Chickenpox and Shingles

 What is chickenpox?

Chickenpox is a disease caused by the varicella-zoster virus, and it is a type of herpes virus. It is very rarely fatal, however, is highly contagious among unimmunized people. Before 1995, chickenpox was extremely common due to its easy-spreading nature, however, ever since the chickenpox vaccine was licensed for used in March 1995 in the US, chickenpox had been a much less significant issue. According to CDC, before the vaccine, every year about 4 million people had chickenpox, 10500-13000 were hospitalized and 100-150 died. Now, that number is cut off by 80%. How about in Canada? Between 1986 and 2018, 1987 had reported 72343 cases, making it the year with most cases. The numbers decreased until 1993 when it spiked to 49779 again. There was a steep drop from 2003 to 2004, dropping from 17572 cases to 1734 cases. In 2018, there were 339 cases. 

What is shingles?

Shingles, although caused by the same virus of chickenpox, is a much more severe disease than chickenpox. When the varicella-zoster virus reactivates, chickenpox doesn't reactivate. Instead, shingles takes its place. So if you've never had chickenpox or the chickenpox vaccine, you could never get shingles. Shingles is rarely fatal as well, but it could bring severe pain and itch to the patient.

Symptoms of Chickenpox:

- Rash that turns into blisters and scabs

- Fever and Headache

- Tiredness

- Loss of appetite

These symptoms usually come between 10-21 days of contracting the virus.

Symptoms of Shingles:

- Symptoms of Chickenpox

- Tingling, Prickling and Burning Pain

Transmission:

Chickenpox can be spread by airborne droplets or by touching the fresh blisters of an infected person. However, dry blisters cannot transmit chickenpox. Furthermore, chickenpox can live in the air for 2-3 hours.

Treatment: 

There's no specific treatment for Chickenpox. You just have to rest a lot, take care of your body, and if you feel any discomforts, take medicines to treat the symptoms.

Prevention: 

The vaccine, same as polio, is the most important part of chickenpox prevention. The chickenpox vaccine decreased cases by 90%, and the effectiveness of the vaccine in the body for more than 20 years with only 2 shots. In addition, with 2 shots, it is 100% effective against severe cases of chickenpox.

Polio

What is Polio?

Polio, full name Poliomyelitis, is a disease that can be highly severe and deadly and has been eradicated by most of the world in 2020. In 1988, an american polio eradicating goal was created to eradicate all cases of polio by the 2000, however, they did it in 1994. The last case of a wild poliovirus case reported in August 1991 in Peru, and on Nov 20, 1994, polio eradication has been certified. Other countries in Europe and Asia followed on, and in 1998, the last polio case of Europe took place in Turkey, and on June 21, 2002, the WHO declared that Europe eradicated polio. In 2017-2020, only 2 countries in the world, Pakistan and Afghanistan, had wild Polio cases, with other African countries only having the very rare Vaccine Derived Polio (cVDPV). There are 3 types of wild poliovirus - Type 1, 2 and 3. The last type 2 polio case was in October 24, 1999, and it has been certified globally eradicated on September 20, 2015. The last type 3 polio case was on November 10, 2012 in Nigeria, and has also been certified globally eradicated on October 24, 2019. Scientists are now working hard to eradicate Type 1 polio as well. Other than that, polio can also be abortive, nonparalytic or paralytic. Abortive polio and nonparalytic polio can still be found in the US, however it is extremely rare, and happens mostly to children with common and minor flu symptoms or at most, meningitis, that lasts for short periods of time, however, 1% of polio victims can develop paralytic polio and suffer from paralysis and long term to permanent damage after treated. 

Symptoms:

Non paralytic/Abortive:

- Fever and headache

- Sore Throat

- Vomiting

- Meningitis

Paralytic:

- Paralysis

- Severe spasms and pain

How is polio transmitted?

- Fecal-oral transmission

    Polio is transmitted when someone ingests an infected person's faeces. This can happen when an infected person serves food after taking a dump and not washing hands.

-Oral-oral transmission

    Oral-oral transmission via saliva is also possible but very rare.

Treatment:

- Rest

- Antibiotics

- Physical Therapy (Paralysis)

- Ventilators

- Painkillers

Prevention:

The polio vaccine is the most effective cure of polio. The polio vaccine has dropped 99% of polio cases, so remember to take all your polio shots!

