What Is Shingles? What Causes Shingles?

Shingles is caused by the herpes varicella-zoster (or simply zoster) virus. This virus also causes chickenpox. Most of us get chickenpox during childhood, but after we recover the virus remains inactive (dormant) in our nervous system. Our immune system stops the virus from becoming active. However, later in life it may become reactivated, causing shingles. Shingles is an infection of a nerve and the area of skin around it.

According to Medilexicon's medical dictionary, herpes zoster (shingles) is "an infection caused by a herpes virus (varicella-zoster virus), characterized by an eruption of groups of vesicles on one side of the body following the course of a nerve due to inflammation of ganglia and dorsal nerve roots resulting from activation of the virus, which in many instances has remained latent for years following a primary chickenpox infection; the condition is self-limited but may be accompanied by or followed by severe postherpetic pain."

A study found that most Americans are in the dark regarding shingles.

What are the symptoms of shingles?

A bout of shingles will normally last from 2 to 4 weeks. The patient will generally feel a tingling sensation in the affected area at first. This will be followed by pain, and then a rash.

Although the chest and abdomen are the most likely parts of the body to experience pain and a rash, shingles can affect any part, including arms, legs, and even the face and eyes.

• Pain - the pain in the affected area tends to be continuous. Some describe it as a dull pain, while others experience a burning sensation. There may also be occasional stabbing pains. The affected area will nearly always be tender.


• Rash - about two to three days after the onset of pain the rash will appear. It usually emerges on just one side of the body, and develops at the area of the affected nerve. It starts off as red blotches on the skin, and rapidly develops into itchy blisters; similar to those of chicken pox. Each blister may be there for about one week, then they become yellowish and dry out. Some patients may experience slight scarring of the skin.


• Postherpetic neuralgia - some patients experience severe nerve pain (neuralgia). If the nerves are damaged (postherpetic neuralgia) the pain can last for a very long time, even months or years after symptoms have disappeared.

Sometimes there may be additional symptoms, although they are nearly always mild. They might include:

• Confusion
• Fatigue
• Fever
• Headache
• Memory loss
• Upset stomach or abdominal pains

Risk factors for shingles

Any person who has had chickenpox can potentially develop shingles. However, it is much more common among people over the age of 60 (over 50% of cases). The risk of shingles is also much higher among people with weakened immune systems, such as those with HIV/AIDS, patients receiving steroids, radiation and chemotherapy, or those with a history of bone or lymphatic cancer.

Most people who develop shingles only do so once. However, recurrences can happen.

Anyone who has never had chicken pox can become infected by somebody with shingles. This generally happens through direct contact with open sores of the shingles rash. However, that person will develop chickenpox, not shingles. Even so, a chicken pox infection can be dangerous for some people with deficient immune systems. A person with a normal immune system who has already had chicken pox cannot become infected by a person with shingles.

Researchers from Texas, USA, found that those with a family history of shingles may be more susceptible to developing the disease. A person with shingles and blisters should avoid contact with people who have never had chickenpox, people with weakened immune systems, infants and newborn babies, and pregnant women.

German scientists found that some arthritis drugs may be linked to an increased risk of developing shingles.

How is shingles diagnosed?

Most GPs (general practitioners, primary care physicians) can diagnose shingles by the symptoms and a rash. Testing is not generally needed. Sometimes doctors may take a tissue scraping or culture of the blisters for testing in the laboratory.

If a GP suspects there is a risk for the patient of a complication he/she may be referred to a specialist. If shingles is affecting the patient's eyes he/she may be referred to an eye specialist (ophthalmologist) - there is a risk that an eye problem may result in permanent vision deficiency. Patients on chemotherapy/radiotherpy, those with HIV/AIDS, as well as anybody with a weakened immune system may also be referred to a specialist. People with weakened immune systems run a higher risk of complications caused by shingles.

A GP may also refer a patient to a specialist if the patient is not responding to treatment.

What is the treatment for shingles?

Although there is no cure for shingles, there is a lot that can be done to relieve symptoms:

• Shingles rash - keep the rash as dry and as clean as possible. This helps reduce the risk of bacterial infection. Patients find loose-fitting clothes easier to wear than tight-fitting ones.


• Pain - typically, over-the-counter painkillers such as ibuprofen paracetamol (acetaminophen, Tylenol) are effective painkillers for people with shingles. If the pain is very severe the patient may require a prescription-only medication. Ibuprofen is unsuitable for patients with stomach problems, asthma, severe liver disease, or kidney problems. Pregnant women should not generally take ibuprofen. The painkiller oxycodone is effective at treating the acute pain of shingles, according to a study. Another study found that a single epidural injection of steroids and local anaesthetics is not effective for the prevention of long-term pain in shingles.


• Antidepressants - some patients who experience severe pain may be prescribed an antidepressant. Antidepressants are sometimes effective for pain management, especially if the pain is severe or long-lasting. In the UK the most commonly prescribed antidepressants for patients with shingles are amitriptyline, imipramine and nortriptyline. These medications may have the following side-effects: constipation, blurred vision, weight gain, drowsiness, problems urinating, and dry mouth. The antidepressant dosage for shingles is usually much lower than for clinical depression. Some antidepressant may take a while before the benefits are felt.


• Anticonvulsants - these medications are usually prescribed to control seizures. However, they can be effective in helping the patient control nerve pain. The most commonly prescribed anticonvulsant medication for shingles patients in the UK is Gabapentin. Side effects may include swollen ankles, dizziness and drowsiness. It may take a while before the patient starts noticing the benefits.


• Antivirals - these drugs do not kill the shingles virus, but they can stop if from reproducing. They are often effective in reducing the severity of symptoms, especially if taken within 72 hours of the appearance of the skin rash. Commonly prescribed antivirals include aciclovir, valaciclovir and famciclovir. A course of antivirals lasts about one week. Generally patients are prescribed antivirals if they are aged over 50, have symptoms which are affecting their eyes, have weakened immune systems, have moderate to severe pain, have a moderate to severe rash, and have a rash outside the torso, such as the arms, legs or neck. A GP will discuss the pros and cons of antiviral medications for a pregnant patient with a specialist and the patient herself. A possible new anti-viral drug designated FV-100, which is still in clinical trials (June 2009) may help patients with shingles, a study reported.

What are the complications of shingles?

Complications are much more likely if the patient has a weakened immune system. Possible complications may include:

• Infection - the rash may become infected. Usually, a course of antibiotics is all that is needed.


• Loss of pigmentation - the patient may have white patches after the rash has gone.


• Scarring - sometimes the blisters can leave scars. However, this is extremely uncommon.


• Ramsay-Hunt syndrome - the facial nerve becomes infected. The onset of Ramsay Hunt syndrome can be frightening. Some people may wonder whether they are having a stroke. It is important that it is treated promptly because in rare cases it can lead to permanent facial muscle weakness and hearing loss. Symptoms of Ramsay Hunt syndrome include earache, deafness, dizziness and paralysis of the face. The pain usually improves within 48 hours.


• Eye ulceration and permanent scarring - the cornea (surface of the eye) may become scarred and the iris and ciliary body (ring of muscle behind the iris) may become inflamed.


• Encephalitis - inflammation of the brain - the patient has a very high fever, confusion, headaches, lethargy and limb weakness. This is very rare.


• Postherpetic neuralgia - this may be the result of nerve fiber damage. Damaged fibers can't send messages from the skin to the brain. Messages become confused, causing pain - neuralgia - which may become persistent long after other shingles signs have gone.

Prevention

A National Institutes of Health (NIH) funded study (USA) found that Tai Chi helps boost immunity to the shingles virus in older adults.

There are two vaccines which can help prevent shingles - the varicella (chickenpox) vaccine and the varicella-zoster (shingles) vaccine.

• Chickenpox vaccine - This vaccine (Viravax) is routinely given to children aged 12 to 18 months to prevent chickenpox. Experts recommend it also for adults and older children who have never had chickenpox. The vaccine does not provide 100% immunity, but it does considerably reduce the risk of complications and severity of the disease.


• Shingles vaccine - this vaccine (Zostavax) can help protect adults over 60 who have had chickenpox. It does not provide 100% immunity but does considerably reduce the risk of complications and severity of shingles. Experts recommend that people over 60 have this vaccine, regardless of whether or not they have had shingles before. The vaccine is preventative, and is not used to treat people who are infected. The following people should not have the shingles vaccine:
  
  
  • Those who have had a life-threatening reaction to gelatin, neomycin (an antibiotic), or any other shingles vaccine component.
  • People who have a weakened immune system
  • Patients receiving steroids, radiotherapy, and/or chemotherapy
  • Patients with a history of bone marrow or lymphatic cancer
  • Patients with active, untreated TB (tuberculosis)
  
  Doctors say people with a mild cold may take the vaccine, but not those who are moderately or severely ill (they should wait till they are recovered).

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H1N1 Swine Flu Map Of Confirmed Outbreaks To-Date

Featured below is an interactive Google map pinpointing outbreaks of H1N1 swine flu in 2009, together with source attributions, report dates, and current known statuses. This map is updated throughout the day with the latest suspected and confirmed cases of swine flu, as reports come in. Please note that this swine flu map is not owned or updated by Medical News Today staff and, therefore, we cannot guarantee the accuracy of the information provided by it.

