www.elitecme.com | 2019 | INFECTIOUS DISEASE, DISASTER PLANNING & WOUND CARE 11 monly spread by drinking water and recre- ational water. A leading cause of waterborne disease in the U.S., common symptoms will include watery diarrhea, stomach cramps or pain, dehydration, nausea, vomiting, fever, and weight loss. While some individuals may recover without treatment (or with anti-di- arrheal medications), the U.S. Food & Drug Administration has also approved nitazox- anide for treatment in people with healthy immune systems. However, the effectiveness of nitazoxanide in immunosuppressed indi- viduals is unclear, according to the CDC. NON-POLIO ENTEROVIRUSES Most people infected with non-polio entero- viruses (the CDC specifically raises alert to enterovirus D681 and A712 ) do not get sick or only develop mild illness, including the com- mon cold. Infants, children, and teenagers are more likely than adults to become infected and become sick because they do not yet have immunity from previous exposures. Adults can become infected too, but they are less likely to have symptoms or symptoms may be milder. Symptoms of mild illness include fever, runny nose, sneezing, cough, skin rash, mouth blisters, and body and muscle aches. Some non-polio enterovirus infections can cause more severe conditions, however, such as viral conjunctivitis; hand, foot, and mouth disease; viral meningitis; viral encephalitis; myocarditis; pericarditis; acute flaccid paraly- sis; and inflammatory muscle disease. Infants and people with weakened immune systems have a greater chance of having these com- plications, according to the CDC. Healthcare providers are encouraged to practice and pro- mote the following practices because there is no specific treatment for the non-polio entero- virus: wash hands often with soap and water, especially after using the toilet or changing diapers; avoid close contact with people who are sick; and clean and disinfect frequently touched surfaces. GIARDIASIS A diarrheal disease caused by the micro- scopic parasite giardia. Once a person or ani- mal has been infected, the parasite lives in the intestines and is passed in feces. Once out- side the body, giardia can survive for months and can be found within every region of the U.S. The most frequently diagnosed intesti- nal parasitic disease in the U.S. and among travelers with chronic diarrhea, the signs and symptoms of giardiasis may vary and can last longer than two weeks. Acute symptoms include diarrhea, gas, greasy stools, stomach or abdominal cramps, upset stomach or nau- sea/vomiting, and dehydration. Less common symptoms include itchy skin, hives, and swell- ing of the eyes and joints. Effective drug treat- ments include metronidazole, tinidazole, and nitazoxanide. Alternatives include paromo- mycin, quinacrine, and furazolidone. (Some of these drugs may not be routinely available in the U.S., according to the CDC.) Medical his- tory, nutritional status, and condition of one’s immune system will impact how effectively drug regimens work, and healthcare providers are encouraged to promote safe practices such as good hygiene, avoiding contaminated water and food, and cleaning up after ill people (and pets), especially during circumstances when the threat may be raised. LEPTOSPIROSIS A bacterial disease that affects humans and animals that is caused by bacteria of the genus leptospira. Leptospires are long, thin, motile spirochetes that can survive in fresh water, soil, and mud in tropical areas. Symptoms of lepto- spirosis include fever, headache, chills, muscle aches, vomiting/diarrhea, cough, conjuncti- val suffusion, jaundice, and rash. The incuba- tion period is usually 5-14 days, with a range of 2-30 days. If not treated, the disease can lead to kidney damage, meningitis, liver failure, respiratory distress, and death. Leptospirosis is treated with antibiotics, ideally during the early course of the disease. Intravenous anti- biotics may be required in more severe cases. Vibrio vulnificus – A harmful bacteria more likely to be present where hurricanes, storm surges, and coastal flooding are possible. Infection is diagnosed when vibrio bacteria are found in a wound, blood, or stool. Symptoms of infection include serious illness, with a rapid decline in health, watery diarrhea, stomach cramping, nausea, vomiting, fever, skin infec- tion after exposure to brackish or salt water, bloodstream infection, dangerously low blood pressure, and blistering skin lesions. Vibrio vulnificus infection is treated with antibiot- ics, and limb amputation may be necessary to remove dead or infected tissue. n Joe Darrah is a freelance author based in the Philadelphia region who has been covering the healthcare field since 2004 SUGGESTED ADDITIONAL RESOURCES 1. Enterovirus D68. CDC. 2018. Accessed online: www.cdc.gov/non-polio-enterovirus/ about/ev-d68.html 2. Enterovirus A71. CDC. 2018. Accessed online: www.cdc.gov/non-polio-en- terovirus/about/ev-a71.html SIDEBAR Infectious Disease Outbreaks Among CDC’s Most Pressing Health Threats A recent analysis of data by the CDC reveals that life expectancy for Americans continues to decline. Although primarily linked to the drug overdose epidemic, CDC officials com- mitted extensive efforts to investigating and resolving infectious diseases related to food-borne outbreaks, including E. coli infections associated with romaine lettuce, salmonella in ground beef and kosher chicken, and listeria in pork prod- ucts, in 2018. According to CDC officials, careful examination of cases of acute flaccid myelitis (AFM), a serious condi- tion that can be caused by environmen- tal toxins and affects the spinal cord, leading to potential weakness of limbs has led to the establishment of an AFM task force. Challenges also remain with hepatitis C infections due to the opioid epidemic. These infections have more than tripled in recent years, according to the CDC. |  INFECTIOUS DISEASE