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Bacteria are living single-celled organisms that are much more complex than viruses and about one hundred times larger blood pressure chart low to high cheap enalapril 10 mg on-line. Bacteria are extremely significant to medicine, as they are responsible for large numbers of serious human illnesses. Bacteria are classified as prokaryotes because their cells have a simpler structure than those of plants and animals, which are eukaryotes. Despite their relatively simple structure, bacteria possess all the machinery necessary to grow and reproduce on their own. This feature sets them apart from viruses, which depend on host cells for reproduction. The small size and relatively simple structure of bacteria allows them to grow and reproduce rapidly. A variety of antibiotics are available for the treatment of many bacterial diseases. These drugs target features of bacterial cells that are not present in eukaryotic cells. This worldwide problem limits the treatment options for a growing number of bacterial infections. Fungi are common eukaryotic microorganisms that only rarely cause disease in humans. Unlike plants, fungi lack chlorophyll, so they cannot make their own sugars; they must live on nutrients found in their environment. They are made of long filaments that branch and intertwine, creating the familiar mats that are often seen growing on bread and cheese. Yeasts are unicellular fungi that commonly live on fruits and flowers, thriving on the sugars provided there. People who are seriously ill or have weak immune systems are more susceptible to fungal infections. Parasites are eukaryotes that live on other living organisms for nutrition, without providing benefits to their hosts. Protozoa are microscopic, unicellular eukaryotes, and as such are more complex than bacteria and have more in common with human cells. Helminths are multicellular macroscopic worms that find nutrients in body fluids and intestinal contents. Unlike protozoan parasites, most helminths must leave the host to lay eggs, which are the infective forms of the organism. Drugs are available for the treatment of parasitic infections, but few of them are ideal. Similarities between human and parasite cells make it difficult to design drugs that can kill parasites without also being toxic to humans. Some drugs require long-term administration, which is not practical in many developing nations. Routes of Transmission Pathogenic organisms vary in the way they spread from one host to another, a feature known as the route of transmission. For each pathogen, the route of transmission will determine where it enters and infects the body, how it spreads through a population, and how spread of the disease can be controlled. The routes of transmission for the agents of contagious diseases include airborne transmission, fecal-oral transmission, and direct transmission. Airborne transmission occurs through the inhalation of infectious agents in aerosols that are released from an infected person. The smallest of these droplets can remain suspended in air for a surprisingly long time (twenty minutes or longer). Larger particles tend to settle from the air onto tissues sooner than do smaller particles, so the larger particles cause primarily upper respiratory infections. Airborne pathogens can also be spread indirectly by contact with respiratory secretions that are on hands or inanimate objects. These organisms are then transferred to the airway through touching the nose, eyes, or mouth. The most common contagious infections worldwide are respiratory, because transmission through aerosols and contaminated objects occurs quite easily in normal daily activities. These include the common cold (rhinoviruses), influenza (orthomyxovirus), measles (paramyxovirus), and viral pneumonia (multiple virus types). Bacterial respiratory infections include tuberculosis (Mycobacterium tuberculosis), pneumonia (multiple species), strep throat (Streptococcus pneumoniae), and whooping cough (Bordetella pertussis). The more common fungal respiratory infections include valley fever (Coccidioides immitis), histoplasmosis (Histoplasma capsulatum), and cryptococcosis (Cryptococcus neoformans). Fecal-oral transmission is a common route by which many bacterial, viral, and parasitic diseases are spread. Organisms that are spread in this manner grow in the digestive tract, are present in feces, and usually cause diarrhea or vomiting. Infection occurs either by direct contact or through consumption of food or water that has been contaminated with human feces. Raw shellfish, fruits, and vegetables that are washed in contaminated water can also spread disease. Waterborne pathogens are common in developing countries where sewage and drinking water are not treated. Natural disasters, such as earthquakes and floods, can breach water-treatment systems and cause outbreaks of waterborne illness. Diarrheal diseases, which are the third leading cause of death in the world, are most often spread by fecal-oral transmission. Two of the most important are typhoid fever (Salmonella typhi) and cholera (Vibrio cholerae). These life-threatening bacterial illnesses are most often spread through contaminated water. Water purification methods have nearly eliminated these diseases in many countries, yet they remain a serious threat in many areas of the world. Outbreaks of intestinal illnesses, including those on cruise ships, are often caused by viruses (norovirus and rotavirus) Salem Health that are spread through food by infected food handlers. Fecal contamination of food is the most common source of infection by the hepatitis A virus. Cryptosporidium parvum, Entamoeba histolytica, and Giardia intestinalis (also known as G. While rare in areas with good sanitation, these illnesses are still extremely common worldwide. Some pathogens are so sensitive to the environment outside the human body that they cannot survive long enough to be transmitted by casual contact. These organisms must be transmitted from one person to another directly-through the exchange of body fluids during sexual contact, blood transfusion, birth, or breastfeeding. Bacterial infections that are transmitted through sexual contact include syphilis (Treponema pallidum), gonorrhea (Neisseria gonorrhoeae), and chlamydia (Chlamydia trachomatis). Other pathogens are transmitted directly through contact with the skin, often entering through a wound or break in the skin. Antibiotic-resistant forms of staph infections are now common among athletes and are spread during contact sports and in locker rooms. Prevention Public sanitation programs have had a profound impact on the incidence of contagious diseases in developed countries. Public health measures to prevent the spread of waterborne and food-borne illnesses are generally quite effective. These measures include water purification and sewage treatment, waste removal, and enforcement of regulations to promote food safety during production and preparation. A dramatic example of an effective public health program comes from data on typhoid fever in Philadelphia during the early twentieth century. This result is a heartening reminder that the spread of contagious diseases can be controlled. Vaccination is the most effective method of preventing a variety of contagious diseases.

