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COVID-19

Coronaviruses are a large family of viruses that may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes coronavirus disease COVID-19.

COVID-19 is an infectious disease caused by the most recently discovered coronavirus. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019.

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches, pain, nasal congestion, runny nose, sore throat, or diarrhoea. These symptoms are usually mild and begin gradually. Some people become gets infected but don’t develop any symptoms also don’t feel unwell. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who get COVID-19 becomes seriously ill and develop difficulty in breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems, or diabetes, are more likely to develop serious illnesses. People with fever, cough, and difficulty breathing should seek medical attention.

People can catch COVID-19 from others who have the virus. The disease can spread from person to person through small droplets from the nose or mouth which spreads when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose, or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. This is why it is important to stay more than 1 meter (3 feet) away from a person who is sick.

Studies to date suggest that the virus that causes COVID-19 is mainly transmitted through contact with respiratory droplets rather than through the air. See the previous answer on “How does COVID-19 spread?

The main way this disease spreads is through respiratory droplets expelled by someone who is coughing. The risk of catching COVID-19 from someone with no symptoms at all is very low. However, many people with COVID-19 experience only mild symptoms. This is particularly true in the early stages of the disease. It is, therefore, possible to catch COVID-19 from someone who has just a mild cough and does not feel ill. WHO is assessing ongoing research on the period of transmission of COVID-19 and will continue to share updated findings.

 

While we are still learning about how COVID-2019 affects people, older persons and persons with pre-existing medical conditions (such as high blood pressure, heart disease, lung disease, cancer, or diabetes) appear to develop serious illness more often than others.

 

Not yet. To date, there is no vaccine and no specific antiviral medicine to prevent or treat COVID-2019. However, those affected should receive care to relieve symptoms. People with serious illnesses should be hospitalized on an urgent basis.

Possible vaccines and some specific drug treatments are under investigation. They are being tested through clinical trials. WHO is coordinating efforts to develop vaccines and medicines to prevent and treat COVID-19.

The most effective ways to protect yourself and others against COVID-19 are to frequently clean your hands, cover your cough with the bend of elbow or tissue, and maintain a distance of at least 1 meter (3 feet) from people who are coughing or sneezing. (See Basic protective measures against the new coronavirus).

The “incubation period” means the time between catching the virus and beginning to have symptoms of the disease. Most estimates of the incubation period for COVID-19 range from 1-14 days, most commonly around five days. These estimates will be updated as more data become available.

Snake bites

Snake-bite is an occupational disease of farmers, plantation workers, herdsmen, fishermen, snake restaurant workers, and other food producers. It is, therefore, a medical problem that has important implications for the nutrition and economy of the countries where it occurs commonly. It is recommended that snake-bite should be formally recognized as an important occupational disease in the South East Asian region.

Snakebite envenoming is a potentially life-threatening disease that typically results from the injection of a mixture of different toxins (“venom”) following the bite of a venomous snake. Envenoming can also be caused by having venom sprayed into the eyes by certain species of snakes that have the ability to spit venom as a defence measure.

Fundamentally, Envenoming results from snake bites is a particularly important public health problem in rural areas of tropical and subtropical countries situated in Africa, Asia, Oceania, and Latin America.

The major groups of snakes causing envenoming are the elapids (cobras, kraits, mambas, etc.) and vipers, and in some regions, sea snakes. Snake venom is a complex mixture of many different compounds. The composition and effects of venom vary considerably between species to species, but can broadly be divided into categories which include i) cytotoxins causing local swelling and tissue damage, ii) haemorrhages which disturb the integrity of blood vessels, iii) compounds which lead to in-coagulable blood, iv) neurotoxins causing in neurotoxicity and iv) mycotoxins which cause muscle breakdown.

Victims of snake-bite may suffer any or all of the following:

(1) Local envenoming confined to the part of the body that has been bitten. These effects may be debilitating, sometimes permanently.

(2) Systemic envenoming involving organs and tissues away from the part of the body that has been bitten. These effects may be life-threatening and debilitating, sometimes permanently.

(3) Effects of anxiety prompted by the frightening experience of being bitten and by exaggerated beliefs about the potency and speed of action of snake venoms. These symptoms can be misleading for medical personnel.

(4) Effects of first-aid and other pre-hospital treatments that may cause misleading clinical features.

