Pink Eye (Conjunctivitis)

What is "pink eye"?

Pink eye, or conjunctivitis, is redness and inflammation of the membranes (conjunctiva) covering the whites of the eyes and the membranes on the inner part of the eyelids. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents, as well as to underlying diseases within the body. Viral and bacterial forms of conjunctivitis are common in childhood, but they occur in adults as well. Pink eye can occur in people of any age. Overall, however, there are many causes of pink eye. These can be classified as either infectious or noninfectious. Pink eye does not cause any changes in vision.

What infections cause pink eye, what are infectious pink eye symptoms, and how are they treated?

Viral pink eye

The leading cause of a red, inflamed eye is virus infection. Adenoviruses are the type of virus that are most commonly responsible for the infection. Viral pink eye symptoms are usually associated with more of a watery discharge that is not green or yellow in color. Often, viral "cold-like" symptoms, such as sinus congestion and runny nose, are also present. The eyelids may be swollen. Sometimes looking at bright lights is painful.

While viral pink eye may not require an antibiotic, those affected should see a doctor, as occasionally this form of pink eye can be associated with infection of the cornea (the clear portion of the front of the eyeball). This infection must be correctly detected and treated. Viral pink eye is highly contagious. The symptoms of viral pink eye can last one to two weeks. Symptoms are pronounced for the first three to five days after symptoms appear, with slow resolution over the following one to two weeks.

Bacterial pink eye

Staphylococci and Streptococci, among others, are types of bacteria that commonly cause pink eye. Symptoms of bacterial pink eye include

• eye pain,



• swelling,



• redness,
  
  
• a moderate to large amount of discharge, usually yellow or greenish in color.

The discharge commonly accumulates after sleeping. Affected children may awaken most unhappy that their "eyes are stuck shut," requiring a warm washcloth applied to the eyes to remove the discharge. Bacterial pink eye is treated by repeated warm washcloths applied to the eyes (try applying these to your child's eye one eye at a time during a favorite video) and requires antibiotic eyedrops or ointment prescribed by the doctor.

What does pink eye look like?

Be careful not to use medication prescribed for someone else, or from an old infection, as these may be inappropriate for your current infection or may have been contaminated from other infections by accidentally touching the medicine bottle to infected areas. A safe, effective, and potentially less frightening method of putting drops into the eyes involves asking your child to lie down flat, with instructions to merely "close your eyes," and placing the recommended number of drops in the inner corner of the eye, next to the bridge of the nose, and letting them make a little "lake" there. When your child relaxes and opens the eyes, the medicine will flow gently into the infected mucous membranes without the need to "force open" the eyes.

When you feel that you or your child might have bacterial pink eye, it is very important to see your doctor immediately for several reasons. First, if the cause is a bacterial infection, an antibiotic will be needed to help the infection-fighting immune system to kill this infection. Secondly, if you are experiencing other symptoms such as a runny nose, cough, earache, etc., there is a good chance that these symptoms are caused by the same bacteria, and an oral antibiotic may also be needed to treat this infection along with the antibiotic drops or ointment for the eyes. Finally, your doctor will want to exclude the possibility that the infection has spread to areas where the symptoms may not yet be recognizable.

Chlamydia pink eye

Pink eye due to infection with chlamydia is an uncommon form of bacterial pink eye in the U.S., but it is very common in Africa and Middle Eastern countries. Chlamydia can cause pink eye in adults and neonates. It is a cause of pink eye in adolescents and adults that can be sexually transmitted. Chlamydia pink eye is typically treated with erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone) or oral tetracycline (Sumycin), except in children less than 8 years of age, because of possible discoloration of the teeth.

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Hives (Urticaria & Angioedema)

What are hives (urticaria)?

Hives (medically known as urticaria) appear on the skin as wheals which are red, very itchy, smoothly elevated areas of skin often with a blanched center. They appear in varying shapes and sizes, from a few millimeters to several inches in diameter anywhere on the body.

It is estimated that 20% of all people will develop urticaria at some point in their lives. Hives are more common in women than in men. One hallmark of hives is their tendency to change size rapidly and to move around, disappearing in one place and reappearing in other places, often in a matter of hours. Individual hives usually last no longer than 24 hours. An outbreak that looks impressive, even alarming, first thing in the morning can be completely gone by noon, only to be back in full force later in the day. Very few, if any other skin diseases occur and then resolve so rapidly. Therefore, even if you have no evidence of hives to show the doctor when you get to the office for examination, he or she can often establish the diagnosis based upon the history of your symptoms. Because hives fluctuate so much and so fast, it is helpful to bring along a photograph of what the outbreak looked like at its worst.

Swelling deeper in the skin that may accompany hives is called angioedema. This swelling may be seen on the hands and feet, as well as the lips or eyes, that can be as dramatic as it is brief.

What causes hives?

Hives are produced when histamine and other compounds are released from cells called mast cells, which are normally found in the skin. Histamine causes fluid to leak from the local blood vessels, leading to swelling in the skin.

