How to makewater safe for drinking and cooking?

Surface water and water from leaking pipes and open cisterns and wells may be contaminated with

cholera and other germs. This water should be carefully treated before drinking! There are different ways to treat surface water or other water sources that are likely to be contaminated. The quickest ways are boiling, bleaching, and adding lime or lemon. No matter how it is treated it should be settled and filtered first, or the treatment may not work.

1.Settle and filter the water.

• L et water settle until solids have settled out and water is more-or-less clear.

• Pour water through a filter made of clean fabric or a sand and charcoal filter. To use a fabric filter: Fold clean sari cloth 4 times and stretch or tie it over the mouth of a clean water jar. Pour water slowly into the jar through the cloth. After using the cloth, wash it and leave it in the sun to dry, or disinfect the cloth with bleach to kill germs. Boil or add bleach. If you have no bleach, use lemon or lime.

2.Boil or add bleach. If you have no bleach, use lemon or lime.

Boiling

• Bring water to a rapid boil for at least 1 minute.

• Pour water into a clean container to cool.

Use of bleach

Because household bleach is the most common form of chlorine, this chart shows how to disinfect water with household bleach. Household bleach may have different amounts of chlorine. Most common are 3.5% and 5%. The easiest way to measure the amount of bleach needed is to first make a mother solution (about 1% chlorine) and then add this solution to the water you want to disinfect.

First prepare the mother solution:

1. Add 1 cup of bleach to a clean, empty beer bottle.

2. Fill the bottle with clean water.

3. Shake the bottle for 30 seconds.

4. Let it sit for 30 minutes. Your mother solution is ready.

Add these amounts of the mother solution to clear water and wait at least 30 minutes before drinking the water. If the water is cloudy, you need twice as much of the bleach solution.

Use of lime or lemon

(This method will not kill allgerms, but is safer than notreatment at all and can prevent many cases of cholera)

• Add the juice of 1 lime or lemon per liter of drinking water, to kill cholera germs.

• Pour water into a clean container.

3. Keep water containers clean.

• Make sure the water storage container stays

clean! Do not put dirty containers, hands or

anything else in the water container. Pour it off

into clean cups for use.

How to treat CHOLERA?

The most important treatment for cholera is

oral rehydration. Except in severe cases, antibiotics will not help at all. When a person has watery diarrhea or diarrhea and vomiting, do not wait for signs of dehydration. Act quickly.

Give lots of liquids to drink such as a thin cereal porridge or gruel, soup, water or rehydration drink.

Keep giving food. As soon as the sick person can eat, give frequent feedings of foods he likes. To babies, keep giving breast milk often — and before other drinks.

Rehydration drink helps to prevent or treat dehydration. It does not cure cholera or diarrhea, but may give enough time for the illness to go away by itself.

How to prevent Cholera?

Cholera can be prevented through careful sanitation, careful use and treatment of

water before drinking or cooking, and careful handling of food.

SANITATION

• Dispose of dead bodies far from water sources.Always wash carefully after handling.

• Build emergency sanitation facilities at least 30 meters from any water source. Ensure that people can wash carefully after using the toilet.

• Always wash hands after using the toilet.

• Always wash hands before cooking.

WATER

• Do not drink untreated water.

• Treat water using at least 2 methods: Filtering through fabric, sand or other material and boiling Filtering through fabric, sand or other material and adding lime or lemon Filtering through fabric, sand or other material and adding chlorine

• Keep water containers clean and do not put hands in drinking water.

FOOD

• Cook food thoroughly and eat it while it is hot. Fish and shellfish are a major cause of cholera: only eat them if they are well-cooked. • Do not mix cooked foods with raw foods like salads or relishes. • Exclude infected persons from handling food. • Wash vegetables and fruit in treated water before use, or peel them if there is no water. • Discourage the habit of several people eating together from a communal food container.

* Preparing an Emergency Pit Latrine

In an emergency, while a more permanent latrine is being built, a simple pit can be dug as a temporary solution for the disposal of human excreta. It should have a depth of at least 1/2 meter, and be at least 20 meters from a well or other source of drinking water. Where possible, the pit should be at least 6 meters from the nearest house. It should not be located uphill from the water source or dug in marshy soil. The bottom of the pit should never penetrate the groundwater table. After each use, a layer of soil should be laid down in the pit. In an area affected by cholera, the pit should also be coated each day with a layer of unslaked lime. For more information about other latrine designs, please see Sanitation and Cleanliness for a Healthy Environment.

How to identify cholera?

Cholera is a severe form of diarrhea caused by bacteria in water.

The symptoms of cholera are:

• Diarrhea “like rice water” in very large quantities

• Vomiting

• Leg cramps

• Weakness

Diarrhea and vomiting can lead very quickly to severe dehydration and shock. Without treatment, death can occur within hours.

How Is a Heart Attack Treated?

Early treatment can prevent or limit damage to the heart muscle. Acting fast, at the first symptoms of heart attack, can save your life. Medical personnel can begin diagnosis and treatment even before you get to the hospital.