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At what point should I seek medical care for possible complications of chickenpox How long do I need to keep my child isolated after he (or she) has been infected with chickenpox Specific Questions About Outlook Are there any possible long-term complications from chickenpox Where this is not feasible heart attack krokus album discount enalapril online master card, one should carefully discuss risks and benefits with a doctor. Immunoglobulin is a blood product that contains antibodies to the chickenpox virus. These persons include adults (including pregnant women), newborns whose mothers have chickenpox, and people who are immunosuppressed or very ill. The vaccine Zostavax has been effective in boosting cell-mediated immunity (antibody production) and in providing partial immunity. The most common side effects of varicella vaccine include fever, injection-site complaints, and a varicella-like rash. The vaccine is not recommended for persons with hypersensitivity to its ingredients, which include gelatin and neomycin; for persons with immunosuppression or with active tuberculosis; or for women or girls who are pregnant. Postexposure Vaccine Post-varicella-exposure vaccination in children has shown some effectiveness in preventing disease if administered within three days of exposure. Impact Before the development of a chickenpox vaccine, four million people in the United States acquired varicella annually, leading to ten thousand hospitalizations and one hundred deaths. After the development of a vaccine, these numbers were reduced by 85 to 90 percent. The initial vaccine dose reduced varicella infection by 64 percent, and the second dose further reduced infection by 90 percent. Research has shown that the administration of varicella vaccine in childhood reduces the incidence of herpes zoster in adulthood as well. Transmission is by respiratory droplets or by direct contact with the virus-containing vesicle fluid. During the ensuing week, the virus spreads to various parts of the body, including the skin, liver, central nervous system, lymphatic system, and spleen. The majority of affected persons have symptoms that include fever, malaise, and inflamed, pruritic vesicles, which resolve in two to three weeks. Approximately 1 in 50 persons exhibit complications that include encephalitis, pneumonia, and hepatitis. Secondary bacterial skin infections can occur as open skin lesions provide an entry portal. Varicella virus can be transmitted through the placenta to the fetus if the disease is acquired by the pregnant girl or woman during pregnancy. The fetus may be born with congenital varicella syndrome and demonstrate skin, extremity, ocular, and brain abnormalities. Reemergence of the herpesvirus is called shingles and can lead to extremely painful postherpetic neuralgia, which lasts from weeks to years. In 1996, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention recommended Varivax as part of routine childhood immunizations. Chikungunya Category: Diseases and conditions Anatomy or system affected: All Definition Chikungunya is a relatively rare form of viral infection caused by an alphavirus spread by mosquito bites. It is debilitating but generally nonfatal, with an estimated mortality rate of about one death per one thousand cases. Causes Chikungunya is transmitted primarily through two species of mosquito, Aedes aegypti and Aedes albopictus. The mosquitoes become infected when they feed on an infected person during the viraemic period (within five days of the onset of the mosquito bites and symptoms), then transmit the virus to other humans. Risk Factors the only known risk factor for chikungunya is an initial exposure to the virus through bites from infected mosquitoes. Before 2013, known outbreaks had occurred primarily in the Eastern Hemisphere, specifically in France, Italy, southern and southeastern Asia, the Arabian Peninsula, central and southern Africa, and various islands in the Indian and Pacific Oceans. In 2013, however, an outbreak of chikungunya in several Caribbean countries marked the first occurrence of the disease in the Americas. Since then, cases have been identified in the United States, Mexico, the Caribbean, Central America, and northern and central South America. Symptoms the clinical symptoms of the disease appear within two to twelve days after the initial infection. Symptoms include fever, debilitating joint pains, swelling and stiffness of joints, muscular pain, headache, fatigue, nausea, vomiting, and rash. Infection with the virus, whether clinically symptomatic or silent, confers lifelong immunity. Screening and Diagnosis the common screening and diagnostic confirmation tests for chikungunya include detection of antigens or antibodies in the blood. This technique involves exposing specific cell lines to whole blood samples and identifying chikungunya-specific responses. Treatment and Therapy There are no specific vaccines or antiviral treatments for chikungunya. Treatments include rest, fluids, and drugs to relieve the symptoms of fever and aching. Other preventive measures include using insect repellants on exposed skin and wearing bite-proof long sleeves and trousers. In addition, the developing immunity of the fetus does not effectively protect against disease. Maternal IgG antibodies (proteins that fight infection, also called immunoglobulins) cross the placenta to provide protection, but IgM (immunoglobulin M) antibodies do not. The function of disease-fighting white blood cells and complement-protein activity (another form of immune protection) are decreased. Threats to the fetus include bacterial, viral, and other pathogens inside and outside the genital tract. Some of these cause serious infection in both the pregnant woman and the fetus, while others threaten only the pregnant women or only the fetus. Intrapartum infections are passed during labor and delivery as the fetus travels through the infected birth canal. Postpartum infections occur after delivery and most often involve the genitourinary tract of the mother. In the past, these infections were known as childbirth fever and were once leading causes of morbidity and mortality. However, with the widespread use of improved sterile techniques and of antibiotics, incidence has decreased dramatically. In addition, some microbes (such as human immunodeficiency virus and cytomegalovirus) can infect the newborn through breast-feeding; other infections are acquired during the postdelivery hospital stay, an infection known as nosocomial. Threats to the Fetus and the Newborn Many infectious agents are able to cross the placenta during pregnancy and cause congenital infection, whether these agents originate in the genitourinary system or elsewhere in the body. Some organisms that cause little or no clinical illness in the pregnant woman can present significant danger to the developing fetus; these organisms are teratogenic (they cause birth defects). In utero transmission of infection can occur at any time before birth, and the period of greatest risk varies by organism. The agents responsible for congenital infection carry significant risk of morbidity and mortality and can cause neurological damage, blindness, deafness, cardiac defects, intrauterine growth restriction, skin lesions, and a host of other abnormalities. Based on their level of need, neonatologists and other specialists can treat infant infections. Congenital infections, which occur during pregnancy, cross the placenta to infect a growing fetus and may result in abnormal development, fetal disease, or fetal death. Many of these organisms can also be transmitted during passage through the birth canal if they are present at the time of delivery. Routine maternal screening for serologic evidence of organisms causing congenital infection during pregnancy is commonplace in many parts of the world, but its use as a diagnostic tool is controversial in the United States because of overuse and a lack of consistent interpretation of results. Screening is limited to cases in which exposure is known or suspected or in which symptoms are present. Fever, hypothermia, vomiting, rash, and decreased muscle tone may indicate infectious illness, and many congenital infections acquired during gestation are accompanied by abnormalities specific to the organism involved.