Hives are very common. Although they can be annoying, they usually resolve on their own over a period of weeks and are rarely medically serious. Some hives are caused by allergies to such things as foods, medications, and insect stings, but in the majority of cases, no specific cause for them is ever found. Although patients may find it frustrating not to know what has caused their hives, maneuvers like changing diet, soap, detergent, and makeup are hardly ever helpful in preventing hives and are not necessary for the most part.

Having hives may cause stress, but stress by itself does not cause hives.

In rare cases (some hereditary, others caused by bee stings or drug allergy), urticaria and angioedema are accompanied by a striking decrease in blood pressure (shock) and difficulty breathing. This is called anaphylaxis. Ordinary hives may be widespread and disturbing to look at, but the vast majority of cases of hives do not lead to life-threatening complications.

What does urticaria (hives) look like?

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ELISA Tests

What is ELISA?

ELISA is an abbreviation for "enzyme-linked immunosorbent assay."

What is an ELISA test?

An ELISA test uses components of the immune system and chemicals to detect immune responses in the body (for example, to infectious microbes). The ELISA test involves an enzyme (a protein that catalyzes a biochemical reaction). It also involves an antibody or antigen (immunologic molecules).

What is the use of an ELISA test?

ELISA tests are widely utilized to detect substances that have antigenic properties, primarily proteins (as opposed to small molecules and ions such as glucose and potassium). The substances detected by ELISA tests include hormones, bacterial antigens and antibodies.

How does an ELISA test work?

There are variations of the ELISA test, but the most basic type consists of an antibody attached to a solid surface. This antibody has affinity for (will latch on to) the substance of interest, for example, human chorionic gonadotropin (HCG), the commonly measured protein which indicates pregnancy. A mixture of purified HCG linked (coupled) to an enzyme and the test sample (blood, urine, etc) are added to the test system. If no HCG is present in the test sample, then only HCG with linked enzyme will bind. The more HCG which is present in the test sample, the less enzyme linked HCG will bind. The substance the enzyme acts on is then added, and the amount of product measured in some way, such as a change in color of the solution.

What are the advantages of ELISA?

ELISA tests are generally relatively accurate tests. They are considered highly sensitive and specific and compare favorably with other methods used to detect substances in the body, such as radioimmune assay (RIA) tests. They have the added advantages of not needing radioisotopes (radioactive substances) or a costly radiation counter (a radiation-counting apparatus).

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Eczema

What is eczema?

Eczema is a general term for many types of skin inflammation (dermatitis). The most common form of eczema is atopic dermatitis (sometimes these two terms are used interchangeably). However, there are many different forms of eczema.

Eczema can affect people of any age, although the condition is most common in infants, and about 85% of those affected have an onset prior to 5 years of age. Eczema will permanently resolve by age 3 in about half of affected infants. In others, the condition tends to recur throughout life. People with eczema often have a family history of the condition or a family history of other allergic conditions, such as asthma or hay fever. The nature of the link between these conditions is inadequately understood. Up to 20% of children and 1%-2% of adults are believed to have eczema. Eczema is slightly more common in girls than in boys. It occurs in people of all races.

Eczema is not contagious, but since it is believed to be at least partially inherited, it is not uncommon to find members of the same family affected.

What are the causes of eczema?

Doctors do not know the exact cause of eczema, but a defect of the skin that impairs its function as a barrier, possibly combined with an abnormal function of the immune system, are believed to be important factors. Studies have shown that in people with atopic dermatitis there are gene defects that lead to abnormalities in certain proteins (such as filaggrin) that are important in maintaining the barrier of normal skin.

Some forms of eczema can be triggered by substances that come in contact with the skin, such as soaps, cosmetics, clothing, detergents, jewelry, or sweat. Environmental allergens (substances that cause allergic reactions) may also cause outbreaks of eczema. Changes in temperature or humidity, or even psychological stress, can lead to outbreaks of eczema in some people.

What are eczema symptoms and signs in babies, children, and adults?

Eczema most commonly causes dry, reddened skin that itches or burns, although the appearance of eczema varies from person to person and varies according to the specific type of eczema. Intense itching is generally the first symptom in most people with eczema. Sometimes, eczema may lead to blisters and oozing lesions, but eczema can also result in dry and scaly skin. Repeated scratching may lead to thickened, crusty skin.

While any region of the body may be affected by eczema, in children and adults, eczema typically occurs on the face, neck, and the insides of the elbows, knees, and ankles. In infants, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck.

Eczema can sometimes occur as a brief reaction that only leads to symptoms for a few hours or days, but in other cases, the symptoms persist over a longer time and are referred to as chronic dermatitis.

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Dental Health: Dentures

Introduction

A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available -- complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.

Complete Dentures

Complete dentures can be either "conventional" or "immediate." Made after the teeth have been removed and the gum tissue has begun to heal, a conventional denture is ready for placement in the mouth about 8 to 12 weeks after the teeth have been removed.

Unlike conventional dentures, immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums shrink over time, especially during the healing period following tooth removal. Therefore a disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.

Partial Dentures

A removable partial denture or bridge usually consists of replacement teeth attached to a pink or gum-colored plastic base, which is connected by metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed (permanent) bridge replaces one or more teeth by placing crowns on the teeth on either side of the space and attaching artificial teeth to them. This "bridge" is then cemented into place. Not only does a partial denture fill in the spaces created by missing teeth, it prevents other teeth from changing position. A precision partial denture is removable and has internal attachments rather than clasps that attach to the adjacent crowns. This is a more natural-looking appliance.

