Hepatitis: Another Reason For Caution

With all the hoopla (deserved) for the HIV virus, many people have forgotten a greater danger. Every healthcare worker is cognizant of the fact that contracting Hepatitis is a more immediate concern and far more likely.

Physicians order hepatitis testing for a number of reasons including; elevated liver enzyme levels during routine blood testing, diffuse abdominal tenderness, jaundice (yellow eyes/skin), exposure to body fluids, and high risk lifestyles.

There are at least six different viruses that cause Hepatitis. Some forms are more dangerous because of the possibility of the patient becoming chronic. In this stage the virus continues to do damage, has few clinical symptoms, and is capable of being transmitted to others.

1. HepA/HepE: Caused by ingesting contaminated food or water. Associated with mild to moderate symptoms. Has no chronic phase.
    
2. HepG: Common in patients receiving multiple and repeated blood transfusions. Symptoms are mild, often non-existent. Rarely causes liver damage.
    
3. HepB: HBV is life threatening. Frequently leads to liver damage, sometimes severe. HBV can be transmitted through transfusions, exposure (accidental or intentional) to contaminated needles or sharps (broken glass, dental tools), hetero- or homosexual contact, or from mother to infant at birth. Symptoms range sub-clinical (none or mild - mistaken for a cold) to cirrhosis and liver failure. There is a chronic carrier stage.
    
4. HepC: HCV is life threatening. HCV can be transmitted by needle-sharing or accidental contact, tattooing, acupuncture, and certain dental procedures. HCV is rarely transmitted sexually or from mother to child. Initial symptoms are usually milder than HBV, but have a much higher incidence of chronic infection. HCV is the most important cause of chronic liver disease in the US. Significant percentages of patients develop cirrhosis and hepatocellular carcinoma (liver cancer).
    
5. HepD: HDV is a co-infection with HBV and HCV and can lead to further liver damage. Its presence heralds the probability of severity.

Blood tests will reveal the specific virus or viruses. Treatment and prognosis (outcome probability) varies for each strain.

Preventative measures include sanitary handling of food, treatment (tablets available in camping supply stores) of water from questionable sources, strict adherence to safety protocols in the clinical setting (dental offices, labs, hospitals, etc) when dealing with potentially hazardous substances, and avoidance of shared needles for drug-use or tattooing.

Most dentists, blood banks, doctor's offices, and tattoo establishments use sterilizers and autoclaves to cleanse equipment. If you have reason to doubt the sanitary conditions of one of these, leave and report the matter to the proper authorities. Most states have a department of health or public safety.

References:

• Use and Interpretation of Laboratory Tests in Infectious Disease - editor: James B. Peter, MD
• The Merck Manual of Diagnostic Therapy - editor: Robert Berkow, MD

And You Thought Picnic Ants Were Bad

Definition: A tick-transmitted spirochetal, inflammatory disorder best recognized clinically by an early skin lesion, erythema chronicum migrans (ECM), which may be followed weeks to months later by neurologic, cardiac, or joint abnormalities.

In plain English the above reads: Lyme's Disease is a bacterial disease a person can get by being bitten by a tick. There are certain easily recognizable symptoms that help diagnose the disorder.

Your doctor will order a Lyme Titer (or Titre) if you have:

1. Found a tick on your skin
2. Developed the characteristic rash
3. Complained of certain symptoms

The tick is about the size of a dull pencil point. The common dog tick is much larger. The ECM (rash) is a macule (red spot) or papule (pimple-like bump) that expands and often becomes ring-like in appearance. At least 75% of Lyme's Disease sufferers exhibit the ECM, and a quarter of these report having removed a tick from the site recently - 3 to 32 days - from the same spot. Many people develop multiple smaller lesions that last for a few weeks.

Symptoms include malaise (that indefinite "I'm coming down with something" feeling) and fatigue, chills and fever, headache, and stiff neck. Myalgias (muscle pain) and arthralgias (joint pain) are common. Symptoms are frequently intermittent and changeable, but the malaise and fatigue tend to linger.

Some patients suffer chronic and debilitating effects such as arthritis, cardiac (heart) complications, meningitis (inflammation of the lining of the brain or spinal cord), and a hodge-podge of other neurologic (nerves) and ocular (eye) disorders.

A positive or reactive Lyme Titer indicates the disease is present, but a negative or non-reactive titer does not eliminate the possibility and is usually repeated as the symptoms flare up. This is because the spirochete (a bacteria shaped like a rotini macaroni) can lie dormant or occult (hidden) and not trigger an immunological (the body's defense against infection) response. The antibodies the titer measures are not evident in these cases and only persistence will finally result in the proper diagnosis.

Once the diagnosis is established, extended courses of antibiotics are initiated. Because the bacteria can hide, sometimes several courses of medicine are required. Unfortunately, not all cases can be completely cured by the drugs now employed.

Prevention is the best defense against this insidious disorder. Wear long pants and high boots while hiking. Apply appropriate insect repellent as directed by manufacturer. Bath thoroughly afterward and wash the potentially infested clothing before re-wearing.

Lyme's Disease is now found in a large portion of the Eastern and Northern United States.

Perfume: Invitation or Invasion?

My family vacationed in Orlando when my son was in first grade. We used the Disney transit to get to and from the parks. On one of the first trips, my son piped up, "There must be a lot of mosquitoes in Florida!"

Well, there are but I was curious to know why he'd decided that then. "Why do you think so?" I asked.

"That lady," he said in a loud, carrying voice and pointing at a vacationer who had climbed aboard at the previous stop. "She sure is wearing a lot of bug-spray."

She wasn't. She was wearing what some people consider enough perfume. Of all the allergies in the world, there is one that receives scant press. Scent sensitivities are becoming a real problem in the closed environment of the modern workplace. Scent allergies have no cure and no treatment except avoidance. In a job requiring extensive public contact this is an impossible task.

Headaches, continuous sinus inflammation, hives, and nausea are the most common symptoms. If you notice these discomforts happening with increasing frequency, you may be developing the sensitivity.

Explaining can be difficult. How do you tell a sweet old lady that her Jean-Nate could asphyxiate a small rodent? How do you inform the well-dressed businessman that his aftershave is better suited to a bordello than a boardroom?

Regular patrons, acquaintances and friends will respond to a polite request and avoid wearing cologne. But that doesn't solve the problem for anyone. Everywhere, the sensitive are bombarded with scents strong enough to cause permanent nerve damage or, at least, temporary discomfort and lingering symptoms. The same people who would never think about smoking in public places wear a cloud of equally offensive, if politically correct, chemical pollutant.

This isn't the Middle Ages. You've probably bathed in the past two or three months and aren't a leper. Covering body odor and disguising the offensive smell of decaying flesh were the primary reasons why our forbearers used perfumes.

If you layer your scent products, consider stopping after the body lotion for everyday wear. If you use perfume alone, listen to the advice of experts. LESS IS MORE. Someone should have to stand in your personal space to detect the hint of your signature fragrance. If your perfume lingers longer than you do, you have applied too much.

Wear your perfume like a secret. Wear it like sexy lingerie.

Be subtle. Be considerate.

Are you inviting? Or are you invading?

Lisa Binkley works within the medical industry and is the popular author of this health series in the Kudzu Monthly. She also serves as the fiction editor of this ezine, edits for the online sci-fi magazine Distant Worlds, and maintains her own site for her fanciful sci-if work called Jolie Howard Fiction.

As Lisa phrases it, "Woman, wife, worker, writer. We all wear many faces and fill our niches as best we can."

Image: "In the Tent," John Ida, 1905

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