Thursday, March 19, 2009

Communicable And Non-communicable Diseases

The word “disease” means absence of deviation from normal health. Whenever the body or any of its parts dysfunction and the person suffers as a result, we call it disease. This suffering can be physical like fever, body pain, injuries, sores; mental like insanity, depression; or social like maladjustment in family life.In this `unit we shall discuss a group of diseases classified as:CommunicableNon-communicable.Communicable diseases are the diseases which are caused by germs (germs are micro – organisms) or worms or other parties. Usually these are infectious and spread from a person suffering from the diseases (measles, diphtheria , cholera, etc.) to the healthy ones. The non-communicable diseases (heart attack, cancer, diabetics, etc) are not so transmitted from person to person. For the prevention of diseases we must know at least:
1. The causes of the diseases and the ways by which they spread
2. The measures for prevention
3. Signs and symptoms.
For early diagnosis it is very important to have regular medical check ups.

COMMUNICABLE DISEASES

Communicable diseases are caused by germs, worms and parasites. In disease conditions, germs live and multiply in human body, or animals, or birds or insects. They may also be present in water or milk or food, or soil or dust when these are contaminated. These germs are called “agents’ that cause the disease. The contaminated articles of the medium through which they are spread are called the “environment”. Germs can live and travel only in ‘an environment suitable for their existence? If unsuitable, they die. By “host”, we generally mean the one who welcomes the guests. In case of communicable diseases, the host is the person or the animal who welcomes the germs (agents) to enter, survive and multiply in its body. Normally you welcome guests, but you should avoid the germ-guests who are your enemies and not friends. The next question is how they can be avoided, controlled or completely driven out. The germs travel in suitable environment but this environment is not the same for all germs. Their habits vary. Germs or some diseases like chickenpox, tuberculosis, diphtheria, influenza, etc., are transmitted through air directly from person to person. The germs of cholera, typhoid fever, etc., prefer water, milk and food, as a medium of transmission from the afflicted to the healthy persons, whereas in case of germs of malaria, filariasis and dengue, the insect acts as the agent. Again, there are some diseases where germs require soil for transmission, for example, tetanus, hookworms. Some germs do not require any environment at all, but are spread by direct contacts, examples being the germs or venereal disease, leprosy, anthrax.

DISEASES SPREAD THROUGH AIR

CHICKENPOX

It is caused by a virus. Children are commonly affected. The early symptoms are mild or moderate fever with skin rashes which develops within a day. The pimples are soft and they change into blisters with pus within a day or two. The rash appears in such a way that you can see pimples or blisters and dry scabs on a particular skin area, say, on the chest. The rash appears first on the chest and back and then spreads out. The patients recover and no blindness occurs. The latter part of winter is the season for chickenpox. A chickenpox vaccination is now available in the market. This is supposed to prevent chickenpox, though some cases of chickenpox have occurred. This is given to children below 12 years of age, only to those who haven’t had chickenpox. This falls under the optional category, and the paediatrician has to be contacted by the interested parents.

MEASLES

It is also caused by a virus which affects infants and small children. It may be confused with smallpox and chickenpox. The disease starts with fever, sneezing cough and red eyes. Dusky red rash appears on the third or fourth day, on the face and then spread all over the body. The patients usually recover unless the disease is further complicated by pneumonia.

DIPHTERIA

It is caused by bacteria. The symptoms are fever, cough, running nose, sore throat .It may cause great suffering like difficulty in breathing, choking sensation, and loss of power of vocal cords, and leading to voice defects. Diagnosis is made by seeing a grayish white patch on the tonsils and inside the throat and finding the diphtheria germs in it.
TUBERCULOSIS

It is caused by bacteria. It mainly affects the lungs. The symptoms are fever, chronic cough, weakness and loss of body weight. It may affect the intestines resulting in symptoms like fever, indigestion, loose motions and loss of weight. Tuberculosis can also occur in other parts of the body, like bones, nervous system, skin, eye, etc.