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Prevention and Outcomes Mosquito control and eradication with chemical and biological agents is the key blood pressure 7030 purchase enalapril online from canada, first-line defense against mosquitoes and mosquito-borne infectious diseases. Some garden plants, including lemon thyme and rosemary, are known mosquito repellants. Biological agents, such as predatory fish (mosquitofish) and dragonflies, feed on mosquito larva and adult mosquitoes. Other preventive measures include behavioral and physical modifications, such as staying indoors at night and using insecticide-treated sleeping nets and permethrin-treated clothing to cover as much of the body as possible. Yellow fever vaccine, a live attenuated vaccine, is commonly used as a preventive agent. This fungus normally resides in the mouth and invades the protective barriers when opportunities arise. The resulting fungal infection, thrush or pseudomembranous candidiasis, appears as creamcolored patches on the tongue, buccal mucosa, or palate. Hyperplastic candidiasis is a chronic superficial infection that cannot be easily wiped away. Erythematous candidiasis appears as red patches most commonly found on the roof of the mouth or under the tongue. Angular cheilitis (perleche) affects the corners of the mouth, causing redness and cracking of the skin. They have the potential of causing damage to oral tissue, and their presence typically indicates that the body has other infections. Aspergillosis is the second most common fungal mouth infection; it is caused by the Aspergillus group of fungus. Histoplasmosis (Histoplasma capsulatum), cryptococcosis (Cryptococcus neoformans), blastomycosis (Blastomyces dermatitidis), zygomycosis (Rhizopus), geotrichosis (Geotrichum capitatum), and coccidioidomycosis (Coccidioides immitis) are rare fungi that cause infections in the deep layers of the mouth. All but geotrichosis appear as ulcers or nodules on the interior walls of the cheek, tongue, or roof of the mouth. Although hundreds of types of bacterial organisms can potentially cause oral mucosal infections, there are several that are most common. Streptococcus, Bacteroides, Peptostreptococcus, oral anaerobic bacteria, and gram-negative bacilli are Mouth infections Category: Diseases and conditions Anatomy or system affected: Lips, mouth, tissue, tongue Definition Infections of the mouth can range from minor to severe to life-threatening. They occur when the natural protective mechanisms of the oral cavity are breached. Organisms that cause mouth infections are those that normally reside in the oral cavity and those that have been introduced from other sources. Resident and foreign mouth microorganisms can infect the tongue, gums, the roof of the mouth, toothsupporting structures, and the inner lining of the cheeks and lips (buccal mucosa). These infections are most often localized to the mouth but can also spread Infectious Diseases and Conditions the most common organisms that cause oral mucosal infections. Gangrenous stomatitis, also known as noma, is a rapidly spreading infection of oral and facial tissues typically found in the presence of debilitating illnesses. Caused by multiple bacteria, this infection begins as a small vesicle found on the gum. Ulceration of the deeper layers causes eventual destruction of the mouth, facial tissues, and bones. Several types of bacteria can cause this polymicrobial disease, but the most commonly isolated organisms are Fusobacterium nucleatum, Borrelia vincentii, and Prevotella melaninogenica. Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum. Secondary syphilis rarely produces oral ulcerations and is most likely to manifest as flat or raised red patches on the roof of the mouth or tongue. Gumma is a painless mass that is surrounded by inflamed tissue and forms on the tongue or on roof of the mouth. Difficult to diagnose, oral tuberculosis may invade and cause destruction to the bones of the face. Located in the cheeks at the angle of the jaw and under the tongue, the salivary glands may become infected with bacteria, causing pain and swelling. Although dozens of bacteria can cause salivary gland infections, the most common are Staphylococcus aureus, Prevotella, Porphyromonas, Fusobacterium, and Peptostreptococcus. Most commonly caused by Streptococccus and Actinomyces, bacterial gingivitis causes discoloration and thickening of the gums. Prevotella, Fusobacterium, Tannerella, and Treponema are the most common varieties of bacteria that cause this form of gingivitis. Like gingivitis, poor oral hygiene can lead to bacterial infections of the deep supporting structures of the teeth. Although periodontitis is typically an inflammatory disease, a more destructive form of periodontitis caused by bacteria infiltration can develop, causing breakdown of the supporting structures of the teeth and, ultimately, tooth loss. Pericoronitis is an infection under the gum flaps of wisdom teeth or nonerupted teeth. Bacteria can become trapped under the gums and cause local infection or an abscess. The most common bacteria causing bacterial periondontitis and pericoronitis are Actinobacillus, Treponema, Prevotella, Porphyromona, and Tannerella. Recurrent infections are triggered by emotional stress, sunlight, and systemic illnesses. Herpetic stomatitis is a condition in young children that likely represents the initial herpes simplex infection, causing fever and blistersonthetongueorcheeks. This vesicular rash occurs primarily in children age three to six years who have not been vaccinated for the varicella virus and who are at risk for chickenpox. Shingles or herpes zoster is the reactivation of the disease in adults, especially persons age sixty years and older. The vesicular lesions of shingles occur unilaterally and localize in an area of the skin corresponding to a spinal nerve. Condyloma,whichcausesclusters of warty, pink, or whitish lesions on the tongue, roof of the mouth, and gums, is seen primarily in the genitalarea. These contagious lesions manifest as hard, rough, pointy clusters of white lesions and are found on the tongue, gums, and the roof of the mouth. Coxsackie virus causes two primary types of disorders in the mouth, namely hand, foot, and mouth disease and herpangina. Hand, foot, and mouth disease manifests as multiple vesicles surrounded by a red base and are found on the cheeks, tongue, and the roof of the mouth. Herpangina initially appears as painful small red lesions, which then become vesicles and, eventually, ulcers. Caused by the Rubulavirus genus, mumps are a viral infection of the salivary glands of the cheek (parotid glands). It is seen primarily in unvaccinated or "failed" vaccinated children age five to nine years. Infected children have the characteristic chipmunk appearance because of swollen parotid glands. Caused by the Morbillivirus genus, measles is a highly infectious disease typically seen in unvaccinated or failed vaccinated children less than five years of age. Koplik spots are small, white lesions found on the buccal mucosa during the initial stages of measles infection. There are, however, cases reported in the literature in which children have developed red spots on the buccal mucosa. Risk Factors Oral fungus infections are opportunistic diseases that mainly occur because of compromised defense mechanisms. Medications such as corticosteroids, broadspectrum antibiotics, tricyclic antidepressants, and immunosuppressive agents (chemotherapy) can Salem Health cause superficial oral infections. Additionally, a high carbohydrate diet, iron deficiency anemia, and ill-fitting dentures have been implicated in causing oral candida.