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Cortisone Injection (Corticosteroid Injection) of Soft Tissues & Joints

What are corticosteroids?

Corticosteroids are a class of medications that are related to cortisone. Medications of this class reduce inflammation powerfully. They are used to reduce inflammation caused by a variety of diseases. Cortisone is one type of corticosteroid. For the purpose of this review, "cortisone" is used interchangeably with "corticosteroid."

Corticosteroids can be taken by mouth, inhaled, applied to the skin, given intravenously (into a vein), or injected into the tissues of the body. Examples of corticosteroids include prednisone and prednisolone (given by mouth), Solu-Medrol (given intravenously), as well as triamcinolone, Kenalog, Celestone, Depo-Medrol, and others (given by injection into body tissues). This article describes the role of cortisone injections into the soft tissues and joints.

Is a cortisone injection merely a pain reliever or temporary remedy?

Corticosteroids are not pain relievers. They reduce inflammation. When corticosteroids relieve pain, it is because they have reduced inflammation.

While the inflammation for which corticosteroids are given can recur, corticosteroid injections can provide months to years of relief when used properly. These injections also can cure diseases (permanently resolve them) when the problem is tissue inflammation localized to a small area, such as bursitis and tendonitis.

For what conditions are cortisone injections used?

Cortisone injections can be used to treat the inflammation of small areas of the body (local injections), or they can be used to treat inflammation that is widespread throughout the body (systemic injections). Examples of conditions for which local cortisone injections are used include inflammation of a bursa (bursitis), a tendon (tendonitis), and a joint (arthritis). Knee arthritis, hip bursitis, painful foot conditions such as plantar fasciitis, rotator cuff tendinitis and many other conditions may be treated with cortisone injections. Epidural injections in the lumbar spine are cortisone injections inserted into a specific location in the spinal canal by a specialist under X-ray guidance (fluoroscopy). Systemic corticosteroid injections are used for conditions affecting many joints, such as allergic reactions, asthma, and rheumatoid arthritis.

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Chronic Rhinitis and Post-Nasal Drip

What is the purpose of the nose?

The purpose of the nose is to warm, clean, and humidify the air you breathe as well as help you to smell and taste. A normal person will produce about two quarts of fluid each day (mucus), which aids in keeping the respiratory tract clean and moist. Tiny microscopic hairs (cilia) line the surfaces of the nasal cavity, helping to brush away particles. Eventually the mucus blanket is moved to the back of the throat where it is unconsciously swallowed. This entire process is closely regulated by several body systems.

Structurally, the nose is separated into two passageways (left and right nostrils) by a structure called the septum. Protruding into each breathing passage are bony projections, called turbinates, which help to increase the surface area of the inside of the nose. There are three turbinates on each side of the nose (inferior or lower turbinates, middle turbinates, superior or upper turbinates). The sinuses are four paired, air-filled chambers which empty into the nasal cavity. Their purpose is not really known, but may help to lighten the skull, reducing its weight.

What are rhinitis and post-nasal drip?

Rhinitis is a very common condition and has many different causes. Basically, rhinitis may be defined as inflammation of the inner lining of the nose. More specifically speaking, it may be defined by the presence of one or more of the following symptoms:

• Rhinorrhea (runny nose)
  
  
• Nasal itching
  
  
• Nasal congestion
  
  
• Sneezing

Post-nasal drip is mucus accumulation in the back of the nose and throat leading to, or giving the sensation of, mucus dripping downward from the back of the nose. One of the most common characteristics of chronic rhinitis is post-nasal drip. Post-nasal drip may lead to chronic sore throat or chronic cough. Post-nasal drip can be caused by excessive or thick secretions, or impairment in the normal clearance of mucus from the nose and throat.

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Allergy/Allergies

Allergy facts

• Allergy involves an exaggerated response of the immune system.



• The immune system is the body's organized defense mechanism against foreign invaders, particularly infections.



• Allergens are substances that are foreign to the body and can cause an allergic reaction.



• IgE is the allergy antibody.



• Allergies can develop at any age.



• Your risk of developing allergies is related to your parents' allergy history.

Introduction

In this review you will learn how allergy relates to the immune system. You will begin understanding how and why certain people become allergic. The most common allergic diseases are discussed briefly in this article.

What does an allergy mean?

An allergy refers to an exaggerated reaction by our immune system in response to bodily contact with certain foreign substances. It is exaggerated because these foreign substances are usually seen by the body as harmless and no response occurs in non- allergic people. Allergic people's bodies recognize the foreign substance and one part of the immune system is turned on. Allergy-producing substances are called "allergens." Examples of allergens include pollens, dust mite, molds, danders, and foods. To understand the language of allergy it is important to remember that allergens are substances that are foreign to the body and can cause an allergic reaction in certain people.

When an allergen comes in contact with the body, it causes the immune system to develop an allergic reaction in persons who are allergic to it. When you inappropriately react to allergens that are normally harmless to other people, you are having an allergic reaction and can be referred to as allergic or atopic. Therefore, people who are prone to allergies are said to be allergic or "atopic."

