What is CMV (Cytomegalovirus) ?

Cytomegalovirus (pronounced sy-toe-MEG-a-low-vy-rus), or CMV, is a common virus that infects people of all ages. In the United States, nearly one in three children are already infected with CMV by age 5 years. Over half of adults by age 40 have been infected with CMV. Once CMV is in a person’s body, it stays there for life and can reactivate. A person can also be reinfected with a different strain (variety) of the virus.

Most people infected with CMV show no signs or symptoms. That’s because a healthy person’s immune system usually keeps the virus from causing illness. However, CMV infection can cause serious health problems for people with weakened immune systems, as well as babies infected with the virus before they are born congenital.

Signs & Symptoms

Most people with CMV infection have no symptoms and aren’t aware that they have been infected. In some cases, infection in healthy people can cause mild illness that may include

  • Fever,
  • Sore throat,
  • Fatigue, and
  • Swollen glands.

People with weakened immune systems who get CMV can have more serious symptoms affecting the eyes, lungs, liver, esophagus, stomach, and intestines. Babies born with CMV can have brain, liver, spleen, lung, and growth problems. Hearing loss is the most common health problem in babies born with congenital CMV infection, which may be detected soon after birth or may develop later in childhood.

Transmission and Prevention

People with CMV may shed (pass) the virus in body fluids, such as urine, saliva, blood, tears, semen, and breast milk. CMV is spread from an infected person in the following ways:

  • From direct contact with urine or saliva, especially from babies and young children
  • Through sexual contact
  • From breast milk
  • Through transplanted organs and blood transfusions

A woman who is infected with CMV can pass the virus to her developing baby during pregnancy. Women may be able to lessen their risk of getting CMV by reducing contact with saliva and urine from babies and young children. Some ways do this are: kissing children on the cheek or head rather than the lips, and washing hands after changing diapers. These cannot eliminate your risk of getting CMV, but may lessen your chances of getting it.

 

Is it Celiac Disease or Wheat Sensitivity?

 

Do You Have Celiac Disease?

Adults are less likely to have digestive symptoms, with only one-third experiencing diarrhea.  Adults are more likely to have:

unexplained iron-deficiency anemia

  • fatigue
  • bone or joint pain
  • arthritis
  • osteoporosis or osteopenia (bone loss)
  • liver and biliary tract disorders (transaminitis, fatty liver, primary sclerosing cholangitis, etc.)
  • depression or anxiety
  • peripheral neuropathy ( tingling, numbness or pain in the hands and feet)
  • seizures or migraines
  • missed menstrual periods
  • infertility or recurrent miscarriage
  • canker sores inside the mouth
  • dermatitis herpetiformis (itchy skin rash)

 

Classical, Non-Classical and Silent Celiac Disease

According to the World Gastroenterology Organization, celiac disease may be divided into two types: classical and non-classical.

In classical celiac disease, patients have signs and symptoms of malabsorption, including diarrhea, steatorrhea (pale, foul-smelling, fatty stools), and weight loss or growth failure in children.

In non-classical celiac disease, patients may have mild gastrointestinal symptoms without clear signs of malabsorption or may have seemingly unrelated symptoms. They may suffer from abdominal distension and pain, and/or other symptoms such as: iron-deficiency anemia, chronic fatigue, chronic migraine, peripheral neuropathy (tingling, numbness or pain in hands or feet), unexplained chronic hypertransaminasemia (elevated liver enzymes), reduced bone mass and bone fractures, and vitamin deficiency (folic acid and B12), late menarche/early menopause and unexplained infertility, dental enamel defects, depression and anxiety, dermatitis herpetiformis (itchy skin rash), etc.

Silent celiac disease is also known as asymptomatic celiac disease. Patients do not complain of any symptoms, but still experience villous atrophy damage to their small intestine. Studies show that even though patients thought they had no symptoms, after going on a strict gluten-free diet they report better health and a reduction in acid relux, abdominal bloating and distention and flatulence. First-degree relatives (parents, siblings, children) , whether or not experiencing symptoms, should always be screened, since there is a 1 in 10 risk of developing celiac disease.

The number of ways celiac disease can affect patients, combined with a lack of training in medical schools and primary care residency programs, contributes to the poor diagnosis rate in the United States. Currently it is estimated that 80% of the celiac disease population remains undiagnosed.

