Saturday, April 28, 2007

What is whooping cough?

http://www.medicinenet.com/pertussis/article.htm
Whooping cough (pertussis) is an acute, highly contagious respiratory infection that is caused by a bacterium. The first outbreaks of pertussis were described in the 16th century. The bacterium responsible for the infection, Bordetella pertussis, was not isolated until 1906. Each year, 5,000-7,000 cases of whooping cough (pertussis) are recorded each year in the United States. The incidence of pertussis has been steadily increasing since the 1980’s.
Whooping cough (pertussis) commonly affects infants and young children but can be prevented with immunization with pertussis vaccine. Pertussis vaccine is most commonly given in combination with the vaccines for diphtheria and tetanus in the vaccine known as “DPT.” (Pertussis is the "P" in the DPT vaccine.) Immunity from the DPT vaccine wears off, so many teenagers and adults get whooping cough (pertussis).
Treatment of whooping cough is supportive, meaning that treatment is directed at the symptoms, e.g., cough; however, young infants often need hospitalization if the coughing becomes severe.
What are the stages and symptoms of whooping cough?
The first stage of whooping cough is known as the catarrhal stage. In the catarrhal stage, which typically lasts from one to two weeks, an infected person has symptoms characteristic of an upper respiratory infection, including;
runny nose
sneezing
low-grade fever
mild, occasional cough, similar to the common cold
The cough gradually becomes more severe, and after one to two weeks, the second stage begins. It is during the second stage (the paroxysmal stage) that the diagnosis of whooping cough usually is suspected. The second stage is characterized by:
Bursts (paroxysms) of coughing, or numerous rapid coughs, apparently due to difficulty expelling thick mucus from the airways in the lungs. Bursts of coughing increase in frequency during the first one to two weeks, remain constant for two to three weeks, and then gradually begin to decrease in frequency.
At the end of the bursts of rapid coughs, a long inspiratory effort (breathing in) is usually accompanied by a characteristic high-pitched “whoop”.
During an attack, the individual may become cyanotic (turn blue) from lack of oxygen..
Children and young infants appear especially ill and distressed.
Vomiting (referred to by doctors as posttussive vomiting) and exhaustion commonly follow the episodes of coughing.
The person usually appears normal between episodes.
Paroxysmal attacks occur more frequently at night, with an average of 15-24 attacks per 24 hours.
The paroxysmal stage usually lasts from one to six weeks but may persist for up to ten weeks.
Infants under six months of age may not have the strength to have a whoop, but they do have paroxysms of coughing.
The third stage of whooping cough is the recovery, or convalescent stage. In the convalescent stage, recovery is gradual. The cough becomes less paroxysmal and usually disappears over two to three weeks; however, paroxysms often recur with subsequent respiratory infections for many months.

Can adults get whooping cough?
Although whooping cough is considered to be an illness of childhood, adults may also develop the disease. The illness usually is milder in adults than in children, but the duration of the paroxysmal cough is just as long as in children. The characteristic “whoop” that occurs after paroxysmal bouts of coughing is recognized in only 20-40% of adults with whooping cough. Immunity from the pertussis vaccine decreases over time but does not necessarily disappear, Adults who do become infected may have retained a partial degree of immunity against the infection, and this can result in a milder illness. Whooping cough in adults is more common than usually appreciated, accounting for up to 7% of adult illnesses that cause coughing each year. Infected adults are a reservoir (source) of infection for children.
How is whooping cough diagnosed?
When a patient has the typical symptoms of whooping cough, the diagnosis can be made from the clinical history. However, the disease and its symptoms, including its severity, can vary among affected individuals. In cases where the diagnosis is not certain or a doctor wants to confirm the diagnosis, laboratory tests can be carried out. Culture of the bacterium Bordetella pertussis from nasal secretions can establish the diagnosis. Another test that has been used to successfully identify the bacterium and diagnose pertussis is the polymerase chain reaction (PCR) test that can identify genetic material from the bacterium in nasal secretions.
How is whooping cough treated?
Antibiotics directed against Bordetella pertussis can be effective in reducing the severity of pertussis when administered early in the course of the disease. Antibiotic therapy can also help reduce the risk of transmission of the bacterium to other household members as well as to others who may come into contact with an infected person. Unfortunately, most people with pertussis are diagnosed later with the condition in the second (paroxysmal) stage of the disease. Treatment with antibiotics is recommended for anyone who has had the disease for less than 21 days. It is unclear whether antibiotics have any benefit for persons who have been ill with pertussis for longer periods, although antibiotic therapy is still often considered for this group. There is no proven effective treatment for the paroxysms of coughing that accompany pertussis.