Austrian pediatrician Clemens Pirquet (1874-1929) first used the term allergy. He referred to both immunity that was beneficial and to the harmful hypersensitivity as "allergy." The word allergy is derived from the Greek words "allos," meaning different or changed and "ergos," meaning work or action. Allergy roughly refers to an "altered reaction." The word allergy was first used in 1905 to describe the adverse reactions of children who were given repeated shots of horse serum to fight infection. The following year, the term allergy was proposed to explain this unexpected "changed reactivity."

Allergy Fact

• It is estimated that 50 million North Americans are affected by allergic conditions.
• The cost of allergies in the United States is more than $10 billion dollars yearly.
• Allergic rhinitis (nasal allergies) affects about 35 million Americans, 6 million of whom are children.
• Asthma affects 15 million Americans, 5 million of whom are children.
• The number of cases of asthma has doubled over the last 20 years.

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Acute Bronchitis

What is acute bronchitis?

Air is pulled into the lungs when we breathe, initially passing through the mouth, nose, and larynx (voicebox) into the trachea and continues en route to each lung via either the right or left bronchi (the bronchial tree - bronchi, bronchioles, and alveoli). Bronchi are formed as the lower part of the trachea divides into two tubes that lead to the lungs. As the bronchi get farther away from the trachea, each bronchial tube divides and gets smaller (resembling an inverted tree) to provide the air to lung tissue so that it can transfer oxygen to the blood stream and remove carbon dioxide (the waste product of metabolism).

Bronchitis describes inflammation of the bronchial tubes (inflammation = itis). The inflammation causes swelling of the lining of these breathing tubes, narrowing the tubes and promoting secretion of inflammatory fluid.

Acute bronchitis describes the inflammation of the bronchi usually caused by a viral infection, although bacteria and chemicals also may cause acute bronchitis. Bronchiolitis is a term that describes inflammation of the smaller bronchi referred to as bronchioles. In infants, this is usually caused by respiratory syncytial viruses (RSV), and affects the small bronchi and bronchioles more than the large. In adults, other viruses as well as some bacteria can cause bronchiolitis and often manifest as a persistent cough at times productive of small plugs of mucus.

Acute bronchitis is as mentioned above, is a cough that begins suddenly usually due to a viral infection involving the larger airways. Colds (also known as viral upper airway infections) often involve the throat (pharyngitis) and nasal passages, and at times the larynx (resulting in a diminished hoarse voice, also known as laryngitis). Symptoms can include a runny nose, nasal stuffiness, and sore throat. Croup usually occurs in infants and young children and involves the voice box and upper large airways (the trachea and large bronchi).

Chronic bronchitis for research purposes is defined as a daily cough with sputum production for at least three months, two years in a row. Chronic bronchitis is a diagnosis usually made based on clinical findings of a long term persistent cough usually associated with tobacco abuse. From a pathologic standpoint, characteristic microscopic findings involving inflammatory cells in seen in airway tissue samples make the diagnosis. When referring to pulmonary function testing, a decrease in the ratio of the volume of airflow at 1 second when compared to total airflow is less than 70%. This confirms the presence of obstructive airways disease of which chronic bronchitis is one type. Certain findings can be seen on imaging studies (chest X-ray, and CT or MRI of the lungs) to suggest the presence of chronic bronchitis; usually this involves an appearance of thickened tubes.

What causes acute bronchitis?

• Acute bronchitis occurs most often due to a viral infection that causes the inner lining of the bronchial tubes to become inflamed and undergo the changes that occur with any inflammation in the body. Common viruses include the rhinovirus, respiratory syncytial virus (RSV), and the influenza virus.
  
  
• Bacteria can also cause bronchitis (a few examples include, Mycoplasma, Pneumococcus, Klebsiella, Haemophilus).
  
  
• Chemical irritants (for example, tobacco smoke, gastric reflux, solvents) can cause acute bronchitis.

What are the risk factors for acute bronchitis?

Bronchitis describes inflammation of the bronchial tubes. Smoking is a key risk factor for developing acute bronchitis. Any other illnesses that predispose to similar inflammation also increase that risk (for example, asthma patients and patients allergic to airborne chemicals).

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What is influenza?

Influenza, commonly called "the flu," is an illness caused by RNA viruses that infect the respiratory tract of many animals, birds, and humans. In most people, the infection results in the person getting fever, cough, headache, and malaise (tired, no energy); some people also may develop a sore throat, nausea, vomiting, and diarrhea. The majority of individuals has symptoms for about one to two weeks and then recovers with no problems. However, compared with most other viral respiratory infections, such as the common cold, influenza (flu) infection can cause a more severe illness with a mortality rate (death rate) of about 0.1% of people who are infected with the virus.

The above is the usual situation for the yearly occurring "conventional" or "seasonal" flu strains. However, there are situations in which some flu outbreaks are severe. These severe outbreaks occur when the human population is exposed to a flu strain against which the population has little or no immunity because the virus has become altered in a significant way. Unusually severe worldwide outbreaks (pandemics) have occurred several times in the last hundred years since influenza virus was identified in 1933. By an examination of preserved tissue, the worst influenza pandemic (also termed the Spanish flu or Spanish influenza) occurred in 1918 when the virus caused between 40-100 million deaths worldwide, with a mortality rate estimated to range from 2%-20%.