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Studies have shown that vaccinating the sow confers passive immunity on the piglets arrhythmia dizziness discount enalapril 5 mg on-line, a strategy that can have implications for human coronavirus vaccine. Causes Coronavirus is the underlying cause of a variety of illnesses that affect the respiratory system, the gastrointestinal system, and, in rare cases, the neurological system. Infections with the virus are often seasonal in nature, with more occurring in winter. Contact with contaminated droplets from sneezing and coughing and direct contact by touching contaminated objects, such as surfaces and tissues, may transmit the virus from person to person. The virus may live six to nine hours, and the live virus has been found in the stool of people diagnosed Coronaviruses with classic halo-like appearance. The virus can affect humans, cattle, pigs, rodents, cats, dogs, and birds, but there is no evidence of animal and bird variations infecting humans. Risk Factors Risk factors for coronavirus infection are exposure to an infected person through kissing and sharing living spaces and contact with droplets or contaminated surfaces containing the virus. The severity of the infection increases if a person is immunocompromised (less able to fight infections because of a weakened immune system). Symptoms Coronavirus infection that leads to the common cold comes with symptoms of fatigue, a scratchythroat, sneezing, nasal congestion, and a runny nose. Blood work may include blood chemistries and a complete blood count to determine if white blood cell counts, lymphocytes, and platelets are low. Treatment and Therapy In the absence of fever, symptoms may be treated with over-the-counter medications, plenty of fluids, and rest. Antibiotics, antiviral medications, and high doses of steroids to decrease lung inflammation may be prescribed. In severe cases, the patient may need oxygen, breathing support with a respirator, and hospitalization. Prevention and Outcomes the best prevention against coronavirus infection is to limit contact with infected persons. Hand hygiene, including handwashing or cleaning hands with an Salem Health alcohol-based hand sanitizer, is an important part of prevention. Infected persons should cough or sneeze into tissue or into the arm to minimize droplets and airborne particles. Because coronavirus is contagious, one should not share food and drink, utensils, or personal supplies. Household areas, including door knobs, counter tops, and other surfaces, should be cleaned with disinfectant. Corynebacterium Category: Pathogen Transmission route: Direct contact, ingestion, inhalation Infectious Diseases and Conditions Definition Corynebacterium is a gram-positive, non-spore-forming rod with a characteristic club-shaped appearance and worldwide distribution. Along with the Mycobacteria and Nocardia, they produce characteristic long-chain mycolic acids that can be used in their taxonomy. Their metabolism is varied, with both aerobic and facultatively anaerobic members of the genus. The bacteria are fastidious, and all strains require biotin and most require several other supplements. They are usually grown under an enriched carbon dioxide atmosphere and grow slowly, even on complex-enriched culture media. The rods are pleiomorphic, some having clubshaped ends (the Greek word koryne means "club"), and often show incomplete separation during cell division. The incomplete separation is caused by a characteristic "snapping" cell division, which leads to their peculiar cell wall. During cell division, the plasma membrane divides normally, but the cell wall may only partially separate, forming V- and other odd-shaped assemblages of two or more cells. The genomes of three species have been sequenced and contain a single circular chromosome of about 2. Pathogenicity and Clinical Significance Diphtheriae is the most important corynebacterial pathogen of humans and causes diphtheria. This disease is an upper respiratory infection with a characteristic pseudomembrane that covers parts of the pharynx and adjacent areas. Diphtheriae to epithelial cells at the site of infection, causing them to produce the fibrin-based pseudomembrane. The toxin can also be disseminated to many other areas of the body, leading to possible organ failure. Only those strains with an integrated lysogenic phage that carries the gene for the diphtheria toxin are able to produce the toxin. The disease severity is often a consequence of the strain of diphtheriae that causes the infection, because different strains grow at different rates and produce different amounts of diphtheria toxin. The toxin regulatory gene (DtxR), located on the bacterial chromosome, also affects toxin levels. Diphtheriae also can cause cutaneous diphtheria, a skin infection, if it enters a break in the skin. Nonpathogenic Corynebacterium are often referred to as diphtheroids, however, many of them can be opportunistic pathogens, especially in the elderly, the immune compromised, and those with prosthetic devices. Bovis and ulcerans have been isolated from skin ulcers, and bovis and pyogenes have caused systemic bacteremia. Corynebacteria that have been isolated from other infections include xerosis, jeikeium, striatum, and pseudodiphtheriticum. Many other diphtheroids, found as commensal organisms on healthy persons, might become pathogenic under the right circumstances. The antibiotics of choice are penicillin and erythromycin, administered for fourteen days. Antibiotic susceptibility of the diphtheroids varies, but penicillins, erythromycin, and rifampin are usually good choices. Volume 5 of this multivolume work describes Corynebacterium and its relatives in detail. This text outlines many common bacteria and describes their natural history, pathogenicity, and other characteristics. Salem Health Definition Cowpox is an extremely rare zoonotic disease in humans, acquired from direct contact with an infected cow or other mammalian host. It is a skin disease that results in a rash and ulceration, but no long-term effects. Edward Jenner, observing that milkmaids who had had cowpox never were infected with smallpox, used biological material from a cowpox lesion as the basis of the first successful vaccination in 1796. Because the two viruses have similar antigenic sites, antibodies produced against the cowpox virus provide immunity to smallpox. In modern times, inoculation with the related vaccinia virus is used as the smallpox vaccination agent, providing cross-immunity to cowpox. Although found in cattle, from which it derives its name, the cowpox virus has many mammalian reservoirs, including wild rodents such as mice and voles, and cats. The virus also has been found in zoo animals, particularly feline species and elephants. Cowpox is found primarily in the United Kingdom and the former western states of the Soviet Union and adjacent areas of north and central Asia. Risk Factors Infection can occur only through a break in the skin in direct contact with a cowpox lesion, especially from cats. Only one reported case of systemic involvement and death has been reported, and this occurred in an immune-compromised person. Symptoms At the site of infection, which is usually the hands, the normal symptoms is a rash followed by a pustular blister that then ulcerates, scabs over, and leaves a scar. Swollen nodes, slight fever, Cowpox Category: Diseases and conditions Anatomy or system affected: Skin Infectious Diseases and Conditions chills, loss of appetite, headache, and muscle aching may occur. Screening and Diagnosis Because cowpox is so rare, a physician will often misdiagnose the condition as bullous impetigo and treat it with antibiotics, which are ineffective. A patient history of contact with cats, and subsequent scratches, may help in diagnosis. Treatment and Therapy Generally, treatment is only supportive, as the disease is mild. Poxvirus infections can be treated with cidofovir or vaccinia immunoglobulin in immunocompromised persons. Prevention and Outcomes Because of its rarity, cowpox prevention techniques are not needed.

