Echinococcosis granulosus

Ekinokokosis/hidatidosis adalah suatu penyakit zoonosis cestoda yang disebabkan oleh infeksi stadium larva Echinococcosis granulosus. Parasit cacing pita ini berukuran kecil (panjangnya < 1 cm) dan mempunyai tiga segmen. 

Untuk melengkapi siklus hidupnya, 

E. granulosus memerlukan dua mamalia sebagai inangnya. Cacing dewasanya hidup di dalam usus kecil hewan carnivora, terutama anjing (induk semang definitif) dan menghasilkan telur yang mengandung larva infektif. Sedangkan stadium larva, metacestode berkembang didalam organ internal hewan ungulata, misalnya, domba, sapi, babi dan onta (induk semang antara). Secara asidental E. granulosus dapat menginfeksi manusia (bila tertelan telur infektif) dan dalam perkembangan stadium larva (hidatid) dapat membentuk kista pada organ tubuh inangnya (terutama hati dan paru-paru). Penyebaran penyakit hidatid secara kosmopolitan, terutama di daerah yang mempunyai populasi domba dan sapi yang sangat banyak. Penyakit ini merupakan problem utama di daerah Timur Tengah, Afrika utara dan sub sahara serta di Amerika Utara. E. granulosus kurang patogen pada anjing, tetapi bersifat patogen pada manusia dan menyebabkan hidatidosis (cystic hydatidosis). Penyakit ini, pada stadium awal tidak memperlihatkan gejala klinik (aymptomatic). Gejala klinis dapat terjadi setelah masa inkubasi yang cukup lama (diperkirakan beberapa bulan hingga tahunan). Dan, tergantung dari jumlah, besar dan lokasi kista, perkembangannya (aktif/inaktif) serta terjadinya penekanan kista terhadap jaringan di sekitarnya. Ukuran kista pada organ tubuh manusia sangat bervariasi, biasanya sekitar 1-15 cm, tetapi bisa juga lebih besar (diameter > 15 cm). Kista pada hati dapat menimbulkan rasa nyeri perut di bagian atas, hepatomegali dan berbagai macam gejala yang lain. Batuk kronik, sesak nafas dan hemoptysis dapat disebabkan oleh kista pada paru-paru. Pada induk semang antara, diagnosa tergantung ada/tidaknya kista pada organ, terutama pada hati dan paru-paru. Diagnosis pada anjing dengan ditemukannya cacing (dewasa) E. granulosus. Sedang pada manusia diagnosis ekinokokosis didasarkan pada gejala klinik, ultrasonografi dan pemeriksaan dengan sinar X (X-Ray) dan metode lain yang dapat mendukung diagnosis yaitu dengan deteksi serum spesifik antibodi/uji imunodiagnostik. Di Indonesia, secara serologi pernah ditemukan pada penduduk di sekitar danau Lindu, Sulawesi Tengah, namun pada anjing tidak ditemukan cacing E. granulosus.

Tarmudji. Ekinokokosis/hidatidosis Suatu Zoonosis Parasit Cestoda Penting Terhadap Kesehatan Masyarakat. Balai Penelitian Veteriner.bogor. digilib.litbang.deptan.go.id/repository/index.php/repository/.../5971.pdf

Contact Lenses !

What Are Contact Lenses?

Contact lenses are medical devices worn directly on the cornea of the eye. Like eyeglasses, contact lenses help to correct refractive errors and perform this function by adding or subtracting focusing power to the eye's cornea and lens. Contacts provide a safe and effective way to correct vision when used with care and proper supervision. They can offer a good alternative to eyeglasses, depending on your eyes and your lifestyle. Over 24 million people in the United States now wear contact lenses. For certain conditions, contact lenses may be considered medically necessary. Cosmetic contact lenses are used to correct the same conditions that eyeglasses correct:

• Myopia (nearsightedness)
• Hyperopia (farsightedness)
• Astigmatism (distorted vision)
• Presbyopia (need for bifocals)

The health of your eyes should be your main concern. Choose an optometrist who is knowledgeable and experienced with contact lenses.
It is recommended that all patients have a back-up pair of eyeglasses.

Types of Contact Lenses

Many types of contact lenses are available. The type of contacts you use depends on your particular situation. Your optometrist will be able to help you choose from the following types of lenses.

