Contagious Diseases

There are two clinical forms of plague: bubonic plague and pneumonic plague. In bubonic plague do appears acute pain in area of damaged lymphatic glands (located in groin area) before their increase, in children pain appears in underarm and neck areas.

Regional lymphatic glands are damaged in spots of flea-bites. In those spots is rapidly developed haemorrhagic necrotic inflammation. Glands are joined between them (also with adjoining skin and hypoderm) into adhesions forming a large bag (bubo). The skin glosses, becomes red, appear sores on it and bobos get opened. In hemorrhagic exudate is found large amount of plague bacillus.

In pneumonic plague appears  hemorrhagic inflammation with necrosis of small pulmonary focuses.

Then appear acute pains in chest, heartbeats, labored breathing, tachycardia, delirium, fear of a deep breath. Cough appears at the beginning, with big amount of mucilaginous, transparent hyaline wet which then becomes foamy, liquid and rusty. Pain in chest increases, breath becomes weaker. Typical symptoms of common intoxication: quick aggravation of condition, development of infectious toxic shock syndrome. The prognosis is severe, patient dies in 3 – 5 days.

Recognition
Recognition is based on clinic and epidemiologic evidences. The final diagnosis is made on the basis of laboratory tests (bacterioscopic, bacteriologic, biological, serologic).

Treatment
All diseased people must be hospitalized. Major principles of therapy is complex usage of antibacterial, pathogenetic and symptomatic therapies. Are indicated infections of desintoxication liquids such as polyglucin, plasma, hemodez, glucose solution, salt solution.

Prevention
Fighting gnawing animals, especially rats. Supervising people who work with infected materials.

Plague is a quarantine natural focal disease characterized with high fever, severe intoxication , appearing of bobos (necrotic changes in lymphatic glands, lungs and other organs) and sepsis. Pathogen is a motionless barrel shaped bacillus of plague. It is most dangerous infection. In nature it is saved due to periodic appearing of epizootic disease in gnawing animals who are major carriers of plague microbes (marmots, gopher).

The transmission of pathogen from animal to animal occurs via flea. A human gets infected with plague via contacting with diseased animals (skinning, meat cutting), consuming infected products, flea-bites, airbone. Human vulnerability is very high. Person diseased with plague is dangerous for other humans, especially when he suffers from pneumonic form of plague.

Symptoms
Incubation period lasts 3 – 6 days. The disease starts acutely with sudden chill and quick temperature increase to 40C. Chill is changed to fever, severe headache, dizziness, weakness, insomnia, nausea, vomit, muscle pains. Patient suffers from intoxication, impairment of consciousness, in some cases appear psychomotor agitation, delirium, hallucinations, lurch, redding of face and conjunctiva.

Face features become keen and appear dark circles under eyes. Skin is dry and hot to the touch, may appear petechiasis, large haemorrhages. Quickly are developed symptoms of cardio-vascular system damage, cardiac border widening, hollowness of tones, growing tachycardia, blood pressure drop, arrythmia, breathlessness, cyanosis.

The tongue has specific look: it is thick with breakings, covered with thick white accretion. Mouth mucosa is dry. Tonsils often are increased, have sores, on velum palatinum are found hemorrhages.In severe cases occurs frequent liquid stool with admixture of blood mucus. In urine may be found admixture of blood and protide.

Cholera is an acute contagious disease characterized with damage of small intestine, water-salt metabolism failure, different desiccation rate because of liquid loss during vomiting and watery feces.  Cholera belongs to quarantine infections. The agent is bacterium Vibrio cholerae in form of hooked bacillus. During boiling the bacterium dies in a minute. Some bacteria types may persist for a long period of time and multiply in iodine, silt and in organisms that live in ponds. Source of infection is diseased person. Vibrio cholerae is released with feces and vomit mass. Cholera outbreaks may be watery, alimentary, household and combined. Susceptibility to cholera is high.

Symptoms and signs
Cholera may course without symptoms or may show with severe symptoms leading to death.  Incubation period lasts from 1 to 6 days. The disease starts acutely. First sign is sudden diarrhea, mostly  in the evening and in the morning.

