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Fever for 24 hours: Stay Home When You Are Sick


Stay Home When You Are Sick

Stay Home From Work When Sick!

This video list the common signs and symptoms of flu and reminds employees to stay home from work when they are sick.

What Employees Should Know

All employees should stay home if they are sick until at least 24 hours after their fever* (temperature of 100 degrees Fahrenheit or 37.8 degrees Celsius or higher) is gone. Temperature should be measured without the use of fever-reducing medicines (medicines that contains ibuprofen or acetaminophen).

Note: Not everyone with flu will have a fever. Individuals with suspected or confirmed flu, who do not have a fever, should stay home from work at least 4-5 days after the onset of symptoms. Persons with the flu are most contagious during the first 3 days of their illness.

If you become sick at work

CDC recommends that workers who have flu symptoms upon arrival to work or become ill during the day should promptly separate themselves from other workers and go home until at least 24 hours after their fever is gone without the use of fever-reducing medications, or after symptoms have improved (at least 4-5 days after flu symptoms started).

What Employers Should Know

An important way to reduce the spread of flu is to keep sick people away from those who are not sick. Businesses should review and communicate their sick leave policies and practices to employees every year before flu season begins.

  • Advise all employees to stay home if they are sick until at least 24 hours after their fever is gone without the use of fever-reducing medicines, or after symptoms have improved (at least 4-5 days after flu symptoms started).
  • Prepare and advise employees on policies concerning caring for sick household members or children. Flexible leave policies and alternate work schedules can help prevent the spread of flu at your workplace, allow employees to continue to work or function while limiting contact with others, help maintain continuity of operations, and help people manage their health and their family’s needs.
  • Prepare for employees to stay home from work and plan ways for essential business functions to continue.Employees may stay home because they are sick, need to care for sick household members, or because schools have been dismissed and they need to care for their children. Cross-train staff to perform essential functions so that the business can continue operating.

Frequently Asked Questions

Should household members of sick people stay home, too?

No, an employee who is well and lives with a sick household member may go to work. It is especially important that these employees monitor themselves for illness.

Employees with school-aged children may need to stay home to care for their children. Employers should review leave policies for the flexibility to allow employees to stay home if they need to care for their children or other household members.

Why should businesses have flexible leave policies or alternate work schedules?

An important way to reduce the spread of flu is to keep sick people away from those who are not sick. Therefore, any worker who has flu symptoms should stay home and not come to work. It is possible that employees will need to take care of sick household members or care for children if schools are dismissed or early childhood programs are closed. Flexible leave policies and alternate work schedules will help prevent the spread of flu at your workplace, allow employees to continue to work or function while limiting contact with others, help maintain continuity of operations, and help people manage their health and their family’s needs.


*Many authorities use either 100 (37.8 degrees Celsius) or 100.4 F (38.0 degrees Celsius) as a cut-off for fever, but this number actually can range depending on factors such as the method of measurement and the age of the person, so other values for fever could be appropriate. CDC has public health recommendations that are based on the presence (or absence) of fever. What is meant by this is that the person’s temperature is not elevated beyond their norm.

Four Fever Fears and How to Handle Them

It’s easy to get the care you need.

See a Premier Physician Network provider near you.

Fevers can come and go in 24 hours, or they can hang around for days on end. So how do you know when they’re minor — or when a fever means more?

First, a few basics. A fever is when your body temperature is higher than normal. It isn’t an illness. Rather, it’s a symptom of an illness. Fever is the body’s way of fighting infection. So a fever is actually doing your body a favor by fighting the bacteria or virus that is making you sick.

Normal body temperature varies from person to person, and changes based on what you eat and drink and your level of activity. For most people, a normal body temperature is right around 98.6 F (37 C).

Below are common fears parents have about fevers, and what you should know to best take care of your little ones when they’re sick.

Fever is the body’s way of fighting infection.

1. My child’s fever is really high.

Many parents focus on the number of their child’s temperature. But it’s often how long the fever has been around, plus your child’s other symptoms that help determine the cause of your child’s illness.

However, there are some important times when a high fever demands immediate attention:

  • Call your doctor or health care provider right away if:
    • Your infant younger than 3 months old has a temperature of 100.4°F (38.0°C) or higher.
    • Your child of any age repeatedly has a fever over 104°F (40°C).
  • It’s not necessary to give your child fever-reducing medication if they are otherwise comfortable. But it’s fine to give ibuprofen or acetaminophen to bring a fever down if your child feels and looks really sick. Make sure you know the right dose to give based on your child’s weight. Never give aspirin to children under age 18 due to the risk of Reye syndrome.

2. My child’s had a fever for too long.

Another common question is about the length of time fever hangs around. For doctors, that’s often a telltale sign of how serious an illness might be. Follow these guidelines:

  • Call your doctor or health care provider if:
    • Your child under age 2 has had a fever for more than two days.
    • Your child age 2 or older has had a fever more than three days.
  • Be ready to talk about any other symptoms your child has, such as cough, runny nose, sore throat, and how long those symptoms have been around. 
  • Also know the time you last took your child’s temperature, what the temperature was, and how you took it (by armpit/axillary, mouth, ear, forehead or rectum/bottom).

3. The fever means something really serious is going on with my child.

A fever may show up when your child has a virus or a bacterial illness. Often fevers come with respiratory illnesses including croup, pneumonia and ear infections. The fever goes away as the illness runs its course or, for a bacterial infection, has been treated with antibiotics.

Other times, fevers can come and go over weeks at a time. It’s important not to jump to conclusions when this happens. But it’s equally important to recognize repeat fevers in your child, as they can sometimes indicate a more serious condition, including an autoimmune disease or cancer.

If your child has fever that comes and goes, talk to your doctor about it. You’ll likely be asked to keep track of the fevers, the time of day they occur, and how long they last to help identify trends.

4. My child might get dehydrated.

It’s true that people can get dehydrated when they have a fever. This is because fever causes the body to lose fluids more quickly.

To combat dehydration:

  • Make sure your child gets plenty of fluids. For older kids, try water, sports drinks, low-sodium broths and soups, ice chips, frozen juice bars. Breast milk and formula are fine for babies.
  • Watch for signs of dehydration including dry mouth, dry skin, dry or cracked lips, severe thirst, dark yellow urine, not urinating frequently, dull or sunken eyes, crying without tears, fewer wet diapers. Call your health care provider if you notice these symptoms in your child.

When it comes to fevers, above all, rely on how well you know your child. If your child looks sick, feels sick, and you are concerned, call your doctor.

It’s easy to get the care you need.

See a Premier Physician Network provider near you.

Source: American Academy of Pediatrics; National Institutes of Health

Sick baby? When to seek medical attention

Sick baby? When to seek medical attention

When a healthy baby gets sick, don’t panic. Understand when to call the doctor and when to seek emergency care for your baby.

By Mayo Clinic Staff

When you have a baby occasional infections and fevers are inevitable. But even parents who have experience with sick babies can have trouble distinguishing normal fussiness and mild illnesses from serious problems. Here’s when to contact the doctor — and when to seek emergency care — for a sick baby.

When to contact your baby’s doctor

An occasional illness is usually nothing to worry about in an otherwise healthy baby — but sometimes it’s best to contact the doctor. Look for these signs and symptoms:

  • Changes in appetite. If your baby refuses several feedings in a row or eats poorly, contact the doctor.
  • Changes in behavior. If your baby is hard to awaken or unusually sleepy, tell the doctor right away. Let the doctor know if your baby is extremely floppy, crying more than usual or very hard to console.
  • Tender navel or penis. Contact the doctor if your baby’s umbilical area or penis suddenly becomes red or starts to ooze or bleed.
  • Fever. If your baby is younger than 3 months old, contact the doctor for any fever.

    If your baby is 3 to 6 months old and has a temperature up to 102 F (38.9 C) and seems sick or has a temperature higher than 102 F (38.9 C), contact the doctor.

    If your baby is 6 to 24 months old and has a temperature higher than 102 F (38.9 C) that lasts longer than one day but shows no other signs or symptoms, contact the doctor. If your baby also has other signs or symptoms — such as a cold, cough or diarrhea — you might contact the doctor sooner based on their severity.

