Febrile Seizures

What are Febrile Seizures?
Febrile seizures, also known as a fever fit or febrile convulsion are convulsions brought on by a fever in infants or small children. During a febrile seizure, a child often loses consciousness and shakes. Less commonly, a child becomes rigid or has twitches in only a portion of the body. Most febrile seizures last a minute or two; some can be as brief as a few seconds, while others last for more than 15 minutes. They most commonly occur in children below the age of three and should not be diagnosed in children under the age of 6 months or over the age of 6 years. A few factors appear to boost a child's risk of having recurrent febrile seizures, including young age (less than 15 months) during the first seizures, frequent fevers, and having immediate family members with a history of febrile seizures.

What are common cause my toddler to have a seizure?
If your child is between 6 months and 5 years old, a high fever (usually over 102 degrees Fahrenheit) can cause a seizure. In most cases, these "febrile seizures," as they're called, are harmless, but that doesn't make them any less terrifying for you while your toddler is having one. Febrile seizures represent the meeting point between a low seizure threshold (genetically and age determined) - some children have a greater tendency to have a seizure under certain circumstances - and a trigger: fever. The genetic causes of febrile seizures are still being researched. Some mutations that cause a neuronal hyperexcitability and could be responsible for febrile seizures have already been discovered.

The diagnosis is one that must be arrived at by eliminating more serious causes of seizure: in particular, meningitis and encephalitis must be ruled out. Therefore a doctor's opinion should be sought and in many cases the child would be admitted to hospital overnight for observation and/or tests. As a general rule, if the child returns to a normal state of health soon after the seizure, a nervous system infection is unlikely.

What happens during a seizure?
If your toddler has a seizure, it will probably happen during the first few hours of his fever. He may roll his eyes, twitch or jerk his body, drool, vomit, or stiffen his limbs. His skin may appear a little darker than usual. The seizure may last only a few seconds, or three or four (seemingly very long) minutes. Afterward, your child might seem a bit sleepy, or he might seem just fine.

How serious are febrile seizures?

Generally, febrile seizures aren't harmful to a child. Even in cases where the diagnosis is febrile seizure, doctors will try to identify and treat the source of fever. In particular, it is useful to distinguish the event as a simple febrile seizure - in which the seizure lasts less than 15 minutes, does not recur in the next 24 hours, and involves the entire body (classically a generalized tonic-clonic seizure). The complex febrile seizure is characterized by long duration, recurrence, or focus on only part of the body. The simple seizure represents the majority of cases and is considered to be less of a cause for concern than the complex. It is reassuring if the cause of seizure can indeed be determined to have been fever, as simple febrile seizures generally do not cause permanent brain injury; do not tend to recur frequently, as children tend to 'out-grow' them; and do not make the development of adult epilepsy significantly more likely (less than 3-5% which is similar to that of the general public).

How common are these seizures?
Between the ages of 6 months and 5 years, 3 to 5 percent of children will have a seizure. One-third of these children will have another seizure, and about half of those will have a third. Children who have their first febrile seizure in their first year of life are more likely to have another seizure than those who have one after their first birthday. It's rare for a child older than 5 to have one.

What should I do if my toddler has a seizure?
If your child has a febrile seizure, stay calm and follow these steps to help your child during the seizure:

• Place your child on his or her side, somewhere where he or she won't fall.
• Stay close to watch and comfort your child.
• Remove any hard or sharp objects near your child.
• Loosen any tight or restrictive clothing.
• Don't restrain your child or interfere with your child's movements.
• Don't attempt to put anything in your child's mouth.

If your toddler's temperature suddenly soars — for example, from 102 to 105 degrees F (38.9 to 40.5 degrees C), he may have a seizure. In most cases, these febrile seizures, as doctors call them, are harmless, but that doesn't make it any less terrifying if your child is having one.

If your child's having a febrile seizure — breathing heavily, drooling, turning blue, rolling back his eyes, or shaking his arms and legs uncontrollably — quickly place him on his side, away from hard objects. Make sure he doesn't have anything in his mouth, and don't put anything in his mouth while the seizure lasts. After it's over you can carefully wipe away any vomit with a washcloth. Try to remember to note how long the seizure lasts — usually between ten seconds and three to four minutes,so you can tell the doctor.