• Soft contact lenses
  These are the most common type of contact lenses currently prescribed. These lenses are made materials that incorporate water, which makes them soft and flexible and allows oxygen to reach the cornea.
  • Daily disposable lenses: Although generally more expensive, they carry a lower infection risk
  • Two week or monthly disposable lenses: for daily wear
  • Toric contact lenses: Correct moderate astigmatism
  • Bifocal contact lenses: can be helpful for patients that need reading and distance correction but may not be right for everyone
• Gas-permeable lenses
  These lenses are also known as "RGPs." They are rigid or "hard" lenses made of plastics combined with other materials—such as silicone and fluoropolymers—that allow oxygen in the air to pass directly through the lens. For this reason, they are called "gas permeable."

For the safety of your eyes, it is recommended that contacts should be removed at bedtime due to risk of infection and risk of contact lens intolerance.

Risk Factors

• Daily-wear lenses should never be worn as extended-wear lenses. Misuse can lead to temporary and potentially sight threatening damage to the cornea. People who wear any type of lens overnight have a greater chance of developing infections of the cornea. These infections are often due to poor cleaning and lens care. Improper over wearing of contact lenses can result in intolerance, leading to the inability to wear contact lenses.

• Gas permeable lenses can potentially scratch the cornea if the lens does not fit properly or if the lens is worn while sleeping. They are also more likely to slide off the cornea and become hidden under the lid.
• Gas permeable lenses traditionally had a reputation for "popping out" of the eye. Newer lens designs have minimized the chance of losing a contact even during vigorous exercise.
• Gas-permeable lenses and soft extended-wear contacts are the most likely to have protein build-up and cause lens-related allergies. Protein build-up results in discomfort, blurring, and intolerance to the lenses. Thus, nightly disinfection becomes imperative and  you mayneed special cleaning solutions to dissolve the protein.

• Rigid gas-permeable or disposable lenses may be good choices for someone with allergies.

Who Should NOT Wear Contact Lenses?

Most people who need vision correction can wear contact lenses. Among the conditions that might keep you from wearing contact lenses are:

• Frequent eye infections
• Severe allergies
• Dry eye (improper tear film)*
• A work environment that is very dusty or dirty
• Inability to handle and care for the lenses properly

Are Contacts for You?

Whether or not contact lenses are a good choice for you depends on:

• Individual needs and expectations
• Patience and motivation during the initial adjustment period to contact lens wear.
• Adhering to contact lens guidelines for wear, disinfecting, and cleaning
• Diagnosis and treatment of conditions that may prevent contact lens wear

How to Care for Your Lenses

• Contact lenses must be properly cleaned and disinfected when you remove them to kill germs and prevent infections
• All contact lens cases- should be cleaned daily and it is recommended that you replace your case every three months
• Never reuse your contact lens solution
• Dispose of contact lens solution in the lens case after each use and let the case air dry
• Do not put your lens in your mouth and then in your eye
• Never use homemade cleaning  solutions as they have been linked to serious eye infections
• Any eye drops, even nonprescription ones, can interact with all types of contact lenses. Use the prescribed brand of solution or check with your optometrist before changing brands

Wear Your Lenses Properly

• Wash your hands with soap prior to handling contact lenses or touching your eye
• Do not share your lenses with someone else
• Do not use fashion lenses (non-prescription color lenses) unless they are fitted by an optometrist
• Do not purchase bootleg lenses
• Wear lenses on the schedule prescribed by your optometrist
• Dispose of your lenses at the interval prescribed by your optometrist

Remove Your Contact Lenses and Call Your Doctor When You Notice These Symptoms

• Your eye is painful
• You are sensitive to light
• Your eye is red for more than two days
• You have discharge from your eye
• You have blurry vision
• Your eye feels scratchy

Remember to book yearly contact lens and eye health exams for the protection of you eyes.

