Transcript Malaria - Angelfire

Location: Eastern Africa, bordering the Gulf of Aden and the Red Sea, between Eritrea and
Somalia
Geographic 11 30 N, 43 00 E
coordinates:
Map references:
Area:
Africa
total: 22,000 sq km
land: 21,980 sq km
water: 20 sq km
Area - slightly smaller than Massachusetts
comparative:
Land
boundaries:
total: 508 km
border countries: Eritrea 113 km, Ethiopia 337 km, Somalia 58 km
Coastline:
314 km
Climate:
desert; torrid, dry
Terrain:
coastal plain and plateau separated by central mountains
Elevation
extremes:
lowest point: Lac Assal -155 m
highest point: Moussa Ali 2,028 m
Natural hazards:
earthquakes; droughts; occasional cyclonic disturbances from the Indian
Ocean bring heavy rains and flash floods
Environment - inadequate supplies of potable water; desertification
current issues:
Adult length usually 2.5 to 3.0 meters,
maximum of 4.3 meters; relatively slender
snake. Background color may be brown,
olive brown, dark olive, greenish brown or
dark blackish gray. Interior of mouth bluegray to blackish.
Most dreaded African
venomous snake; few people
survive its bite unless antivenom
administered promptly. Vemon
very potent neurotoxin.
Adult length usually 1.2 to 1.5 meters;
relatively slender snake. Background color
varies from almost black to almost
uniform green; no blotches or distinct
spots. Short stubby head and enormous
emerald green eyes. Scales strongly keeled
and overlapping.
Potently hemotoxic; can cause
severe bleeding internally and from
mucous surfaces. Deaths reported.
Adult length usually less than 0.9 meters;
relatively slender snake. Background color
varies; usually uniform dark purplish
brown to black above. Short, conical head,
not distinct from the neck; snout broad,
flattened, often pointed. Fangs well
developed and comparatively large in
relation to size of head. Tail short, ending
in distinct spine.
Venom primarily hemotoxic. Victims
may experience intense local pain,
swelling, and, in some instances,
necrosis.
Adult length usually 0.3 to 0.6 meters;
relatively stout snake. Background
color variable, usually yellowish,
brown, gray, or reddish; may have
series of oblique pale crossbars,
interspersed with dark spaces, along
back. Usually has row of triangular or
circular markings with pale or white
edging along each side. Some
specimens with very faded or almost
invisible markings. Belly pale, usually
with brown or reddish spots. Head
pear-shaped.
No known antivenom
produced
Adult length usually 1.5 to 2.0 meters,
maximum of 3.0 meters. Background
color usually yellow-gray to brown or
blue-black, but extremely variable. Belly
yellowish with dark blotches. Most
specimens have dark brown or black
band across the throat.
Venom primarily neurotoxic, acting
largely on nerves controlling respiratory
muscles. Untreated cases may culminate
in respiratory failure and death
Adult length usually 0.6 to 1.0 meters,
maximum of 1.5 meters; thick, heavily built
snake. Background color varies from bright
yellow to light yellow, yellow-brown,
orange-brown, light brown, or gray. Belly
yellowish white to gray with black blotches.
Rough-scaled appearance and alternating
pattern of dark and light chevron-shaped
markings are characteristic.
Many serious bites reported; only a small
portion prove fatal. Venom potent
cytotoxin, attacking tissue and blood cells.
Symptoms include extreme pain with
swelling and large blisters in region of the
bite.
Envenomations are usually categorized into two or three levels of severity: 1) localized effects, 2) systemic
effects, and 3) systemic effects with central nervous system involvement. Localized effects are common to nearly
all scorpion stings regardless of the toxicity of the venom. These symptoms are restricted to the site of sting and
include intense pain, minor swelling, redness or induration, numbness, tenderness, and tingling. Intense pain
normally subsides within one hour, giving way to numbeness, tenderness, and tingling at the site of the sting. This
normally results in the favoring of an affected limb. These symptoms normally fade after 24 hours.
