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Scarlet Fever Facts

• Scarlet fever is a bacterial infection caused by group A Streptococcus bacteria that results in a rash and fever.
• The incubation period for scarlet fever is about 12 hours to seven days.
• Risk factors for scarlet fever include overcrowding, especially with children age 5 to 15 years old and the communal use of utensils, towels, or other substances.
• The contagious period for scarlet fever ranges from about 12 hours after exposure to the bacteria, even if the individual shows no symptoms, and during the acute phase when the person has a rash and fever; it ends after the fever has gone away for at least 12 hours.
• The signs and symptoms of scarlet fever include fever of 101 F or higher, a sandpaper-like rash, strawberry-like tongue texture, and other features that are relatively nonspecific such as nausea, vomiting, headache, swollen glands, and body aches.
• The treatment for scarlet fever is antibiotics that are effective against the infecting streptococci.
• Complications of scarlet fever can include rheumatic fever and kidney problems; other serious problems can occur on rare occasions, including death.
• The prognosis of scarlet fever, if treated early and effectively, is very good; such treatment usually prevents complications.
• It’s possible to reduce or prevent the chance of getting scarlet fever by good hand-washing techniques and by not using others utensils, towels, or other personal grooming products. There is no vaccine for humans against scarlet fever.

What is scarlet fever?

Scarlet fever or scarlatina, is a bacterial infection caused by group A Streptococcus bacteria. This illness usually occurs in a few people (about 10%) who have strep throat and occasionally streptococcal skin or even wound infections. Scarlet fever symptoms and signs may include a reddish sore throat, a fever (101 F or above), and a red rash with a sandpaper-like texture, and a tongue that resembles a “strawberry” (red with small bumps). Some patients will have whitish coating on the tongue or the throat and may have swollen glands, headache, nausea, vomiting, and/or body aches. The classic description of the rash of scarlet fever has been described as “goose bumps on a sunburned skin.”

Treatment of Scarlet Fever

A physical exam by a medical professional and a throat swab are cultured to determine if a person has scarlet fever. The treatment for scarlet fever is antibiotics. Usually about 10 days of an oral penicillin medication (for example, amoxicillin) can be an effective early treatment.

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Vertigo refers to a sense of dizziness. It is a symptom of a range of conditions. It can happen when there is a problem with the ear, brain, or sensory nerve pathway.
Dizziness, or vertigo, can happen at any age, but it is common in people aged 65 years and over. Over 60 medical and psychiatric conditions can cause it, as well as some medications. Vertigo can be temporary or long term. Persistent vertigo has been linked to mental health issues. A psychiatric problem may cause the dizziness, or the vertigo may affect the person’s ability to function in daily life, potentially leading to depression.

A person with vertigo will have a sense that they, or their environment, are moving or spinning, even though there is no movement. Vertigo is a symptom, but it can also cause other symptoms
These include:
 * dizziness
 * balance problems and lightheadedness
 * nausea and vomiting
 * a sense of motion sickness
 * tinnitus(ringing in the ears)
 * a feeling of fullness in the ear
Vertigo is not just a feeling of faintness, but a rotational dizziness.

Causes and types
There are different types of vertigo, depending on what causes them.

Peripheral vertigo happens when there is a disturbance in the balance organs of the inner ear.

Central vertigo happens when there is a disturbance in parts of the brain known as sensory nerve pathways.

Labyrinthitis: This is an inflammation of the inner ear labyrinth and vestibular nerve, the nerve that is responsible for encoding the body’s motion and position. It is usually caused by a viral infection.

Vestibular neuronitis: This is thought to be due to inflammation of the vestibular nerve, usually due to a viral infection.

Cholesteatoma: A skin growth occurs in the middle ear, usually as a result of repeated infection. If the growth becomes larger, it can damage the ear, leading to hearing loss and dizziness.

Ménière’s disease: A buildup of fluid in the inner ear can lead to attacks of vertigo. It tends to affect people between the ages of 40 and 60 years.

According to The National Institute on Deafness and Other Communication Disorders (NIDCD), 615,000 people in the United States (U.S.) are currently receiving treatment for this condition. It may stem from blood vessel constriction, a viral infection, or an autoimmune reaction, but this is not confirmed.
Benign paroxysmal positional vertigo (BPPV): This is thought to stem from a disturbance in the otolith particles. These are the crystals of calcium carbonate within inner ear fluid that pull on sensory hair cells during movement and so stimulate the vestibular nerve to send positional information to the brain.

