Fever –part 2

Fever – Part 2 • Presented By – Prof.Dr.R.R.Deshpande (M.D in Ayurvdic Medicine & M.D. in Ayurvedic Physiology)

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9/29/2016 1Prof.Dr.R.R.Deshpande

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Fever For Kayachikitsa Syllabus

• This PPT is based on Kayachikitsa Syllabus ( Paper 1 Part B) of CCIM formed in 2012

• Teachers of Forth BAMS & students will be get benefitted by this ready information ,through interesting PPT


Paper 1 Part B Point 1

• Detailed description of Chikitsa Sutra and Management of Jwara and its types. Etiopathogenesis & relevant Ayurvedic and Modern management of following types of Fevers-Typhoid, Pneumonia, Pleurisy, Influenza, Mumps, Meningitis, Encephalitis, Tetanus, Yellow fever, Plague, Dengue Fever, Chikun Guniya, Leptospirosis, Viral Fever, Anthrax, Masurika (Small pox), Laghu Masurika (Chicken pox), Romantika (Measles).


Fevers discussed in this PPT

• 1) Infuenza• 2) Mumps• 3) Tetanus

• 4) Yellow Fever • 5) Plague• 6) Anthrax


1) Influenza ( La Grippe)

• Acute infectious disease with ---

• Fever, Aches & pain all over body

• Symptoms of URTI


Influenza –Causes

• Three Viruses – A,B & C• Virus A --- Pandemic• Virus C ----Sporadic

• Secondary bacterial infection by Staphylococcus & Streptococcus pyogens ,H.Influenze ,Pneumococcus

• Incubation period – 2 to 3 days 9/29/2016 6Prof.Dr.R.R.Deshpande

Influenza virus


Influenza – Clinical features

• Onset – sudden • High temp up to 102 to 104 degree F with chill• Aches & pains all over body ,Headache• Extreme malaise, weakness, anorexia, Nausea, Vomiting

• Followed by sore throat, dry cough, mild conjunctivitis, nasal congestion


Influenza – Clinical features

• Symptoms disappear within few days • Asthenia persists for several days or weeks • May be Pneumonia in extreme age groups or in presence of pre existing heart or lung diseases

• Acute stage – Face flushed ,Tachycardia ,eyes – mouth –throat congested

• Lymphoid follicles in the throat – prominent• Leucopenia ( sometimes Leucocytosis)


Influenza


Influenza -- Complications

• Tracheo bronchitis• Pneumonia

• Gastritis

• Post influenza asthenia• Depression


Influenza

• Prevention – Influenza vaccine • Treatment – • Rest in bed • Tab Combiflam 1 TDS• Tab Relent or Incid L 1 BD ( May cause drowsiness) • If Secondary Infection ,Antibiotic Tab Augmentin 1 TDS

• If Enchephalitis or Carditis – Steroids


Haemophilus Influenzae B Vaccine

• Haemophilus Influenzae – Most common cause of bacterial infection in 0 to 5 year age group

• Most common causative agent of Meningitis

• Other manifestations – Pneumonitis, Cellulitis, bacteraemia ,septic arthritis


Haemophilus Influenzae B Vaccine

Age Group Number of Doses Timing

0 to 6 months 4 6,10,14 weeks & 15 months

6 months to 1 year 3 2 doses 1 month apart .Booster dose at 15 months

1 to 5 years 1 Any time 1 Dose


Hib vaccine

• Quiet safe • Local reactions – Pain & sweeling • Available in combined form with DTP • Market availability –• Hibtiter --- Rs 300/- for single dose• Tetra ACT HiB ( DPT + HiB ) – Rs 380/- for single dose


Influenza Vaccine ( Flu)

• Influenza virus – cause of severe morbidity

• Major Epidemics occur – at interval of 2 to 3 years

• Why this is unique vaccine ? – It is newly prepared every year . Because Influenza virus strains go on changing all the time



• This vaccine is a killed inactivated vaccine • Stored at 2 degree Centigrade

• 0.5 ml single dose is given in adults • Children between 4 to 12 years may require 2 doses

• Contraindicated below 4 years & in pregnancy



• Protective Immunity develops in 1 week • Can cause severe local reaction, fever, rash etc• It is recommended for at risk individuals like In renal failure, chronic cardiac or pulmonary disease ,Immunosupressed