Systemic signs and symptoms are often reported following scorpion envenomation: intense pain that radiates
towards the body and is especially acute at the armpits and groin areas, aggitation or anxiety, increased body
temperature, sweating, chills, a feeling of numbness or swelling of the face, tongue and throat, pain or tightness
in the chest or back, and occasionally slightly increased heart rate and blood pressure.
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Diarrhea
• 3 or more unformed stools in a
24 hour period
• Dysentery: Invasion of intestinal
wall by organisms.
– Pus
– Mucus
– Blood
Prevention
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Diet should exclude human excrement.
Boil it, peel it or forget it.
Eat only hot foods.
Avoid ice.
Carbonated drinks, beer,
straight
alcohol safe.
• Bottled water may not be safe.
• Never ingest untreated water.
• Water purification- heat, chemical, filtration.
Causes of Diarrhea
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Nervousness
Alcohol
Surgery
Medications
Malabsorption
Underlying illness
Infections 30-40% of travelers
to underdeveloped countries
Symptoms: Bacterial
• Sudden onset of relatively
uncomfortable diarrhea.
• Cramping, fecal urgency.
• Fever, nausea, vomiting but not
in all cases
Symptoms: Parasite
• Slow onset with one to two
loose stools.
• No vomiting, no fever
• E. histolytica: alternating
diarrhea, increasing fatigue,
weight loss.
• Giardia: Rumbly, gassy
feeling, upper abdominal
discomfort, mucus in stools
Diarrhea: Other Causes
• If more than six days
between bouts think
unrelated incidences.
• Tropical sprue
• Irritable bowel
syndrome
• Food poisoning
Treatment
• Most self limiting in two
to seven days
• Hydration -ORS if needed
• Antibiotics
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Norfloxacin
Ciprofloxacin
Mitronidazole
(Bactrim)
• Symptomatic relief
– Bowel paralyzers
– Bulk forming agents
Traveller’s Diarrhea: Summary
• Infectious diarrhea rare in developed
countries but common in third world
countries.
• Usually self limiting but easily treatable.
• Prevention when travelling or deployed is
most important.
Malaria (mah-LARE-ee-ah)
What is malaria?
Malaria is a serious, sometimes fatal, disease caused by a parasite. There are four kinds of malaria that can infect
humans:
How do you get malaria?
Humans get malaria from the bite of a malaria-infected mosquito.. The parasites then travel to the person’s liver, enter
the liver’s cells, grow and multiply. The parasites leave the liver and enter red blood cells; this may take as little as 8 days
or as many as several months. Once inside the red blood cells, the parasites grow and multiply. The red blood cells burst,
freeing the parasites to attack other red blood cells. Toxins from the parasite are also released into the blood, making
the person feel sick. If a mosquito bites this person while the parasites are in his or her blood, it will ingest the tiny
parasites. After a week or more, the mosquito can infect another person.
What are the signs and symptoms of malaria?
Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness.
Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and
eyes) because of the loss of red blood cells. Infection with one type of malaria, if not promptly treated, may cause kidney
failure, seizures, mental confusion, coma, and death.
Malaria (mah -LARE-ee-ah
What is the treatment for malaria?
Malaria can be cured with prescription drugs. The type of drugs and length of treatment depend on which kind of
malaria is diagnosed, where the patient was infected, the age of the patient, and how severely ill the patient was at start
of treatment
How can malaria be prevented?
Take your antimalarial drug exactly on schedule without missing doses.
Prevent mosquito and other insect bites. Use DEET insect repellent on exposed skin and flying insect spray in the room
where you sleep.
Wear uniforms rolled down, especially from dusk to dawn. This is the time when mosquitoes that spread malaria bite.
Sleep under a mosquito bednet that has been dipped in permethrin insecticide if you are not living in screened or airconditioned housing
Djibouti
Diseases
Infectious
Sandfly Fever :
Dengue
Rift
ValleyFever
Fever (RVF):
Chikungunya Fever :
Typhoid and Paratyphoid Fevers
Meningococcal Meningitis
Enterically Transmitted Viral Hepatitis A and E
Leishmaniasis
Schistosomiasis
Tuberculosis
/
Bloodborne Viral Hepatitis B,D, and C
STDs including gonorrhea and chlamydial cervicitis/urethritis are highly endemic.