Malaria

 What is Malaria?

Malaria, is a very serious parasitic disease that is transmitted by mosquitoes, and has been eradicated in North America since 1951. In July 1947, the US launched a National Malaria Eradication Program, which with state and local participation, succeeded in eradicating Malaria. Even though Malaria has been eradicated and there are only about 2000 cases in the US per year, it is still a severe problem in third world or developing countries in sub-Saharan Africa and South Asia. In 2018, there were approximately 228 million cases worldwide, causing 408 thousand deaths. According to the WHO, Africa has the most malaria cases, with 93% cases and 94% deaths. Children under 5 were also most vulnerable, accounting for 67% of the 408 thousand deaths. 

Cause of Malaria:

Malaria is caused by parasites. There are 5 more common types of malaria: P. Falciparum, Malarie, Vivax, Ovale and Knowlesi. P stands for Plasmodium, a genus of unicellular parasites. According to counts, 99.7% and 50% of cases in Africa and South-East Asia are caused by the most deadly P. Falciparum. in 2018. In just 24 short hours, P. Falciparum can progress severely, causing deaths if not treated. Since Malaria is caused by parasites, it cannot be transmitted via air, and is only transmitted by mosquito bites. When the mosquito bites, the parasites are inserted into the blood streams of the victim. Female Anopheles Mosquitoes are usually the ones which transmit Malaria. Because they need to feed their eggs with blood, they bite humans, and the parasites take advantage of this to get into humans.

Symptoms:

- High Fever over 38 degree celsius

- Chills

- Sweating

- Bad Headaches

- Vomiting

- Diarrhea

- Abdomen and Muscle Pain

- Fatigue and Weakness

- Anemia

 Severe Symptoms:

- Coma

- Convulsions

Treatment:

- Artemisinin-based combination therapy

- Chloroquine Phosphate

- Antimalarial drugs

Prevention:

If you're going for a trip to developing African or South Asian countries, remember to have closed shelter where mosquitoes can't get in, try to get a bed net to avoid insects from getting in your sleeping areas, wear long sleeved shirts, wear sunscreen then insect repellent or sunscreen with repellent, and if necessary, take an antimalarial every day during the trip and for 4 weeks after the trip. But if somewhere is too dangerous, just don't go.

Epilepsy and seizures

 What is Epilepsy?

Epilepsy, seizure... You always see these words being thrown around, from TV shows to books to jokes. A lot of people know what the simplified meaning of what an epilepsy is, but not a lot knows it in depth or even the true meaning of it. The meaning of having an epilepsy is to have two or more unprovoked seizures. Well, what does unprovoked mean then? An unprovoked seizure is a seizure which its cause is unknown. Seizures caused by allergic reactions, low blood sugar, infections... are provoked seizures, because there is a direct cause for it. Moving onto stats, did you also know that epilepsy is the fourth most common neurological disorder? Unfortunately, it is. As of 2019, a staggering 1.2% of people have active epilepsy, which is about 3.4 million people in the US alone! Other than that, over 1 in 26 will experience an epilepsy in their lifetime. That is scary to think of! That's about 4% of people! And the worse thing is that it doesn't only happen to adults, it happens to children too. Out of the 3.4 million cases in the US, 470000 of them are children. 

What are seizures?

Seizures are sudden surges of electrical activities in a person's brain. This can be an imbalance of activity caused by lack of or too much activity. It can affect the patient in many way, such as the common violent shaking. Over 10% of people will experience a seizure in their lifetime!

Types of Seizures:

- Generalized Seizures: affects the whole brain

    -Petit Mal Seizures:

        - Absence seizure -- Blank out for a few seconds and recover

    -Grand Mal Seizures:

        - Tonic seizure -- Muscle stiffens

        - Clonic seizure -- Recurrent shaking, jerking and twitching for parts of body

        - Myoclonic seizure -- Irregular singular short jerking of parts of body (short clonic seizure)

        - Atonic seizure (Drop attacks) -- Sudden loss of muscle strength

- Focal Seizures: affects a specific part of the brain

    - Simple Focal seizure -- sudden twitch or change in sensation

    - Complex Focal seizure -- causes confusion

    - Secondary Generalized seizure -- causes focal seizure first, then causes generalized seizure

Causes of seizures:

- Alcohol Withdrawal (when you suddenly stop consuming alcohol after a long time of drinking it)4