INFLUENZA

It is caused by virus. There are several types. The disease starts with fever, sore throat, running nose, headache and cough. It usually spreads very quickly and many people are affected as it is highly infectious.All the above diseases spread by coughing, sneezing, and talking, when the germs pass directly from the patients to thee healthy persons and enter through the respiratory passage. In smallpox, the dry skins of the rash called scabs may also infect. In diphtheria, articles of everyday use like handkerchiefs of the infected person may carry the infection if these are contaminated by the saliva of the patient. Tuberculosis of the intestine may occur by drinking milk or eating food which have been contaminated by the tuberculosis germs.

Prevention of these diseases is possible by:-

-DPT (Diphtheria, Pertussis, Tetatus) called Tripple Antigen vaccination prevents diphtheria, whooping cough and tetanus.

-Did you get vaccinated by DPT (2 doses) in your childhood?

-BCG vaccination, very soon after birth, makes you resistant against tuberculosis.

Did you have it? If not please contact the District Tuberculosis Control Centre or nearest health centre for information.

-Inform about such a patient immediately to the nearest health centre or hospital or any doctor. -Isolate the patient immediately to prevent spread of the disease.

-Avoid contacts with the patient. Things used by the patient like utensils, clothes, bed sheets should be boiled, and exposed to sun rays for a long time or burnt.

-Have you ever come across such practice being done?

-If you are a patient cover your mouth and nose while coughing or sneezing. Do you practice this?

DISEASES SPREAD THROUH WATER AND FOOD

CHOLERA

Cholera is caused by vibrio. The symptoms of this disease are sudden occurrence of repeated loose motions which look like rice water, vomiting, cold shrunken skin and sunken eyes. Urine becomes scanty or completely stops. Diagnosis is confirmed by examination of stool in a laboratory.

DYSENTERY

These are two varieties, namely, amoebic and bacillary. Amoebic dysentery is caused by small single-celled animals called amoeba or protozoa. But the bacillary dysentery is caused by bacteria. Symptoms are frequent loose motions with mucus, sometimes blood and pain in the abdomen. Both may become long lasting and chronic.

TYPHOID FEVER

It is caused by bacteria. Symptoms are continued fever, headache, bowel disorder like constipation or diarrhea. Diagnosis is confirmed by examination of blood.

INFECTIOUS HEPATITIS

It is caused by virus. It affects the liver, so the disease is called hepatitis. The symptoms are fever, nausea, loss of appetite and yellow discolouration of the eye balls and the skin which is called jaundice. The liver gets enlarged and so it can be felt in the right side of the belly.

ROUND WORM DISEASE (ASCARIASIS)

The patient having roundworms in his intestine passes the egg of the worm in the faeces. I this faeces is discharged in the soil, the eggs mature and become infectious. Supposing, vegetables are grown in such soils or some fruits fall on it, these come in contact with these roundworm eggs and become contaminated. If you eat such foodstuff raw, without proper washing, you swallow these along with the food and become infected. In a man’s stomach and intestine, the eggs will turned into big worms.The symptoms are those of stomach troubles – poor appetite, diarrhoea, pain in the belly, weakness. Sometimes the worms may cause serious trouble like blocking the intestine and surgical operation may be necessary to save the patient’s life.All the above food and water-borne diseases spread in an almost similar manner except in the case of the roundworm disease. The person who is suffering from a particular disease is the source. He passes the germs in his faeces. Due to poor personal hygiene or bad sanitation, these germs contaminate water and food. You may also carry these germs from faeces to your food. In your stomach and intestine, these germs may multiply and cause the disease. The urine of the typhoid patients also carries germs and so it may also transmit the disease.

