Public Health

Sick person imageWhether you are trying to avoid the seasonal flu or more serious diseases, practicing good hygiene and following simple precautions can help keep you and your family healthy. After all, contagious diseases such as colds, the flu, whooping cough, bacterial meningitis, mumps, measles, rubella, smallpox or chicken pox, can be spread by coughs, sneezes, handshakes or just touching surfaces that are contaminated with tiny droplets from a person’s nose or mouth.

Follow these guidelines to limit the spread of germs and prevent infection:

  • Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
  • If possible, stay home from work, school and errands when sick. This will help prevent others from catching your illness.
  • Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
  • Wash hands often to help protect you from germs.
  • Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose or mouth.
  • Practice other good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.
  • Follow your doctor’s guidance on vaccinations.

Influenza (Flu)

There are several types of influenza that can affect both humans and animals such as birds and poultry. You can prepare for an influenza long before there is any outbreak. Knowing both the magnitude of what can happen during a pandemic outbreak and what actions you can take can help lessen the impact of an influenza on you and your family.

Use this information and resources to prepare for a flu pandemic.pandemic

  • Store a two week supply of water and food. During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand.
  • Periodically check your regular prescription drugs to ensure a continuous supply in your home.
  • Have nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
  • Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.
  • Volunteer with local groups to prepare and assist with emergency response.
  • Get involved in your community as it works to prepare for an influenza pandemic.

Seasonal Flu

Influenza is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions are at high risk for serious flu complications. The best way to prevent the flu is by getting vaccinated each year.

High Risk Includes:

  • Children younger than 5, but especially children younger than 2 years old
  • Adults 65 years of age and older
  • Pregnant women (and women up to 2 weeks post partum)
  • Residents of nursing homes and other long-term care facilities

People with medical conditions such as asthma, chronic lung disease, heart disease, blood disorder, and weakened immune systems are also at a higher risk for contracting influenza.  

Avian Flu

Avian influenza refers to the disease caused by infection with avian (bird) influenza (flu) Type A viruses. These viruses occur naturally among wild aquatic birds worldwide and can infect domestic poultry and other bird and animal species. Avian flu viruses do not normally infect humans. However, sporadic human infections with avian flu viruses have occurred.

Symptoms can vary from conjunctivitis to influenza-like illness, severe respiratory illness, pneumonia, multi-organ disease, and in the most severe cases death. Treatment for avian flu in humans uses prescribed medications administered by a physician.

Avian influenza refers to the disease caused by infection with avian (bird) influenza (flu) Type A viruses. These viruses occur naturally among wild aquatic birds worldwide and can infect domestic poultry and other bird and animal species. Avian flu viruses do not normally infect humans. However, sporadic human infections with avian flu viruses have occurred.

Swine Flu

Swine influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that regularly cause outbreaks of influenza in pigs. Influenza viruses that commonly circulate in swine are called “swine influenza viruses” or “swine flu viruses.” Like human influenza viruses, there are different subtypes and strains of swine influenza viruses.

Swine flu viruses do not normally infect humans. However, sporadic human infections with swine influenza viruses have occurred.

Small Pox

Smallpox is a virus that can be caught through direct contact with an infected person. In a terrorist attack, exposure to smallpox could occur by breathing a sprayed airborne virus. Generally, direct and fairly prolonged face-to-face contact is required to spread smallpox from one person to another. Animals and insects do not carry or spread the smallpox virus. A person who has been exposed to smallpox becomes contagious after a rash appears and remains contagious until the last smallpox scab falls off.

Exposure to smallpox is followed by an incubation period during which people do not have any symptoms and may feel fine. This incubation period averages about 12 to 14 days, but can range from seven to 17 days. During this time, people are not contagious. The first symptoms of smallpox include fever, malaise, head and body aches and sometimes vomiting. The fever is usually high, in the range of 101 to 104 degrees. At this time, people are usually too sick to carry on their normal activities. This phase may last for two to four days. A rash emerges first as small red spots on the tongue and in the mouth. These spots develop into sores that break open and spread large amounts of the virus into the mouth and throat. At this time, the person is the most contagious.

