Advertisements

Alzheimer’s Disease

What is Alzheimer’s Disease?

Although scientists are learning more every day, right now, they still do not know what causes Alzheimer’s disease.

Who has Alzheimer’s Disease?

View and download Alzheimer-related infographics

View and download Alzheimer-related infographics

  • In 2013, as many as 5 million Americans were living with Alzheimer’s disease.1
  • The symptoms of the disease can first appear after age 60 and the risk increases with age.
  • Younger people may get Alzheimer’s disease, but it is less common.
  • The number of people living with the disease doubles every 5 years beyond age 65.
  • By 2050, this number is projected to rise to 14 million people, a nearly three-fold increase.1

What is known about Alzheimer’s Disease?

Scientists do not yet fully understand what causes Alzheimer’s disease. There probably is not one single cause, but several factors that affect each person differently.

  • Age is the best known risk factor for Alzheimer’s disease.
  • Family history—researchers believe that genetics may play a role in developing Alzheimer’s disease.
  • Changes in the brain can begin years before the first symptoms appear.
  • Researchers are studying whether education, diet, and environment play a role in developing Alzheimer’s disease.
  • Scientists are finding more evidence that some of the risk factors for heart disease and stroke, such as high blood pressure and high cholesterol may also increase the risk of Alzheimer’s A man and a woman standing.  The middle-aged man is in the foreground, looking into camera.  The woman is standing behind him with her hands on his shoulder, smiling and also looking into the camera.disease.
  • There is growing evidence that physical, mental, and social activities may reduce the risk of Alzheimer’s disease.

How do I know if it’s Alzheimer’s disease?

Alzheimer’s disease is not a normal part of aging.

Memory problems are typically one of the first warning signs of cognitive loss.

According to the National Institute on Aging, in addition to memory problems, someone with Alzheimer’s disease may experience one or more of the following signs:

Familial Women hugging

  • Memory loss that disrupts daily life, such as getting lost in a familiar place or repeating questions.
  • Trouble handling money and paying bills.
  • Difficulty completing familiar tasks at home, at work or at leisure.
  • Decreased or poor judgment.
  • Misplaces things and being unable to retrace steps to find them.
  • Changes in mood, personality, or behavioral.

If you or someone you know has several or even most of the signs listed above, it does not mean that you or they have Alzheimer’s disease. It is important to consult a health care provider when

you or someone you know has concerns about memory loss, thinking skills, or behavioral changes.

How is Alzheimer’s disease treated?

A middle-aged man and woman sitting.  Both are smiling into the camera.  The woman is leaning onto the man with her head on his shoulder.

Medical management can improve the quality of life for individuals living with Alzheimer’s disease and their caregivers.  There is currently no known cure for Alzheimer’s disease.

Treatment addresses several different areas:

  • Helping people maintain mental function.
  • Managing behavioral symptoms.
  • Slowing or delaying the symptoms of the disease.

Support for family and friends

An older man and woman standing in front of a house.  Both are smiling into the camera.  The man is standing behind the woman with his hands on her shoulders.

Currently, many people living with Alzheimer’s disease are cared for at home by family members.

Caregiving can have positive aspects for the caregiver as well as the person being cared for. It may bring personal fulfillment to the caregiver, such as satisfaction from helping a family member or friend, and lead to the development of new skills and improved family relationships.

Although most people willingly provide care to their loved ones and friends, caring for a person with Alzheimer’s disease at home can be a difficult task and might become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. As the disease gets worse, people living with Alzheimer’s disease often need more intensive care.

You can find more information about caregiving here.

What is the burden of Alzheimer’s disease in the United States?

Alzheimer’s disease is

  • One of the top 10 leading causes of death in the United States.2
  • The 6th leading cause of death among US adults.
  • The 5th leading cause of death among adults aged 65 years or older.3

In 2013, an estimated 5 million Americans aged 65 years or older had Alzheimer’s disease.1 This number may triple to as high as 13.8 million people by 2050.1

In 2010, the costs of treating Alzheimer’s disease were projected to fall between $159 and $215 billion.4 By 2040, these costs are projected to jump to between $379 and more than $500 billion annually.4

Death rates for Alzheimer’s disease are increasing, unlike heart disease and cancer death rates that are on the decline.5 Dementia, including Alzheimer’s disease, has been shown to be underreported in death certificates and therefore the proportion of older people who die from Alzheimer’s may be considerably higher.6

Alzheimer’s Disease Public Health Curriculum

A Public Health Approach to Alzheimer’s and Other Dementias is an introductory curriculum that is intended to increase awareness of the impact of Alzheimer’s disease and other dementias as well as the role of public health. This curriculum addresses cognitive health, cognitive impairment, and Alzheimer’s disease and is intended for use by undergraduate faculty in schools and programs of public health and other related disciplines. This work supports The Healthy Brain Initiative: The Public Health Road Map for State and National Partnerships (Road Map) in its goal of developing a competent workforce. The curriculum is available free of charge and consists of four modules that are designed to be used individually or as a whole each with slides and a faculty guide.