These may be debilitating and rarely even life-threatening. (3) And (4) may develop in patients who are envenomed and in those who are not envenomed (bite by a non-venomous snake or by a venomous snake that failed to inject venom) or who were not in fact bitten by a snake at all but by a rodent or lizard or even impaled by a thorn.

Antivenom treatment for snake-bite was first introduced by Albert Calmette at the Institute Pasteur in Saigon in the 1890s (Bon and Goyffon 1996). Antivenom is immunoglobulin [usually pepsin-refined F(ab’)2 fragment of the whole IgG] purified from the plasma of a horse, mule, or donkey (equine) or sheep (ovine) that has been immunized with the venoms of one or more species of snake. “Specific” antivenom, implies that the antivenom has been raised against the venom of the snake that has bitten the patient and that it can therefore be expected to contain a specific antibody that will neutralize that particular venom and perhaps the venoms of closely related species (para specific neutralization). Monovalent (mono-specific) antivenom neutralizes the venom of only one species of snake. Polyvalent (poly-specific) antivenom neutralizes the venoms of several different species of snakes, usually the most important species, from a medical point of view, in a particular geographical area.
  • No alternative successful therapy
  • A high degree of mortality and morbidity in the absence of treatment
  • The diseases in which they are used represent a heavy toll of human suffering
  • Largely affects children and farmers in rural communities
  • Unfortunately, there are a number of problems for developing countries in accessing and using antivenoms – W.H.O.
Principles of first-aid First-aid treatment is carried out immediately or very soon after the bite before the patient reaches a dispensary or hospital. It can be performed by the snake-bite victim himself/herself or by anyone else who is present and able. Unfortunately, most of the traditional, popular, available, and affordable first-aid methods have proved to be useless or even frankly dangerous. These methods include: making local incisions or pricks/punctures (“tattooing”) at the site of the bite or in the bitten limb, attempts to suck the venom out of the wound, use of (black) snake stones, tying tight bands (tourniquets) around the limb, electric shock, topical instillation or application of chemicals, herbs or ice packs. Must not be allowed to delay medical treatment or to do harm.

Rabies

Rabies is a zoonotic disease (a disease that is transmitted from animals to humans), caused by the rabies virus, of the Lyssavirus genus, within the family Rhabdoviridae. Domestic dogs are the most common reservoir of the virus, with more than 99% of human deaths caused by dog-mediated rabies.

The virus is transmitted in the saliva of rabid animals and generally enters the body via infiltration of virus-laden saliva from a rabid animal into a wound (e.g. scratches), or by direct exposure of mucosal surfaces to saliva from an infected animal (e.g. bites). The virus cannot infiltrate intact skin. Once the virus reaches the brain, it further replicates, resulting in the presentation of clinical signs from the patient. There are two clinical manifestations of rabies – furious (classical or encephalitic) and paralytic. Furious rabies is the most common form of human rabies, accounting for approximately 80% of cases.
Dog rabies potentially threatens over 3.3 billion people in Asia and Africa. People most at risk live in rural areas where human vaccines and immunoglobulin are not readily available or accessible. Poor people are at a higher risk.

Rabies occurs in more than 150 countries and territories. Worldwide, more than 55 000 people die of rabies every year. More than 95% of human deaths occur in Asia and Africa. Once symptoms of the disease develop, rabies is nearly always fatal. 40% of people who are bitten by suspect rabid animals are children under 15 years of age. Dogs are the source of 99% of human rabies deaths.

  • Pain areas: in the muscles
  • Whole body: dizziness, fatigue, fever, loss of appetite, or malaise
  • Psychological: delirium, fear, or hallucination
  • Gastrointestinal: nausea or vomiting
  • Muscular: muscle spasms or paralysis with weak muscles
  • Sensory: pins and needles or sensitivity to light
  • Behavioural: aggression or irritability
  • Also common: anxiety, brain death, coma, difficulty swallowing, dilated pupil, drooling, excess salivation, headache, mental confusion, neck stiffness, or seizures

The person is seriously injured in an animal attack.

  1. Stop Bleeding
  • Apply sustained pressure for several minutes.
  1. Clean Wound
  • Wash with clean water and gentle soap for 15 minutes.
  1. Gather Information about Animal
  • Notify the local health department or animal control about the animal’s possible whereabouts.
  • If the animal is a pet, get the owner’s contact information.
  1. See a Health Care Provider Immediately
  • Do not wait for symptoms to appear.
  • If possible, bring information about the animal.
  • If the person was in an enclosed area with a bat, see a care provider whether or not there is a bite wound. The person may have been bitten and not know it.