http://www.kellogg.umich.edu/patientcare/conditions/contact.lenses.html

Berhenti Merokok dengan pesan teks

Menurut sebuah studi dari Milken Institute School of Public Health milik George Washington University di Washington DC, perokok yang menggunakan program pesan singkat untuk berhenti merokok mempunyai kemungkinan berhasil dua kali lipat dibandingkan perokok yang tidak menggunakan program pesan singkat.
Program pesan singkat ini membantu dengan cara mengirimkan nasehat, alarm pengingat, maupun teknik berhenti merokok kepada si pecandu rokok.
Program pesan singkat ini juga bisa mengirim game agar keinginan merokok dapat teralihkan. Para pengguna yang ingin merokok tinggal menuliskan teks “crave” untuk mendapatkan balasan.
Para peneliti dari Milken Institute SPH menyebutkan, lebih dari 75.000 orang sudah menggunakan program pesan singkat yang dinamakan Text2Quit.
“Pesan-pesan singkat ini membantu para perokok untuk tetap fokus menghindari rokok,” ujar Lorien C. Abroms, professor yang memimpin penelitian di Milken Insitute SPH, dalam sebuah pernyataan.
“Bagaimanapun, studi tambahan juga perlu dilakukan untuk mengkonfirmasi hasil dan melihat seberapa efektif Text2Quit ini jika dibandingkan dengan program lain,” tambah Abroms.
Untuk studi ini, Abrom dan para koleganya merekrut 503 perokok dari internet. Beberapa perokok dikirimkan pesan singkat dari Text2Quit dan beberapa perokok lain hanya dikirimkan panduan manual berhenti merokok.
Setelah enam bulan, para peneliti menghubungi mereka kembali untuk melihat hasil perbandingannya. Mereka menemukan bahwa angka perokok yang berhenti merokok dengan bantuan Text2Quit, lebih tinggi yakni 11 persen. Sedangkan angka perokok yang berhenti merokok dengan bantuan panduan manual hanya 5 persen.
Untuk memastikan apakah perokok tersebut benar-benar berhenti merokok, para peneliti juga mengambil contoh air liur mereka. Di antara yang diuji, tingkat berhenti merokok juga dua kali lipat lebih tinggi dibanding kelompok control.
Pada tahun 2011, penelitian serupa dilakukan di Inggris dan hasilnya mendekati hasil penelitian Milken Institute SPH.
Menurut Centers for Disease Control, merokok telah merenggut 480.000 nyawa setiap setahun di Amerika. Secara global, CDC juga mengatakan lebih dari 5 juta orang meninggal akibat rokok. Angka kematian diprediksikan akan bertambah menjadi 8 juta pada tahun 2030.
Walaupun hasil penelitian Milken Institute SPH terlihat begitu menjanjikan, lebih banyak penelitian masih dibutuhkan, karena penelitian ini hanya melibatkan para perokok yang memang sudah punya keinginan untuk berhenti dan mendapat informasi dari internet.
Sebagai contoh, lebih banyak penelitian perlu dilakukan tentang bagaimana program pesan teks bisa diterapkan di populasi yang tidak terlalu terhubung secara digital, dan juga pada populasi yang mempunyai motivasi untuk berhenti merokok lebih rendah.
Para peneliti juga harus membandingkan penemuan mereka dengan program lain seperti, program SmokefreeTXT milik National Cancer Institute, yang diluncurkan tahun 2011.
Studi yang didanai oleh National Cancer Institute bisa dibaca online dalam American Journal of Preventive Medicine.

http://www.voaindonesia.com/content/pesan-teks-bisa-membantu-berhenti-merokok/1935796.html

Ebola virus disease

Ebola first appeared in 1976 in 2 simultaneous outbreaks, in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.

Genus Ebolavirus is 1 of 3 members of the Filoviridae family (filovirus), along with genus Marburgvirus and genus Cuevavirus. Genus Ebolavirus comprises 5 distinct species:

• Bundibugyo ebolavirus (BDBV)
• Zaire ebolavirus (EBOV)
• Reston ebolavirus (RESTV)
• Sudan ebolavirus (SUDV)
• Taï Forest ebolavirus (TAFV).

BDBV, EBOV, and SUDV have been associated with large EVD outbreaks in Africa, whereas RESTV and TAFV have not. The RESTV species, found in Philippines and the People’s Republic of China, can infect humans, but no illness or death in humans from this species has been reported to date.

Transmission

Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

Among workers in contact with monkeys or pigs infected with Reston ebolavirus, several infections have been documented in people who were clinically asymptomatic. Thus, RESTV appears less capable of causing disease in humans than other Ebola species.