If your child's seizure lasts longer than a few minutes, or if he has difficulty breathing, he's choking, or his skin turns blue, call the emercency intitution. Otherwise, call your doctor after your child's seizure is over — no matter how short it was. She'll probably want to examine him to make sure he doesn't have a serious infection or other problem that caused the seizure. She may also recommend that you give your toddler acetaminophen and/or lukewarm sponge baths to bring down his fever.

When the seizure subsides, try to make your toddler more comfortable — and, possibly, prevent another attack — by lowering his temperature. If your child is alert, you can give him children's acetaminophen or ibuprofen. Remove his clothing and sponge him with lukewarm water. If he's alert and able to keep liquids down, give him some water to drink as well.

Even if the seizure was mild or lasted only seconds, call the doctor right away to see if she wants you to bring your toddler in. If your child has trouble breathing after his seizure, call the emercency intitution. If he started turning blue during the seizure, had convulsions that lasted for more than a few minutes, or is still drowsy or lethargic, take him to an emergency room right away.

Can these seizures be prevented with medicine?

Maybe, but many doctors and parents believe the side effects from the medicine are worse than the child having another febrile seizure. Even if medicine is used, it may not prevent another seizure.

Most of the time, a febrile seizure occurs the first day of an illness. Often, a febrile seizure occurs before parents realize that their child is ill.

Giving your child acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) at the first indication of fever will help reduce the fever, but won't necessarily prevent a seizure. You can also help control fever by making sure your child drinks plenty of fluids and not bundling him or her up too tightly at night.

Don't give aspirin to a child. Aspirin may trigger a rare but potentially fatal disorder known as Reye's syndrome.

Rarely, prescription medications are used to prevent febrile seizures. Anticonvulsant medications such as phenobarbital, valproic acid (Depakene) and divalproex sodium (Depakote) can prevent febrile seizures when taken daily. Oral or rectal diazepam (Valium, Diastat) also can reduce the risk of febrile seizures if taken at the time of a fever. But these medications all have drawbacks. They carry a definite risk of serious side effects in young children. Doctors rarely prescribe these prevention medications because most febrile seizures are harmless and most children outgrow them without any problems.

If my child has a febrile seizure, does this mean that he or she has epilepsy?

No. A single seizure is never epilepsy. Even repeated febrile seizures aren't considered epilepsy, because children outgrow the risk of having a seizure caused by fever. A child with epilepsy has two or more seizures that aren't caused by fever.

Febrile seizures don't cause epilepsy. But the chance of epilepsy developing in a child who has had a febrile seizure is slightly higher than if he or she didn't have a febrile seizure. The chance of epilepsy developing in a child who has had a febrile seizure is about 2% to 4%. There is a better than 95% chance that your child will not have epilepsy, and there is no evidence that treating your child with medicine will prevent epilepsy.

Children with febrile convulsions who are destined to suffer from afebrile epileptic attacks in the future will usually exhibit the following:

• A family history of afebrile convulsions in first degree relatives (a parent or sibling)
• A pre-convulsion history of abnormal neurological signs or developmental delay
• A febrile convulsion lasting longer than 15 minutes
• A febrile convulsion with strong indications of focal features before, during or afterward

Fever –- Medications

Many healthcare providers will ask that you not use medication to treat your baby's fever so that you can follow the course of the fever, especially in a baby who appears well, is eating and sleeping fine, and behaving normally. Don't give a baby younger than four months old any medicine unless your family doctor tells you to. Although healthcare providers may have slightly varying approaches to fever, there are a few accepted rules to follow.

Types of medication
Acetaminophen that found in Tylenol®, Parasol®, Tempra®, etc. is available in liquid, chewable, and suppository forms. It should not be given more often than every four to six hours.

Ibuprofen that found in Motrin®, Advil®, etc. is available in liquid and chewable forms. Check with your baby's provider before using ibuprofen in a child under one year of age.