In people with BPPV, normal movement of the inner ear fluid continues after head movement has stopped.
BPPV usually affects older people and the cause is usually unknown, or idiopathic. It has been linked to dementia. It is twice as common in women as in men.
However, it can also follow:
 * a head injury
 * reduced blood flow in part of the brain, known as vertebrobasilar ischemia
 * labyrinthitis
 * ear surgery
 * prolonged bed rest
Drug toxicity and syphilis can also lead to inner ear disturbances.

Other, rarer causes of peripheral vertigo are:
 * perilymphatic fistula, a tear in one/both of the membranes separating the middle and inner ear
 * herpes zoster oticus, a viral infection of the ear, also known as Ramsay Hunt syndrome
 * otosclerosis, a genetic ear bone problem that causes hearing loss

Central vertigo
Central vertigo is linked to problems with the central nervous system.
It involves a disturbance in one of the following areas:
 * the brainstem and cerebellum, which are the parts of the brain that deal with interaction between the senses of vision and balance
 * sensory messages to and from the part of the brain known as the thalamus

Migraine headache is the most common cause of central vertigo. An estimated 40 percent of patients with migraine have some vertigo, which can involve disrupted balance, dizziness, or both, at some time.
Uncommon causes are:
 * stroke
 * transient ischemic attack
 * cerebellar brain tumor
 * acoustic neuroma, a benign growth on the acoustic nerve in the brain
 * multiple sclerosis

Tests and diagnosis
During an evaluation for vertigo, a health care professional may obtain a full history of the events and symptoms. This includes medications that have been taken (even over-the-counter medications), recent illnesses, and prior medical problems (if any). Even seemingly unrelated problems may provide a clue as to the underlying cause of the vertigo.

After the history is obtained, a physical examination is performed. This often involves a full neurologic exam to evaluate brain function and determine whether the vertigo is due to a central or peripheral cause. New symptoms of vertigo should be worked up to rule out stroke as the primary cause. History, physical exam, and imaging as needed are critical to insure any life-threatening conditions are ruled out. Signs of nystagmus (abnormal eye movements) or incoordination can help pinpoint the underlying problem. The Dix-Hallpike test is done to try to recreate symptoms of vertigo; this test involves abruptly repositioning the patient’s head and monitoring the symptoms which might then occur. However, not every patient is a good candidate for this type of assessment, and a physician might instead perform a “roll test,” during which a patient lies flat and the head is rapidly moved from side to side. Like the Dix-Hallpike test, this may recreate vertigo symptoms and may be quite helpful in determining the underlying cause of the vertigo. If indicated, some cases of vertigo may require an MRI or CT scan of the brain or inner ears to exclude a structural problem like stroke.

Vertigo Treatments
Some of the most effective treatments for peripheral vertigo include particle repositioning movements. The most well-known of these treatments is the Epley maneuver or canalith repositioning procedure. During this treatment, specific head movements lead to movement of the loose crystals (canaliths) within the inner ear. By repositioning these crystals, they cause less irritation to the inner ear and symptoms can resolve. Because these movements can initially lead to worsening of the vertigo, they should be done by an experienced health care professional or physical therapist.

Medications may provide some relief, but are not recommended for long-term use. Meclizine is often prescribed for persistent vertigo symptoms, and may be effective. Benzodiazepine medications like Valium are also effective but may cause significant drowsiness as a side effect. Other medications may be used to decrease nausea or vomiting. It is should be recognized that medications can provide symptomatic relief, but are not considered “cures” for vertigo. Many cases of vertigo resolve spontaneously within a few days.

Can Vertigo Be Prevented?
Controlling risk factors for stroke may decrease the risk of developing central vertigo. This includes making sure that blood pressure, cholesterol, weight, and blood glucose levels are in optimal ranges. To decrease symptoms of vertigo in cases of Meniere’s disease, controlling salt intake may be helpful. If peripheral vertigo has been diagnosed, then performing vestibular rehabilitation exercises routinely may help prevent recurrent episodes.

As most cases of vertigo occur spontaneously, it is difficult to predict who is at risk; as such, complete avoidance or prevention may not be possible. However, maintaining a healthy lifestyle will decrease the risks of experiencing this condition.

In Conclusion…
Most patients with peripheral vertigo can find substantial relief with treatment; it has been suggested that the Epley maneuver in cases of BPPV can benefit as many as 90% of affected patients. Although recurrence of BPPV may be more than 15% in the first year after an episode, it is unlikely that vertigo will persist beyond a few days. When vertigo persists, evaluation for any underlying structural problems of the brain, spinal canal, or inner ear may be necessary.