At the beginning feces are watery, then smell disappears and may appear blood. Then appears vomit that occurs suddenly. Diarrhea and vomit are not followed with abdomen pains. When patient loses great amount of liquid, the symptoms of digestive tract damage drops back. Most important sign of failure in activity of major body systems, severity of which is determined by degree of dehydration:
 - first degree: dehydration is slightly frank
 - second degree: body weight lowering by 4 – 6%, lowering of erythrocytes number and drop in hemoglobulin level. Patient complains on sudden weakness, dizziness, dry mouth, thirst. Lips and fingers turn blue, appears hoarseness of voice, occurs jactitation of gastrocnemius muscles, fingers and chewing muscles.
 - third degree:  body weight lowering by 7 – 9% and all symptoms of dehydration are aggravated. Blood pressure drop may lead to collapse. Body temperature lowers up to 35.5C. Urine may stop releasing. Blood becomes more concentrated because of dehydration.
 - forth degree: body loses 10% of liquid. Facial features do sharpen, appear dark spots around eyes. Skin is blue. Patient is in state of exhaustion. Blood pressure suddenly drops. Body temperature lowers up to 34,5C. Frequently all these symptoms lead to death.

Complications
Pneumonia, abscesses, phlegmon, erysipelas, phlebitis.

Treatment
Hospitalization of all patients. First of all it is necessary to fight dehydration and restore water-salt balance. It is recommended to take solutions containing sodium chloride, potassium chloride, sodium bicarbonate, glucose. In menu should be included products containing potassium salt (tomatoes, potatoes). Antibiotics are used only in case of 3 – 4 degree of dehydration - tetracycline and laevomycetin are used in average daily doses. The prognosis in adequate treatment is favorable.

Prevention
Protection and deintoxication of potable water. Active supervision of people who were in contact with diseased people during 5 days. 

Testicles are major male sex gland. This pair organ produces major male sex hormone, testosterone, and male sperm cells.

In case testicles tissue is affected, it leads to development of most severe form of infertility.

Mostly, the gland is exposed to the inflammation called orchitis. The inflammation breaks nutrition of adenoid tissue, thus tissue that was destroyed is unable to provide sex cells and sex hormones anymore.

Male infertility may be a complication of sinusitis, mumps virus and even influenza.

Orchitis causes:

• viral or bacterial infections which may spread through the blood from center of infection found in other organs of the body
• trauma (posttraumatic orchitis)

Orchitis symptoms:

• pains in testicles area
• scrotum increase (most frequently - on one side)
• edema of scrotum tissue
• increase of groin lymph glands on affected side

In assumption of orchitis or after trauma you should necessarily undergo an examination. After all examinations, the diagnosis should also be confirmed with ultrasound examination.

Orchitis is treated with antibiotics.

Prevention
major way to prevent men from infertility is to vaccinate them in childhood from mumps
sportsmen (boys and men) should use special devises to protect their groin from all possible traumas

It was James Wright, famous scientist, who discovered that steroids help to treat different diseases. He was the first man who started to study effects of particular amount of these substances on the body when the person has particular disease. 

Steroids may really treat diseases. Most important thing here is to maintain healthy lifestyle and follow all doctor's directions.

So what is the medical usage of steroids?
First of all, steroids may be prescribed to a person as a replacement therapy, or in other words, in case when the man suffers from their deficiency in the body. Very frequently steroids are used to increase proteins in aged people. In case protein deficiency occurred in early age, then you cannot do without steroids.

Refractory anemia, growth retardation and kidney failure are indications for steroids administration. Steroids are used in treatment of hyper catabolism in patients with burns. In some cases steroids are prescribed as addition to common therapy. Most frequently this occurs in such serious disease as diabetes.

Steroids also are used in case of impotency caused by androgens deficiency. Male climax, male infertility, liver cirrhosis, angioedema in newborn babies – in all those cases are used steroids.

Buy anabolic steroids to treat male climax.

Bubonic tularemia is characterized with primary damage of spot where infection entered. This form may occur on eyes when pathogen hits conjunctiva. Typically, on conjunctiva appears yellow follicular growth of millet grain size. When bubo develops in periotic and inframaxillary areas, the disease course is more lasting.

Anginal bubonic tularemia occurs in case of primary damage of mucus membrane of one of tonsils. Patient is infected via food.

Some forms of  tularemia do damage internals. Pulmonary tularemia frequently occurs in fall and winter time. Generalized form courses like common infection with frank toxicosis, loss of consciousness, delirium, severe headaches and muscle pains.
There may be specific complications (secondary tularemic pneumonia, peritoneal inflammation, pericarditis, meningoencephalitis), and apostasis, gangrene caused by secondary bacterial flora.