Within 24 hours, a rash appears on the skin, starting on the face and then spreading to the arms and legs and then to the hands and feet. Usually the rash spreads to all parts of the body within 24 hours. As the rash appears, the fever usually falls and the person may start to feel better.

By the third day, the rash becomes raised bumps.

By the fourth day, the bumps fill with a thick, opaque fluid and often have a depression in the center that looks like a belly-button. (This is a major distinguishing characteristic of smallpox.) Fever often will rise again at this time and remain high until scabs form over the bumps.

Days 5-10, the bumps become “pustules” — sharply raised, usually round and firm to the touch. They feel like there’s a small round object under the skin. People often say it feels like there is a BB pellet embedded under the skin.

Days 11-14, the pustules begin to form a crust and then scab. By day 14, most of the sores have scabbed over.

Days 15 – 21, the scabs begin to fall off, leaving marks on the skin that eventually become pitted scars. The person is contagious to others until all of the scabs have fallen off. Most scabs will fall off after three weeks.

After the 21st day, scabs have fallen off. Person is no longer contagious. Humans are the only natural hosts of smallpox which is caused by the variola virus that emerged in human populations thousands of years ago. Except for laboratory stockpiles, the virus has been eliminated as a disease.

Meningitis

Meningitis is a disease caused by the inflammation of the protective membranes covering the brain and spinal cord known as meninges. The inflammation is usually caused by an infection of the fluid surrounding the brain and spinal cord.

Meningitis may develop in response to a number of causes, usually bacteria or viruses, but meningitis can also be caused by physical injury, cancer or certain drugs.The severity of illness and the treatment for meningitis differ depending on the cause. Thus, it is important to know the specific cause of meningitis.

There are several types of meningitis: Bacterial, Viral, Fungal, Parasitic, and Non-Infectious. Fungal Meningitis is caused by fungi and is usually acquired by inhaling fungal spores from the environment. People with certain medical conditions like diabetes, cancer, or HIV are at a higher risk of fungal meningitis. Parasitic Meningitis is caused by parasites and is less common in developed countries. Non-Infectious Meningitis is caused by cancers, systemic lupus erythematosus (lupus), certain drugs, head injury, and brain surgery. Bacterial and Viral Meningitis are both contagious. Read more about each type below.

Bacterial Meningitis

Bacterial meningitis is usually severe. While most people with meningitis recover, it can cause serious complications, such as brain damage, hearing loss, or learning disabilities.

Risk Factors
Factors that can increase your risk of bacterial meningitis include:

  • Age
    • Infants are at higher risk for bacterial meningitis than people in other age groups. However, people of any age are at risk. See the table above for which pathogens more commonly affect which age groups.
  • Community setting
    • Infectious diseases tend to spread more quickly where larger groups of people gather together. College freshmen living in residence halls and military personnel are at increased risk for meningococcal meningitis (caused by Neisseria meningitidis).
  • Certain medical conditions
    • There are certain diseases, medications, and surgical procedures that may weaken the immune system or increase risk of meningitis in other ways.
  • Working with meningitis-causing pathogens
    • Microbiologists who are routinely exposed to meningitis-causing pathogens are at increased risk.
  • Travel
    • Travelers to the meningitis belt in sub-Saharan Africa may be at risk for meningococcal meningitis, particularly during the dry season. Also at risk for meningococcal meningitis are travelers to Mecca during the annual Hajj and Umrah pilgrimage.

The germs that cause bacterial meningitis can be contagious. Some bacteria can spread through the exchange (e.g., by kissing) of respiratory and throat secretions (e.g., saliva or mucus). Fortunately, most of the bacteria that cause meningitis are not as contagious as viruses that cause the common cold or the flu. Also, the bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been. Other meningitis-causing bacteria are not spread person-to-person, but can cause disease because the person has certain risk factors (such as a weak immune system or head trauma). Unlike other bacterial causes of meningitis, you can get Listeria monocytogenes by eating contaminated food.