Aspirin can cause Reye's syndrome in children who have the flu or the chickenpox. Reye's syndrome is a serious illness that can lead to death. Because it may be hard to tell if your child has one of these infections, it's best not to use aspirin unless your family doctor says it's okay. Acetaminophen and ibuprofen are safer choices to use in children with a fever. So, never give that to your children.

Many combination cold and cough medications contain fever-reducing drugs such as ibuprofen or acetaminophen. Check the labels carefully and don't give your toddler a separate fever reducer if he's taking one of these combination products.

You can also try to lower your toddler's fever by sponging him down with lukewarm (not cold) water or giving him a lukewarm bath. Never try to reduce a fever by sponging down your toddler with rubbing alcohol. Rubbing alcohol can be absorbed into your child's bloodstream through the skin.

Dosing
Acetaminophen products for treating fever in infants usually come in liquid form to be given by mouth. The infant type is usually labeled as "infant drops." Be sure you know exactly what type of liquid form you have because there are many types available, and the strength of medication will vary. Acetaminophen also can be given rectally as a suppository.

If you are giving your child a liquid form of acetaminophen, be sure you know exactly what type of liquid form you have, as there are many types available and the strength of medication will vary.

Dosing is based on your child's weight, so be sure to ask your child's provider for an appropriate dose. It may change as your child grows. Don't give more than five doses in one day. Read labels of all medications carefully.

Don't replace the drops with elixir because the drops are stronger.

Giving medication your baby or toddler
Liquid medication in the form of infant drops usually comes with a medicine dropper. It is best given by leaning your infant back slightly and putting the dropper in one of her cheeks. Fill the dropper to the line when using drops. For liquid elixir, use a liquid measuring device to make sure you give the right dose. Get one at your drug store or ask your pharmacist.

Check with your pharmacist or your child's provider about the possibility of mixing or crushing medicine in with foods or drink. Never assume it's OK, since certain mixtures may make the medication ineffective.

Never tell your child that medications are candy in an attempt to get her to take it. From as early as the toddler years, teach your child that medications should be taken only when she is sick and when given to her by an adult.

Rectal suppositories are not generally the first choice at this age. However, they are very quick and easy. More than half the parents I talk to shudder at the thought, and there are definitely toddlers who won't tolerate insertion of a suppository.

However, when children are very sick, vomiting, or refuse other forms of medicine, this is a reasonable alternative if medication is necessary to bring down a fever. It easiest to have your toddler lay on her back with legs folded up to her belly (like I'm changing a diaper).

Using a little petroleum jelly on the suppository, you can easily and gently slide it into your child's rectum. Gently hold your baby's buttocks together to keep the suppository from slipping out. Be aware that every now and then, inserting a suppository can trigger your child to have a bowel movement. If this occurs immediately following the suppository, you can repeat the dose. But if it occurs more than a few minutes after inserting a suppository, discuss with your child's provider when another dose should be given to avoid overdosing your child.

The other ways to help children feel better

• Give your child plenty to drink to prevent dehydration (not enough fluid in the body) and help the body cool itself.
  
• Keep your child quiet. Moving around can raise the temperature even more.
  
• Keep the room temperature at about 21oC (70 oF) to 23 oC (74 oF).
  
• Dress your child in light cotton pajamas so that body heat can escape. Don't over bundle your child. If your child is chilled, put on an extra blanket but remove it when the chills stop.

Fever –- From Zero to Three Years

Not every child who feels warm has a fever?

Babies under four months of age don't control their body temperatures very well. Becoming too warm is often related to how warmly they are dressed or bundled. If your infant feels warm to the touch but cools down quickly when unbundled, and is otherwise acting well, chances are it isn't a true fever or cause for concern. It have also found that skin-to-skin contact, such as when breastfeeding, can also cause babies to feel warm temporarily.

For babies at 4-9 months age don't control their body temperatures as well as older children. Becoming too warm is often related to how warmly they are dressed. If your baby feels warm to the touch but cools down quickly when unbundled, and is otherwise acting well, chances are it isn't a true fever or cause for concern.