Module Description Faculty Guide Slides
Course Overview Provides an overview of each module with learning objectives. View[PDF – 530 KB]
Module 1: Alzheimer’s Disease – A Public Health Crisis Alzheimer’s and other dementias are framed as a public health epidemic with a large and rapidly growing burden that bears significant impact on the nation. View[PDF – 4 MB] View[PPT – 3 MB]
View[PDF – 2 MB]
Module 2: Alzheimer’s and Other Dementias – The Basics Alzheimer’s and other dementias are described including symptoms, stages, risk factors, diagnosis, and management. View[PDF – 3 MB] View[PPT – 4 MB]
View[PDF – 2 MB]
Module 3: Alzheimer’s Disease – What is the Role of Public Health? Three tools of public health that may play a significant role in mitigating the Alzheimer’s disease epidemic are discussed: surveillance/monitoring, primary prevention, and early detection and diagnosis. View[PDF – 3 MB] View[PPT – 4 MB]
View[PDF – 2 MB]
Module 4: Dementia Capable Systems and Dementia Friendly Communities The public health response to the Alzheimer’s disease epidemic on a state and community level is addressed. The module describes the concept of a “dementia capable” system and explores how public health may support the development of such systems through public health research and translation, support services and programs, workforce training, and the creation of dementia-friendly communities. View[PDF – 3 MB] View[PPT – 11 MB]
View[PDF – 2 MB]
Complete Course An introductory curriculum that is intended to increase awareness of the impact of Alzheimer’s and other dementias as well as the role of public health. View[PDF – 10 MB]
About the Curriculum Curricular materials developed on cognitive health, cognitive impairment, and Alzheimer’s disease for use by undergraduate faculty in schools and programs of public health. View[PDF – 578 KB]
References  Provides the references and supporting material for the curriculum content. View[PDF – 624 KB]
Advertisements

Amyotrophic lateral sclerosis (ALS)

LouGAmyotrophic lateral sclerosis (ALS), sometimes called Lou Gehrig’s disease, is a progressive disease that attacks the nerve cells that control voluntary movement. The National ALS Registry is a congressionally mandated registry for persons in the U.S. with ALS. It is the only population-based registry in the U.S. that collects information to help scientists learn more about who gets ALS and its causes. No one knows for sure what causes ALS and currently there is no cure. If you have the disease, consider joining the Registry and completing the brief risk-factor surveys because your answers could help scientists defeat ALS. Learn more about the National ALS Registry Video[MP4 – 30 MB]

NEWS ABOUT ALS

ALS Prevalence in the United States
A new journal article has just been published on data gathered by the National ALS Registry “Estimation of the Prevalence of Amyotrophic Lateral Sclerosis in the United States Using National Administrative Healthcare Data from 2002 to 2004 and Capture-Recapture Methodology”.  Learn more at https://www.ncbi.nlm.nih.gov/pubmed/30092573

Alkhurma hemorrhagic fever (AHF)

Alkhurma hemorrhagic fever (AHF) is caused by Alkhurma hemorrhagic fever virus (AHFV), a tick-borne virus of the Flavivirus family. The virus was initially isolated in 1995 from a patient in Saudi Arabia. Subsequent cases of AHF have been documented in tourists in Egypt, extending the geographic range of the virus and suggesting that geographic distribution of the virus is wide and that infections due to AHFV are underreported.

The persistence of the virus within tick populations, and the role of livestock in the disease transmission process, are not well understood. The AHFV virus is a variant of Kyasanur Forest Disease (KFD), a tick-borne Flavivirus found in Karnataka State and environs in India.

Since the first description of AHFV, several hundred cases of AHF have been reported. Cases appear to peak in spring and summer. Further study of AHFV is needed to improve public health measures.

Transmission

Transmission of AHFV is not well understood. AHFV is a zoonotic virus, and its described tick hosts (the soft tick Ornithodoros savignyi and the hard tick Hyalomma dromedari) are widely distributed. People can become infected through a tick bite or when crushing infected ticks. Epidemiologic studies indicate that contact with domestic animals or livestock may increase the risk of human infection. No human-to-human transmission of AHF has been documented.

index

Although livestock animals may provide blood meals for ticks, it is thought that they play a minor role in transmitting AHFV to humans. No transmission through non-pasteurized milk has been described, although other tick-borne flaviviruses have been transmitted to humans through this route.

Signs and Symptoms

Based on limited information, after an incubation period that could be as short as 2-4 days, the disease presents initially with non-specific flu-like symptoms, including fever, anorexia (loss of appetite), general malaise, diarrhea, and vomiting; a second phase has appeared in some patients, and includes neurologic and hemorrhagic symptoms in severe form. Multi-organ failure precedes fatal outcomes. No repeated or chronic symptoms have been reported following recovery. Evidence suggests that a milder form may exist, where hospitalization is not required.