Complications of whooping cough (pertussis)
Young infants are at highest risk for whooping cough (pertussis) and for pertussis-associated complications. The most common complication and the cause of most pertussis-related deaths, is secondary bacterial pneumonia. (Secondary bacterial pneumonia is bacterial pneumonia that follows another infection of the lung, be it viral or bacterial. Secondary pneumonia is caused by a different virus or bacterium than the original infection.) Data from 1997-2000 indicate that secondary pneumonia occurred among 5.2% of all reported pertussis cases, and among 11.8% of infants less than six months of age. Pertussis can cause death in young children; 13 children died from the infection in 2003. Most of the pertussis-related deaths have occurred in children who have not been vaccinated or who are too young to have received the vaccine.
Other possible complications of pertussis include seizures, encephalopathy (abnormal function of the brain due to decreased oxygen delivery to the brain), reactive airway disease (asthma), and malnutrition.
Addendum: Whooping cough on the rise in California
The California Health Department announced in the fall of 2005 that the number of people developing whooping cough is increasing in California. For the first eight months of the year, the number of cases reported in California (1,276) was almost triple the number of cases reported during the same period in 2004 (450). The number of deaths and illnesses from whooping cough reported through August, 2005, had already surpassed the totals for the entire year of 2004. Other areas of the United States are experiencing the same trend.
For immunization information on pertussis for children, adolescents, and adults, please visit the following areas:
Immunizations (Vaccination) for Adolescents and Adults
Immunizations (Vaccinations) for Infants and Children

Thursday, April 26, 2007

Pneumococcal pneumonia

From www.edcp.org/factsheets/pneumo.html
Pneumococcal pneumonia and pneumococcal disease are caused by a bacterium
The bacterium is called Streptococcus pneumoniae (“pneumococci”). Pneumococci can cause ear infections and severe infections of the lungs (pneumonia), blood (bacteremia), and covering of the brain and spinal cord (meningitis). Increases in cases of pneumococcal pneumonia may occur during outbreaks of influenza.
Pneumococcal disease can be very serious. Infants, young children, persons 65 and older, and persons with underlying disease are at increased risk of getting pneumococcal disease
Persons are more likely to get very sick or die from pneumococcal disease if they have problems such as alcoholism, heart or lung disease, kidney failure, diabetes, cancer, weakness of the immune system, or sickle cell disease. Older persons as a group are more likely to die from pneumococcal disease. The high risk of death occurs despite treatment.
Antibiotics are used to treat pneumococcal disease
Two types of vaccine are available to prevent pneumococcal disease
One type of pneumococcal vaccine is recommended for all persons aged 65 and older, and for persons of any age (over 2 years old) who have heart or lung disease, kidney failure, diabetes, alcoholism, cirrhosis, sickle cell disease, and for Alaskan natives and certain American Indian groups. This vaccine is also recommended for those with a weakened immune system or who are taking drugs that weaken the immune system (including persons with cancer, organ transplant, infection with human immunodeficiency virus [HIV or AIDS], or who have had their spleen removed). This vaccine needs to be given only once initially, but it can be repeated in 5 years for those at highest risk.
A second type of pneumococcal vaccine has recently been licensed for use in infants and young children (called the “conjugate pneumococcal vaccine”). This vaccine is recommended for all children less than 2 years old. Additionally, the vaccine is recommended for certain children between 2 and 5 years old, including those who have sickle cell disease; chronic heart or lung disease; kidney failure; diabetes; or weakened immune systems (such as patients who have cancer, organ transplant, take steroids for a long time, or have HIV infection or AIDS). The vaccine can also be given to any child between 2 and 5 years old, children who attend group daycare, or children who are African-American, Alaskan Native, or American Indian. This vaccine may need to be given between 1 to 4 times depending on how old the child is. You should talk to your doctor to find out if your child should receive this vaccine.

Sunday, December 10, 2006

A day @ the Zoo




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Sunday, July 09, 2006

more info on Hand Foot mouth disease

http://www.nlm.nih.gov/medlineplus/ency/article/000965.htm

Coxsackievirus infection
Definition Return to top

Hand-foot-mouth disease is a viral infection that usually begins in the throat. It is caused by the Coxsackievirus.

Causes, incidence, and risk factors Return to top

Hand-foot-and-mouth disease is caused by the Coxsackie virus (a member of the Enterovirus family). The throat and tonsils develop small ulcers while the hands, feet, and diaper area are affected by a rash with characteristic vesicles (very small blisters). This is usually a mild illness with the rash healing in 5 to 7 days.

The actual incidence is unknown, but hand-foot-and-mouth disease is a relatively common infection. Another coxsackie virus infection with a high incidence and related features is herpangina. This is characterized by painful ulcers in the mouth and throat, but does not show a rash on the hands, feet or buttocks.

The most important risk factor is age. The infection affects young children, but can be seen in adolescents and occasionally adults. The outbreaks occur most often in the summer and fall.

