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Infections
Infections (Meningitis, Tuberculosis, Q Fever, Common Cold, Hepatitis) Infections (Meningitis, Tuberculosis, Q Fever, Common Cold, Hepatitis)

Infections (Meningitis, Tuberculosis, Q Fever, Common Cold, Hepatitis) Infectious organisms found in indoor air Meningitis Tuberculosis Q fever Common cold Hepatitis Antibiotics and infections Infectious Organisms Found in Indoor Air Infectious diseases caused by bacteria, fungi viruses, or other infectious agents which are distributed by various means from person to person (such as intimate contact, respiratory droplet dispersion while coughing or sneezing, or poor handwashing habits) or to people from other vectors, such as insects, animals, or other reservoirs can be found in indoor air. Examples of infectious diseases include colds, influenza, measles, tuberculosis, and chickenpox. An example of a building-related infectious disease is Legionnaires' disease, which is a kind of pneumonia. The infectious diseases that will be discussed here include: Meningitis Tuberculosis Q fever Common cold Hepatitis Meningitis Symptoms Meningitis is an inflammation of the meninges, which are the membranes that cover the brain and spinal cord. Infectious meningitis can be caused by either bacteria or viruses: Bacteria: Bacterial meningitis can be fatal if it is not immediately diagnosed and treated with antibiotics. With prompt treatment, the fatality rate from bacterial meningitis is less than 15 percent. Anyone can get bacterial meningitis, but most cases occur among infants and young children. Two-thirds of the reported cases of bacterial meningitis in the United States occur in children under the age of five. Viruses: Viral infection of the meninges is more common and usually is less severe than bacterial. Patients usually recover fully; there is no specific medical treatment. Again, young children are the most at risk. Bacterial meningitis is usually spread through close personal contact such as kissing or sharing a drinking glass. People are not likely to catch this disease in a work or school setting, even if one has contact with someone with the disease. However preschool age children are more at risk in a day care setting since young kids often engage in behaviors, such as chewing on the same toy, that might result in the exchange of saliva. Viral forms of meningitis are usually intestinal viruses spread by fecal contamination. This can happen if somebody does not wash their hands after using the bathroom or after diapering small children. Symptoms of Meningitis High fever Headache Fatigue Stiff neck Sensitivity to light There is a vaccination to protect children from some forms of bacterial meningitis. Tuberculosis (TB) High Risk Symptoms Tuberculosis is an infectious disease caused by a bacterium called Mycobacterium tuberculosis. This germ primarily affects the lungs and may infect anyone at any age. TB bacteria infect two billion people worldwide and are very infectious. Every year two million people die of TB.¹ It can be spread from person to person by an infectious person sneezing, singing, or talking. TB is spread from person to person by bacteria attached to tiny particles in the air. However, TB is not as easy to catch as measles or the flu, which can be spread by one brief contact. Because of this method of transmission, TB is more commonly transmitted in crowded conditions such as: Correctional facilities. Homeless shelters. Drug and alcohol treatment facilities. Healthcare facilities. Military facilities: One of the most studied examples of the spread of tuberculosis occurred in 1965 aboard a US naval vessel when seven crewmembers developed tuberculosis that was spread via the ship's ventilation system.² Tuberculosis is a disease that was steadily declining in the United States, due to improvements in nutrition, hygiene, and medical care. Nevertheless, the number of people with TB began rising in 1986. TB has continued to rise ever since with about 26,000 new cases of active TB each year. It is thought that the increase in TB infection can be attributed to several factors such as: A decline in public funding for tuberculosis control programs in the 1970s and 1980s Immigration of persons with active infections More than a decade of homelessness, drug abuse and AIDS has left a large population whose immune systems are unable to fight off the TB germs Crowding Inadequate ventilation Inhaling the TB germ and becoming infected with TB does not usually mean you will develop active disease. A person's natural body defenses (the immune system) are usually able to control the infection so that it does not cause disease. Even though about one out of three people in the world (including about 10 million Americans) are infected with the TB germ, only about 10 percent of those infected will actually develop TB in their lifetimes. Most may not even know they are infected. The only way to know is to have a skin test done. This test involves injecting a small amount of liquid containing protein from the tubercle bacterium into your skin; TB cannot be transmitted to you through this test. The test is usually done on the forearm. You must return two to three days later to have this test interpreted by a healthcare provider, who will carefully measure any hardness and swelling. It is critical that skin tests be administered, read, and recorded correctly. If your test is positive, then