Don't let the bed bugs bite...

Does anyone else remember Mom saying that (see title) to you at night?  When I was hearing this saying as a child, I had no idea that it was a real critter who could chew on us.  What do bed bugs look like?

What are signs of bed bug infestation?  Look at the folds of mattresses and sheets and search for rusty-brown (old blood) spots where the bugs have feasted on a sleeping person.  If you see any bug shells where the bed bugs have molted and left behind the old shells, suspect bed bugs. The bed bugs themselves are reddish-brown in color, have no wings and range from 1 mm to 7 mm (compare to the size of Lincoln’s head on a penny) in size.  More information about bed bugs can be found at CDC website:  http://www.cdc.gov/parasites/bedbugs/faqs.html

Several years ago our travel agent was helping us make arrangements for a trip to a major city in North Eastern USA.  She felt we should become educated on bed bugs.  Now I’ve never seen a bed bug and don’t want to see or experience them. We bought the bed bug luggage repellant and sprayed our luggage with it.  When we arrive at our destination (whether hotel, resort or ship), I always pull up the sheets and look at the mattress folds for the tell-tale reddish-brown spots and bug shells.  Then I move my luggage into our room. 

For information about identifying and treating bed bug infestations, go to http://www.epa.gov/bedbugs/

Bed bugs--another ancient critter that bugs us

I remember hearing Mom & Dad talk about the Mississippi River flood during the 1930s that affected the Charleston—Dogwood area of Missouri.  The flood refugee families camped out at the Dogwood Methodist church.  Some of the local families took in refugee families and their hitch-hiker bed bugs.  In those days, bed bugs were a problem.  Mom & Dad remembered when the insecticide DDT was developed and eradicated bed bugs in America.  

Well, bed bugs are back.  Many speculate that bed bugs have returned to America by hitchhiking on the belongings and luggage of travelers from other countries. If you never travel or have company come stay at your home, you probably won’t need to know about bed bugs.  Everyone else should become educated on this pest.  They are not discriminating hitch hikers; they go wherever they can be transported in people’s luggage and clothing.  Bed bugs have been found in 5 star hotels so the quality and cleanliness of a hotel isn’t relevant. 

Bed bugs (Cimex lectularius) are small parasite bugs that feed on the blood of humans and animal while they sleep.  When asked whether bed bugs spread disease, the experts at CDC say probably not.  But bed bugs cause annoying, itchy bites.  Some people will not react to bed bug bites; other people will deal with severe anaphylactic (allergic) reactions which could be life threatening to those people. Next time I will discuss identifying and treating for bed bugs.

Protect yourself and family from ancient critters who bug us

Ancient critters that bug us include mosquitos and ticks.  Today we will look at recommended safe ways to using insect repellents according to the Environmental Protection Agency (EPA):

1.      Follow the insect repellent label to properly apply repellents to exposed skin or clothing.  Don’t apply repellent under clothes. 

2.      Do not apply the insect repellent over wounds, cuts or irritated skin.

3.      Do not apply (or spray) insect repellent onto the face, especially eyes and mouth. A safer way to apply to the face is spray it onto your hands and then apply to face (avoiding eyes and mouth).

4.      Apply the repellent for children by applying it to your hands and then gently rubbing it onto the child’s skin. Avoid the child’s eyes and mouth. You should avoid getting it on the child’s hands. Do not let children play with insect repellent containers.

5.      Apply the insect repellent in a light (not heavy) coat. If the first light coat doesn’t repel, add another light coat of insect repellent.

6.      When going back indoors, wash the repellent off treated skin with soap and water or bathe.  Launder clothes before you wear them again. (Check the product label about clothes laundering.)

7.      If anyone using the insect repellent develops a rash or itching, wash the repellent off with soap and water, stop applying the repellent product and call your local poison center. Take the repellent product with you for any doctor visits pertaining to the rash, itching reaction. 