In April 2009, a new influenza strain against which the world population has little or no immunity was isolated from humans in Mexico. It quickly spread throughout the world so fast that the WHO declared this new flu strain (termed novel H1N1 influenza A swine flu, often shortened to H1N1 or swine flu) as the cause of a pandemic on June 11, 2009. This was the first declared flu pandemic in 41 years. Fortunately, there was a worldwide response that included vaccine production, good hygiene practices (especially hand washing) were emphasized, and the virus (H1N1) caused far less morbidity and mortality than was expected and predicted. The WHO declared the pandemic's end on Aug. 10, 2010, because it no longer fit into the WHO's criteria for a pandemic.

Haemophilus influenzae is a bacterium that was incorrectly considered to cause the flu until the virus was demonstrated to be the correct cause in 1933. This bacterium can cause lung infections in infants and children, and it occasionally causes ear, eye, sinus, joint, and a few other infections, but it does not cause the flu.

What are the causes of the flu?

The flu (influenza) viruses

Influenza viruses cause the flu and are divided into three types, designated A, B, and C. Influenza types A and B are responsible for epidemics of respiratory illness that occur almost every winter and are often associated with increased rates of hospitalization and death. Influenza type C differs from types A and B in some important ways. Type C infection usually causes either a very mild respiratory illness or no symptoms at all; it does not cause epidemics and does not have the severe public-health impact of influenza types A and B. Efforts to control the impact of influenza are aimed at types A and B, and the remainder of this discussion will be devoted only to these two types.

Influenza viruses continually change over time, usually by mutation (change in the viral RNA). This constant changing often enables the virus to evade the immune system of the host (humans, birds, and other animals) so that the host is susceptible to changing influenza virus infections throughout life. This process works as follows: a host infected with influenza virus develops antibodies against that virus; as the virus changes, the "first" antibody no longer recognizes the "newer" virus and infection can occur because the host does not recognize the new flu virus as a problem until the infection is well under way. The first antibody developed may, in some instances, provide partial protection against infection with a new influenza virus. In 2009, almost all individuals had no antibodies that could recognize the novel H1N1 virus immediately.

Type A viruses are divided into types based on differences in two viral surface proteins called the hemagglutinin (H) and the neuraminidase (N). There are at least 16 known H subtypes and nine known N subtypes. These surface proteins can occur in many combinations. When spread by droplets or direct contact, the virus, if not killed by the host's immune system, replicates in the respiratory tract and damages host cells. In people who are immune compromised (for example, pregnant individuals, infants, cancer patients, asthma patients, people with pulmonary disease and many others), the virus can cause viral pneumonia or stress the individual's system to make them more susceptible to bacterial infections, especially bacterial pneumonia. Both pneumonia types, viral and bacterial, can cause severe disease and sometimes death.

Antigenic shift and drift

Influenza type A viruses undergo two kinds of changes. One is a series of mutations that occurs over time and causes a gradual evolution of the virus. This is called antigenic "drift." The other kind of change is an abrupt change in the hemagglutinin and/or the neuraminidase proteins. This is called antigenic "shift." In this case, a new subtype of the virus suddenly emerges. Type A viruses undergo both kinds of changes; influenza type B viruses change only by the more gradual process of antigenic drift and therefore do not cause pandemics.

A diagram that illustrates both antigenic shift and drift can be found at http://www.medicinenet.com/swine_flu/page5.htm and shows how both mechanisms can lead to antigenically diverse virus strains. The 2009 pandemic-causing H1N1 virus is a classic example of antigenic shift. The U.S. Centers for Disease Control and Prevention (CDC) has indicated that novel H1N1 swine flu has an RNA genome that contains five RNA strands derived from various swine flu strains, two RNA strands from bird flu strains, and only one RNA strand from human flu strains. They suggest mainly antigenic shifts over about 20 years have led to the development of novel H1N1 flu virus.

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Chikungunya

What does the "Chikungunya"?
Chikungunya comes from the Swahili language based on patient symptoms, which
means (body position) bend or curve (That the which contorts or bends up),
refers to the bent posture of patients due to severe joint pain
(Arthralgia).
Joint pain, according to safety data sheets (MSDS) Safety Office
Laboratory of Canada, mainly in the knees, ankles and
joints of the hands and feet.
Apart from cases of dengue fever are rampant in some parts of Indonesia, the community
Also troubled by the case of Chikungunya.
The cause of this disease is a type of virus, the alphaviruses and is transmitted through
mosquito Aedes aegypti. The same mosquitoes transmit dengue fever
dengue. Although still "brothers" with dengue fever, the disease is not
deadly.
The following questions and answers about the disease whose symptoms similar to dengue fever
This bloody.
Chikungunya disease spread by Aedes aegypti mosquitoes. Is this disease
also caused by dengue virus? So, what's the difference with DHF and how
differentiate?
Chikungunya disease is caused by a virus called chikungunya virus.
Chikungunya virus was signed in the family Togaviridae, genus alphaviruses.