How to use the H1N1 map

You can zoom in and out and scroll around to view any country that you like, or any region that you like. To view information on a specific case, simply click on a map marker. Due to the amount of H1N1 cases, some content appears hidden until you zoom in to a specific map area.

Swine Flu Map

This Swine flu map was created by L R - a computer scientist working in the UK, together with a team of 18 other people.

Swine Flu Map - Key

• Red markers are confirmed infections of swine flu H1N1
• Pink markers are probable infections
• Black markers are confirmed deaths
• Grey markers are unconfirmed deaths
• Blue markers are influenza-like illness

Click on any marker to view information on that case.

2009 Swine Flu (H1N1) Outbreak Map in a larger map

Please note that this h1n1 swine flu map is not owned or updated by Medical News Today staff and, therefore, we do not guarantee the accuracy of the information provided by it.

What is Swine Flu?

Swine flu (swine influenza) is a disease of pigs. It is a highly contagious respiratory disease caused by one of many Influenza A viruses. Approximately 1% to 4% of pigs that get swine flu die from it. It is spread among pigs by direct and indirect contact, aerosols, and from pigs that are infected but do not have symptoms. In many parts of the world pigs are vaccinated against swine flu.

Most commonly, swine flu is of the H1N1 influenza subtype. However, they can sometimes come from the other types, such as H1N2, H3N1, and H3N2.

The current outbreak of swine flu that has infected humans is of the H1N1 type - this type is not as dangerous as some others.

Avian Influenza (Bird Flu) can also infect pigs

Avian flu and human seasonal flu viruses can infect pigs, as well as swine influenza. The H3N2 influenza virus subtype, a virulent one, is thought to have come from pigs - it went on to infect humans.

It is possible for pigs to be infected with more than one flu virus subtype simultaneously. When this happens the genes of the viruses have the opportunity to mingle. When different flu subtypes mix they can create a new virus which contains the genes from several sources - a reassortant virus.

Although swine influenza tends to just infect pigs, they can, and sometimes do, jump the species barrier and infect humans.

What is the risk for human health?

Outbreaks of human infection from a virus which came from pigs (swine influenza) do happen and are sometimes reported. Symptoms will generally be similar to seasonal human influenzas - this can range from mild or no symptoms at all, to severe and possibly fatal pneumonia.

As swine flu symptoms are similar to typical human seasonal flu symptoms, and other upper respiratory tract infections, detection of swine flu in humans often does not happen, and when it does it is usually purely by chance through seasonal influenza surveillance. If symptoms are mild it is extremely unlikely that any connection to swine influenza is found - even if it is there. In other words, unless the doctors and experts are specifically looking for swine flu, it is rarely detected. Because of this, we really do not know what the true human infection rate is.

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What Is Health? What Does Good Health Mean?

The English word "health" comes from the Old English word hale, meaning "wholeness, a being whole, sound or well,". Hale comes from the Proto-Indo-European root kailo, meaning "whole, uninjured, of good omen". Kailo comes from the Proto-Germanic root khalbas, meaning "something divided". Medilexicon's medical dictionary has three definitions for health, the first being "The state of the organism when it functions optimally without evidence of disease or abnormality"

World Health Organization's (WHO's) definition of "health"

The most famous modern definition of health was created during a Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

The Definition has not been amended since 1948.

During the Ottawa Charter for Health Promotion in 1986, the WHO said that health is:

"a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities."

The Lancet questions WHO's definition of health

An article in The Lancet states that health is not a "state of complete physical, mental, and social well-being". Neither is it "merely the absence of disease or infirmity". The article says the WHO definitions of health will not do in an era marked by new understandings of disease at molecular, individual, and societal levels. (The Lancet, Volume 373, Issue 9666, Page 781, 7 March 2009).

Two aspects to health

Most people accept that health can be divided into two broad aspects - physical and mental health.

• Physical health
  
  For humans, physical health means a good body health, which is healthy because of regular physical activity (exercise), good nutrition, and adequate rest.
  
  As a country's or region's people experience improved nutrition, health care, standards of living and quality of life, their height and weight generally increase.
  
  In fact, most people, when asked for a definition of health talk about physical health. Physical health relates to anything concerning our bodies as physical entities. Physical health has been the basis for active living campaigns and the many nutrition drives that have swept the industrialized world. People are exposed to so much "physical health" data these days that it is hard to decide what is relevant and what is not.
  
  Another term for physical health is physical wellbeing. Physical wellbeing is defined as something a person can achieve by developing all health-related components of his/her lifestyle. Fitness reflects a person's cardiorespiratory endurance, muscular strength, flexibility, and body composition. Other contributors to physical wellbeing may include proper nutrition, bodyweight management, abstaining from drug abuse, avoiding alcohol abuse, responsible sexual behavior (sexual health), hygiene, and getting the right amount of sleep.


• Mental health
  
  Mental health refers to people's cognitive and emotional well-being. A person who enjoys good mental health does not have a mental disorder. According to WHO, mental health is "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community".
  
  No matter how many definitions people try to come up with regarding mental health, its assessment is still a subjective one.
  
  People have always found it easier to explain what mental illness is, rather than mental health. Most people agree that mental health refers to the "absence of mental illness". For some, this definition is not enough. They argue that if you pick 100 people who do not suffer from any mental disorder or illness that could be diagnosed by a psychiatrist, some people within those 100 will be mentally healthier than others. Most people also agree that mental health includes the ability to enjoy life, the ability to bounce back from adversity, the ability to achieve balance (moderation), the ability to be flexible and adapt, the ability to feel safe and secure, and self-actualization (making the best of what you have).

Determinants of health

The health of individual people and their communities are affected by a wide range of contributory factors. People's good or bad health is determined by their environment and situations - what is happening and what has happened to them, says WHO. WHO says that the following factors probably have a bigger impact on our health than access and use of health care services:

• Where we live
• The state of our environment
• Genetics
• Our income
• Our education level
• Our relationship with friends and family

WHO says the main determinants to health are:

• Our economy and society ("The social and economic environment")
• Where we live, what is physically around us ("The physical environment")
• What we are and what we do ("The person's individual characteristics and behaviors")

As our good health depends on the context of our lives, praising or criticizing people for their good or bad health is wrong. Most of the factors that contribute towards our good or bad health are out of our control. According to WHO, these factors (determinants), include the following, among others:

• Socioeconomic status - the higher a person's socioeconomic status is, the more likely he/she is to enjoy good health. The link is a clear one. Socioeconomic status affects all members of the family, including newborn babies. An Australian study found that women of lower socioeconomic status are less likely to breastfeed their newborn babies - a factor which will have an impact on the health of the baby just as he/she enters the world. A South Korean study revealed a clear link between low socioeconomic status and heart attack and stroke risk.


• Education - people with lower levels of education generally have a higher risk of experiencing poorer health. Their levels of stress will most likely be higher, compared to people with higher academic qualifications. A person with a high level of education will probably have higher self-esteem. A study carried out by researchers at Northwestern University Feinberg School of Medicine, Chicago, found that elderly people who had a higher level of health literacy were more likely to live longer. Another study from San Francisco VA Medical Center found that Literacy at less than a ninth-grade level almost doubles the five-year risk of mortality among elderly people.


• Physical environment - if your water is clean and safe, the air you breathe is pure, your workplace is healthy, your house is comfortable and safe, you are more likely to enjoy good health compared to somebody whose water supply is not clean and safe, the air he/she breathes is contaminated, the workplace is unhealthy, etc. A study carried out by researchers at Zuyd University, The Netherlands, found that just an hour of sniffing car exhaust fumes induces a stress response in the brain's activity. Another study carried out at Indiana University-Purdue University found that chronic lead poisoning, caused in part by the ingestion of contaminated dirt, affects hundreds of thousands more children in the United States than the acute lead poisoning associated with imported toys or jewelry.


• Job prospects and employment conditions - if you have a job, statistics show you are more likely to enjoy better health than people who are unemployed. If you have some control over your working conditions your health will benefit too. A study by researchers at State University of New York at Albany found that workers who lost their job through no fault of their own were twice as likely as continuously employed workers to report over the next 18 months that they developed a new illness, such as high blood pressure, diabetes or heart disease.


• Support from people around you - if you have family support, as well as support from friends and your community your chances of enjoying good health are far greater than somebody who has none of these things. A study carried out at the University of Washington found that strong family support, not peer support, is protective in reducing future suicidal behavior among young adults when they have experienced depression or have attempted suicide.


• Culture - the traditions and customs of a society and how a family responds to them play an important role in people's health. The impact could be either good or bad for health. The tradition of genital mutilation of women has an impact on infection rates and the mental health of millions of girls and women in many countries. A study published in the Journal of Epidemiology and Community Health found that when young people dress according to the customs of their own ethnic group, they may be less likely to have mental health problems later in life.


• Genetic inheritance - people's longevity, general health, and propensity to certain diseases are partly determined by their genetic makeup. Researchers from Vrije Universiteit, Holland, the Medical College of Georgia, USA, and Duke University, USA showed that people's genes play a key role in how they respond both biologically and psychologically to stress in their environment.


• What we do and how we manage - what we eat, our physical activity, whether or not we smoke or drink or take drugs, and how we cope with stress play an important role on our physical and mental well-being.