Thrombocytopenia, leukopenia, and elevated liver enzymes are nearly always observed in patients who have been hospitalized.

Risk of Exposure

Contact with livestock with tick exposure are risk factors for humans, as is contact with infected ticks, whether through crushing the infected tick with unprotected fingers or by a bite from an infected tick. Slaughtering of animals which may acutely but asymptomatically infected may also be a risk factor, as it is possible that infected animals develop a viremia without obvious clinical signs.

Diagnosis

Treatment

There is no standard specific treatment for the disease. Patients receive supportive therapy, which consists of balancing the patient’s fluid and electrolytes, maintaining oxygen status and blood pressure, and treatment for any complications. Mortality in hospitalized patients ranges from 1-20%.

Prevention

Given that no treatment or specific prophylaxis is presently available, prevention and increased awareness of AHFV are the only recommended measures. Complete control of ticks and interruption of the virus life cycle is impractical; in endemic regions, it is important to avoid tick-infested areas and to limit contact with livestock and domestic animals.

Individuals should use tick repellants on skin and clothes and check skin for attached ticks, removing them as soon as possible. Tick collars are available for domestic animals, and dipping in acaricides is effective in killing ticks on livestock. People working with animals or animal products in farms or slaughterhouses should avoid unprotected contact with the blood, fluids, or tissues of any potentially infected or viremic animals.

Outbreak Distribution Map

Outbreak distribution map

African Trypanosomiasis

hqdefault

African Trypanosomiasis, also known as “sleeping sickness,” is caused by microscopic parasites of the species Trypanosoma brucei. It is transmitted by the tsetse fly (Glossina species), which is found only in rural Africa. Although the infection is not found in the United States, historically, it has been a serious public health problem in some regions of sub-Saharan Africa. Currently, about 10,000 new cases each year are reported to the World Health organization; however, it is believed that many cases go undiagnosed and unreported. Sleeping sickness is curable with medication, but is fatal if left untreated.

Epidemiology & Risk Factors

Trypomastigotes of T. brucei ssp. in a blood smear stained with Giemsa. Credit: DPDx

There are two subspecies of the parasite Trypanosoma brucei that cause disease in humans. The clinical features of the infection depend on the subspecies involved. The two subspecies are found in different regions of Africa. At present, there is no overlap in their geographic distribution.

T. b. rhodesiense (East African sleeping sickness) is found in focal areas of eastern and southeastern Africa. Each year a few hundred cases are reported to the World Health Organization. Over 95% of the cases of human infection occur in Tanzania, Uganda, Malawi, and Zambia. Animals are the primary reservoir of infection. Cattle have been implicated in the spread of the disease to new areas and in local outbreaks. A wild animal reservoir is thought to be responsible for sporadic transmission to hunters and visitors to game parks. Infection of international travelers is rare, but it occasionally occurs. In the U.S., one case per year, on average, is diagnosed. Most cases of sleeping sickness imported into the U.S. have been in travelers who were on safari in East Africa.

T. b. gambiense (West African sleeping sickness) is found predominantly in central Africa and in limited areas of West Africa. Most of the sleeping sickness in Africa is caused by this form of the parasite. Epidemics of sleeping sickness have been a significant public health problem in the past, but the disease is reasonably well-controlled at present, with 7,000-10,000 cases reported annually in recent years. Over 95% of the cases of human infection are found in Democratic Republic of Congo, Angola, Sudan, Central African Republic, Chad, and northern Uganda. Humans are the important reservoir of infection, although the parasite can sometimes be found in domestic animals (e.g., pigs, dogs, goats). Imported infection in the U.S. is extremely rare, and most cases have occurred in African nationals who have immigrated rather than in returning U.S. travelers.

Close up of a tsetse fly taking a blood meal. Tsetse flies can transmit T. brucei.

Both forms of sleeping sickness are transmitted by the bite of the tsetse fly (Glossina species). Tsetse flies inhabit rural areas, living in the woodlands and thickets that dot the East African savannah. In central and West Africa, they live in the forests and vegetation along streams. Tsetse flies bite during daylight hours. Both male and female flies can transmit the infection, but even in areas where the disease is endemic, only a very small percentage of flies are infected. Although the vast majority of infections are transmitted by the tsetse fly, other modes of transmission are possible. Occasionally, a pregnant woman can pass the infection to her unborn baby. In theory, the infection can also be transmitted by blood transfusion or sexual contact, but such cases have rarely been documented.


This information is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider. If you have any questions about the parasites described above or think that you may have a parasitic infection, consult a health care provider.

Biology

Causal Agents:

Protozoan hemoflagellates belonging to the complex Trypanosoma brucei. Two subspecies that are morphologically indistinguishable cause distinct disease patterns in humans: T. b. gambiense causes West African sleeping sickness and T. b. rhodesiense causes East African sleeping sickness. (A third member of the complex, T. b. brucei, under normal conditions does not infect humans.)