Certain treatments are usually started right away if a heart attack is suspected, even before the diagnosis is confirmed. These include:
     Oxygen
     Aspirin, to prevent further blood clotting 
     Nitroglycerin, to reduce the workload on the heart and improve blood flow through the                  coronary arteries
     Treatment for chest pain 

Once the diagnosis of heart attack is confirmed or strongly suspected, treatments to try to restore blood flow to the heart are started as soon as possible. Treatments include medicines and medical procedures.

1.Medicines 

   A number of different kinds of medicines may be used to treat heart attack. They include the       following. 

    Thrombolytic Medicines 

    These medicines (also called clot busters) are used to dissolve blood clots that are blocking the      coronary arteries. To be most effective, these medicines must be given within 1 hour after the      start of heart attack symptoms. 

     Beta Blockers

     These medicines decrease the workload on your heart. Beta blockers also are used to relieve         chest pain or discomfort and to help prevent additional heart attacks. Beta blockers also are         used to correct arrhythmias (irregular heartbeats). 

      Angiotensin-Converting Enzyme (ACE) Inhibitors 

     These medicines lower blood pressure and reduce the strain on your heart. They also help             slow down further weakening of the heart muscle. 

       Anticoagulants 

       These medicines thin the blood and prevent clots from forming in your arteries. 

       Antiplatelet Medicines 

       These medicines (such as aspirin and clopidogrel) stop platelets (a type of blood cell) from              clumping together and forming unwanted clots. 

       Other Medicines

       Medicines may also be given to relieve pain and anxiety, and to treat arrhythmias, which              often occur during a heart attack.

Causes of Hypertension Heart Attacks

Heart disease has been more frequently found in certain persons who show peculiar personality physical and mental traits. It will therefore, be worthwhile to discuss these factors. Coronary heart disease is considered to have multiple causative factors i.e., no one single factor perhaps could be identified as one causing a heart attack.

Heredity: There is ample evidence to show that incidence of heart disease is more in persons whose direct predecessors like fathers, grandfathers, mothers, brothers have suffered from similar disease. Coronary artery disease is found to run mainly in families. A strong family history of the disease is important in diagnosis.

Stress: Heart disease has often been identified with certain personality patterns. It is labelled as personality disease or a high executive disease, that is, it strikes persons with a certain personality. A certain study has shown that there was four times as much coronary disease among aggressive type of individuals. 
In addition to this other factors such as family responsibilities, interpersonal relationship, financial worries, leisure interests, habits of eating drinking and smoking etc. may play a part that may effect one's heart.

Smoking: It has been found by some workers that death rate among those who had heart attack was 50-150 percent higher in those who were heavy cigarette smoker than non-smokers.

Physical Exercise: There is a fairly general trend towards encouraging regular physical effort of a kind suited to age and condition of the person concerned. As a preventive as well as a remedial measure exercise is of great importance. There is abundant evidence to suggest that a stressful sedentary life without much exercise provides a situation fraught with coronary danger. Death rate from coronary heart disease is lower among those who do strenuous physical work.
Even for patients, who have survived coronary attacks, there has lately been a change in the thinking in marked contrast in earlier ideas. The doctors are now a day advocating, after the initial prescribed rest, walking up the stairs, going on hikes, bicycles and other forms of exercise. The quantum of exercise in each case must of course be decided by the attending physician. 

Diet and obesity: Certain studies have shown 50 percent increase in heart attacks in employees who were over weight similarly diet and amount of fat are matter of vital importance in incidence of heart disease. The sound advice which could be given is to lead a life of moderation in matter of diet and activity an also to avoid obesity. Large fatty meals and strenuous exercise after them is not conducive to a healthy heart.

Saturated fats: are likely of animal origin like whole milk, cream, butter, cheese meat, fat, etc. They raise blood cholesterol level. And they are not included in proper heart attack diet. On the other hand unsaturated fats are of vegetable origin and they tend to lower blood cholesterol levels like maize oil, cottonseed oil sunflower oil and fat of fish.

Heart Attack Signs

It has been said earlier that any disturbance in the supply of blood to heart muscle leads to its functional impairment. There are also other heart attack symptoms which need to be observed on time to take required measures for heart attack prevention.

It will be useful to discuss symptoms of heart attacks, which may lead to disturbances in the supply of blood to heart muscles. Certain conditions increase the strains on the heart. Among these are lack of rest, over exertion or prolonged hard labor which create an excessive body demand for oxygen that the heart, muscle must supply through pumping more blood. If the blood vessels are inelastic on account of arteriosclerosis fibrous thickening or narrowing of passage (atherosclerosis) additional work on the part of the heart will be needed to push blood through these vessels. Other indirect factors that may result in causing disturbance in blood supply are indigestion of food, anger and other emotional excitements.

There are some early heart attack symptoms, which may be important to watch for. Their appearance calls for a visit to the doctor for a check up. The heart attack symptoms are:

1.Dizzy spell or fainting fits 

2.Discomfort following meals, especially if long continued.

 3.Shortness of breath, after slight exertion. 

