Author Dr M McCabe
Using the layman’s term “germs” loosely in this blog will include all micro-organisms that can cause disease including bacteria, viruses, parasites and fungi co-inhabiting with us.
When asked about the greatest health risks, most people still mention smoking, climate and environmental pollution, along with an unhealthy or wrong diet, followed by alcohol and unhealthy or contaminated foods and people.
The latest scare and panic in South Africa was the Listeriosis outbreak at the processed meat factory in Limpopo that had to be shut down, with people going into frenzy spreading hair raising stories of how this happened; while institutions presented small informative sessions to educate the public (adults) as to what Listeriosis is and how to prevent yourself from being infected. It boiled down to age old standard hygiene and food preparation practices. This is something we either should have been taught a long time ago or we just do not practice or we tend to ignore what we do not “see.”
Are people aware of where and how they can contract germs and how to prevent and treat possible germ infections. Let’s take the case of a child’s view of “clean”:
“But my hands are clean,” your four-year-old insists, after he sneezes right into them “Look at them- I don’t see any germs on them.”
How do you explain the concept of germs for kids to understand? But not only kids, many adults also do not understand the concept of hygiene or the germ theory of disease and how they make us ill. Should we just focus on the actions behind hygiene – washing your hands, catching your sneeze with your elbow, not sharing utensils or food, avoiding foul still standing water or should we delve deeper into what and how germs go to work to engrain how the world of micro-organisms affect us every day and how they can be detrimental to our health.
According to health experts, giving kids (and adults) explanations behind these basic hygiene practices can go a long way toward helping them become more germ-conscious. For example, in layman’s terms it should be explained clearly and that germs can be described as small “bugs” that live on all things, and that sometimes these bugs can make you sick. That they are so small that they can only be seen with a microscope. While they are not actually insects, they are living organisms that can grow and multiply quickly.
It is important to teach even very young children about germs. It is important to explain to kids, as they get older, that some germs are good – for example pro-biotics and some of those living in and on our bodies, and that others are bad, such as cold viruses. When they get even older, you can explain the difference between viruses and bacteria etc. to them, so they understand why antibiotics can help with some illnesses, but not others. And remember this is not only to be taught at school, it must be taught at home by the parents. Point out several examples of ways that your child can avoid becoming sick of germs, such as coughing into her sleeve or washing her hands after blowing her nose.
Personal hygiene begins and ends with our hands. And though we’re taught as youngsters to wash our hands before dinner, it’s important to remember that germs don’t care what time of day it is. Clean hands prevent sickness. So, it’s especially important to learn the basics about hand hygiene so that you, too, can become a champion hand washer!
Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases and conditions are spread by not washing hands with soap and clean, running water.
How germs get onto hands and make people sick
Faeces (poop) from people or animals is an important source of germs like Salmonella, E. coli ,and norovirus that cause diarrhoea, and it can spread some respiratory infections like adenovirus and hand-foot-mouth disease. These kinds of germs can get onto hands after people use the toilet or change a diaper, but also in less obvious ways, like after handling raw meats that have invisible amounts of animal poop on them.
A single gram of human faeces—which is about the weight of a paper clip—can contain one trillion germs. Germs can also get onto hands if people touch any object that has germs on it because someone coughed or sneezed on it or was touched by some other contaminated object. When these germs get onto hands and are not washed off, they can be passed from person to person and make people sick (This is why grocery stores have wipes for the trolleys!)
Washing hands prevents illnesses and spread of infections to others
Handwashing with soap removes germs from hands. This helps prevent infections because:
· Reduces the number of people who get sick with diarrhoea by 23-40%
· Reduces diarrheal illness in people with weakened immune systems by 58%
· Reduces respiratory illnesses, like colds, in the general population by 16-21%
· Reduces absenteeism due to gastrointestinal illness in schoolchildren by 29-57%
Not washing hands harms children around the world
About 1.8 million children under the age of 5 die each year from diarrheal diseases and pneumonia, the top two killers of young children around the
Handwashing helps battle the rise in antibiotic resistance
Preventing sickness reduces the amount of antibiotics people use and the likelihood that antibiotic resistance will develop. Handwashing can prevent about 30% of diarrhoea-related sicknesses and about 20% of respiratory infections (e.g., colds). Antibiotics often are prescribed unnecessarily for these health issues. Reducing the number of these infections by washing hands frequently helps prevent the overuse of antibiotics—the single most important factor leading to antibiotic resistance around the world. Handwashing can also prevent people from getting sick with germs that are already resistant to antibiotics and that can be difficult to treat.