    If your baby has a fever that lasts for more than 3 days, contact the doctor.

  • Diarrhea. Contact the doctor if your baby’s stools are especially loose or watery.
  • Vomiting. Occasional spitting up, the easy flow of a baby’s stomach contents through his or her mouth, is normal. Vomiting occurs when the flow is forceful — shooting out inches rather than dribbling from the mouth. Contact the doctor if your baby vomits forcefully after feedings or your baby hasn’t been able to keep liquids down for eight hours.
  • Dehydration. Contact the doctor if your baby cries with fewer tears, has significantly fewer wet diapers or has a dry mouth. Also contact the doctor if your baby’s soft spot appears sunken.
  • Constipation. If your baby has fewer bowel movements than usual for a few days and appears to be struggling or uncomfortable, contact the doctor.
  • Colds. Contact the doctor if your baby has a cold that interferes with his or her breathing, has nasal mucus that lasts longer than 10 to 14 days, has ear pain or has a cough that lasts more than one week.
  • Rash. Contact the doctor if a rash appears infected or if your baby suddenly develops an unexplained rash — especially if it’s accompanied by a fever.
  • Eye discharge. If one or both eyes are red or leaking mucus, contact the doctor.

If you think you should contact the doctor, go ahead. After hours, you might be able to use a 24-hour nurse line offered through the doctor’s office or your health insurance company.

When to seek emergency care

Seek emergency care for:

  • Bleeding that can’t be stopped
  • Poisoning
  • Seizures
  • Increasing difficulty breathing
  • Any change in consciousness, confusion, a bad headache or vomiting several times after a head injury
  • Unconsciousness, acting strangely or becoming more withdrawn and less alert
  • Large or deep cuts or burns or smoke inhalation
  • Skin or lips that look blue, purple or gray
  • Increasing or severe persistent pain
  • Major mouth or facial injuries
  • Near drowning

Prepare for emergencies in advance by asking your baby’s doctor during a checkup what to do and where to go if your baby needs emergency care. Learn basic first aid, including CPR, and keep emergency phone numbers and addresses handy.

Be ready to answer questions

Be prepared to help the medical staff understand what’s happening with your baby. Expect questions about:

  • Your baby’s symptoms. What prompted you to seek medical attention for your baby? What are your specific concerns?
  • Your baby’s medical history. Does your baby have any known allergies? Are your baby’s immunizations current? Does your baby have any chronic conditions? Be prepared to share details about your pregnancy and the baby’s birth.
  • Changes in your baby’s feeding and bowel movements. Have you noticed changes in your baby’s eating or drinking patterns, in the number of wet diapers, or in the number, volume or consistency of bowel movements?
  • Changes in your baby’s temperature. What’s your baby’s temperature? How did you take it and at what time?
  • Home remedies and medications. Have you tried any home remedies or given your baby any over-the-counter or prescription medications? If so, what, how much and when? If you suspect your child ingested poison or medications, bring the bottle with you.
  • Possible exposures. Is anyone ill among your household contacts or, if relevant, at your baby’s child care center? Have you traveled with your baby recently?

Before you contact your baby’s doctor, make sure you’re prepared to jot down any instructions. Have your pharmacy’s contact information ready, too.

Being prepared will save you and your baby’s doctor time during a phone call, office visit or emergency situation.


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Show references

  1. Schmitt BD. In: Pediatric Telephone Protocols. 15th ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2016.
  2. When to call the baby’s doctor: Print-and-go guide. National Women’s Health Information Center. http://www.womenshealth.gov/pregnancy/childbirth-beyond/newbon-care-safety.html. Accessed Aug. 24, 2016.
  3. Shelov SP, et al. Emergencies. In: Caring for Your Baby and Young Child: Birth to Age 5. 6th ed. New York, N.Y.: Bantam; 2014.

See more In-depth


Kids’ Fevers: How High is Too High?

Fevers often get a bad rap, particularly when it comes to children. Although they leave many parents worried, in most people, a fever is rarely dangerous. In fact, they are actually a good thing. Fevers are a natural way that our bodies fight off infections by increasing the body’s temperature in order to make it more difficult for germs to live and multiply.  When it comes to kids’ fevers, here is some helpful information to help you determine how high is too high:

When to Check for a Fever

A child’s temperature can change slightly during the day, depending on the time of day and how active your child is. The normal range for body temperature taken orally (by mouth) ranges from 97.7°F to 99.5°F. Parents should take their child’s temperature if they notice any of the following symptoms:

  • Excessive sweating
  • Dry, hot skin
  • A rash
  • Very pale or very red face
  • Changes in breathing such as unusually fast, slow, noisy or strained
  • Cold symptoms such as runny nose, cough, sneezing, sore throat or hoarseness
  • Mood changes such as irritability, crankiness, fatigue
  • Vomiting
  • Diarrhea
  • Pain in any part of your child’s body
  • Your child says, “I feel sick”

How to Take Your Child’s Temperature

Your first inclination may be to feel your child’s forehead to determine if he or she has a fever. But, a digital thermometer is the best method to take both oral and rectal temperatures quickly and accurately. Despite their appeal, tympanic (ear) and temporal artery (forehead) thermometers that are available for home use often aren’t as high quality or accurate as those used in physician’s offices.

There are three ways to check your child’s temperature:

  • Oral: Suitable for children age 5 and older. Be sure your child has not had anything to drink in the 10 minutes prior to taking their temperature.
  • Rectal: The most accurate method to take a temperature for children under the age of 5.
  • Axillary (Armpit): Not quite as reliable, armpit temperatures are generally used for infants. This method is also used when older children aren’t cooperative or can’t close their mouth due to congestion.

How High is Too High?

Whether or not a visit to your child’s physician for a fever is necessary depends on a variety of factors, including age. Call your pediatrician if:

  • Your child is under 3 months old with a fever of 100.4 °F or higher
  • Your child is 3 to 6 months old with a fever of 101.0 °F or higher
  • Your child is 6 months or older with a fever of 103.0 °F or higher
  • Your child has a fever 104.0 °F or higher regardless of age

You should see a physician for any fever under the following circumstances:

  • Lethargy that persists after taking fever-reducing medication
  • Lasting more than 3 consecutive days with or without an obvious source of infection, such as cold symptoms
  • In conjunction with severe pain
  • In conjunction with sore throat lasting more than 24-48 hours
  • Accompanied by pain when urinating
  • Accompanied by headache, stiff neck or red or purple-colored patches on the skin
  • In a child with compromised immunity
  • Occurrence following a trip overseas

Caring for a Child with a Fever

Children with fevers who aren’t uncomfortable typically don’t need treatment, and for fevers under 102°F medicine is usually not necessary.

Ways you can care for a child with fever include:

  • Keeping them home from daycare, school or extracurricular activities until he or she has had no fever or symptoms for 24 hours without the use of fever-reducing medications.
  • Avoiding clothing that’s too warm. You should also refrain from covering your child with extra blankets, as they stop the heat of the fever from escaping.
  • Keeping your child hydrated by giving them plenty of cool, clear liquids. Pedialyte and water are preferable, but if it encourages your child to drink more you can also offer fruit juices, popsicles or sports drinks like Gatorade.
  • Checking for early signs of dehydration such as dry mouth, lack of tears when crying, decreased urine output or decreased frequency of urination. If you have an infant younger than 6 months old with less than 6 to 8 wet diapers per day or an older child that urinates fewer than three times a day or once every 8 hours, call your child’s doctor immediately.
  • Helping reduce discomfort with acetaminophen (Tylenol) or ibuprofen for children 6 months and older. Infants age 2 to 6 months may be given Tylenol, but you should consult with you his or her doctor prior to use.
  • Lowering the fever with lukewarm baths. You should never use cold baths.

Schedule an Appointment

HealthPark Pediatrics offers sick visits by appointment Monday through Friday from 8:30 a.m. to 5:20 p.m. and Saturday and Sunday from 9 a.m. to noon. Urgent visits may be scheduled after hours on weekdays between 5:30-6:30 p.m. To schedule an appointment, call 919-896-7066. This number can also be used after hours to reach our dedicated nurse triage line.