There is a Vaccine and also Anti Rabies Serum (ARS) for the Rabies disease. But, Anti Rabies Vaccine alone may not save lives. W.H.O recommends ARS (Anti Rabies Serum) with ARV (Anti Rabies Vaccine) in all category III & immune-compromised category II patients. Anti-Rabies Serum is prepared from Human origin and Equine origin.

Equine Rabies Immunoglobulin (ERIG) is obtained from the blood plasma of healthy equines that have been immunized against rabies by vaccination.

Cheaper and safe (purified pepsin digested horse serum) equine immunoglobulin (ERIG) is available Purification techniques can be used to reduce the risk of sensitization to ERIG.

The objective is to maximize the specific activity and to minimize the allergenic substances in the product.

*Effective treatment of Rabies is critically dependent on the availability of good-quality antisera-W.H.O-2007

Diphtheria

Diphtheria is an infectious disease caused by the bacterium Corynebacterium diphtheriae, which primarily infects the throat and upper airways, and produces a toxin affecting other organs. The illness has an acute onset and the main characteristics are sore throat, low fever and swollen glands in the neck, and the toxin may, in severe cases, cause myocarditis or peripheral neuropathy. The diphtheria toxin causes a membrane of dead tissue to build up over the throat and tonsils, making breathing and swallowing difficult.
The disease is spread through direct physical contact or from breathing in the aerosolized secretions from coughs or sneezes of infected individuals.
  • Whole-body: chills, fatigue, fever, or malaise
  • Respiratory: noisy breathing or shortness of breath
  • Skin: rashes or ulcers
  • Speech: hoarseness or impaired voice
  • Throat: difficulty swallowing or soreness
  • Also common: coughing, muscle weakness, runny nose, swelling, or swollen lymph nodes
Diphtheria Antitoxin is prepared by hyper-immunized horses with diphtheria toxoid, Plasma obtained from the hyper-immunized horses which are rich in antibodies to diphtheria toxin is enzyme refined, purified, and concentrated. The antitoxin has the specific power of neutralizing the toxin secreted by Corynebacterium diphtheria the causative organism of diphtheria.

Scorpion Stings

Scorpion stings can be painful, but the vast majority of them are harmless. Some species, however, can inflict potentially fatal stings. Stings are most serious in young children and the elderly.

Mild symptoms include pain and swelling at the sting site. Severe symptoms include muscle twitching, sweating, and drooling.

Most stings don’t need treatment. Severe cases may need anti-venom.

Most scorpion stings cause only localized signs and symptoms, such as pain and warmth at the site of the sting. Sometimes these symptoms may be quite intense, even if you don’t see redness or swelling.

Signs and symptoms at the site of the sting may include:

  • Pain, which can be intense
  • Numbness and tingling in the area around the sting
  • Slight swelling in the area around the sting

Signs and symptoms related to widespread (systemic) venom effects usually occur in children who are stung and may include:

  • Difficulty breathing
  • Muscle twitching or thrashing
  • Unusual head, neck and eye movements
  • Drooling
  • Sweating
  • Nausea and vomiting
  • Low blood pressure (hypo tension)
  • Accelerated heart rate (tachycardia) or irregular heart beat (arrhythmia)
  • Restlessness or excitability or inconsolable crying (in children)

As with other stinging insects, such as bees and wasps, it is possible for people who have previously been stung by scorpions to also have allergic reactions with subsequent stings. These subsequent stings are sometimes severe enough to cause a life-threatening condition called anaphylaxis. Signs and symptoms in these cases are similar to those of anaphylaxis caused by bee stings and can include hives, trouble breathing, and nausea and vomiting

Continuously apply ice to the sting area.

If there is no danger to other people, carefully collecting a dead or injured scorpion into a sealed container to show to the physician may be helpful.

Antivenom therapy is available for the many scorpion species. The antivenom has been made by immunizing horses with the venom and then the antivenom (immunoglobulin) is harvested from horse blood. The antivenom may stop all symptoms within about 4 hours after administration. Other researchers are developing antivenom to other species of scorpions. All but the mildest of symptoms require hospital admission for 24 hours of observation, especially for children.

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