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Epidemic Typhus: Transmission & Treatments

Epidemic Typhus: Transmission & Treatments

Epidemic typhus (also called “camp fever”, “jail fever”, “hospital fever”, “ship fever”, “famine fever”, “putrid fever”, “petechial fever”, “Epidemic louse-borne typhus,” and “louse-borne typhus”) is a form of typhus so named because the disease often causes epidemics following wars and natural disasters. The causative organism is Rickettsia prowazekii, transmitted by the human body louse (Pediculus humanus humanus). Feeding on a human who carries the bacterium infects the louse. R. prowazekii grows in the louse’s gut and is excreted in its feces. The disease is then transmitted to an uninfected human who scratches the louse bite (which itches) and rubs the feces into the wound. The incubation period is one to two weeks. R. prowazekii can remain viable and virulent in the dried louse feces for many days. Typhus will eventually kill the louse, though the disease will remain viable for many weeks in the dead louse.

Symptoms and Signs of Epidemic Typhus

After an incubation period of 7 to 14 days, fever, headache, and prostration suddenly occur. Temperature reaches 40° C in several days and remains high, with slight morning remission, for about 2 wk. Headache is generalized and intense. Small, pink macules, which appear on the 4th to 6th day, rapidly cover the body, usually in the axillae and on the upper trunk and not on the palms, soles, and face. Later, the rash becomes dark and maculopapular. In severe cases, the rash becomes petechial and hemorrhagic.

Splenomegaly sometimes occurs. Hypotension occurs in most seriously ill patients. Vascular collapse, renal insufficiency, encephalitic signs, ecchymosis with gangrene, and pneumonia are poor prognostic signs.

Transmission of Epidemic Typhus

  • Rickettsia prowazekii is transmitted from human to human by the body louse Pediculus humanus humanus. The head louse (Pediculus humanus capitis) and crab louse (Phthirus pubis) can transmit R. prowazekii experimentally but known epidemics are linked to the body louse.
  • Rickettsiae may remain viable and infectious in the dead louse for weeks and in louse faeces for up to 100 days.
  • When feeding on an infected human, the body louse ingests R. prowazekii which multiplies in the epithelial cells of the midgut. When these burst, the pathogens are excreted with the faeces of the body louse. R. prowazekii has an impact on the longevity of the body louse and might kill it.
  • On average a mature body louse will live for 20–30 days. Body lice multiply rapidly and their population can increase by 11% per day.
  • Overcrowding leads to close personal contact and spread of arthropod vectors (particularly lice) among individuals. Humans become infected by contamination of the bite site with infected faeces or through contamination of the conjunctivae or mucous membranes with lice faeces. Presumed infection through aerosols of faeces-infected dust has been reported.
  • Rickettsia prowazekii is considered a bioterrorism agent due to specific biological features (notably with regards to environmental stability and possible aerosol transmission).
  • While exposed in refugee camps and other settings characterised by crowding and poor hygiene, humanitarian relief workers and military personnel are potentially at higher risk in disease foci than the general population. In general, the risk for travellers is very low as they are applying measures that reduce exposure to body lice during travel.

Treatment for Epidemic Typhus

The infection is treated with antibiotics. Intravenous fluids and oxygen may be needed to stabilize the patient. The mortality rate is 10% to 60%, but is vastly lower (close to zero) if intracellular antibiotics such as tetracycline are used before 8 days. Chloramphenicol is also used. Infection can also be prevented by vaccination.

Prevention of Epidemic Typhus

Immunization and louse control are highly effective for prevention. However, vaccines are not available in the US. Lice may be eliminated by dusting infested people with malathion or lindane.

Hay Fever: Symptoms, Causes & Treatments

Hay Fever: Symptoms, Causes & Treatments

Hay fever, also known as allergic rhinitis, is a common condition that shows signs and symptoms similar to a cold with sneezing, congestion, runny nose and sinus pressures.

Hay fever is caused by an allergic response to airborne substances, such as pollen – unlike a cold which is caused by a virus. The time of year in which you get hay fever depends on what airborne substance you are allergic to.

The substance that causes an allergic reaction in hay fever is called an “allergen”. For the majority of people, those who do not get hay fever, these substances are not allergens, because their immune system does not react to them.

Despite its name, hay fever does not mean that the person is allergic to hay and has a fever. Hay is hardly ever an allergen, and hay fever does not cause fever.

Although hay fever and allergic rhinitis have the same meaning, most lay people refer to hay fever only when talking about an allergic reaction to pollen or airborne allergens from plants or fungi, and understand allergic rhinitis as an allergy to airborne particles, such as pollen, dust mites or pet dander which affect the nose, and maybe the eyes and sinuses as well.

The rest of this article focuses on hay fever caused by pollen and other airborne allergens that come from plants or fungi. Hay fever caused by pollen is also known as pollinosis.

Some people are only mildly affected by hay fever and rarely reach a point where they decide to seek medical advice. However, for many, symptoms may be so severe and persistent that they are unable to carry out their daily tasks at home, work or at school properly – these people will require treatment. Treatments may not get rid of the symptoms altogether, but they usually help to lessen their impact, making them easier to live with.

As with other allergies, hay fever symptoms are a result of your immune system mistaking a harmless substance as a harmful one, and releasing chemicals that cause the symptoms.

It is estimated that about 20% of people in Western Europe and North America suffer from some degree of hay fever. Although hay fever can start affecting people at any age, it generally develops during childhood or early adulthood. It is said that the majority of hay fever sufferers find their symptoms become less severe as they get older.

Hay fever facts

  • Hay fever (allergic rhinitis) is a common allergic condition.
  • Symptoms of hay fever mimic those of chronic colds.
  • The best way to treat an allergy condition is to identify the allergic trigger and avoid it.
  • Histamine is a key chemical cause of allergic rhinitis and other allergic reactions.
  • Effective treatment is available in many forms, including medications and desensitization therapy (immunotherapy).
  • Antihistamines are the drugs most commonly used to treat allergic rhinitis.

Hay Fever Symptoms

  • Runny nose
  • Itchy eyes, mouth or skin
  • Sneezing
  • Stuffy nose due to blockage or congestion
  • Fatigue (often reported due to poor quality sleep as a result of nasal obstruction)

Hay Fever Triggers

  • Outdoor allergens, such as pollens from grass, trees and weeds
  • Indoor allergens, such as pet hair or dander, dust mites and mold
  • Irritants, such as cigarette smoke, perfume and diesel exhaust

Hay Fever Causes

Hay fever occurs when the immune system mistakes a harmless airborne substance as a threat. As your body thinks the substance is harmful it produces an antibody called immunoglobulin E to attack it. It then releases the chemical histamine which causes the symptoms.

There are seasonal hay fever triggers which include pollen and spores that will only cause symptoms during certain months of the year.

The following are some examples of hay fever triggers:

  • Tree pollen – these tend to affect people in the spring.
  • Grass pollen – these tend to affect people later on in the spring and also in the summer.
  • Weed pollen – these are more common during autumn (fall).
  • Fungi and mold spores – these are more common when the weather is warm.

Hay Fever Treatments

There is a vast array of OTC (over-the-counter) and prescription medications for treating hay fever symptoms. Some patients may find that a combination of two or three medications works much better than just one.

It is important for parents to remember that some hay fever medications are just for adults. If you are not sure, talk to a qualified pharmacist, or ask your doctor.

Antihistamine sprays or tablets

These are commonly available over the counter. The medication stops the release of the chemical histamine. They usually effectively relieve symptoms of runny nose, itching and sneezing. However, if your nose is blocked they don’t work.

Newer antihistamines are less likely to cause drowsiness than older ones – but older ones are just as effective. Examples of OTC antihistamines include loratadine (Claritin, Alavert) and cetirizine (Zyrtec). Examples of prescription antihistamines include Fexofenadine (Allegra) and the nasal spray azelastine (Astelin). Azelastine starts working very rapidly and can be used up to 8 times a day – however, it can cause drowsiness and leave a bad taste in the mouth after use.

Eye Drops

These reduce itching and swelling in the eyes and are usually used alongside other medications. Eye drops containing cromoglycate are commonly used.

Nasal Corticosteroids

These sprays treat the inflammation caused by hay fever, and are a safe and very effective long-term treatment. Examples include fluticasone (Flonase), fluticasone (Veramyst), mometasone (Nasonex) and beclomethasone (Beconase). Most patients may have to wait about a week before experiencing any significant benefits. Some patients may notice an unpleasant smell or taste, and have nose irritation.

Oral corticosteroids

For very severe hay fever symptoms the doctor may prescribe prednisone in pill form. They should be prescribed only for short-term use, because of their long-term link to cataracts, muscle weakness and osteoporosis.

Immunotherapy

Immunotherapy (allergy shots) is a proven treatment approach providing long-term relief for many people suffering from allergic rhinitis. It works by gradually desensitizing the patient’s immune system to the allergens that trigger their symptoms.

Immunotherapy can potentially lead to lasting remission of allergy symptoms, and it may play a preventive role in the development of asthma and new allergies.

The Food and Drug Administration (FDA) approved another form of allergy immunotherapy in April 2014 called sublingual immunotherapy.

Herpes: Causes & Treatments

Herpes: Causes & Treatments

What is Herpes?

Herpes simplex virus, or HSV, is an extremely common and usually mild viral infection. One in five adults in the US is believed to be infected with genital herpes. HSV causes cold sores or fever blisters (oral herpes), and it also causes genital sores (genital herpes). Even if the HSV infection is not currently causing signs and symptoms, it may cause symptoms later. Herpes can be a recurring and upsetting disease but is rarely dangerous. However, it can cause recurrent painful sores and can be severe for people with suppressed immune systems. HSV frequently causes psychological distress and may play a major role in the spread of HIV (HSV causes people to be more susceptible to HIV). Although there is not yet a cure for herpes, appropriate treatment is effective in helping to control the disease.

Genital herpes is a sexually transmitted infection caused by HSV (herpes simplex virus). This virus affects the genitals, the cervix, as well as the skin in other parts of the body. There are two types of herpes simplex viruses: a) HSVp1, or Herpes Type 1, and b) HSV-2, or Herpes Type 2.

Herpes is a chronic condition. Chronic, in medicine, means long-term. However, many people never have symptoms even though they are carrying the virus. Many people with HSV have recurring genital herpes. When a person is initially infected the recurrences, if they do occur, tend to happen more frequently. Over time the remission periods get longer and longer. Each occurrence tends to become less severe with time.

What does Herpes look like and how would I know if I had it?

Symptoms of primary herpes (the first episode) usually develop within 2-14 days after the virus is transmitted. The infection usually develops quickly during the first episode and causes obvious symptoms because the immune response is not well developed. However, some people have a very mild first episode and may not notice symptoms until a later episode.

Picture of mild Genital WartsGenital herpes, herpes, herpes simplex virus, Symptoms of genital herpes, treatment for genital herpesGenital herpes, herpes, herpes simplex virus, Symptoms of genital herpes, treatment for genital herpes

During the first episode, the virus starts to multiply within the skin cells and the skin becomes red and sensitive. Soon afterward, small red bumps appear and may develop into blisters or painful sores. Individuals may also experience flu-like symptoms including swollen glands, headache, muscle aches, or fever. Sometime the glands in the groin may enlarge and cause discomfort. In the following week or so, the blister-like sores break open, scab over, and heal without scarring. However, signs of herpes may be obvious like previously stated or may cause no discomfort and be undetectable.

Causes of Genital Herpes?

When HSV is present on the surface of the skin of an infected person it can easily pass on to another person through the moist skin which lines the mouth, anus and genitals. The virus may also pass onto another person through other areas of human skin, as well as the eyes.

A human cannot become infected by touching an object, such as a working surface, washbasin, or a towel which has been touched by an infected person.

The following can be ways of becoming infected:

  • Having unprotected vaginal or anal sex
  • Having oral sex with a person who gets cold sores
  • Sharing sex toys
  • Having genital contact with an infected person.

HSV leaves the skin just before a blister appears. The virus is most likely to be passed on just before the blister appears, when it is visible, and until the blister is completely healed. HSV can still pass onto another person when there are no signs of an outbreak (but it is less likely).

If a mother with genital herpes has sores while giving birth it is possible that the infection is passed on to the baby (see section on pregnancy below).

How is Herpes diagnosed?

Your health care provider can often diagnose herpes on the basis of your history and the examination of the sores. The health care provider may take a sample of fluid from the sore(s) to determine if the herpes virus is present and to determine if you have HSV-1 or HSV-2.

Herpes Treatment

Is there a cure or treatment for herpes?

Yes. Once you’ve been tested and diagnosed with oral or genital herpes, it can be treated … but not cured.

Remember, herpes is not life-threatening in adults … and depending on the severity of herpes outbreaks, no treatment may be necessary. Oral antiviral medications most commonly, acyclovir (Zovirax), famciclovir (Famvir) and valacyclovir (Valtrex) are safe and effective, and can prevent or shorten the duration of outbreaks, reduce the frequency and severity of recurrent outbreaks, and decrease the risk of spreading the infection to others.

Herpes can recur

Even if you’re being treated for herpes, outbreaks may continue … the frequency of recurring outbreaks depends on the duration and severity of the first herpes episode. An initial infection that lasts five weeks or more correlates with almost twice the number of recurrences, compared to an initial infection that doesn’t last as long.

Additionally, there’s a 60% likelihood of recurring outbreaks with HSV-2, compared to a 14% likelihood of recurrences with HSV-1. The good news is that people with recurrent outbreaks usually have milder symptoms, or no symptoms at all. Be sure to continue to use latex condoms or a dental dam to minimize the risk of spreading herpes to your sexual partner, even if you don’t notice any outbreak symptoms … this is especially important if you are pregnant.

Episodic vs. suppressive therapy

With episodic therapy, you only take the prescribed medication when you’re experiencing herpes symptoms; however, to minimize the aggravation of symptomatic herpes (more than five outbreaks per year), daily suppressive therapy may be your best option … this also reduces the risk of transmitting herpes to an uninfected partner. We’re happy to help you determine the best treatment for you, including FDA-approved use of Valtrex to treat recurrent genital herpes.

Note: The Clinic does not provide medical consultation for HSV-1 positive test results because this type of herpes is usually a benign infection that is most often asymptomatic, or only results in cold sores on the lip. Please see your regular doctor for HSV-1 oral or topical treatment options.

Pregnancy and treatment

Ideally, to protect the health of your baby, avoid genital exposure to HSV-1 or HSV-2 during pregnancy.

In general, herpes can also be treated during pregnancy with prescription medication. Consult your regular doctor about the risks involved, and to identify a treatment that’s best for you and your baby.

Osteoporosis: Risk Factors & Preventions

Osteoporosis: Risk Factors & Preventions

Osteoporosis is a progressive disorder defined by loss of bone mass and density, which leads to an increased risk for fractures. The term literally means “porous bone.”

Osteoporosis is a disorder of the skeleton in which bone strength is abnormally weak. This leads to an increase in the risk of breaking bones (bone fracture). In the United States, more than 10 million people have osteoporosis of the hip and almost 19 million more have low hip bone density. Between 4 to 6 million postmenopausal white women have osteoporosis, and an additional 13 to 17 million have low hipbone density. One in two white women will experience a bone fracture due to osteoporosis in her lifetime. In 1993, the United States incurred an estimated loss of 10 billion dollars due to loss of productivity and health care costs related to osteoporosis. With the aging of America, the number of people with osteoporosis related fractures will increase exponentially. The pain, suffering, and economic costs will be enormous.

What Are the Risk Factors for Osteoporosis?

Important risk factors for osteoporosis include:

  • Age. After maximum bone density and strength is reached (generally around age 30), bone mass begins to decline naturally with age.
  • Gender. Women over the age of 50 have the greatest risk of developing osteoporosis. In fact, women are four times more likely than men to develop it. Women’s lighter, thinner bones and longer life spans are part of the reason they have a higher risk.
  • Ethnicity. Research has shown that Caucasian and Asian women are more likely to develop osteoporosis. Additionally, hip fractures are twice as likely to occur in Caucasian women as in African-American women. However, women of color who fracture their hips have a higher death rate.
  • Bone structure and body weight. Petite and thin women have a greater risk of developing osteoporosis. One reason is that they have less bone to lose than women with more body weight and larger frames. Similarly, small-boned, thin men are at greater risk than men with larger frames and more body weight.
  • Family history. Heredity is one of the most important risk factors for osteoporosis. If your parents or grandparents have had any signs of osteoporosis, such as a fractured hip after a minor fall, you may be at greater risk of developing the disease.
  • Prior history of broken bones.
  • Cigarette smoking. Smoking puts you at higher risk of having osteoporosis and fractures.
  • Alcohol. Heavy alcohol use can lead to thinning of the bones and increase your risk of fracture.
  • Certain Diseases. Some diseases such as rheumatoid arthritis increase the risk for osteoporosis.
  • Certain medications. The use of some medications — for example, the long term use of steroids such as prednisone — can also increase your risk of developing osteoporosis.

Risk Factors You Can Change

There are other risk factors for osteoporosis that can be changed.

  • Poor diet. Getting too little calcium over your lifetime can increase your risk for osteoporosis. Not getting enough vitamin D either from your diet, supplements, or sunlight can also increase your risk for osteoporosis. Vitamin D is important because it helps the body absorb calcium. An overall diet adequate in protein and other vitamins and minerals is also essential for bone health.
  • Physical inactivity. Not exercising and being inactive or staying in bed for long periods can increase your risk of developing osteoporosis. Like muscles, bones become stronger with exercise.
  • Smoking. Cigarette smokers may absorb less calcium from their diets. In addition, women who smoke have lower levels of estrogen in their bodies.
  • Medications. Some commonly used medicines can cause loss of bone mass. These include a type of steroid called glucocorticoids, which are used to control diseases such as arthritis and asthma; some antiseizure drugs; some medicines that treat endometriosis; and some cancer drugs. Using too much thyroid hormone for an underactive thyroid can also be a problem. Talk to your doctor about the medications you are taking and what you can do to protect your bones.
  • Low body weight. Women who are thin and small-boned are at greater risk for osteoporosis.

Are there any other risk factors?

Some risk factors cannot be changed but it’s important to know about them as some research suggests they make it much more likely you will have fragile bones and fractures in later life. It’s important to understand that, often, osteoporosis and fractures aren’t caused by something you have ‘done’ or could have changed. Their cause may just be part of your genetic makeup or, like many medical conditions, something that happens but where we don’t fully understand why.

Genes: our genes determine our risk of osteoporosis to a large extent although there isn’t a simple genetic test for osteoporosis. Research has shown that if one of your parents had a broken hip you are more likely to have a fragility fracture yourself.

Age: bone loss increases in later life, so by the age of 75 years about half of the UK population will have osteoporosis as measured on a bonedensity scan. As you get older, bones become more fragile and generally more likely to break, whatever your bone density as measured on a scan. This is partly because of generally reduced bone strength but also the result of an increased risk of falling as we get older.

Gender: osteoporosis and fractures are more common in women than men. Women tend to live longer, which makes fractures more likely, but in each age group the fracture risk is higher. Men have bigger bones, and bone size in itself seems to protect against fracture. In addition, at around the age of 50, women experience the menopause, at which point their ovaries almost stop producing the sex hormone oestrogen, which helps to keep bones strong.

Race: Afro-Caribbean people are at a lower risk of osteoporosis and fractures than those of Caucasian or Asian origin because their bones are bigger and stronger.

Previous fractures: if you have already broken bones easily, including in the spine, you are much more likely to have fractures in the future – having already broken bones easily is one of the most obvious indicators that your bones are fragile. In fact, research has shown that after one fragility fracture you are two to three times more likely to have another.

What medicines increase my risk?

Some medications (see below) are linked with an increased risk of osteoporosis and/or fractures. Once you know about these, you can discuss with your doctor the ways to limit their effects. Your doctor may review your medicines and possibly change the dose or even the drug (don’t make any changes without talking to your doctor first). Sometimes an osteoporosis drug or a supplement can be prescribed to help protect your bones from the effect of these medicines. However, if you are only taking the drug at a low dose or for a limited period, your doctor may be able to reassure you the effect on your bones is insignificant.

  • glucocorticoid (‘steroids’) tablets for other medical conditions for over three months
  • anti-epileptic drugs
  • breast cancer treatments such as aromatase inhibitors
  • prostate cancer drugs that affect either the production of the male hormone testosterone or the way it works in the body.

Other medicines may increase risk, but more research is needed:

  • drugs to reduce inflammation of the stomach and oesophagus, called proton pump inhibitors (PPIs)
  • diabetic drugs in the glitazone group, including pioglitazone
  • injectable progestogen contraceptives such as medroxyprogesterone acetate, known as Depo Provera
  • some drugs used for mental health problems such as tricyclic antidepressants and particularly selective serotonin reuptake inhibitors (SSRIs).
Allergic Conjunctivitis: Symptoms, Causes & Treatments

Allergic Conjunctivitis: Symptoms, Causes & Treatments

What is Allergic Conjunctivitis?

When your eyes are exposed to substances like pollen or mold spores, they may become red, itchy, and watery. These symptoms mean you have allergic conjunctivitis. Allergic conjunctivitis refers to eye inflammation resulting from an allergic reaction to substances like pollen or mold spores.

The inside of your eyelids and the covering of your eyeball have a membrane called the conjunctiva. The conjunctiva is susceptible to irritation from allergens, especially during hay fever season. Allergic conjunctivitus is quite common and affects about one-fifth of the population. It is your body’s reaction to substances it considers potentially harmful.

Infection is the most common cause of conjunctivitis and, in addition to itch, redness and grittiness, there is usually a sticky discharge. Many bacteria and viruses can cause conjunctivitis.

When your eyes are exposed to allergy-causing substances, a substance call histamine is released by your body. The blood vessels in the conjunctiva become swollen. The eyes can become red, itchy, and teary very quickly.

The pollens that cause symptoms vary from person to person and from area to area. Tiny, hard-to-see pollens that may cause hay fever include grasses, ragweed and trees.

Your symptoms may be worse when there is more pollen in the air. Higher levels of pollen are more likely on hot, dry, windy days. On cool, damp, rainy days most pollen is washed to the ground.

Allergies tend to run in families. It is hard to know exactly how many people have allergies. Many conditions are often lumped under the term “allergy” even when they might not truly be an allergy.

What Are the Symptoms of Allergic Pink Eye?

Symptoms of allergic pink eye include:

  • Redness in the white of the eye or inner eyelid
  • Increased amount of tears
  • Itchy eyes
  • Blurred vision
  • Swelling of the eyelid

In allergic conjunctivitis, these symptoms are usually present in both eyes (not always equally).

See your ophthalmologist (a doctor and surgeon who is trained to treat eye conditions), optometrist (doctor trained to treat eye conditions), or family doctor if you have any of these persistent symptoms.

Types of Allergic Conjunctivitis

Allergic conjunctivitis is usually broken down into different categories. Below are some of them:

1) Seasonal allergic conjunctivitis (allergic rhinoconjunctivitis)

Pollen is the most common allergen to cause conjunctivitis in countries that have cold winters (not near the equator).

If you get conjunctivitis from pollen you will probably have symptoms of hay fever, which includes sneezing, blocked or runny nose, itchy nose, and itchy and watery eyes. When the conjunctivitis occurs along with sneezing and blocked nose, etc., the whole thing is calledhay fever.

This type of conjunctivitis is called seasonal allergic conjunctivitis (allergic rhinoconjunctivitis) because it almost exclusively occurs during the spring and summer months when plants, especially grass, trees, and flowers are in pollen. Some people even have symptoms during early autumn (fall).

2) Contact conjunctivitis (Contact dermatoconjunctivtis)

These are usually caused by make-up (cosmetics), eye-drops or other chemical which irritate the conjunctiva of sensitive people, causing an allergic response. Some people are sensitive to specific substances.

Symptoms usually develop two to four days after the substance comes into contact with the eyes.

3) Giant papillary conjunctivitis

This is generally caused by contact lenses. When sensitive people put the contacted lenses on they cause discomfort – this can get progressively worse and more and more uncomfortable, causing the eyes to become red.

Giant papillary conjunctivitis (GPC) may also occur after eye surgery when the patient uses hard contact lenses.

Some people say that poor hygiene when handling contact lenses, solutions and cases may contribute to infections of the eye.

How Allergic Conjunctivitis be Treated?

Home Care

Treating allergic conjunctivitis at home involves a combination of prevention strategies and activities to ease your symptoms. To minimize your exposure to allergens:

  • close windows when the pollen count is high
  • keep your home dust-free
  • use an indoor air purifier
  • avoid exposure to harsh chemicals, dyes, and perfumes

To ease your symptoms, avoid rubbing your eyes. Applying a cool compress to your eyes can also help reduce inflammation and itching.

Medications

In more troublesome cases, home care may not be adequate. You will need to see a doctor who might recommend:

  • an oral or over-the-counter antihistamine to reduce or block histamine release
  • anti-inflammatory and/or anti-inflammation eye drops
  • eye drops to shrink congested blood vessels
  • steroid eye drops (only in severe cases)
Cystic Fibrosis: Causes, Symptoms, Diagnosis & Treatments

Cystic Fibrosis: Causes, Symptoms, Diagnosis & Treatments

What is Cystic Fibrosis?

Cystic fibrosis is a life-threatening, genetic disease that causes persistent lung infections and progressively limits the ability to breathe.

In people with Cystic fibrosis, a defective gene causes a thick, buildup of mucus in the lungs, pancreas and other organs. In the lungs, the mucus clogs the airways and traps bacteria leading to infections, extensive lung damage and eventually, respiratory failure. In the pancreas, the mucus prevents the release of digestive enzymes that allow the body to break down food and absorb vital nutrients.

Although cystic fibrosis requires daily care, people with the condition are able to attend school and work, and have a better quality of life than in previous decades. Improvements in screening and treatments mean most people with cystic fibrosis now live into their 20s and 30s, and some are living into their 40s and 50s.

What Causes of Cystic Fibrosis

Cystic fibrosis is a genetic disease that occurs when a child inherits two abnormal genes, one from each parent. Approximately, one in 25 Canadians carry an abnormal version of the gene responsible for cystic fibrosis. Carriers do not have cystic fibrosis, nor do they exhibit any of the symptoms of the disease.

When two parents who are carriers have a child, there is a 25 percent chance that the child will be born with cystic fibrosis; there is also a 50 percent chance that the child will be a carrier; and a 25 percent chance that the child will neither be a carrier nor have cystic fibrosis.

How common is Cystic Fibrosis?

Cystic fibrosis is a common genetic disease within the white population in the United States. The disease occurs in 1 in 2,500 to 3,500 white newborns. Cystic fibrosis is less common in other ethnic groups, affecting about 1 in 17,000 African Americans and 1 in 31,000 Asian Americans.

Who is affected with Cystic Fibrosis?

Cystic fibrosis is most common in white people of northern European descent.

It is estimated that one in every 2,500 babies born in the UK will be born with cystic fibrosis and there are more than 9,000 people living with the condition in this country.

The condition is much less common in other ethnic groups.

Symptoms of Cystic Fibrosis

Cystic fibrosis is a multi-system disorder that produces a variety of symptoms including:

  • Persistent cough with productive thick mucous
  • Wheezing and shortness of breath
  • Frequent chest infections, which may include pneumonia
  • Bowel disturbances, such as intestinal obstruction or frequent, oily stools
  • Weight loss or failure to gain weight despite possible increased appetite
  • Salty tasting sweat
  • Infertility (men) and decreased fertility (women)

Cystic Fibrosis Diagnosis

Cystic fibrosis is one of the conditions babies are screened for with the newborn blood spot test.

A small amount of the baby’s blood is taken by a heel prick and transferred onto a card. The blood sample on the card is then analysed in the laboratory for cystic fibrosis and eight other conditions, including sickle cell anaemia.

Treatments for Cystic Fibrosis Diagnosis

The type and severity of CF symptoms can differ widely from person to person. Therefore, there is not a typical treatment plan.

People with CF need to work closely with their medical professionals and families to create individualized treatment plans.

The CF Foundation accredits more than 120 care centers that are staffed by dedicated healthcare professionals who provide expert CF care and specialized disease management.

Each day, people with CF complete a combination of the following therapies:

  • Airway clearance to help loosen and get rid of the thick mucus that can build up in the lungs. Some airway clearance techniques require help from family members, friends or respiratory therapists. Many people with CF use an inflatable vest that vibrates the chest at a high frequency to help loosen and thin mucus.
  • Inhaled medicines to open the airways or thin the mucus. These are liquid medicines that are made into a mist or aerosol and then inhaled through a nebulizer. These medicines include antibiotics to fight lung infections and therapies to help keep the airways clear.
  • Pancreatic enzyme supplement capsules to improve the absorption of vital nutrients. These supplements are taken with every meal and most snacks. People with CF also usually take multivitamins.

The CF Foundation supports research to discover and develop new CF treatments and maintains a pipeline of potential therapies that target the disease from every angle.

In 2015, the FDA approved the second drug to treat the root cause of cystic fibrosis, a defective protein known as CFTR. The first drug targeting the basic genetic defect in CF was approved in 2012. The arrival of this group of drugs, called CFTR modulators, signals a historic breakthrough in how CF is treated. It’s expected that CFTR modulators could add decades of life for some people with CF.