History of Chikungunya in Indonesia
This disease came from mainland Africa and began to be found in Indonesia in
1973. Chikungunya fever was first reported in Samarinda, then spread
Kuala Tungkal, Martapura, Ternate, Yogyakarta extends further into
other regions.
In early 2001, outbreaks of Chikungunya fever occurred in Muara Enim, Sumatera
And South Aceh. Followed Bogor October. A year later, Chikungunya fever
outbreak again in Bekasi (West Java), Purworejo and Klaten (Central Java).
It is estimated that during 2001-2003 the number of chikungunya cases reached 3918.
and no deaths caused by this disease.
Symptoms of Chikungunya Patients
The main symptoms of Chikungunya disease is the body suddenly feels fever
followed by a shooting pain in the joints. In fact, because one of the typical symptoms
is the emergence of a sense of fatigue, aching, also arise in the bone-pain
bone, there is a name it as fever or flu bone bone.
The symptoms are similar to dengue virus infection with a slight difference
on certain things. The virus is transferred from one patient to another patient
through the mosquito, Aedes aegypti, among others.
The virus is transmitted by Aedes aegypti mosquitoes will breed in
the human body. The virus attacks all ages, both children and adults in the area
endemic. The patient will experience sudden high fever for five days,
so that the term is also known five-day fever.
In young children begins with sudden fever, skin redness. Red rashes
It appears after 3-5 days. The eyes are usually accompanied by red signs such as flu.
Febrile seizures are common child.
In older children, fever is usually followed by pain in muscles and joints,
and enlarged lymph nodes occurred. In adults, symptoms of pain

joints and muscles are very dominant and to cause temporary paralysis due to
pain when walking. Sometimes arise nausea to vomiting.
In general, the child's fever lasts for only three days with no or
encountered very little bleeding and shock.
The difference with dengue hemorrhagic fever, on Chikungunya no bleeding,
shock (shock) and death. With adequate rest, drug fever, compress,
and anticipation of febrile seizures, the disease usually resolves itself in
seven days.
Not Causing Death or Paralysis!
There are many assumptions in the community, that Chikungunya fever or flu
bone or bone fever as a dangerous disease, so make panic.
Not seldom did people believe that this disease can lead to
paralysis.
Indeed, while viruses multiply in the blood, the patient felt pain in
bones especially around the joints so as not dare move
member body. However, please note that this does not mean there
paralysis. Rather it is more than just the patient's reluctance to move
because the sense of pain in the joints.
The incubation period of Chikungunya fever two to four days. Manifestation of disease
lasts three to 10 days. These viruses include a self limiting disease alias
disappear by itself. However, the pain is still left behind in a matter of weeks
to months.
There is no vaccine or specific drug for Chikungunya. Self-lowering medication
heat and pain relievers that can be purchased at the shop. What is important enough
rest, drink and nutritious food. These viruses include a self limiting disease
aka disappear by itself. However, the pain will still be left behind
within weeks to months.
So, do not panic if there was a family member who suffers illness
This, as not to cause death. And pain in the joints that
not cause paralysis. The patient could move his body like
usual.
Doctors usually only give painkillers and fever or
class of drugs known as cold medicines and vitamins for the power amplifier
stamina. Some people say the disease can be overcome with
fresh fruit juice, is it true?
Highly recommended for people with eating nutritious food, enough carbohydrates and
mainly of protein and drink as much as possible. Expand consume fruits
fresh. We recommend that you drink fresh fruit juice. After the past five days, the fever will
gradually subsided, the sense of pain and pain in the joints and muscles is reduced,
and sufferers will recover as before.
Immune-enhancing vitamin is also useful to deal with this disease.
Besides vitamins, foods that contain enough protein and carbohydrates as well
increase endurance. Good endurance and adequate rest
can make sense of pain in the joints quickly disappear. Drink lots of water also
recommended to eliminate the symptoms of fever.
How do I avoid this disease?
How to avoid this disease is to eradicate mosquitoes carrying the virus.
Well .. turned out to have a habit of this mosquito unique.
First, They like to live and breed in stagnant water such as
bathtub, flower vases, as well as cans or bottles that hold water.
Second, black and white patterned Insects are also happy to live in the objects
hung like clothes in the back door of the room.
Third, this mosquito is like a dark and musty.
Given the spread of this disease is the mosquito Aedes aegypti is the best way
to break the chain of transmission is to eradicate mosquitoes, the
as is often suggested in the eradication of dengue fever.
Insecticides are used to eradicate this mosquito is of class
malathion, whereas themopos to kill larvae-jentiknya. Malathion is used
by fogging, not by spraying into walls. This is because
Aedes aegypti do not like to perch on the wall, but on the objects
hanging.

However, prevention is cheap and effective way to combat this mosquito is
by way of draining clean water reservoirs, bathtub, flower vases and
so, at least once a week, considering the growing mosquito
breed from egg to mature within a period of 7-10 days.
Home or the garden around the house must be clean of objects
lets hold water, especially during the rainy season like now.
Doors and windows should be opened every day from the morning until late afternoon,
for fresh air and sunlight to enter, resulting in air exchange
sound and lighting. Thus, creating an environment that is not ideal
for these mosquitoes.
Can someone stricken with this illness many times?
The good news, the disease is difficult to attack the same patient. Why, in
the patient's body will make antibodies that would make them immune to
outbreaks of this disease in the future. Thus, little possibility for
them to hit again. Selengkapnya...