Life Cycle:

AfrTryp LifeCycleDuring a blood meal on the mammalian host, an infected tsetse fly (genus Glossina) injects metacyclic trypomastigotes into skin tissue. The parasites enter the lymphatic system and pass into the bloodstream . Inside the host, they transform into bloodstream trypomastigotes , are carried to other sites throughout the body, reach other blood fluids (e.g., lymph, spinal fluid), and continue the replication by binary fission . The entire life cycle of African Trypanosomes is represented by extracellular stages. The tsetse fly becomes infected with bloodstream trypomastigotes when taking a blood meal on an infected mammalian host ( , ). In the fly’s midgut, the parasites transform into procyclic trypomastigotes, multiply by binary fission , leave the midgut, and transform into epimastigotes . The epimastigotes reach the fly’s salivary glands and continue multiplication by binary fission . The cycle in the fly takes approximately 3 weeks. Humans are the main reservoir for Trypanosoma brucei gambiense, but this species can also be found in animals. Wild game animals are the main reservoir of T. b. rhodesiense.

Disease

The clinical course of human African trypanosomiasis has two stages. In the first stage, the parasite is found in the peripheral circulation, but it has not yet invaded the central nervous system. Once the parasite crosses the blood-brain barrier and infects the central nervous system, the disease enters the second stage. The subspecies that cause African trypanosomiasis have different rates of disease progression, and the clinical features depend on which form of the parasite (T. b. rhodesiense or T. b. gambiense) is causing the infection. However, infection with either form will eventually lead to coma and death if not treated.

T. b. rhodesiense infection (East African sleeping sickness) progresses rapidly. In some patients, a large sore (a chancre) will develop at the site of the tsetse bite. Most patients develop fever, headache, muscle and joint aches, and enlarged lymph nodes within 1-2 weeks of the infective bite. Some people develop a rash. After a few weeks of infection, the parasite invades the central nervous system and eventually causes mental deterioration and other neurologic problems. Death ensues usually within months.

T. b. gambiense infection (West African sleeping sickness) progresses more slowly. At first, there may be only mild symptoms. Infected persons may have intermittent fevers, headaches, muscle and joint aches, and malaise. Itching of the skin, swollen lymph nodes, and weight loss can occur. Usually, after 1-2 years, there is evidence of central nervous system involvement, with personality changes, daytime sleepiness with nighttime sleep disturbance, and progressive confusion. Other neurologic signs, such as partial paralysis or problems with balance or walking may occur, as well as hormonal imbalances. The course of untreated infection rarely lasts longer than 6-7 years and more often kills in about 3 years.

Diagnosis

Trypanosoma brucei ssp. in a thin blood smear stained with Giemsa. Credit: DPDx

The diagnosis of African Trypanosomiasis is made through laboratory methods, because the clinical features of infection are not sufficiently specific. The diagnosis rests on finding the parasite in body fluid or tissue by microscopy. The parasite load in T. b. rhodesiense infection is substantially higher than the level in T. b. gambiense infection.

T. b. rhodesiense parasites can easily be found in blood. They can also be found in lymph node fluid or in fluid or biopsy of a chancre. Serologic testing is not widely available and is not used in the diagnosis, since microscopic detection of the parasite is straightforward.

The classic method for diagnosing T. b. gambiense infection is by microscopic examination of lymph node aspirate, usually from a posterior cervical node. It is often difficult to detect T. b. gambiense in blood. Concentration techniques and serial examinations are frequently needed. Serologic testing is available outside the U.S. for T. b. gambiense; however, it normally is used for screening purposes only and the definitive diagnosis rests on microscopic observation of the parasite.

All patients diagnosed with African trypanosomiasis must have their cerebrospinal fluid examined to determine whether there is involvement of the central nervous system, since the choice of treatment drug(s) will depend on the disease stage. The World Health Organization criteria for central nervous system involvement include increased protein in cerebrospinal fluid and a white cell count of more than 5. Trypanosomes can often be observed in cerebrospinal fluid in persons with second stage infection.

Treatment

A patient in the Democratic Republic of Congo receiving treatment for stage 2 sleeping sickness.

All persons diagnosed with African Trypanosomiasis should receive treatment. The specific drug and treatment course will depend on the type of infection (T. b. gambiense or T. b. rhodesiense) and the disease stage (i.e. whether the central nervous system has been invaded by the parasite). Pentamidine, which is the recommended drug for first stage T. b. gambiense infection, is widely available in the U.S. The other drugs (suramin, melarsoprol, eflornithine, and nifurtimox) used to treat African trypanosomiasis are available in the U.S. only from the CDC. Physicians can consult with CDC staff for advice on diagnosis and management and to obtain otherwise unavailable treatment drug.

There is no test of cure for African trypanosomiasis. After treatment patients need to have serial examinations of their cerebrospinal fluid for 2 years, so that relapse can be detected if it occurs.