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This drug has shown potent hypertension jnc 7 classification buy discount enalapril 5 mg on-line, broad-spectrum, activity against the rhinovirus, according to one study. These viruses are not considered life-threatening, although older or immune-compromised persons may acquire serious infections that can be life-threatening. Continued research for new vaccines is ongoing because the genetics of virulence phenotypes of picornaviruses needs further study to be understood. This family has twelve genera, although some of these are unique either to plants or to animals. Picornaviruses are common and have worldwide prevalence, with the exception of poliovirus, which has been virtually eliminated in most countries. Causes Picornaviruses are most commonly transmitted by the fecal-oral route or by the respiratory route. They also may be sexually acquired, as with hepatitis A, or during pregnancy through the placenta or labor and delivery. Also, many enteroviruses are often spread in hospitals because of improper handwashing or through contaminated equipment. Enterovirus infections may occur at any age, but the younger the person, the higher the risk. Hepatitis A infections increase with age, sexual contact with the virus, or illicit drug use. Additional risk factors include occupational exposure, such as in a day-care or hospital setting, and poor living conditions. Common findings include a flulike fever, upper respiratory tract infection, lethargy, irritability, poor feeding, and rash. More severe findings are inflammation of the liver (hepatitis), pancreas (pancreatitis), heart (myocarditis), and brain (encephalitis or meningitis), which place a person at an increased risk for long-term complications such as liver dysfunction or neurological deficits. The greatest risk for morbidity and mortality exists with hepatitis and poliomyelitis. Screening and Diagnosis Testing is performed by sampling through serum, throat, or rectal swab; stool sample; or cerebrospinal fluid. Prenatal diagnostic tests such as amniocentesis may be available for specific types of enteroviruses. Salem Health Treatment and Therapy the majority of affected persons have mild symptoms that do not require treatment, as many infections independently resolve within one week. Possible avenues of treatment include medication for cold and flu symptoms, hospitalization, immunoglobulins, diet modification, or liver transplantation in the case of hepatitis. However, recommendations for some include routine vaccination for poliovirus and hepatitis. Universal hygiene practices such as handwashing, avoiding contact with contaminated items, and safer sexual practices may reduce the spread of picornaviruses. Unlike other fungal scalp infections, such as tinea capitis, Piedraia-infected hairs usually do not break off. The colonies are distinguished by thick-walled, branched, dark-colored septate hyphae. A colony may remain glabrous (smooth and hairless) or become covered with short, light, airy hyphae. Under microscopic examination, colonies of hortae reveal packed masses of dark septate hyphae (segmented filaments). Also seen are asci, which are thinwalled sacs that contain sexual spores called ascospores. The ascospores of hortae are hyaline (transparent), one-celled, and tapered toward both ends to form whiplike appendages. Pathogenicity and Clinical Significance Hortae is the cause of black piedra, an infection of scalp hair. White piedra, in contrast, is caused by five species of the fungus Trichosporon and infects hair on the scalp, face, and pubic regions. Because of this, and because the nodules, although plentiful, are small, the infection may be under-reported. Drug Susceptibility There is scant data on drug susceptibility of infection caused by hortae. No standard method for testing or comparison has been developed, although terbinafine has been shown to be effective. Shaving or clipping infected hair may resolve the infection, and it is the standard treatment of choice. In persons who are reluctant to have hair removed, a topical antifungal agent (cream, ointment, or solution) may be used instead. A topical agent may also be applied to the scalp in conjunction with hair removal. Common choices of topical agents are a salicylic acid preparation or an imidazole cream. Medical treatment without hair removal has a greater risk of relapse than does Piedraia Category: Pathogen Transmission route: Direct contact Definition Piedraia is a genus of fungi of which one species, P. Natural Habitat and Features Piedraia is found in soils worldwide but most often in humid tropical regions of Central America, South America, Southeast Asia, and Africa. In Brazil, it is found almost exclusively in regions with a mean average temperature of 78. International travel and migration have led to reports of isolated detection and sporadic outbreaks of infection in nontropical areas. Piedraia is a saprotrophic mold, meaning it lives on decaying material and dead tissue. Quintanilhae has been isolated from the hair of chimpanzees in central Africa, but no cases of human infection have been reported. Hortae causes an infection of human scalp hair and can occur anywhere on the scalp. Infection of hair elsewhere on the body, such as beard, moustache, or pubic hairs, almost never occurs. Transmission of hortae and its infection between persons occurs primarily through the use of shared hair-care tools and products. In the tropics of Brazil, some indigenous people use plant oils to dress the hair, which can introduce hortae to the scalp and encourage its transmission. Infection is most common among young adults, with a slightly higher preponderance among males. In persons infected with hortae, the scalp reveals small, firm, tightly packed, irregular (oval or elongated), dark brown to black nodules that are composed of fungal matter attached to the sides and tip of hairs. In immunocompromised persons, infection may spread and produce purplish hemorrhagic nodules on the skin. Salem Health Direct Contact the swine flu received its name because of similarities in the genetic makeup of the flu strain with a strain that lived in pigs. The World Health Organization declared a swine flu pandemic in 2009; however, there is no indication that humans contacted this strain from pigs. To avoid using this rather misleading name, some have preferred to call swine flu the H1N1 virus, a name derived from the presence of two surface antigens on the virus. Although cross-species (pig to human and human to pig) infections have been known to occur, these infections were caused by direct contact of humans with pigs and have been limited to local areas. The H1N1 virus consists of one segment from a human flu segment, two from avian strains, and five from swine strains. If a pig is infected simultaneously by a pig and human flu virus, for example, segments from both species can be incorporated into a new virus with different surface antigens. The host species is then vulnerable to infections because its immune system does not recognize the different antigens.