you must follow-up with an x-ray. Once you have had a positive skin test, no further stain tests will provide further information. Instead, chest x-rays become the primary screening method for activation of the disease. Being infected with TB means the germs are in your body. However, if your immune system is able to contain the bacteria, you will not be sick or contagious. However, even a healthy immune system cannot kill all the bacteria; some will survive. Therefore, once you become infected, you always remain at risk for developing TB disease. People who have been recently infected will benefit from preventive treatment with medication, even though the TB is not active, to reduce the risk of becoming sick later in their lives. There are many factors associated with risk for developing active disease. This risk is highest for: Those in the first two years following the initial infection Those with a weakened immune system such as: HIV infection Certain kinds of cancer; for example, leukemia, lymphoma Prolonged therapy with steroid drugs or other drugs that suppress the immune system Those with silicosis of the lungs Those with severe kidney disease, especially those requiring dialysis Those who have suffered rapid weight loss or chronic malnutrition Diabetics requiring treatment with insulin Alcoholics or intravenous drug users Having active TB disease means the germs are multiplying, causing damage to your body and making you contagious to others. In active TB, the bacteria grow rapidly, most commonly in the lung, destroying tissue and causing illness. The amount of damage may be quite extensive, yet the symptoms may be minimal. Symptoms of TB Fever Night sweats Cough Loss of appetite Weight loss (unexplained) Blood in the sputum (phlegm) Loss of energy Tuberculosis can often be treated very effectively through a combination of drugs. Most people with TB disease can be treated by therapy with several drugs (usually including four drugs: INH, rifampin, ethambutol and pyrazinamide) for six months, then two drugs (INH and rifampin) for three additional months. It is important to follow the physician's directions and take the drugs exactly as recommended. If you forget to take your pills or if you take only one of them, the tuberculosis germs might become resistant to the drugs and start growing again. Drug resistance means that a drug does not work anymore in fighting TB. Drug-resistant TB can infect somebody else. When the TB germ is resistant to two or more of these drugs, treatment is very difficult, and the risk of dying from the disease is much higher. The best way to prevent drug resistant TB is to make sure that everyone who is diagnosed with TB disease takes all of their medicine for as long as necessary, and that they closely follow-up with their doctor. There is a vaccine for tuberculosis called the BCG vaccine, but it is only 50 percent effective. It was first developed between 1906 and 1919 from weakened Mycobacterium bovis bacilli, which infect cattle. More then three billion doses of the vaccine have been given to people worldwide. However a new and improved vaccine against tuberculosis might be ready for testing in people as early as 2001 according to researchers.¹ Q fever Health problems Q fever is an infectious disease that spreads from animals to humans. Q fever is caused by a bacterium called Coxiella burnetii. This microbe can survive for months and even years in dust or soil. Animals such as cattle, sheep, and goats can carry Q fever bacteria. Infected animals release the bacteria in milk and manure. People can be infected by breathing the Q fever germ that easily becomes airborne with dust from infected soil or manure or by drinking infected milk. Most infections are spread through the air. Many people do not realize they have been infected or they confuse the symptoms with those of the flu. Some of the health problems that may be seen with Q fever include: Sudden onset of high fever Chills and sweating General feeling of sickness and loss of appetite Possible liver disease (hepatitis) Possible heart disease (endocarditis or inflammation of the inside lining of the heart) Slight, dry cough because of a lung inflammation known as pneumonitis Most symptoms disappear after 7 to 10 days. However, people with Q fever may still feel under the weather and not hungry for several weeks. Antibiotics are usually prescribed to treat Q fever. Recovery usually begins shortly after treatment is started. The Common Cold Health Effects The common cold is an infection of the upper respiratory tract?the nose, and the throat. More than 200 viruses can cause colds. The kinds of viruses that cause most common colds in adults are called rhinoviruses. There are more than one hundred kinds of rhinoviruses. Despite the fact that very few of us escape from at least a couple of common cold infections each year, common cold viruses are not very contagious. Close personal contact for a period of time is usually needed for cold viruses to spread. Then the viruses must get into the nose where they can infect the nasal membranes. Even though the best chance of getting a cold is breathing in the infected droplets when somebody with a cold talks or sneezes, cold viruses can live outside of the body for up to several hours. This means that you could catch a cold if you picked up something contaminated with a cold virus and then rubbed your nose or eyes. In the US, there are nearly 62 million