Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
International travelers should make sure that these
vaccinations are up to date and that no boosters are required, since many
conditions which are rare in the U.S. due to immunity in the general population
may be more common in other countries.
"Recommended" vaccinations are given to protect travelers from illnesses that
occur routinely in other parts of the world. Doctors determine which vaccines
are recommended for international travel on an individual basis, taking into
consideration your destination, whether you will be spending time in rural
areas, the season of the year you are traveling, your age, your overall health
status, and your immunization history.
Some examples of vaccines that may be recommended for international travelers
(remember you may need more, fewer, or different vaccinations, depending on your
individual circumstances) include the following:
Hepatitis A: This
condition is spread by person-to-person contact, through contaminated water,
shellfish harvested in contaminated water, or other food products contaminated
during preparation or handling. Hepatitis A may be contracted where sanitation
conditions may be lacking.
Rabies: Rabies virus is
endemic in dogs in many countries throughout the world, including, but not
limited to, parts of Thailand, Vietnam, Brazil, China, the Philippines, Sri
Lanka, and Indonesia.
Typhoid fever: This
condition may be contracted in many areas of the world through contaminated
drinking water or food or by consuming food or beverages that have been
handled by an infected person.
Rabies is a disease caused by a virus that affects the nervous system and, unless treated
quickly and appropriately, usually results in death.
Rabies symptoms and signs
occur after exposure and may consist of some or many of the following: odd
behaviors, delirium, combativeness, loss of muscle function, muscle spasms,
drooling, convulsions, pain, and other problems.
Rabies is caused when the
virus, Lyssavirus rabies, enters the human body by the bite from an infected
animal, in most cases. The virus progresses through the nerves to the brain and
other organs.
Although the majority of rabies infections worldwide originate
from bites from infected dogs, other animals (for example, bats, foxes, raccoons,
coyotes, wolves) may transmit the disease. Saliva from infected animals and bat
guano may also transmit the rabies virus to humans under certain conditions.
A
person exposed to rabies should ideally be treated within 12 hours of the
exposure and definitely within 48 hours for the best outcome.
People exposed
to rabies are usually treated with rabies immune globulin and rabies vaccine
initially and then get an additional vaccine injection on days three, seven, 14, and
occasionally 28 after the first treatment.
Diagnostic tests for rabies
exposure usually involve taking tissue samples (often brain tissue) from the
potentially rabies-infected animal exposed to the patient and using
immunofluorescence or other immunological techniques to detect the virus in the
animal tissue.
Patients who develop the symptoms of rabies, due to no
treatment or incomplete treatment, in almost every instance, will die from the
disease.
Rabies can be prevented or greatly reduced in incidence by
government-mandated animal vaccinations, by oral vaccines fed to wild animals,
and by avoiding any contact with an animal suspected of having rabies.
What is rabies?
Rabies is a disease caused by a virus that enters the body through the bite
of infected animals and causes brain swelling and, if not quickly treated,
results in convulsions,
respiratory failure, and death in almost every person infected. Very rarely, rabies has been transmitted only by saliva droplets from an infected animal that contacts a skin break (abrasion or
cut, not a bite) or in rabies research laboratory accidents. Aerosols of saliva droplets or bat guano may also rarely cause rabies.
Rabies is worldwide (except for Australia and New Zealand currently);
developing countries have dogs as the most common source of
bites that lead to
rabies. However, many wild animals (especially foxes, skunks, raccoons, and bats)
in both developed and developing countries can be infected with rabies virus so
their bites (and saliva) can transmit the disease to other animals and humans.
Most developed countries have animal vaccination programs that effectively
reduce or eliminate the source of rabies in domestic animals (especially dogs and
cats);
some even have programs to reduce or eliminate the virus in wild animals.
For example, vaccine materials are set out in the wild for coyotes to ingest to
reduce or eliminate rabies in their population in Texas. Until recently, when
rabies-infected bats were found in Scotland, all of England was rabies-free due
to its vaccine program. Rabies is termed a
zoonosis, which means a disease that is usually transmitted from animals to other animals and but can also be transmitted to humans. The terms
rabies and rabies virus (Lyssavirus rabies) are currently interchanged in most of the medical literature although technically rabies is the disease process and rabies virus is the species of
lyssavirus that causes the disease. However, the dual meaning is so pervasive in the medical and lay literature that
rabies will be used in this article to mean both the disease and the viral cause of the disease.
About 55,000 deaths per year worldwide are due to rabies (World Health Organization statistics), and the majority of these deaths occur in children.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
Tetanus is an often-fatal disease caused by nerve toxins produced by the common bacteria Clostridium tetani. In a seven-day period after infection, a person experiences muscle spasms, restlessness, headache, irritability, then lockjaw, and the lungs stop functioning. Tetanus is treatable with antibiotics and drainage. Sedation is often give to stop muscle spasms.
There are millions of dogs living in the United States, and thus many cases of dog bites. Annually, hundreds of people seek emergency medical care for dog bites. Treatment for a dog bite depends on how deep the injury is and the amount of tissue damage. Dog bites can be prevented by employing preventative measures.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Dysphagia is the medical term for the symptom of difficulty
swallowing, derived from the Latin and Greek words meaning difficulty eating.
Mechanism of swallowing
Swallowing is a complex action.
Food is first chewed
well in the mouth and mixed with saliva.
The tongue then propels the chewed food
into the throat (pharynx).
The soft palate elevates to prevent the food from
entering the posterior end of the nasal passages, and the upper pharynx
contracts, pushing the food (referred to as a bolus) into the lower pharynx. At
the same time, the voice box (larynx) is pulled upwards by muscles in the neck,
and, as a result, the epiglottis bends downwards. This dual action closes off
the opening to the larynx and windpipe (trachea) and prevents passing food from
entering the larynx and trachea.
The contraction of the muscular pharynx
continues as a progressing, circumfe...