• Access and use of health services - a society that has access and uses good quality health services is more likely to enjoy better health than one that doesn't. For example, developed countries that have universal health care services have longer life expectancies for their people compared to developed countries that don't.


• Gender - men and women are susceptible to some different diseases, conditions and physical experiences, which play a role in our general health. For example, childbirth, ovarian cancer, and cervical cancer, are experienced only by women, while prostate cancer, testicular cancer are only experienced by men. During wars more men than women tend to be called up to fight, and subsequently become injured or die. Adult women are more likely to be the physical victims of domestic abuse, compared to adult men. In some societies women are not given the same access to education as men - education is a factor that influences health. Many studies have revealed gender disparities in healthcare services, even in developed countries.

What is wellness?

The term wellness was first used by a doctor called Halbert L. Dunn, USA, who published a small booklet entitled "High Level Wellness" in 1961. The term is much more widely used in North American than in the United Kingdom.

According to the Mickinley Health Center, University of Illinois, wellness "is a state of optimal well-being that is oriented toward maximizing an individual's potential. This is a life-long process of moving towards enhancing your physical, intellectual, emotional, social, spiritual, and environmental well-being."

The University of East Carolina defines wellness as "the integration of mind, body and spirit. Optimal wellness allows us to achieve our goals and find meaning and purpose in our lives. Wellness combines seven dimensions of well-being into a quality way of living. Overall, wellness is the ability to live life to the fullest and to maximize personal potential in a variety of ways. Wellness involves continually learning and making changes to enhance your state of wellness. When we balance the physical, intellectual, emotional, social, occupational, spiritual, and environmental aspects of life, we achieve true wellness."

According to Medilexicon's medical dictionary, wellness is "A philosophy of life and personal hygiene that views health as not merely the absence of illness but the full realization of one's physical and mental potential, as achieved through positive attitudes, fitness training, a diet low in fat and high in fiber, and the avoidance of unhealthful practices (smoking, drug and alcohol abuse, overeating)".

Famous health quotes

"There are some remedies worse than the disease."
Publilius Syrus

"We must turn to nature itself, to the observations of the body in health and in disease to learn the truth."
Hippocrates

"Take care of your body with steadfast fidelity. The soul must see through these eyes alone, and if they are dim, the whole world is clouded."
Johann Wolfgang Von Goethe

"I am convinced digestion is the great secret to life."
Sydney Smith

"Nature, time and patience are three great physicians."
H.G. Bohn

"Our own physical body possesses a wisdom which we who inhabit the body lack. We give it orders which make no sense."
Henry Miller

"Time is the great physician."
Benjamin Disraeli

"A man too busy to take care of his health is like a mechanic too busy to take care of his tools."
Spanish Proverb

"I am dying with the help of too many physicians."
Alexander the Great

"God heals, and the doctor takes the fee."
Benjamin Franklin

"The only way to keep your health is to eat what you don't want, drink what you don't like, and do what you'd rather not."
Mark Twain

"Time is the great physician."
Benjamin Franklin

"The art of medicine consists of amusing the patient while nature cures the disease."
Voltaire

"Water, air, and cleanliness are the chief articles in my pharmacopoeia."
Napoleon

"It is health that is real wealth and not pieces of gold and silver."
Mahatma Gandhi

"A wise man should consider that health is the greatest of human blessings, and learn how by his own thought to derive benefit from his illnesses."
Hippocrates

"Attention to health is life's greatest hindrance."
Plato

"As you improve health in a society, population growth goes down. You know, I thought it was... before I learned about it, I thought it was paradoxical."
Bill Gates

"The secret of health for both mind and body is not to mourn for the past, worry about the future, or anticipate troubles but to live in the present moment wisely and earnestly."

Buddha

"The devil has put a penalty on all things we enjoy in life. Either we suffer in health or we suffer in soul or we get fat."
Albert Eisntein

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Common Food Allergies

In theory, any food can cause a food allergy. But in fact just a handful of foods are to blame for 90% of allergic reactions to food. These common foods are known as the 'big eight'. They are:

-- milk
-- eggs
-- peanuts (groundnuts)
-- nuts from trees (including Brazil nuts, hazelnuts, almonds and walnuts)
-- fish
-- shellfish (including mussels, crab and shrimps)
-- soya
-- wheat

In children, most allergic reactions to food are to milk, peanuts, nuts from trees, eggs, soya and wheat. Most children grow out of most allergic reactions to food in early childhood. In adults, most allergic reactions are to peanuts, nuts, fish, shellfish, citrus fruit and wheat.

This section mainly describes foods that can cause food allergy, but it also includes lactose intolerance and gluten intolerance/sensitivity (coeliac disease). These are types of food intolerance, but they aren't allergies. Remember, if you think you have a food intolerance, you should contact your GP.

Cereal allergy

A number of cereals have been reported to cause allergic reactions in sensitive children and adults. These include wheat, rye, barley, oats, maize (corn) and rice. Sometimes people can react to more than one type of cereal.

Coconut allergy

Allergy to coconut is rare in the UK, but coconut can cause allergic reactions (including anaphylaxis) in people who are sensitive.

A small number of people who are allergic to nuts have reacted to coconut. It might also cause reactions in people who are allergic to latex.

Coeliac disease

Gluten is the mixture of proteins found in some cereals, including wheat, rye and barley. Gluten intolerance, or coeliac disease, is a lifelong disease, which is caused by sensitivity to gluten. It can damage the lining of the small intestine, which stops the body from absorbing nutrients, causing diarrhoea and eventually malnutrition. Coeliac disease can sometimes run in families, but we don't know exactly what causes it.

Until recently, coeliac disease was only thought to affect about one in 1500 people in the UK. Now we think it's more common, and better tests for the condition have shown that it might affect as many as one in 300 people in the UK. In some areas of the world it seems to be more common, for example in parts of Ireland as many as one in 100 people may be affected.

Coeliac disease is often diagnosed after weaning, when cereals are introduced into the diet, but it can also be diagnosed at a later age. Research suggests that waiting until a baby is about four to six months old before starting to give them wheat makes it less likely that they will develop coeliac disease.

If it isn't treated, coeliac disease can lead to anaemia, bone disease and, on rare occasions, certain forms of cancer. It can also cause growth problems in children.

People with some medical conditions might be more likely to develop coeliac disease, for example Type 1 diabetes, thyroid problems, ulcerative colitis and certain neurological disorders, such as epilepsy.

There is no cure for coeliac disease. The only way to avoid the symptoms is not to eat foods containing gluten, such as wheat, rye, barley, malt, malt extract, malt flavouring, beer and lager. Processed food can often contain hidden gluten, but a large number of gluten-free products, such as bread, cakes and pasta are now available. Coeliac UK, a charity to support people with gluten intolerance, works with manufacturers to produce a regularly updated list of foods that don't contain gluten.

What is Coeliac Disease?

Egg allergy

Like most food allergies, egg allergy is more common in childhood and about half the children who have it will grow out of it by the age of three. In a few cases, egg allergy can cause anaphylaxis.

Egg allergy is mainly caused by three proteins in the egg white called ovomucoid, ovalbumin and conalbumin. Cooking can destroy some of these allergens, but not others. So some people might react to cooked eggs, as well as raw eggs.

Occasionally someone might react to egg because they have an allergy to chicken, quail or turkey meat, or to bird feathers. This is called bird-egg syndrome.

Fish allergy

Fish allergy can often cause severe reactions, including anaphylaxis. Adults are more likely to have an allergic reaction to fish and shellfish than children, which is probably because adults will have eaten these foods more often.

People who are allergic to one type of fish, such as cod, often react to other types of fish such as hake, haddock, mackerel and whiting as well. This is because the allergens in these fish are quite similar. Cooking doesn't destroy fish allergens. In fact, some people with fish allergy can be allergic to cooked but not raw fish.

Fruit and vegetable allergy

Allergic reactions to fruits and vegetables are usually mild and often they just affect the mouth, causing itching or a rash where the food touches the lips and mouth. This is called oral allergy syndrome. A number of people who react in this way to fruit or vegetables will also react to tree and weed pollens. So, for example, people who are allergic to birch pollen are also likely to be allergic to apples.

Cooking can destroy a number of the allergens in fruits and vegetables, so cooked fruit often won't cause a reaction in people with an allergy to fruit. Pasteurised fruit juice might not cause an allergic reaction either, for the same reason. However, the allergens in some vegetables, such as celery, aren't affected by cooking. Some fruits and vegetables, such as tomatoes, are more likely to cause a reaction as they get riper.

Gluten intolerance

Gluten is the mixture of proteins found in some cereals, including wheat, rye and barley. Gluten intolerance, or coeliac disease, is a lifelong disease, which is caused by sensitivity to gluten. It can damage the lining of the small intestine, which stops the body from absorbing nutrients, causing diarrhoea and eventually malnutrition. Coeliac disease can sometimes run in families, but we don't know exactly what causes it.

Until recently, coeliac disease was only thought to affect about one in 1500 people in the UK. Now we think it's more common, and better tests for the condition have shown that it might affect as many as one in 300 people in the UK. In some areas of the world it seems to be more common, for example in parts of Ireland as many as one in 100 people may be affected.