Diagnosis is made on the basis of skin and serological tests.

Treatment
Admission of patient. Major treatment with antibacterial medications (tetracycline, aminoglycoside, streptomicin, laevomycetin) is performed till fifth day of normal body temperature. In long-running cases is used combination therapy with antibiotics and vaccine. It is very important to take vitamins and make recurrent donor-specific transfusions. In case of bubo fluctuation is performed surgical intervention (a wide cut to help bubo to release liquid). Patients leave hospital only after full clinic recovery.

Prevention
1. liquidation of hot spots or reduction of their areas
2. protection of houses, surface waters and food from mouse-like rodents
3. vaccination of people in hot spots of  tularemia

Tularemia is a zoogenous infection with natural nidality. Tularemia is characterized with intoxication, fever, lymph nodes damage. Pathogen is tiny microbe which dies at the temperature 60C in 5 – 10 minutes. Reservoirs of the rod are rabbits, water rats, field mice. The infection is transmitted to human directly via infected animals (hunting) or via infected products and water, and rarely via aspiration way (while processing grain products) or blood-sucking insects (acarian, mosquito).

Symptoms and treatment
Incubation period is from several hours to 3 – 7 days. There are three forms of tularemia: bubonic, pulmonic and generalized. The disease starts acutely with sudden temperature rise up to 38 – 40C. Appears acute headache, giddiness, pains in muscles of legs, back, lumbar region and appetite loss. In severe cases may appear vomit and nose bleed.

Specific symptoms: frank sweating, sleeping disorders such as insomnia or sleepiness. Frequently is observed euphoria and activity increase on the back of high temperature. Sometimes in the first days of the disease is observed redding and puffiness of face and conjunctiva. Then on oral mucosa appear punctate hemorrhages. Tongue has grayish fur. Most specific symptom is increase of lymph nodes and it may have various sizes.

Patient may experience brachycardia and hypotension. Liver and spleen get increased not in all cases. Pains in abdomen are possible when lymph nodes are significantly increased. Fever lasts from 6 to 30 days.

Bubonic form of Tularemia
Pathogen enters into the body via skin without leaving any trail. In 2 – 3 days develops regional lymphadenitis. Buboes are less painful and have crisp outlines with size of 5 cm. Then in 1 – 4 months occurs softening of buboes or their self-induced opening with releasing stiff creamy pus and formation of fistula. Most often are damaged lymph nodes in armpits, groin and tights. 

Epidemic typhus is caused by Rickettsia prowazekii and is characterized with cyclic course and fever, typhoid condition, specific rash and damage of cardiovascular and nervous systems.

The only source of infection is diseased person with headlice which suck blood full of rickettsiae and diseased people transmit it to healthy person. Man gets infected while scratching bite spots by rubbing lice excrements into skin. Bite itself not leads to infection because pathogens of epidemic typhus are not found in salivary gland. In humans vulnerability to epidemic typhus is high.

Symptoms and course
Incubation period lasts 12 – 14 days. Sometimes in the end of incubation period patient experiences mild headache and body pains.

Body temperature increases and appears chill, the temperature is high (38 C) and in some cases it achieves maximum by the end of first day. Further, fever is permanent and temperature may decrease by  4, 8, 12th day of the disease. At the beginning appear acute headaches, insomnia, breakdown, excitement. Face is red and doughy. On eye conjunctiva sometimes appear small hemorrhages. Tongue is dry, not thickened and has dun fur on it.  Skin is dry and hot by the feel. In the first days there is no sweating.

Occurs weakening of heart sounds, shortness of breath, increase of liver and spleen (on 3 – 4 day of disease). One of specific signs is typhus exanthema. Rash appears on 4 -5 day of disease. Rash is multiple, heavy, is located mainly in areas of belly-band surface, on arms flexure, and spreads on palms and feet. Rash never appears on face.

Rash gradually disappears (during 78 days) and leaves pigmentation for some time. With the rash patient's condition aggravates. Dramatically increases intoxication. Excitement is replaced with depression. At this time, collapse is developed: patient is exhausted, his skin is covered with cold sweat, pulse is frequent, heart sounds are dull.  Recovery is characterized with body temperature lowering, headache decrease, sleep improvement, recovery of internals activity.