Prevention & Control

There is no vaccine or drug for prophylaxis against African trypanosomiasis. Preventive measures are aimed at minimizing contact with tsetse flies. Local residents are usually aware of the areas that are heavily infested and they can provide advice about places to avoid. Other helpful measures include:
  • Wear long-sleeved shirts and pants of medium-weight material in neutral colors that blend with the background environment. Tsetse flies are attracted to bright or dark colors, and they can bite through lightweight clothing.
  • Inspect vehicles before entering. The flies are attracted to the motion and dust from moving vehicles.
  • Avoid bushes. The tsetse fly is less active during the hottest part of the day but will bite if disturbed.
  • Use insect repellent. Permethrin-impregnated clothing and insect repellent have not been proved to be particularly effective against tsetse flies, but they will prevent other insect bites that can cause illness.

Control of African trypanosomiasis rests on two strategies: reducing the disease reservoir and controlling the tsetse fly vector. Because humans are the significant disease reservoir for T. b. gambiense, the main control strategy for this subspecies is active case-finding through population screening, followed by treatment of the infected persons that are identified. Tsetse fly traps are sometimes used as an adjunct. Reducing the reservoir of infection is more difficult for T. b. rhodesiense, since there are a variety of animal hosts. Vector control is the primary strategy in use. This is usually done with traps or screens, in combination with insecticides and odors that attract the flies.

AFib, AF (Atrial fibrillation)

Atrial Fibrillation Fact Sheet

In the normal heart, the electrical activity proceeds in an organized manner, going from the atrium and into the ventricles. In a heart with atrial fibrillation, the electrical activity occurs in an unorganized manner rather than being sequential. The irregular line in the electrocardiogram on the right reflects the disorganized electrical activity producing the fine (fibrillating) wavy lines.

Electrical activity of a normal heart (left) and a heart with atrial fibrillation (right).

Atrial fibrillation, often called AFib or AF, is the most common type of heart arrhythmia. An arrhythmia is when the heart beats too slowly, too fast, or in an irregular way. When a person has AFib, the normal beating in the upper chambers of the heart (the two atria) is irregular, and blood doesn’t flow as well as it should from the atria to the lower chambers of the heart (the two ventricles). AFib may occur in brief episodes, or it may be a permanent condition.

AFib Facts1

  • An estimated 2.7–6.1 million people in the United States have AFib. With the aging of the U.S. population, this number is expected to increase.
  • Approximately 2% of people younger than age 65 have AFib, while about 9% of people aged 65 years or older have AFib.
  • African Americans are less likely than those of European descent to have AFib.
  • Because AFib cases increase with age and women generally live longer than men, more women than men experience AFib.

AFib Symptoms

Some people who have AFib don’t know they have it and don’t have any symptoms. Others may experience one or more of the following symptoms:

  • Irregular heartbeat
  • Heart palpitations (rapid, fluttering, or pounding)
  • Lightheadedness
  • Extreme fatigue
  • Shortness of breath
  • Chest pain

AFib Risk Factors

The risk for AFib increases with age. High blood pressure, which also increases in risk with advancing age, accounts for 14% to 22% of AFib cases.2

Risk factors for AFib include2:

  • Advancing age
  • High blood pressure
  • Obesity
  • European ancestry
  • Diabetes
  • Heart failure
  • Ischemic heart disease
  • Hyperthyroidism
  • Chronic kidney disease
  • Heavy alcohol use
  • Enlargement of the chambers on the left side of the heart

AFib increases a person’s risk for stroke by four to five times compared with stroke risk for people who do not have AFib. Strokes caused by complications from AFib tend to be more severe than strokes with other underlying causes. AFib causes 15%–20% of ischemic strokes, which occur when blood flow to the brain is blocked by a clot or by fatty deposits called plaque in the blood vessel lining.2

AFib Costs and Consequences

More than 750,000 hospitalizations occur each year because of AFib. The condition contributes to an estimated 130,000 deaths each year. The death rate from AFib as the primary or a contributing cause of death has been rising for more than two decades.3,4

AFib costs the United States about $6 billion each year. Medical costs for people who have AFib are about $8,705 higher per year than for people who do not have AFib.1,2

AFib Treatment

Treatment for AFib can include:

  • Medications to control the heart’s rhythm and rate.
  • Blood-thinning medication to prevent blood clots from forming and reduce stroke risk.
  • Surgery.
  • Medication and healthy lifestyle changes to manage AFib risk factors.

CDC’s Public Health Efforts Related to AFib

Atrial fibrillation hospitalization rates for fee-for-service Medicare beneficiaries ages 65 and older were highest in counties in the Eastern U.S. and Missouri, Arkansas, and Louisiana.

Resources

  1. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation. Journal of the American College of Cardiology. 2014;64(21):2246–80.
  2. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation. 2015;131:e29–e322
  3. Agency for Healthcare Research and Quality. Weighted national estimates. HCUP National Inpatient Sample [online]. 2012. [cited 2015 Feb 9]. Available from: http://hcupnet.ahrq.gov/HCUPnet.jsp.
  4. Centers for Disease Control and Prevention. About multiple cause of death 1999–2011. CDC WONDER Online Database. 2014. [cited 2014 Oct 2]. Available from: http://wonder.cdc.gov/mcd-icd10.html.

