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| Volume 1, Issue 4 | DECEMBER 2001 |
| Inside This Issue | |||||
| 1 | Encephalitis | ||||
| 2 | Fungal Infections | ||||
| 3 | Updates and Announcements | ||||
| 4 | Drug Fact Sheets | ||||
Medical Information Fact Sheet
Encephalitis is an acute inflammation of the brain caused by a viral infection. This severe and potentially life threatening disease is rare.
Encephalitis takes two forms:
- Primary. This form is due to a direct viral invasion of your brain and spinal cord. The virus can be sporadic or epidemic. The most common sporadic form is herpes simplex encephalitis, may start as a minor illness with headache and fever, followed by more serious symptoms. Mosquito-borne viruses commonly cause epidemic varieties.
- Secondary (postinfectious). This form follows or occurs with a viral infection in another part of the body—such as measles, chickenpox, rubella, polio or mumps. The cause of encephalitis in some secondary cases may be a hypersensitivity reaction—an overreaction of your immune system to a foreign substance.
Primary encephalitis is the most serious kind of encephalitis. The secondary form is more common but because of the milder nature of secondary encephalitis, doctors see more cases of primary encephalitis.
Some 1500 to 2000 cases of all types of encephalitis are reported in the U.S. About 200 of these cases are mosquito borne encephalitis.
The mortality rate varies with the source of the virus. Insect borne might cause low mortality one year but more severe the next year.
Signs & Symptoms may include:
- Drowsiness
- Confusion and disorientation
- Seizures
- Sudden fever
- Severe headaches
- Nausea and vomiting
- Tremor
- Bulging in the soft spot of the skull (in infants)
- Stiff neck (occasionally)
Emergency signs and symptoms may include altered levels of consciousness. In infants, the key symptoms are a stiff neck and bulging in the soft spot. In older children, the initial symptom may be severe headache and sensitivity to light. In adults, mental disturbances may be prominent as an initial symptom.
Diagnosis:
- Spinal Tap (lumbar puncture). The most common way to diagnose encephalitis is to analyze the cerebrospinal fluid surrounding your brain and spinal cord. A needle is inserted into your spine and extracts a sample of fluid for laboratory analysis. Analysis may indicate infection or an increase in the white blood cell count, a signal that your immune system is fighting an infection. Diagnosis of herpes simplex encephalitis is sometimes difficult but advances in DNA methods have allowed detection of the virus in the spinal fluid.
- Electroencephalography (EEG). This procedure measures the waves of electrical activity in the brain. It is often used to diagnose and manage seizure disorders. Electrodes are placed on the scalp. Different actions are done to stimulate your brain and then the electrical activity is recorded on a sheet of paper. Some actions may be to have you breathe deeply or flash a bright light in your eyes.
- Brain imaging. A computed tomography (CT) or magnetic resonance imaging (MRI) scan may reveal swelling in the brain. The swelling may be localized in herpes simplex encephalitis. The scan may also reveal other conditions with similar signs such as a concussion.
- Brain Biopsy. This procedure is rare. If herpes simplex encephalitis cannot be diagnosed with the previous methods than a biopsy may be done. A biopsy is when a small sample of tissue is taken. The sample is analyzed to determine presence of the virus. Antiviral may be given first, if the condition persists a brain biopsy may be done.
Treatment:
- To treat herpes simplex encephalitis, an antiviral such as acyclovir may be prescribed in the early stages of the illness. In some case an anticonvulsant (anti-seizure) medication may be given. Anti-inflammatory drugs may be given to reduce pressure within the skull.
- Viruses do not respond to antibiotics, so treatment usually consists of rest and a healthy diet including plenty of liquids to let your immune system fight the virus. Physical and speech therapy may also be a part of the treatment.
Prevention:
Even though viral encephalitis is rare a good way to prevent secondary encephalitis is to make sure you and your children are immunized against viral infections that may lead to encephalitis, including measles, chickenpox, rubella and mumps.
To protect your family against mosquito borne encephalitis:
- Wear long sleeves and pants if you're outside when mosquitos are active.