Treatment
Most effective are antibiotics of tetracycline group which should be taken 0,3 – 0,4g four times daily. Also may be used laevomycetin. When patient has normal body temperature, he should take antibiotics only two days, otherwise the course of treatment is 4 – 5 days. For detoxication is used 5% glucose solution. Oxygen therapy is recommended. Ultimate nutrition and vitamins are very important as well as right care for sick person (profound rest, fresh air, comfortable bed and clothing, everyday hygiene).

Prevention

• hospitalization of diseased people in time
• sanitary processing of disease focus
• monitoring of people who were in contact with diseased during 25 days

Tetanus treatment is complex:
1. surgical treatment of wound
2. providing rest-cure for the patient
3. neutralization of toxin which circulates through the blood
4. reduction of convulsive disorder
5. prevention and treatment of complications such as pneumonia and sepsis
6. maintaining normal gas composition in blood, along with acid-base balance
7. fight with hyperthermia
8. maintaining adequate cardio-vascular activity
9. lung ventilation improvement
10.  right diet
11. control over body functions

Doctor performs radical cut of wound edges which provides good outflow. As a preventive measure are precsribed antibiotics.  Unvaccinated people should perform preventive measures with antitetanic serum by injecting tetanus toxoid into different parts of body. Vaccinated people also should inject  antitetanic serum but in smaller amounts.

Nowadays is used specific gamma globulin obtaned from donor. Adsorbed tetanus toxoid is injected intramusculary three times 0.5ml each 3rd day.  All preparations listed above affect toxin which circulates through the blood. Key role in intensive therapy against tetanus plays reduction or full elimination of tetanic spasm and for that purpose are used tranquilizing drugs. In severe cases to reduce spasms are used muscle relaxants. Respiratory insufficiency is provided by well developed methods of respiratory intensive care.

Prevention
Planned immunization of population with tetanus toxoid. 

In case of genetic mutations of sex chromosome (these mutations are called Klinefelter syndrome), genetic set of chromosomes in men has additional chromosome responsible for body formation of female type.

Tetanus is an acute contagious disease characterized with hypertonia of sceletal muscles, spasms, hyperexcitability, common intoxication, high rate of mortality.

Tetanus pathogen - large-size anaerobic rod. This microorganism is able to produce strongest poison which aggravates secretion production in myoneural junctions. Microorganism is widely spread in nature, it persists in soil for a long time. Also it lives in intestinal tract of many domestic animals. So the animals are major source of infection, and way of transmission is soil.

Symptoms and course
Incubation period is 5 – 14 days, and the more shorter it is, the more severe disease is. Tetanus starts with unpleasant sensations in wound area, general uneasiness, anxiety, irritancy, appetite loss, headache, chills, fever. Patient suffers from masseteric cramps which make it difficult to open his mouth.

Cramp of swallowing muscles causes appearing of sardonic grin on patient's face and also makes it difficult to swallow. Those primary symptoms are specific only for tetanus. Then are developed stiffness  of neck and long back muscles, back pains; therefore, patient is forced to lie in typical position with head drawn backwards and body bent forwards. By the third day abdomen muscles become tense, legs are drawn and their motions are restricted, however hands motions are little bit easier.

Dramatic tension of abdomen muscles makes breath more frequent and shallow. Crotch muscle contraction makes it difficult to urinate. Patient suffers from common cramps which last from several seconds to several minutes and often are caused by external irritants (when touching the bed). Patient's face turns blue and expresses suffering. Cramps may cause asphyxia, paralysis of heart work and breath.

During the whole illness patient keeps his consciousness. Tetanus is followed by high body temperature and sweatiness. The higher temperature is, the worse prognosis is. In favorable oucome the disease manifestations last 3 – 4 weeks, and usually on 10 – 12 day condition significantly improves. People who recovered from tetanus may suffer for a long time from common weakness, muscle constraint and weakness of cardiovascular activity.

Complications: pneumonia, muscle rupture, spinal compression fracture.

Scarlet fever is an acute streptococcic disease characterized with rash, fever, common intoxication, angina, tachycardia. Pathogen is streptococcus belonging to group A. Source of infection is diseased person at first days of his illness. Most frequently scarlet fever affects children under 10 years old. Morbidity increases at autumn and winter period.