• Product – Vaxigrip – 0.5 ml – at Rs 525/- per dose


2) Mumps ( Epidemic Parotitis)

• Cause – Virus .Spread by droplet infection • Involves one or both parotid glands • Sometimes Submandibular or sublingual glands may be involved

• Testis ,Ovary ,Pancreas ,brain etc may be involved

• Seen in young children & young adults • Incubation period – 3 weeks 9/29/2016 19Prof.Dr.R.R.Deshpande

Mumps – Clinical features

• Fever – 100 to 101 degree F with chill & little rigor

• Weakness ,malaise• Stiffness of jaw ,Inability to open the mouth • Dryness of mouth with foul smell • Pain & swelling over Parotid region • Parotid glands are enlarged one after another at an interval of 24 to 36 hours


Salivary Glands


Mumps


Mumps – Clinical features

• Sometimes both glands are enlarged at the same time

• The hollow or groove between the angle of jaw & the mastoid process is filled up

• Tenderness over the posterior ramus of mandible • Some times ,upper abdominal pain due to Pancreatitis or pain in the testis or lower abdomen due to Oophoritis or headache due to meningitis

• Fever & glandular swelling subside within few days


Mumps – Complications

• Orchitis – Commonest complication .Usually unilateral .But when bilateral ,may produce Sterility ,due to Testicular atrophy

• Oophoritis ,Prostatitis• Mastitis • Pancreatitis – severe abdominal pain ,vomitting, fever ,collapse

• Encephalitis, Meningitis, Thyroiditis


Mumps -- Investigations

• Complement Fixation Test – Positive

• Serum Amylase – Raised ( even without Pancreatic involvement )


Mumps – Treatment

• Patient should be isolated • Oral Hygiene • Liquid diet

• Symptomatic Treatment like Tab Combiflam 1 TDS

• For Orchitis – Steroids may be used


3) Tetanus

• Tetanus is a serious bacterial disease • Affects nervous system --- • Leading to painful muscle contractions, particularly of your jaw and neck muscles

• Tetanus can interfere with ability to breathe and ultimately threaten your life.

• known as “Lock Jaw."


Tetanus occurrence

• Rare in the United States and the developed world.

• The incidence of tetanus is much higher in less developed countries.

• Around a million cases occur worldwide each year.


Tetanus – No cure

• There's no cure for tetanus • Treatment focuses on managing complications until the effects of the tetanus toxin resolve

• Fatality is highest in individuals who haven't been immunized and in older adults with inadequate immunization


Tetanus – Symptoms

• Appear anytime from a few days to several weeks after tetanus bacteria enter your body through a wound.

• The average incubation period is seven to eight days.


Tetanus Symptoms

• Spasms and stiffness in your jaw • Muscles Stiffness of your neck muscles • Difficulty in swallowing • Stiffness of your abdominal muscles• Painful body spasms lasting for several minutes, typically triggered by minor stimulus , such as a draft, loud noise, physical touch or light


Tetanus


Tetanus Signs

• Fever

• Sweating

• Elevated blood pressure

• Rapid heart rate


Tetanus -- Causes

• The bacteria that cause tetanus, Clostridium tetani, are found in soil, dust and animal feces

• When they enter a deep flesh wound, spores of the bacteria may produce a powerful toxin, tetano spasmin, which actively impairs your motor neurons, nerves that control your muscles


Tetanus -- Causes

• The effect of the toxin on your motor neurons ------

• Cause muscle stiffness and spasms — the major signs of tetanus


Tetanus -- Risk Factors

• Certain factors are necessary for tetanus bacteria to proliferate in your body. These include ---Lack of immunization or inadequate immunization

• failure to receive timely booster shots against tetanus

• A penetrating injury that results in tetanus spores being introduced to the wound site


Tetanus -- Risk Factors

• The presence of other infective bacteria

• Injured tissue

• A foreign body, such as a nail or splinter

• Swelling around the injury


Types of Injuries – Can cause Tetanus

• Puncture wounds including from splinters • Body piercings • Tattoos • Injection drugs• Gunshot wounds • Compound fractures , Crush injuries• Burns


Types of Injuries – Can cause Tetanus

• Surgical wounds ,Injection drug use • Ear infections• Animal bites• Infected foot • Ulcers• Infected umbilical stumps • In newborns born of inadequately immunized mothers


Tetanus – Complications

• Once tetanus toxin has bonded to your nerve endings it is impossible to remove

• Complete recovery from a tetanus infection requires the growth of new nerve endings and can take up to several months.