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Types of Atypical Pneumonia

Pneumonia is a respiratory infection, which causes the air sacs in the lungs to be filled with pus or fluid. The infection is more likely to affect those with a weakened immune system. Some forms of pneumonia may be prevented with vaccination. However, there are many different causes for pneumonia. These can be broadly classified under bacterial, viral and fungal infections.

Types of Atypical Pneumonia

Atypical pneumonia is also referred to as walking pneumonia. This is because the symptoms of the illness are not the typical symptoms of pneumonia caused by other bacteria. Atypical pneumonia is always caused by a bacterial infection.

The severity of the symptoms of walking pneumonia are not as much as regular pneumonia. In fact, often the patient doesn’t even realise that they are suffering from pneumonia. Atypical pneumonia is primarily caused by three different forms of bacteria.

1. Mycoplasma Pneumonia

This type of atypical pneumonia is caused by the Mycoplasma pneumoniae bacteria. It is a milder form of pneumonia which affects children and adults alike. Symptoms often resemble that of the common cold or flu. This includes sneezing, coughing and low grade fever. Most people are unaware that it is pneumonia and may not even receive medication for it. The illness runs its course and disappears.

2. Chlamydophila Pneumonia

The Chlamydophila pneumoniae bacteria causes this a typical pneumonia. It primarily affects children. Since it spreads due to its contagious nature, it is also known as community acquired pneumonia. It can take nearly 21 days after exposure to the bacteria for the symptoms to become visible. Symptoms include runny nose, feeling of fatigue, low fever, sore throat, headache and a slowly worsening cough. The disease has a tendency to peak every four years in the community.

3. Legionella Pneumonia

Legionnella pneumophila bacteria is responsible for this type of a typical pneumonia. This is a respiratory infection which does not spread from contact with another infected person. It spreads through mist such as that generated by air conditioning systems in a big building. Or the mist that may be generated from hot tubs or showers at the gym. Also called Legionnaire’s disease, it can be fatal. This lethal form of pneumonia is very rare. It’s a life-threatening illness, where symptoms often show up too late or not at all. If caught in time it can be treated successfully with antibiotics.

Diagnosis of Atypical or Walking Pneumonia

Mycoplasma pneumonia doesn’t have very severe symptoms. They rival the symptoms of a common cold and are usually not taken very seriously by the patient. The patient continues walking and taking care of their normal, daily routine activities, which is why it is also referred to as Walking Pneumonia. Chlamydophila pneumonia has more pronounced symptoms and is likely to be brought to the attention of a health care professional. In case of Legionnaires’ disease, the symptoms often don’t manifest until it is too late to do anything about them.

For all types of pneumonia, a chest x-ray is a good way to diagnose the infection. The sound of the lungs may also be checked via a stethoscope. Respiratory secretions may be tested to determine the type of infection. This can aid in prescribing the correct antibiotic should the infection be bacterial in nature. Blood tests may also be performed as part of the diagnostic procedure. In some cases, urine tests may also be recommended.

Treating Atypical Pneumonia

There are no vaccines currently in existence to help prevent a typical pneumonia. Even recovering from these forms of pneumonia does not guarantee immunity from a second bout with the illness. Prevention is not always possible as the bacteria may be transmitted in many different manners to the patient. However once diagnosed, Mycoplasma pneumonia, Chlamydia pneumonia and Legionella pneumonia can all be treated using antibiotics.

A sample of phlegm or a swab of the nose or throat is usually enough to help identify the bacteria causing the infection. The correct antibiotic for the infection is then easy to prescribe. The most commonly used antibiotic medication include macrolide antibiotics, fluoroquinolones, and tetracyclines. Out of these fluoroquinolones are not usually administered to young children. The other two are suitable for both adults and children.

Besides medication, patients will be asked to increase their fluid intake and get lots of rest. Some pain medication may be used to alleviate body ache. Fever may be controlled using other medication. Should blood oxygen levels run low, oxygen therapy may be recommended. Most cases are treated at home after visiting an urgent care or local physician but if the illness becomes too severe hospitalization may take place.