Attention-Deficit / Hyperactivity Disorder (ADHD)

People with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active. Although ADHD can’t be cured, it can be successfully managed and some symptoms may improve as the child ages.

Basic Information

ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.

About 2 million of the more than 6 million children with ADHD were diagnosed as young children aged 2-5 years.

Signs and Symptoms

It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviors. The symptoms continue, can be severe, and can cause difficulty at school, at home, or with friends.

A child with ADHD might:

  • daydream a lot
  • forget or lose things a lot
  • squirm or fidget
  • talk too much
  • make careless mistakes or take unnecessary risks
  • have a hard time resisting temptation
  • have trouble taking turns
  • have difficulty getting along with others

Types

There are three different types of ADHD, depending on which types of symptoms are strongest in the individual:

  • Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.
  • Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
  • Combined Presentation: Symptoms of the above two types are equally present in the person.

Because symptoms can change over time, the presentation may change over time as well.

Causes of ADHD

Scientists are studying cause(s) and risk factors in an effort to find better ways to manage and reduce the chances of a person having ADHD. The cause(s) and risk factors for ADHD are unknown, but current research shows that genetics plays an important role. Recent studies of twins link genes with ADHD.1

In addition to genetics, scientists are studying other possible causes and risk factors including:

  • Brain injury
  • Exposure to environmental (e.g., lead) during pregnancy or at a young age
  • Alcohol and tobacco use during pregnancy
  • Premature delivery
  • Low birth weight

Research does not support the popularly held views that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos. Of course, many things, including these, might make symptoms worse, especially in certain people. But the evidence is not strong enough to conclude that they are the main causes of ADHD.

For more information about cause(s) and risk factors, visit the National Resource Center on ADHD.

Diagnosis

Deciding if a child has ADHD is a process with several steps. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, sleep problems, and certain types of learning disabilities, can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Another part of the process may include a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.

Learn more about the criteria for diagnosing ADHD

Treatments

physician speaking to family

In most cases, ADHD is best treated with a combination of behavior therapy and medication. For preschool-aged children (4-5 years of age) with ADHD, behavior therapy, particularly training for parents, is recommended as the first line of treatment. What works best can depend on the child and family. Good treatment plans will include close monitoring, follow-ups, and making changes, if needed, along the way.

Learn more about treatments

Managing Symptoms: Staying Healthy

Being healthy is important for all children and can be especially important for children with ADHD. In addition to behavioral therapy and medication, having a healthy lifestyle can make it easier for your child to deal with ADHD symptoms. Here are some healthy behaviors that may help:

Get Help!

If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a child psychologist or developmental pediatrician, or you can contact your local early intervention agency (for children under 3) or public school (for children 3 and older).

Sharing Concerns

For tips on sharing concerns about a child’s development, click on one of the following:

The Centers for Disease Control and Prevention (CDC) sponsors the National Resource Center on ADHD, a program of CHADD – Children and Adults with Attention-Deficit/Hyperactivity Disorder. Their website has links to information for people with ADHD and their families. The National Resource Center operates a call center with trained staff to answer questions about ADHD. The number is 1-800-233-4050.

For more information on services for children with special needs, visit the Center for Parent Information and Resources.  To find the Parent Center near you, you can visit this website.

In order to make sure your child reaches his or her full potential, it is very important to get help for ADHD as early as possible.

ADHD in Adults

ADHD often lasts into adulthood. For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD and the National Institutes of Mental Health.

Adenoviruses

Adenoviruses are common viruses that cause a range of illness. They can cause cold-like symptoms, sore throat, bronchitis, pneumonia, diarrhea, and pink eye (conjunctivitis). You can get an adenovirus infection at any age. People with weakened immune systems or existing respiratory or cardiac disease are more likely than others to get very sick from an adenovirus infection.

Symptoms

A little girl in red with flu looking sick.Adenoviruses can cause a wide range of illnesses such as

  • Common cold
  • Sore throat
  • Bronchitis (a condition that occurs when the airways in the lungs become filled with mucus and may spasm, which causes a person to cough and have shortness of breath)
  • Pneumonia (infection of the lungs)
  • Diarrhea
  • Pink eye (conjunctivitis)
  • Fever
  • Bladder inflammation or infection
  • Inflammation of stomach and intestines
  • Neurologic disease (conditions that affect the brain and spinal cord)

Adenoviruses can cause mild to severe illness, though serious illness is less common. People with weakened immune systems, or existing respiratory or cardiac disease, are at higher risk of developing severe illness from an adenovirus infection.