Symptoms Return to top

Fever.
Sore throat.
Ulcers in the throat, mouth and tongue.
Headache.
A rash with vesicles on hands, feet, and diaper area. The vesicles are typically on the palm side of the hands, the sole side of the feet, and are very characteristic in appearance. The vesicles are also tender or painful if pressed.
Loss of appetite.
Signs and tests Return to top

A history of recent illness and a physical examination, demonstrating the characteristic vesicles on the hands and feet, are usually sufficient to diagnose the disease.

Treatment Return to top

There is no specific treatment for the infection other than relief of symptoms.

Treatment with antibiotics is not effective, and is not indicated. Acetaminophen or Ibuprofen can be used to treat fever. Aspirin should not be used in viral illnesses in children under age 12 years.

Salt water mouth rinses (1/2 teaspoon of salt to 1 glass of warm water) may be soothing if the child is able to rinse without swallowing. Ensure an adequate fluid intake because swallowing may be painful. Extra fluid is needed when a fever is present. The best fluids are cold milk products, especially ice cream. Many children refuse juices and sodas, for example, because their acidity causes burning pain in the ulcers.

Expectations (prognosis) Return to top

Generally, complete recovery occurs in 5 to 7 days.

Complications Return to top

Dehydration can occur because the mouth lesions can cause pain with swallowing.
Possible febrile seizures.
Calling your health care provider Return to top

Apply home treatment and call the health care provider if there are signs of complications, such as pain in neck or arms and legs. Other times to call include:

When a high fever is not reduced by medication
Signs of dehydration occur:
Dry skin and mucus membranes
Weight loss
Irritability
Lethargy
Decreased or dark urine.
Emergency symptoms include convulsions.

Prevention Return to top

Avoid contact with people with known illness. Practice strict hand washing if in contact with infected children.


Update Date: 10/27/2005

Updated by: Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor of Pediatrics, NYU School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.

Thursday, July 06, 2006

Hand Foot Mouth Disease


Today, I got HFM Disease...here are the details...

From:- http://www.cha.state.md.us/edcp/factsheets/handfoot.html
"Hand, Foot, and Mouth Disease (Coxsackievirus) Fact Sheet
--------------------------------------------------------------------------------

Hand, foot, and mouth disease is caused by one of several types of viruses

Hand, foot, and mouth disease is usually characterized by tiny blisters on the inside of the mouth and the palms of the hands, fingers, and soles of the feet. It is commonly caused by coxsackievirus A16 (an enterovirus), and less often by other types of viruses.

Anyone can get hand, foot, and mouth disease

Young children are primarily affected, but it may be seen in adults. Most cases occur in the summer and early fall. Outbreaks may occur among groups of children especially in child care centers or nursery schools. Symptoms usually appear 3 to 5 days after exposure.

Hand, foot, and mouth disease is usually spread through person-to-person contact

People can spread the disease when they are shedding the virus in their feces. It is also spread by the respiratory tract from mouth or respiratory secretions (such as from saliva on hands or toys). The virus has also been found in the fluid from the skin blisters. The infection is spread most easily during the acute phase/stage of illness when people are feeling ill, but the virus can be spread for several weeks after the onset of infection.

The symptoms are much like a common cold with a rash

The rash appears as blisters or ulcers in the mouth, on the inner cheeks, gums, sides of the tongue, and as bumps or blisters on the hands, feet, and sometimes other parts of the skin. The skin rash may last for 7 to 10 days.

There is no specific treatment for the virus that causes hand, foot, and mouth disease

Help prevent and control the spread of hand, foot, and mouth disease by:

Washing hands well, especially after going to the bathroom, changing diapers and/or handling diapers or other stool-soiled material.
Covering the mouth and nose when coughing or sneezing.
Washing toys and other surfaces that have saliva on them.
Excluding children from child care or school settings if there is a fever, or ulcers in the mouth and the child is drooling. "

Monday, March 20, 2006

Carrot, Egg & Coffee

uncle Chee Meng, taught me the 1st lesson in life....hmm, just like my 1st hair cut.

A carrot, an egg and a cup of coffee... You will never look at a cup of coffee the same way again.

A young woman went to her mother and told her about her life and how things were so hard for her. She did not know how she was going to make it and wanted to give up. She was tired of fighting and struggling. It seemed as one problem was solved, a new one arose.

Her mother took her to the kitchen. She filled three pots with water and! placed each on a high fire. Soon the pots came to boil. In the first she placed carrots, in the second she placed eggs, and in the last she placed ground coffee beans. She let them sit and boil, without saying a word.

In about twenty minutes she turned off the burners.
She fished the carrots out and placed them in a bowl.
She pulled the eggs out and placed them in a bowl.
Then she ladled the coffee out and placed it in a bowl.

Turning to her daughter, she asked, "Tell me, what do you see?"

"Carrots, eggs, and coffee," she replied.