• Broken bones -- The severity of spasms may cause the spine and other bones to break.

• Disability --- • Treatment for tetanus typically involves the use of powerful sedatives to control muscle spasms.

• Prolonged immobility due to the use of these drugs can lead to permanent disability



• In infants, tetanus infections may cause lasting brain damage, ranging from minor mental deficits to cerebral palsy

• Death -- Severe tetanus-induced (tetanic) muscle spasms can interfere with your breathing, causing periods in which you can't breathe at all

• Respiratory failure is the most common cause of death

• Lack of oxygen may also induce cardiac arrest and death. Pneumonia is another cause of death


Tetanus – Tests

• Doctors diagnose tetanus based on a physical exam, medical and immunization history, and the signs and symptoms of muscle spasms, stiffness and pain.

• Laboratory tests generally aren't helpful for diagnosing tetanus


Tetanus – Treatment

• Since there's no cure for tetanus ---

• Treatment consists of wound care

• Medications to ease symptoms and

• Supportive care.


Tetanus – wound care

• Cleaning the wound is essential to preventing growth of tetanus spores.

• This involves removing dirt, foreign objects and dead tissue from the wound.


Tetanus – Vaccine

• Inj TT --- As a preventive measure • If a child has taken 5 doses of TT ,in the form of DPT & a TT at 10 years of age ,then a booster dose ,every 10 years is enough

• In an adult ,with no history of childhood immunization ,then 2 doses of TT at 2 months apart with a third dose at 7 months after 1st dose –Gives protection for next 10 years


Tetanus – Vaccine

• When patient with an injury – • For Tetanus prone wounds i.e contaminated ,penetrating with significant tissue damage – only 1 dose of Inj TT is required if patient has taken booster within 10 years

• If more than 10 years – Give Human Tetanus Immunoglobulins – 250 to 500 IU


Tetanus – Vaccine

• If Immunization status of the patient is not known – Give complete course of Inj TT + HTI ( Human Tetanus Globulin)

• Side effects of Inj TT – Local pain ,redness, swelling – lasting for 10 days .Also there may be fever, Myalgia, headache

• In Pregnancy – 2 doses of TT after first Trimester ,at one month interval .Second dose ,atleast 15 days prior to Expected date of Delivery ( EDD)


Tetanus Medicines

• Sedatives -- Doctors generally use powerful sedatives to control muscle spasms.

• Other medications, such as magnesium sulfate and certain beta blockers, may be used to help regulate involuntary muscle activity, such as your heartbeat and breathing

• Morphine may be used for this purpose as well as sedation


Tetanus Management

• Supportive therapies

• Tetanus infection often requires a long period of treatment in an ICU

• Since sedatives may result in shallow breathing, you may need to be supported temporarily by a ventilator.


4) Yellow Fever

• Cause – Virus• Vector – Female Aedes Aegypti • The female Aedes must bite a diseased person within first 4 days of the disease. After 10 to 20 days of latent period ,the Aedes becomes infective ,as long as 7 months

• Incubation period – 3 to 6 days


Yellow Fever – Clinical Features

• If no Immunity – 3 stages are seen • First Stage – Fever with rigor• Maximum on 1st day & gradually declines • Like Dengue ,pain around aye balls ,headache ,bone pain

• Eyes are read ,Tongue is coated ,Vomitting• Sometimes Haemetemesis



• First stage Contd – • Symptoms of Meningeal irritation like Photophobia,Neck stiffness

• Disproportional fall of pulse in elation to temperature ,marked on 3rd day ( Faget’s Sign)

• This stage lasts for 4 days



• Second Stage – Temp comes down to normal & many cases recovery takes place

• Third Stage – Seen in serious cases • Temperature again rises but pulse remains slow • Involvement of Liver & Kidney • Jaundice,Bleeding,Proteinuria • Liver –Palpable & tender • Renal angle – Tender • Coma & Death 9/29/2016 54Prof.Dr.R.R.Deshpande