Coeliac disease is often diagnosed after weaning, when cereals are introduced into the diet, but it can also be diagnosed at a later age. Research suggests that waiting until a baby is about four to six months old before starting to give them wheat makes it less likely that they will develop coeliac disease.

If it isn't treated, coeliac disease can lead to anaemia, bone disease and, on rare occasions, certain forms of cancer. It can also cause growth problems in children.

People with some medical conditions might be more likely to develop coeliac disease, for example Type 1 diabetes, thyroid problems, ulcerative colitis and certain neurological disorders, such as epilepsy.

There is no cure for coeliac disease. The only way to avoid the symptoms is not to eat foods containing gluten, such as wheat, rye, barley, malt, malt extract, malt flavouring, beer and lager. Processed food can often contain hidden gluten, but a large number of gluten-free products, such as bread, cakes and pasta are now available. Coeliac UK, a charity to support people with gluten intolerance, works with manufacturers to produce a regularly updated list of foods that don't contain gluten.

Lactose intolerance

Lactose is a sugar found naturally in milk. It's important to distinguish between lactose intolerance and milk allergy, because milk allergy can cause severe reactions. See the section on milk allergy for more information.

Lactose intolerance is caused by a shortage of the enzyme lactase, which is needed to break down lactose so it can be absorbed into the bloodstream. When someone doesn't have enough of this enzyme, lactose isn't absorbed properly from the gut, which can cause symptoms such as bloating and diarrhoea.

Lactose intolerance can be caused by a number of things. In humans, the body produces less lactase after the age of two. However, in white Western Europeans, lactase can be produced into adult life, which allows lactose to be broken down properly.

Because of this, lactose intolerance is more common in certain ethnic and racial populations than in others. In the UK, we think about 5% of the general population have lactose intolerance. In communities where milk is not traditionally part of the typical adult diet, a much bigger proportion of people are affected. For example, up to 75% of the black African community and more than 90% of the Asian community are intolerant to lactose.

Digestive diseases, or injuries to the small intestine can sometimes cause lactose intolerance, because they reduce the amount of lactase produced. In rare cases, the condition can be inherited.

Milk from mammals including cows, goats, sheep and humans contain lactose. This means that goats' milk and sheep milk aren't suitable alternatives to cows' milk for people who are intolerant to lactose. There is no medical treatment for lactose intolerance, but symptoms can be avoided by controlling the amount of lactose in the diet. Adults with lactose intolerance can often have a small amount of milk without getting any symptoms.

Latex-food syndrome

Latex allergy is caused by a reaction to a number of allergens found in natural rubber or latex. In recent years, the number of people with latex allergy has increased, particularly among healthcare workers and people with spina bifida, because they come into contact with lots of latex products.

Latex contains lots of allergens that are similar to the allergens in some foods. So people who are allergic to latex might also find they react to foods such as banana, mango, kiwi, chestnut, paprika, celery, apple, carrot, cherry, coconut, strawberry and avocado. This is called latex-food syndrome. In the same way, people who are allergic to these foods may also react to latex.

People with a latex allergy should be tested for allergies to foods that are linked to the latex-food syndrome.

Lupin allergy

Lupins are common garden plants, which are related to legumes such as peas, lentils and beans. Many types of lupin seed are poisonous, because they contain bitter-tasting toxins. But sweet lupins don't contain these toxins and they can be eaten by humans or livestock. Sweet lupin seeds are being used more and more to replace cereal grain in many food products, for example flour and pasta.

Allergy to lupin has been recognised for some time in mainland Europe, where lupin flour is used widely in food products. This type of allergy only seems to have started emerging in the UK quite recently, which is probably because lupin is used quite rarely in food products and hasn't been used for as long as in mainland Europe. Lupin allergy can cause severe reactions, including anaphylaxis, but there have been very few confirmed reports of lupin allergy in the UK so far.

The major allergens in lupin are also found in peanut, so people who are allergic to peanuts could react to lupin. The Anaphylaxis Campaign in the UK has advised people with peanut allergy to avoid lupin. It's mainly used in flour-based products such as pastry.

Maize allergy

Maize (or corn) allergy isn't common in the UK, although there have been reported cases. For people who are sensitive to maize, avoiding it can be very difficult, because maize is commonly used in a wide variety of food products.

Meat allergy

People with a meat allergy might react to beef, mutton, pork or chicken. Sometimes people who are allergic to one type of meat or poultry might also react to other types. Cooking destroys some of the allergens in meat, but some people will still react to cooked meat.

Processed meats, such as frankfurters, luncheon meats and pates, sometimes contain other ingredients, particularly milk products, as emulsifiers or flavour enhancers. So it's possible for someone who is allergic to milk to react to a meat product because it contains milk. For example, milk is sometimes used in chicken nuggets to stick the breadcrumbs to the chicken pieces.

Milk allergy

Allergy to cows' milk is the most common food allergy in childhood, and affects 2-7% of babies under one year old. It's more common in babies with atopic dermatitis. A reaction can be triggered by small amounts of milk, either passed to the baby through the mother's breast milk from dairy products she has eaten, or from feeding cows' milk to the baby.

Children usually grow out of milk allergy by the age of three, but about a fifth of children who have an allergy to cows' milk will still be allergic to it as adults. The symptoms of milk allergy are often mild and can affect any part of the body. They can include rashes, diarrhoea, vomiting, stomach cramps and difficulty in breathing. In a very few cases, milk allergy can cause anaphylaxis.

Cows' milk allergy is caused by a reaction to a number of allergens in cows' milk, such as casein and whey. Casein is the curd that forms when milk sours, and whey is the watery part that is left when the curd is removed.

People can be allergic to either whey or casein, or both, and an allergic reaction can be triggered by very small amounts of these allergens in people who are sensitive. Heat treatment, such as pasteurisation, changes whey, so people who are sensitive to whey might not react to pasteurised milk. But heat treatment doesn't affect casein, so someone who is allergic to casein will probably react to all types of milk and milk products.

Milk from other mammals (such as goats and sheep), and hydrolysed milk and soya formulas, are sometimes used as a substitute for babies who are at risk of developing cows' milk allergy. However, the allergens in milk from goats and sheep are very similar to those in cows' milk. This means that someone with a cows' milk allergy might react to these other types of milk as well, so goat's and sheep milk aren't suitable alternatives for people who are sensitive to cows' milk.

Some highly hydrolysed milk formulas are suitable for babies with cows' milk allergy, but other types of formula, such as partially hydrolysed milk and soya formulas, aren't suitable, because many babies with cows' milk allergy might react to them as well.

Milk protein intolerance

Intolerance to cows' milk protein is a type of intolerance that is common in babies and children, and symptoms start from the time when cows' milk is first introduced into the diet. There is no cure for it and the only way to stop the symptoms is to avoid cows' milk products. Cows' milk protein intolerance is different to lactose intolerance and milk allergy. See the sections on lactose intolerance and milk allergy for more information.

Nut allergy

Allergy to nuts from trees is usually lifelong. The nuts that are most likely to cause allergic reactions are walnuts, hazelnuts, almonds, pecans, Brazil nuts, pine nuts, macadamia nuts and cashew nuts. On rare occasions, all these nuts can cause anaphylaxis in people who are sensitive. Sometimes people with an allergy to one type of nut will also react to other nuts. So if you have a nut allergy, you need to be very careful to avoid nuts and unrefined (crude) nut oil. Talk to your GP for advice.

Strictly speaking, peanuts are legumes, not nuts, and they grow underground rather than on trees. See the section on peanut allergy.

Peanut allergy

Allergy to peanuts (also known as groundnuts and monkey nuts) is often lifelong, but research suggests that, in a very few cases, young children diagnosed with peanut allergy may grow out of it.

Peanuts are one of the most common causes of food allergy and can cause severe reactions, including anaphylaxis. They contain a number of allergens that are not destroyed by cooking or roasting.

Peanut allergy can be so severe that very tiny amounts can cause a reaction. Because of this, coming into contact with traces of peanut can be enough to cause a reaction in people who are sensitive. For example, someone might come into contact with traces of peanuts from unrefined oils, or when food is served using utensils that have been used with food containing peanuts, or even being close to someone eating peanuts.

Refined peanut oil is thought to be safe for people with peanut allergy, because the proteins that cause allergic reactions are removed during the manufacturing process. However, cold-pressed, or unrefined/unprocessed (crude) peanut oil can contain small amounts of peanut allergens, which can cause a reaction in people who are sensitive.

Some people with peanut allergy might also react to other legumes such as soya, green beans, kidney beans, green peas and lupins, because these foods contain similar allergens to peanuts. Even though, strictly speaking, peanuts aren't nuts, people with peanut allergy are sometimes allergic to nuts from trees such as almonds, walnuts, hazelnuts, Brazil nuts and cashew nuts.

Pine nut allergy

Pine nuts can cause severe allergic reactions, including anaphylaxis, in people who are sensitive. People who are allergic to pine nuts might also react to peanuts and nuts such as almonds.

Quorn allergy

Quorn is a type of protein, which is made from a fungus. It has been available in the UK since 1985, and is often used as a meat substitute. There have been some reports of intolerance to Quorn, but this is not surprising, because it has a high protein content (allergens are usually proteins). Intolerance to Quorn is much less frequent than to other foods such as soya and dairy products. As Quorn is made from a fungus, some people who react to other fungi or moulds (including by inhalation) may also react to Quorn.

