DENGUE FEVER

Dengue fever is an acute febrile viral illness presenting with headache, bone or joint and muscular pains. Rash and leukopenia caused by arthropod-borne viruses.Dengeu hemorrhagic fever is characterized by four major manifestations high grade fever, hemorrhagic phenomenon often with signs of circulatory failure. Such patients may develop hypovolemic shock resulting from plasma package this is called as dengue shock syndrome and it can be fatal .Children under the age of 15 years are mostly infected by this disease. Dengue virus infects the peripheral blood mononuclear cells within a few days of infective mosquito bite.Aedes aegypti mosquito is the principal vector this mosquito lives indoors and bites the host during daytime. Aedes aegypti has a short flight range and therefore infection is spread through the movement of patients with viremia rather than that of the mosquito, this disease is widely prevalent in cities with higher population density. Incubation period for this fever is around 2-7 days. There are non-specific symptoms such as anorxia, bad taste in the mouth and vomiting.There is no specific antiviral treatment for this disease.The patients are closely monitored for vital signs and the fluid intake should be maintained despite vomiting and bad taste in the mouth. Strategies for prevention and control include breaking the transmission cycle of Aedes aegypti and by holding the mosquito population at extremely low levels. Community participation should be sought for keeping water storage containers such as overhead tanks, desert coolers,etc. Free of mosquitos

TRICHINOSIS

Humans acquire Trichinosis spiralis by consumption of undercooked or raw meat contaminated with infective larvae. Larvae develop into adult worms in the small intestine. After 1-2 weeks, adult female worms produce newborn larvae that penetrate the intestinal mucosa and reach striated muscles in the blood stream. The larvae then encyst in the muscles and can remain viable for many years. Most cases of human trichinosis are caused by the ingestion of infected pork meat. Most infections are asymptomatic. Large infestations may lead to diarrhea, vomiting and abdominal discomfort .After about 2 weeks of infection, fever, and myalgia .there may be associated cough, dyspnea, headache, dysphagia rash and sub-conjunctival haemorrhages. Severe infection may be complicated by myocarditis, pneumonia, or encephalitis.Extraocular, jaw, neck, biceps, diaphragm and lumbar muscles are commonly involved. Peripheral smear shows eosinophilia.Muscle enzymes are elevated in the presence of myositis.Seorlogy becomes positive 3 weeks after infection .Biopsy from tender, swollen muscle confirms the diagnosis although it is necessary in most cases. Hence the prevention method is more complicated in this disease, adult worms can be eradicated by taking drug like mebendazole for 3 days and alternative therapy consists of albendazole for 8-12 days. Both these drugs appear to be effective against muscle larvae. Severe myostitis may require a short course .

FILARIASIS

Lymphatic filariasis is caused by Wuchereria Bancrofti virus. These are thread like parasites reside in the lymphatic system of the host. It remains a public health problem in many tropical countries of the especially in Southern and South east Asia. Most heavily infested areas in India are the states of Andhra Pradesh, Tamil nadu, Kerala, Orissa, Bihar, and Eastern Uttar Pradesh. Wuchereria Bancrofti is transmitted in India through C.quinquefasciatus and has animal reservoirs have been observed incats, dogs and monkeys. The infected mosquito bites a person and deposits the larvae in the skin these may remain in the skin or cross this barrier to enter the lymphatics.In human larvae develop into adult male or female worms over a period of 4 to 6 months. Adult worms reside in afferent lymphatics.The life cycle of the parasite is completed when a mosquito ingests microfilariae during a blood meal. The microfilariae show a characterized periodicity in the course of 24 hours. Acute clinical manifestations are characterized by recurrent attacks of fever associated with inflammation of the lymph nodes. In chronic stage lymphadenitis may progress to lymphatic obstruction resulting in changes associated with elephantiasis. Microfilariae can be detected in blood, urine, hydrocele fluid or tissues. Examination of a blood is still the best diagnostic tool. Treatment is the drug of choice for lymphatic filariasis and is active against both adult worms and microfilariae.Control of lymphatic filariasis should be aimed at decreasing morbidity, reducing transmission and interrupting the transmission cycle.