4.Fatigue with out otherwise explained origin. 

5.Pain or tightness in the chest a common sign of coronary insufficiency is usually constrictive in nature and is located behind the chest bone with radiation into the arms or a sense of numbness or a severe pain in the center of the chest 

6.Palpitation

 These symptoms of heart attack should be observed minuetly and should be taken care of as and when required.

Introduction to Heart Disease

What is Heart Disease?

The term heart disease actually applies to a number of illnesses that affect the circulatory system, which consists of heart and blood vessels. It is intended to deal here only with the condition commonly called "Heart Attack" and the factors, which lead to such condition.

Heart attack is the popular term for sudden pain in chest with breathing difficulty arising out of certain heart conditions. Heart attacks can be suddenly fatal, but the great majority- an estimated 85 percent are not. The patient recovers under proper treatment and goes on to live many useful years.

Like all muscles and organs of the body, the heart also needs nourishment and food which it gets thorough its own arterial system. The arteries, which supply blood to the heart muscle, may lead to impairment of its function. The sudden narrowing of the artery may result in the sudden stoppage of blood supply to the heart muscle. Such attacks of narrowing of arteries are called angina. If the damage takes place it is called infarction.

Infarction can also occur because of a blood clot, big enough to interfere with blood supply, is formed in the coronary artery. This formation of blood clot is called trombosis and the clot itself is known a thrombus. The term coronary heart disease is usually applied to diseases of the heart secondary to defective or interrupted supply of blood to the heart muscles through the coronary arteries.

Besides the sudden narrowing of coronary arteries such as in anginal attacks or thrombosis the blood supply to heart muscle could also be impaired by certain long term and (chronic) conditions like arteriosclerosis and atherosclerosis.

Arteriosclerosis is a condition when certain arteries (may be all) start losing their elasticity and their walls, due to some unknown factors, become thickened and hardened. When this happens. Blood pressure inside the arteries tends to become high and which in its wake puts more stress and strain on heart.

Recent researches in connection with heart diseases have demonstrated a high correlation between fats in the diet, cholesterol level and atherosclerosis. Cholesterol is fat like substance found in animal fats, oils and some tissues of the human body.

Self-Care at Home

Short episodes of vomiting and small amounts of diarrhea lasting less than 24 hours can usually be cared for at home.

1.Do not eat solid food while nauseous or vomiting but drink plenty of fluids. 

   Small, frequent sips of clear liquids (those you can see through) are the best way to stay                hydrated. 

   Avoid alcoholic, caffeinated, or sugary drinks. Over-the-counter rehydration products made        for children such as Pedialyte and Rehydralyte are expensive but good to use if available. 

   Sports drinks such as Gatorade and Powerade are fine for adults if they are diluted with water    because at full strength they contain too much sugar, which can worsen diarrhea.

2.After successfully tolerating fluids, eating should begin slowly, when nausea and vomiting have    stopped. Plain foods that are easy on the stomach should be started in small amounts. Consider    eating rice, wheat, breads, potatoes, low-sugar cereals, lean meats, and chicken (not fried) to        start. Milk can be given safely, although some people may experience additional stomach upset   due to lactose intolerance. 

3.Most food poisonings do not require the use of over-the-counter medicines to stop diarrhea,        but they are generally safe if used as directed. It is not recommended that these medications      be given to children. If there is a question or concern, you should always check with a doctor.

Prevention

Safe steps in food handling, cooking, and storage are essential to avoiding food-borne illness. Bacteria cannot be seen, smelled, or tasted, which may be on any food.

Follow the CDC food safety guidelines to keep contaminants away.

1.Safe shopping 

  Buy cold foods last during your shopping trip. Get them home fast. 
  Never choose torn or leaking packages. 
  Do not buy foods past their "sell-by" or expiration dates. 
  Keep raw meat and poultry separate from other foods. 

2.Safe storage of foods 

    Keep it safe; refrigerate. 
    Unload perishable foods first and immediately refrigerate them. Place raw meat, poultry, or         fish in the coldest section of your refrigerator. 
    Check the temperature of your appliances. To slow bacterial growth, the refrigerator should         be  at 40°F, the freezer at 0°F. 
    Cook or freeze fresh poultry, fish, ground meats, and variety meats within two days.

Food Poisoning Symptoms

Symptoms of food poisoning depend on the type of contaminant and the amount eaten. The symptoms can develop rapidly, within 30 minutes, or slowly, worsening over days to weeks. Most of the common contaminants cause nausea, vomiting, diarrhea, and abdominal cramping. Usually food poisoning is not serious, and the illness runs its course in 24-48 hours. 

Viruses account for most food poisoning cases where a specific contaminant is found.

Noroviruses are a group of viruses that cause a mild illness (often termed "stomach flu") with nausea, vomiting, diarrhea, abdominal pain, headache, and low-grade fever. These symptoms usually resolve in two to three days. It is the most common viral cause of adult food poisoning and is transmitted from water, shellfish, and vegetables contaminated by feces, as well as from person to person. Outbreaks are more common in densely populated areas such as nursing homes, schools and cruise ships (hence why the virus is also known as the "Cruise Ship Illness"). The term norovirus has been approved as the official name for this group of viruses. Several other names have been used for noroviruses, including Norwalk-like viruses, caliciviruses (because they belong to the virus family Caliciviridae), and small round structured viruses.