Symptoms and course
Incubation period lasts 2 – 7 days. The disease starts acutely. Body temperature increases, patient suffers from weakness, headache, chill, sore throat during swallowing. Common and persistent symptom is angina: pharynx redding, lymphatic glands increase, amygdala increase and pellicle on them. By the end of first day appears red punctulated rash, especially on spots where natural skin lines are located. Face has red color, and nose with mouth have white color with punctulated rash. On limb flexures frequently occur punctate hemorrhages.

Rash may have small blisters filled with liquid. Some patients may suffer from itching. Rash keeps for 2 – 5 days and then turns pale, body temperature lowers. On the second week occurs lamellar skin damage, especially on hand flexures.

Patient suffers from tachycardia, high angiasthenia. Liver and spleen are increased. At average, scarlet fever lasts from 5 to 10 days. Mild forms have mild symptoms, severe forms are characterized with intoxication, loss of consciousness, spasms, cardiovascular collapse, kidney failure.

Complications: lymphadenitis, otitis, mastoiditis, nephritis, rheumatism, myocarditis, brain otitic abscess.

Treatment
If patient gets treatment at home, there must be created special conditions for him. Hospitalization is required in severe cases. Bed regimen is required for 5 – 6 days. Are prescribed antibiotics of penicillin group, vitamins (vitamins B, P, C), detoxication. Course of treatment with antibiotics is 5 – 7 days.

Preventive measures
Isolation of diseased patients. Recovering patients should avoid contacts with newly diseased people. The release from hospital not earlier than in 10 days. Children should go to school in 23 days after the onset of scarlet fever. In apartment should be performed disinfection regularly.

In gastrointestinal form of anthrax (alimentary anthracic sepsis) toxicosis develops from first hours of the disease onset. Appear severe weakness, abdominal pain, vomiting, bloody diarrhea. Patient's condition worsens. On skin may occur secondary pustular and haemorrhagic rash. Then occurs shortness of breath and cyanosis. Possibly may occur meningoencephalitis. Diseased people die from growing heart failure in 3 – 4 days after disease onset.

Pulmonary anthrax is characterized with heavy onset: chill, sudden body temperature increase, chest pains, cough with albuminoid sputum, common intoxication, respiratory and cardio-vascular failure. Clinically and radiologically are identified bronchial pneumonia and hemorrhagic pleurisy. Death occurs on 2 – 3 day and is caused by pulmonary edema and collapse.

Septic form of anthrax courses severely and terminates with death.

Treatment
Independently of the form, in anthrax treatment may be used nosotropic or causal therapies. Prognosis for cutaneous anthrax is favorable. In septic forms prognosis is doubtful, even if the treatment was started at once.

Preventive Measures

• right organization of veterinary inspection
• vaccination of domestic animals
• animals dead from anthrax must be burned and products obtained from them must be destroyed

Anthrax is an acute contagious disease from zoonosis group characterized with fever, damage of lymph system, intoxication. It courses in cutaneous, rarely gastrointestinal, pulmonary and septic forms.  The causative agent is aerobic bacterium, a motionless large rod with blunt ends.

Outside human and animal body it makes spores which are quite resistant to chemical impacts. Source of infection are diseased animals.  Humans get infected after contacts with diseased animals (butchering, coat processing, etc) and via water and food which are polluted with spores.
Symptoms and course

Anthrax affects first of all skin, rarely affects internal organs. Incubation period lasts 2 – 14 days. Cutaneous anthrax is characterized with damage of open skin area. The disease courses severely when  carbuncles appear on head area, neck, mouth and nose mucosa.  There may occur single or multiple carbuncles.  First (on the spot where microbe enters)  appears red itching blemish which looks like insect bite. Within 24 hours skin notably thickens, itching increases, on the spot of blemish do appear vesicles – a blister filled with serous substance and then with blood.  While scratching, the blister is teared off and on its spot appears sore with black bottom.

From this moment body temperature increases, patient suffers from headaches and loss of appetite. Sore edges get swelled and do form inflammatory swab, then appears edema which starts spreading rapidly. Sore bottom sinks more and more and on the edges get formed “daughter” vesicles with transparent substance.  Such sore growing lasts 5 – 6 days.

By the end of the first day sore size reaches 8 – 15 mm and from this moment it is called anthax. Peculiarity of anthax consists in pain syndrome missing in necrosis area and its specific coloring: black in center with a narrow yellow border round it (scab), and further wide red swell. Lymphatic system may also be affected (lymphadenitis).

