Tuberculosis - APPSC Group 1 Mains - Paper 4

Causative agent

Tuberculosis is caused by a bacteria called Mycobacterium tuberculosis. It usually affects the lungs (pulmonary tuberculosis). Other parts of the body can also be affected (extrapulmonary tuberculosis) such as lymph nodes, kidneys, bones, joints.

Clinical features

The symptoms of pulmonary TB include low-grade fever, night sweats, fatigue, weight loss, a persistent cough and blood in sputum. Some people may not have obvious symptoms.

Mode of transmission

Tuberculosis is spread through the air. When a person with infective pulmonary tuberculosis coughs or sneezes, the bacteria gets into the air and causes disease if a susceptible person inhales it. Effective antibiotic treatment usually shortens the infectious period to within a few weeks.

Incubation period

Symptoms may occur as early as several weeks after infection, or it may occur after many years. An infected person has the greatest risk of developing TB within the first two years after infection.

Management

People with tuberculosis should seek medical treatment as soon as possible. They are prescribed multiple drug therapy for at least six months. In order to eradicate the bacteria, patients should follow their doctors' instruction and complete the course of treatment.

Prevention

1. Maintain good personal and environmental hygiene.
2. Adopt a healthy lifestyle, i.e., have balanced diet, adequate exercise and rest.
3. Keep hands clean and wash hands properly.
4. Wash hands when they are dirtied by respiratory secretions e.g. after sneezing.
5. Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly.
6. Seek treatment promptly if symptoms similar to tuberculosis appear, particularly persistently cough for more than one month.

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Amoebic Dysentery - APPSC Group 1 Mains - Paper 4

Causative Agent

Amoebic dysentery is an intestinal infection caused by a parasite called Entamoeba histolytica.

Clinical Features

Infection by Entamoeba histolytica may be asymptomatic. The symptoms of amoebic dysentery include fever, chills, diarrhoea and abdominal pain. Stool may contain blood and/or mucus. Entamoeba histolytica may rarely invade the liver to form an abscess. Less commonly, it spreads to other parts of the body, such as the lungs or brain. Other complications include inflammation of the intestine or rarely perforation.

Mode of Transmission

Transmission of amoebic dysentery occurs mainly by ingestion of faecal contaminated food or water containing the cyst of Entamoeba histolytica. Transmission can also occur sexually through oral-anal contact.

Risk Factors

People who live in institutions and those who travel to developing countries with poor sanitary conditions are at a higher risk of getting the disease.

Incubation Period

The incubation period is variable, and may range from a few days to several months. It is usually 2 to 4 weeks.

Diagnosis

Diagnosis is usually made by microscopic examination of patient's stool specimen for Entamoeba histolytica trophozoites and/or cysts. Presence of red blood cells and white blood cells facilitates the diagnosis of amoebic dysentery.

Treatment

Treatment should include fluid replacement and antibiotics.

Prevention

1. Maintain good personal, food and environmental hygiene.
2. Wash hands properly with soap and water before eating or handling food, and after toilet or changing diapers.
3. Drinking water should be from the mains and preferably boiled.
4. Purchase fresh food from reliable sources.
5. Do not patronize illegal hawkers.
6. Cook food thoroughly.
7. Exclude infected persons and asymptomatic carriers from handling food and from providing care to children, elderly and immunocompromised people.
8. Persons with gastrointestinal symptoms such as diarrhoea should refrain from work/school and seek medical consultation promptly.
9. When traveling to a country with poor sanitary conditions, persons should take the following precautions:
* Always wash hands before eating and after going to toilets
* Drink only boiled water, or bottled drinks by reputable companies, and pasteurized milk or dairy products
* Avoid drinks prepared by ice of unknown origin
* Eat only thoroughly cooked food
* Avoid peeled fruits and vegetables that are not thoroughly cleaned
* Do not patronize illegal hawkers

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Cholera _ APPSC Group 1 Mains - Paper 4

Cholera  

Causative agent

Cholera is an acute diarrhoeal disease caused by the bacterium Vibrio cholerae.  Vibrio cholerae serogroups O1 and O139 can cause epidemic cholera.

Clinical features

Although most patients have mild symptoms, such as mild diarrhoea or vomiting, some patients may have severe symptoms with sudden onset of profuse diarrhoea with rice-water like and fishy smelling stool, nausea and vomiting.  Without prompt treatment, these patients may die from severe dehydration.

Mode of transmission

Cholera is usually contracted through consumption of food or water contaminated with Vibrio cholerae.  Human-to-human transmission rarely happens.

Incubation period

Ranges from a few hours to 5 days, usually 2-3 days.

Management

The mainstay of treatment is timely and adequate rehydration. For mild dehydration, patients may take oral rehydration salts (ORS) fluid.  Severe dehydration cases usually require intravenous rehydration to replenish  fluid and mineral loss.  For severe cases of diarrhoea, antibiotics may be used .

Prevention

Preventive measures are based on good personal, food and environmental hygiene:

1.  Personal hygiene

• Wash hands properly with soap and water
• before eating or handling food
• after toilet or changing diapers
• after handling garbage
• Avoid handling food when having symptoms of vomiting or diarrhoea

2.  Food hygiene

• Purchase food from reliable sources.  Do not patronise illegal hawkers
• Handle raw, cooked and ready-to-eat food with separate utensils and store them separately
• Ensure thorough cooking of food before consumption 
• Discard any spoilt food 
• Clean refrigerator regularly. Maintain the fridge at or below 4°C and freezer at or below -18°C
• Supervisors of food premisesshould use water from reliable sources to keep live fish or shellfish. They should also filter and change fish tank water frequently and cleanse the fish tanks regularly

3.  Environmental hygiene

• Maintain proper drainage system
• Dispose of infected person's stool properly

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