Fever in children | NHS inform

Urgent advice:

Contact your GP or, if your GP’s closed, phone 111 for urgent advice if your child:

  • is under 3 months and has a temperature of 38°C (101°F) or above 
  • is over 3 months and has a temperature of 39°C (102°F) or above
  • has persistent vomiting
  • is refusing to feed

Always trust your instincts and phone 999 if you think there’s an emergency. 

If your child seems to be otherwise well – for example, if they’re playing and attentive – it’s less likely they’re seriously ill. 

As a parent it can be extremely worrying if your child has a high temperature. However, it’s very common and often clears up by itself without treatment. 

A quick and easy way to find out whether your child has a fever is to take their temperature using a thermometer.

What causes a high temperature?

Most fevers are caused by infections or other illnesses. The high body temperature makes it more difficult for the bacteria and viruses that cause infections to survive.

Common conditions that can cause fevers include:

Your child’s temperature can also be raised after vaccinations, or if they overheat because of too much bedding or clothing.

Fever in babies and children under 2 years of age self-help guide

Complete this guide to assess fever symptoms in babies and children under 2 years of age. Find out if you should visit A&E, your GP, pharmacist or treat their condition at home.

Treating a fever

If your child has a fever, it’s important to keep them hydrated by giving them plenty of cool water to drink.

Babies should be given plenty of liquids, such as breast milk or formula. Even if your child isn’t thirsty, try to get them to drink little and often to keep their fluid levels up.

If the environment is warm, you could help to your child to stay at a comfortable temperature by covering them with a lightweight sheet or opening a window.

However, they should still be appropriately dressed for their surroundings and sponging your child with cool water isn’t recommended to reduce a fever.


Children’s paracetamol or ibuprofen work as antipyretics, which help to reduce fever, as well as being painkillers. You can’t give them both at the same time, but if one doesn’t work, you may want to try the other later.

Antipyretics aren’t always necessary. If your child isn’t distressed by the fever or underlying illness, there’s no need to use antipyretics to reduce a fever.

When using antipyretics, always read the patient information leaflet that comes with the medication to find the correct dose and frequency for your child’s age.

More serious illnesses

Sometimes a high temperature in children is associated with more serious signs and symptoms, such as:

Possible serious bacterial illnesses include:

  • meningitis – infection of the meninges, the protective membranes that surround the brain and spinal cord
  • septicaemia – infection of the blood
  • pneumonia – inflammation of the lung tissue, usually caused by an infection

It’s important to remember that potentially serious causes of fever are relatively rare.

Fever in adults – HSE.ie

This page provides general information about fever. If you have a child with a fever, see fever in children.

Your body’s normal temperature is between 36 and 36.8 degrees Celsius.

A high temperature or fever, for most people, is when your body temperature is 38 degrees Celsius or higher. This can be a sign that you are unwell. It usually means you have an infection such as a cold. But it can also be due to more serious infections, such as COVID-19 (coronavirus).

Read about the symptoms of COVID-19

Even if you don’t have a high temperature you may still be seriously ill. So it’s important to look at all your symptoms.

A fever is usually caused by your body fighting a viral or bacterial infection.

A fever usually lasts 3 to 5 days and most people will recover from a mild fever with self-care at home.


Mild fever (38 to 38.9 degrees Celsius)

With a mild fever you might have flushed cheeks, feel tired and be warm to touch. You will generally be able to carry out normal daily activities.

High fever (39 to 39.9 degrees Celsius)

With a high fever, you’ll feel hot to touch. You may not feel well enough to go to work and you may have aches and pains.

Very high fever (40 degrees Celsius or higher)

With a very high fever, you will usually want to stay in bed or be inactive – you won’t feel well enough to carry out normal activities. You’ll feel hot to touch and you may have lost your appetite.

When to see a GP

Young babies and pregnant women

Babies under 3 months old with fever must be checked by your GP. Contact your GP if your baby is between 3 and 6 months and has a high or very high fever. Read more about fever in children.

If you’re pregnant and have a temperature of 38.5 degrees Celsius, or any fever lasting for 3 days or more, see your GP. They need to monitor the effects of the fever on your baby.

Other ages

Older infants, children and adults will not usually need any medical treatment for mild fever, especially if you are otherwise well.

You should contact your doctor if you:

  • have a very high fever (over 40 degrees Celsius)
  • are still feverish after 3 days of home treatment or seem to be getting sicker
  • are shivering or shaking uncontrollably, or have chattering teeth, and it doesn’t stop within an hour or so
  • have a severe headache that doesn’t get better after taking painkillers
  • are having trouble breathing
  • are getting confused or are unusually drowsy
  • have recently travelled overseas

Causes of fever

Fever is usually caused by a viral or bacterial infection. Fever is your body’s way of fighting infection. Raising the temperature inside your body helps to kill the virus or bacteria causing the infection.

Common conditions that can cause fevers include:

  • respiratory tract infections
  • flu (influenza) and flu-like conditions
  • colds
  • tummy bugs (gastroenteritis)
  • ear infections
  • infection of your tonsils (tonsillitis)
  • kidney or urinary tract infections
  • common childhood illnesses, such as chickenpox, scarlet fever, rubella (German-measles), whooping cough and rheumatic fever

You might have a mild fever after getting a vaccine.

Adults should not take paracetamol before or after getting a vaccine. It may make the vaccine less effective.


Medication for fever

Fever is your body’s way of fighting infection. Medication is not needed for mild fever, but you can use paracetamol if you also have a headache, pain or distress.

Self management

  • Drink plenty of fluids, especially water (little and often is best). Aim for 2 to 3 litres in 24 hours while you have a fever. This will reduce the risks of dehydration.
  • Get plenty of rest. Sleeping for 2 to 3 hours at a time is slightly better than just resting.
  • Make sure the room temperature is comfortable – not too hot or too cold.
  • If possible, open a window for ventilation but avoid draughts.
  • Wear lightweight clothing and use lighter bedding.
  • Do not use hot water bottles or electric blankets.
  • Use a cool cloth to wash face, hands and neck.
  • Change bed linen and clothing regularly.

How to deal with influenza

BMJ. 2004 Nov 20; 329(7476): 1238.

Fever may be used as treatment

Editor—Because there is no specific treatment for influenza, Jefferson’s editorial and the accompanying articles concentrate on vaccination and chemoprophylaxis.1 However, I plead for recognition that fever may be used as a non-specific treatment of flu. The fever is not just an unpleasant symptom of flu but a crucial part of the body’s defence mechanism that should be encouraged.

Infectious organisms are adapted to the temperature of the part of the body they colonise, so it follows that they will grow best at that temperature. Rhinoviruses, which infect the cooler upper airway and sinuses, grow best between 33° C and 35° C, so inhaling air at about 45° C for 20 minutes will much improve the symptoms of a common cold.2 Conversely, treating the common cold with aspirin causes an increase in the rate of production of the virus.3

By contrast, influenza viruses, which infect the whole body, grow best at temperatures slightly below body temperature, and at 40° C they will die off after 12-24 hours. So it is not surprising that if fever is suppressed in ferrets infected with the flu virus, their illness is prolonged.4

There seem to be no studies of the effect of lowering or raising body temperatures in humans with flu. But there are obviously good reasons for trials of treating flu by raising the temperature to 40° C and maintaining this for at least 24 hours. The absence of such trials may result from a deep seated fever phobia, stemming from prescientific medicine when fever was perceived as an illness in itself. A famous 17th century physician, Thomas Sydenham, said, “Fever is nature’s engine which she brings into the field to remove her enemy.”5 The public and the medical profession have still not realised the full importance and potential of this statement.


Competing interests: None declared.