However, the only available evidence available comes from healthy adult males. It would be premature to extrapolate the health effects of the virus to all population groups, such as immuno-compromised persons, persons with underlying medical conditions, pregnant women and children. More studies of RESTV are needed before definitive conclusions can be drawn about the pathogenicity and virulence of this virus in humans.

Signs and symptoms

EVD is a severe acute viral illness often characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

People are infectious as long as their blood and secretions contain the virus. Ebola virus was isolated from semen 61 days after onset of illness in a man who was infected in a laboratory.

The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days.

Diagnosis

Other diseases that should be ruled out before a diagnosis of EVD can be made include: malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis, hepatitis and other viral haemorrhagic fevers.

Ebola virus infections can be diagnosed definitively in a laboratory through several types of tests:

• antibody-capture enzyme-linked immunosorbent assay (ELISA)
• antigen detection tests
• serum neutralization test
• reverse transcriptase polymerase chain reaction (RT-PCR) assay
• electron microscopy
• virus isolation by cell culture.

Samples from patients are an extreme biohazard risk; testing should be conducted under maximum biological containment conditions.

Vaccine and treatment

No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use.

Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes or intravenous fluids.

No specific treatment is available. New drug therapies are being evaluated.

Natural host of Ebola virus

In Africa, fruit bats, particularly species of the genera Hypsignathus monstrosus, Epomops franqueti and Myonycteris torquata, are considered possible natural hosts for Ebola virus. As a result, the geographic distribution of Ebolaviruses may overlap with the range of the fruit bats.

Ebola virus in animals

Although non-human primates have been a source of infection for humans, they are not thought to be the reservoir but rather an accidental host like human beings. Since 1994, Ebola outbreaks from the EBOV and TAFV species have been observed in chimpanzees and gorillas.

RESTV has caused severe EVD outbreaks in macaque monkeys (Macaca fascicularis) farmed in Philippines and detected in monkeys imported into the USA in 1989, 1990 and 1996, and in monkeys imported to Italy from Philippines in 1992.

Since 2008, RESTV viruses have been detected during several outbreaks of a deadly disease in pigs in People’s Republic of China and Philippines. Asymptomatic infection in pigs has been reported and experimental inoculations have shown that RESTV cannot cause disease in pigs.

Prevention and control

Controlling Reston ebolavirus in domestic animals

No animal vaccine against RESTV is available. Routine cleaning and disinfection of pig or monkey farms (with sodium hypochlorite or other detergents) should be effective in inactivating the virus.

If an outbreak is suspected, the premises should be quarantined immediately. Culling of infected animals, with close supervision of burial or incineration of carcasses, may be necessary to reduce the risk of animal-to-human transmission. Restricting or banning the movement of animals from infected farms to other areas can reduce the spread of the disease.

As RESTV outbreaks in pigs and monkeys have preceded human infections, the establishment of an active animal health surveillance system to detect new cases is essential in providing early warning for veterinary and human public health authorities.

Reducing the risk of Ebola infection in people

In the absence of effective treatment and a human vaccine, raising awareness of the risk factors for Ebola infection and the protective measures individuals can take is the only way to reduce human infection and death.

In Africa, during EVD outbreaks, educational public health messages for risk reduction should focus on several factors:

• Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
• Reducing the risk of human-to-human transmission in the community arising from direct or close contact with infected patients, particularly with their bodily fluids. Close physical contact with Ebola patients should be avoided. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
• Communities affected by Ebola should inform the population about the nature of the disease and about outbreak containment measures, including burial of the dead. People who have died from Ebola should be promptly and safely buried.

Pig farms in Africa can play a role in the amplification of infection because of the presence of fruit bats on these farms. Appropriate biosecurity measures should be in place to limit transmission. For RESTV, educational public health messages should focus on reducing the risk of pig-to-human transmission as a result of unsafe animal husbandry and slaughtering practices, and unsafe consumption of fresh blood, raw milk or animal tissue. Gloves and other appropriate protective clothing should be worn when handling sick animals or their tissues and when slaughtering animals. In regions where RESTV has been reported in pigs, all animal products (blood, meat and milk) should be thoroughly cooked before eating.

Controlling infection in health-care settings

Human-to-human transmission of the Ebola virus is primarily associated with direct or indirect contact with blood and body fluids. Transmission to health-care workers has been reported when appropriate infection control measures have not been observed.