PREVENTION

Prevention for water and food-borne diseases are:Sanitary disposal of human excreta. Use sanitary latrine.Wash your hands well after defecation.Safe water supply. If in doubt, use boiled water. You should use safe water not only for drinking, but also for washing utensils, cleaning your hands, washing vegetables, fruits, etc., and also for washing clothes.Eat fresh food. Keep the food covered to get rid of flies and rats.Inoculations of anti-typhoid vaccine or anti-cholera vaccine should be taken to raise your body resistance against these diseases. However, these can not be completely relied upon as they are not as effective as other vaccines. If a large number of cases occur in an area, inoculation is a must.Wash fruits well in clean running water.Prevent flies by keeping kitchen waste covered and then disposing it properly.Wash your hands properly before taking food.Avoid contacts with patients unnecessarily. If your friend is suffering from cholera or typhoid fever avoid visiting him till he is cured.The patient should be isolated at home or hospital. Follow the doctor’s advice.Inform the nearest hospital, health centre or a doctor about the patient, giving the name, age and full address. This is important.Raw milk should never be taken. Boil it or drink pasteurized one.

DISEASES SPREAD THROUGH INSECTS AND ANIMALS

MALARIA

The word “malaria” literally means foul (mal) air. This name was given because of the earlier belief that the disease occurred due to inhalation of foul air coming out from marshes. But that belief was later proved to be wrong. Actually, the disease malaria is caused by a germ called malaria parasite. The symptoms of this disease are fever with violent shivering which comes on every alternate day or every third day or may be every day and at a fixed time. With sweating, the fever goes off after half an hour or so. The spleen swells up and can be felt under the rib margin in the left half of belly. Diagnosis is confirmed by blood tests for malaria parasites.

FILARIASIS

Filariasis is caused by a small worm called microfilaria. The symptoms are irregular fever and swelling of legs and scrotum. Diagnosis is confirmed by testing the blood sample taken at night for microfilaria.

DENGUE

Dengue is caused by a virus. The symptoms are moderate or high fever, severe pain all over the body, specially in joints and a reddish rash on the skin. Because of the painful condition, the other name of this disease is “breakbone fever”.

MODE OF SPREAD OF INSECT-BORNE DISEASES

When a mosquito bites a patient, it sucks the germs along with the blood. The germs undergo some changes in the body of the mosquito and become infectious. When a healthy man is bitten by such infectious mosquitoes, the germs are introduced into his body and thus he gets the disease.There are many varieties of mosquitoes but all do not transmit the disease. Malaria is transmitted by female anopheles mosquitoes, filariasis by culex and dengue by aedes mosquitoes. The peculiar habit of the anopheles is to take rest nearby immediately after sucking the blood. Therefore, we should spray the inside of the bed rooms and other resting places with DDT in order to kill these mosquitoes.

PREVENTION OF INSECT-BORNE DISEASES

Case detection and immediate treatment is the best prevention of insect-borne diseases. Both malaria and filarial can be treated by medicines which kill the germs. So if you suspect malaria or filarial, it can be diagnosed by blood examination and the patient can be made free from germs. If adequately treated, the mosquitoes can no longer find the germs during bites and disease-transmission can no longer occur. Therefore, all fever cases must be blood-tested for malaria parasites or microfilariae.Indoor DDT spray in places where transmission of malaria is suspected.All healthy persons must avoid mosquito bites by using nets and by applying mosquito repellent creams on exposed parts of the body.Anti-mosquito measures:In some of the country like India, it is not possible at this moment to kill all the mosquitoes, their eggs and larvae, and make the country mosquito free. It is because these insects breed in water and we have so many tanks, ditches, surface drains, etc., which help that. But you can do something to reduce their number in your own locality. These are:-Do not allow unnecessary collection of water in open cans, tins, coolers, etc., in your house.You may spray or pour anti-mosquito oils on surface drains and other places where artificial collection of water cannot be avoided.Mosquito screens (wire netting) may be fixed on windows and doors.Mosquitoes may be killed by spraying chemicals like gammaxine, DDT, malathion.Use mosquito nets at night and when this is not possible, apply mosquito repellent creams on exposed parts of the body.RABIES OR HYDROPHOBIAIt is a very dangerous disease because once it occurs, the person is almost sure to die. It is caused by a virus and develops about 4 – 6 weeks after being bitten by a rabid animal. The symptoms include headache, fever, difficulty in swallowing water and food. The patient develops great fear of water and he cannot drink, although he is thirsty. Therefore, the name “hydrophobia” (hydro means-water and phobia means-fear) has been given to this disease. Rabies is fairly common in India.