3. Stanley ED, Jackson GG, Panusarn C, Rubenis M, Dirda V. Increased virus shedding with aspirin treatment of rhinovirus infection. JAMA
1975;231: 1248-51. [PubMed] [Google Scholar]4. Husseini RH, Sweet C, Collie MH, Smith H. Elevation of nasal virus levels by suppression of fever in ferrets infected with influenza viruses of differing virulence. J Infect Dis
1982;145: 520-4. [PubMed] [Google Scholar]

5. Payne JF. Thomas Sydenham. London: T Fisher Unwin, 1900.

90,000 Familial Mediterranean Fever

1.1 What is it?

Familial Mediterranean fever (FMF) is a genetic disorder that is inherited. Patients suffer from recurrent bouts of fever, accompanied by pain in the abdomen or chest, or pain and swelling of the joints. The disease more often affects individuals originating from the Mediterranean and the Middle East, in particular Jews (especially Sephardic people), Turks, Arabs and Armenians.
1.2 How common is this disease?
The incidence in high-risk populations is about 1-3 per 1000.In other ethnic groups, this disease is rare. However, since the discovery of the corresponding gene, the disease has been diagnosed more often, even among populations among which it was considered very rare, such as Italians, Greeks and Americans.
In about 90% of patients, the first episodes of FMF begin before the age of 20. In more than half of patients, the disease manifests itself during the first decade of life. Boys suffer slightly more often than girls (1.3: 1).1.3 What are the causes of the disease?
FMF is a genetic disorder. The gene responsible for it is called MEFV. It affects a protein that plays a role in the natural resolution of inflammation. If this gene carries a mutation, as occurs in FMF, this regulation cannot function properly and patients experience fever attacks.
1.4 Is this disease hereditary?
The disorder is inherited primarily as an autosomal recessive disorder, which means that the parents usually do not have symptoms of the disease.This type of transmission means that for a person to have FMF, both copies of the person’s MEFV gene (one from the mother and the other from the father) must be mutated; thus, both parents are carriers (the carrier has only one mutant copy of the gene, but not the disease). If the disease is present in a large family, it is likely to be in a brother, cousin, uncle, or distant relative. However, as seen in a small percentage of cases, if one parent has FMF and the other carries the mutant gene, then there is a 50% chance that their child will inherit the disease.In a small proportion of patients, one or even both copies of the gene turn out to be normal.
1.5 Why did my child get this disease? Can this disease be prevented?
Your child has a disease because he or she carries mutant genes that cause FMF.
1.6 Is this disease contagious?
1.7 What are the main symptoms?
The main symptom of the disease is a periodic increase in body temperature, which is accompanied by pain in the abdomen, chest or joints.The most common bouts of abdominal pain occur in about 90% of patients. Attacks of chest pain are observed in 20-40%, and joint pain in 50-60% of patients.
Typically, children complain of a specific type of seizure, such as recurrent abdominal pain and fever. However, some patients experience different types of seizures, alone or in combination.
These attacks are self-limiting (meaning they go away without treatment) and last from one to four days.By the end of the seizure, the patient’s well-being is fully restored, and he feels well between attacks. Some seizures can be so painful that the patient or family seeks medical attention. Severe bouts of abdominal pain can resemble acute appendicitis, and therefore, some patients may undergo unnecessary abdominal surgery, such as an appendectomy.
However, some seizures, even in the same patient, may be mild enough to be mistaken for mild stomach upset.This is one of the reasons why FMF is difficult to recognize in a patient. When the child has abdominal pain, it is usually constipated, but when the pain is relieved, it produces softer stools.
A child may have a very high fever during one attack and a moderate fever during another. Chest pain usually affects only one side and can be so severe that the patient is unable to breathe deeply enough. This goes away within a few days.
Typically, only one joint is affected during an attack (monoarthritis).This is usually the ankle or knee joint. The joint can be so swollen and painful that the child cannot walk. In about a third of patients, the skin over the affected joint becomes red. Seizures affecting joints can last slightly longer than other types of seizures: it can take four days to two weeks before the pain completely subsides. In some children, recurrent joint pain and swelling may be the only symptom of the disease, which is misdiagnosed as acute rheumatic fever or juvenile idiopathic arthritis.
In 5-10% of cases, joint damage becomes chronic and can lead to joint damage.
In some cases, a skin rash that is characteristic of FMF is called erythema erysipelas. As a rule, it is observed on the lower limbs and in the area of ​​the joints. Some children may complain of leg pain.
More rare forms of seizures include recurrent pericarditis (inflammation of the outer lining of the heart), myositis (inflammation of the muscles), meningitis (inflammation of the lining of the brain and spinal cord), and periorchitis (inflammation of the tissue around the testicle).1.8 What are the possible complications?
Children with FMF are more likely to have some other diseases that are characterized by inflammation of the blood vessels (vasculitis), such as Schönlein-Henoch purpura and polyarteritis nodosa. The most severe complication of FMF in the absence of treatment is the development of amyloidosis. Amyloid is a special protein that is deposited in certain organs, such as the kidneys, intestines, skin and heart, and causes a gradual decline in function, especially of the kidneys. Amyloidosis is not specific to FMF; it is a complication that develops in other chronic inflammatory diseases, if they do not receive the right treatment.Proteins in the urine may be the key to diagnosis. Finding amyloid in the intestines or kidneys confirms the diagnosis. Children who receive the correct dose of colchicine (see section on drug therapy) are protected from the risk of developing this life-threatening complication.
1.9 Does the disease appear the same in all children?
The disease manifests itself differently in different children. In addition, the type, duration, and severity of seizures may be different each time, even for the same child.1.10 Is the disease in children different from the disease in adults?
In general, FMF manifestations in children are similar to those seen in adults. However, some features of the disease, such as arthritis (joint inflammation) and myositis, are more common in childhood. The frequency of seizures usually decreases with age. Periorchitis is found more often in boys than in adult men. The risk of amyloidosis is higher among untreated patients with early onset of the disease.

2.1 How is this disease diagnosed?

Typically, the following approach is used for diagnosis:

Clinical alertness:
FMF is suspected only after a child has had at least three seizures. It is necessary to review a detailed history of ethnicity, as well as find out if there are relatives with similar complaints or kidney failure.
Parents should be asked to provide detailed descriptions of previous seizures.

a child with suspected FMF must be closely monitored before definitive diagnosis is made. During this observation period, the patient should, if possible, visit a doctor during an attack for a thorough physical examination and blood tests to assess the presence of inflammation. Typically, these tests become positive during an attack and return to normal or near-normal readings after the attack subsides.Classification criteria have been developed to help recognize FMF. For various reasons, it is not always possible to observe a child during an attack. In this regard, parents are asked to keep a diary and describe what is happening. They can also use the local laboratory for blood tests.

Colchicine response:
Children who are likely to be diagnosed with FMF on clinical and laboratory tests are given colchicine for about six months, after which symptoms are re-evaluated.In the case of FMF, the attacks either stop completely or the number, severity, and duration are reduced.
Only after these steps have been completed can the patient be diagnosed with FMF and prescribed life-long colchicine.
Because FMF affects a number of different systems in the body, a variety of professionals can be involved in the diagnosis and treatment of FMF, including pediatricians, pediatric or adult rheumatologists, nephrologists (specialists in kidney disease), and gastroenterologists (specialists in diseases of the digestive system).

Genetic Analysis:
Recently, it has become possible to perform genetic analysis in patients to detect the presence of mutations believed to be responsible for the development of FMF.
The clinical diagnosis of FMF is confirmed if the patient is diagnosed with 2 mutant genes, one from each parent. However, mutations that have been described so far are detected in 70-80% of FMF patients. This means that there are FMF patients with one mutation or even no mutation at all; therefore, the diagnosis of FMF is still dependent on clinical judgment.Genetic testing is not possible in every treatment center
Fever and abdominal pain are very common complaints in children. Therefore, FMF is sometimes not easy to diagnose, even in high-risk groups. It may take several years before the FMF is recognized. This delay in diagnosis should be minimized because untreated patients are at high risk of amyloidosis.
There are a number of other diseases characterized by recurrent attacks of fever and attacks of abdominal and joint pain.Some of these diseases are also genetic and share some common clinical features, but each has its own distinctive clinical and laboratory characteristics.