Rotavirus: Causes moderate to severe illness with vomiting followed by watery diarrhea and fever. It is the most common cause of food poisoning in infants and children and is transmitted from person to person by fecal contamination of food and shared play areas.


Hepatitis A: Causes mild illness with sudden onset of fever, loss of appetite, and feeling of tiredness followed by jaundice, which is a yellowing of the eyes and skin. It is transmitted from person to person by fecal contamination of food.

Food Poisoning Causes

More than 250 known diseases can be transmitted through food. The CDC estimates unknown or undiscovered agents cause 81% of all food-borne illnesses and related hospitalizations. Many cases of food poisoning are not reported because people suffer mild symptoms and recover quickly. Also, doctors do not test for a cause in every suspected case because it does not change the treatment or the outcome.

1.The known causes of food poisoning can be divided into two categories: infectious agents and        toxic agents. 

2.Infectious agents include viruses, bacteria, and parasites. 

3. Toxic agents include poisonous mushrooms, improperly prepared exotic foods (such as                   barracuda), or pesticides on fruits and vegetables.

4.Food usually becomes contaminated from poor sanitation or preparation. Food handlers who      do not wash their hands after using the bathroom or have infections themselves often cause        contamination. Improperly packaged food stored at the wrong temperature also promotes            contamination.

Food Poisoning Overview

Food poisoning is a common, usually mild, but sometimes deadly illness. Typical symptoms include nausea, vomiting, abdominal cramping, and diarrhea that occur suddenly (within 48 hours) after consuming a contaminated food or drink. Depending on the contaminant, fever and chills, bloody stools, dehydration, and nervous system damage may follow. These symptoms may affect one person or a group of people who ate the same thing (called an outbreak).

The Centers for Disease Control and Prevention (CDC) estimates that in the United States, food poisoning causes about 76 million illnesses, 325,000 hospitalizations, and up to 5,000 deaths each year. One of the most common bacterial forms of infection, the salmonellae organisms, account for $1 billion in medical costs and lost work time.

Worldwide, diarrheal illnesses are among the leading causes of death. Travelers to developing countries often encounter food poisoning in the form of traveler's diarrhea or "Montezuma’s revenge." Additionally, there are possible new global threats to the world's food supply through terrorist actions using food toxins as weapons.

overview of lung Cancer

Lung cancer affects more than 200,000 Americans each year. Although cigarette smoking is the main cause, anyone can develop lung cancer. Lung cancer is always treatable, no matter

the size, location, or if the cancer has spread.

The lungs absorb oxygen from the air and bring the oxygen into the bloodstream for delivery to the rest of the body. As the body’s cells use oxygen, they release carbon dioxide. The

bloodstream carries carbon dioxide back to the lungs, and the

carbon dioxide leaves the body when people exhale. The lungs

contain many different types of cells. Most cells in the lung are

epithelial cells. Epithelial cells line the airways and produce

mucus, which lubricates and protects the lung. The lung also

contains nerve cells, hormone-producing cells, blood cells, and

structural or supporting cells.

There are two major types of lung cancer: non-small cell and

small cell. Non-small cell lung cancer (NSCLC) arises from

epithelial cells and is the most common type. Small cell lung

cancer begins in the nerve cells or hormone-producing cells of

the lung. The term “small cell” refers to the size and shape of

the cancer cells as seen under a microscope. It is important

for doctors to distinguish NSCLC from small cell lung cancer

because the two types of cancer are usually treated in

different ways.

Prevention For Skin Factor

• Avoid being in the sun from 10 AM to 4 PM.

• Wear clothing such as a hat, long sleeves and pants to block the sun’s rays.

• Use a sunscreen with a sun protection factor (SPF) of 15 or higher year round when you are going outside.

• Learn to know what skin cancer looks like.

• Check your skin monthly. Report any changes to your doctor.

• If you are at risk, see a doctor who specializes in the skin called a dermatologist each year for a skin exam.

Risk Factor of Skin Cancer

Anyone, including people with dark skin, hair and eyes, can develop skin

cancer, not just those at higher risk. You are at higher risk if you have:

• Spent a lot of time in the sun

• Family members with skin cancer

• Certain types or a large number of moles

• Skin that burns or freckles in the sun

• Light-colored skin, hair and eyes

Fighting Cervical Cancer

The most important tool in the fight against cervical cancer is prevention. Prevention is best achieved by regular screening (1). This presents some important challenges to women, especially poor women

· Poor women, in particular those in developing countries often do not have access to free health services, or cannot afford to pay for screening. Moreover, if such services are available they are often in urban areas, which can act as an impediment for many rural women.

· A woman is more likely to put the health needs of her family above her own, so if money for a doctor is available, it will be spent on the children rather than their mother.