Her mother brought her closer and asked her to feel the carrots. She did and noted that they were soft.

The mother then asked the daughter to take an egg and break it. After pulling off the shell, she observed the hard boiled egg.

Finally, the mother asked the daughter to sip the coffee. The daughter smiled as she tasted its rich aroma. The daughter then asked, "What does it mean, mother?"

Her mother explained that each of these objects had faced the same adversity .. boiling water. Each reacted differently. The carrot went in strong, hard, and unrelenting. However, after being subjected to the boiling water, it softened and became weak. The egg had been fragile. Its thin outer shell had protected its liquid interior, but after sitting through the boiling water, its inside became hardened.
The ground coffee beans were unique, however. After they were in the boiling water, they had changed the water.

"Which are you?" she asked her daughter. "When adversity knocks on your door, how do you respond?
Are you a carrot, an egg or a coffee bean?"

Think of this: Which am I? Am I the carrot that seems strong, but with pain and adversity do I wilt and become soft and lose my strength?

Am I the egg that starts with a malleable heart, but changes with the heat? Did I have a fluid spirit, but after a death, a breakup, a financial hardship or some other trial, have I become hardened and stiff? Does my shell look the same, but on the inside am I bitter and tough with a stiff spirit and hardened heart?

Or am I like the coffee bean? The bean actually changes the hot water, the very circumstance that brings the pain When the water gets hot, it releases the fragrance and flavor. If you are like the bean, when things are at their worst, you get better and change the situation around you. When the hour is the darkest and trials are their greatest, do you elevate yourself to another level? How do you handle adversity? Are you a carrot, an egg or a coffee bean?

May you have enough happiness to make you sweet, enough trials to make you strong, enough sorrow to keep you human and enough hope to make you happy.

The happiest of people don't necessarily have the best of everything; they just make the most of everything that comes along their way. The brightest future will always be based on a forgotten past; you can't go forward in life until you let go of your past failures and heartaches.

When you were born, you were crying and everyone around you was smiling. Live your life so at the end, you're the one who is smiling and everyone around you is crying. You might want to send this message to those people who mean something to you (I JUST DID); to those who have touched your life in one way or another; to those who make you smile when you really need it; to those who make you see the brighter side of things when you are really down; to those whose friendship you appreciate; to those who are so meaningful in your life.

If you don't send it, you will just miss out on the opportunity to brighten someone's day with this message!

"It's easier to build a child than repair an adult"

Monday, February 20, 2006

umbilical granuloma


Today, Mom and Dad brought me to see the pediatrician (Neo-natal specialist)..wow...what a cool name...when I grow up, maybe I'll be a doctor...;-)

My belly button/ umbilical cord was sometimes having liquid out...Doc says its a condition called umbilical granuloma...ie some part of the umbilical cord (why can't they call it UG???) skin was quite thing thus some times blood or liquid was coming out..my cuz (short form for cousin accidentally touch it once, and she freak out as it was a stinker!) ......

Doc Ng, put some cool blue stuff, they call it copper sulphate and water and it flooded my belly button.

Doc said to wait 15-30 min after which he would clean it. tic-toc tic toc..zzzzzz

15 min later, Doc cleaned the umbillical cord and the weak tube was now a blue crystal...Holy cow, cool!!

Well, that's all I learned today...when I grow up, maybe I'll be a chemist and play with all those cool chemicals...;-)

Dad did some research and found something UG. He said must reference..( http://www.intelihealth.com)
"In some infants, the belly button area seems to heal slowly and looks moist, pink and lumpy. This is usually a harmless condition called an umbilical granuloma. If this occurs, tell your baby's doctor, who may want to treat the area with a special medicine that helps the condition heal. Rarely, the umbilical cord and/or surrounding skin gets infected. Call your doctor if:
The skin around the cord area becomes red or swollen.
The belly button is draining green or yellow liquid.
The area develops a bad odor.
Your baby has a fever or seems sick.
When the cord stays on longer than usually expected, the area gets infected, or there is continued discharge from the belly button, your doctor will consider whether this is normal. These conditions can happen in healthy babies. On rare occasion, they may occur because a newborn has problems fighting infection, or some connection to the inside of the belly (as there was when the baby was inside the womb) is still open."

Allo, my name is Torsten SEE or Yan Tze. I was born 16 Dec 2005.

Most people would go Huh? What? when they first hear my name...or they would go Sun Yanzi when they piece together my surname SEE and Yan Tze....oh please...

Where the name came from...Well, it came from my Dad while he was watching soccer and testing the names of all the players with my surname. Well some horrible....Mum kind of like the name so the name stuck.

So where did it originate from. It is basically a scandinavian name, after Thor, God of thunder, and stone...when I grow up...I'll write some more about it.


Thursday, January 12, 2006


When I grow up....