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The concern for donor transmission had prompted the deferral of blood donations from persons considered high risk blood pressure levels chart order enalapril without a prescription. During the clinically silent period, biological material from the affected person is potentially infectious. One should exercise caution in surgical settings and pathology laboratories that manipulate brain-derived biological material. One should use disposable instruments for spinal tap, brain biopsy, or histological processing. If this is not possible, special autoclaving procedures and chemical agents (for example, household bleach and detergents) help inactivate the prions. This article describes both human and animals forms of prion diseases and their modes of transmission. Includes basic information on prion diseases with continually updated online references. Croup Category: Diseases and conditions Anatomy or system affected: Larynx, lungs, respiratory system, throat, tissue Also known as: Laryngotracheobronchitis Definition Croup is inflammation or infection of the larynx(voice box) and trachea (windpipe). The inflammation causes tissue in the respiratory tract to swell, making it difficult for air to reach the lungs. As children grow older, their air passages widen, so swelling that is severe enough to block breathing is less likely in older children. Causes Causes of croup include viral infections such as parainfluenza, paramyxovirus, influenza virus type A, respiratory syncytial virus, adenovirus, rhinovirus, enterovirus, coxsackie virus, enteric cytopathogenic human orphan virus, reovirus, and measles virus. Tests for specific viruses are rarely performed, so the actual cause of croup is usually not known. Conditions that resemble croup can also be caused by bacterial infections, allergies, and softening of cartilage in the larynx. Risk Factors Risk factors include attending day care, having a personal or family history of croup, and having frequent upper respiratory infections. Children ages three years and younger are at greatest risk, and there is a Infectious Diseases and Conditions greater risk of developing croup in the colder months of October through March. Croup symptoms come on suddenly, often at night and include cough spasms; cough that sounds like a barking seal; hoarseness; fever; harsh, high-pitched breath sounds, especially when crying or upset; trouble breathing; and poor appetite and fluid intake. More serious symptoms of croup that require immediate medical attention include a bluish color of the nails and lips or around the mouth. Other serious symptoms are decreased alertness, restlessness or agitation (possibly from a dangerous lack of oxygen); struggling for each breath; harsh, high-pitched breathing sounds, even at rest; trouble swallowing; drooling; and an inability to speak because of troubled breathing. Tests may include blood tests, to check for signs of infection; neck X rays, to look for changes associated with croup; laryngoscopy (in which a thin tube is inserted into the mouth to look at throat tissue); and a culture of mucus from the trachea, to test for infection. Treatment and Therapy Treatment aims to keep the airway open while the infection resolves on its own in five to seven days. One should take the child into a bathroom, close the door, and run hot water in the shower, which will fill the room with moisture, and do so for fifteen to twenty minutes. The doctor may prescribe steroids to reduce swelling in the airways; this treatment has been shown to benefit croup and may keep a child from becoming sick enough to need hospitalization. Breathing treatments with a medicine called racemic epinephrine may provide temporary help until steroid medications (usually dexamethasone) start to work. Because most croup is caused by a viral infection, antibiotics are not usually given unless there is an accompanying problem, such as an ear infection or pneumonia. A child with serious croup may be hospitalized and placed in a plastic croup tent, in which cool, moist air is delivered. If the child continues to get worse, a breathing tube may be inserted in his or her throat to help keep the airway open. In severe cases, a surgical procedure called a tracheotomy can be performed to keep the airway open. Prevention and Outcomes Croup usually occurs in response to an upper respiratory infection. Yearly influenza immunization can prevent those cases of croup caused by influenza A. Influenza immunization is strongly recommended for all children between the ages of six months and five years. Salem Health Causes Cryptococcosis can be caused by either of two types of fungi Cryptococcus neoformans or C. Because the fungi enter the body through inhalation of airborne fungal spores, the most common site of infection is the lungs. However, cryptococcosis can develop in any part of the body, including skin, eyes, central nervous system, and bones. Risk Factors Risk factors for cryptococcosis include exposure to areas with a high concentration of bird droppings and to soil or trees contaminated with C. Symptoms When the lungs are affected, symptoms include fever, cough, shortness of breath, and coughing up blood (hemoptysis). If the central nervous system becomes involved, symptoms of meningitis occur, these include stiff neck, headache, vomiting, and seizures. Screening and Diagnosis A complete physical exam will reveal impaired immunity in combination with symptoms that lend suspicion for cryptococcosis. To confirm the diagnosis, the patient may receive a chest X ray; routine laboratory testing and culture of skin lesions, blood, urine, or sputum; and a lumbar puncture, which involves aspiration of cerebrospinal fluid for analysis. Treatment and Therapy Cryptococcosis is treated with oral or intravenous antifungal medication, such as amphotericin B and flucanozole, for a minimum of fourteen days. Infectious Diseases and Conditions symptoms, require hospitalization, and often experience a recurrence of infection. Prevention and Outcomes Avoiding infested tropical and subtropical areas is key to preventing cryptococcosis. Cryptococcus Category: Pathogen Transmission route: Inhalation Definition Cryptococcus is a type of fungus that can be found worldwide in soil and in areas on and around trees. Natural Habitat and Features A Cryptococcus infection, or cryptococcosis, is typically caused by contaminated soil. Neoformans and gattii are the only two forms of cryptococcosis that are transmitted to humans. Neoformans is the most common species found in the United States and comes from the aged feces of wild birds, such as pigeons. The feces become dry and, once disrupted, produce spores that are released into the air. Gattii, which is typically found in tropical and subtropical climates, has also been identified in Canada and the United States. Gattii is not associated with bird feces; rather, it is associated with the bark, leaves, and plant debris of eucalyptus trees and gum trees. Cryptococcus cells are round or oval shaped and are surrounded by a polysaccharide capsule comprising mannose, xylose, and glucuronic acid. During sexual reproduction of the Cryptococcus cell, two fungal cells fuse and develop threadlike extensions called hyphae. Each species has five serotypes based on the antigenic specificity of the capsular polysaccharide. Responses include harmless colonization of the airway and asymptomatic infections to meningitis and disseminated disease. Once the fungal elements have been inhaled, the yeast spores deposit themselves in the pulmonary alveoli. They must survive the neutral to alkaline pH (acidity) and physiologic concentrations of carbon dioxide before they can be phagocytized by alveolar macrophages. Both neoformans and gattii, once inhaled, may cause pneumonia-like symptoms, including shortness of breath, cough, chest pain, and fever. The mode of entry for Cryptococcus is through the lungs; however, the central nervous system is the main site of clinical involvement. Cryptococcal meningitis and meningoencephalitis are the most common and most serious forms of cryptococcal disease affecting the central nervous system.

