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Yeast Vaginitis
Definition:
Vaginitis is an inflammation of the vagina characterized by discharge, odor, irritation, and/or itching. Vaginitis is often caused by infections. The yeast Candida albicans is one of the most common culprits.
Other common causes of vaginal infections are bacterial vaginosis and trichomoniasis (where the culprit is a protozoan parazite called Trichomonas ). While most cases of yeast vaginitis are not transmitted sexually, vaginal infections caused by trichomonas and many other bacteria are transmitted through sexual contact. The yeast Candida albicans lives in our environment. It can be found in our skin. The yeast tends to prefer a moist and warm environment, hence it is frequently present in the surface of the vagina as part of the normal flora without causing trouble. However, when there are changes in the living environment, the yeast may become more active than usual and start causing symptoms.
Who is at risk?
Yeasts are always present in small numbers in the vagina of women, and symptoms only appear with overgrowth. Approximately 75 percent of all women will experience at least one symptomatic yeast infection during their lifetimes. Very often this is a recurrent problem.
Yeast vaginitis can become symptomatic in pregnant women or happen with the use of oral contraceptives. Yeast vaginitis is also common in women with diabetes mellitus, and when women receive antibiotics for whatever causes. Recurrent episodes may indicate underlying immunodeficiency, and can be the first symptom of AIDS.
Other factors that may increase the incidence of yeast infection include using douches, perfumed feminine hygiene sprays, topical antimicrobial agents, and wearing tight, poorly ventilated clothing and underwear.
Symptoms:
Itching, burning, and irritation of the vagina are the most frequent symptoms of yeast vaginitis. Other symptoms are painful urination and/or intercourse.
Vaginal discharge is typically thick and whitish-gray. However vaginal discharge is not always present, and sometimes can appear watery or vary in consistency. The male partners may have a transient rash and burning sensation of the penis, but do not have any symptoms, though the yeast is present in their genitalia.
Treatment:
Yeast vaginitis usually responds to a topical antifungal in the form of vaginal creams or pessaries. There are many preparations available. Women may need to be treated for extended periods of time to complete the course of treatment.
When topical treatment fails, a number of oral medications can be effective, but make sure you have consulted with your doctor for a prescription.
Because yeast vaginitis can be difficult to distinguish from other bacterial causes of vaginitis on the basis of symptoms alone, a woman with vaginal symptoms should see her physician for an accurate diagnosis. Over-the-counter products may contain antihistamines (a class of drug commonly used in cough and cold preparations and for relieve of itchy symptoms) or topical anaesthetics that only mask the symptoms and do not treat the underlying disease. Some may contain irritants that can aggravate the problem.
Prevention:
The use of vaginal douches, perfumed feminine hygiene sprays, and topical antimicrobial agents are associated with yeast vaginitis. Avoid using these without medical supervision. Wearing tight, poorly ventilated clothing and underwear.
Do not use antibiotics unless absolutely necessary since these can affect the balance of microorganisms living in the vagina normally and give a chance for yeast overgrowth to occur. If you are diabetic, make sure your blood sugar level is in good control.
Although experts agree that yeast vaginitis is not a sexually transmitted disease, the use of male condoms would decrease the risk of acquiring other causes of vaginitis and sexually transmitted diseases.
Yellow Fever
Definition:
Yellow fever is a tropical disease that is spread to humans by infected mosquitoes. It causes large epidemics in Africa and the Americas. The word "yellow" refers to the jaundice that affects some patients. The disease is caused by the yellow fever virus, which belongs to the flavivirus group.
The virus infects humans and monkeys and is carried from one animal to another by a biting mosquito (the vector). The mosquito can also pass the virus via infected eggs to its offspring (vertical transmission). The mosquito population forms a reservoir for the virus, ensuring transmission from one year to the next.
There are two kinds of yellow fever, spread by two different cycles of infection.
Jungle yellow fever is mainly a disease of monkeys. It is spread from infected mosquitoes to monkeys in the tropical rain forest. People get jungle yellow fever when they put themselves in the middle of this natural cycle and are bitten by mosquitoes that have been infected by monkeys. Jungle yellow fever is rare and occurs mainly in persons who work in tropical rain forests.
Urban yellow fever is a disease of humans. It is spread by mosquitoes that have been infected by other people. Aedes aegypti is the type of mosquito that usually carries yellow fever from human to human. These mosquitoes have adapted to living among humans in cities, towns, and villages. Urban yellow fever is the cause of most yellow fever outbreaks and epidemics.
People get yellow fever from the bite of an infected female mosquito. The mosquito injects the yellow fever virus via the bite. Symptoms start 3 to 6 days after being bitten by an infected mosquito.
Who is at risk?
People traveling to countries where yellow fever occurs are at risk. These include thirty-three countries in Africa 15oN to 10oS of the equator. Yellow fever is also endemic in 9 South American countries and in several Caribbean islands. Bolivia, Brazil, Colombia, Ecuador and Peru are considered at greatest risk.
Although an effective vaccine has been available for 60 years, the number of people infected over the last two decades has increased and yellow fever is now a serious public health issue again. It is important that you should take special precaution when traveling to these countries.
Symptoms:
The virus remains silent in the body during an incubation period of three to six days. During the acute phase, the patient develops high fever, chills, muscle pain (with prominent backache), headache, shivers, loss of appetite, nausea and/or vomiting. Often, the high fever is paradoxically associated with a slow pulse. After three to four days most patients improve and their symptoms disappear.
In about 15% of the patients, a toxic phase follows within 24 hours after the acute phase. Fever reappears. The patient rapidly develops jaundice and complains of abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes and/or stomach. Blood can appear in the vomit and faeces. Kidney function deteriorates, which can end in complete kidney failure. Half of patients in the "toxic phase" die within 10-14 days. The remainders recover without significant organ damage.
Although yellow fever can be diagnosed by a blood test, diagnosis can be missed, especially during the early stages as the clinical picture can easily be confused with other tropical diseases.
Treatment:
There is no specific treatment for yellow fever. Dehydration and fever can be corrected with oral rehydration salts and paracetamol. Any superimposed bacterial infection should be treated with an appropriate antibiotic. Intensive supportive care may improve the outcome for seriously ill patients, but is rarely available in poorer, developing countries. Patients should be kept away from mosquitoes for the protection of others.
Prevention:
Yellow fever can be prevented by vaccination. Yellow fever vaccine is safe and highly effective. The protective effect (immunity) occurs within one week in 95% of people vaccinated. A single dose of vaccine provides protection for 10 years and probably for life. Travelers should get vaccinated for yellow fever before visiting areas where yellow fever is found. Fatal cases in unvaccinated tourists have been reported.
International regulations require proof of yellow fever vaccination for travel to and from certain countries. People who get vaccinated should be given an International Certificate of Vaccination. The vaccine is not recommended in children less than six months old, and should only be given to pregnant women in the midst of an epidemic.
Travelers should also take precautions against mosquito bites when traveling to tropical countries. Mosquitoes that spread yellow fever usually bite during the day. Travelers should take steps to reduce contact with mosquitoes when staying outdoors or indoors. When staying outdoors, wear long-sleeved clothing and long pants. For extra protection, treat clothing with the insecticide permethrin. Use insect repellent on exposed skin. The most effective repellents contain 20% to 35% DEET (N,N-diethylmethyltoluamide).
When staying indoors, remain in well-screened areas as much as possible. Spray living and sleeping areas with insecticide. Use a bednet when sleeping in a room that is not screened or air-conditioned. For extra protection, treat the bednet with the insecticide permethrin.