HIV/AIDS Predominantly heterosexual transmission. HIV transmission is much more widespread than official
reporting indicates, and rates are likely to increase substantially. HIV-1 prevalence among high-risk and low-risk
urban populations was estimated at 38 and 4 percent, respectively, as of early 1998. Prostitutes tested in 1994
and 1995 were found to have rates as high as 45 percent.
Heat-Related Illness
General
• Vast majority of heat-related problems are a
direct result of the environmental conditions in
which the person has been exercising,
Factors Affecting Heat
Injury/Illness
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Temperature (ambient vs. body)
Wind
Illness
Hydration level
Acclimatization
Heat Index
• Combined effects of temperature and
humidity (what it feels like to the body)
Environmental Temperature (°F)
Relative
Humidity
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
70
75
80
85
90
95
100
Apparent temperature
105
110
115
120
64
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73
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85
86
88
91
78
80
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88
90
93
97
102
108
83
85
87
90
93
96
100
106
113
122
95
100
105
113
123
135
149
99
105
112
123
137
150
103
111
120
135
151
107
116
130
148
87
90
93
96
101
107
114
124
136
91
95
99
104
110
120
132
144
Flag conditions
• White: WBGT<80, no restrictions
• Green: WBGT 80-84.9, discretion in
heavy exercise for unaclimatized people
• Yellow: WBGT 85-87.9, no strenuous
exercise for unaclimatized personnel
during first three weeks of exposure
Flag conditions
• Red: WBGT 88-89.9, strenuous exercise
curtailed for all less than 12 weeks in hot
climate
• Black: WBGT 90 or greater, NO
unnecessary or strenuous outdoor exertion
Hot environments
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Desert
Jungle
Temperate
HOT WORK SPACES
Aircraft
Heat injuries
• High humidity causes body to cool less
efficiently
• Increased body core temp leads to heat
injuries
Dehydration
• Dehydration is the major contributing
factor to heat injures
• High temperatures and exercise lead to the
production of sweat
• Normal conditions about 1 gallon a day
Dehydration
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Weak, dizzy
Exhausted
Problems thinking clearly
Urine become darker
Thirst is not a good indicator
What to Do?
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Replace fluids before they are lost
Hydrate with water approximately1 L hour
Drink slowly
Alcohol and
caffeine cause
faster water loss!
Heat injuries
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Heat Cramps
Heat exhaustion
Heat stroke
Sunburn
Heat Cramps
• Muscle spasm
• Usually occur in the extremities or
abdomen
• Caused by
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Heavy exertion/fatigue
Heavy sweating
Loss of water and electrolytes
lack of acclimatization
Heat Cramps
• Treatment
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Get to a cooler place
Replace water
Stretching better than massage
Rest
Heat Exhaustion
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Headache
Nausea and vomiting
Rapid heartbeat and breathing
usually profuse sweating
Heat Exhaustion Treatment
• Get out of the heat!!!!
– Stay off concrete, asphalt, and hot aircraft
• Cool off’
– Fans, keep clothing wet
• Drink Fluids
• Elevate legs
• Rest
Heat Stroke
• TRUE EMERGENCY
• Up to 50% of cases are fatal even with
treatment
• MUST be prevented
Heat Stroke
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Skin red, hot and dry
Confusion and loss of coordination
Body temp high (105°F)
Rapid heartbeat and breathing
May stop sweating
Heat Stroke Treatment
• LIFE THREATENING EMERGENCY
• Call EMS
• Decrease body temperature
– Move to a cooler place
– Loosen/remove tight clothing
– Cool with wet towels, apply ice to arm pit & groin
areas
– Elevate feet
– Nothing to eat or drink!
Sunburn
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1st to third degree
preventable
Causes loss of fluids
Skin does not sweat normally
Best treatment is prevention
What can you do?
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Hydrate , Hydrate, Hydrate (Water is life)
Know the flag conditions
Dress appropriately
Use Sunscreen
Questions?