In a favorable course of the disease, in 4 -6 days body temperature decreases, overall health improves, edema reduces, lymphadenitis lowers, scab sloughs, wound heals and scar remains. In unfavorable course is developed secondary sepsis with repetitive body temperature increase, significant aggravation of overall condition, headache strengthening, tachyrhythmia growth, appearing of secondary pustules on the skin. Patient suffers from bloody vomiting and diarrhea. Fatal cases are not excluded. 

Food toxicoinfection is a pluricausal disease occurring when microbe agents and toxins enter with food in human body. The disease starts acutely, courses heavy, shows with symptoms of intoxication and affection of digestive organs. Causative agents are staphylococcal enterotoxins. salmonella, shigella, escherichia, streptococci, spore anaerobia, halophilic vibrions. Way of transmission is fecal-oral. Source of infection is diseased person or bacteria carrier,  including diseased animals. The disease may course as sporadic case or an outbreak. Incidence of disease is registered for a full year and increases in warm time.

Symptoms and course
Incubation period is short – just several hours. Patient suffers from chill, high body temperature, nausea, vomit, spasmodic abdomen pains. Then appears frequent liquid stool (sometimes with mucus), giddiness, headache, weakness, appetite lose. Skin and visible mucous membranes are dry.

Recognition
The diagnosis of contagious intoxication is made according to clinical picture, epidemiological anamnesis and laboratory tests. Most important are results of bacteriological test of excrements, examination of vomit mass and stomach washings.

Treatment
To remove contagious products and toxins, stomach lavage should be made which gives best effects at first hours of intoxication.  However, when nausea and vomiting occurred, this procedure may be performed at latest stages.

Stomach lavage is made with 2% solution of sodium bicarbonate or 0.1% of potassium permanganate till appearing of pure waters. In purposes of detoxification and rehydration are used salt solutions. The sufferer must drink plenty of water and keep to a diet. From menu are excluded foods that do irritate gastrointestinal tract. It is recommended to consume well-boiled, shabby and mild foods. To regenerate digestive insufficiency it is necessary to take enzymes and enzymic complexes (pepsin, pancreatine, etc) for 7 – 15 days.

Prevention
It is necessary to respect sanitary and hygienic rules at eating places and food manufacturing industries. Early detection of people with angina, pneumonia, pustular skin affections and other contagious diseases. Important role has veterinary control over diary farms and healthy cows (staphylococcic mastitis, pustular diseases).

Mumps is a virus disease characterized with common intoxication, increase of one or several salivary glands, frequently damage of other glands and nervous system. Causative agent is a spherical shape virus with tropism to glanderous and nervous tissues. It is less resistant to physical and chemical factors. Source of infection is diseased person. Infection occurs by drop infusion. Virus is found in saliva at 3 – 4 day of incubation period after which virus stops its releasing. Outbreaks usually bear local character.

Symptoms and course
Incubation period is 15 – 19 days. Primary symptoms are weakness, muscle pains, headache, chilling, sleeping and appetite disorders. With development of inflammatory process in salivary gland do appear  signs of its damage (dryness in mouth, pains in ear area during eating and talking). The disease may course in mild or severe forms. Depending on form the body temperature may rise up to 40 C and degree of intoxication may be different. Most common symptom is damage of salivary glands.

The gland increases, appear pains during palpation. Great diagnostic value has inflammatory reaction in area of emunctory canal of damaged parotid gland. Skin above inflammatory gland is strained, inflation may spread to the neck. Gland increase lasts usually three days and is kept for 2 – 3 days. The disease may result in severe complications such as  meningitis, meningoencephalitis, orchitis, pancreatitis, labyrinthitis, arthritis, glomerulonephritis.

Treatment
Bed regimen is recommended for 10 days. Patient must follow special diet, no white bread, fats and fiber (cabbage). In orchitis is prescribed suspensory, prednisolone 5 – 7 days.  In meningitis are prescribed corticosteroid medications, are made lumbar punctures, 40% Urotropine injections intravenously.  In acute pancreatitis is prescribed liquid light diet, daturine, papaverine, coldness on abdomen. If patient suffers from vomiting is prescribed aminazin. Prognosis is favourable.

Preventive measures
During mumps epidemic in schools it is necessary to set in 21 days quarantine. Children who had contacts with diseased children are not allowed in schools from 9 to 21 day of incubation period and they should get injections of placentary gamma globulin. Disinfection in the focus is not performed.