2.2 Why are tests important?
Laboratory tests are very important in the diagnosis of FMF. Tests such as erythrocyte sedimentation rate (ESR), C-reactive protein levels, CBC and fibrinogen are important during the seizure period (within 24 to 48 hours after the onset of the seizure) to assess the extent of inflammation.These tests are repeated when the child’s symptoms pass to check whether the analyzed parameters are back to normal. In about a third of patients, test results return to normal levels. For the remaining two-thirds, the levels decrease significantly, but remain above the upper limit of the norm.
A small amount of blood is also needed for genetic analysis. Children who are on lifelong colchicine therapy should have regular blood and urine tests taken twice a year to monitor their condition.
Urinalysis also aims to determine the presence of protein and red blood cells in it. Temporary changes are possible during seizures, but persistent increases in urinary protein levels may indicate amyloidosis. The doctor may then take a biopsy of the rectum or kidneys. A rectal biopsy involves the removal of a very small piece of tissue from the rectum, which is very easy to perform. If the rectal biopsy shows no amyloid, a kidney biopsy is needed to confirm the diagnosis. For a kidney biopsy, the child must spend the night in the hospital.Biopsy tissue is stained and then inspected for amyloid deposits.
2.3 Can this disease be treated / cured?
FMF cannot be cured, but it can be controlled with lifelong colchicine use. In this way, recurrent seizures can be prevented or reduced and the development of amyloidosis can be prevented. If the patient stops taking the drug, seizures and the risk of developing amyloidosis will return.
2.4 What are the treatments?
FMF treatment is simple, inexpensive, and does not have any serious side effects when taken in the correct dose.Today, the natural drug, colchicine, is the drug of choice for the preventive treatment of FMF. Once the diagnosis is made, the child must take the medication for the rest of his life. If the drug is taken correctly, the seizures disappear in about 60% of patients, a partial effect is achieved in 30%, and in 5-10% of patients, the treatment is ineffective.
This therapy not only controls seizures, but also eliminates the risk of developing amyloidosis. Therefore, it is imperative that doctors repeatedly explain to parents and the patient how important it is to take this drug at the prescribed dose.Strict adherence to the doctor’s recommendations is very important. With strict adherence to these recommendations, the child can live a normal life and the disease will not affect his life expectancy. Parents should not change the dose of the drug without consulting a doctor.
The colchicine dose should not be increased during an already active attack, as such an increase is ineffective. Preventing seizures is important.
Biologics are used in colchicine-resistant patients.2.5 What are the side effects of drug therapy?

It is not easy to accept that a child should always take pills. Parents are often worried about the possible side effects of colchicine. This drug is safe; it causes only minor side effects, which usually stop with dose reduction. The most common side effect is diarrhea.
Some children are unable to adhere to the prescribed dose due to frequent watery stools. In such cases, the dose should be reduced until it is well tolerated by the child, and then slowly, in small increments, should be increased again to the appropriate dose.The lactose content of the diet can also be reduced within 3 weeks, and gastrointestinal symptoms often disappear.
Other side effects include nausea, vomiting, and abdominal cramps. In rare cases, the drug can cause muscle weakness. The number of peripheral blood cells (white and red blood cells and platelets) can sometimes decrease, but when the dose is reduced, these parameters are restored.
2.6 How long should treatment last?
FMF requires lifelong preventive treatment.2.7 What about alternative or complementary therapies?
Adjunctive therapy for FMF is unknown.
2.8 What periodic inspections are required?
Children undergoing treatment should have blood and urine tests at least twice a year.
2.9 How long will the illness last?
FMF is a lifelong disease.
2.10 What is the long-term prognosis of the disease (expected outcome and course of the disease)?
With correct lifelong use of colchicine, children with FMF live normal lives.In the case of a delay in diagnosis or non-adherence to the treatment regimen, there is a risk of developing amyloidosis, in which the prognosis is disappointing. Children who develop amyloidosis may need a kidney transplant.

Growth retardation is not a significant problem in FMF. In some children, growth development during puberty is restored only after treatment with colchicine.

2.11 Is a complete cure possible?

No, because it is a genetic disorder. However, lifelong colchicine therapy enables the patient to live a normal life, without restrictions and without the risk of developing amyloidosis.

3.1 How can the illness affect the child and the family’s daily life?
The child and his family have significant problems even before the disease is diagnosed. The child needs frequent counseling because of severe pain in the abdomen, chest, or joints. Some children undergo unnecessary surgery due to misdiagnosis. Once a diagnosis is made, the goal of treatment should be so that both the child and his parents can live an almost normal life.FMF patients require long-term regular treatment, therefore colchicine administration may be irregular. Failure to adhere to the same regimen of taking the drug may put the patient at risk of developing amyloidosis.
The psychological burden of lifelong treatment is a significant problem. Psychological support and education programs can be of great help to patients and their parents.
3.2 How about school?
Frequent attacks cause serious problems with school attendance, and colchicine treatment can reduce this problem.
Informing teachers about the illness can be helpful, in particular, so that they know how to deal with an attack.
3.3 What about sports?
FMF patients who receive colchicine for life can practice any sport they want. The only problem may be prolonged bouts of joint inflammation, which can lead to restriction of movement in the affected joints.
3.4 How about diet?
There are no specific dietary recommendations.
3.5 Can climate influence the course of the disease?
3.6 Can my child be vaccinated?
Yes, the child can be vaccinated.
3.7 What about sexuality, pregnancy, contraception?
FMF patients may have fertility problems prior to colchicine treatment, but once colchicine is prescribed, this problem disappears. At the doses used for treatment, a decrease in sperm count is very rare. Patients should not stop taking colchicine during pregnancy or breastfeeding.
90,000 WHO recognizes the Ebola epidemic as a threat of international concern – Society

GENEVA, 8 August. / ITAR-TASS /. The World Health Organization (WHO) announced Friday that the spread of the Ebola virus in West Africa is a threat of international concern. The experts held a two-day meeting of the WHO emergency committee in Geneva and concluded that “the outbreak of fever in West Africa is an emergency event and poses a threat to public health in other countries.”

“The flash is progressing faster than it can be controlled.”

The head of the World Health Organization Margaret Chen called the Ebola outbreak the largest in 40 years.


People who have had exposure to the virus in unprotected circumstances should not travel

Keiji Fukuda

WHO Assistant Director-General

All countries with reported cases are encouraged to “declare an emergency”.Among other things, it is recommended that, within 24 hours from the moment the first case of infection was recorded, control measures were introduced, all circumstances of the infection were investigated and special teams deployed to monitor the situation.

90,024 According to the latest WHO statistics, the number of victims of the Ebola outbreak since February this year has reached 932 people, 1711 have become infected. Most people died in Guinea, Liberia and Sierra Leone. The death was also recorded in Nigeria.The Liberian authorities, like Sierra Leone, have declared a state of emergency in their country.

WHO declares a public health emergency for the third time in history. The first time this was done in response to the swine flu (h2N1) pandemic in 2009, and the second time in May this year in response to an outbreak of polio in ten countries in Asia, Africa and the Middle East.

Who develops a vaccine against the virus

The Canadian company Tekmira Pharmaceuticals has received approval from the US Food and Drug Administration for limited human trials of an Ebola vaccine it is developing for the US government.

On this topic

  • Spread of Ebola haemorrhagic fever

90,024 Infected Americans were told that the drug has not been tested in humans, but has shown positive results in experiments in monkeys. The patients agreed to the treatment. After the introduction of the experimental vaccine, they went on the mend, now their condition is assessed as stable, the newspaper writes.

On this topic

The Ministry of Health explained the danger of high temperature after vaccination against COVID-19: Society: Russia: Lenta.Common crawl en

A high temperature after vaccination against COVID-19, persisting for more than two days, may indicate that a person contracted the coronavirus before or during vaccination. Olga Tkacheva, the chief geriatrician of the Russian Ministry of Health, warned about this, as reported by Gazeta.Ru.

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According to her, there are no antibodies at the time of administration of the drug, and a few days after the procedure, COVID-19 may appear.

“But I note that the vaccination itself cannot cause a coronavirus infection,” Tkacheva said.

In turn, the Honored Doctor of Russia, the leading scientific editor of the Vrachu.ru service, Mikhail Kagan, recommended to undergo PCR testing in case of prolonged high temperature. “You and your family members should stay at home until results are obtained,” the specialist advised.