MODE OF SPREAD OF RABIES

Rabies is spread by the bite of a rabid (mad) dog, fox or some other animal. Sometimes the infection may be transmitted even through licking on a broken skin by a rabid animal.

PREVENTION OF RABIES

In case of animal bite, report immediately to the nearest doctor, hospital, health centre or dispensary for getting rabies vaccine before the disease occurs.Any dog or other animal suspected of having rabies should be watched for 10 days. If it is rabies, the animal would surely die within 10 days. In that case, persons bitten or licked must me given the full course anti-rabies vaccine.Avoid playing with stray dogs.All the pet dogs must be immunized against rabies. Do you have any pet dog in your house? If so, has it been vaccinated?

Diseases Spread by Close Contacts and (Spread) by Soil

LEPROSY

Leprosy is a chronic disease caused by a bacteria (Lepra bacilli). Early symptoms are loss of sensation and loss of normal colour in certain skin areas and thickening of some nerves. If untreated, ulcers and disfigurement occur. Children are common victims. Diagnosis is confirmed by detection of leprosy germs erom affected areas under the microscope.

MODE OF SPREAD

Close contact for long periods with leprosy patients causes leprosy but all leprosy patients do not spread infection.

PREVENTION

1. Early diagnosis is necessary for complete treatment of patients. The treatment has to be continued for several hours. Remember, leprosy is curable just like tuberculosis. Don’t be scared of the people suffering from leprosy and don’t hate them. Help them to get cured and become one of you.

2. The patient should keep himself, his clothings and his surroundings clean.

3. Any discharge from the open sore should be clean.

TRACHOMA

Trachoma is an eye disease caused by a germ. It makes the eyes sore and itching. Grain like things from under the eyelids. If untreated, blindness may result.

MODE OF SPREAD

It spreads from the eye of the patients to the eyes of the patients to the eyes of the healthy persons through clothes, handkerchiefs, etc., which are used to wipe the aeeected eyes. It also spreads by direct contact and through flies.

PREVENTION

1. Patients must be treated.

2. Eyes must not be rubbed.

3. Consult the doctor as soon as eyes appear sore.

PEDICULOSIS

It is commonly called lousiness as it is caused by insects called lice. It mainly affects the head and gives rise to itching. It spread through combs or clothings infested with lice and also by direct contacts.

PREVENTION

De-licing of patients.Avoid close contact with people who have the disease.Good personal hygiene is a must.

SCABIES

It is caused by itchmite: It gives rise to pimples and itching in between fingers, elbow folds and armpits. Mode of spread is by contact with the patient or his clothings.

PREVENTION

The patients and the whole family members must be treated simultaneously.Avoid contacts with patients.Maintain cleanliness and good personal hygiene.

GONORRHOEA AND SYPHILIS

These are venereal diseases causes by germs. In gonorrhoea, there is a burning sensation and discharge of pus while passing urine.In syphilis, a painless ulcer appears in the external genital organ (glans penis in males and mouth of the the womb in females). About two weeks later, a rash appears on the body. If untreated, more severe complications may develop.Mode of spread is by sexual contact.

PREVENTION

Treatment of patient and use of condom during sex.

DISEASES SPREAD THROUGH SOILTETANUS

Tetanus is a dangerous disease. It is caused by a germ. Symptoms are stiffness and pain in the neck and locking of jaws. It follows some injury when germs in the soil get into your body through a cut and especially by a puncture by a pointed object .

PREVENTION

Wash the wound and the skin around it with clean water and supply some disinfection like dettol immediately.Preventive immunization with vaccine in childhood and during pregnancy and repeat vaccination are best safeguards especially after you get a puncture wound by a nail or a similar object.

HOOKWORM DISEASE
Hookworm is a chronic disease which is caused by worms called hookworms. The symptoms are loose motions loss of appetite, weakness, feeling unwell and anaemia. Later the legs and belly may be swollen.