· Fear of her partner may also discourage a woman from having regular screening check-ups. He may refuse to allow her to go to the gynecologist, to pay for the screening, or for transportation to the clinic/hospital.

· In many societies women have no control over their sexual relations. Whether or not a woman can control when and with whom she has sexual contact is crucial in determining whether she can protect herself from exposure to HPV.

· Negative experiences with doctors or health workers in general may prevent women from having regular screening check-ups (6).

· Screening programs in Latin America tend to be linked to family planning programs, as a result they reach mainly women who are under thirty. Since the high-risk group for cervical cancer includes women between the ages of 30 and 60, screening programs are not as beneficial as they could be (1).

· A lack of information about the screening procedure, or fear of the results can also act as an impediment to regular screening check-ups (6).

What is Cervical Cancer?

Cervical cancer is caused by a change in the cells that line the wall of the

cervix (the lower part of the womb which connects the uterus to the vagina,

or birth canal). These cells begin as normal, then gradually change to precancerous

cells, which appear as lesions on the cervical wall. The cells

may eventually become cancerous, however in over 50% of women

with pre-cancerous lesions, the cells remain benign (pre-cancerous).

Cervical cancer in its early stages often exhibits no symptoms, which is

why it is frequently not detected until it becomes severe (3).

The most common risk factor for cervical cancer is exposure to certain strains of the Human Papillomavirus (HPV) (3). HPV is a

sexually transmitted infection (STI), which may or may not be accompanied by symptoms. Because HPV is often asymptomatic, it can

go for long periods without being detected (4).

Other risk factors for cervical cancer include:

· Not having regular screening.

· Initiation of sexual relations at a young age.

· Having multiple sexual partners, or having sex with someone who has had multiple sexual partners.

· Being HIV positive, which weakens a woman’s immune system and makes her more vulnerable to infection with HPV.

· A family history of cervical cancer

· Age group – women aged 30-60 are most at risk and the risk also increases with age.

· Smoking

· Socio-economic status - because poor women have less access to screening and treatment services, their incidence and mortaliy

rates are much higher.

overview of cervical cancer

Across the Americas, lack of access to adequate screening and treatment

services means that one of the most easily preventable, detectable and

treatable forms of cancer has become a significant cause of mortality

among women, especially poor women.

Although the mortality rate for cervical cancer in North America has

declined over the last 10 years, it remains constant in the developing

countries of the Americas (1). This reflects the need for a new approach

to cervical cancer, one that emphasizes prevention and the positive

aspects of screening and early detection.

Gender is all too often a factor in a woman’s decision not to be screened

for cervical cancer. A gender-focused analysis of the situation is

necessary to fully understand the incidence of cervical cancer in the

Americas

Travel advice to prevent BIRD FLU.

Australians travelling to areas affected by avian influenza

should reduce their risk of infection by avoiding poultry

farms and live bird markets. They should also ensure that

they wash their hands thoroughly after handling uncooked

poultry products such as eggs, and that they ensure that

poultry is cooked thoroughly before eating.

What is the public health response for BIRD FLU?

Outbreaks of different strains of avian influenza have

occurred previously in Australia. However, there have been

no recent reports of avian influenza in Australian birds and

there are no reports of Australian people with H5N1 virus

infection. There is surveillance for the illegal importation

of birds or bird products at Australian borders.

Human infection with avian influenza must be notified to

the local public health unit. Should suspected human cases

occur in NSW, the local public health unit would work

with the patient, the treating doctors, and the laboratory to

confirm the diagnosis. Suspected cases would be isolated

from others to prevent further infections. Close contacts of

these cases who may have been exposed to the virus will

be given information about the risk of infection. Should

these people also develop symptoms, they would also be

isolated and tested for avian influenza.

How BIRD FLU is treated?

Specific anti-influenza drugs are likely to be effective

against avian influenza in humans and are used to treat

people with the H5N1 strain.

How BIRD FLUE is diagnosed?

Avian influenza virus infection can be diagnosed using

specimens of blood, or from swabs of the nose and throat.

Testing is done at a specialised laboratory.

How BIRD FLU is prevented?

A human vaccine is not available for the new avian influenza

strain. Existing vaccines for normal human influenza will

not provide protection against avian influenza, including the

H5N1 strain. Scientists worldwide are currently working

to develop a suitable vaccine for this strain.

Who is at risk of BIRD FLU?

Most people are not at risk of this disease. People at risk

of becoming infected with H5N1 are those who come into

contact with sick birds or their secretions or droppings while

living or travelling in areas where the virus is circulating, or

(possibly) people who have had close contact with a person

with the human form of the disease in the affected areas.

In the absence of a vaccine, the best method of prevention

is to ensure that all people who are working with infected

birds are supplied with appropriate personal protective

equipment, such as masks, goggles, gloves and protective

clothing, and, if necessary, anti-influenza medication.

What are the symptoms of BIRD FLU?