Transmission

Girl lying in bed coughing.Adenoviruses are usually spread from an infected person to others through

  • close personal contact, such as touching or shaking hands
  • the air by coughing and sneezing
  • touching an object or surface with adenoviruses on it, then touching your mouth, nose, or eyes before washing your hands

Some adenoviruses can spread through an infected person’s stool, for example, during diaper changing. Adenovirus can also spread through the water, such as swimming pools, but this is less common.

Sometimes the virus can be shed (released from the body) for a long time after a person recovers from an adenovirus infection, especially among people who have weakened immune systems. This “virus shedding” usually occurs without any symptoms, even though the person can still spread adenovirus to other people.

Prevention & Treatment

Prevention

There is currently no adenovirus vaccine available to the general public.

A vaccine specific for adenovirus types 4 and 7 was approved by the U.S. Food and Drug Administration in March 2011, for use only in U.S. military personnel who may be at higher risk for infection from these two adenovirus types. For more information about the vaccine, see Adenovirus Vaccine Information Statement (VIS).

Follow simple steps to protect yourself and others

You can protect yourself and others from adenoviruses and other respiratory illnesses by following a few simple steps:

  • Wash your hands often with soap and water (see CDC’s Clean Hands Save Lives! )
  • Avoid touching your eyes, nose, or mouth with unwashed hands
  • Avoid close contact with people who are sick

If you’re sick you can help protect others:

  • Stay home when you are sick
  • Cover your mouth and nose when coughing or sneezing
  • Avoid sharing cups and eating utensils with others
  • Refrain from kissing others
  • Wash your hands often with soap and water, especially after using the bathroom

Frequent handwashing is especially important in childcare settings and healthcare facilities.

Maintain proper chlorine levels to prevent outbreaks

Adenoviruses are resistant to many common disinfectant products and can remain infectious for long periods on surfaces and objects. It is important to keep adequate levels of chlorine in swimming pools to prevent outbreaks of conjunctivitis caused by adenoviruses. For guidance to prevent adenovirus infections in healthcare settings, see Prevention & Treatment for Health Care Professionals.

Treatment

There is no specific treatment for people with adenovirus infection. Most adenovirus infections are mild and may require only care to help relieve symptoms.

Acquired Immune Deficiency Syndrome (AIDS) — see HIV/AIDS

HIV Basics

HIV basics slider

HIV stands for human immunodeficiency virus. It weakens a person’s immune system by destroying important cells that fight disease and infection. No effective cure exists for HIV. But with proper medical care, HIV can be controlled. Some groups of people in the United States are more likely to get HIV than others because of many factors, including their sex partners, their risk behaviors, and where they live. This section will give you basic information about HIV, such as how it’s transmitted, how you can prevent it, and how to get tested for HIV.

About HIV/AIDS

HIV is a virus spread through certain body fluids that attacks the body’s immune system, specifically the CD4 cells, often called T cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These special cells help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells (T cells) in the body. This damage to the immune system makes it harder and harder for the body to fight off infections and some other diseases. Opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS. Learn more about the stages of HIV and how to know whether you’re infected.

What Is HIV?

HIV stands for human immunodeficiency virus. It is the virus that can lead to acquired immunodeficiency syndrome or AIDS if not treated. Unlike some other viruses, the human body can’t get rid of HIV completely, even with treatment. So once you get HIV, you have it for life.

HIV attacks the body’s immune system, specifically the CD4 cells (T cells), which help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells (T cells) in the body, making the person more likely to get other infections or infection-related cancers. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS, the last stage of HIV infection.

No effective cure currently exists, but with proper medical care, HIV can be controlled. The medicine used to treat HIV is called antiretroviral therapy or ART.  If people with HIV take ART as prescribed, their viral load (amount of HIV in their blood) can become undetectable. If it stays undetectable, they can live long, healthy lives and have effectively no risk of transmitting HIV to an HIV-negative partner through sex. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS in just a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can live nearly as long as someone who does not have HIV.

Learn about how to protect yourself, and get information tailored to meet your needs from CDC’s (BETA).

Stages of HIV

When people get HIV and don’t receive treatment, they will typically progress through three stages of disease. Medicine to treat HIV, known as antiretroviral therapy (ART), helps people at all stages of the disease if taken as prescribed. Treatment can slow or prevent progression from one stage to the next. Also, people with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load have effectively no risk of transmitting HIV to an HIV-negative partner through sex.

Stage 1: Acute HIV infection

Within 2 to 4 weeks after infection with HIV, people may experience a flu-like illness, which may last for a few weeks. This is the body’s natural response to infection. When people have acute HIV infection, they have a large amount of virus in their blood and are very contagious. But people with acute infection are often unaware that they’re infected because they may not feel sick right away or at all. To know whether someone has acute infection, either a fourth-generation antibody/antigen test or a nucleic acid (NAT) test is necessary. If you think you have been exposed to HIV through sex or drug use and you have flu-like symptoms, seek medical care and ask for a test to diagnose acute infection.