Doctors noted that a high temperature that lasts no longer than one or two days is normal.“There may also be weakness, discomfort at the injection site – this indicates an inflammatory response of the body in response to the vaccine,” explained Tkacheva.

According to Kagan, a mild fever after the procedure means that the vaccine is working and the body is producing antibodies to fight the infection. It usually develops within 24 hours after drug administration and can last from two to three days.

At low temperatures, the doctor recommended not to cover yourself with a warm blanket and drink plenty of water.If, after vaccination, the body temperature rises above 38.5 degrees, you need to drink paracetamol or ibuprofen. It is worth contacting doctors only if the temperature is above 40 degrees, and the fever persists for more than two days, as well as in case of a noticeable allergic reaction, Kagan concluded.

Earlier, the head of the Ministry of Health, Mikhail Murashko, said that on the day of vaccination against COVID-19, one should not go to the bathhouse and drink alcohol. Also, after vaccination, it is worth excluding sports and other intense physical activity.90,028 90,000 Mastitis – blog article Medscan

What is mastitis? What are the symptoms of the disease? How to recognize a pathology and take measures to prevent its occurrence? Questions that do not lose their relevance. Mastitis is an inflammation of the mammary glands that may or may not be accompanied by infection. In most cases, the disease is directly related to the process of lactation in a woman, therefore, in medical practice, another name for the pathology is lactational mastitis.In the absence of timely treatment and the development of complications, mastitis can lead to death, therefore it is so important to consult a doctor when the first signs and symptoms of inflammation are detected.

According to research, mastitis in most cases develops within the first 2-3 weeks after a baby is born. However, the disease can occur in other stages of lactation. About 10-15% of the disease occurs in non-lactating women and 0.5-1% in pregnant women. Mastitis usually affects one breast, but the other breast (bilateral mastitis) can also be inflamed.

Causes of mastitis

To date, experts identify two main factors that contribute to the development of the disease:

  • milk stasis;
  • infection.

If we talk about lactational mastitis, then the root cause of the pathology is milk stagnation, which occurs due to improper attachment of the newborn to the breast, minimal emptying of the mammary glands, blockage of the ducts.Excessive milk secretion and breastfeeding of multiple twin babies are also recognized as other conditions contributing to the development of mastitis.
Infectious mastitis, as the name implies, occurs due to excessive colonization of pathological microorganisms. In most cases, the causative agent of this disease is Staphylococcus aureus, which can penetrate into the tissues of the breast through cracks in the nipples when breastfeeding or expressing milk.
Other factors increase the risk of developing mastitis, which include:

  • concomitant diseases that cause a weakening of the woman’s immunity;
  • difficult childbirth and late latching of the baby to the breast;
  • postpartum complications;
  • mastopathy;
  • gross cicatricial changes in tissues after surgery, for example, to remove benign neoplasms;
  • improper breast care.

Symptoms of the disease

Signs of mastitis are as follows:

  • Gland engorgement – a woman experiences chest discomfort and pain. It looks swollen, the skin acquires a characteristic shine. There may be hyperemia (redness of the skin), which has blurry edges. The nipple stretches, becomes flat, which makes it difficult for the infant to suckle because of the impossibility of grasping.There is a fever that resolves within 24 hours.
  • The blockage of the milk ducts manifests itself in the form of the formation of painful nodules, the skin over which acquires a characteristic red tint. In some cases, a white spot forms on the nipple, which gives a characteristic severe pain when sucking.
  • Enlargement of the venous network due to impaired milk outflow and tissue fluid accumulation.

Symptoms of mastitis also directly depend on the stage of disease progress.With a serous form of mastitis, a woman may experience pain in one of the mammary glands; palpation can reveal a dense formation that has clear boundaries and good mobility. The outflow of milk is free, therefore, when the breast is empty, lactostasis can pass without medical assistance within 1-2 days. But despite this, doctors recommend that patients, if such signs of mastitis occur, seek help from specialists. Only timely help will help to avoid complications and the transition of the disease to an infiltrative or destructive form, which require hospital treatment, often by surgery.

Diagnosis of mastitis

In most cases, the diagnosis of mastitis is straightforward for the doctor. To do this, it is enough to know the patient’s complaints and conduct a visual examination. To clarify the clinical diagnosis, laboratory tests can be prescribed:

  • UAC and OAM;
  • bacteriological analysis of milk from two mammary glands;
  • cytological analysis of milk;
  • Study of reductase activity and determination of the pH level of breast milk.

From functional examination methods, an ultrasound examination of the mammary gland can be performed if the symptoms of mastitis indicate a destructive form. To clarify the diagnosis and for the differential diagnosis of cancer, mammography may be recommended.

Treatment of the disease

If we talk about the therapy of this pathology, then both a conservative method and a radical one, which involves the opening of abscesses, can be applied.Conservative treatment of mastitis is indicated if:

  • the patient feels well;
  • breast inflammation lasts less than 3 days;
  • the temperature did not rise above 37.5 degrees;
  • there are no symptoms indicating a purulent abscess;
  • moderate soreness;
  • UAC indicators are within normal limits.

If other symptoms of mastitis join, and treatment does not help, then an urgent surgical operation is necessary.

Preventive measures

Is there a prevention of mastitis? Undoubtedly. A woman should pay special attention to the condition of the mammary glands and, at the first signs of milk stasis, take measures to prevent stagnation. The correct technique for attaching the baby to the breast is also important, since in the absence of cracks and other damage to the nipples, the risk of infection penetrating into the breast tissue is minimal.
When the first symptoms of mastitis appear, you should seek the help of a specialist.The diagnostic centers of Medskan.rf have installed modern premium-class equipment, thanks to which it is possible to make a clinical diagnosis in a matter of hours, which is the key to the health and successful motherhood of every woman.

Rosselkhoznadzor – Useful information

Leptospirosis is a zoonotic natural focal infectious disease of wild, domestic animals and humans.

Sources of causative agents of leptospirosis infection are divided into two groups.The first includes rodents and insectivores, which are the main hosts (reservoir) of pathogens in nature; to the second – domestic animals (pigs, cattle, sheep, goats, horses, dogs), as well as fur-bearing animals of cell content (foxes, arctic foxes, nutria), which form anthropurgic (agricultural) foci.

The causative agents of leptospirosis are microorganisms of the genus Leptospira.

Pathogenic leptospira are represented by 202 serovars, which, according to the degree of antigenic relationship, are combined into 23 serological groups.

The main route of transmission of infection is water, contact and food (forage) are of lesser importance.

In humans and animals, leptospira penetrate through minor skin lesions and intact mucous membranes of the mouth, nose, eyes, gastrointestinal and urinary tracts.

The main epizootic feature of leptospirosis in farm animals is the prevalence of asymptomatic forms of infection in the form of leptospirosis and leptospirosis immunizing subinfection.

In cattle fulminant form is characterized by sudden depression, loss of appetite, fever, agitation, rapid breathing, yellowness of the mucous membranes, diarrhea, and sometimes hemoglobinuria. The disease lasts 12-24 hours, the animal dies in convulsions. Acute course is recorded more often, it is characterized by fever, depression, refusal to feed, weakness, unsteadiness of gait, diarrhea, alternating atony of the gastrointestinal tract with the termination of ruminants.After 1-2 days, the temperature drops to normal and the main signs appear – hemoglobinuria, yellowness of the mucous membranes and skin. The color intensity is different – pale or ocher yellow. Urine is excreted in small portions – red, sometimes brown.
With a prolonged course of the disease, necrotic areas appear on the skin of the ears, nipples, tips of the tail and mucous membranes of the oral cavity. At the same time, the skin is hard, exfoliates in large pieces. The disease lasts up to 12 days, the mortality rate reaches 50-70%.
With subacute form of leptospirosis, the same symptoms are recorded as with acute, but they develop more slowly and the disease ends in most cases with recovery. Recurrent fever; the yellowness of the mucous membranes, hemoglobinuria and atony of the gastrointestinal tract are intensely expressed. These signs may subside or worsen again.
Productivity decreases sharply, milk yield decreases, animals lose weight. More pronounced necrosis of the mucous membranes and skin.The latter exfoliates in large pieces in the dewlap, back, groin, udder. Abortions are observed in pregnant animals. The duration of the disease in the subacute course is up to 3 weeks, the mortality rate is up to 45%.
With chronic form – emaciation, attacks of fever with relapses in 5-7 days, brown urine, delayed molting, abortions in pregnant women, barrenness are noted. The disease lasts 3-5 months. Animals die of starvation.
Atypical current .Animals get sick easily, they have only a short-term increase in body temperature, a slight yellowness of the mucous membranes, after a few days the animals recover.
The phenomenon of immunizing subinfection is the cornerstone of atypical forms of leptospirosis. Now many animals have antibodies – lysines and agglutinins, but such animals are not sick or leptospirosis. These antibodies are produced against the Hebdomadis serotype, which is carried by murine rodents.Small doses of Leptospira of this serotype, repeatedly entering the body of animals, contribute to the creation of their immunity. And it has now been established that infection of animals with certain serotypes of Leptospira causes the formation of not only homologous antibodies, but also heterogeneous – related ones. This phenomenon of immunizing infection prevents 100% coverage of the disease in susceptible animals.
In pigs , a feature of leptospirosis is mass abortions or the birth of non-viable young animals.Abortions are more often registered in the last stages of pregnancy. Aborted fruits are reduced in size, as if mummified. Yellowness of mucous membranes and skin in pigs is not a permanent sign, a more constant sign is hemoglobinuria.
In young animals aged from 1 to 4 months, clinical signs of leptospirosis are characterized by – refusal to feed, diarrhea, rhinitis, conjunctivitis, cough, blue tips of the ears and tail, followed by necrosis. Young animals die, and adult pigs get sick for a long time.

The basis for suspicion that the farm is not doing well for leptospirosis is the clinical signs of the disease and the pathological changes characteristic of this infection, the detection of specific antibodies in the blood of animals. The diagnosis of leptospirosis in all cases must be confirmed by laboratory tests.

Leptospirosis is considered the cause of death of animals in the presence of clinical signs and pathological changes characteristic of this infection, confirmed by the detection of leptospira in the blood or parenchymal organs (except for the kidneys).

In order to prevent leptospirosis in animals, the owners and owners of livestock, veterinarians are obliged to do the following:

– monitor the clinical condition of animals, take into account the number of abortions and, if leptospirosis is suspected, select pathological material for laboratory research;

– recruiting breeding farms (farms), enterprises, artificial insemination stations from farms free of leptospirosis;

– to examine all animals entering the farm during the 30-day quarantine for leptospirosis in the PMA at a serum dilution of 1:25.In addition, pigs introduced into the farm for breeding purposes are examined for leptospirosis by urine microscopy, regardless of the results of serological studies. When animals are identified, whose blood serum contains specific antibodies or emitting leptospira in the urine, measures are taken for farms that are unfavorable for leptospirosis;

– it is allowed to equip fattening farms (departments, farms) with clinically healthy animals without testing for leptospirosis, but with their mandatory vaccination against leptospirosis during the quarantine period;

– to prevent animal contact with livestock of farms (farms), inhabited by leptospirosis, in the pasture, in places of watering, etc.etc .; not to graze unvaccinated animals on the territory of natural foci of leptospirosis;

– do not arrange summer camps for animals on the banks of open water bodies;

– systematically destroy rodents in livestock buildings, on farms, in places where feed is stored, etc.

Animals arriving by import are kept in a quarantine room and their blood serum is examined in the RMA with leptospira serological groups registered in the exporting country.

When a positive PMA is obtained with the blood serum of individual animals, urine microscopy is performed and the blood serum is re-examined after 7-10 days in animals of the entire group to resolve the issue of well-being for leptospirosis.

The farm in which leptospirosis is diagnosed is declared unfavorable.

Restrictions are removed in breeding and consumer farms after establishing their well-being by laboratory tests 2 months after the completion of anti-leptospirosis measures.At the same time, blood serum from replacement young animals is examined, and in cattle of various age groups, boars, replacement and main sows, in addition, urine samples are taken from animals.
Repeated studies of animals for leptospirosis in previously dysfunctional farms are carried out 6 months after the restrictions were lifted.

What if you test positive for coronavirus? We give advice to patients.

A diagnostic laboratory test that determines if a person is infected with SARS-CoV-2, the new coronavirus that causes COVID-19, helps manage resources for patients most at risk of COVID-19.Coronavirus testing also helps track the spread of the virus. The CDC (Centers for Disease Control and Prevention) has created the most widely used test, but commercial versions of the test are also in use.

If you develop a cough, fever, shortness of breath, or other flu symptoms after recent contact with someone known to have COVID-19, your doctor may recommend testing. Here’s what to expect from testing and what to do if you test positive for the new coronavirus.

Prepare to wait for your test results.

The most commonly used COVID-19 test takes 3 to 5 days to receive a test result from the time you collect your sample. Once your healthcare provider collects your sample for analysis with nasal and throat swabs, you will be responsible for your own care if you have not already been hospitalized. The doctor who ordered the test will contact you with the results.

If you have symptoms consistent with an acute upper respiratory infection (such as COVID-19, flu, cold, or other respiratory infection), you should isolate yourself at home and not leave your home unless instructed to visit a health facility.

If you are asymptomatic, you should still isolate yourself, or at least practice social distancing – keeping a distance of at least 6 feet from others – until you get your test results.You can test positive for coronavirus without symptoms and pass the virus on to others. Symptoms develop within 2-14 days after infection; the median is 5 days.

Take immediate action to prevent the further spread of COVID-19.

Have you received a notification that your test for the virus that causes COVID-19 has been positive? There is no reason to panic. Most people who are not at increased risk of severe COVID-19 illness usually go through a flu-like episode and make a full recovery.

If you test positive for COVID-19, you should:

  • Isolate yourself at home and do not leave your home unless asked to visit a health facility. (According to the CDC, you can stop home isolation if these three conditions are met: At least 10 days have passed since the first symptoms appeared, you have not had a fever in 24 hours without antipyretic drugs, and your symptoms are improving. (If you are not are experiencing symptoms, you may be around others 10 days after the date of the examination.)
  • Wear the disposable face mask to protect others from contaminated airborne droplets that enter the air when you cough or sneeze.
  • If possible, stay in a separate room with a private bathroom.
  • Keep at least 2 meters away from others.
  • Keep all touch surfaces clean. This includes doorknobs, countertops, telephones, and even a computer and keyboard.
  • Limit contact with your neighbors, especially those at increased risk of severe COVID-19 (elderly, immunocompromised and people with respiratory problems).

Respiratory etiquette and hand hygiene are among the most effective methods of limiting the spread of COVID-19:

  • Avoid touching eyes and mouth.
  • Throw away tissues after coughing or sneezing.
  • Wash your hands regularly and thoroughly with warm water and soap for 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.

If you are over 65 years of age and / or have a weakened immune system or a chronic illness, you are at increased risk of developing more severe COVID-19 illness. Follow the same practice as everyone else, monitor your symptoms closely and seek medical attention if your symptoms worsen.

Notify close contacts of the illness.

As a courtesy and as an important step in dealing with the pandemic, try to notify the people you have been in contact with in the last 7-10 days.

Call your doctor if symptoms worsen.

Do not do self-treatment at home! Medicines that will help alleviate the patient’s condition can only be prescribed by the attending physician and no one else!

Serious illness COVID-19 extends beyond coughs, fever and nasal congestion.

Tell your doctor right away if you have any of the following symptoms:

– Chest pain

– Oppression in the chest

– Difficulty breathing (difficult to “catch” breathing)

– Changes in mental state

– Bluish lips / skin (cyanosis)

Keep track of your symptoms in the calendar.

Keep a diary to record your temperature readings. Measure the temperature more often as the temperature rises. Note the dates of onset of symptoms, their severity, and resolution. This is important information to share with your healthcare team as they track your progress or if complications arise. You can remain isolated until your fever has cleared for at least 24 hours, without taking antipyretic drugs and with a steady improvement in your other symptoms.

Give yourself time and space to fully recover, which in most cases takes a few days to a week. Reach out to friends, family, and other support groups. Get more tips on social distancing wellness on our resources.