MODE OF INFECTION
The eggs of the hookworms are passed in the faeces of the patients. In soil, these eggs change into larvae. These larvae enter our body through the skin, mostly of the feet. The larvae go to the intestine and grow into mature adult worms. These worms suck blood and cause anaemia.
PREVENTION
- Sanitary disposal of human excreta is the most important measure. For example, sanitary latrine must be used.
- Shoes, chappals, or some kind of footwear must be used while walking on the soil.
- Detection and treatment of all patients.
There are many other communicable diseases and almost all communicable diseases can be prevented. If we follow healthy habits and the principles, we can make our country free from most of these diseases.
Non- Communicable Diseases

Let us now briefly discuss another group of diseases which are called non- communicable diseases. These are very difficult to prevent, but fortunately these do not spread from person to person. As such, they do not appear in large numbers at a time but still we can lower their incidence if we follow some principles. Let us discuss some of them which may be of interest to you.

DENTAL CARIES

Dental caries is a common cause of loss of teeth in children and young people. It causes pain in tooth. How ugly would you look if you don’t have a few teeth? But you can prevent this if you do the following:·

Regularly brush your teeth twice daily after principal meals and particularly after last meal at night.

Eat less sweet. When you do eat, brush well after eating.

Eat food that requires chewing. This will be an exercise for your gums.

Consult your dentist once in every six months.

After drinking tea/coffee or any other drink, rinse well.

DIABETES

Diabetes is due to the disorder of a gland called pancreas. As a result, excessive sugar accumulates in the blood. Symptoms are too much thirst, too much hunger, frequent passing of urine and loss of body weight. Rightly, the word diabetes comes from the Greek word for fountain.The diagnosis is confirmed by urine and blood tests. The disease makes one very susceptible to infections by various germs, and complications like pneumonia, heart, nerve, kidney diseases, etc, may occur.The exact cause for the disease is not known but it is hereditary and runs in families.

PREVENTION AND CONTROL

Diabetic patients and their children should take less sweets and carbohydrate food.

This habit should grow from childhood.

Adequate physical exercise is a must.

The patient should not become overweight.

In case of suspicion, medical advice should be taken.

One who is diabetic should have regular medical check-ups and follow his/her doctor’s advice.

HEART DISEASES

There are many heart diseases. In general, the symptoms and signs are:·

Dyspnoea (sudden shortness of breath) on exertion, or without exertion at night.

Dizziness.

Swelling of legs and ankles.

Pain in the chest.

PREVENTION

One must consult a doctor or even better, a cardiologist at the appearance of early symptoms and follow the advice given seriously.In general, remember, too much fatty food, smoking, overweight and sedentary habits are bad for your heart. You should be aware of this, because you can die or become crippled by heart disease at an early age.

CANCER

It is very dangerous disease. It can affect any part of the body like lungs, liver, stomach, rectum, breast, genital organs, skin, nerves, bones, blood, etc. But very early diagnosis may cure or slow down the progress of disease. Usually people above 40 years of age are victims. Generally speaking, the early signs are:· Long lasting cough· Indigestion· Bleeding from rectum· A lump in the breast· Irregular menstrual bleeding· A lump suddenly growing· A mole that is suddenly getting biggerA doctor should be consulted immediately in such cases.

WARNING SIGNALS

Cancer starts insidiously and does not show any specific signs or symptoms in the early stages. However, experience has revealed that the occurrence of cancer in a part of the body is often associated with the presence of any one of the following seven warning signals:· A sole that does not heal, particularly in the mouth.· Unusual and repeated bleeding, especially in women after menopause.· A lump or thickening in any part of the body, particularly the breast in women.· Persistence hoarseness or cough.· A change in the usual bowel habits.· A change in the size and colour of a mole or want.

MISCELLANEOUS

There are many other non-communicable diseases, namely:·

Genetic disorders.

Congenital defects.

Diseases due to malnutrition.

Life-style diseases due to smoking, alcoholism, self-medication, eating junk food, etc.

Diseases due to industrial hazards.