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Human physiology, hazards and health risks
Published in Stephen Battersby, Clay's Handbook of Environmental Health, 2016
David J. Baker, Naima Bradley, Alec Dobney, Virginia Murray, Jill R. Meara, John O’Hagan, Neil P. McColl, Caryn L. Cox
To control or prevent its spread all cases of acute meningitis should be promptly notified to public health authorities. Where the causative organism is believed to be a meningococcal infection (caused by the bacterium Neissera meningitides), the case should be admitted to hospital for immediate antibiotic therapy and laboratory investigations commenced to confirm diagnosis. Public health action requires the tracing of ‘close contacts’ who should be offered chemoprophylaxis and vaccination (if the infection is due to a vaccine preventable strain), to prevent early and late secondary cases in the network of close contacts. If an outbreak occurs (for example two or more confirmed or probable cases in a household or educational setting) then wider chemoprophylaxis may be required as a public health action. Many countries have a wide-ranging schedule of vaccination programmes covering serogroups A, C, W135 and Y and most recently introduced in a small number of countries for serogroup B.
Pulmonary complications of solid-organ transplantation
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Prior to the widespread introduction of chemoprophylaxis, PCP was a common opportunistic infection among solid-organ transplant recipients. As documented in older series, organspecific prevalence rates for at-risk patients (i.e. not receiving prophylaxis) were 4 per cent for kidney and heart transplant recipients, 11 per cent for liver transplant recipients, and up to 33 per cent for heart–lung recipients.35 With the administration of low-dose trimethoprim–sulfamethoxazole or an alternative prophylactic agent, PCP can be effectively prevented. In a large contemporary series from the Cleveland Clinic, PCP was documented in only 25 of 1299 solid-organ transplant recipients and it occurred exclusively in patients who were not receiving prophylaxis.35 The greatest risk of PCP falls between the second and sixth post-transplantation months. The risk declines significantly beyond the first year for all groups except lung transplant recipients,35 prompting many non-lung programmes to discontinue prophylaxis beyond this point. Likely because of the need for augmented immunosuppression, patients with refractory acute allograft rejection or with chronic allograft rejection appear to be at increased risk for the late development of PCP and continuation or resumption of PCP prophylaxis may be warranted under these circumstances.35 Indefinite prophylaxis is advocated for lung transplant recipients.
Salmonids (Salmonidae)
Published in John A Plumb, Health Maintenance Of Cultured Fishes, 1994
Chemotherapy and chemoprophylaxis have been practiced with limited success in managing BKD- infected populations. Erythromycin has been most widely used as an oral treatment at 4.5 g/45 kg (about 100 mg/kg) of body weight daily for 10 to 21 d.274 Moffitt278 found that erythromycin fed at 200 mg/kg of body weight daily for 21 d reduced mortality more than lower dosages for a shorter duration, but palatability of the medicated feed was a problem. Overall, chemotherapy of clinically infected BKD fish does not appear to be overly successful because drugs do not eliminate R. salmoninarum from all treated fish; therefore, relapses can be expected following application.279
Occupational CNS aspergillosis in an immunocompetent individual a diagnostic challange
Published in Archives of Environmental & Occupational Health, 2018
Parul Punia, Nidhi Goel, Ishwar Singh, Uma Chaudhary
Nosocomial outbreaks of aspergillosis esp. in immunocompromised patients during construction, demolition or renovation in or around hospital premises are well documented in literature.2 These activities of construction lead to dispersion of the already settled spores of Aspergillus spp. The immunocompromised patients are prone to developing pulmonary aspergillosis by inhalation of these aerosolized spores, which may further proceed to invasive disease.6 This patient who had been working as a laborer at a construction site also seems to be a victim of aspergillus infection due to the inhalation of spores released at the construction sites. In view of this, preventive measures like proper ventilation measures, infection control practices and chemoprophylaxis must be implemented to protect at risk patients.7