Signs and Symptoms

Meningitis infection may show up in a person by a sudden onset of fever, headache, and stiff neck. It will often have other symptoms, such as

  • Nausea,
  • Vomiting,
  • Increased sensitivity to light (photophobia), and
  • Altered mental status (confusion).

The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3-7 days after exposure.

Babies younger than 1 month old are at a higher risk for severe infections, like meningitis, than older children. In newborns and infants, the classic meningitis symptoms of fever, headache, and neck stiffness may be absent or difficult to notice. The infant may appear to be slow or inactive (lack of alertness), irritable, vomiting or feeding poorly. In young infants, doctors may look for a bulging fontanelle (soft spot on infant’s head) or abnormal reflexes, which can also be signs of meningitis. If you think your infant has any of these symptoms, call the doctor or clinic right away.

Later symptoms of bacterial meningitis can be very severe (e.g., seizures, coma). For this reason, anyone who thinks they may have meningitis should see a doctor as soon as possible.

Treatment

Bacterial meningitis can be treated effectively with antibiotics. It is important that treatment be started as soon as possible. Appropriate antibiotic treatment of the most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk remains higher among young infants and the elderly.

Viral Meningitis

Meningitis is an inflammation of the tissue that covers the brain and spinal cord. Viral meningitis is the most common type of meningitis. It is often less severe than bacterial meningitis, and most people usually get better on their own (without treatment). However, infants younger than 1 month old and people with weakened immune systems are more likely to have severe illness.

Causes

Non-polio enteroviruses are the most common cause of viral meningitis in the United States, especially from summer to fall when these viruses spread most often. However, only a small number of people who get infected with enteroviruses will actually develop meningitis.

Other viruses that can cause meningitis are

  • Mumps Virus
  • Herpesviruses, including , herpes simplex viruses, and varicella-zoster virus (which causes chickenpox and shingles)
  • Measles Virus
  • Influenza Virus
  • Arboviruses, such as West Nile virus
  • Lymphocytic choriomeningitis virus

People at Risk

You can get viral meningitis at any age. However, some people have a higher risk of getting the disease, including

  • children younger than five years old, and
  • people with weakened immune systems caused by diseases, medications (such as chemotherapy), and recent organ or bone marrow transplantations.

Infants younger than 1 month old and people with weakened immune systems are more likely to have severe illness.

Transmission

If you have close contact with a person who has viral meningitis, you may become infected with the virus that made that person sick. However, you are not likely to develop meningitis as a complication of the illness.

Symptoms

Common symptoms in infants:

  • Fever
  • Irritability
  • Poor eating
  • Sleepiness or trouble waking up from sleep
  • Lethargy (a lack of energy)

Common symptoms in adults:

  • Fever
  • Headache
  • Stiff neck
  • Sensitivity to bright light
  • Sleepiness or trouble waking up from sleep
  • Nausea
  • Vomiting
  • Lack of appetite
  • Lethargy (a lack of energy)

Most people with viral meningitis usually get better on their own within 7 to 10 days.

Initial symptoms of viral meningitis are similar to those for. However, bacterial meningitis is usually severe and can cause serious complications, such as brain damage, hearing loss, or learning disabilities. It is very important to see a healthcare provider right away if you think you or your child might have meningitis; a doctor can determine if you have the disease, the type of meningitis, and the best treatment.

Treatment

In most cases, there is no specific treatment for viral meningitis. Most people who get viral meningitis completely recover on their own within 7 to 10 days. However, people with meningitis caused by certain viruses such as herpesvirus and influenza, may benefit from treatment with an antiviral medication.

Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. However, antibiotics are very important when treating bacterial meningitis.

Infants and people with weakened immune systems who develop severe illness may need to be hospitalized.