What Is Rubella? What Are German Measles? What Causes Rubella Or German Measles?

What Is Rubella? What Are German Measles? What Causes Rubella Or German Measles? Rubella, also known as German measles, is an infectious disease caused by the rubella virus. The virus passes from person-to-person via droplets in the air expelled when infected people cough or sneeze - the virus may also be present in the urine, feces and on the skin. The hallmark symptoms of rubella are an elevated body temperature and a pink rash. Although rubella can infect people of all ages, it most commonly affects young children. If a pregnant woman becomes infected with Rubella there is a serious risk of birth defects in the unborn baby. If the pregnant mother is infected within the first 20 weeks of pregnancy the child may be born with congenital rubella syndrome, which consists of a range of serious incurable illnesses. About one-fifth of infected pregnant women will miscarry. The name "rubella" comes from the Latin word rubella meaning "little red". As the disease was first described by German doctors in the mid-eighteenth century, it is also known as German measles. Rubella is usually mild and frequently passes unnoticed. The disease can last from one to three days. Children usually recover faster than adults. What are the signs and symptoms of rubella? A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign. Rubella's incubation period is from 14 to 21 days. Some people may be infected and never know it. Patients typically have flu-like symptoms. The main symptom is a rash - pink or light red - on the face, which then spreads to the chest, stomach, back, arms and legs. When the rash reaches other parts of the body it usually fades from the face. Within about three days the rash goes away with no staining or peeling of the skin. After it has cleared up the skin may shed very small flakes where the rash was. While the rash is present there may be itching. Patients may also have a slight fever and swollen glands (which may persist for a week), headache, conjunctivitis and joint pains. The older the patient is the more severe symptoms tend to be. A significant number of older girls and adult women may have arthritic type symptoms. Infected people are contagious about one week before the rash appears and about one week after it has cleared up. What causes rubella? Rubella is caused by an extremely infectious virus that is transmitted from person-to-person in droplets in the air. When an infected person sneezes or coughs, those nearby are at risk of becoming infected. It is also possible to infect another person if they come into contact with the saliva of an infected person. The virus is capable of crossing the placenta and infecting the unborn child (feuts) where it stops cells from developing or destroys them. Diagnosis of rubella The National health Service (NHS), UK instructs people who suspect somebody in the household may have rubella to call their doctor - not to visit, as there is a risk others in the clinic or GP practice, including pregnant women, may become infected. Since the rubella rash is similar in appearance to irritations caused by other viral infections, a GP will confirm the diagnosis by doing a virus culture or a blood test. The presence of different types of rubella antibodies will corroborate the diagnosis. By law, doctors have to notify the local authority of all suspected rubella cases. The child's school or nursery should be told immediately. IgM (rubella virus specific) antibodies are found in individuals who have been recently infected. However, these antibodies may persist for a long time, sometimes for over a year. Therefore, a positive blood test result needs to be interpreted with caution. Treatment options for rubella In the vast majority of cases rubella infection signs and symptoms will resolve within a week or two. Patients should stay at home and avoid contact with other people, especially pregnant women. The NHS advises people to stay away from work/school for at least five days. If there is any fever or aches an OTC (over-the-counter), such as Tylenol (paracetamol) or ibuprofen may help. Do not give aspirin to children under the age of 16 years. To avoid dehydration it is important to consume plenty of liquids, preferably water. Prevention of rubella Immunization with the MMR vaccine is the most effective way to protect against rubella. It is a combined vaccine that protects children against all three conditions - measles, mumps and rubella. It contains the safest and most effective form of each vaccine. This is usually given to children between 12 and 15 months followed by a booster injection before entering school (usually between three to five years of age). Children who are too young to have had the MMR vaccine and are exposed to the virus may be given an injection of immunoglobulin antibodies which provide short-term but immediate protection against the disease. As a pregnant mother passes on her own immunity to her baby, the baby is protected at least during his/her first six months of life. Despite fears of an association between the MMR vaccine and autism risk, all studies over the last decade have shown that there is no link. Complications of rubella Complications, if they do occur, tend to be mild and may include diarrhea, vomiting, otitis media (inner ear infection), and convulsions (if there is a fever). Much more rarely, there is a risk of encephalitis, croup, bronchitis, and pneumonia. The most important complication is if a pregnant woman becomes infected, especially during the first 11 weeks of her pregnancy (the danger is present throughout pregnancy). Her offspring may suffer from heart defects, stunted growth, hearing problems, organ defects, eye problems (cataracts) and cognitive defects. Written by Christian Nordvist http://www.medicalnewstoday.com/articles/164504.php

Managing stress as a doctor

What is it about doctors that makes them vulnerable to poorly managing their own health?
Our research at the Doctors for Doctors Unit shows that only one in three doctors would see their GP when unwell, despite almost all being registered with one (which is often simply required for work, insurance and so on). One in eight doctors reported that they use alcohol or drugs to help them cope with work and ill health, about one in four reported knowing of colleagues who do so.
It is probably a combination of factors leading to such problems: the conscientious personalities of doctors, the demands of the job, and the culture and systems around doctors health.