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They have a strong cell wall but one that lacks the peptidoglycan seen in most bacterial cell walls arrhythmia journal articles purchase enalapril 10mg on-line. Instead, the protective wall contains lipopolysaccharides and unique cysteine-rich proteins. Infection can be transmitted through contact with eye discharges on skin, inanimate objects, or eye-seeking flies. Infection also can be transmitted during birth, as the fetus passes through the birth canal of an infected woman. In trachoma, the inside of the eyelid becomes scarred and, after repeated infection, can cause scarring of the cornea, which eventually leads to blindness. About 84 million people worldwide have trachoma, and the disease is responsible for 3 percent of all blindness, down from 15 percent in 1996. Its exact prevalence is not known because it is asymptomatic in 60 to 75 percent of infected women and in 25 to 50 percent of infected men. Also, women with chlamydial infections are five times more likely to be infected with the human immunodeficiency virus if exposed to that virus. In men, the most common symptom is urethritis, which leads to painful urination, purulent discharge from the penis, and swollen or tender genitalia. It is possible for the bacteria to spread farther through the reproductive tract and cause prostatitis and epididymitis. The Centers for Disease Control and Prevention guidelines suggest either a single dose of azithromycin or twice-daily doses of doxycycline for seven to four- Salem Health teen days. Tetracycline and erythromycin are also effective, and ciprofloxacin also has been used. Penicillin and other beta-lactam antibiotics are ineffective because they are chlamydiostatic only, not chlamydiocidal. This text outlines many common bacteria, describing their natural history, pathogenicity, and more. This article describes chlamydial pathogenesis and possibilities for decreasing infections worldwide. Chlamydiales is now thought to contain three families: Chlamydiaceae, Parachlamydiaceae, and Simkaniaceae. Their cell wall is without a peptidoglycan layer but does contain gram-negative-like lipopolysaccharides and uniquecysteine-rich proteins found only in Chlamydiales. The genomes of several Chlamydophila strains have been sequenced, and most strains also contain a large plasmid of about 7,550 base pairs. This plasmid seems to be involved in virulence because avirulent strains have been found to lack this plasmid. In addition, pathways to produce many amino acids and other cellular building blocks are incomplete or missing, so that these too must be obtained from the host. Some carbohydrates can be broken down by a modified glycolytic pathway, but carbohydrate metabolism is incomplete. Pathogenicity and Clinical Significance Of the six species of Chlamydophila, two, pneumoniae and psittaci, commonly cause human disease. Humans are occasional hosts for two others, abortus and felis, while the final two, pecorum and caviae, are not known to infect humans. In humans, pneumoniae, as its name implies, is primarily found in the respiratory tract, where it causes bronchitis and pneumonia. It has also been associated with other chronic respiratory diseases and chronic infections have been implicated in a higher risk of lung cancer. The bacterium had been considered a strictly human parasite, but some strains have been found in koalas, where they are associated with respiratory infections too, and in horses, where they seem to be asymptomatic. Occasionally, strains can be also isolated from the conjunctiva and the urogenital tract. In humans, the infection leads to a severe atypical pneumonia called psittacosis (also known as ornithosis and parrot fever). A pandemic of the disease occurred in 1929-1930 following a shipment of infected parrots to various parts of the world. Abortus, once considered a subspecies of psittaci, is associated with placental colonization and abortion in ruminants. These bacteria have been associated with respiratory disease in humans who work with infected animals and associated with abortion in women who work with infected sheep. Humans who have close contact with infected cats are occasionally infected, showing many of the same symptoms. Pecorum has a broader host range and has been found in koalas, ruminants, and swine. In most organisms, it is associated with abortion, conjunctivitis, and respiratory infections. In koalas, it is also a leading cause of infertility and other reproductive diseases. This article gives a detailed description of the taxonomy of the order Chlamydiales, including the genus Chlamydophila and its species. A good introduction to zoonotic diseases, including psittacosis and other Chlamydophila infections. This two-volume textbook provides background and detailed information about all types of microbes and infectious sources, including Chlamydophila. A chest X ray will show if a person has pneumonia, although the X ray does not differentiate the type of pneumonia. Treatment and Therapy Antibiotics such as erythromycin, doxycycline, and tetracycline are used for acute infections. For example, tetracycline may be given at 500 milligram (mg) doses, four times daily for fourteen days; doxycycline at 100 mg twice daily for fourteen days; and erythromycin at 500 mg for fourteen days. If cough or malaise continues after a full course of treatment, the doctor may choose to prescribe a second course of treatment. Prevention and Outcomes Stopping a smoking habit decreases the risk for all forms of pneumonia, including infection with C. Chlamydophila pneumoniae infection Category: Diseases and conditions Anatomy or system affected: Lungs, respiratory system Definition Chlamydophila pneumoniae infection is caused by the bacterium Chlamydophila pneumoniae, which leads to pneumonia, bronchitis, sinusitis, and pharyngitis. Risk Factors Persons who are sixty-five to seventy-nine years of age have the greatest risk for infection with C. In addition, persons of all ages who are immunocompromised also have an elevated risk for infection. Persons with asthma often experience worsening symptoms, and recurrent infections with this bacterium may lead to the onset of chronic asthma in children and adults. The presence of laryngitis is the most common symptom differentiating persons with infection caused by C. Swollen mucosa Salem Health Normal Inflamed Exudate on surface Reddish color Mixture of bile, blood, pus A normal gallbladder and one inflamed by cholecystitis. Cholecystitis Category: Diseases and conditions Anatomy or system affected: Digestive system, gallbladder, gastrointestinal system Definition Cholecystitis is an inflammation of the gallbladder, usually caused by the formation of gallstones (cholelithiasis). Research has revealed cholecystitis is often accompanied by a bacterial infection, particularly a form of Helicobacter. If it is acute, pain generated by the inflammation is extremely severe, and most affected persons attempt to see their physicians as soon as possible or go to a hospital emergency room. If cholecystitis is chronic, pain is intermittent and characterized by periodic bouts of exacerbation. Causes About 90 percent of all cases of cholecystitis involve gallstones, which can cause blockage and inflammation of the gallbladder. About 80 percent of these stones are formed by cholesterol, while others are pigment stones comprising bilirubin or are mixed stones composed of cholesterol and pigment. Some persons have acalculous cholecystitis, gallbladder inflammation without gallstones.