- Alcohol Overdose

- Brain Infection

- Brain/Head Injury

- Brain Defect

- Brain Tumor/Cancer

- Choking

- COVID-19 (severe cases)

- Drug Withdrawal

- Drug Overdose

- Electric Shock

- High Blood Pressure (Too high)

- High Fever

- Kidney Failure

- Liver Failure

- Low Glucose Levels (Too low)

- Sleep Deprived

- Strobe lights/sounds (Photosensitive seizure)

- Stroke

Treatment:

- Anti-Seizure medication

- Surgery

- Vagus Nerve Stimulation

- Neurostimulation 

- Deep Brain Stimulation

Prevention:

- Get enough sleep

- Take less alcohol

- Don't take drugs without prescription

- Don't play video games for too long

- Try to relieve stress

Gangrene

 What is Gangrene?

Gangrene is an extremely dangerous medical condition. Gangrene is the term used to describe body tissue death, which usually only happens with severe blood loss or bacterial infection. Even though it usually only affects limbs, fingers, toes... it can also affect muscle tissues, organ tissues and even genitals in cases of Fournier's Gangrene.

Types of Gangrene: 

- Dry Gangrene

- Wet Gangrene

- Gas Gangrene (wet)

- Internal Gangrene (wet)

- Fournier's Gangrene (wet)

- Meleney's Gangrene (wet)

What is Dry gangrene?

Dry gangrene is a type of gangrene that is not caused by infection. Dry gangrene is only caused by loss of blood, which causes the tissue to turn black, dry up and fall off. However, a dry gangrene can become an infection, causing a wet gangrene.

What is Wet gangrene?

Wet gangrene is usually always because of a bacterial infection. As the name suggests, wet gangrene causes blisters to build up, causing it to be wet from the pus. The blisters swells and can quickly cut off blood circulation and also easily spread to other parts of the body.

What is Internal gangrene?

Internal gangrene is a type of wet gangrene. It refers to gangrene of internal organ tissues, and it can affect organs like the colon, intestines and more. This can be extremely fatal if left untreated. 

What is Fournier's gangrene?

Fournier's gangrene is a rare type of gangrene, usually caused by Necrotizing Fasciitis, and it specifically attacks the male genitals. 1 in 62500 men have Fournier's Gangrene every year, making them 10 times more affected than women, but this doesn't mean women won't be affected. Older males between the ages of 50 and 60 are also more vulnerable to it. On the opposite end of the spectrum, children almost never get Fournier's Gangrene.

What is Meleney's gangrene?

Meleney's gangrene, or Progressive Bacterial Synergistic Gangrene is another rare type of gangrene. It is very dangerous because it can spread at a phenomenal speed. It usually only happens after surgeries with an unclean wound, however, the mortality rate can be up to 40%, and for diabetic people, the mortality rate can shoot up to 90%. It is also hard to diagnose it because symptoms aren't obvious.

Causes:

- Trauma

- Burns

- Deep wounds

- Blocked off blood supply

- Bacterial infection

Symptoms:

- Blisters/Swelling with pus and blood coming out

- Foul-smelling wound

- Discoloured skin

- Pale and cold skin

- Severe pain

- Numbness

- Septic Shock

Treatment: 

- Antibiotics (kill bacteria)

- Skin Debridement (Surgery)

- Maggot Debridement

- Hyperbaric Oxygen Chamber (for Gas Gangrene)

- Vascular Surgery

Prevention:

- Wash your wounds 

- Lose weight

- Eat less cholesterol so it wouldn't block your arteries

- Care for Diabetes

- Prevent severe frostbites

Necrotizing Fasciitis (NF)

 What is Necrotizing Fasciitis?

Necrotizing Fasciitis (NF) is an extremely rare but lethal flesh-eating disease. Most NF cases are caused by bacteria, even though there is a slim chance where it could be fungal-caused. There are 4 types of NF, Type I, II, III and IV/Other. This will be elaborated below. Only 0.0004% or 4 out of 1,000,000 people in the US and 0.001% or 1 per 100,000 in Europe fall victim to this, however, according to the CDC, the death rate can be 20-40%, especially with STSS (Streptococcal Toxic Shock Syndrome). STSS was introduced in the last article, so go check it out after reading this. CDC Data shows that 9000-11500 cases of NF are diagnosed every year, with 1000-1800 deaths every year.