Rice allergy

Rice allergy is common in countries in Eastern Asia, such as Japan, where rice is commonly eaten, but it isn't common in the UK. People who are allergic to rice can react when they eat it or when they inhale its pollen. Rice can cause hayfever symptoms in areas where it's grown commercially.

People who are allergic to rice can sometimes react to a number of other foods from the same botanical family, such as barley, maize, wheat, oats and rye, as well as other foods such as peach and apple.

Sesame allergy

We don't know how many people in the UK suffer from sesame allergy, but it's quite common in countries such as Australia and Israel. We think that sesame allergy is increasing, possibly because it's now more commonly used.

Sesame seeds, sesame oil and other sesame products such as tahini, are used in cooking, for example in Turkish or oriental dishes, and in manufactured products such as bread, biscuits, salads, sauces and houmous. Sesame allergy can be severe, and can cause anaphylaxis. People with sesame allergy might also react to poppy seeds, kiwi fruit, hazelnuts and rye grain.

People who are allergic to sesame should avoid sesame oil. This is because it's made by cold-pressing sesame seeds and isn't refined, so it can contain small amounts of allergens, which can cause a reaction in people who are sensitive to them.

Shellfish allergy

Allergy to shellfish is quite common, and a number of different types of shellfish can cause reactions in people who are sensitive, for example shrimps, prawns, lobster, crab, crayfish, oysters, scallops, mussels and clams.

People who are allergic to one type of shellfish often find that they react to other types. Shellfish allergy can often cause severe reactions, and some people can react to the vapours from cooking shellfish.

Soya allergy

Soya allergy is a common childhood allergy. Most people grow out of it by the age of two, but occasionally adults are allergic to soya. The symptoms of soya allergy are similar to milk allergy, and they include rashes, diarrhoea, vomiting, stomach cramps and breathing difficulties. Some people with soya allergy might also react to milk. Very rarely, soya can cause anaphylaxis.

Soya is used as an ingredient in about two-thirds of all manufactured food products, including bakery goods, sweets, drinks, breakfast cereals, ice cream, margarine, pasta, processed meats and seasoned foods.

Soya can be described in a number of different ways on food labels, for example as hydrolysed vegetable protein, vegetable oil and lecithin. Soya flour is used to increase the shelf life of many products and to improve the colour of pastry crusts. Textured soya protein, which is sometimes called textured vegetable protein, is made from compressed soya flour. It's used as a meat substitute and to improve the consistency of meat products.

Refined soya oil (the main component of vegetable oil) should be safe for people with soya allergy, because the proteins that cause allergic reactions are removed during the refining process.

Children who are allergic to cows' milk are sometimes given soya-based formulas as a substitute. But people with a cows' milk allergy can sometimes be allergic to soya too. So soya-based formulas might not be suitable for children with cows' milk allergy. Highly hydrolysed milk or casein formulas are often recommended for these children. Ask your GP for advice.

Sometimes people with an allergy to soya will also react to foods such as peanuts, green peas, chickpeas, rye and barley flour.

Spice allergy

Allergic reactions to spices are rare and usually mild, but severe reactions can happen occasionally. Some people react to mustard, coriander, caraway, fennel, paprika or saffron and, less frequently, to onions, garlic or chives. Reactions to mustard have been reported to cause anaphylaxis, particularly in mainland Europe, where mustard is used more. The allergens in spices are similar to those in pollens and vegetables, and people who are allergic to mugwort and birch are more likely to be sensitive to spices for this reason.

Vegetable oil allergy

Vegetable oil is usually a blend of oils. In the UK, the oils used the most to make up vegetable oil are soya, rapeseed, sunflower, maize, palm, coconut and palm kernel oils. Where they appear in pre-packed food, these oils will have been refined. The refining process removes proteins from the oil. Since it's the proteins in oils that can cause allergic reactions, sensitive people probably won't react to refined oils. Some speciality oils, such as sesame and walnut, aren't refined, so they are best avoided by people who are sensitive to the nuts or seeds they are made from.

Wheat allergy

Wheat allergy is common, particularly among babies. One of the main allergens in wheat is a protein called gliadin, which is found in gluten. Because of this, people with a wheat allergy are sometimes recommended to eat a gluten-free diet.

As with all food allergies, if you think you're allergic to wheat you should talk to your GP before changing your diet

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What Is Progeria?

The word Progeria comes from the Greek progeros meaning 'prematurely old'. The Greek word pro means 'before', while the word geras means 'old age'. HGPS (Hutchinson-Gilford Progeria Syndrome) or Progeria is an extremely rare, fatal genetic condition.

Progeria affects children and gives them an appearance of accelerated aging. The classic type of Progeria (there are different forms) is Hutchinson-Gilford Progeria Syndrome (HGPS). Progeria was first described in an academic journal by Dr. Jonathan Hutchinson in 1886, and Dr. Hastings Gilford in 1897 - both in England.

How prevalent is Progeria?

According to Hayley's Page "At present there are 53 known cases of Progeria around the world and only 2 in the UK". There is a reported incidence of Progeria of approximately 1 in every 4 to 8 million newborns. Both boys and girls run an equal risk of having Progeria.

Progeria appears to affect children of all races equally. Over the last 15 years the following countries have had reported cases - Algeria, Argentina, Australia, Austria, Canada, China, Cuba, England, France, Germany, Israel, Italy, Mexico, the Netherlands, Poland, Puerto Rico, South Africa, South America, South Korea, Switzerland, Turkey, the US, Venezuela, Vietnam and Yugoslavia.

What are the characteristics of Progeria?

In Progeria patients, the cell nucleus has dramatically aberrant morphology (bottom, right) rather than the uniform shape typically found in healthy individuals (top, right).

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The Cell Nucleus and Aging: Tantalizing Clues and Hopeful Promises. Scaffidi P, Gordon L, Misteli T. PLoS Biology Vol. 3/11/2005, e395

 

Children with Progeria are born looking healthy. When they are about 10 to 24 months old, features of accelerated aging start to appear. Signs of Progeria may include:

• Growth failure
• Loss of body fat
• Loss of hair
• Skin starts to look aged
• Stiffness in the joints
• Hip dislocation
• Generalized atherosclerosis (cardio and heart disease)
• Stroke

Although they may come from varying ethnic backgrounds, children with Progeria have a surprisingly similar appearance. Progeria patients generally die between the ages of 8 and 21 - with the average age being 13.

How are Progeria and ageing similar?

Children who suffer from Progeria are genetically susceptible to premature, progressive heart disease. Nearly all Progeria patients die from heart disease. Heart disease is also one of the leading causes of death globally. Children with Progeria commonly experience cardiovascular events, such as hypertension (high blood pressure), stroke, angina, enlarged heart and heart failure - conditions linked to aging.

Experts say that any research into finding a cure for Progeria would probably have results which would benefit adults with diseases linked to aging.

What causes Progeria?

90% of children with Progeria have a mutation on the gene that encodes Lamin A, a protein that holds the nucleus of the cell together. It is believed that the defective Lamin A protein makes the nucleus unstable. This instability seems to lead to the process of premature aging among Progeria patients.

Progeria appears to occur without cause - it is not seen in siblings of affected children. In extremely rare cases more than one child in the same family may have the condition.

Is Progeria hereditary?

Experts do not believe that Progera is hereditary. They say it is due to a rare gene change which happens purely by chance. A non-twin sibling runs the same risk of having Progera as any other child from another family. In about 1 in every 100 cases of HGPS the syndrome is passed down to the next generation within the same family.

Diagnosis of Progeria

The health care professional will possibly suspect Progeria if the signs and symptoms are there - aging skin, loss of hair, stiffness of joints, etc. This can then be confirmed through a genetic test. The Progeria Research Foundation has created a Diagnostic Testing Program.

Treatment hope

Farnesyltransferase inhibitors (FTIs), currently used for treating cancer, might reverse the nuclear structure abnormalities that are believed to cause Progeria. Studies carried out on mice with Progeria-like signs and symptoms showed that FTIs appeared to offer some improvements. Of the 13 mice treated with FTI, only one died during the 20-week UCLS study. Dr Leslie Gordon, director of the Progeria Research Foundation, said: "This study gives us pieces of information critical to our movement toward clinical trials in children with progeria."

Frequently Asked Questions about FTIs (Progeria Research Foundation).

Hayley Okines

Hayley's Progeria Page is dedicated to Hayley Okines, who suffers from HGPS, or Progeria. A ten-year-old Progeria child will look like an eighty-year-old - but her mind is still that of a ten-year-old.

According to Hayley's Progeria Page there is at present no cure for Progeria, but it is close.

Hayley's parents wrote "When Hayley was diagnosed with Progeria in 1999 we had never heard of it and neither did any of our friends or family. With the help of the internet we were able to build an understanding of Progeria as well as finding organisations and individuals that can help."

There is no cure for Progeria but we can treat some of the symptoms. Here are some of the remedies and medicines that we give to Hayley to make her quality of life as comfortable as possible.

Continue to Read more ...

What Is Measles? What Are The Symptoms Of Measles?