Stage 2: Clinical latency (HIV inactivity or dormancy)

This period is sometimes called asymptomatic HIV infection or chronic HIV infection. During this phase, HIV is still active but reproduces at very low levels. People may not have any symptoms or get sick during this time. For people who aren’t taking medicine to treat HIV, this period can last a decade or longer, but some may progress through this phase faster. People who are taking medicine to treat HIV (ART) the right way, every day may be in this stage for several decades. It’s important to remember that people can still transmit HIV to others during this phase, although people who are on ART and stay virally suppressed (having a very low level of virus in their blood) are much less likely to transmit HIV than those who are not virally suppressed. At the end of this phase, a person’s viral load starts to go up and the CD4 cell count begins to go down. As this happens, the person may begin to have symptoms as the virus levels increase in the body, and the person moves into Stage 3.

Stage 3: Acquired immunodeficiency syndrome (AIDS)

AIDS is the most severe phase of HIV infection. People with AIDS have such badly damaged immune systems that they get an increasing number of severe illnesses, called opportunistic illnesses.

Without treatment, people with AIDS typically survive about 3 years. Common symptoms of AIDS include chills, fever, sweats, swollen lymph glands, weakness, and weight loss. People are diagnosed with AIDS when their CD4 cell count drops below 200 cells/mm or if they develop certain opportunistic illnesses. People with AIDS can have a high viral load and be very infectious.

Learn about how to protect yourself, and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

Hoe do i Know i have HIV?

The only way to know for sure whether you have HIV is to get tested. Knowing your status is important because it helps you make healthy decisions to prevent getting or transmitting HIV.

Some people may experience a flu-like illness within 2 to 4 weeks after infection (Stage 1 HIV infection). But some people may not feel sick during this stage. Flu-like symptoms include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, or mouth ulcers. These symptoms can last anywhere from a few days to several weeks. During this time, HIV infection may not show up on an HIV test, but people who have it are highly infectious and can spread the infection to others.

If you have these symptoms, that doesn’t mean you have HIV. Each of these symptoms can be caused by other illnesses. But if you have these symptoms after a potential exposure to HIV, see a health care provider and tell them about your risk. The only way to determine whether you are infected is to be tested for HIV infection.

To find places near you that offer confidential HIV testing,

You can also use a home testing kit, available for purchase in most pharmacies and online.

After you get tested, it’s important to find out the result of your test so you can talk to your health care provider about treatment options if you’re HIV-positive or learn ways to prevent getting HIV if you’re HIV-negative.

Learn about how to protect yourself, and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

Is There A cure for HIV

No effective cure currently exists for HIV. But with proper medical care, HIV can be controlled. Treatment for HIV is called antiretroviral therapy or ART. If people with HIV take ART as prescribed, their viral load (amount of HIV in their blood) can become undetectable. If it stays undetectable, they can live long, healthy lives and have effectively no risk of transmitting HIV to an HIV-negative partner through sex. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS (the last stage of HIV infection) in a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can live nearly as long as someone who does not have HIV.

Learn about how to protect yourself, and get information tailored to meet your needs from CDC’s (BETA).

Acinetobacter Infection

Acinetobacter in Healthcare Settings

General information about Acinetobacter

Acinetobacter [asz−in−ée−toe–back−ter] is a group of bacteria commonly found in soil and water. While there are many types or “species” of Acinetobacter and all can cause human disease, Acinetobacter baumannii [asz−in−ée−toe–back−ter   boe-maa-nee-ie] accounts for about 80% of reported infections.

Outbreaks of Acinetobacter infections typically occur in intensive care units and healthcare settings housing very ill patients. Acinetobacter infections rarely occur outside of healthcare settings.

Symptoms of Acinetobacter infection

Acinetobacter causes a variety of diseases, ranging from pneumonia to serious blood or wound infections, and the symptoms vary depending on the disease. Acinetobacter may also “colonize” or live in a patient without causing infection or symptoms, especially in tracheostomy sites or open wounds.

Acinetobacter baumannii bacteriaFor more images of this bacterium, search the Public Health Image Library

Transmission of Acinetobacter infection

Acinetobacter poses very little risk to healthy people. However, people who have weakened immune systems, chronic lung disease, or diabetes may be more susceptible to infections with Acinetobacter. Hospitalized patients, especially very ill patients on a ventilator, those with a prolonged hospital stay, those who have open wounds, or any person with invasive devices like urinary catheters are also at greater risk for Acinetobacter infection. Acinetobacter can be spread to susceptible persons by person-to-person contact or contact with contaminated surfaces.

Prevention of Acinetobacter infection

Acinetobacter can live on the skin and may survive in the environment for several days. Careful attention to infection control procedures, such as hand hygiene and environmental cleaning, can reduce the risk of transmission.

Treatment of Acinetobacter infection

Acinetobacter is often resistant to many commonly prescribed antibiotics. Decisions on treatment of infections with Acinetobacter should be made on a case-by-case basis by a healthcare provider. Acinetobacter infection typically occurs in ill patients and can either cause or contribute to death in these patients.

Up ↑

%d bloggers like this: