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Tetanus
http://www.mayoclinic.org/diseases-conditions/tetanus/basics/definition/con-20021956
Definition
By Mayo Clinic Staff
Tetanus is a serious bacterial disease that affects your nervous system, leading to painful muscle contractions,
particularly of your jaw and neck muscles. Tetanus can interfere with your ability to breathe and, ultimately,
threaten your life. Tetanus is commonly known as "lockjaw."
Thanks to the tetanus vaccine, cases of tetanus are rare in the United States and the developed world. The
incidence of tetanus is much higher in less developed countries. Around a million cases occur worldwide each year.
There's no cure for tetanus. Treatment focuses on managing complications until the effects of the tetanus toxin
resolve. Fatality is highest in individuals who haven't been immunized and in older adults with inadequate
immunization.
Symptoms
By Mayo Clinic Staff
Signs and symptoms of tetanus may appear anytime from a few days to several weeks after tetanus bacteria enter
your body through a wound. The average incubation period is seven to eight days.
Common signs and symptoms of tetanus, in order of appearance, are:

Spasms and stiffness in your jaw muscles

Stiffness of your neck muscles

Difficulty swallowing

Stiffness of your abdominal muscles

Painful body spasms lasting for several minutes, typically triggered by minor occurrences, such as a draft, loud
noise, physical touch or light
Other signs and symptoms may include:

Fever

Sweating

Elevated blood pressure

Rapid heart rate
Causes
By Mayo Clinic Staff
The bacteria that cause tetanus, Clostridium tetani, are found in soil, dust and animal feces. When they enter a deep
flesh wound, spores of the bacteria may produce a powerful toxin, tetanospasmin, which actively impairs your
motor neurons, nerves that control your muscles. The effect of the toxin on your motor neurons can cause muscle
stiffness and spasms — the major signs of tetanus.
Risk factors
By Mayo Clinic Staff
In addition, certain factors are necessary for tetanus bacteria to proliferate in your body. These include:

Lack of immunization or inadequate immunization — failure to receive timely booster shots — against tetanus

A penetrating injury that results in tetanus spores being introduced to the wound site

The presence of other infective bacteria

Injured tissue

A foreign body, such as a nail or splinter

Swelling around the injury
Tetanus cases have developed from the following types of injuries:

Puncture wounds — including from splinters, body piercings, tattoos, injection drugs

Gunshot wounds

Compound fractures

Crush injuries

Burns

Surgical wounds

Injection drug use

Ear infections

Animal bites

Infected foot ulcers

Infected umbilical stumps in newborns born of inadequately immunized mothers
Complications
By Mayo Clinic Staff
Once tetanus toxin has bonded to your nerve endings it is impossible to remove. Complete recovery from a tetanus
infection requires the growth of new nerve endings and can take up to several months.
Complications of tetanus infection may include:

Broken bones. The severity of spasms may cause the spine and other bones to break.

Disability. Treatment for tetanus typically involves the use of powerful sedatives to control muscle spasms.
Prolonged immobility due to the use of these drugs can lead to permanent disability. In infants, tetanus
infections may cause lasting brain damage, ranging from minor mental deficits to cerebral palsy.

Death. Severe tetanus-induced (tetanic) muscle spasms can interfere with your breathing, causing periods in
which you can't breathe at all. Respiratory failure is the most common cause of death. Lack of oxygen may also
induce cardiac arrest and death. Pneumonia is another cause of death.
Typhoid
http://www.mayoclinic.org/diseases-conditions/typhoid-fever/basics/definition/con-20028553
Definition
By Mayo Clinic Staff
Typhoid fever is caused by Salmonella typhi bacteria. Typhoid fever is rare in industrialized countries. However, it
remains a serious health threat in the developing world, especially for children.
Typhoid fever spreads through contaminated food and water or through close contact with someone who's
infected. Signs and symptoms usually include high fever, headache, abdominal pain, and either constipation or
diarrhea.
When treated with antibiotics, most people with typhoid fever feel better within a few days, although a small
percentage of them may die of complications.
Vaccines against typhoid fever are available, but they're only partially effective. Vaccines usually are reserved for
those who may be exposed to the disease or are traveling to areas where typhoid fever is common.
Symptoms
By Mayo Clinic Staff
Although children with typhoid fever sometimes become sick suddenly, signs and symptoms are more likely to
develop gradually — often appearing one to three weeks after exposure to the disease.
1st week of illness
Once signs and symptoms do appear, you're likely to experience:

Fever, that starts low and increases daily, often to as high as 103 or 104 F (39.4 or 40 C)

Headache

Weakness and fatigue

Dry cough

Loss of appetite

Abdominal pain

Diarrhea or constipation

Rash
2nd week of illness
If you don't receive treatment for typhoid fever, you may enter a second stage during which you become very ill
and experience:

Continuing high fever

Either diarrhea or severe constipation

Considerable weight loss

Extremely distended abdomen
3rd week of illness
By the third week, you may:

Become delirious

Lie motionless and exhausted with your eyes half-closed in what's known as the typhoid state
Life-threatening complications often develop at this time.
4th week of illness
Improvement may come slowly during the fourth week. Your fever is likely to decrease gradually until your
temperature returns to normal in another week to 10 days. But signs and symptoms can return up to two weeks
after your fever has subsided.
Causes
By Mayo Clinic Staff
Typhoid fever is caused by a virulent bacterium called Salmonella typhi. Although they're related, S. typhi and the
bacterium responsible for salmonellosis, another serious intestinal infection, aren't the same.
Fecal-oral transmission route
The bacteria that cause typhoid fever spread through contaminated food or water and occasionally through direct
contact with someone who is infected. In developing nations, where typhoid is endemic, most cases result from
contaminated drinking water and poor sanitation. The majority of people in industrialized countries pick up the
typhoid bacteria while traveling and spread it to others through the fecal-oral route.
This means that S. typhi is passed in the feces and sometimes in the urine of infected people. You can contract the
infection if you eat food handled by someone with typhoid fever who hasn't washed carefully after using the toilet.
You can also become infected by drinking water contaminated with the bacteria.
Typhoid carriers
Even after treatment with antibiotics, a small number of people who recover from typhoid fever continue to harbor
the bacteria in their intestinal tracts or gallbladders, often for years. These people, called chronic carriers, shed the
bacteria in their feces and are capable of infecting others, although they no longer have signs or symptoms of the
disease themselves.
Risk factors
By Mayo Clinic Staff
Typhoid fever remains a serious worldwide threat — especially in the developing world — affecting an estimated
22 million people each year, according to the Centers for Disease Control and Prevention. The disease is endemic in
India, Southeast Asia, Africa, South America and many other areas.
Worldwide, children are at greatest risk of getting the disease, although they generally have milder symptoms than
adults do.
If you live in a country where typhoid fever is rare, you're at increased risk if you:

Work in or travel to areas where typhoid fever is endemic

Work as a clinical microbiologist handling Salmonella typhi bacteria

Have close contact with someone who is infected or has recently been infected with typhoid fever

Have an immune system weakened by medications such as corticosteroids or diseases such as HIV/AIDS

Drink water contaminated by sewage that contains S. typhi
Complications
By Mayo Clinic Staff
Intestinal bleeding or holes
The most serious complication of typhoid fever — intestinal bleeding or holes (perforations) — may develop in the
third week of illness. About 5 percent of people with typhoid fever experience this complication.
Intestinal bleeding is often marked by a sudden drop in blood pressure and shock, followed by the appearance of
blood in your stool.
A perforated intestine occurs when your small intestine or large bowel develops a hole, causing intestinal contents
to leak into your abdominal cavity and triggering signs and symptoms such as severe abdominal pain, nausea,
vomiting and bloodstream infection (sepsis). This life-threatening emergency requires immediate medical care.
Other, less common complications
Other possible complications include:

Inflammation of the heart muscle (myocarditis)