Healthy babies and toddlers, 9 months to 3 years, have normal changes in their body temperature over the course of a day. They can feel warm to the touch after a lot of crawling or running around, or if they are dressed particularly warmly.

What is a normal temperature?

A normal temperature depend on the ways are taken. There were any ways to take body’s temperature orally or by mouth, rectally or by rectum, axillary or by placing the bulb of the thermometer under the arm, or using an ear thermometer.

When taken orally, it‘s about 37oC or 98oF. Temperatures taken rectally usually run 0.5oC higher than those taken orally. So, a normal temperature is about 37.5oC or 99.5oF when taken rectally. But temperatures may vary during the day, even in healthy children. Many doctors define a fever as an oral temperature above 37.8oC or 100oF or a rectal temperature above 38.0oC or 101oF or an axillary (by ear) temperature above 37.2oC or 99oF. But, ear temperatures are not accurate in children under 6 months of age and often not recommended in children less than 1 to 2 years of age.

When to take fever seriously?
Fever in a newborn or infant younger than three or four months of age requires more attention than in older infants and children. At this age, the immune system is not fully developed and infants are not as well-equipped to fight infections as an older child or adult. In addition, there are certain serious infections that are more likely to appear in the newborn period.

Fever often serves a useful purpose in helping your child's body fight an infection. After nine months of age, babies and toddlers generally fight infections pretty well. Somewhere around six months of age, your baby's immune system becomes more fully developed, and she will start to fight infections more effectively.

Four to nine months a transitional period when fevers in otherwise healthy babies (they're eating well and not acting sick) don't automatically require a phone call to the doctor. However, most healthcare professionals will still use a little extra caution when evaluating babies this age.

This would include the evaluation of any baby with a high fever (e.g., higher than 102 degrees F, 38.8 degrees C), or any baby who isn't eating well or looks sick. Providers' definitions of "fever" and "high fever" may vary a bit, so be sure you clarify when your baby's provider wants to be called about your baby's fever. Of course, you should always call if you are concerned.

Rather than just paying attention to whether your child has a fever, it's more important to assess how long the fever lasts, how high it goes, and, most importantly, how sick your child seems.

How high a fever goes doesn't necessarily predict how serious your child's illness will be. When in doubt, ask your child's healthcare provider: "At what point should I call again?"

How can I tell if my child has a fever?
Kiss or touch your child's forehead. If you think he feels hot, you're probably right. A fever is usually a sign that the body is waging a war against infection. An exact temperature reading will confirm your suspicions and help you and your child's doctor figure out the best way to get your toddler back on the road to health.

Most doctors — and the American Academy of Pediatrics (AAP) — agree that a normal body temperature for a healthy child is between 97 and 100.4 degrees Fahrenheit (36 to 38 degrees Celsius). A toddler is considered feverish if his temperature is over 101 degrees F (38.3 degrees C). If you are unable to get the fever down with medication, or if your child still appears to be very ill, seek medical attention.

Fevers often help to follow the course of an infection, so many health professionals want to be informed if fevers continue more than a certain number of days without resolving. (I generally use five days as a rough rule of thumb.)

Don't depend on fever as your only sign of infection. If your child is irritable, lethargic, not feeding well, or just looks sick to you, whether or not she has a fever, you should suspect an infection. Don't assume that a fever has to be present before seeking medical attention if you have concerns about your child's health.

Common causes
The most common causes of fever in a child this age are generally the same as adult, viral infections. If your child has symptoms of a viral infection (such as the common cold or diarrhea), especially if she has been exposed to others with the same symptoms, she may well have the same infection.

Infants may become much sicker than older children and adults with the same infection. The same cold that causes a simple runny nose in an eight-year-old can cause fever, congestion, poor sleep, poor feeding, and even vomiting in a baby.

The best approach is to limit your child's exposure to people who are sick, especially people with fevers. Keep in mind, however, that babies at this age benefit greatly from being around other kids, and it's not practical to avoid every child with a runny nose for fear of a fever or cold.

How to prevent infection?
The best approach you can take with your infant is to ask all who hold her to wash their hands first, and to limit her exposure to people who are sick, especially people with fevers. By using these simple measures, you can decrease (but not eliminate) your infant's chances of getting a viral infection and therefore, fever.