This information can be found at the CDC website:  http://www.cdc.gov/ncidod/dvbid/westnile/repellentupdates.htm

Another ancient critter who bugs us --ticks

Ticks are another ancient critter that bug us. When I have been bitten by ticks, I find the bite area becomes a sore which itches and heals very slowly. Weeks later I am still dealing with that slowly healing, itchy sore spot. I have become very watchful for ticks on myself and my husband.  I don’t want to be a meal for some tick. And even worse than that, ticks carry diseases like Lyme Disease and Rocky Mountain Spotted Fever. I discussed these two illnesses and how to protect yourself on my blog April 16-18, 2012 so I will refer you to those posts. 

Mosquitos also carry malaria

I recently talked about malaria (August 11 and 13) because it’s an old disease that still causes illness in many parts of the world. However, the CDC records an average of 1500 cases of malaria in America every year. Malaria is carried by the Anopheles mosquito (a different breed mosquito from the Culex which carries West Nile virus). 

We have drugs which travelers can take to prevent malaria. Information about these drugs can be found at http://www.cdc.gov/malaria/travelers/drugs.html However, we don’t routinely take anti-malarial drugs while at home in the USA. So how do we protect ourselves from mosquito bites and malaria?  The same prevention techniques for West Nile Virus will protect us from malaria:  mosquito repellents such as DEET, Picaridin, Oil of Lemon Eucalyptus or IR3535 which the CDC recommends on our skin. If you want to wear repellent on your clothing, an insect repellent containing permethrin is recommended.  Other prevention methods include wearing long sleeves and long pants while outside, and avoiding being outside when the mosquitos are most likely feeding (between dusk and dawn).  Next time I will share safe ways to use insect repellents. 

More about West Nile virus

The Culex mosquitos can carry West Nile virus. With no vaccines or medications to treat West Nile virus, our best protection is prevention. 

How can we protect our families from West Nile Virus?  The CDC gives these suggestions:  avoid mosquito bites. Make ourselves unattractive by using mosquito repellant when we go outdoors, wear long sleeves and pants, especially between dusk and dawn when the Culex mosquito likes to feed.  Stay inside and use your air conditioning.  If no air conditioning, replace window and door screens to keep mosquitos outside.  One last suggestion:  get rid of standing water such as flower pots, buckets, etc where mosquitoes can breed.  http://www.cdc.gov/ncidod/dvbid/westnile/RepellentUpdates.htm

What type of mosquito repellent do the experts recommend?  The CDC staff suggests mosquito repellents which contain DEET, Picaridin, Oil of Lemon Eucalyptus or IR3535 on our skin.  If you want to use repellents on your clothing, permethrin is the suggested chemical for clothing, shoes, etc.  For precautions about using insect repellents safely, see the CDC website at http://www.cdc.gov/ncidod/dvbid/westnile/RepellentUpdates.htm

Ancient critters who bug us--mosquitos

Mosquitos ---West Nile Virus

A July 28, 2012 article in our local newspaper spread the news.  The hot, dry summertime weather we are dealing with this year provides excellent breeding grounds for the sneaky, small Culex mosquito and its disease, West Nile virus (WNV).  The Midwest states are reporting increased numbers of infected Culex mosquitoes.  This means an increased risk for people being bitten and developing West Nile disease.  As of August 2, 2012, 42 states reported infections of West Nile, with 241 people confirmed ill.

West Nile disease was first recognized in 1937 in Uganda, Africa.  This virus has been carried around the world by migrating birds.   More information can be found at CDC website at http://www.cdc.gov/media/releases/2012/p0801_west_nile.html

Symptoms of WNV:  most people (80%) who contract WNV will not feel bad. Some who get the illness will have mild symptoms such as “fever, headache, and body aches, nausea, vomiting and sometimes swollen lymph nodes or a skin rash on chest, stomach and back.”  Symptoms may last for a few days or it may last for several weeks.  One in 150 people who catch WNV will become really ill with severe symptoms of “high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis.  These symptoms may last weeks and neurological symptoms may become permanent.”  This information can be found at http://www.cdc.gov/ncidod/dvbid/westnile/wnv_factSheet.htm

Prevention and Treatment of Cholera

Cholera is an old disease which travelers can encounter.  Prevention of cholera involves clean drinking water.  Obviously we should always drink bottled water (unopened bottles or canned drinks).  Be wary of ice and salad foods unless you know they were prepared with clean water.  For more prevention tactics for cholera, see the CDC website at http://www.cdc.gov/cholera/prevention.html  Travelers can check out their destination for health reports and recommended immunizations at http://www.cdc.gov/malaria/travelers/index.html

Treatment for cholera includes fluid and electrolyte (salt) replacement. People suffering severe cases of cholera can be treated with antibiotics (doxycycline being first choice according to the CDC).  Efforts to create a vaccine for cholera have been unsuccessful because of multiple versions of the bacteria.   