Different strains of avian influenza can lead to different

symptoms in people. All strains can cause symptoms typical

of human influenza (fever, cough, tiredness, muscle aches,

sore throat, shortness of breath, runny nose, headache). In

some cases the H5N1 strain has caused a severe pneumonia

and, in a small number of cases, encephalitis (inflammation

of the brain) or diarrhoea. The most common symptom

of humans infected with H7 strains of avian influenza

is conjunctivitis (inflammation of the lining of the eye).

Symptoms generally appear between two to four days

following exposure.

What is avian influenza (bird flu)?

Avian influenza is an infectious disease of birds, caused by a

number of different strains of avian influenza virus. Usually

the virus circulates in wild bird populations causing no

disease or only mild disease. Infection of domestic poultry,

such as chickens, can cause severe disease in these birds.

There are a number of different strains of avian influenza,

only a few of which can cause disease in humans.

A new type of avian influenza, called influenza A H5N1

(hereafter referred to as H5N1), was first recognised in 1997

in Hong Kong. This strain reappeared in late 2003 and has

rapidly spread to many Asian, Middle-Eastern, European

and African countries, causing severe infection in wild birds

and domestic poultry flocks. There is no evidence that avian

influenza is currently infecting birds in Australia.

This virus has also infected a number of people in Asia, the

Middle East and Africa who had close contact with infected

poultry or poultry droppings.

At this stage, humans infected with the H5N1 virus do not

easily transmit the infection to others. Exposure to infected

poultry, or their infected secretions or droppings, or dust or

soil contaminated with their secretions or droppings, can

result in human infection. Eating cooked poultry products

including chicken or eggs does not result in infection.

A large-scale, worldwide influenza epidemic is called a

pandemic. Pandemics occur when a new virus emerges to

which people have little or no immunity. Previous influenza

pandemics occurred in 1918-19, 1957-58 and 1968-69. In

the 1918-19 pandemic, between 20 and 40 million people

died. Many scientists are concerned that the recent H5N1

outbreak in birds could mutate to produce a new strain of

influenza virus that is easily spread among people, resulting

in a pandemic.

RESTRICTION OF ACTIVITY IF SWINE FLU DETECTED.

As there is no evidence that treatment with antiviral medication reduces a person’s contagious
state, it must be assumed that persons remain contagious for 7 days after the onset of
symptoms regardless of whether or not they are treated with antiviral medication. The
following restrictions on activity shall be implemented when there is a suspected or confirmed
case of influenza.

1. To the extent possible, maintain individuals with suspected or confirmed influenza on
droplet precautions in their bedroom for 7 days from the onset of symptoms.
2. At a minimum, restrict individuals(s) with suspected or confirmed influenza to the
affected unit/residence.
3. To the extent possible, individuals with suspected or confirmed influenza are to dine in
their rooms.
4. If dining in the common area, individuals(s) with suspected or confirmed influenza are to
dine separately from those who are well/not exposed, with the well individuals dining
first followed by the individuals(s) with suspected or confirmed influenza.
5. When in common areas, promote spatial separation of at least 6 feet whenever possible
between individuals(s) with suspected or confirmed influenza and other individuals.
6. Bedrooms, bathrooms, dining and common areas and “high touch” areas such as
doorknobs, telephones, faucet handles, remote controls, etc. should be thoroughly
cleaned frequently with a product that is effective against influenza. It is important that
staff use any product according to the manufacturer’s recommendations, paying
particular attention to any “sit time” that is required.
7. To the extent possible in large facilities, cohort individuals with suspected influenza with
other individuals with suspected influenza; cohort individuals confirmed to have
influenza with other individuals with confirmed influenza.
8. All individuals in a residence (or in a large facility, in the area, wing or unit) who have
suspected or confirmed influenza or who have been exposed to influenza are not to
attend day program, to interact with individuals or staff from other residences or units,
or go to activities outside of the residence.
9. Individuals must remain out of day program for a minimum of 7 days after the last
known exposure. Individuals may return to day program after 7 days provided the
following criteria are met:
a. the individual has completed at least 5 days of prophylactic medication; AND
b. the individual is asymptomatic and has been afebrile for at least 48 hours; AND
c. there is no evidence of on-going transmission in the residence, area, wing or unit.
(NOTE: if the primary care provider determines that a person cannot/should not
receive prophylactic medication, conditions b and c above must be met prior to
the person returning to program.
10. During the period of possible contagion, staff must be restricted from floating into or out
of the residence, area, wing or unit. In addition, staff that have been exposed must be
restricted from doing overtime or extra service in other programs, residences, areas,
wings or units for at least 7 days after the last known exposure. Staff restrictions may
be lifted after the following criteria are met:
a. the staff person has completed at least 5 days of prophylactic medication; AND
b. the staff person is asymptomatic and has been afebrile for at least 48 hours; AND
c. there is no evidence of on-going transmission in the residence, area, wing or unit
11. Restrict visitors to the residence to the extent possible until the contagious period is
over.
12. Restrict the use of respite in any residence with an individual with influenza. Restrict
the use of respite to individuals who are free of respiratory symptoms or a known
exposure to influenza.
13. Restrict admissions, discharges or transfers of individuals during the period of
infectivity. In the event that an individual must be re-located, the following measures
should be followed:
a. Carefully screen individuals to be relocated for symptoms of, and exposure to,
influenza.
b. If discharging/transferring an individual with respiratory symptoms or a known
exposure to influenza, notify the receiving facility.
c. Individuals admitted with respiratory symptoms or known exposure to
influenza are to be placed on droplet precautions.
d. Individuals admitted without respiratory symptoms or known exposure may be
admitted to the residence and treated as any other individual in the residence
without influenza.