These are acute infectious diseases which are similar to typhoid fever.  Causing agent is bacteria belonging to Salmonella group resistant in external environment. Detergents kill them in several minutes. The only source of infection in Paratyphoid A are diseased people, and in paratyphoid B may be animals (cattle, etc) It may be transmitted orally or via objects.

Symptoms and course
As a rule, paratyphoid  A and B start gradually with symptoms of intoxication (fever, weakness), then appear nausea, vomiting, diarrhea, cough, cold, rash, helcoid damage of bowels lymphatic system.

Paratyphoid A Symptoms
Disease starts acutely in comparison with paratyphoid B. Incubation period lasts from 1 to 3 weeks. Is characterized with nausea, vomiting, diarrhea, cough, cold with possible face reddness and herpes appearing. Rash appears on 4 – 7 day. In the course of the disease are possible several waves of rashing. Temperature is remittent. Spleen increases rarely. In peripheral blood often are found lymphopenia, leucocytosis, eosinocyte. Here is maintained high possibility of backsets.

Paratyphoid B Symptoms
Incubation period is shorter than in haratyphoid A. It may course differently. In transmission of infection via water the disease starts gradually and its course is mild. When salmonella enters human body with foods occurs its massive entry in the body with prevailing gastroenteric conditions (gastroenteritis) with its further spread in other organs. Paratyphoid B may course in mild or severe forms. Backsets occur rarely. Rash may appear and sometimes it is heavy enough. Spleen and liver increase in the very onset of disease.

Treatment
Must be complex and includes care, diet, etiotropic and nosotropic medications, and in some cases immune stimulants. Is recommended bed regimen up to 6-7th day of normal body temperature, since 7th day is permitted to get seated and since 10th day to walk. Food must be digestible reducing impact on digestive tract. Doctors prescribe laevomycetin (0,5g four times a day) up to 10th day of normal temperature. To increase effectiveness of casual treatment in order to prevent patient from backsets and chronic forms, it must be performed along with medications that stimulate body defences and increasing body resistance (vaccine)

Preventive Measures:

• improvement of water supply quality
• sanitary purification of conglomerations and canalization
• fighting with flies

Ornithosis is an acute infectious disease of influenza group which is characterized with fever, general intoxication, damage of lungs and nervous system, liver and spleen increase. Source of infection are poultry and wild birds. Today are distinguished about 140 ornithosis agents. Great epidemiologic importance have poultry and pet birds especially pigeons.

Infection occurs via airbone, however, in 10% cases occurs alimentary contagion. Ornithosis agent belongs to chlamydia and keeps in external environment for 2 – 3 weeks. It is resistant to sulfanilamides and susceptible to antibiotics of tetracycline group and macrolides.

Symptoms and course
Incubation period is from 6 to 17 days. Ornithosis may be typical and atypical (aseptic meningitis, ornithosis without lungs damage). Besides acute forms, ornithosis may be chronic.

Pneumonic forms start with symptoms of intoxication, which are followed with signs of respiratory organs damage. Chill is followed with temperature rise above 39 C, headaches in parietofrontal area, pains in back muscles and limbs, general weakness, adynamia, appetite lose. In some cases patient suffers from vomit, nosebleeds. On 2 – 4 day appear signs of lungs damage. Also patient may have dry cough, stabbing pains in chest. Then releases mucopurulent viscous sputum (in 15% of cases with blood)

The onset of the disease is characterized with pallidness of skin, brachycardia, blood pressure dicrease, heart sound muting. X-ray examination shows condition of lower lung lobes. During recovery, especially after severe forms of ornithosis, patient experiences vascular dysfunctions for a long time.

Complications: thrombophlebitis, hepatitis, myocarditis, iridocyclitis, thyroadenitis.

Recognition is made according to clinical data relying on epidemiologic background.

Treatment
Most effective are antibiotics of tetracycline group which are 3 – 5 active than laevomycetin. Daily dozes of tetracycline vary from 1,2 to 2 mgs. The amount of lethal cases is 1%. Are possible bacsets and transformation into chronic form (10 – 15% cases) .

Preventive measures:

• fighting against ornithosis among  poultry
• controlling pigeons population

Upper respiratory infections are common conditions with predominant damage of respiratory tract. URI is caused by various aetiologic agents (viruses, micoplasmas, bacterias). Immune system after past diseases is strongly compound-specific to virus of influenza, parainfluenza, herpes, rhinovirus.