Types of NF:

- Type I: Type I NF describes NF that is caused polymicrobially. Poly means many, and microbial means microorganism, so polymicrobial-caused NF means that there are more than one bacteria involved in the infection. An example of a Type I infection would be Staphylococcus Aureus and Haemophilus.

- Type II: Type II NF describes monomicrobial NF. Mono means one/single, and microbial as said above means microorganism, so monomicrobial-caused NF means single bacteria caused NF. This is mostly caused by a Group A Strep infection or MRSA infection, and is the most common among the four.

- Type III: Type III NF is caused by Clostridia. This is usually caused by Clostridia Perfringens, but it could also be caused by Clostridia Septicum. Clostridia is a disease that causes gas gangrene to develop. 

- Type IV / Other: Type IV NF is caused by other organisms and fungi. The most common Type IV NF is caused by marine organisms, mostly with them getting into cuts and open wounds.

How is NF transmitted?

NF isn't contagious, nor is it communicable. It is only transmitted when there is a wound, and usually it has to be a deep one. It is also very rare, so there is a low chance of transmission from human to human. However, this doesn't mean it isn't possible. If you have a small wound that is not cared for properly or someone that has NF touches your open wound, there is a chance the disease could develop there.

Symptoms:

- Extreme pain at the wound

- Redness, warmness and swelling at wound

- Fever

- (Pus)

- (Blisters/ulcers)

- (Fatigue and dizzy)

- (Diarrhea)

Consequences:

If left untreated, the situation and infection would get worse, and eventually cause shock, sepsis, organ failure and death. 

Treatment:

The treatment of necrotizing fasciitis is surgery and antibiotics. Usually in a serious case of NF, removal of the infected tissue or amputations have to happen to remove the bacteria from the body. In some cases, people have their whole limbs chopped off just to stop the spread.

Prevention:

The best prevention for NF is to clean your wounds thoroughly so bacteria don't get into your wound. Avoid going out to the sea if you have a wound, especially a deep one. Avoid touching your wound before washing your hands, or else bacteria can sneak in. 

Strep A

 What is Strep?

Streptococcus, also known as strep is a bacteria that is most commonly found in the mouth and throat. There are 4 main types of strep - A, B, C and G, which Strep A is the most common of all. Streptococcus Group A is rarely life-threatening. In most cases, it is healed in a one or two days with the help of antibiotics, but on rare occasions, they can get very dangerous. It can cause high fevers and muscle aches. In more severe cases, it even causes pneumonia, multi organ failures, heart problems, amputations, Necrotizing Fasciitis, STSS and death in a few hours. Approximately 12000 people get Strep A every year, and it kills up to 1600 patients per year.

What is Necrotizing Fasciitis?

Necrotizing Fasciitis (NF), commonly known as the flesh-eating disease is a severe infection that causes a rapid death of soft tissue. Usual symptoms are purple coloured dead skin and severe pain with fever. There are 4 types of NF. Type I is polymicrobial, Type II is monomicrobial, Type III is Marine Vibrio and Type IV is fungal. Type II is where Strep caused and MRSA caused NF lies.

What is STSS?

Streptococcal Toxic Shock Syndrome, or STSS is a rare complication of Strep with serious effects. STSS has to be treated with antibiotics in a hospital by a doctor, or else a patient can get shock and organ failure from STSS and die shortly after. Some may even need surgery and 30% to 70% of patients die after contracting STSS. However, even though anyone can get STSS, elders 65 and above or people with wounds are more likely to contract STSS with serious complications.

How do you catch strep?

Strep is very contagious. It is spread by airborne droplets, such as someone sneezing or coughing at another person, or someone touching an infected surface and then touching their face. 

Symptoms:

- Sore and Painful Throat

- Fever

- Swelling in Tonsils with redness, white patches and pus

- Swollen Lymph Nodes

- Red spots on roof of mouth

Consequences if left untreated:

If Strep is left untreated, it can cause lots of other problems, such as kidney inflammation, joint inflammations, rashes or even heart valve problems even though it can go away on its own in about a week.

Treatment:

Antibiotics are very useful during strep. Most doctors will prescribe it to decrease the time of healing.

Prevention:

- Sneeze or cough into a tissue or elbow

- Stay home if you're sick

- Wash or disinfect your hands