Yellow Fever – Clinical features


Yellow Fever- Investigations

• Urine – Albumin ,RBCS, Bile pigments, Casts

• Leucopenia

• SGPT – Raised

• Serum Bilirubin – Raised


Yellow Fever – Treatment

• Symtomatic • Prevention – 17 D vaccine • A single dose of 0.5 ml SC of reconstituted vaccine – gives immunity for more than 10 years

• Taken at least 10 days before ,travel to endemic countries


Yellow Fever

• Yellow fever – Name is not given ,because it causes Jaundice

• Name is due to – Yellow quarantine flag was used by the ships to give warning of the highly infectious fatal disease

• Found rarely in Asian Population • Endemic in African & American countries • Caused by arbovirus & transmitted by mosquitoes


Yellow fever – Areas


Yellow fever

• Causes symptoms like other viral haemorragic fevers but with severe hepatic & renal involvement & death

• Seen in children below 15 years • In Endemic countries ,Yellow fever vaccine is now included in EPI ( Expanded Programme of Immunization) – Given at 9th month after birth


5) Small Pox ( Variola)

• Highly contagious viral disease

• Diphasic febrile episodes

• Skin eruption


Small Pox – Causes

• Virus ,closely related to Vaccinia & cowpox• Affects all ages & both genders• Occurs in Epidemic ,sometimes in Endemic • Unvaccinated persons are more susceptible

• Incubation period – 7 to 16 days • Quarantine period – 18 days


Small pox – Pathogenesis

• Spreads by droplet infection or by contamination with materials from skin lesions

• After penetration ,virus localizes in nearby Lymph nodes .Followed by in Liver & spleen

• After Incubation period .viraemia occurs & spreads to skin & mucous membrane ( Prodromal period)



• Antibody will be formed in blood

• Virus, after disappearing from blood continues to multiply in skin ,lungs & brain

• Initial cutaneous lesion is Epidermal necrosis with capillary dilatation ( macule)



• In same lesions ,epidermis will proliferate ( Papule) & Vacuolate (Vesicles)

• Vesicles invaded by Polymorphs & transformed into pustules

• Masses of virus particles appear as Guarnieri bodies in the cytoplasm of cells


Small pox – Clinical features

• Onset – sudden • High fever ,restlessness, headache,severe backache, cough, vomiting ,prostration

• Prodromal rash as irregular macules in axilla & inguinal region or

• Widespread purpuric rash ( Purpura variolosa or Black smallpox)


Small pox – Eruptive stage

• Rash appears on 3rd day & temperature drops down with it

• Initial eruption is macular & first appears on forehead & wrists .Then arms & trunk .Then on legs

• Eruptions are dense in extremities • Within few hours macules turn into papules .After 3 days papules turn to vesicles



• The vesicles are multilocular • There are numbers of septae running from the center & going to periphery .So vesicles are umbilicated

• On pricking ,there is partial collapse & clear fluid comes out

• There is marked itching • In this stage ,again temperature rises ,which is called Secondary Pustular Fever



• In 10 days pustules dry up with formation of scabs

• Scabs separate after few days leaving behind pitted scars & Temperature comes down


Small pox-Complications

• Heart – Heart failure, Myocarditis• Lungs – Pneumonia

• Brain – Encephalitis

• Bone – Viral osteomyelitis• Eye – Corneal ulcer ,loss of vision


Types of Smallpox

• Mild Type • Confluent Type – When no healthy skin remains in between rashes

• Semiconfuent type• Abortive smallpox – Mild form ,in vaccinated individual

• Variola Haemorrhagica• Congenital 9/29/2016 71Prof.Dr.R.R.Deshpande

Smallpox -- Investigations

• Leucocyte count low initially ,but increases in Pustular eruption

• Microscopic Examination of fluid from eruption show – Guarnieri bodies

• Complement fixation test – Positive• Agar gel diffusion test --- Positive 9/29/2016 72Prof.Dr.R.R.Deshpande

Smallpox – Treatment

• Curative – Nothing specific • Isolation of patient • Liquid diet with high protein content • Care of skin & eyes by soothing lotions eg Liquid paraffin drops in eyes

• Antibiotic from 4th day to prevent secondary infection

• Other symptomatic treatment 9/29/2016 73Prof.Dr.R.R.Deshpande

Smallpox – Kindly note

• Smallpox is globally eradicated in 1980• India’s first records of smallpox can be found in a medical book that dates back to A.D. 400

• In India beliefs created a goddess in response to its exposure to smallpox. The Hindu goddess Shitala was both worshipped and feared during her reign.



• It was believed that Shitala goddess was both evil and kind and had the ability to inflict victims when angered, as well as calm the fevers of the already afflicted.

• Portraits of the goddess show her holding a broom in her right hand to continue to move the disease and a pot of cool water in the other hand in an attempt to soothe victims



• Shrines were created of Shitali Devi or Godesses where many India natives, both healthy and not, went to worship and attempt to protect themselves from this disease.


6) Plague

• Plague is a serious bacterial infection that's transmitted by fleas.

• Known as the Black Death during medieval times

• Today plague occurs in fewer than 5,000 people a year worldwide.

• It can be deadly if not treated promptly with antibiotics


Plague Tranmission


Plague

• The organism that causes plague, Yersinia pestis, lives in small rodents on every continent except Australia

• The organism is transmitted to humans who are bitten by fleas that have fed on infected rodents or by humans handling infected animals.


Plague

• The most common form of plague results in swollen and tender lymph nodes (buboes) — in the groin, armpits or neck

• The rarest and deadliest form of plague affects the lungs, and it can be spread from person to person.


Plague - Symptoms

• Plague is divided into three main types

• 1) Bubonic

• 2) Septicemic • • 3) Pneumonic


Bubonic Plague

• Bubonic plague -- most common variety of the disease

• It's named after the buboes ( swollen lymph nodes), which typically develop within a week after an infected flea bites


Bubonic Plague

• Buboes may be situated in the groin, armpit or neck . Size of a chicken egg

• Tender and warm to the touch• Sudden onset of fever and chills• Headache• Fatigue or malaise • Muscle aches


Septicemic Plague

• Occurs when plague bacteria multiply in bloodstream.

• Fever and chills • Abdominal pain, diarrhea and vomiting • Bleeding from mouth, nose or rectum, or under skin

• Shock • Blackening and death of tissue (gangrene) in extremities, most commonly in fingers, toes and nose


Pneumonic Plague

• Affects the lungs• It's the least common variety of plague but the most dangerous, because it can be spread from person to person via cough droplets

• Cough, with bloody sputum , Difficulty in breathing , High fever, Nausea and vomiting, Weakness


Pneumonic Plague

• Pneumonic plague progresses rapidly and may cause respiratory failure and shock within two days of infection

• • If antibiotic treatment isn't initiated within a day after signs and symptoms first appear, the infection is likely to be fatal


Plague –Causes

• The plague bacteria, Yersinia pestis, is transmitted to humans when they are bitten by fleas which have previously fed on infected animals, such as ----

• • Rats ,Squirrels ,Rabbits, Prairie , dogs, Chipmunks


Black Plague


Plague –Causes

• The bacteria can also enter into body if there is break in your skin that comes into contact with an infected animal's blood.

• Domestic cats can become infected with plague from flea bites or from eating infected rodents.


Plague –Causes

• Pneumonic plague, which affects the lungs, is spread by -----

• Inhaling infectious droplets coughed into the air by a sick animal or person


Plague – Risk Factors

• The risk of developing plaque is very low • Worldwide, only a few thousand people develop plague each year

• However, risk of plague can depend on where person lives or travel, or his occupation and even depend on person’s hobbies



• Plague outbreaks are most common in rural areas and in urban areas where there is overcrowding, poor sanitation and a high rat population.

• The greatest number of human plague infections occurs in Africa.



• Veterinarians and their assistants have a higher risk of coming into contact with domestic cats which are infected with plague

• Also people are at high risk who work outdoors in areas where plague-infested animals are common



• Camping, hunting or hiking in areas where ---

• plague-infected animals reside can increase risk of being bitten by an infected flea.


Plague – Complications

• Most people who receive prompt antibiotic treatment survive from bubonic plague

• Untreated plague has a high fatality rate • Blood clots in the tiny blood vessels of fingers and toes can disrupt the flow of blood and cause that tissue to die ( Gangrene) . Gangrenous part may need to be amputated.

• Rarely, plague may cause Meningitis


Plague – Tests

• Blood Test for Yersinia pestis bacteria in septicemic plague

• A fluid sample can be taken from bubo in bubonic plague to look for Yersinia pestis bacteria

• To check for pneumonic plague -- sputum or fluid is tested


Plague – Treatment

• Isolation in Hospital

• Powerful antibiotics like Gentamicin , Doxycycline or Ciprofloxacin or levofloxacin


7) Anthrax

• Anthrax is a rare but serious illness caused by a spore-forming bacterium, Bacillus anthracis

• Anthrax mainly affects livestock and wild game

• Humans can become infected through direct or indirect contact with sick animals


Anthrax Transmission

• There is no evidence that anthrax is transmitted from person to person

• It's possible that anthrax skin lesions may be contagious through direct contact

• Usually, anthrax bacteria enter the body through a wound in the skin

• Infection may occur by eating contaminated meat or inhaling the spores


Anthrax – Transmission


Anthrax – Clinical features

• Depends on severity of infection • Can range from skin sores to vomiting to shock.

• Prompt treatment with antibiotics can cure most anthrax infections

• Inhaled anthrax is more difficult to treat and can be fatal


Anthrax – Clinical features

• There are four common routes of anthrax infection,

• Each with different signs and symptoms• In most cases, symptoms develop within seven days of exposure to the bacteria

• The one exception is inhalation anthrax, which may take weeks after exposure before symptoms appear


Cutaneous Anthrax

• A cutaneous anthrax infection enters body through a cut or other sore on skin

• • It's by far the most common route the disease takes

• It's also the mildest — with appropriate treatment, cutaneous anthrax is seldom fatal


Cutaneous Anthrax – Clinical feature

• A raised, itchy bump resembling an insect bite

• It quickly develops into a painless sore with a black center

• Swelling in the sore and nearby lymph glands


Gastrointestinal Anthrax

• This form of anthrax infection begins by eating undercooked meat from an infected animal Clinical features --

• Nausea, Vomiting, Abdominal pain, Headache Loss of appetite ,Fever, Severe bloody diarrhea

• in the later stages of the disease ---- Sore throat and difficulty in swallowing ,Swollen neck


Inhalation or Pulmonary Anthrax

• Inhalation anthrax develops when

• Person breathe in anthrax spores • It's the most serious type

• even with treatment it is often fatal


Pulmonary Anthrax –Clinical features

• Flu-like symptoms, such as sore throat, mild fever, fatigue and muscle aches -- last a few hours or days

• Mild chest discomfort ,Shortness of breath Nausea ,Haemoptysis ,Dysphagia

• As the disease progresses, you may experience --- High fever , Dyspnoea ,Shock ,Meningitis ,Multiple organ failure


Injection Anthrax

• This is the most recently identified route of anthrax infection.

• It's contracted through injecting illegal drugs and has been reported only in Europe so far.

• Initial signs and symptoms of injection anthrax include ---

• Redness at the area of injection ,Significant swelling


Anthrax – Causes

• Anthrax spores are formed by anthrax bacteria that occur naturally in soil in most parts of the world

• The spores can remain dormant for years until they find their way into a host

• Common hosts for anthrax include wild or domestic livestock, such as sheep, cattle, horses and goats


Anthrax – Geographical Distribution

• Rare in the United States

• Common throughout the developing world, such as in Iran, Iraq, Turkey, Pakistan and sub-Saharan Africa


Anthrax – Causes

• Most human cases of anthrax occur as a result of exposure to infected animals or their meat or hides.

• In the United States, a few people have developed anthrax while making traditional African drums from the skins of infected animals.


Injection Anthrax

• More recently, 54 heroin users in Europe contracted anthrax through injecting illegal drugs

• Eighteen people died from injectable anthrax

• Heroin sold in Europe likely comes from areas where naturally occurring anthrax is more common


Anthrax – Risk Factors

• Direct contact with anthrax

• Occupation of a person is in the military or to an area with a high risk of exposure to anthrax

• Work with anthrax in a laboratory setting• Handle animal skins, furs or wool from areas with a high incidence of anthrax


Anthrax – Risk Factors

• Work in veterinary medicine, especially if you deal with livestock

• Handle or dress game animals — in the United States, seasonal outbreaks of anthrax are common among livestock and game animals, such as deer

• Inject illegal drugs, such as heroin

• Anthrax –Complications -- Hemorrhagic meningitis and death


Anthrax – Tests

• Skin testing --- A sample of fluid from a suspicious lesion on your skin or biopsy may be tested in a lab for signs of cutaneous anthrax

• Blood tests for Anthrax Bacteria

• Chest X-ray or computerized tomography (CT) scan – To check for Inhalation Anthrax


Anthrax – Tests

• Stool testing for Anthrax Bacteria is done to diagnose gastrointestinal anthrax

• CSF Examination to confirm a diagnosis of anthrax meningitis


Anthrax –Treatment

• The standard treatment for anthrax is a 60-day course of an antibiotic, such as ciprofloxacin or doxycycline

• Treatment is most effective when started as soon as possible

• Some cases of injection anthrax were successfully treated with the surgical removal of infected tissue.