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Other defenses include bactericidal enzyme action in secreted bodily fluids and more complex complement proteins arrhythmia from caffeine buy generic enalapril 10 mg on-line. The innate immune system is nonspecific, focusing on conserved pathogen-associated molecular patterns so that many organisms are attacked in a similar fashion. Although the quality and efficacy of the initial innate response do not improve after subsequent exposures to the same pathogen, innate immunity includes a number of other defense mechanisms. Epithelial surfaces, including the genitourinary tract, respiratory tract, skin, and gastrointestinal tract, produce antimicrobial peptides such as defensins and cathelicidins that inhibit bacterial and fungal growth. Two nonspecific methods to eliminate microorganisms are phagocytosis and opsonization. In phagocytosis, specialized cells such as neutrophils, monocytes, and macrophages ingest and destroy ingested pathogen particles. In opsonization, phagocytic cells recognize a plasma protein (opsonin) binding to the surface of the pathogen, leading to enhanced phagocytosis. The hallmark of innate immunity is an inflammatory response (inflammation or edema). Proinflammatory mediators such as cytokines, chemokines, and lipid mediators clear the infection. Inflammation, however, is damaging and painful to tissues, and some chronic diseases possess an inflammatory pathology component. Innate immune response is an early defense mechanism against infection, but it is also essential in boosting subsequent adaptive immune responses. During adaptive (acquired) immunity, the immune system develops a defense specific to a particular antigen and does so with immunological specificity and long-lasting memory beyond the acute infection. Virtually any substance of a certain size, including cell proteins, viral nucleic acids, chemicals, or foreign particles (such as a splinter), can become an antigen. The goal of an acquired immune response is to recognize and destroy substances containing antigens. Immunity and infectious disease Category: Immune response Also known as: Acquired (adaptive) immunity, cellular immunity, immune response, inflammatory response, innate immunity Definition Immunity is the state, quality, or condition of being resistant to pathogens, parasites, and nonliving harmful substances. Innate and Acquired Immunity Ubiquitous pathogens are found on surfaces, on food, and in the air. Innate and acquired immunity confer lifelong protective immunity to the body against foreign substances, including harmful toxins, viruses, and bacteria. Three basic components work closely to protect the body: physical barriers such as the various epithelial surfaces, innate immunity, and acquired immune responses. Inherited genes, environment, lifestyle, and acquired characteristics can influence the state of immunity. Following antigen exposure, antigens are taken up and presented to B and T lymphocytes by antigenpresenting cells such as macrophages from the innate system or by dendritic cells from the acquired system. After recognizing their specific matching antigen, B cells differentiate into plasma cells, which then produce and secrete large amounts of antibodies against the specific antigen. Likewise, T cells differentiate after antigen recognition into helper T cells (Th) or cytotoxic (killer) T cells (Tc); the T cells release lymphotoxins causing cell lysis. Although innate immunity is available instantly upon infection, acquired immunity takes approximately seven to ten days to mount an initial response. Parts of the innate system, such as complement or phagocytosis, can also be activated by the acquired system through antibody mediation. Immunoglobulin (Ig) is another term for antibody; it binds specifically to antigenic determinants or epitopes. Immunoglobulins inactivate antigens by complement fixation, neutralization, agglutination, and precipitation. Immunoglobulins are made of two identical heavy chains and identical light chains. Passive and Active Immunity Antibody-mediated immunity includes passive and active immunity. In passive immunity, "natural" or "artificial," the body does not manufacture its own antibodies; rather, the body gets antibodies from another person. For example, infants undergo natural passive immunity during the transfer of antibodies through the maternal placenta or milk. These infant antibodies disappear between six and twelve months of age with the replacement of breast milk. Passive immunity is Salem Health short-lived because these antibodies are degraded in the body over time and because no immunological memory exists to produce more antibodies. Artificial passive immunity involves the transfusion of antiserum or the injection of antibodies that were produced by another person or animal. Immediate protection against an antigen is achieved through these antibodies, although it is a short-lived immunity. Examples of passive immunization include tetanus antitoxin and purified human gammaglobulin. Immunity Disorders and Complications Sometimes single components of the immune system are inefficient, absent, or excessive. The impaired immune system is considered immunocompromised, and it could leave the host body vulnerable to various opportunistic infections. The failure of host defense mechanisms can lead to conditions such as autoimmune diseases, immunodeficiencies, allergies, delayed hypersensitivity states, and transplant rejections. Immune responses in the absence of infection include allergy or hypersensitivity reactions, autoimmunity, and graft rejections. Impact Vaccination is a preventive measure against morbidity and mortality resulting from infectious diseases such as polio, measles, diphtheria, pertussis, rubella, mumps, tetanus, and Haemophilus influenzae type B. It is an artificial method of building immunity by deliberately infecting a person so that the body learns selfprotection from a pathogen. Another immunization strategy is herd immunity, in which immunization of a high percentage (a herd) of a population provides protection to unvaccinated persons. This type of community immunity tries break Infectious Diseases and Conditions the chain of infection by having large sections of a population immune. Reviews the concepts of active and passive immunity and discusses the commercially available vaccine types and how they generate an adaptive immune response. Presents a theoretical disease-ecology framework in which fertility, poverty, and disease interact and lead to the acquisition of herd immunity. A standard textbook for medical and immunology students that offers a comprehensive overview of the subject. Highlights the efficacy of antibodies in the prevention and treatment of infectious diseases. Examines evidence that secretory antibodies offer defense against infection in some animal models. Introduction the period from 1870 to the start of World War I is considered to have been the golden age of immunology. Others are looking to improve the effectiveness of antigens in stimulating immunity with the use of additives called "adjuvants. Before the invention of vaccines, it was known that people who recovered from certain diseases, such as smallpox, were immune to the disease thereafter. Reportedly, Chinese physicians were the first to try to exploit this phenomenon to prevent disease by drying and grinding up smallpox scabs that were then inhaled by children. In England, contaminating a fresh skin cut, called "variolation," with scabs from smallpox wounds became common in the eighteenth century. Most often, localized skin reactions occurred; serious cases of smallpox were less common. Although only 1 percent of people became seriously sick after variolation, the mortality rate was as high as 50 percent. English physician Edward Jenner occasionally encountered patients who did not respond with the usual reactions to variolation. According to one story, a milkmaid had told Jenner that she would not get smallpox because she had already had cowpox, a mild disease that causes lesions on the udders of cows and would sometimes infect the hands of milkmaids.