If fever is a defense against infection, is it really a good idea to try to bring it down?
Since fever is part of the body's defense against bacteria and viruses, some researchers have suggested that the body may fight infections more effectively when its temperature is elevated. On the other hand, if your toddler's temperature is too high, he'll be too uncomfortable to eat, drink, or sleep, and that makes it harder for him to get better.

If your toddler's fever isn't affecting his behavior, you don't need to give him anything to lower it. Offer him plenty of liquids to prevent dehydration, and don't overdress him. If his body temperature is higher than normal because of extra clothes, a scorching day, or a lot of active play, help him cool down by taking off a few of his layers, and encourage him to rest or play quietly in a cool spot

When should I call the doctor?
You're the best judge of whether your child is really ill, so call if you're worried, no matter what his temperature is. Besides, a temperature reading isn't the only indication of whether a fever is serious. Your toddler's behavior is a factor, too, since a high fever that doesn't stop him from playing and eating normally may not be cause for alarm. Keep in mind that your child will be hotter if he's been running around than if he's waking up from a nap.

Something else to remember: Your child's temperature — as well as your own — rises in the late afternoon and early evening and falls between midnight and early morning. The natural cycle of our internal thermostat explains why doctors get most of their phone calls about fever in the late afternoon and early evening.

You can follow the guidelines below to help decide when to call your doctor, but it's important to call your doctor whenever you feel that your child needs help or if you have any questions.

• Under one month old. Call your family doctor right away if your baby's temperature goes over 38.5oC (101.3oF) rectally, even if he or she doesn't seem sick. Your doctor may want to see your baby and may want to put him or her in the hospital to find out what's causing the fever. Babies this young can get very sick, very quickly. Also call your doctor if your baby has any of the warning signs listed below, even if he or she isn't running a fever.
  
• One to three months old. Call your doctor if your baby has a temperature of 38.5oC (101.4oF) even if your baby doesn't seem sick, or a temperature of 38oC (100.4oF) that has lasted more than 24 hours. Also, call if your baby has any of the warning signs listed below.
• Three months to two years. If your child has a fever of 38.6oC (101.4oF), watch how he or she acts. Call the doctor if the fever rises or lasts for more than three days, or if your child has any of the warning signs listed below. If the temperature is 39oC (103oF), call your doctor even if your child seems to feel fine.
• Over two years old. If your child has a fever of 38.6oC (101.4oF), watch how he or she acts. Call the doctor if the fever rises or lasts more than three days, or if your child has any of the warning signs listed below.
• Be sure to mention symptoms such as a cough and ear pain (if you suspect it) or vomiting and diarrhea — these can help the doctor make a diagnosis. She will then give you instructions on how to care for your toddler and whether you need to come into the office.

Be on the lookout for any of the following symptoms, which could indicate a more serious problem when coupled with a fever:

• Purple-red spots on his skin that don't turn white or paler when you press on them, or he has large purple blotches. Both of these can signal a very serious bacterial infection.
• Difficulty breathing (he's working harder to breathe or is breathing faster than usual) even after you clear his nose with a bulb syringe. This could mean pneumonia or asthma.
• Changes in behaviour
• Severe headache
• Constant vomiting or diarrhea
• Skin rashvDry mouth
• Sore throat that doesn't improve
• Earache that doesn't improve
• Stiff neck
• Fever comes and goes over several days
• Stomach pain
• High-pitched crying
• Swelling on the soft spot on the head
• Irritable
• Unresponsive or limp
• Not hungry
• Pale
• Whimperi

How fever affects your child's eating?
Babies under 4 months

Babies under 4 months having a fever may not affect fluid intake, and this is very reassuring. If your baby does seem to be drinking less, pay attention to how much and how often, as well as whether she is having fewer wet diapers. Fever, as well as vomiting and diarrhea, are all potential causes of dehydration. Even if they don't have vomiting and diarrhea, infants can become dehydrated more quickly than larger children and adults. Also, poor feeding can be a sign of a more serious infection, so be sure to discuss any concerns you have with your baby's healthcare provider.