Measles is a very infectious illness caused by a virus - a viral infection caused by the rubeola virus. It is an endemic disease; meaning it is continually present in a community and many people develop resistance. If measles enters an area where the people have never been exposed the result can be devastating. A measles outbreak in 1592 in the island of Cuba killed approximately two-thirds of the native population who had previously survived smallpox. A couple of years later half the indigenous population of Honduras died.

Over the last 150 years estimates place the total global measles death toll at 200 million people. One fifth of Hawaii's population died in the 1850s from measles.

Scientists have identified 21 different strains of the measles virus.

Etymology of measles (origin of the word)

The English word "measles" is thought to come from the Middle Dutch word masel, meaning "blemish".

Some say the word is connected to the Middle English word meseles, the plural of mesel, meaning "infested with tapeworms". The British slang word measly, which appeared in the mid 1860s meaning "meager and contemptible" was an adaptation of the modern word "measles" which had become established before that time.

What are the symptoms of measles?

Measles symptoms invariably include fever, together with at least one of the three C's (cough, coryza, conjunctivitis).

Symptoms will appear about 9-11 days after infection, and may include the following:

• Coryza - runny nose.


• Dry hacking cough.


• Conjunctivitis - swollen eyelids, inflamed eyes.


• Watery eyes.


• Photophobia - sensitivity to light.


• Sneezing.


• Fever - this may be mild to severe and can reach 105F (40.6C) for a number of days. Fever may drop, and then rise again when the rash appears.


• Koplik's spots - very small grayish-white spots with bluish-white centers in the mouth, insides of cheeks, and throat.


• Aches generally all over the body.


• Rash - 3 to 4 days after initial symptoms a reddish-brown spotty rash appears. The rash can last for over a week. It usually starts behind the ears and spreads all over the head and neck. After a couple of days it spreads to the rest of the body, including the legs. As the little spots grow many of them will join together.

Although the majority of childhood rashes are not measles, you should take your child to the doctor if:

• You suspect it could be measles.


• Symptoms do not improve, or get worse.


• The fever rises to above 38C (100F).


• When the symptoms have gone, but the fever hasn't.

What causes measles?

Measles is caused by infection with the rubeola virus, a paramyxovirus of the genus Morbillivirus. The virus lives in the mucus of the nose and throat of an infected child or adult. The infected person is contagious for four days before the rash appears, and continues so for about four to five days afterwards.

You can become infected through:

• Physical contact with an infected person.


• Being nearby infected people if they cough or sneeze.


• Touching a surface that has infected droplets of mucus (the virus remains active for two hours) and then putting your fingers into your mouth, rubbing your nose or eyes.

How does a measles infection develop in a person?

As soon as it enters the body the virus multiplies in the back of the throat, lungs and the lymphatic system. It later infects and replicates in the urinary tract, eyes, blood vessels and central nervous system.

Scientists at the Mayo Clinic say that replication in the airways is not required. They found that a virus replicating only in immune cells causes measles in monkeys.

Experts say it takes from 1 to 3 weeks for the virus to establish itself. However people show symptoms 9-11 days after infection.

A person who has had measles before does not become infected again; cases of re-infection are very rare. However, anyone who has never been infected and has not been vaccinated and breathes in infected droplets, or is in close physical contact with an infected person is likely to become ill. Approximately 90% of people who share a house with an infected person and have no immunity develop measles.

How is measles diagnosed?

A GP (general practitioner, primary care physician) will be able to diagnose measles fairly easily if the signs and symptoms are present. A blood test will confirm the presence of the rubeola virus.

In most countries measles is a notifiable disease. This means that doctors have to notify the authorities of any suspected cases. If the patient is a child the doctor will also notify the school.

A child with measles should not return to school until at least five days after the rash has appeared.

What is the treatment for measles?

There is no specific measles treatment. If there are no complications the doctor will recommend plenty of rest and normal measures to control the fever and prevent dehydration (drink fluids). Symptoms will usually go away within 7 to 10 days.

If your child has measles, the following measures may help:

• Fever - if the temperature is high try to keep the child cool, but make sure he/she is not cold. Tylenol (paracetamol, acetaminophen) or ibuprofen are effective in controlling fever, as well as aches and pain. Children under 16 should not be given aspirin. Check with your doctor about acetaminophen dosage - too much can harm the child, especially the liver.


• Smoking - do not let anyone smoke near the child with measles.


• Photophobia - as the child may be painfully sensitive to light, keeping the lights dim or the room darkened may help. Sunglasses may also help.


• Conjunctivitis - if there is crustiness around the eyes gently clean with damp cotton wool.


• Cough - cough medicines will not relieve the cough. Making the room more humid by placing a bowl of water may help the cough. If the child is over twelve a glass of warm water with a teaspoon of lemon juice and two teaspoons of honey may help. Do not give honey to babies.


• Dehydration - make sure the child is hydrated. If the child has a fever he/she can become dehydrated more quickly. Encourage the child to drink plenty of fluids.


• Isolation - while children are contagious they should be kept away from school and should not return to activities that involve human interaction. Non-immunized people who have never had measles should be kept out of the house.


• Vitamin A supplements - studies have shown that Vitamin A supplements significantly help prevent complications caused by measles. Supplements are recommended for children with vitamin A deficiency and children under the age of two who have severe measles. Vitamin A deficiency is virtually non-existent in developed countries, but fairly common in much of the developing world.

As measles is caused by a virus antibiotics will not have any effect on it. However, sometimes antibiotics may be prescribed for any infections that may develop.

What are the complications of measles?

Complications from measles are fairly common, and are more likely to get worse for patients who have weak immune systems, such as those with HIV/AIDS or leukemia, those with vitamin deficiency, and very young children. Adults over the age of 20 are more likely to have complications than healthy children over the age of 5.

About 20% of people who develop measles have some kind of complication, which may include:

• Diarrhea.


• Vomiting.


• Eye infection.


• Laryngitis and bronchitis - laryngitis is inflammation of the voice box. Bronchitis is inflammation of the inner walls that line the main air passageways. About 4% of people with measles have difficulties breathing.


• Otitis media - inner ear infection and inflammation.


• Febrile convulsion - fits caused by fever. Occurs in 1 in 200 cases. May be alarming, but children usually make a full recovery.


• Pneumonia - patients with weakened immune system who develop measles are vulnerable to an especially dangerous type of pneumonia (Streptococcus pneumoniae) which can be fatal.

The following less common complications are also possible:

• Hepatitis - liver complications in childhood measles is rare and temporary. However, it can be severe in children receiving hepatotoxic drugs (medications which may be toxic to the liver). Acetaminophen (Tylenol, paracetamol) can harm the liver if the dose is too high. Check acetaminophen dosage with your doctor if you wish to use it to treat fever.


• Encephalitis - approximately 1 in every 1,000 patients with measles develops encephalitis. This is an inflammation of the brain which may cause vomiting, and convulsions. Coma and even death is possible, but rare. Encephalitis may occur soon after measles, or several years later.


• Thrombocytopenia - low platelet count. The blood's ability to clot is affected. The patient may bruise easily.


• Squint - eye nerves and eye muscles may be affected.

The complications listed below are very rare, but possible:

• Neuritis - infection of the optic nerve, which can lead to blindness.


• Heart complications


• Subacute sclerosing panencephalitis (SSPE) - Occurs in 1 in every 100,000 cases. SSPE is a brain disease which can occur several months or years after measles infection and causes convulsions, motor abnormalities, mental retardation and death.


• Other nervous system complications - toxic encephalopathy, retrobulbar neuritis, transverse myelitis, and ascending mielitis.

Pregnancy

Measles during pregnancy can cause miscarriage, premature labor, or low birth weights. If you are planning to get pregnant and have not been vaccinated against measles talk to your doctor about getting the MMR jab.

Prevention of measles

People who have already had measles are immune and will not get it again - cases of re-infection are extremely rare. If you were born or living in the USA before 1957 you will be immune, experts say.

For people who are not immune there is the measles vaccine.

Vaccination

Before vaccination became available in the 1960s approximately 400 to 500 people died each year from measles in the USA. There are no reliable statistics on the number of complications which led to permanent disabilities, such as brain damage or blindness that occurred before the measles vaccine became available.

The World Health Organization (WHO) says that nearly 600 million children received the measles vaccine between 2000 and 2007, resulting in a 74% drop in global deaths caused by measles - and a drop of about 90% in the eastern Mediterranean and Africa regions. Measles deaths in Africa fell by 91 percent between 2000 and 2006, from an estimated 396,000 to 36,000, thanks to The Measles Initiative. Unfortunately, due to political and religious disagreements, vaccination rates in Nigeria dropped dramatically two years after the program started, resulting in a significant rise in infections and hundreds of childhood deaths.

In 2000 an estimated 750,000 people died from measles globally, most of them children. By 2007 the annual number of deaths dropped to 197,000 thanks to a concerted effort to vaccinate children in Africa and other hard-hit regions, the World Health Organization reported.

Herd immunity protects people who cannot take the vaccine

Before measles vaccines became available over 3 million people in the USA became infected with measles each year. By the year 2000 the Centers for Disease Control and Prevention (CDC) declared that measles had been eliminated from the country.

For people who cannot take the vaccine because of certain medical conditions this was great news, because they had herd immunity. Their risk of becoming infected, even though they had not received the vaccine, was significantly low because so few people in the community - in the herd - carried the virus.