Inflammation of the lining of the heart and valves (endocarditis)

Pneumonia

Inflammation of the pancreas (pancreatitis)

Inflammation of the gallbladder (cholecystitis)

Kidney or bladder infections

Infection and inflammation of the membranes and fluid surrounding your brain and spinal cord (meningitis)

Psychiatric problems such as delirium, hallucinations and paranoid psychosis
With prompt treatment, nearly all people in industrialized nations recover from typhoid. Without treatment, some
people may not survive complications of the disease.
Tuberculosis
http://www.mayoclinic.org/diseases-conditions/tuberculosis/basics/definition/con-20021761
Definition
By Mayo Clinic Staff
Tuberculosis (TB) is a potentially serious infectious disease that mainly affects your lungs. The bacteria that cause
tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and
sneezes.
Once rare in developed countries, tuberculosis infections began increasing in 1985, partly because of the
emergence of HIV, the virus that causes AIDS. HIV weakens a person's immune system so it can't fight the TB
germs. In the United States, because of stronger control programs, tuberculosis began to decrease again in 1993,
but remains a concern.
Many strains of tuberculosis resist the drugs most used to treat the disease. People with active tuberculosis must
take several types of medications for many months to eradicate the infection and prevent development of
antibiotic resistance.
Symptoms
By Mayo Clinic Staff
Although your body may harbor the bacteria that cause tuberculosis, your immune system usually can prevent you
from becoming sick. For this reason, doctors make a distinction between:

Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state
and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious. It can turn into
active TB, so treatment is important for the person with latent TB and to help control the spread of TB in
general. An estimated 2 billion people have latent TB.

Active TB. This condition makes you sick and can spread to others. It can occur in the first few weeks after
infection with the TB bacteria, or it might occur years later.
Signs and symptoms of active TB include:

Coughing that lasts three or more weeks

Coughing up blood

Chest pain, or pain with breathing or coughing

Unintentional weight loss

Fatigue

Fever

Night sweats

Chills

Loss of appetite
Tuberculosis can also affect other parts of your body, including your kidneys, spine or brain. When TB occurs
outside your lungs, signs and symptoms vary according to the organs involved. For example, tuberculosis of the
spine may give you back pain, and tuberculosis in your kidneys might cause blood in your urine.
Causes
By Mayo Clinic Staff
Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into
the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes,
spits, laughs or sings.
Although tuberculosis is contagious, it's not easy to catch. You're much more likely to get tuberculosis from
someone you live with or work with than from a stranger. Most people with active TB who've had appropriate drug
treatment for at least two weeks are no longer contagious.
HIV and TB
Since the 1980s, the number of cases of tuberculosis has increased dramatically because of the spread of HIV, the
virus that causes AIDS. Infection with HIV suppresses the immune system, making it difficult for the body to
control TB bacteria. As a result, people with HIV are many times more likely to get TB and to progress from latent
to active disease than are people who aren't HIV positive.
Drug-resistant TB
Another reason tuberculosis remains a major killer is the increase in drug-resistant strains of the bacterium. Since
the first antibiotics were used to fight tuberculosis 60 years ago, some TB germs have developed the ability to
survive, and that ability gets passed on to their descendants.
Drug-resistant strains of tuberculosis emerge when an antibiotic fails to kill all of the bacteria it targets. The
surviving bacteria become resistant to that particular drug and frequently other antibiotics as well. Some TB
bacteria have developed resistance to the most commonly used treatments, such as isoniazid and rifampin.
Some strains of TB have also developed resistance to drugs less commonly used in TB treatment, such as the
antibiotics known as fluoroquinolones, and injectable medications including amikacin, kanamycin and
capreomycin. These medications are often used to treat infections that are resistant to the more commonly used
drugs.
Risk factors
By Mayo Clinic Staff
Anyone can get tuberculosis, but certain factors can increase your risk of the disease. These factors include:
Weakened immune system
A healthy immune system often successfully fights TB bacteria, but your body can't mount an effective defense if
your resistance is low. A number of diseases and medications can weaken your immune system, including:

HIV/AIDS

Diabetes

End-stage kidney disease

Certain cancers

Cancer treatment, such as chemotherapy

Drugs to prevent rejection of transplanted organs

Some drugs used to treat rheumatoid arthritis, Crohn's disease and psoriasis

Malnutrition

Very young or advanced age
Traveling or living in certain areas
The risk of contracting tuberculosis is higher for people who live in or travel to countries that have high rates of
tuberculosis and drug-resistant tuberculosis, such as:

Sub-Saharan Africa

India

China

Russia

Pakistan
Poverty and substance abuse

Lack of medical care. If you receive a low or fixed income, live in a remote area, have recently immigrated to
the United States, or are homeless, you may lack access to the medical care needed to diagnose and treat TB.

Substance abuse. IV drug use or alcohol abuse weakens your immune system and makes you more vulnerable
to tuberculosis.

Tobacco use. Using tobacco greatly increases the risk of getting TB and dying of it.
Where you work or live

Health care work. Regular contact with people who are ill increases your chances of exposure to TB bacteria.
Wearing a mask and frequent hand-washing greatly reduce your risk.

Living or working in a residential care facility. People who live or work in prisons, immigration centers or
nursing homes are all at a higher risk of tuberculosis. That's because the risk of the disease is higher anywhere
there is overcrowding and poor ventilation.

Living in a refugee camp or shelter. Weakened by poor nutrition and ill health and living in crowded,
unsanitary conditions, refugees are at especially high risk of tuberculosis infection.
Complications
By Mayo Clinic Staff
Without treatment, tuberculosis can be fatal. Untreated active disease typically affects your lungs, but it can spread
to other parts of the body through your bloodstream. Examples of tuberculosis complications include:

Spinal pain. Back pain and stiffness are common complications of tuberculosis.

Joint damage. Tuberculous arthritis usually affects the hips and knees.

Swelling of the membranes that cover your brain (meningitis). This can cause a lasting or intermittent
headache that occurs for weeks. Mental changes also are possible.

Liver or kidney problems. Your liver and kidneys help filter waste and impurities from your bloodstream.
These functions become impaired if the liver or kidneys are affected by tuberculosis.

Heart disorders. Rarely, tuberculosis can infect the tissues that surround your heart, causing inflammation
and fluid collections that may interfere with your heart's ability to pump effectively. This condition, called
cardiac tamponade, can be fatal.
Polio
http://www.mayoclinic.org/diseases-conditions/polio/basics/definition/con-20030957
Definition
By Mayo Clinic Staff
Polio is a contagious viral illness that in its most severe form causes paralysis, difficulty breathing and sometimes
death.
In the U.S., the last case of naturally occurring polio happened in 1979. Today, despite a concerted global
eradication campaign, poliovirus continues to affect children and adults in Afghanistan, Pakistan and some African
countries.
The Centers for Disease Control and Prevention (CDC) advises taking precautions to protect against polio if you're
traveling anywhere there's a risk of polio.
If you're a previously vaccinated adult who plans to travel to an area where polio is occurring, you should receive a
booster dose of inactivated poliovirus vaccine (IPV). Immunity after a booster dose lasts a lifetime.
Symptoms
By Mayo Clinic Staff
Although polio can cause paralysis and death, the vast majority of people who are infected with the poliovirus
don't become sick and are never aware they've been infected with polio.
Nonparalytic polio
Some people who develop symptoms from the poliovirus contract nonparalytic polio — a type of polio that doesn't
lead to paralysis (abortive polio). This usually causes the same mild, flu-like signs and symptoms typical of other
viral illnesses.
Signs and symptoms, which generally last one to 10 days, include:

Fever

Sore throat

Headache

Vomiting

Fatigue

Back pain or stiffness

Neck pain or stiffness

Pain or stiffness in the arms or legs

Muscle weakness or tenderness

Meningitis
Paralytic polio
In rare cases, poliovirus infection leads to paralytic polio, the most serious form of the disease. Paralytic polio has
several types, based on the part of your body that's affected — your spinal cord (spinal polio), your brainstem
(bulbar polio) or both (bulbospinal polio).
Initial signs and symptoms of paralytic polio, such as fever and headache, often mimic those of nonparalytic polio.
Within a week, however, signs and symptoms specific to paralytic polio appear, including:

Loss of reflexes

Severe muscle aches or weakness

Loose and floppy limbs (flaccid paralysis), often worse on one side of the body
Post-polio syndrome
Post-polio syndrome is a cluster of disabling signs and symptoms that affect some people several years — an
average of 35 years — after they had polio. Common signs and symptoms include:

Progressive muscle or joint weakness and pain

General fatigue and exhaustion after minimal activity

Muscle atrophy

Breathing or swallowing problems

Sleep-related breathing disorders, such as sleep apnea

Decreased tolerance of cold temperatures

Cognitive problems, such as concentration and memory difficulties

Depression or mood swings
Causes
By Mayo Clinic Staff
The poliovirus resides only in humans and enters the environment in the feces of someone who's infected.
Poliovirus spreads primarily through the fecal-oral route, especially in areas where sanitation is inadequate.
Poliovirus can be transmitted through contaminated water and food or through direct contact with someone
infected with the virus. Polio is so contagious that anyone living with a recently infected person is likely to become
infected, too. People carrying the poliovirus can spread the virus for weeks in their feces.
Risk factors
By Mayo Clinic Staff
You're at greatest risk of polio if you haven't been immunized against the disease. In areas with poor sanitation and
sporadic or nonexistent immunization programs, the most vulnerable members of the population — pregnant
women, the very young and those with weakened immune systems — are especially susceptible to experience
paralysis if they are infected with poliovirus.
These factors also increase your risk if you haven't been vaccinated:

Travel to an area where polio is common or that has recently experienced an outbreak

Living with or caring for someone who may be shedding poliovirus

A compromised immune system, such as occurs with HIV infection

Having had your tonsils removed (tonsillectomy)

Extreme stress or strenuous physical activity after being exposed to poliovirus, both of which can depress your
immune system
Complications
By Mayo Clinic Staff
Paralytic polio can lead to temporary or permanent muscle paralysis, disability, and deformities of the hips, ankles
and feet. Although many deformities can be corrected with surgery and physical therapy, these treatments may not
be options in developing nations where polio is still common. As a result, children who survive polio may spend
their lives with severe disabilities.
Mononucleosis
Definition
By Mayo Clinic Staff
Infectious mononucleosis (mono) is often called the kissing disease. The virus that causes mono is transmitted
through saliva, so you can get it through kissing, but you can also be exposed through a cough or sneeze, or by
sharing a glass or food utensils with someone who has mono. However, mononucleosis isn't as contagious as some
infections, such as the common cold.
You're most likely to get mononucleosis with all the signs and symptoms if you're an adolescent or young adult.
Young children usually have few symptoms, and the infection often goes unrecognized.
If you have mononucleosis, it's important to be careful of certain complications such as an enlarged spleen. Rest
and adequate fluids are key to recovery.
Symptoms
By Mayo Clinic Staff
Signs and symptoms of mononucleosis may include:

Fatigue

General feeling of unwellness (malaise)

Sore throat, perhaps a strep throat that doesn't get better with antibiotic use

Fever

Swollen lymph nodes in your neck and armpits

Swollen tonsils

Headache

Skin rash

Soft, swollen spleen
The virus has an incubation period of approximately four to six weeks, although in young children this period may
be shorter. Signs and symptoms such as fever and sore throat usually lessen within a couple of weeks, although
fatigue, enlarged lymph nodes and a swollen spleen may last for a few weeks longer.
Causes
By Mayo Clinic Staff
The cause of mononucleosis is the Epstein-Barr virus.
Mononucleosis usually isn't very serious. Most adults have been exposed to the Epstein-Barr virus and have built
up antibodies. They're immune and won't get mononucleosis again.
Complications
By Mayo Clinic Staff
Complications of mononucleosis may be more serious than the disease itself.
Enlargement of the spleen
Mononucleosis may cause enlargement of the spleen. In extreme cases, your spleen may rupture, causing sharp,
sudden pain in the left side of your upper abdomen. If such pain occurs, seek medical attention immediately — you
may need surgery.
Liver issues
Problems with your liver also may occur:

Hepatitis. You may experience mild liver inflammation (hepatitis).