When should you was your hands?
Why should you wash your hands? (The science behind it)
Because hands could become re-contaminated if placed in a basin of standing water that has been contaminated through previous use, clean running water should be used. However, washing with non-potable water when necessary may still improve health. The temperature of the water does not appear to affect microbe removal; however, warmer water may cause more skin irritation and is more environmentally costly.
Turning off the faucet after wetting hands saves water, and there are few data to prove whether significant numbers of germs are transferred between hands and the faucet.
Using soap to wash hands is more effective than using water alone because the surfactants in soap lift soil and microbes from skin, and people tend to scrub hands more thoroughly when using soap, which further removes germs.
To date, studies have shown that there is no added health benefit for consumers (this does not include professionals in the healthcare setting) using soaps containing antibacterial ingredients compared with using plain soap. As a result, FDA issued a final rule in September 2016 that 19 ingredients in common “antibacterial” soaps, including triclosan, were no more effective than non-antibacterial soap and water and thus these products are no longer able to be marketed to the general public. This rule does not affect hand sanitizers, wipes, or antibacterial products used in healthcare settings.
Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between the fingers and under your nails. Why? Lathering and scrubbing hands creates friction, which helps lift dirt, grease, and microbes from skin. Microbes are present on all surfaces of the hand, often in particularly high concentration under the nails, so the entire hand should be scrubbed.
Scrub your hands for at least 20 seconds. Hum the “Happy birthday” song from beginning to end twice. from beginning to end twice. Why? Determining the optimal length of time for handwashing is difficult because few studies about the health impacts of altering handwashing times have been done. Of those that exist, nearly all have measured reductions in overall numbers of microbes, only a small proportion of which can cause illness, and have not measured impacts on health. Solely reducing numbers of microbes on hands is not necessarily linked to better health. The optimal length of time for handwashing is also likely to depend on many factors, including the type and amount of soil on the hands and the setting of the person washing hands. For example, surgeons are likely to come into contact with disease-causing germs and risk spreading serious infections to vulnerable patients, so they may need to wash hands longer than a woman before she prepares her own lunch at home. Nonetheless, evidence suggests that washing hands for about 15-30 seconds removes more germs from hands than washing for shorter periods.
Accordingly, many countries and global organizations have adopted recommendations to wash hands for about 20 seconds (some recommend an additional 20-30 seconds for drying):
Why? Soap and friction help lift dirt, grease, and microbes—including disease-causing germs—from skin so they can then be rinsed off of hands. Rinsing the soap away also minimizes skin irritation. While some recommendations include using a paper towel to turn off the faucet after hands have been rinsed, this practice leads to increased use of water and paper towels, and there are no studies to show that it improves health.
Dry your hands using a clean towel or air dry them.
Why? Germs can be transferred more easily to and from wet hands; therefore, hands should be dried after washing. However, the best way to dry hands remains unclear because few studies about hand drying exist, and the results of these studies conflict. Additionally, most of these studies compare overall concentrations of microbes, not just disease-causing germs, on hands following different hand-drying methods. It has not been shown that removing microbes from hands is linked to better health. Nonetheless, studies suggest that using a clean towel or air-drying hands are best.
What is Dementia?
Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Dementia is not a specific disease. It's an overall term that describes a group of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80 percent of cases. There are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.
While symptoms of dementia can vary greatly, at least two of the following core mental functions must be significantly impaired to be considered dementia:
What causes dementia?
Dementia is caused by damage to brain cells. This damage interferes with the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behaviour and feelings can be affected.