Anthrax Vaccine

• An anthrax vaccine for humans is available

• The vaccine doesn't contain live bacteria • Side effects, ranging from soreness at the injection site to more serious allergic reactions

• The vaccine isn't recommended for children or older adults.


Anthrax Vaccine

• The vaccine isn't intended for the general public

• Instead, it's reserved for military personnel, scientists working with anthrax and people in other high-risk professions


Anthrax – Prevention

• Avoiding infected animals -- • If person lives or travel in a country where anthrax is common and herd animals aren't routinely vaccinated, avoid contact with livestock and animal skins as much as possible.

• Also avoid eating meat that hasn't been properly cooked


Anthrax – Prevention

• Even in developed countries, it's important to handle any dead animal with care and to take precautions when working with or processing imported hides, fur or wool.


TB Lung – Cavitation


Miliary TB


Public Education

• By Medical officer PCMS in Sep 2016• Regarding –Prevention from Dengue ,Malaria etc

• Contact – Kasba peth office ,’Nagari Hivtap Nirmulan Yojana’ ( Malaria Eradication Programme )

• Phone – 020-25508474


Dengue,Chikunguniya

• Cause of Dengue & Chikunguiniya – Mosquito Aedes aegypti & For Malaria – Anaphilis

• In Dengue & Chikunguniya – Mosquitoes bite in day time & in Malaria they bite in Night

• In Dengue & Chikunguniya – As infection is viral ,No Specific Treatment .Treatment is aimed at improving patient’s resistance .But For malaria ,Specific curative treatment is available .But if tratment is not given in time ,patient can die ,due to complications & also if incomplete treatment ,taken ,recurrance is common


Similarity in Dengue/Chikunguiniya & Malaria Infection

• Only Female mosquito bites & not male mosquito

• Mosquitoes breeding is common in stored clean water

• Infected mosquito when bites to healthy individual ,diseases occur


Prevention

• Eggs of Aedes stuck up to container of stores water & breeding occur .So following measures should be taken –

• Do not allow to stagnate water in maniplant or flowerplot .Do not keep plate below flowerpot or change the water of that plate every day

• Change the water from plate behind or below the freeze or AC


Prevention

• On the Terrace ,always check for any stagnation of water

• Close drums ,barrel ,can with lid & always clean them every after 2 to 3 days & make them dry

• Keep lids on drainage mesh .Water should be always flowing & never should be stagnant in drainage system


Prevention

• Do not keep rubbish or any throw off material

( Bhangar in Marathi) like chairs ,cupboards shoes etc on terrace or nearby house

• Because in rainy season ,water accumulates in these material .So dispose off matter ,time to time & keep your house & surrounding clean


Prevention

• Tank or Mud barrels should always kept covered .Clean & dry them every after 2 to 3 days

• While going away from home for trip etc ,water storages should be kept covered

• Anaphilis mosquito can also bite to animals like cow ,bull etc .So change the water from storage of stable also


Prevention

• Keep one day dry per week .This means on this day all water storages should be washed ,cleaned & make dry

• Water storages should be get checked from Medical Department of local corporation

• As per Indian Government directives ,effectiveness of fumigation is limited .So it is not done routinely by corporation. But only done in particular area if patient of Dengue ,Malaria ,Chikunguniya is found in that area


Prevention

• Fix net to your windows• Apply mosquito repellant ointment to the body

• Use mosquito repellants like Good Night Nimba sticks or All out

• Use clothes of faint colour & of full sleves • Gappi fish should be kept in large water storages


Prevention

• Intimate immediately about Dengue or Chickunguniya patient to nearby corporation

• Doors & windows should not be kept open in the evening hours

• Do not use dark colored & short clothes


Prof.Dr.R.R.Deshpande

• Sharing of Knowledge

• FOR

• Propagating Ayurved