DIARRHEA

Diarrhea is the passage of liquid or water stool more than three times a day. Persistent Diarrhea is defined as diarrhea of presumed infectious origin that begins acutely. Incubation period for this diarrhea is about 14 days or more. It is caused by Vibrio cholera, rota virus, shigella etc.The main syndrome is dysentery which is characterized by the presence of blood and fever. Gross blood in the stool is the most reliable sign. The two main risks of diarrhea are malnutrition and death. Dehydration is the most common cause for death. A significant number of death occur as a result of malnutrition consequent to a series of diarrhea. Diarrheal illnesses are important contributors to the pool of malnourished children in developing countries. Rehydration is the first line of management and it can be carried out by oral rehydration solution. Drugs like Metronidazole, Tinidazole are used to cure this diahrrea. Loperamide should be avoided in moderate to severe diahrrea. Racecadotril decreases hyper secretion of water and electrolytes into the intestinal lumen by preventing degradation of enkephalins.It is contraindicated in renal insufficiency, pregnancy and breast-feeding state. Oral rehydration solution is effective in preventing, treating and maintaining hydration in all except very severe cases of acute diarrhea.However one limitation of oral rehydration solutions is that it does not reduce the severity or duration of diarrhea.Water given to the child or used foe preparing feds should be clean, portable, preferably boiled these should be maintained for control of all the infectious illnesses including diarrhea. These measures should be sustained to achieve the desired goals.

AMOEBIASIS

Amoebiasis is a common intestinal protozoan infection. In most of the cases the infection is asymptomatic. It is present in worldwide and more common in the regions where there is a poor standards of personal and food hygiene and inadequate sanitation. Approximately 10 percent of world‘s population are infected by this disease.Entamoeba is a bacterial protozoa which is responsible for cause of this disease. The infection is transmitted by ingestion of food or water, contaminated with material containing cysts of Entamoeba.Cysts are easily destroyed by most disinfectants and by heating to 55C but may survive chlorination of water and in water at low temperature. Incubation period for this disease varies from 2 weeks to months. Acute amoebic infection of the intestine causes dysentery with low grade fever, blood or mucus in the stools these are the some of the important symptoms of this disease. Amoebic liver abscess develops in 1 percent of infected persons. The child presents with high fever with chills and abdominal pain and half of the patients may have associated diarrhoea, dysentery and weight loss.Metronidazole is the drug of choice for the treatment of Amoebic liver abscess.Percutaneous drainage of abscess under guidance is preferred over open surgical drainage. Metronidazole is the most popular drug used in treatment of Amoebiasis.

DIPHTHERIA

Diphtheria is an acute infectious disease of childhood characterized by local inflammation of epithelial surface. This infection is caused by a Gram positive bacillus, Corynebacterium diphtheria. It occurs more in the autumn and winter seasons. The pre-school children are especially vulnerable to diphtheria. Corynebacterium diphtheria liberate a powerful exotoxin .The exotoxin affects the heart, kidney and central nervous system. The secretions and discharge from an infected person or carrier are the sources of infection. The infections are transmitted by contact or through droplets of infection. Incubation period for this disease is around 2-5 days. Main symptoms of this diphtheria are fever, head ache and loss of appetite. The treatment for this disease includes following principles they are Neutralization of exotoxin by using antitoxin, Antibotics to destroy bacteria, Supportive and symptomatic therapy, and Management of complications .Some antibiotics used are penicillin or erythromycin should be used to terminate the production of toxin. To Prevent and control this disease the patient should be isolated until two successive cultures from the throat and nose are negative for diphtheria bacillus. Previously immunized. Asymptomatic patients should receive a booster dose of diphtheria toxoid which is helpful in curing this diphtheria. Those who are not fully immunized, but asymptomatic contacts should receive immunization appropriate for their age. By following the above methods, we can prevent and control this diphtheria disease.