Doctors' personalities

There are traits that typically feature in a doctor's profile that might make us good at being doctors, but not necessarily at looking after ourselves. We are obsessive and perfectionist, overly conscientious, and we seek approval. Doctors need to be in control, but may harbour chronic self-doubt. We also tend to dislike praise and delay gratification or the rewards from the job.
The very definition of the job also creates a fine line that doctors walk. To be a good doctor, one needs to be involved with patients (capable of empathy and humanity); yet to remain objective and survive emotionally, one needs to be detached from their pain and suffering. And higher levels of self-criticism are associated with high rates of depression; yet doctors need to be obsessional and self-critical in order to avoid mishaps. The very traits that are necessary for good patient care may not be good for the doctor's health.

Demands of the job

But there are also external factors that cause doctors to burn out. We are giving all day (and night) emotionally, and dealing with physical and emotional distress but who cares for us? For GPs in particular, there is isolation, both psychologically and physically. Doctors are also practising intensively at front line. Long hours lead to poor family relationships/support. Added to all this there is:
* A lack of feedback (except in the form of complaints!);
* Perceived threat of, for example, violence, complaints;
* Insecurity (poor support from management; and NHS reorganisation);

Culture

Comments doctors have given us sum up how there is much collusion allowing the health effects of all these stresses to go unchecked - that doctors are not supposed to be ill, everyone expects a doctor to get on with it and cure himself, doctors with health problems are seen as potential problems and I don't think the avenues are clear enough. There is enormous pressure on doctors not to give in to ill health.
So how do doctors know when these three factors - themselves, the job, and the culture around them have conspired to start causing damage, and what can they do about it?

The symptoms of burn out are identifiable in four areas: emotional, cognitive, behavioural and physical.
Emotional:
Loss of humour;
Irritability/resentment/bitterness;
Depressed mood, apathy;
Feelings of failure/guilt/blame.

Cognitive:
Poor concentration;
Rigidity/resistance to change;
Suspicion/mistrust;
Stereotyping;
Objectification/distancing;
Ruminations (of leaving, revenge, and so on).

Behavioural:
Work avoidance (absenteeism, clock-watching, and so on);
Diminished personal conduct with clients/colleagues;
Inflexible behaviour;
Habitual lateness;
Acting out (alcohol/drugs/affairs/shopping, and so on).

Physical:Tiredness, lethargy;

Sleep disorders;
Increased minor illnesses (headache, backache, and so on).
Many of the ways in which we can help ourselves will read as common sense and are often not too difficult  First and foremost, register with a GP before any problem presents itself. When there are stresses, share problems with family, friends, and colleagues and admit vulnerability. You are a human-being like any of your patients. Set boundaries and make space for yourself; learn to say NO. Try to build in some protection to your spare time so that it doesnt get eaten into. And seek help early if you do develop problems that need further management, and consider options including psychotherapy or counselling.

If you are feel that you are getting symptoms of burn out, keeping a stress diary for just a week can help with identifying the stressors and doing something about preventing further ill effects. Divide the day into hours and record events occurring in each hour. Rate events on a scale of one to ten on two parallel charts one for how stressful the event was and another for how much benefit that same event provided you. After a week, reflect on your ratings and try to alter those events that are causing you high stress for low value. The process of keeping a diary means you will also be paying some attention to time management, which can also help against stress. An example of a time management tool that is quick and easy to use can be found at this web page from Bristol GP solutions [http://www.bristolgpsolutions.org.uk/h4.htm ].
Applying a CBT approach to stressful events can help you identify and manage problems too, simply by thinking about your reactions to situations and asking these sorts of questions:

- Was it stressful and how?
- What was I thinking and how did I react?
- What was the outcome?
- How could I have reacted differently?
- What changes could I make?

