism?

2010-12-08T08:21:00.001-08:00

Fetishism involves being fixated on inanimate objects or non-sexual body
parts. The person assigns special significance or power to the object for the
purpose of mental or sexual stimulation. Fetishes are considered a common
part of human sexuality. Fetish objects may play a role in masturbation or
sexual fantasies. Fetishism is more common among men than women.

Are There Different Types of Fetishism?

2010-12-08T08:20:00.000-08:00

There are two different categories for fetishes.
Form fetishes are those that focus on the shape and appearance
of concrete objects such as high heeled shoes, lingerie, lipstick, or
gloves.
Media fetishes tend to be more focused on the texture or feel of certain
objects. These might include leather, rubber, or silk.
Fetishists use the items that they desire during masturbation or during
sexual activity with their partners to achieve sexual satisfaction. Often,
they need these items to become aroused. In many cases, fetishists simply
need to see the object to become aroused, but more often, they prefer to
touch, rub, and smell the object. Many fetishists prefer objects that have
been worn or used, although they have no interest in the person who has
used the object, only the object itself.