You can test for COVID-19 coronavirus in our medical centers located at:

MED Family in Solntsevo
+7 (495) 212-92-92
e-mail: solncevo @ medsemya.ru Moscow, Solntsevsky prospect, 19
Opening hours

Mon-Sat from 8:00 to 20:00
Sun from 10:00 to 19:00

MED Family in Orekhovo
+7 (495) 212-09-90
e-mail: [email protected] Moscow, Marshal Zakharova, 10, building 1
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Malaria. Prevention and Treatment. / Blog / Clinic EXPERT

Currently, Zanzibar (in Swahili Funguvisiwa ya Zanzibar, in English Zanzibar Archipelago), which is an archipelago of 75 islands in the Indian Ocean, stretching along the eastern coast of Africa opposite to modern Tanzania, has become a very popular holiday destination.Part of the archipelago is part of the autonomy of Zanzibar. Stunning landscapes, wildlife, exoticism. However, the cloudlessness of the holiday may hide a health hazard that we would like to inform our patients about. This is malaria. Malaria Italian. mala aria – “bad air”, formerly known as “swamp fever”, is an infectious and parasitic disease, which is characterized by the defeat of “red blood cells” – erythrocytes by the simplest intracellular parasites of the genus Plasmodiu (plasmodia).Malaria ranks fifth in the number of deaths per year among infectious diseases. Until 2010, up to a million people died annually from malaria, for example, 781,000 in 2009 and 655,000 in 2010. As of 2008-2009, one death from malaria accounted for $ 2,200 for treatment and research worldwide. For comparison, one death from HIV / AIDS accounted for $ 6800.

Epidemiology and prevention.

Malaria is quite an ancient disease, but at the moment it is widespread throughout the world, especially in African countries.For some populations, the risk of contracting malaria, as well as developing a more severe form of the disease, is higher. These are babies, children under five years of age, as well as pregnant women. In addition, people with HIV / AIDS, migrants who lack immunity, travelers and mobile populations are at risk. Russia, Ukraine and other post-Soviet countries are malaria-free countries, that is, isolated cases of imported malaria are recorded. However, with the development of tourism, it is possible to contract malaria while traveling to countries that are endemic (characteristic of the area) for malaria.85-90% of cases of infection occur in sub-Saharan Africa, some countries in Asia, South America, Oceania are also endemic. Before the trip, it is recommended to consult the embassy of the country to which the trip is planned regarding the epidemic situation and effective malaria prevention measures for this region. Pregnant women, children under the age of 4 and people living with HIV should not travel to countries affected by malaria. Methods used to prevent the spread of disease in areas where malaria is endemic include the use of prophylactic drugs and the use of mosquito bites.Regional drug resistance of malaria should be clarified before travel. Drug prophylaxis does not provide 100% protection, but it significantly reduces the risk of disease. It should be started 1–2 weeks prior to travel and continued 4–6 weeks after arriving home.


Developing a universal vaccination against malaria is difficult due to the genetic diversity of Plasmodia (malaria parasites). In the same habitat, hundreds of species of malaria pathogens, different from each other, can simultaneously be found.It is impossible to combine antigens of all these types in a single vaccination. The malaria vaccine exists, but today it is not universal. Its planned use is not approved in European countries of the world. The effectiveness of the existing vaccine against Plasmodium malaria is low (31–56%). A new highly effective vaccine is being tested (90% or more of plasmodia weakened by radiation.

Clinical manifestations.

Malaria is accompanied by fever, chills, splenomegaly (an increase in the size of the spleen), hepatomegaly (an increase in the size of the liver), anemia (a decrease in hemoglobin).It is characterized by a chronic recurrent course. The first symptoms — fever, headache, and chills — may be mild, making it difficult to detect malaria. If treatment is not started within the first 24 hours, P. falciparum malaria can develop into a serious illness, often fatal. There are 4 types of malaria: Three-day malaria, Oval malaria, Four-day malaria, Tropical malaria. Infection (contamination) with malaria occurs while an infected Anopheles mosquito sucks in human blood.Plasmodium with mosquito saliva in the form of sporozoites enter the bloodstream. The incubation (asymptomatic) period lasts from the moment of infection to the first clinical manifestations. This period corresponds to tissue schizogony or hibernation of sporozoites and, depending on the type of pathogen, lasts from 10 days to several months !!! Harbingers of the disease appear within 3 – 4 days – a deterioration in the general condition in the form of the appearance of flu-like symptoms: weakness, malaise, headaches, joint pain, a feeling of chills, etc.Acute period, which is characterized by the appearance of recurrent paroxysmal fever. The duration of the attack is from 5 to 12 hours, sometimes up to a day. The period of attacks of fever is associated with erythrocytic schizogony of Plasmodium. After an attack of fever, an interictal period sets in, the body temperature returns to normal, and the patient’s well-being improves. Convalescence occurs when the stage of late relapses passes. Thus, the total duration of the disease is determined by the type of invasion (infection).The total duration for three-day and four-day malaria is from two to four years, for oval malaria – from one and a half to three years, for tropical – up to a year. Sometimes a latent stage (complete absence of symptoms) can occur between the periods of early and late relapses. It can last from two to ten months and is mainly characteristic of three-day malaria and oval malaria.

Diagnosis of malaria is based on the following criteria:

  • Clinical – characteristic clinical manifestations (symptoms), the presence of fever.
  • Epidemic – stay of the patient in regions endemic for malaria during the last three years. Do not forget to inform the doctors about this!
  • Anamnestic (patient’s life history): previous malaria, facts of blood transfusion.
  • Laboratory tests remain the main criteria in the diagnosis of malaria. Malaria should only be treated after laboratory confirmation of the diagnosis.

Basic laboratory methods:

  • Blood microscopy
  • A blood test with microscopy (examination under a microscope) must be passed to detect the malaria parasites themselves.

Microscopy of a thick blood drop reveals large, relatively pale erythrocytes, which contain malaria plasmodia at various stages of development. Their amount in the peripheral blood depends on the severity of the disease. Microscopy of a thin blood smear allows you to study in more detail the altered erythrocytes and parasites in particular. Such an analysis is prescribed to determine the type of parasite and its stage of development.

Immunological blood test

To detect malaria antigens (special proteins), it is necessary to donate blood for an immunological test.There are several rapid tests for different types of plasmodia, which allow you to diagnose the disease right at the patient’s bed. The immunological tests take 10 to 15 minutes to complete. This analysis is widely used for epidemiological research in countries at high risk of contracting malaria.

Serological blood test

For malaria, a serological blood test is required to detect antibodies to plasmodium in the patient’s blood. The results of this analysis may indicate not only the presence of the parasite in the body, but also the transferred disease.An increase in the concentration of antibodies in the blood of more than 1 in 20 is considered a positive result.

Polymerase chain reaction based on a drop of blood

PCR for malaria should be taken only if previous tests have not confirmed the disease. PCR is performed on the basis of a drop of peripheral blood of a sick person. This type of analysis is highly specific. It tests positive and detects the pathogen in more than 95 percent of cases.


Without parasitological evidence of the disease, treatment can be carried out:

  • firstly, if there are clinical symptoms in foci endemic for malaria,
  • secondly, if laboratory research methods are unavailable.

Treatment is carried out in an infectious hospital.

The goal of malaria treatment is to interrupt the vital activity of the parasite in the patient’s blood, to prevent the occurrence of complications of the disease, to prevent the death of the patient,

to prevent the chronic course and relapses of malaria.Depending on the type of malaria, the presence or absence of complications of the disease, the stage of the development cycle of malarial plasmodium, the presence of resistance (resistance) to antimalarial drugs, individual schemes of etiotropic therapy are developed from the presented antimalarial drugs. Quinine is still the most widely used malaria drug today. For some time it was replaced by chloroquine, but now it has gained popularity again. The reason for this was the appearance in Asia and then spread to Africa and other parts of the world of Plasmodium falciparum with a mutation of resistance to chloroquine.There are also several other substances that are used both to treat and prevent malaria (doxycycline, sulfadoxine / pyrimethamine, atovaquone / proguanine).