Cholera--an disease travelers may encounter

You may remember hearing of an outbreak of cholera in Haiti after the 2010 earthquake.  People get cholera from water containing the bacteria Vibrio cholera. Another ancient disease, a cholera epidemic is recorded in the 16^th century but cholera-like symptoms are recorded in ancient Sanskrit writings (500-400 B.C.) from India. Historians recognize that cholera has affected the world population in at least seven different pandemics (a global epidemic).  

Cholera can cause a person’s death very rapidly because of dehydration that occurs. GI symptoms of cholera include sudden onset and uncontrollable stools and possibly vomiting. The loss of body fluids due to diarrhea causes dehydration. The person’s blood pressure drops, muscle cramps can affect the person’s body including legs and abdomen. As the person’s organs start to fail, the body temperature plummets. A person suffering from cholera can die within 24 hours.  (Moore, Peter, The Little Book of Pandemics, (New York City:  Fall River Press, 2009), 81-83.  For more information about cholera, see the CDC website at Cholera http://www.cdc.gov/cholera/index.html

Prevention and treatment of Malaria

Last time I talked about malaria--an old disease that we could encounter while at home or during vacations to tropical and subtropical areas.  (While most malaria cases occur in tropical countries, 1500 new cases are reported every year in the US.)  Today we look at how to prevent catching malaria and any treatments.

Prevention of malaria involves a person becoming educated in prevention strategies such as learning whether a travel destination is at risk, learning when the mosquitos are most likely to bite (for malaria it’s dusk to dark), dressing appropriately to avoid mosquito bites, using mosquito repellants and using mosquito netting, More information about malaria and how to avoid mosquito bites and malaria can be found at http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/protection-against-mosquitoes-ticks-and-other-insects-and-arthropods.htm 

Treatment of malaria involves several drugs; the protozoa are becoming resistant to these drugs.

More information about malaria can be found at http://www.cdc.gov/malaria/

Old diseases that travelers may encounter--Malaria

World travelers need to know about old diseases they may encounter during travels like malaria, cholera and diptheria.

Malaria 

Malaria causes illness and even death to people. While most of the malaria infections occur in sub-sahara Africa and Asia, 1500 cases are reported every year in the US. People traveling to tropical and sub –tropical areas of the world can check to see if their destination poses a malaria-risk at http://www.cdc.gov/malaria/travelers/index.html

Malaria is caused by a protozoa (tiny parasite) which is passed onto people by mosquito bites (a specific mosquito called the Anopheles mosquito). When the infected mosquito bites a person, the tiny parasites are injected into the person’s body, move to the person’s bloodstream and are carried to the person’s liver where they invade and reproduce. The reproduced protozoas then burst out of the person’s liver cells and cause symptoms such as fever, shivering, fatigue, headache, and possibly GI (gastrointestinal symptoms) such as nausea, vomiting, and diarrhea.  

Next time we talk about prevention and treatment of malaria. 

In the news--Ebola kills people in Uganda

Currently 16 people have died (and 38 people are ill) in western Uganda during the month of July 2012.  The World Health Organization (WHO) staff have identified the cause of death as Ebola.  What is Ebola Hemorrhagic Fever? 

The Ebola virus first became known in 1976 when 280 people (out of 318 who became ill) died.  These people lived on the banks of the Ebola River. Since that time, the Ebola virus has caused illness and death, then seems to disappear.  But it reoccurs and again, causes illness and death. 