Unfortunately, this herd immunity has weakened slightly. The CDC informed that cases of measles infections rose significantly in 2008. In 2008, the number of reported measles cases in the United States more than doubled from 63 in 2002 to 140 total in 2008.

Autism concerns and the MMR vaccine

In many countries, especially those in North America, Western Europe and Australasia, concern grew about an alleged link between the MMR vaccine and autism risk - caused by mercury (thimerosal) in the vaccines. Several extensive studies from North America, UK, France, Germany, Scandinavia and Japan have found no evidence of a link. Scientists and virtually all doctors believe the risk does not exist - this includes hundreds of thousands of scientists and doctors worldwide who have no vested interest in the outcome of those studies. However, a significant number of people, especially parents of very young children (who are candidates for the MMR vaccines) remain concerned. The result has been a drop in the number of children being vaccinated against measles, leading to a rise in measles cases, and a subsequent increase in measles complications, and a weakening of herd immunity.

Government agencies, GPs (general practitioners) in all countries and from the public and private sectors, doctors and health care professionals who work in aid organizations, voluntary missionary doctors and nurses, religious charities representing most faiths, say that the evidence demonstrating the benefits of vaccinating children against measles is overwhelming and compelling - and that all children should be vaccinated.

Autism spectrum disorders continued to rise at the same rate as before in the state of California, USA, even seven years after mercury-containing thimerosal was removed from childhood vaccines, a study revealed. Thimerosal was removed from most vaccines in North America and Europe in 2001 - reports from every country so far indicate no change in the rate of increase in new diagnoses of autism. However, the number of people becoming infected with measles as a result of fewer people being vaccinated because autism link concerns, is growing at an alarming rate in those countries.

When should children be vaccinated?

Children should receive the MMR (Mumps, Measles, Rubella) vaccine when they are between 12 and 15 months of age, and then again (a booster) before entering school when they are 4-6 years old. Babies carry their mother's immunity for a few months after birth if their mothers are immune.

Sometimes babies require vaccination before they are 12 months old. This may happen if there is a serious outbreak in their area, or if they are going to travel to an area with a serious outbreak. In such cases they can receive the vaccination from the age of 6 months, and will need a booster when they are 12 months old.

Adults do not require a vaccine in the USA if:

• They were born before 1957 in the USA, or lived there before 1957.
• Received two MMR shots after they were 12 months old.
• Had one MMR vaccine plus a second dose of measles vaccine.
• Are found to be immune to measles, mumps and rubella after a blood test

The vaccine should not be taken by:

• Pregnant women.
• Women who plan to become pregnant very soon (check with your doctor).
• People who are seriously allergic to gelatin or neomycin (antibiotic).

Anybody who has a condition or disease that affects their immune system, as well as people receiving treatment which weakens their immune system should ask their doctor whether they should receive the vaccine.

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What Is An Alcoholic? What Is Alcoholism?

An alcoholic is a person who suffers from alcoholism - the body is dependent on alcohol. An alcoholic is addicted to alcohol. Alcoholism is a chronic (long-term) disease. People who suffer from alcoholism are obsessed with alcohol and cannot control how much they consume, even if it is causing serious problems at home, work and financially. Alcohol abuse generally refers to people who do not display the characteristics of alcoholism but still have a problem with it - these people are not as dependent on alcohol as an alcoholic is; they have not yet completely lost their control over its consumption.

Consuming moderate quantities of alcohol will not usually cause any physical or psychological harm. Unfortunately, for some people social drinking eventually leads to heavier drinking, which can cause devastating health and psychological problems. According to the National Health Service (NHS), UK, approximately 1 in every 13 people in the UK is an alcoholic - a sizable proportion of the UK population drinks excessively. According to the NIH (National Institutes of Health), 15% of people in the United States are problem drinkers, and about 5% to 10% of male drinkers and 3% to 5% of female drinkers could be diagnosed as alcohol dependent. According to the World Health Organization (WHO) there are at least 140 million alcoholics in the world, and the majority of them are not treated. A US study estimated that about 30% of Americans report having an alcohol disorder at some time in their lives.

Alcohol consumption more severely affects women than men, according to a coordinated study carried out by researchers at RTI International, Pavlov Medical University, Leningrad Regional Center of Addictions, Pacific Institute for Research and Evaluation, and Johns Hopkins School of Medicine.

A Canadian study found that alcohol is a factor in 1 in 25 deaths worldwide. The British Medical Association says that alcohol kills six people in Scotland every day.

The lifetime risk of alcohol-use disorders for men is more than 20%, with a risk of about 15% for alcohol abuse and 10% for alcohol dependence, according to researchers from the University of California, San Diego, USA.

What are the symptoms of alcoholism?

The signs of alcoholism and alcohol abuse are very similar, and are often just a question of degree or intensity.

Typically, the last person to be aware that he/she has a serious drinking problem is the alcoholic himself/herself - they are in denial. Some signs and symptoms of alcoholism as well as alcohol abuse include:

• Drinking alone.
• Drinking in secret.
• Not being able to limit how much alcohol is consumed.
• Blacking out - not being able to remember chunks of time.
• Having rituals and being irritated/annoyed when these rituals are disturbed or commented on. This could be drinks before/during/after meals, or after work.
• Dropping hobbies and activities the person used to enjoy; losing interest in them.
• Feeling an urge to drink.
• Feeling irritable when drinking times approach. This feeling is more intense if the alcohol is not available, or there appears to be a chance it may not be available.
• Having stashes of alcohol in unlikely places.
• Gulping drinks down in order to get drunk and then feel good.
• Having relationship problems (triggered by drinking).
• Having problems with the law (caused by drinking).
• Having work problems (caused by drinking, or drinking as root cause).
• Having money problems (caused by drinking).
• Requiring a larger quantity of alcohol to feel its effect.
• Nausea, sweating, or even shaking when not drinking.

A person who abuses alcohol may have many of these signs and symptoms - but they do not have the withdrawal symptoms like an alcoholic does, nor the same degree of compulsion to drink.

The problems linked to alcohol dependence are extensive, and affect the person physically, psychologically and socially. Drinking becomes a compulsion for a person with a drink problem - it takes precedence over all other activities. It can remain undetected for several years.

What is binge drinking?

In the UK, binge drinking occurs when a man consumes more than eight units of alcohol and a woman consumes over six units in one sitting. Drinking large amounts of alcohol now-and-again is worse for the heath than frequently drinking small quantities.

Binge drinking has become a growing problem in many countries, especially in the UK where 40% of emergency hospital admittances are alcohol-related. Sipping wine, beer or spirits three to four times per week increases the risk of binge drinking, particularly among young men, according to a study carried out by researchers from the Université de Montréal and the University of Western Ontario. Men who drink 22 or more units of alcohol a week have a 20% higher rate of admissions into acute care hospitals than non-drinkers, researchers from the University of Glasgow found.

What causes alcoholism (alcohol dependence)?

Alcohol dependence is a gradual process which can take from a few years to several decades to become a problem - with some very vulnerable people addiction can come in a question of months. Eventually, over time, regular alcohol consumption can disrupt the balance of the brain chemical GABA (gamma-aminobutyric acid), which controls impulsiveness, as well as glutamate, which stimulates the nervous system. Brain levels of dopamine are raised when we consume alcohol - dopamine levels may make the drinking experience more gratifying. Over the long- or medium-term, excessive drinking can significantly alter the levels of these brain chemicals, making the person's body crave alcohol in order to feel good and avoid feeling bad.

These risk factors may also be linked to excessive drinking:

• Genes - scientists say there are specific genetic factors which may make some people more likely to become addicted to alcohol, as well as other substances. People who have a family history of addiction are at higher risk for abusing alcohol. Alcoholics are six times more likely than nonalcoholic to have blood relatives who are alcohol dependent. Researchers from the Universidad de Granada, Spain, revealed that "the lack of endorphin is hereditary, and thus that there is a genetic predisposition to become addicted to alcohol".


• The age of first alcoholic drink - a study found that people who started drinking alcohol before the age of 15 were much more likely to have an alcohol problem later in life.


• Smoking, especially non-daily smokers - A study by Yale University researchers found that non-daily smokers are five times more likely to have a problem with alcohol compared to people who have never smoked.


• Easy access - Experts say there is a correlation between easy access to alcohol (cheap prices) and alcohol abuse and alcohol-related deaths. A US study found a strong link between alcohol tax increases in 1983 and 2002 and a significant drop in deaths related to alcohol use in one American state - the effect was found to be nearly two to four times that of other prevention strategies such as school programs or media campaigns.


• Stress - some stress hormones are linked to alcoholism. If our levels of stress, anxiety are high some of us may consume alcohol in an attempt to blank out the upheaval. Military service members returning from Iraq and Afghanistan are likely to experience posttraumatic stress disorder and alcohol use disorders simultaneously, according to researchers at the National Institute on Alcohol Abuse and Alcoholism.


• Peer drinking - people who have friends who drink regularly or abuse alcohol are more likely to drink excessively and eventually have an alcohol problem.


• Low self-esteem - experts say that people with low self-esteem who have alcohol readily available are more likely to abuse it.


• Depression - people with depression may deliberately or unwittingly use alcohol as a means of self-treatment. On the other hand, a statistical modeling study suggested that alcohol abuse may lead to depression risk, rather than vice versa.


• Media and advertising - in some countries alcohol is portrayed as a glamorous, worldly and cool activity. Many experts believe that alcohol advertising and media coverage of it may convey the message that excessive drinking is acceptable. The Royal College of Physicians is asking for a European Union ban on alcohol advertising to protect children.


• How the body processes (metabolizes) alcohol - people who need comparatively more alcohol to achieve an effect have a higher risk of eventually having an alcohol problem, a study carried out by researchers at the University of California, San Diego, found.

How is alcoholism diagnosed?

In the USA a person must meet the criteria laid out in the DSM (Diagnostic and Statistical Manual of Mental Disorders), published by the APA (American Psychiatric Association). This includes a pattern of alcohol abuse which leads to considerable impairment or distress. The patient should experience at least three of the criteria below during the past 12 months:

• Alcohol tolerance - the patient needs a large quantity of alcohol to feel intoxicated. However, when the liver is damaged and cannot metabolize the alcohol so well, this tolerance may drop. Damage to the central nervous system may also reduce tolerance levels.


• Withdrawal symptoms - when the patient abstains from alcohol or cuts down he/she experiences tremors, insomnia, nausea or anxiety. Typically, the patient drinks more to avoid these symptoms.


• Beyond intentions - the patient ends up drinking more alcohol, or drinks for a longer period than he/she intended.


• Unsuccessfully attempting to cut down - the patient is continuously trying to cut down alcohol consumption, but does not succeed. Or the patient has a persistent desire to cut down.


• Time consuming - the patient spends a lot of time obtaining, using or recovering from alcohol consumption.


• Withdrawal - the patient withdraws from recreational, social, or occupational activities. This did not used to be the case.


• Persistence - the patient carries on consuming alcohol even though he/she knows it is harming him/her physically and psychologically.

Some signs and symptoms of alcohol abuse may be due to another condition, or simple aging, such as memory problems, or falling. Some patients may go to their doctor about a medical condition, such as a digestive problem, and not mention their alcohol abuse. It is not always easy for a doctor to identify candidates for alcohol dependency screening. If a doctor suspects alcohol may be a problem, he/she may ask a series of questions - if the patient answers in a certain way the doctor may go on to use a standardized questionnaire. A single question can identify unhealthy alcohol use in patients, a study revealed.

Blood tests can only reveal very recent alcohol consumption. They cannot tell whether a person has been drinking heavily for a long time.

If a blood test reveals that the red blood cells have increased in size it could be an indication of long-term alcohol abuse.

Carbohydrate-deficient transferrin (CDT) - this is a test which helps detect heavy alcohol consumption. It is a blood test.

There are other tests which can indicate whether the liver has been damaged, or whether a man has reduced testosterone levels - however, screening with a good questionnaire is seen as the most effective means for an accurate diagnosis.

Most alcoholics deny they have a problem and tend to minimize the extent of their drinking. Talking to family members may help the doctor in his/her diagnosis (permission will be needed for this).

Complications of alcoholism and alcohol abuse

Usually, drinking alcohol initially elevates the person's mood. However, after a long period of regular heavy drinking the person's nervous system will become depressed and the drinker will become sedated by alcohol. Alcohol may undermine a person's judgment; it can lower inhibitions and alter the drinker's thoughts, emotions and general behavior. Heavy regular drinking can have a serious effect on a person's ability to coordinate his/her muscles and speak properly. Heavy binge drinking could cause the patient to go into coma.

Eventually, regular heavy drinking may cause at least one of the following problems:

• Fatigue - the patient is tired most of the time.


• Memory loss - especially the patient's short-term memory.


• Eye muscles - the eye muscles can become significantly weaker.


• Liver diseases - the patient has a considerably higher chance of developing hepatitis, and cirrhosis. Cirrhosis of the liver is an irreversible and progressive condition.


• Gastrointestinal complications - the patient can develop gastritis, or pancreas damage. These problems also seriously undermine the body's ability to digest food, absorb certain vitamins, and produce hormones which regulate metabolism.


• Hypertension - regular heavy drinking invariably raises the person's blood pressure.


• Heart problems - regular heaving drinking can lead to cardiomyopathy (damaged heart muscle), heart failure, and stroke.


• Diabetes - alcoholics have a very high risk of developing diabetes type 2. Patients who have diabetes will invariably have serious complications if they are regular heavy drinkers of alcohol. Alcohol prevents the release of glucose from the liver, causing hypoglycemia. A person with diabetes is already taking insulin to lower his/her blood sugar levels - hypoglycemia could be devastating.


• Menstruation - alcoholism will usually stop menstruation or disrupt it.


• Erectile dysfunction - alcoholic men are much more likely to have problems getting an erection, or sustaining one.


• Fetal alcohol syndrome - women who abuse alcohol during their pregnancy are much more likely to have babies with birth defects, including a small head, heart problems, shortened eyelids, as well as developmental and cognitive problems.


• Thinning bones - alcoholics invariably suffer from thinning of the bones because alcohol interferes with the production of new bone. This means an increased risk of fractures.


• Nervous system problems - alcoholism often causes numbness in the extremities, dementia and confused/disordered thinking.


• Cancer - alcoholics have a much higher risk of developing several cancers, including cancer of the mouth, esophagus, liver, colon, rectum, breast, prostate and pharynx.
  
  An international study found that the key causes of bowel cancer are alcohol and smoking.
  
  In fact, even moderate alcohol consumption is linked to a higher incidence of cancer among women, a study found. Another study found that consuming just two or more drinks per day could increase a person's risk of pancreatic cancer by about 22%.


• Accidents - alcoholics are vulnerable to injuries from falls, car crashes, being run over, etc. The NIH says that over half of all American traffic deaths are alcohol-related.


• Domestic abuse - alcohol is a major factor in spouse beating, child abuse, and conflicts with neighbors.


• Work (school) problems - employment problems, unemployment, school problems, are often alcohol-related.


• Suicide - suicide rates among people who are alcohol-dependent or who abuse alcohol are much higher than among other people.


• Mental illness - alcohol abuse can cause mental illness and make existing mental illnesses worse.


• Problems with the law - the percentage of alcoholics who end up in court or in prison is significantly higher compared to the rest of the population.

Treatment for alcohol dependency

Some medical inpatients with unhealthy alcohol use may benefit from a brief intervention, say researchers from Boston University School of Medicine.

The first step for the alcoholic is to acknowledge that there is an alcohol dependency problem. The next step is to get help. In most of the world there are several support groups and professional services available.

A study found that people with a stable psychosocial life situation often delay in seeking help for their alcohol problems even though they are serious.

In another study, published in March 2012, scientists from Norway re-analyzed data from old trials that tested LSD (lysergic acid diethylamide) for the treatment of alcoholism and concluded that a single dose of the psychedelic drug was effective in decreasing alcohol misuse.

The following are recognised treatment options for alcoholism:

• Do-it-yourself - experts say about 30% of people with an alcohol problem manage to reduce their drinking or abstain without seeking professional help. There is a great deal of material in books and the internet that may help the self-helper.


• Counseling - a qualified counselor can help the alcoholic talk through his/her problems and then devise a plan to tackle the drinking. CBT (cognitive behavioral therapy) is commonly used to treat alcohol dependency.


• Treating underlying problems - the alcoholic may have a problem with self-esteem, stress, anxiety, depression, or some other mental health problem. It is important to treat these problems too. It is crucial for the alcoholic to realize that drinking will probably make mental health problems worse. As alcoholics commonly suffer from hypertension, liver diseases, and possibly heart diseases, these will need to be treated too.


• Residential programs - residential programs are ideal for some people. They include expert professional help, individual or group therapy, support groups, training, family involvement, activity therapy, and a host of strategies that are aimed at treating the alcoholic successfully. Some people find that being physically away from access to temptation is a great help.


• Drug that provokes a severe reaction to alcohol - Antabuse (disulfiram) causes a severe reaction when somebody drinks alcohol, including nausea, flushing, vomiting and headaches. It is a deterrent. It will not treat the alcoholic's compulsion and will not cure alcoholism.


• Drugs for cravings - Naltrexone (ReVia) may help with the urge to have a drink. Acamprosate (Campral) may help with cravings.


• Hormone ghrelin - Researchers at the Sahlgrenska Academy, Gothenburg, have discovered a new brain mechanism involved in alcohol addiction involving the stomach hormone ghrelin. When ghrelin's actions in the brain are blocked, alcohol's effects on the reward system are reduced. It is an important discovery that could lead to new therapies for addictions such as alcohol dependence.


• Detoxification - the patient takes some medication to prevent withdrawal symptoms (delirium tremens) which many alcoholics experience when they give up drinking. Treatment usually lasts from four to seven days. Chlordiazepoxide, a benzodiazepine medication, is frequently used for detoxification (detox). Doses will be initially high, and will then taper off. It is important that the patient abstains completely from alcohol during the detox.


• Staying on the wagon (remaining abstinent) - some patients find the detox acheivable, but start drinking again soon after, or some time later. It is important to remember Samuel Johnson's phrase "If at first you don't succeed. Try, try, and try again." Success rates are significantly improved if the patient has access to counseling or some support group. Family support is crucial. Sometimes a good GP can provide vital support. A study found that genetics is a factor in predicting the risk of relapse among alcohol-dependent patients.

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