Beware of rat fever !

With the ongoing scattered showers and the rainy season the health ministry warns the public on possible outbreak of Leptospirosis (Rat fever).

Leptospirosis (Rat fever) is an infectious disease caused by pathogenic bacteria called leptospires, which are maintained in nature in the kidneys of certain animals such as rodents, livestock, canines and wild mammals. These organisms are transmitted directly or indirectly from animals to humans i.e. zoonosis.

Some animal species have a commensal relationship with certain types of leptospires (serovars) i.e. natural hosts for those serovars. These animals continuously excrete leptospires in urine, though they do not suffer from the disease. If other animals including humans are infected by the same serovars, they often become ill. If a natural host for a particular serovar is infected with another serovar, it may also develop the disease. Serovars found in rats and bandicoots are often identified as the cause for serious illness in humans.

Man is an incidental or accidental host. Exposure through water, soil, or foods contaminated by urine of affected animals is the most common route.

Leptospire-contaminated environment caused by, for example, local agricultural practices and poor housing and waste disposal give rise to many sources of infection.

Leptospires enter the body through abraded or traumatized skin, or nasal, oral, or eye mucous membranes. Ingestion of contaminated water can also lead to infection. After infection, they enter the blood and invade practically all tissues and organs.

Symptoms

Symptoms normally appear within 5 - 14 days following exposure to the germ. The range is between 2 - 30 days.

Leptospirosis may present with a wide variety of clinical manifestations.

These may range from a mild flu-like illness to a serious and sometimes fatal disease.

It may also mimic many other diseases such as dengue fever, influenza, meningitis, and hepatitis. Jaundice is a relatively common symptom in leptospirosis but is also found in many other diseases involving the liver. However, diagnosis of leptospirosis should be considered in any patient presenting with an abrupt onset of fever, chills, conjunctival suffusion, headache, muscle tenderness (notable in calf and lumbar areas) and jaundice. Case fatality rate is reported to range from less than 5% to 30% and important causes of death include renal failure, heart failure and widespread haemorrhage. Liver failure is rare despite the presence of jaundice.

Knowledge of local epidemiology and varied clinical presentation, and high index of suspicion are essential to make a diagnosis. Suspicion should be further increased if there is a history of occupational or recreational exposure. Confirmatory diagnosis is mainly by detecting antibodies (e.g. MAT). However, simple investigations like urine full report (albumin +) and

white blood cells/differential count (polymorpholeucocytosis) would help the clinicians to make a probable diagnosis and also to decide on the need for hospital admission. For epidemiological and public health reasons also laboratory support is important. Identifying serovars (serotyping) is costly, time consuming and the results are not likely to affect treatment of an individual patient. However, the resulting information is useful in investigating its source/ potential reservoir, and planning and evaluating interventions.

Treatment

Leptospirosis is a potentially serious but treatable disease. Treatment with effective antibiotics should be initiated as soon as the disease is suspected. Clinicians should never wait for the results of laboratory tests before starting treatment with antibiotics because serological tests do not become positive until about a week after the onset of illness, and culture may not become positive for several weeks. Supportive care with strict attention to fluid and electrolyte balance is essential. Dialysis is indicated in renal failure.

Prevention

Preventive measures must be based on knowledge of the high risk groups and the local epidemiological factors. It is very important to raise awareness about the disease among the risk groups, health care providers and general population, so that the disease can be recognized early and treated as soon as possible. If you are involved in occupations such as farming, mining, cleaning drains and canals etc. please inform your area MOH or PHI. They will explain how to prevent you getting the disease. The following specific measures can help to prevent leptospirosis.

Removal of rubbish and keeping areas around human habitation clean to control rodents Keep animals away from gardens, playgrounds, sandboxes, and other places where children play Where appropriate, protective clothing, knee-high boots, gloves etc should be worn and wounds covered with waterproof dressing Use boiled water (chlorination is seldom useful, as virulent organisms withstand up to 4 ppm; filtered water is also not safe) Avoid walking in flood water Doxycycline has been reported to give some protection against infection and disease.

Courtesy: epitemiology unit Ministry of Health.

Chronic stress promotes excess belly fat

by Madeline ELLIS

Do you ever feel like everything you eat goes directly to your belly? If you are under chronic stress, that may be truer than you think.

When researchers at Wake Forest University fed monkeys a typical American diet high in fat and cholesterol, they gained weight.

But those who were socially stressed developed much more belly fat, a known risk factor for heart disease. And although the study was conducted primarily on monkeys, the researchers say the results would be very similar in humans and could lead to new ways of combating the ever-growing obesity epidemic in America and other Western nations.

"We are in the midst of an obesity epidemic," said lead researcher Carol A. Shively, a professor of pathology at Wake Forest. "Much of the excess fat in many people who are overweight is located in the abdomen, and that fat behaves differently than fat in other locations.

If there's too much, it can have far more harmful effects on health than fat located in other areas."

To better understand the role social stress plays in the development of heart disease, Shively and colleagues studied female cynomolgus monkeys that were fed a high fat and cholesterol diet and housed in a natural setting where subordinate and dominant personalities emerged.

The team observed that the subordinate monkeys were less likely to be included in group activities, such as grooming, and were often targets of aggression.While all the monkeys gained weight, CT scans detected more abdominal or visceral fat in the socially stressed monkeys than the others. The monkeys with a lower social status also had high levels of the stress hormone called cortisol, which causes belly fat to accumulate and makes individual fat cells get larger. And when the researchers looked at the animals' arteries, they found plaque blocking those of the stressed monkeys. "The monkeys that have a lot of abdominal fat have the metabolic syndrome, just like people with a lot of abdominal fat," Shively says. "When you have lots more fat in visceral fat cells and all the characteristics of the metabolic syndrome, each of these things promotes atherosclerosis."