There is much we do not know about Ebola.  What the experts do know is this:  Ebola is caused by a virus (Filoviridae) It spreads between people through blood and body fluids of people infected and sick from the virus. There are four strains of the virus and the illness kills between 50 to 90% of the people who become infected.  (The different virus strains have different mortality rates.)  Symptoms begin with 2 to 21 days of being infected:  fever, weakness, pain in muscles, joints and abdomen, headache, sore throat, nausea, exhaustion, then profuse bleeding within the body tissues (including the eyes) as well as externally. 

Treatment for Ebola is supportive care of the infected person.  No vaccine has been developed. The numbers of people infected and dying are relatively small (usually in the hundreds during outbreaks).  So far all outbreaks of Ebola has been confined to the African continent.  But Ebola is a scary infectious disease.  According to the news story, the current epidemic has sent Ugandan people fleeing their homes and communities to escape the virus.  Any travelers contemplating travel to Uganda (or anywhere outside the US), should check the CDC website for travel advisories at http://wwwnc.cdc.gov/travel/destinations/list.htm  For more information on the Ebola outbreak and how travelers can protect themselves, see http://wwwnc.cdc.gov/travel/notices/outbreak-notice/ebola-uganda-2012.htm

Treatment for the ancient disease, tuberculosis

In 1921 A vaccine for Tuberculosis was developed and given in some countries.  It’s not used in the US because according to the CDC, “it does not completely prevent people from getting TB”.  Antibiotics have been American treatment for TB since 1946 when streptomycin was developed.  Over the years, the Mycobacterium has evolved and become resistant to antibiotics used in the past.  Currently treatment involves 6-12 month-long treatment with multiple antibiotics but promising research may change that.  In March 2012 a new two-drug combo treatment was reported at the American Chemical Society meeting.  This drug combo involves the antibiotic meropenem plus clavulanate (a Beta-lactam inhibitor drug which is a component of the antibiotic combo-drug Augmentin).  This information can be found at http://www.sciencedaily.com/releases/2012/03/120326160528.htm A second announcement involves a three-in-one combo drug called PaMZ which shows promise for treating TB.  This drug combo is a combination of the TB drug pyrazinamide, the antibiotic moxifloxacin and PA-824. 

Both of these drug combos are currently in scientific trials and show promise for future treatments.  This information can be found at http://www.newscientist.com/article/dn22095-threeinone-drug-wipes-the-floor-with-tb.html?full=true&print=true

Tuberculosis poses a serious threat to people whose immune systems are weakened (those taking immunosuppressant drugs, and those suffering with HIV/AIDS.) TB thrives in poor living conditions where people lack good nutrition, and live in crowded areas.  More information about tuberculosis can be found at CDC, Tuberculosis, http://www.cdc.gov/tb/publications/factsheets/general/tb.htm

Moore, Peter, The Little Book of Pandemics, (New York City:  Fall River Press, 2009), 57-59. 

An ancient disease that won't die off--tuberculosis

Tuberculosis (TB)---A few years ago (maybe 25) the medical community thought they had defeated  tuberculosis.  That didn’t happen; the tuberculosis bacteria has become resistant to antibiotics that formerly killed the germs.

Tuberculosis has a long history.  As far back as 4000 B.C., skeletal remains show evidence of TB.  A German doctor, Robert Koch, is credited for identifying the Mycobacterium tuberculosis bacteria.  Dr Koch received the Nobel Prize of Physiology and Medicine in 1905 for this discovery.  What is TB?  It’s a disease caused by a bacteria (mycobacterium tuberculosis).  In the past TB was called “consumption or wasting disease”.  TB presents itself as a “bad cough that lasts three weeks or longer, pain in the chest, coughing up blood or sputum (phlegm from deep inside the chest), weakness or fatigue, weight loss, no appetite, chills, fever, sweating at night” 

 CDC, http://www.cdc.gov/Features/TBsymptoms/     TB is spread from one person who has TB through his coughing (sneezing, singing, speaking) to another person who doesn’t have TB.  The healthy person breathes in the germs left in the air by the ill person’s coughing, sneezing, etc.) The healthy person may not become ill if his immune system is strong and healthy.  The healthy person may become ill with the tuberculosis bacteria.  Next time I will discuss treatment for tuberculosis.