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assortied points

In childhood:

streptococcus pneumoniae

haemophilus influenza

what else?

viral illness

Chickenpox is caused by Herpes-Zoster virus also known as "human (alpha> herpes virus 3. Chickenpox is uncommon in adults but when it occurs may have severe constitutional symptoms. The rash is vesiculated but starts as macules in randomly occurring crops and as an enanthem as well. Treatment is supportive. In the adult watch for pneumonitis which is associated with the rare fatal case. Smallpox is no longer considered a problem since the last human case occured in 1977 in Somalia and there are no longer reservoirs in existence that are known.

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Tuberculosis (TB) causes more deaths worldwide than any other infectious disease: in 1995, TB caused an estimated 3 million deaths, of which 170,000 (6%) occurred among children aged less than 15 years (1,2). Diagnosing TB in children often is difficult and relies on clinical judgement and use of algorithms that include chest radiography and the tuberculin skin test (TST).

--- Fleas- Of the 2,000 species and subspecies of fleas, only a handful serve as vectors of human diseases. Several bacterial pathogens of public health importance are maintained and transmitted by fleas, among them, Yersinia pestis, the causative agent of plague (known in history as black death). Flea-borne human pathogens are maintained in a zoonotic cycle involving mammalian hosts and fleas. They seldom cause overt disease in their natural hosts but commonly result in clinical disease, e.g., plague, murine typhus, and cat-scratch disease, in humans. The rapid spread of pathogens to human populations is due to the frequent feeding behavior and extraordinary mobility of fleas. Flea-borne diseases are widely distributed throughout the world, in the form of endemic foci, where components of the cycle are present; however, these diseases become epidemic in human populations when infected mammalian hosts die and their fleas leave in search of a bloodmeal. Of flea-borne bacterial pathogens (e.g., Y. pestis, Rickettsia typhi, R. felis, and Bartonella henselae), the most studied and reviewed is Y. pestis.

The classic cycle of R. typhi, the etiologic agent of murine typhus, involves rats (Rattus rattus and R. norvegicus) and the rat flea, Xensopsylla cheopis

Table 3. Comparison of Rickettsia felis with other vector-borne Rickettsiae

Species Vector

R. prowazekii - louse

R. typhi -flea

R. canada - tick

R. felis - flea

R. akari -mite

R. australis - tick

R.ricketsii - tick

R. conorii - tick

. ABDU AZAD

Foodborne diseases have a major public health impact (Table 1; 1). In the United States, each year foodborne illnesses affect 6 to 80 million persons, cause 9,000 deaths, and cost an estimated 5 billion U.S. dollars (2). The epidemiology of foodborne diseases is rapidly changing as newly recognized pathogens emerge and well-recognized pathogens increase in prevalence or become associated with new food vehicles (Table 2). In addition to acute gastroenteritis, many emerging foodborne diseases may cause chronic sequelae or disability. Listeriosis, for example, can cause miscarriages (3) or result in meningitis in patients with chronic diseases (3). Toxoplasmosis is an important cause of congenital malformation (4), and Escherichia coli O157:H7 infection is a leading cause of hemolytic uremic syndrome, the most common cause of acute kidney failure in children in the United States (5). Salmonellosis can cause invasive disease (6) or reactive arthritis (7), and campylobacteriosis can lead to Guillain-Barré syndrome, one of the most common causes of flaccid paralysis in the United States in the last 50 years (8).


Links

sepsis in infancy: PMH Emergency Room presentation,lists bugs
Center for Disease Control: Home page
national conference of indfectious diseasesai: newsletter
actinomycetes-streptomyces database: u.minn
NCID monograph on flea borne illness: ABDU AZAD
MEDWEB: I.D links at EMORY U.



Joseph Ferrara

uncljoedoc@aol.com