DIAGNOSIS OF SWINE FLU.

Appropriate treatment of patients with respiratory illness depends on accurate and timely
diagnosis. Clinicians should consider the possibility of swine influenza virus infections in any
person presenting with febrile respiratory illness.

If swine flu is suspected, clinicians should obtain a recent travel history to affected areas
(including New York City) and test anyone meeting the case definition for swine flu:

1. A person with an acute respiratory illness who was a close contact to a confirmed case of
swine influenza A (H1N1) virus infection while the case was ill OR
2. A person with an acute respiratory illness with a recent history of contact with an animal with
confirmed or suspected swine influenza A (H1N1) virus infection OR
3. A person with an acute respiratory illness who has traveled to an area where there are
confirmed or probable cases of swine influenza A (H1N1) **INCLUDING TRAVEL TO NEW
YORK CITY

Definitions of Respiratory Illness from the NYS DOH:

1. Acute respiratory illness: Recent onset of at least two of the following:
-> rhinorrhea or nasal congestion
-> sore throat
-> cough
-> fever or feverishness
2. Influenza-like illness: fever >37.8°C (100°F) plus cough or sore throat.

Patients who meet the suspect case definition should be tested for influenza.

WHAT ARE THE SYMPTOMS OF SWINE FLU?

Some of the symptoms are the sudden onset of fever, cough or shortness of breath. Other symptoms can include headache, sore throat, tiredness, aching muscles, chills, sneezing, runny nose or loss of appetite.

WHAT CAN I DO TO PROTECT MYSELF AND OTHERS AGAINST FLU?

The best thing you can do to protect yourself is to follow good hygiene practices. These will help to slow the spread of the virus and will be the single most effective thing you can do to protect yourself and others from infection.

When you cough or sneeze it is especially important to follow the rules of good hygiene to prevent the spread of germs:

->Always carry tissues.
->Use clean tissues to cover your mouth and nose when you cough and sneeze.
->Bin the tissues after one use.
->Wash your hands with soap and hot water or a sanitiser gel often.

IS THERE A VACCINATION I CAN HAVE?

Not at this stage. This type of flu is not the same as seasonal flu: it involves a completely new type of virus. A vaccine can only be developed when the specific strain has been identified, and it would then take several months to produce.

The UK governments have agreements in place with manufacturers so that we can get stocks as soon as possible after a vaccine has been developed.

HOW DOES SWINE FLU SPREAD?

Flu viruses are made up of tiny particles that can be spread through the droplets that come out of your nose and mouth when you cough or sneeze.

When you cough or sneeze without covering your nose and mouth with a tissue, those droplets can spread and others will be at risk of breathing them in.

If you cough or sneeze into your hand, those droplets and the germs in them are then easily spread from your hand to any hard surfaces that you touch, and they can live on those surfaces for some time. Everyday items such as door handles, computer keyboards, mobile and ordinary phones and the TV remote control are all common surfaces where flu viruses can be found.
If other people touch these surfaces and then touch their faces, the germs can enter their systems and they can become infected. That’s how all cold and flu viruses, including swine flu, are passed on from person to person.

WHAT IS SWINE FLU ?

Swine flu is a respiratory disease and has some elements of a virus found in pigs. There is no evidence of this disease circulating in pigs in the UK and scientists are investigating its origins.
Swine flu has been confirmed in a number of countries and it is spreading from human to human, which could lead to what is referred to as a pandemic flu outbreak.

Pandemic flu is different from ordinary flu because it’s a new flu virus that appears in humans and spreads very quickly from person to person worldwide. The World Health Organization (WHO) is closely monitoring cases of swine flu globally to see whether this virus develops into a pandemic.
Because it’s a new virus, no one will have immunity to it and everyone could be at risk of catching it. This includes healthy adults as well as older people, young children and those with existing medical conditions.

What is High Blood Pressure??

Hypertension can result from too much fluid in normal blood vessels or from normal fluid in narrow blood vessels. Blood pressure measures the force of blood against the walls of your blood vessels. Blood pressure that remains high over time is called hypertension. Extra fluid in your body increases the amount of fluid in your blood vessels and makes your blood pressure higher. Narrow or clogged blood vessels also raise your blood pressure.

What is Hepatitis??

The term 'hepatitis' simply means inflammation of the liver. Hepatitis may be caused by a virus or a toxin such as alcohol. Other viruses that can cause injury to liver cells include the hepatitis A and hepatitis C viruses. These viruses are not related to each other or to hepatitis B virus and differ in their structure, the ways they are spread among individuals, the severity of symptoms they can cause, the way they are treated, and the outcome of the infection.