Jaundice. A yellowing of your skin and the whites of your eyes (jaundice) also occurs occasionally.
Less common complications
Mononucleosis can also result in the following less common complications:

Anemia — a decrease in red blood cells and in hemoglobin, an iron-rich protein in red blood cells

Thrombocytopenia — low count of platelets, which are blood cells involved in clotting

Heart problems — an inflammation of the heart muscle (myocarditis)

Complications involving the nervous system — meningitis, encephalitis and Guillain-Barre syndrome

Swollen tonsils — which can block breathing
The Epstein-Barr virus can cause much more serious illness in people who have impaired immune systems, such as
people with HIV/AIDS or people taking drugs to suppress immunity after an organ transplant.
Rabies
http://www.mayoclinic.org/diseases-conditions/rabies/basics/definition/con-20019900
Definition
By Mayo Clinic Staff
Rabies is a deadly virus spread to people from the saliva of infected animals. The rabies virus is usually transmitted
through a bite.
Animals most likely to transmit rabies in the United States include bats, coyotes, foxes, raccoons and skunks. In
developing countries of Africa and Southeast Asia, stray dogs are the most likely to spread rabies to people.
Once a person begins showing signs and symptoms of rabies, the disease is nearly always fatal. For this reason,
anyone who may have a risk of contracting rabies should receive rabies vaccines for protection.
Symptoms
By Mayo Clinic Staff
The first symptoms of rabies may be very similar to the flu and may last for days. Signs and symptoms may include:

Fever

Headache

Nausea

Vomiting

Agitation

Anxiety

Confusion

Hyperactivity

Difficulty swallowing

Excessive salivation

Fear of water (hydrophobia) because of the difficulty in swallowing

Hallucinations

Insomnia

Partial paralysis
When to see a doctor
Seek immediate medical care if you're bitten by any animal. Based on your injuries and the situation in which the
bite occurred, you and your doctor can decide whether you should receive treatment to prevent rabies.
Even if you aren't sure whether you've been bitten, seek medical attention. For instance, a bat that flies into your
room while you're sleeping may bite you without waking you. If you awake to find a bat in your room, assume
you've been bitten. Also, if you find a bat near a person who can't report a bite, such as a small child or a person
with a disability, assume that person has been bitten.
Causes
By Mayo Clinic Staff
Rabies infection is caused by the rabies virus. The virus is spread through the saliva of infected animals. Infected
animals can spread the virus by biting another animal or a person. In rare cases, rabies can be spread when
infected saliva gets into an open wound or the mucous membranes, such as the mouth or eyes. This could occur if
an infected animal were to lick an open cut on your skin.
Animals that can transmit the rabies virus
Any mammal (an animal that suckles its young) can transmit the rabies virus. The animals most likely to transmit
the rabies virus to people include:
Pets and farm animals

Cats

Cows

Dogs

Ferrets

Goats

Horses
Wild animals

Bats

Beavers

Coyotes

Foxes

Monkeys

Raccoons

Skunks

Woodchucks
In rare cases, the virus has been transmitted to tissue and organ transplant recipients from an infected organ.
Risk factors
By Mayo Clinic Staff
Factors that can increase your risk of rabies include:

Traveling or living in developing countries where rabies is more common, including countries in Africa and
Southeast Asia

Activities that are likely to put you in contact with wild animals that may have rabies, such as exploring caves
where bats live or camping without taking precautions to keep wild animals away from your campsite

Working in a laboratory with the rabies virus

Wounds to the head, neck or hands, which may help the rabies virus travel to your brain more quickly