cases of common cold every year resulting in approximately 58 million sick days. Symptoms usually show up about two days after a person becomes infected and may persist for up to 14 days. Health effects from a cold may include: A sore, scratchy throat Sneezing A runny nose Headache Stuffy, congested nose and sinuses Watering eyes Hacking cough Chills General malaise (overall ill-feeling) Laryngitis (inflammation of the "voice box" making it painful to talk) Tracheitis (inflammation of the lining of the "wind pipe") Bronchitis (inflammation of the airways inside the lung) Sinusitis (inflammation of the linings of the sinuses) There is no cure for the common cold, but there are things you can do to cut down on your chances of getting or passing on a cold: Keep your immune system strong by getting enough sleep and eating a healthy diet Cover your mouth if you cough or sneeze Throw away dirty tissues when you are through with them Wash your hands frequently Hepatitis Health Effects Hepatitis is a serious and sometimes life-threatening inflammation of the liver caused by a virus. There are at least five different kinds of viral hepatitis (A, B, C, D, and E), none of which is spread through the air. Hepatitis A is usually spread from one person to another through contaminated feces. One way this happens is by eating something contaminated with infectious feces. Examples of this happening would be if somebody did not wash their hands after using the restroom, after diapering a baby, or helping young children with their potty training; eating with contaminated eating utensils; or eating contaminated seafood caught from lakes, streams, or rivers containing raw sewage. Hepatitis B and C are spread by exposure to contaminated blood and possibly bodily fluids. People cannot catch Hepatitis from casual contact in an office or school. It is possible for infected people to spread the virus for as long as two weeks before symptoms appear. The disease can last from one to two weeks to several months. Health Effects Associated with Hepatitis Mild fever Fatigue Loss of appetite Nausea/vomiting Muscle/joint pain Abdominal pain Dark urine Yellowing of the skin and eyeballs (jaundice) Most people recover completely from hepatitis. There are usually no long-term health effects from Hepatitis A, but about 10 percent of people with Hepatitis B and 50 percent of people with Hepatitis C will develop chronic liver disease, which can result in cirrhosis, which is a life threatening scarring of the liver. Those people who have chronic, or long-term, Hepatitis B or C are also at a greater risk of developing liver cancer. About one percent of people with Hepatitis B die from it. Hepatitis C causes about 8,000 to 10,000 deaths per year in the US Symptoms of acute (short-term) hepatitis generally disappear within several months. About 15 percent to 25 percent of people infected with Hepatitis C completely eliminate the virus from their bodies during this time. The other 75 percent to 85 percent continue to carry the virus in the blood even if their symptoms disappear. This is called "chronic Hepatitis C infection." Chronic cases of Hepatitis C may cause only mild symptoms; but 10 percent to 20 percent of these chronic patients develop cirrhosis of the liver within 30 years, and one percent to five percent develops liver cancer. Antibiotics and Infections Bacterial infections may be treated with antibiotics. Physicians base antibiotic selections upon several factors, including the likelihood of various bacteria causing the patient's illness, known bacterial sensitivity patterns, and bacterial culture results from tests on infected material from the patient. If your doctor prescribes an antibiotic, it is important to follow these steps: DO take the ENTIRE prescribed antibiotic unless another antibiotic is prescribed by your doctor. DO NOT stop taking the antibiotic when you begin feeling better DO NOT share antibiotics with other family members DO NOT "save" antibiotics for a time when you might get sick again. DO NOT flush unused antibiotics down the toilet. They can get into the water system and kill off "good" bacteria, which help break down waste, and sensitize "bad" bacteria so that they may become resistant to that antibiotic. The reason for doing these things is that even though you may be feeling better, some of the infection may still be in your body. If there is not enough antibiotic to completely knock out the infection, the bacterial organisms can learn to adapt to the low levels of antibiotic until they become resistant to it. These drug-resistant organisms become difficult to treat and can be transmitted to other people. Today many bacteria are becoming resistant to antibiotics and at a faster pace than pharmaceutical science can develop new antibiotics. Bacterial resistance could be even more of a problem in the future. Because of the threat of drug-resistant organisms, it is also important that you see your doctor again if you are running out of an antibiotic and you still have an infection. You may need to take the antibiotic longer or you may need another antibiotic altogether. This is especially true of infections in hard to reach places like sinuses and bones. References Reuters. Vaccine may work against tuberculosis. November 30, 2000. Houk VN, Baker JH, Sorensen K, Dent DC. The epidemiology of tuberculosis infection in a closed environment. Archives of Environmental Health. 1968;16(1):26-35.