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FAQs on Whooping Cough (Pertussis)

Pertussis or Whooping Cough is a highly contagious disease of the respiratory tract caused by
Bordetella pertussis, a bacteria that lives in the mouth, nose, and throat. Many children who
contract pertussis have coughing spells that last four to eight weeks. The disease is most
dangerous in infants and spreads easily from person to person, mainly through droplets produced
by coughing or sneezing. The first symptoms generally appear 7–10 days after infection, and
include mild fever, runny nose, and cough, which in typical cases gradually develops into a
spasmotic cough followed by whooping (hence the common name of whooping cough). In the
youngest infants, the spasms of coughing may be followed by periods of difficulty to catch a
breath. Pneumonia is a relatively common complication; seizures and brain dysfunction occur
more rarely. Untreated patients may be contagious for three weeks or more following onset of
the cough. Pertussis or whooping cough can be prevented by immunization.

How does whooping cough start out?
Whooping cough often starts with cold or flulike symptoms – sneezing, runny nose,
and a mild cough, which may last up to two weeks before the more severe coughing
spells begin. Your child may also have a fever. … The patient may cough up or vomit a
thick mucus

How common is whooping cough in the US?
Even with the success of pertussis (whooping cough) vaccines, the disease is still
common in the United States. Many cases are not diagnosed and so are not reported.
In recent years between 10,000 and 40,000 cases are reported each year.

How serious is the Whooping Cough?
Whooping cough—or pertussis—is a very serious respiratory (in the lungs and
breathing tubes) infection caused by the pertussis bacteria. It causes violent coughing
you can’t stop. Whooping cough is most harmful for young babies and can be deadly.

How contagious is whooping cough?
Infected people are most contagious up to about 2 weeks after the cough begins.
Antibiotics may shorten the amount of time someone is contagious. While pertussis
vaccines are the most effective tool we have to prevent this disease, no vaccine is
100% effective

How long does it take to get over whooping cough?
Pertussis disease can be divided into three stages: Inflammation of the mucous
membrane stage: can last 1–2 weeks and includes a runny nose, sneezing, low-grade
fever, and a mild cough (all similar symptoms to the common cold). Coughing stage:
usually lasts 1–6 weeks, but can persist for up to 10 weeks

Is whooping cough worse at night?
In this second phase of pertussis, coughing fits occur once every one to two hours
and are worse at night. The cough can be so severe that it can cause vomiting or
passing out. In older infants and toddlers, a gasp for air after a coughing fit can
sometimes produce a loud “whoop.”

Do adults get whooping cough?
Adults may not have the classic “whoop,” if they have a milder case of the disease.
Whooping cough is most contagious before the coughing starts, so the most effective
way to prevent it is to get vaccinated. The whooping cough vaccine for adults (and
adolescents) is called Tdap (tetanus-diphtheria-acellular pertussis).

What are the signs of whooping cough in adults?
In general, whooping cough starts off like a common cold. Symptoms can include runny
nose, low-grade fever, tiredness, and a mild or occasional cough. Over time, coughing
spells become more severe. Coughing may last for several weeks, sometimes 10
weeks or longer.

How do you get tested for whooping cough?
A nose or throat culture and test. Your doctor takes a swab or suction sample from the
area where the nose and throat meet (nasopharynx). The sample is then checked for
evidence of the presence of whooping cough bacteria. Blood tests.

How long does it take to get the results of a whooping cough test?
It is easiest to find it in the first 2 weeks but very unlikely after 3 weeks. But the patient
has often had it for 3 weeks before whooping cough is suspected. So it is unusual to
get a positive culture in whooping cough. In other words, if a swab is negative, the
patient can still have whooping cough.

Can whooping cough come back?
This is very common. When whooping cough is in its recovery phase, catching
another mild respiratory infection will cause all the bad whooping cough symptoms to
come back again, but only for the duration of the cold , then it will settle again. Q5.

Can you get whooping cough if you had the vaccine?
If you’ve been vaccinated and get pertussis, you are less likely to have a serious
infection. Typically, your cough won’t last as many days and coughing fits, whooping,
and vomiting after coughing fits won’t occur as often

How often do you need to be vaccinated for whooping cough?
All adults age 19 years and older need a one-time whooping cough booster vaccine.
The whooping cough booster, called Tdap, is a combination vaccine with tetanus and
diphtheria. Pregnant women need Tdap vaccine during the third trimester (between 27
and 36 weeks of every pregnancy).