That is why one and the same person may get diseased with acute respiratory disease up to 7 times throughout a year. The source of infection is  a diseased person with clinically showed or hiden symptoms of acute respiratory disease. Virus transmission occurs mainly via airbone. URI occurs as individual cases or epidemic outbreaks.

Symptoms and the course
URI is characterized with mild symptoms of general intoxication, damage of upper respiratory tract and benign course. Damage of respiration organs shows as rhinitis, rhinopharyngitis, pharyngitis, laryngitis, bronchitis, pneumonia.

Some aetiologic agents besides manifestations mentioned above also cause another symptoms: conjunctivitis, mild symptoms of herpangina in enterovirus diseases, syndrome of catarrhal croup in parainfluenza infections. The duration of the disease without pneumonia is 2 – 8 days. In pneumonia (often caused by microplasmas, respiratory syncytial virus and adenovirus along with bacterial infection) the duration is 3 – 4 weeks and is more hardly cured.

Recognition
URI is recognized clinically – diagnosis “URI” is made and its breakdown is given (rhinitis, nasopharyngitis). Etiological diagnosis is made only after laboratory tests.

Treatment
Antibiotics and other chemotherapeutic compounds are not effective because they do not act on the virus. Antibiotics may be prescribed in acute bacterial respiratory diseases. Treatment is performed at home. In ceses when patient suffers from fever it is recommended bed regimen. Are prescribed nosotropic and fever-reducing remedies.

Preventive Measures
Vaccination is performed. In order to prevent A influenza it is recommended to use remantadin.

This is a disease caused by meningococcus which has different forms. In external environment the microbe dies quickly at temperature of 55 C during 5 minutes, under the influence of detergents during 1 – 2 minutes, it is sensitive to  penicillin, laevomycetin, tetracycline.

People infected with meningococcus are the source of infection for people around. Infected people on the early stage of their disease do intensively release microbes in external environment  During treatment patients remain carriers for three weeks. Meningococcal disease spreads via airborne. Most frequently get diseased children of preschool age. Meningococcus is located mainly in meninx vasculosa causing there suppurative inflammation. The infection enters into central nervous system either via epipharynx along olfactory nerves or via hematogenic path.

Symptoms and course
Incubation period is from 2 to 10 days. Meningococcal disease forms:
1) localized forms, when causative mocroorganism occurs in a particular organ (acute nasopharyngitis)
2) generalized forms when the infection is spread trough the whole body (meningococcemia, meningitis, meningoencephalitis)
3) orphan forms (endocarditis, polyarthritis, pneumonia)

Acute nasopharyngitis may be the onset of purulent meningitis or an independent clinical implication. Temperature increases up to 38 C, appear signs of intoxication and affection of mucus membrane of nose and throat (stuffiness in nose, reddening,  back of the throat puffiness).

In meningococcemia the meningococcal sepsis starts suddenly and courses violently. Symptoms: chill, headache, body temperature up to 40 C. Blood vessel permeability increases, in 5 – 15 hours from the disease onset appears hemorrhagic rash.  Meningitis symptoms are not observed. Are possible arthritis, pneumonia, myocarditis and endocarditis.

Meningitis develops acutely. Some people may experience nasopharyngitis symptoms at early stages. Meningitis starts with chill, temperature rise, agitation, motor anxiety. In the beginning appear strong headache, vomit without nausea, high skin, ear and visual sensibility. By the end of the day do appear and increase meningeal symptoms: neck stiffness, impossibility to turn at right angle leg bended in joint.

Patient may experience delusions, agitation, tremor, may be damaged cerebral nerves. In half of patients on 2 – 5 days of diseases appears herpetic rash. In the blood is detected neutrophilia. In adequate treatment recovery occurs on 12 – 14 day from beginning of therapy.

Complications: deafness due to the affection of auditory nerve and inner ear; blindness due to affection of visual nerve or uvea; hydrocephaly (loss of consciousness, acute panting, tachycardia, agitation, blood pressure increase, myosis,  meningeal syndrome senility).

Treatment
Most effective treatment are penicillin therapy, taking semisynthetic penicillins (ampicillin, oxacillin). Also are performed body deintoxication, oxygen therapy, vitamins. Corticosteroids are prescribed.

Preventive measures
Early detection and isolation of patients. After discharge from the hospital it is necessary to perform double bacteriological tests.