While most changes in the brain that cause dementia are permanent and worsen over time, thinking and memory problems caused by the following conditions may improve when the condition is treated or addressed: depression, medication side effects, excess use of alcohol, thyroid problems, vitamin deficiencies.
Diagnosis of dementia
There is no one test to determine if someone has dementia. Doctors diagnose Alzheimer's and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behaviour associated with each type. Doctors can determine that a person has dementia with a high level of certainty.
Dementia treatment and care
Treatment of dementia depends on its cause. In the case of most progressive dementias, including Alzheimer's disease, there is no cure and no treatment that slows or stops its progression. But there are drug treatments that may temporarily improve symptoms. The same medications used to treat Alzheimer's are among the drugs sometimes prescribed to help with symptoms of other types of dementias. Non-drug therapies can also alleviate some symptoms of dementia.
How Alzheimer's medications work
To understand how Alzheimer's medications work, you first need to understand the communication network in the brain. The picture below depicts nerve cells, or neurons, in the brain. Neurons are the chief cells destroyed by Alzheimer's disease.
In the brain, neurons connect and communicate at synapses, where tiny bursts of chemicals called neurotransmitters carry information from one cell to another. Alzheimer's disrupts this process, and eventually destroys synapses and kills neurons, damaging the brain's communication network.
As Alzheimer’s progresses, brain cells die and connections among cells are lost, causing cognitive symptoms to worsen. While current medications cannot stop the damage Alzheimer’s causes to brain cells, they may help lessen or stabilize symptoms for a limited time by affecting certain chemicals involved in carrying messages among the brain's nerve cells.
Overview of disease progression
The symptoms of Alzheimer's disease worsen over time. On average, a person with Alzheimer's lives four to eight years after diagnosis, but can live as long as 20 years, depending on other factors. Changes in the brain related to Alzheimer's begin years before any signs of the disease. This time period, which can last for years, is referred to as preclinical Alzheimer's disease.
Mild Alzheimer's disease (early stage)
In the early stage of Alzheimer's, a person may function independently. He or she may still drive, work and be part of social activities. Despite this, the person may feel as if he or she is having memory lapses, such as forgetting familiar words or the location of everyday objects. Friends, family or others close to the individual begin to notice difficulties. Common difficulties include:
Moderate Alzheimer's disease (middle stage)
During the moderate stage of Alzheimer’s, the dementia symptoms are more pronounced. A person may have greater difficulty performing tasks, such as paying bills, but they may still remember significant details about their life.
You may notice the person with Alzheimer's confusing words, getting frustrated or angry, or acting in unexpected ways, such as refusing to bathe. Damage to nerve cells in the brain can make it difficult to express thoughts and perform routine tasks. At this point, symptoms will be noticeable to others and may include:
In the final stage of this disease, dementia symptoms are severe. Individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases, but communicating pain becomes difficult. As memory and cognitive skills continue to worsen, significant personality changes may take place and individuals need extensive help with daily activities. At this stage, individuals may:
Top of Form
A person living with dementia will eventually need assistance with daily living. By using creativity and caregiving skills, you can adapt routines and activities as needs change. Use our resources to get ideas and connect with other caregivers.
Examples of different aspects on assisting a person with dementia in caregiving:
A daily Care Plan, activities of daily living, communication and Alzheimers, incontinence, bathing, dressing and grooming, dental care, treatments, medication safety, working with the doctor, adequate food and fluid intake, care of bowel and bladder function, skin and body health, infections and pneumonia, pain and illness
The role of a caregiver
During the late stages, the role as a caregiver focuses on preserving quality of life and dignity. Although a person in the late stage of Alzheimer's typically loses the ability to talk and express needs, research tells us that some core of the person's self may remain. This means you may be able to continue to connect throughout the late stage of the disease.
At this point in the disease, the world is primarily experienced through the senses. Express caring through touch, sound, sight, taste and smell.
Dementia help and support is available
Since care needs are extensive during the late stage, they may exceed what you can provide at home, even with additional assistance. This may mean moving the person into a facility in order to get the care needed.
Deciding on late-stage care can be one of the most difficult decisions families face. Families that have been through the process tell us that it is best to gather information and move forward, rather than second guessing decisions after the fact. There are many good ways to provide quality care. Remember, regardless of where the care takes place, the decision is about making sure the person receives the care needed.
At the end of life, another option is hospice. The underlying philosophy of hospice focuses on quality and dignity by providing comfort, care and support services for people with terminal illnesses and their families.
Ideally, discussions about end-of-life care wishes should take place while the person with the dementia still has the capacity to make decisions and share wishes about life-sustaining treatment.
The information was extracted from the following sites:
Other sites with helpful information on local care and support:
https://www.newseveryday.co.za/news/online-dementia-support-group This is a South African Facebook support group that aims to provide a safe and accessible space for families and individuals impacted by dementia
KwaZulu-Natal 031-702 4321: Support groups
Amanzimtoti, Durban (Berea), Durban North, Hillcrest, Howick, KwaNgcolosi, Lower Molweni, Musgrave, Newcastle, Pietermaritzburg, Pinetown, Port Shepstone, Scottburgh, Umbilo, Upper Molweni, Vryheid
The Vales Care Centre Pennington : 039 975 1337 or email firstname.lastname@example.org
Meningitis is an infection of the meninges, the thin lining that surrounds the brain and the spinal cord. Several different bacteria, viruses, fungi and some drugs and medical conditions i.e. inflammatory diseases such as lupus can cause meningitis. Neisseria meningitidis is one of the most important because of its potential to cause epidemics.
Meningococcal meningitis is caused by Neisseria meningitidis bacteria.
The diagnosis of meningococcal meningitis is suspected by the clinical presentation and a lumbar puncture showing a purulent spinal fluid.
Sometimes the bacteria can be seen in microscopic examinations of the spinal fluid.
The diagnosis is confirmed by growing the bacteria from specimens of spinal fluid or blood.
Meningitis in South Africa has sporadic outbreaks, which are most prevalent during droughts, dry and dusty or winter seasons. The number of cases increases in winter and spring.
During the dry season, between December and June, because of dust winds and upper respiratory tract infections due to cold nights, the local immunity of the pharynx is diminished increasing the risk of meningitis.
At the same time, the transmission of N. meningitidis is favoured by overcrowded housing at family level and by large population displacements due to pilgrimages and traditional markets at regional level.
Currently recommendations for chemoprophylaxis in South Africa are as follows:
Vaccines are available to prevent the disease.
Headaches are one of the most common medical complaints that we see in family practice. Most people experience them at some point in their life. They can affect anyone regardless of age, race, and gender.
A headache can be a sign of stress or emotional distress, or it can result from a medical disorder, such as migraine or high blood pressure, anxiety, or depression. It can lead to other problems. People with chronic migraine headaches, for example, may find it hard to attend work or school regularly.
Primary headaches are stand-alone illnesses caused directly by the overactivity of, or problems with, structures in the head that are pain-sensitive. This includes the blood vessels, muscles, and nerves of the head and neck. They may also result from changes in chemical activity in the brain. Common primary headaches include migraines, cluster headaches, and tension headaches.
Secondary headaches are symptoms that happen when another condition stimulates the pain-sensitive nerves of the head. In other words, the headache symptoms can be attributed to another cause. A wide range of different factors can cause secondary headaches. These include:
· alcohol-induced hangover
· brain tumor
· blood clots
· bleeding in or around the brain
· "brain freeze," or ice-cream headaches
· carbon monoxide poisoning
· teeth-grinding at night
· overuse of pain medication, known as rebound headaches
· panic attacks
As headaches can be a symptom of a serious condition, it is important to seek medical advice if they become more severe, regular, or persistent. For example, if a headache is more painful and disruptive than previous headaches, worsens, or fails to improve with medication or is accompanied by other symptoms such as confusion, fever, sensory changes, and stiffness in the neck, a doctor should be contacted immediately.
Tension headaches are the most common form of primary headache. Such headaches normally begin slowly and gradually in the middle of the day. The person can feel:
· as if they have a tight band around the head
· a constant, dull ache on both sides
· pain spread to or from the neck
Tension-type headaches can be either episodic or chronic. Episodic attacks are usually a few hours in duration, but it can last for several days. Chronic headaches occur for 15 or more days a month for a period of at least 3 months.
A migraine headache may cause a pulsating, throbbing pain usually only on one side of the head. The aching may be accompanied by:
· blurred vision
· sensory disturbances known as auras
Migraine is the second most common form of primary headache and can have a significant impact on the life of an individual. According to the WHO, migraine is the sixth highest cause of days lost due to disability worldwide. A migraine can last from a few hours to between 2 and 3 days.
Rebound or medication-overuse headaches stem from an excessive use of medication to treat headache symptoms. They are the most common cause of secondary headaches. They usually begin early in the day and persist throughout the day. They may improve with pain medication, but worsen when its effects wear off. Along with the headache itself, rebound headaches can cause:
· neck pain
· a feeling of nasal congestion
· reduced sleep quality
Rebound headaches can cause a range of symptoms, and the pain can be different each day.
Cluster headaches usually last between 15 minutes and 3 hours, and they occur suddenly once per day up to eight times per day for a period of weeks to months. In between clusters, there may be no headache symptoms, and this headache-free period can last months to years. The pain caused by cluster headaches is:
· often described as sharp or burning
· typically located in or around one eye
The affected area may become red and swollen, the eyelid may droop, and the nasal passage on the affected side may become stuffy and runny.
These are sudden, severe headaches that are often described as the "worst headache of my life." They reach maximum intensity in less than one minute and last longer than 5 minutes. A thunderclap headache is often secondary to life-threatening conditions, such as intracerebral hemorrhage, cerebral venous thrombosis, ruptured or unruptured aneurysms, reversible cerebral vasoconstriction syndrome (RVS), meningitis, and pituitary apoplexy. who experience these sudden, severe headaches should seek medical evaluation immediately.
Headaches in children
Importantly, in children and adolescents, primary headaches are often co-morbid with psychiatric conditions. Awareness of, and enquiry about, sleep disorders, PTSD, school phobias, ADHD, conduct disorder, learning disorders, encopresis (soiling of underwear with stool past the age of toilet training), enuresis (bedwetting), depression and anxiety is important when assessing a child with headaches.
The most common ways of treating headaches are rest and pain relief medication. Generic pain relief medication is available over the counter (OTC), or doctors can prescribe preventative medication, such as tricyclic antidepressants, serotonin receptor agonists, anti-epilepticdrugs,andbeta-blockers.
It is important to follow the doctor's advice because overusing pain relief medication can lead to rebound headaches. The treatment of rebound headaches involves the reducing or stopping pain relief medication. In extreme cases, a short hospital stay may be needed to manage withdrawal safely and effectively.
Several alternative forms of treatment for headaches are available, but it is important to consult a doctor before making any major changes or beginning any alternative forms of treatment. Alternative approaches include:
· cognitive behavior therapy
Research has not provided evidence to confirm that all these methods work.
Sometimes, a headache may result from a deficiency of a particular nutrient or nutrients, especially magnesium and certain B vitamins. Nutrient deficiencies can be due to a poor quality diet, underlying malabsorption issues, or other medical conditions.
A number of steps can be taken to reduce the risk of headaches and to ease the pain if they do occur:
1. Apply a heat pack or ice pack to your head or neck, but avoid extreme temperatures.
2. Avoid stressors, where possible, and develop healthy coping strategies for unavoidable stress.
3. Eat regular meals, taking care to maintain stable blood sugar.
A hot shower can help, although in one rare condition hot water exposure can trigger headaches. Exercising regularly and getting enough rest and regular sleep contributes to overall health and stress reduction.
A doctor will usually be able to diagnose a particular type of headache through a description of the condition, the type of pain, and the timing and pattern of attacks. If the nature of the headache appears to be complex, tests may be carried out to eliminate more serious causes.
Further testing could include:
· blood tests
· brain scans, such as CT and MRI
The WHO points out that headaches are often not taken seriously because they are sporadic, most headaches do not lead to death, and they are not contagious.