How often do you need to get the Tdap vaccine?
All adults who have not yet received a dose of Tdap, as an adolescent or adult, need to
get Tdap vaccine (the adult whooping cough vaccine). Pregnant women need a dose in
every pregnancy. After that, you will need a Td booster dose every 10 years

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Meningitis B Vaccine- Now Available at Doctors Urgent Care


Hear the story of a survivor: https://www.gsksource.com/pharma/content/gsk/source/us/en/campaign/luckyones.html#03

This concerns the parents of students going off to colleges and other boarding schools.    Recently a new Meningitis B vaccine has been approved for use in the US to protect against the meningitis group B.  There have been several recent outbreaks of the MenB disease, which have resulted in a small number of deaths.  This vaccine was approved by the FDA in 2014 and is recommended by the CDC for young adults 16-23 years of age.  Some schools, especially where outbreaks of group B have occurred, are requiring all students to be vaccinated with a MenB vaccine.  Most people have been vaccinated for the most common forms of meningitis with the A vaccine which protects against groups A,C,W and Y.  These vaccines have been available in the US since the 1980’s and are known as quadrivalent (4 group) vaccines.

MenB vaccine is being offered by Doctors Urgent Care as a 2 dose vaccination using the GSK vaccine called Bexsero®.  The vaccinations are given at least 30 days apart which means that if you wish to protect your young adult before they go off to college, they can start the program now, and complete it when they return home for a visit.  The only requirement is that they get the second dose at least 30 days after the first, and that they use the same brand vaccine for the second dose.  Doctors Urgent Care has selected to offer the Bexsero because it only requires 2 doses. 

Additional Information and Frequently Asked Questions

I already got meningitis shots from my doctor as a teenager.  Do I still need to get this MenB shot?

Yes, you still need to get this new shot.  The MenB shots are NEW vaccines (called Bexsero®) approved in 2014-2015.  They cover meningococcal serogroup, or type, B; while the shot you received as a teenager covers serogroup A, C, W & Y.  All types of this disease are very serious, potentially life-threatening, so please be sure your last booster for those shots was at age 16 or later.  You will not have protection against the MenB disease unless you get the new MenB shots.

Who is considered at risk of Meningitis B?

The target population considered to be at most risk is younger students, especially new students going to a campus for the first time. Previous cases occurred in undergraduates living in shared residences, and members of sports teams and Greek organizations. Older persons have much less risk, although cases do rarely occur in any age group.

Who can get the vaccine?

It is licensed for use in the U.S.A. by the Food and Drug Administration (FDA) for persons aged 10-25 years of age, except in an outbreak setting where the CDC recently recommended the vaccine be given with no upper age limit.

Students can obtain the vaccine from Doctors Urgent Care. Graduate students are considered to be at lower risk than undergraduates; however, the FDA has approved both vaccines for those up to age 26. For students over 26 it is considered “off-label” but can be administered after consultation with your medical provider.

Can I wait until later to get the MenB shots?  What is the urgency for getting the shots now?

We do not recommend any delays in obtaining the new MenB vaccines, because the highest risk of disease occurs when new students are exposed to the meningococcal bacteria for the first time when they arrive in their new environment.

Unfortunately, the meningococcal bacteria may still be present in students who have had the vaccine, so they can pass it to others even though they are protected from the disease. The best way for students to protect themselves is to receive the full series of the new MenB vaccines (2 doses of Bexsero®) as soon as possible.

How many shots are needed for full protection against MenB disease?

For Bexsero®, a series of 2 shots given now and one month later is needed to provide maximum immunity.

Although some protection is achieved after the first shot, studies have shown this response soon wanes, and it is very important to complete the series for each product in order to develop full and longer lasting protection against disease.

NOTE: There are two brands of the vaccine, and they cannot be interchanged. Doctors Urgent Care uses Bexsero®

If I can’t get the shots exactly on schedule, will that be a problem?

No, the vaccine still works if the intervals between the shots have to be extended longer than the recommended follow-up doses. However, the fastest protection will be achieved by adhering to the schedule.

How much does it cost?

Currently we do not know which insurance companies will pay for these vaccinations.  The current charge is $195 for each of the two Bexsero® shots (pricing subject to changes in product cost), Doctors Urgent Care will file your insurance and if it is approved through your plan, we will send a refund check to you automatically.  You can also request a billing statement to submit to your health insurance company on your own if you like. 

What are side effects?

Most commonly reported is sore arm at the site of the injection. Extensive testing in clinical trials was presented to FDA who approved the widespread use of the vaccines.

Local College and University Checklists

LSU Freshman Checklist:

SLU Freshman Checklist:

UNO New Student Checklist:


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