It is not always possible to identify patients with EBV early because initial symptoms may be non-specific. For this reason, it is important that health-care workers apply standard precautions consistently with all patients – regardless of their diagnosis – in all work practices at all times. These include basic hand hygiene, respiratory hygiene, the use of personal protective equipment (according to the risk of splashes or other contact with infected materials), safe injection practices and safe burial practices.

Health-care workers caring for patients with suspected or confirmed Ebola virus should apply, in addition to standard precautions, other infection control measures to avoid any exposure to the patient’s blood and body fluids and direct unprotected contact with the possibly contaminated environment. When in close contact (within 1 metre) of patients with EBV, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

Laboratory workers are also at risk. Samples taken from suspected human and animal Ebola cases for diagnosis should be handled by trained staff and processed in suitably equipped laboratories.

WHO response

WHO provides expertise and documentation to support disease investigation and control.

Recommendations for infection control while providing care to patients with suspected or confirmed Ebola haemorrhagic fever are provided in: Interim infection control recommendations for care of patients with suspected or confirmed Filovirus (Ebola, Marburg) haemorrhagic fever, March 2008. This document is currently being updated.

WHO has created an aide–memoire on standard precautions in health care (currently being updated). Standard precautions are meant to reduce the risk of transmission of bloodborne and other pathogens. If universally applied, the precautions would help prevent most transmission through exposure to blood and body fluids.

http://www.who.int/mediacentre/factsheets/fs103/en/

MERS-CoV

Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

Coronaviruses are a large family of viruses that can cause a range of illnesses in humans, from the common cold to severe acute respiratory syndrome (SARS). These viruses also cause disease in a wide variety of animal species.
In late 2012, a novel coronavirus that had not previously been seen in humans was identified for the first time in a resident of the Middle East. The virus, now known as the Middle East Respiratory Syndrome Coronavirus (MERS-CoV),1 has caused more than 50 laboratory-confirmed cases of human infection. Thus far, all patients infected with MERS-CoV have had a direct or indirect link to the Middle East, however, local non-sustained human-to-human transmission has occurred in other countries, in people who had recently travelled to the Middle East.
All MERS-CoV patients have primarily had respiratory disease, although a number of secondary complications have also been reported, including acute renal failure, multi-organ failure, acute respiratory distress syndrome (ARDS), and consumptive coagulopathy. In addition, many patients have also reported gastrointestinal symptoms, including diarrhoea. More than half of infected patients have died. The majority has had at least one comorbid condition, but many have also been in previous good health. A small number of cases had had co-infection with other viruses including influenza A, parainfluenza, herpes simplex, and pneumococcus. As of 6 June, the median age of reported laboratory-confirmed cases is 56 years (Range 2–94 years) and majority (72%) are males.2 A current update of the cases can be found at WHO’s Coronavirus website.
The MERS-CoV virus is thought to be an animal virus that has sporadically resulted in human infections, with subsequent limited transmission between humans. The evidence for the animal origin of the virus is circumstantial. Nevertheless, the alternative explanation to explain the sporadic appearance of severe human cases with long periods of time between them, and the wide geographical area over which the virus was apparently distributed, is unrecognized ongoing transmission in people. Surveillance efforts since the discovery of the virus and retrospective testing of stored respiratory specimens suggest this is not the case.
The virus has been demonstrated to grow well in cell lines that in the past have commonly been used for diagnostic viral cultures. Finally, early comparisons with other known coronaviruses suggest a genetic similarity to viruses previously described in bats. However, even if an animal reservoir is identified, it is critical to identify the types of exposures that result in infection and the mode of transmission. It is unlikely that transmission occurs directly from animals to humans and the route of transmission may be complex requiring intermediary hosts, or through contaminated food or drink.
A considerable proportion of MERS-CoV cases have been part of clusters in which limited non-sustained human-to-human transmission has occurred. Human-to-human transmission has occurred in health care settings, among close family contacts, and in the work place. Sustained transmission in the community beyond these clusters has not been observed and would represent a major change in the epidemiology of MERS-CoV.
A number of unanswered questions remain on the virus reservoir, how seemingly sporadic infections are being acquired, the mode of transmission from animals to humans and between humans, the clinical spectrum of infection, and the incubation period.

www.who.int%2Fcsr%2Fdisease%2Fcoronavirus_infections%2FMERS_CoV_investigation_guideline_Jul13.pdf