What is Malaria??

Malaria is an infectious disease caused by a parasite, Plasmodium, which infects red blood cells. Malaria is characterized by cycles of chills, fever, pain and sweating. Historical records suggest malaria has infected humans since the beginning of mankind. The name "mal 'aria" (meaning "bad air" in Italian) was first used in English in 1740 by H. Walpole when describing the disease. The term was shortened to "malaria" in the 20th century. C. Laveran in 1880 was the first to identify the parasites in human blood. In 1889, R. Ross discovered that mosquitoes transmitted malaria. Of the four species of malaria, the most serious type is Plasmodium falciparum malaria. It can be life-threatening. The other three species of malaria (P. vivax, P. malariae, and P. ovale) are generally less serious and are not life-threatening.

What is Pneumonia??

Pneumonia is an infection of one or both lungs which is usually caused by bacteria, viruses, or fungi. Prior to the discovery of antibiotics, one-third of all people who developed pneumonia subsequently died from the infection. Currently, over 3 million people develop pneumonia each year in the United States. Over a half a million of these people are admitted to a hospital for treatment. Although most of these people recover, approximately 5% will die from pneumonia. Pneumonia is the sixth leading cause of death in the United States.

What is Diabetes??

Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar (glucose) levels, that result from defects in insulin secretion, or action, or both. Diabetes mellitus, commonly referred to as diabetes (as it will be in this article) was first identified as a disease associated with "sweet urine," and excessive muscle loss in the ancient world. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine, hence the term sweet urine.
Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.

What is Cancer??

Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems.

Major Types Of Cancer

• Carcinoma - cancer that begins in the skin or in tissues that line or cover internal organs.

• Sarcoma - cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

• Leukemia - cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.

• Lymphoma and myeloma - cancers that begin in the cells of the immune system.

• Central nervous system cancers - cancers that begin in the tissues of the brain and spinal cord.

Origins Of Cancer

All cancers begin in cells, the body's basic unit of life. To understand cancer, it's helpful to know what happens when normal cells become cancer cells.
The body is made up of many types of cells. These cells grow and divide in a controlled way to produce more cells as they are needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells.
However, sometimes this orderly process goes wrong. The genetic material (DNA) of a cell can become damaged or changed, producing mutations that affect normal cell growth and division. When this happens, cells do not die when they should and new cells form when the body does not need them. The extra cells may form a mass of tissue called a tumor.


Not all tumors are cancerous; tumors can be benign or malignant.
• Benign tumors aren't cancerous. They can often be removed, and, in most cases, they do not come back. Cells in benign tumors do not spread to other parts of the body.

• Malignant tumors are cancerous. Cells in these tumors can invade nearby tissues and spread to other parts of the body. The spread of cancer from one part of the body to another is called metastasis.
Some cancers do not form tumors. For example, leukemia is a cancer of the bone marrow and blood.

Cancer statistics

A new report from the nation's leading cancer organizations shows cancer death rates decreased on average 2.1 percent per year from 2002 through 2004, nearly twice the annual decrease of 1.1 percent per year from 1993 through 2002.
Estimated new cases and deaths from cancer in the United States in 2008:
• New cases: 1,437,180 (does not include nonmelanoma skin cancers)

• Deaths: 565,650

Types Of Cancer

The list of common cancer types includes cancers that are diagnosed with the greatest frequency in the United States. Cancer incidence statistics from the American Cancer Society and other resources were used to create the list. To qualify as a common cancer, the estimated annual incidence for 2008 had to be 35,000 cases or more.
The most common type of cancer on the list is nonmelanoma skin cancer, with more than 1,000,000 new cases expected in the United States in 2008. Nonmelanoma skin cancers represent about half of all cancers diagnosed in this country.
The cancer on the list with the lowest incidence is thyroid cancer. The estimated number of new cases of thyroid cancer for 2008 is 37,340.
Because colon and rectal cancers are often referred to as "colorectal cancers," these two cancer types were combined for the list. For 2008, the estimated number of new cases of colon cancer is 108,070, and the estimated number of new cases of rectal cancer is 40,740.
Kidney cancers can be divided into two major groups, renal parenchyma cancers and renal pelvis cancers. Approximately 85 percent of kidney cancers develop in the renal parenchyma, and nearly all of these cancers are renal cell cancers. The estimated number of new cases of renal cell cancer for 2008 is 46,232.
Leukemia as a cancer type includes acute lymphoblastic (or lymphoid) leukemia, chronic lymphocytic leukemia, acute myeloid leukemia, chronic myelogenous (or myeloid) leukemia, and other forms of leukemia. It is estimated that more than 44,270 new cases of leukemia will be diagnosed in the United States in 2008, with chronic lymphocytic leukemia being the most common type (approximately 15,110 new cases).

Defining cancer

Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems.
Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start -- for example, cancer that begins in the colon is called colon cancer; cancer that begins in basal cells of the skin is called basal cell carcinoma.