Chikungunya atau Flu Tulang

Apa arti "Chikungunya"?
Chikungunya berasal dari bahasa Swahili berdasarkan gejala pada penderita, yang
berarti (posisi tubuh) meliuk atau melengkung (that which contorts or bends up),
mengacu pada postur penderita yang membungkuk akibat nyeri sendi hebat
(arthralgia).
Nyeri sendi ini menurut lembar data keselamatan (MSDS) Kantor Keamanan
Laboratorium Kanada, terutama terjadi pada lutut, pergelangan kaki serta
persendian tangan dan kaki.
Selain kasus demam berdarah yang merebak di sejumlah wilayah Indonesia, masyarakat
direpotkan pula dengan kasus Chikungunya.
Penyebab penyakit ini adalah sejenis virus, yaitu Alphavirus dan ditularkan lewat
nyamuk Aedes aegypti. Nyamuk yang sama juga menularkan penyakit demam berdarah
dengue. Meski masih "bersaudara" dengan demam berdarah, penyakit ini tidak
mematikan.
Berikut tanya jawab seputar penyakit yang gejalanya mirip dengan penyakit demam
berdarah ini.
Penyakit Chikungunya disebarkan oleh nyamuk Aedes aegypti. Apakah penyakit ini
juga disebabkan virus dengue? Lalu, apa bedanya dengan DBD dan bagaimana
membedakannya?
Penyakit chikungunya disebabkan oleh sejenis virus yang disebut virus chikungunya.
Virus Chikungunya ini masuk keluarga Togaviridae, genus alphavirus.

Sejarah Chikungunya di Indonesia
Penyakit ini berasal dari daratan Afrika dan mulai ditemukan di Indonesia tahun
1973. Demam Chikungunya dilaporkan pertama kali di Samarinda, kemudian berjangkit
di Kuala Tungkal, Martapura, Ternate, Yogyakarta selanjutnya berkembang ke
wilayah-wilayah lain.
Awal 2001, kejadian luar biasa demam Chikungunya terjadi di Muara Enim, Sumatera
Selatan dan Aceh. Disusul Bogor bulan Oktober. Setahun kemudian, demam Chikungunya
berjangkit lagi di Bekasi (Jawa Barat), Purworejo dan Klaten (Jawa Tengah).
Diperkirakan sepanjang tahun 2001-2003 jumlah kasus chikungunya mencapai 3.918.
dan tanpa kematian yang diakibatkan penyakit ini.
Gejala Penderita Chikungunya
Gejala utama terkena penyakit Chikungunya adalah tiba-tiba tubuh terasa demam
diikuti dengan linu di persendian. Bahkan, karena salah satu gejala yang khas
adalah timbulnya rasa pegal-pegal, ngilu, juga timbul rasa sakit pada tulang-
tulang, ada yang menamainya sebagai demam tulang atau flu tulang.
Gejala-gejalanya memang mirip dengan infeksi virus dengue dengan sedikit perbedaan
pada hal-hal tertentu. Virus ini dipindahkan dari satu penderita ke penderita lain
melalui nyamuk, antara lain Aedes aegypti.
Virus yang ditularkan oleh nyamuk Aedes aegypti ini akan berkembang biak di dalam
tubuh manusia. Virus menyerang semua usia, baik anak-anak maupun dewasa di daerah
endemis. Secara mendadak penderita akan mengalami demam tinggi selama lima hari,
sehingga dikenal pula istilah demam lima hari.
Pada anak kecil dimulai dengan demam mendadak, kulit kemerahan. Ruam-ruam merah
itu muncul setelah 3-5 hari. Mata biasanya merah disertai tanda-tanda seperti flu.
Sering dijumpai anak kejang demam.
Pada anak yang lebih besar, demam biasanya diikuti rasa sakit pada otot dan sendi,
serta terjadi pembesaran kelenjar getah bening. Pada orang dewasa, gejala nyeri