Identify your negative thoughts review them rationally and challenge them. Counter what have become automatic negative thoughts - with positive alternatives. Sometimes it can also be helpful to try and see the point of view of those with whom you are in conflict.
A final note is that one of the factors that need not necessarily be out of your control is your colleagues and your particular work set up. GPs in particular should place some importance on finding the right practice or partners as far as possible.
In summary, there is much you are in control of yourself to prevent problems caused by the pressures of the profession. Your personality, what being a doctor demands, and the culture around you are three factors that you can recognise and manage too.

Dr Michael Peters, Head of the Doctors for Doctors Unit of the BMA

Leave the Poop-Scooping to the Pros

Leave the Poop-Scooping to the Pros The Environmental Protection Agency (EPA) deemed pet waste a “nonpoint source of pollution” in 1991, which put poop in the same category as oil and toxic chemicals! Far from Fertilizer Woof-woof waste does not a good fertilizer make. It is actually toxic to your lawn, causing burns and unsightly discoloring. Beyond your grass, it has been estimated that a single gram of dog waste can contain 23 million fecal coliform bacteria, which are known to cause cramps, diarrhea, intestinal illness, and serious kidney disorders in humans. EPA even estimates that two or three days’ worth of droppings from a population of about 100 dogs would contribute enough bacteria to temporarily close a bay, and all watershed areas within 20 miles of it, to swimming and shell fishing. Dog feces are one of the most common carriers of the following diseases: Heartworms Whipworms Hookworms Roundworms Tapeworms Parvo Corona Giardiasis Salmonellosis Cryptosporidiosis Campylobacteriosis For example, in the Four Mile Run watershed in Northern Virginia, a dog population of 11,400 is estimated to contribute about 5,000 pounds of solid waste every day and has been identified as a major contributor of bacteria to the stream. Nearly 500 fecal coliform samples have been taken from Four Mile Run and its tributaries since 1990, and about 50 percent of these samples have exceeded the Virginia State water quality standard for fecal coliform bacteria, according to EPA. Why all this fanfare for feces, you may ask? Well, EPA explains that the decay of your pet’s waste actually creates nutrients for weeds and algae that grow in the waterways. As these organisms thrive on your dog’s droppings, they overtake the water in a “Little Shop of Horrors-esque” manner, and limit the amount of light that can penetrate the water’s surface. As a result, oxygen levels in the water decrease, and the fish and seafood we eat can be asphyxiated, EPA says. A Toxic Cycle If you aren’t worried about the state of your local waterways, you may be a bit more concerned about the impact of dog waste a little closer to home. The thing about persistently disposing of stools improperly (or not at all) is that it kicks off a harmful cycle that can affect your whole family—including your pet. According to the U.S. Centers for Disease Control and Prevention (CDC), pet droppings can contribute to diseases animals pass to humans, called zoonoses. When infected dog poop is deposited on your lawn, the eggs of certain roundworms and other parasites can linger in your soil for years. Anyone who comes into contact with that soil—be it through gardening, playing sports, walking barefoot or any other means—runs the risk of coming into contact with those eggs; especially your dog. Some of the hard-to-pronounce parasites your lawn could harbor include Cryptosporidium, Giardia, Salmonella, as well as hookworms, ringworms and tapeworms. Infections from these bugs often cause fever, muscle aches, headache, vomiting, and diarrhea in humans. Children are most susceptible, since they often play in the dirt and put things in their mouths or eyes. What You Can Do If you are far too harried to keep vigilant watch over your dog’s leftovers, you may want to hire a pooper-scooper company to manage the dog waste. EPA discovered from a survey that 40 percent of the people who live in the area immediately surrounding the Chesapeake Bay—which experienced significant pollution throughout much of the 1990s—did not pick up after their dogs because it was “too much work.” Others neglected to do so because they assumed it eventually goes away, or because the dog deposited the feces in an area far from the water, such as in the owner’s yard or in the woods. For all of these reasons, EPA says, “The reluctance of many residents to handle dog waste is the biggest limitation to controlling pet waste.” So, in essence, the cycle begins and ends with you. In the instance of the Chesapeake Bay survey, 44 percent of dog walkers who did not pick up after their dogs indicated they would still refuse to pick up—even if confronted by complaints from neighbors, threatened with fines, or provided with more sanitary and convenient options for retrieving and disposing of dog waste. Perhaps if they knew there were services designed to put poop at their disposal, they would not let Rover’s relief become their neighbors’ nuisance. Sources Environmental Protection Agency U.S. Centers for Disease Control and Prevention Whole Earth magazine, Spring 1999 Excerpted from Let it Rot!: The Gardener’s Guide to Composting, Stu Campbell. Third edition, 1998. 153 PP. Storey Books. http://doodycalls.com/resources_toxic_dog_waste.asp