Non-Celiac Wheat Sensitivity

Some people experience symptoms found in celiac disease, such as “foggy mind”, depression, ADHD-like behavior, abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain, and chronic fatigue when they have gluten in their diet, yet do not test positive for celiac disease. The terms non-celiac gluten sensitivity (NCGS) and non-celiac wheat sensitivity (NCWS) are generally used to refer to this condition, when removing gluten from the diet resolves symptoms.

wheat-field_1088-323

 

Is it Crohn’s or UC/Ulcerative Colitis?

Crohn’s disease vs. ulcerative colitis

Both Crohn’s disease and ulcerative colitis (UC) are inflammatory bowel diseases (IBDs), but there are some key differences.

Crohn’s disease

  • Inflammation may develop anywhere in the GI tract from the mouth to the anus
  • Most commonly occurs at the end of the small intestine
  • May appear in patches
  • May extend through entire thickness of bowel wall
  • About 67% of people in remission will have at least 1 relapse over the next 5 years

Ulcerative colitis

  • Limited to the large intestine (colon and rectum)
  • Occurs in the rectum and colon, involving a part or the entire colon
  • Appears in a continuous pattern
  • Inflammation occurs in innermost lining of the intestine
  • About 30% of people in remission will experience a relapse in the next year

What is Lupus?

Lupus is a chronic autoimmune disease that can damage any part of the body (skinjoints, and/or organs). “Chronic” means that the signs and symptoms tend to last longer than six weeks and often for many years.

In lupus, something goes wrong with the immune system, which is the part of the body that fights off viruses, bacteria, and germs (“foreign invaders,” like the flu). Normally our immune systems produce proteins called “antibodies” which protect the body from these invaders.

“Autoimmunity” means your immune system cannot tell the difference between these foreign invaders and your body’s healthy tissues (“auto” means “self”). As a result, it creates autoantibodies that attack and destroy healthy tissue.

These autoantibodies cause inflammation, pain, and damage in various parts of the body.

  • Lupus is not contagious, not even through sexual contact. You cannot “catch” lupus from someone or “give” lupus to someone.
  • Lupus is not like or related to cancer. Cancer is a condition of malignant, abnormal tissues that grow rapidly and spread into surrounding tissues. Lupus is an autoimmune disease, as described above. However, some treatments for lupus may include immunosuppressant drugs that are also used in chemotherapy.
  • Lupus is not like or related to HIV (Human Immune Deficiency Virus) or AIDS (Acquired Immune Deficiency Syndrome). In HIV or AIDS the immune system is underactive; in lupus, the immune system is overactive.
  • Lupus can range from mild to life-threatening and should always be treated by a doctor. With good medical care, most people with lupus can lead a full life.
  • More than 16,000 new cases of lupus are reported annually across the country.
  • Our research estimates that at least 1.5 million Americans have lupus. The actual number may be higher; however, there have been no large-scale studies to show the actual number of people in the U.S. living with lupus.
  • It is believed that 5 million people throughout the world have a form of lupus.
  • Lupus strikes mostly women of childbearing age. However, men, children, and teenagers develop lupus, too. Most people with lupus develop the disease between the ages of 15-44.
  • Women of color are two to three times more likely to develop lupus than Caucasians.
  • People of all races and ethnic groups can develop lupus.
  • (info provided by Lupus.org)

What is Hepatitis A?

Hepatitis A is a highly contagious liver disease caused by the HAV virus. The virus is found in the feces of people with the disease and is most frequently transmitted by eating food or drinking water handled by someone who has not properly washed their hands. It also can be transmitted by sex and by illicit drug use.
Some of the most common symptoms include nausea, vomiting, fever, fatigue, loss of appetite and jaundice, or yellowing of the skin or eyes. It can take 15 to 50 days to show symptoms of the infection; however, an infected person is most contagious during the two weeks before their skin turns yellow.
Most people recover from the virus and are immune to further infection, according to the CDC, but some can develop liver failure that leads to death. That is most common in people with compromised immune systems, those older than 50 and those with other liver diseases.
According to the CDC, the hepatitis A virus is very hard to kill and can live for months outside the body. Hand sanitizers are not effective against the virus, so frequent handwashing is critical to controlling any outbreak.
Outbreaks of hepatitis A are normally small; rates have declined 95% since the vaccine became available in 1995. GlaxoSmithKline and Merck are the only companies approved by the Food and Drug Administration to sell a hepatitis A adult or pediatric vaccine in the US.
The current outbreaks of hepatitis A, virus genotype IB, is normally not found in the US; it’s more common to the Mediterranean, Turkey and South Africa. However, the current vaccine is effective against all strains of the virus.