sendi dan otot sangat dominan dan sampai menimbulkan kelumpuhan sementara karena
rasa sakit bila berjalan. Kadang-kadang timbul rasa mual sampai muntah.
Pada umumnya demam pada anak hanya berlangsung selama tiga hari dengan tanpa atau
sedikit sekali dijumpai perdarahan maupun syok.
Bedanya dengan demam berdarah dengue, pada Chikungunya tidak ada perdarahan hebat,
renjatan (shock) maupun kematian. Dengan istirahat cukup, obat demam, kompres,
serta antisipasi terhadap kejang demam, penyakit ini biasanya sembuh sendiri dalam
tujuh hari.
Tidak Menyebabkan Kematian atau Kelumpuhan !
Masih banyak anggapan di kalangan masyarakat, bahwa demam Chikungunya atau flu
tulang atau demam tulang sebagai penyakit yang berbahaya, sehingga membuat panik.
Tidak jarang pula orang meyakini bahwa penyakit ini dapat mengakibatkan
kelumpuhan.
Memang, sewaktu virus berkembang biak di dalam darah, penderita merasa nyeri pada
tulang-tulangnya terutama di seputar persendian sehingga tidak berani menggerakkan
anggota tubuh. Namun, perlu diperhatikan bahwa hal ini bukan berarti terjadi
kelumpuhan. Melainkan lebih dari sekedar keengganan si penderita melakukan gerakan
karena rasa ngilu pada persendian.
Masa inkubasi dari demam Chikungunya dua sampai empat hari. Manifestasi penyakit
berlangsung tiga sampai 10 hari. Virus ini termasuk self limiting disease alias
hilang dengan sendirinya. Namun, rasa nyeri masih tertinggal dalam hitungan minggu
sampai bulan.
Tak ada vaksin maupun obat khusus untuk Chikungunya. Cukup minum obat penurun
panas dan penghilang rasa sakit yang bisa dibeli di warung. Yang penting cukup
istirahat, minum dan makanan bergizi. Virus ini termasuk self limiting disease
alias hilang dengan sendirinya. Walau demikian, rasa nyeri masih akan tertinggal
dalam hitungan minggu sampai bulan.
Jadi, jangan panic dulu apabila terdapat anggota keluarga yang menderita penyakit
ini, sebab tidak sampai menyebabkan kematian. Serta ngilu pada persendian itu
tidaklah menyebabkan kelumpuhan. Penderita bisa menggerakkan tubuhnya seperti
sedia kala.
Dokter biasanya hanya memberikan obat penghilang rasa sakit dan demam atau
golongan obat yang dikenal dengan obat-obat flu serta vitamin untuk penguat daya
tahan tubuh. Sebagian orang mengatakan penyakit ini bisa diatasi dengan
mengonsumsi jus buah segar, benarkah?
Bagi penderita sangat dianjurkan makan makanan yang bergizi, cukup karbohidrat dan
terutama protein serta minum sebanyak mungkin. Perbanyak mengkonsumsi buah-buahan
segar. Sebaiknya minum jus buah segar. Setelah lewat lima hari, demam akan
berangsur-angsur reda, rasa ngilu maupun nyeri pada persendian dan otot berkurang,
dan penderitanya akan sembuh seperti semula.
Vitamin peningkat daya tahan tubuh juga bermanfaat untuk menghadapi penyakit ini.
Selain vitamin, makanan yang mengandung cukup banyak protein dan karbohidrat juga
meningkatkan daya tahan tubuh. Daya tahan tubuh yang bagus dan istirahat cukup
bisa membuat rasa ngilu pada persendian cepat hilang. Minum banyak air putih juga
disarankan untuk menghilangkan gejala demam.
Bagaimana cara menghindari penyakit ini?
Cara menghindari penyakit ini adalah dengan membasmi nyamuk pembawa virusnya.
Nah.. ternyata nyamuk ini punya kebiasaan unik.
Pertama, Mereka senang hidup dan berkembang biak di genangan air bersih seperti
bak mandi, vas bunga, dan juga kaleng atau botol bekas yang menampung air bersih.
Kedua, Serangga bercorak hitam putih ini juga senang hidup di benda-benda yang
menggantung seperti baju-baju yang ada di belakang pintu kamar.
Ketiga, nyamuk ini sangat menyukai tempat yang gelap dan pengap.
Mengingat penyebar penyakit ini adalah nyamuk Aedes aegypti maka cara terbaik
untuk memutus rantai penularan adalah dengan memberantas nyamuk tersebut,
sebagaimana sering disarankan dalam pemberantasan penyakit demam berdarah dengue.
Insektisida yang digunakan untuk membasmi nyamuk ini adalah dari golongan
malation, sedangkan themopos untuk mematikan jentik-jentiknya. Malation dipakai
dengan cara pengasapan, bukan dengan menyemprotkan ke dinding. Hal ini karena
Aedes aegypti tidak suka hinggap di dinding, melainkan pada benda-benda yang
menggantung.

Namun, pencegahan yang murah dan efektif untuk memberantas nyamuk ini adalah
dengan cara menguras tempat penampungan air bersih, bak mandi, vas bunga dan
sebagainya, paling tidak seminggu sekali, mengingat nyamuk tersebut berkembang
biak dari telur sampai menjadi dewasa dalam kurun waktu 7-10 hari.
Halaman atau kebun di sekitar rumah harus bersih dari benda-benda yang
memungkinkan menampung air bersih, terutama pada musim hujan seperti sekarang.
Pintu dan jendela rumah sebaiknya dibuka setiap hari, mulai pagi hari sampai sore,
agar udara segar dan sinar matahari dapat masuk, sehingga terjadi pertukaran udara
dan pencahayaan yang sehat. Dengan demikian, tercipta lingkungan yang tidak ideal
bagi nyamuk tersebut.
Bisakah seseorang terserang penyakit ini berkali-kali?
Kabar baiknya, penyakit ini sulit menyerang penderita yang sama. Sebabnya, pada
tubuh penderita akan membentuk antibodi yang akan membuat mereka kebal terhadap
wabah penyakit ini di kemudian hari. Dengan demikian, kecil kemungkinan bagi
mereka untuk kena lagi.
(Edy Ramdan/berbagai sumber). Selengkapnya...