- Use a mosquito repellent that contains DEET. For children, use a repellent that contains 10 percent DEET or less.
- Eliminate sources of standing water in your yard. Discarded tires are the most common human source of mosquito breeding areas.
- Repair holes in screens to keep mosquitos out of your house.
- Avoid mosquito feeding hours (dusk) when engaging in summertime outdoor activities.
Mayo Clinic. (1999). Encephalitis. [Online]. Available: http://www.mayoclinic.com/findinformation/conditioncenters/invoke.cfm?objectid=A63631AF-C85E-40BB-A5BD3F9EC09245C7
Fungal infections are caused by microscopic organisms that become parasites on your body. Mold like fungi called dermatophytes cause athlete's foot, jock itch and ringworm of the skin or scalp. These fungi live on dead tissues of your hair, nails and the outer layer of your skin. Poor hygiene, continually moist skin and minor skin or nail injuries increase your susceptibility to fungal infections.
Self-care (general).
- Practice good personal hygiene to prevent all forms of fungal infections.
- Use antifungal creams or drying powder two or three times a day until the rash disappears. Use medications that contain miconazole (Zeasorb-AF, Micatin), Clotrimazole (Lotirimin AF, Mycelex OTC) or undecylenic acid (Desenex, Cruex).
Athlete's foot:
Usually begins between your toes causing your skin to itch, burn and crack. Sometimes the sole and sides of the foot are affected, becoming thickened and leathery in texture. Although locker rooms and public showers are often blamed for spreading athletes foot, the environment inside your shoes is probably more important. It is also more common with age.
Self-Care:
- Keep your feet dry, particularly the area between your toes.
- Wear well-ventilated shoes. Avoid shoes made of synthetic materials.
- Don't wear the same shoes every day, and don't store them in plastic.
- Change socks (cotton or polypropylene) twice a day if your feet sweat a lot.
- Wear waterproof sandals or shoes around public pools, showers or locker rooms.
Jock itch causes itching or burning sensation around your groin. A red rash may also be present that may spread to your inner thighs, anal area and buttocks. This infection is mildly contagious. Contact or sharing towels can spread it.
Self-care:
- Keep your groin clean and dry.
- Shower and change clothes after exercise.
- Avoid clothes that chafe, and launder athletic supporters frequently.
Ringworm often affects children. Symptoms are itchy, red, scaly, slightly raised, expanding rings on the trunk, face, groin and thigh fold. The rings grow outward as the infection spreads, and the central area begins to look like normal skin. The infection is passed from shared clothing, combs and barber tools. Pets can also transmit the fungus to humans.
Self-care:
- Thoroughly clean brushes, combs or headgear that may have been infected.
- Wash hands before and after examining your child.
- Keep your child's linens separate from the rest of the family's.
Medical Help:
See your Health care provider if symptoms last longer than four weeks or if you notice increased redness, drainage or fever. You may require treatment with prescribed medications.
Mayo Clinic. (2001). Skin, Hair and Nails: Fungal Infections. [Online]. Available: http://www.mayoclinic.com/findinformation/conditioncenters/invoke.cfm?objectid=264FD15C-26CC-49E6-B4EA0E235557DF19
HCPCFC PROGRAM UPDATES and ANNOUNCEMENTS!!!
Since August I have provided trainings on the PATCHS program to the new advocates of CASA (Court Appointed Special Advocates) and to foster parents at the foster parent association meeting.
Since October I created/updated 211 Health and Education Passports. We are working towards our goal of having a Health and Education Passport for every child in foster care.
We would like to extend a warm welcome to our two newest PHN's to the PATCHS program. Mary Redman will be stationed at the Lake Elsinore DPSS office and covering the Temecula/Lake Elsinore region. Kim Robitaille will be stationed at the Hole Ave. DPSS office and covering the Banning/Hemet region.
Editor: Kristen Thompson, PHN,Contributors: Hermia Parks, SPHN, MA, and Judy Earp, MHA, Director of Public Health Nursing.