CNN reports Michigan hard hit with Hepatitis A outbreak

(CNN)A hepatitis A outbreak has hit several states across the country, killing dozens of people and potentially sickening thousands. Michigan has been hardest-hit in terms of deaths, with 22.

The outbreak there began in August 2016 and, after a dropoff during the winter, continued to climb last year, according to the Michigan Department of Health and Human Services.
“We currently have 677 cases in Michigan and continue to see approximately 15-20 cases matching into the cluster every week,” Lynn Sutfin, spokeswoman for the Michigan Department of Health and Human Services, wrote in an email. “The Michigan outbreak now includes 15 different county jurisdictions. We believe that person-to-person transmission is the primary route of infection.”
Fighting the outbreak was challenging in some jurisdictions due to a national shortage of the vaccine for hepatitis A.
“Vaccine supply is still ‘constrained,’ ” Sutfin wrote. “We continue to prioritize vaccine to the highest risk individuals that have been identified and focus our vaccination efforts in the parts of the state who are experiencing the largest number of cases.”
Vaccine supplier Merck said the shortage of pre-filled syringes, the easiest to administer, would not ease until the second quarter of 2018. However, vials containing 10 single doses are available.
“The company is taking steps to continue to increase our capacity to meet demand globally in 2018,” Merck spokeswoman Pamela Eisele wrote in an email. “We apologize for any inconvenience this supply availability may be causing.”
The only other vaccine maker, GlaxoSmithKline, said it has adult hepatitis A vaccine in prefilled syringes in stock and is “working diligently to increase our supply.” The company is also working closely with the US Centers for Disease Control and Prevention, spokeswoman Robin Gaitens wrote in an email, to ensure that its vaccines “are directed to areas of greatest need.”

Cold, or the Flu?

Is It the Flu or a Cold?

It’s easy to confuse a common cold with seasonal flu. A cold is milder than the flu, but since the flu can make older people very sick, you should know the difference. That way you will know when to call the doctor, who might want to give you a prescription for medicines that can help you get over the flu.

People with the flu can have fever, chills, dry cough, general aches and pains, and a headache. They feel very tired. Sore throat, sneezing, stuffy nose, or stomach problems are less common. What some people call “stomach flu” is not influenza. (courtesy of NIH.gov)

 

Symptoms If It’s a Cold If It’s the Flu
Fever Rare Usual
Headache Rare Common
General aches, pains Slight Usual; often severe
Tiredness, weakness Sometimes Usual; can last 2 to 3 weeks
Extreme exhaustion Rare Usual; when first become sick
Stuffy nose Common Sometimes
Sneezing Usual Sometimes
Sore throat Common Sometimes
Chest discomfort, cough Mild to moderate hacking cough Common; can become severe

Flu Treatment Advice from the CDC

Antiviral Drugs

Most people with the flu have mild illness and do not need medical care or antiviral drugs. If you get sick with flu symptoms, in most cases, you should stay home and avoid contact with other people except to get medical care.

If, however, you have symptoms of flu and are in a high risk group, or are very sick or worried about your illness, contact your health care provider (doctor, physician assistant, etc.).

You might need antiviral medication to treat flu:

  • Antiviral drugs can treat flu illness
  • Antiviral drugs are different from antibiotics. They are prescription medicines (pills, liquid or an inhaled powder) and are not available over-the-counter
  • Antiviral drugs can make illness milder and shorten the time you are sick. They also can prevent serious flu complications, like pneumonia
  • It’s very important that antiviral drugs be used early to treat people who are very sick with the flu (for example, people who are in the hospital) and people who are sick with the flu and have a greater chance of getting serious flu complications, either because of their age or because they have a high risk medical condition. Other people also may be treated with antiviral drugs by their doctor this season. Most otherwise-healthy people who get the flu, however, do not need to be treated with antiviral drugs.

Studies show that flu antiviral drugs work best for treatments when they are started within 2 days of getting sick. However, starting them later can still be helpful, especially if the sick person has a high-risk health condition or is very sick from the flu (for example, hospitalized patients). Follow your doctor’s instructions for taking these drugs.

If you get sick:

1. Take Antivirals Drugs, if prescribed by a doctor

2. Take everyday precautions to protect others while sick

  • While sick, limit contact with others as much as possible to keep from infecting them.
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
  • Clean and disinfect surfaces and objects that may be contaminated with germs like the flu.

3. Stay home until you are better

  • If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. Your fever should be gone without the use of fever-reducing medicine.
  • See Other Important Information for People Who are Sick.