Female monkeys, as do women, have a natural protection against heart disease. However, the monkeys with high social stress and larger amounts of abdominal fat had ovaries that produced fewer protective hormones, eroding this female protection. "Suppressed ovarian function is a very serious condition in a woman," Shively said. "Women who are hormone-deficient will develop more atherosclerosis and be at greater risk of developing coronary heart disease and other diseases such as osteoporosis and cognitive impairment."

The researchers found that the stressed monkeys had abnormal menstrual cycles and, compared to the unstressed monkeys, were much less likely to ovulate. However, Shively says women are not always aware that their bodies are not producing adequate amounts of hormones and that in order to diagnose serious health problems in

Healthnews

Dengue : Prevention better than cure

Dengue is an acute flu-like fever caused by a virus. It can cause disease in two forms:

(a) Dengue Fever (DF) - marked by an onset of sudden high fever, severe headache, pain behind the eyes, and pain in muscles and joints. Some may also have a rash.

(b) Dengue Haemorrhagic Fever (DHF) - is a more severe form, seen only in a small proportion of those infected. Typically DHF is characterised by high continuous fever for less than 7 days; bleeding from various parts of the body (including nose, mouth and gums or skin bruising) ; severe continuous abdominal pain mainly due to enlarged liver, and shock in severe cases. This can lead to death.

DHF is more serious in children.

Dengue Fever spreads via bite of an infected dengue mosquito. It can spread fast in urban areas when the mosquito population increase during rainy season.

Symptoms

We may all confuse dengue fever with flu or a cold. Clinical features of dengue fever vary according to the age of the patient. Infants and young children may have nonspecific febrile illness with rash. Older children/adults may have a mild febrile illness or classical incapacitating disease with abrupt onset and high fever, severe headache, pain behind the eyes, muscle and joint pains, and rash.

1. Dengue Fever is a self limiting disease. For those who develop DHF hospital treatment is required.2. Patient may feel ill and fever may last up to a week. They could feel weak and in low spirits for up to two weeks or so.What you should really watch-out for are features of DHF.

Treatment procedure

There is no specific treatment for dengue fever. Treatment is symptomatic -keep the person home and allow to rest, this will help recover more quickly give plenty of fluids to drink allow to eat what they can Paracetamol may relieve symptoms of fever and joint pain. Aspirin and other NSAIDs must be avoided.However, careful early clinical management frequently saves lives of DHF patients. It would be advisable to see a qualified doctor if you/your child has high fever without any underlying reason for more than few days. However, even if dengue fever is suspected, you may not be expected to admit to a hospital.

Since Dengue fever is transmitted through a mosquito, the best way to avoid dengue infection is to prevent mosquito bites. Still there is no vaccine or preventive drug.

Preventive measures

Avoid mosquito bites during day time by wearing protective clothing.

Use mosquito nets when sleeping (both day and night)

Get rid of mosquito breeding sites regularly in and around your household.

These usually are discarded tyres, plastic containers, coconut shells, leaf axils, blocked roof gutters, bird baths flower vases, or any other place where rain water collect. If you/your child develop dengue fever try to be protected from exposure to mosquito bites in order to avoid further spreading of the infection. Especially children should stayat home during the illness, ideally under a mosquito net when resting.

Courtesy:- Health Ministry

 Secrets of good sleep

By Dr. R. A. R. Perera Clinical Psychologist

Sleep is basically a loss of consciousness combined with loss of muscle tone. Sleep that is puzzling but most routine of activities is due to a series of chemical reactions.

Psychologists and psychiatrists have long known that three brain chemicals - serotonin, norepinephrine and histamine - are involved in sleeping and waking. These chemicals dwindle when people sleep and spike as people wake up.

A recent study conducted at the University of Toronto has found that each of these chemicals (called neurotransmitters) plays a distinct role. The ebb and flow of serotonin and norepinephrine affect the muscle tone, keeping the body still at night, while histamine controls arousal.

These findings could lead to new treatments for sleep disorders and drugs that enhance wakefulness. They might also shed light on the familiar sleep-inducing effects of cold and allergy medications that contain anti-histamines.During wakefulness, levels of histamine, norepinephrine and serotonin remain high.

In deep sleep, when dreams are most vivid, their levels go down. People who have sleep disorders like sleep walking or acting out dreams have a reverse pattern - that they are losing consciousness without losing the muscle tone.Insomniacs (people who find difficult to fall asleep at night) are thought to have excess of histamines. A drug which can suppress these histamines can be used to treat these people effectively with minimum side effects. This will open up a new avenue of potential drugs targeted at the histamine system.

The pre-bedtime routine is the key of a successful bedtime routine. People who find difficult to sleep at night, must cool down by switching off the TV, Internet and the phone. When preparing to sleep you must get in to a dark, comfortable safe place that is dedicated for sleep.

Consistent bed times and wake-up times is also another major factor for a good sleep. Late meals, smoking and caffeine, even if taken in the late afternoon can effect you at the sleeping time.

Generally, exercise will enhance sleep, especially if done after school or work, but it needs to be finished at least three hours before the sleep time.Unfortunately the bodies and sleep patterns of teenagers are programmed on a different clock. They are programmed to go to bed late and get up late. This is called delayed sleep phase syndrome.

Teenagers are not sleepy till midnight but they are very sleepy at 6 or 7 a.m. If your teenager is a night owl, that is a completely normal teen. Teenagers are wired to have a different sleep cycle than adults or younger children. It is a biological reality that they want go to bed later and sleep later.