Babies 4-9 months

Many babies start eating baby cereal and foods by around six months of age. For some babies, having a fever may not affect their fluid or food intake, and this is very reassuring. It is very common, however, for babies who develop fevers with viral infections at this age to lose interest in solid foods until they feel better. There's no need to focus on how much solid food your baby eats while she has a fever and cold. You may find that your child is more interested in eating when the fever has come down. If she does not show any interest in food, don't worry. During a normal cold or fever, it does not matter if your child does not eat as long as she continues to get enough to drink. Offer more frequent breast- or bottle-feedings and pay close attention to whether your baby starts to urinate less often, as this can be a sign of dehydration. Be sure to discuss with your baby's healthcare provider any concerns you may have.

Toddler 9 months - 3 years

Instead of focusing on food, direct your attention toward making sure that she gets enough to drink and doesn't become dehydrated. Offer more frequent breast- or bottle-feedings and pay close attention to whether your baby starts to urinate less often, as this can be a sign of dehydration. Be sure to discuss with your baby's healthcare provider any concerns you may have. Even if they don't have vomiting or diarrhea, smaller children can become dehydrated more quickly than larger children and adults, but not as quickly as when they were infants. Offer small amounts of fluids more frequently. For toddlers who are not drinking well, you can be a little more creative in your attempts by offering items such as popsicles, ice cream, and Jell-O. Discuss with your child's healthcare provider any concerns you may have.

Can a high fever cause brain damage?
This is a common concern for parents, but brain damage from a fever is extremely unlikely. It's not unusual for a sick toddler to run a temperature of 104 or even 105 degrees Fahrenheit. Although fevers over 106 degrees are very unusual, most children can tolerate a temperature of slightly greater than 107 degrees without long-term effects from the fever itself. Of course, when your toddler starts to get a high fever, you'll want to take steps to bring it down.

There are times, too, when you should contact your doctor if your toddler runs a fever. Ask your doctor what her guidelines are for phoning. She may suggest you call if your toddler's fever reaches 103 degrees F (39.4 degrees C) or higher. The most important thing is how ill your child looks and acts. The doctor will probably ask you about other symptoms when you call, and give you instructions on how to care for your toddler and whether you need to come into the office.

By the way, some children between 6 months and 5 years of age have brief seizures when they're running a high fever, but even these febrile seizures don't cause brain damage.

Should I give my child a sponge bath or a drawn bath to lower his fever?
Many times when a child's temperature climbs, especially over 103°F, parents become concerned that the child is in danger due to the fever. But remember — a fever helps your toddler fight an infection. If your child has a high fever, his doctor may suggest giving him the proper dose of acetaminophen or ibuprofen, to reduce his temperature. It can be a slow process, though, and parents always want to do more. A bath is often suggested by well-meaning advisors. If you do give your toddler a bath, make sure the water is lukewarm to warm, not too cool, because shivering can actually increase his temperature rather than help reduce it. Alcohol baths are no longer recommended, because they can cool your child too quickly, which can be dangerous. You might also simply try a cool cloth on your toddler's forehead and not over-dressing him to help cool him down.

Why does my toddler's fever keep coming back?
Fever-reducing medicines bring down body temperature temporarily. They don't affect the bug that's producing the infection, so your child may run a fever until his body is clear of the infection. This can take at least two or three days. Some infections, such as influenza (the flu), can last from five to seven days. If your toddler has been treated with antibiotics to fight a bacterial infection, it may take 48 hours for his temperature to fall.

My toddler has a fever and no other symptoms. What's wrong?
When a child has a high fever that isn't accompanied by a runny nose, a cough, vomiting, or diarrhea, figuring out what's wrong can be difficult. There are many viral infections that can cause a fever and no other symptoms. Some viral infections, such as roseola, cause three days of very high fever followed by a light pink rash on the trunk. More serious infections, such as meningitis, urinary tract infections, or bacteremia (bacteria in the bloodstream), may also trigger a high fever without any other specific symptoms. If your toddler has a high fever and no other symptoms, call the doctor.

See another article, Fever medication.

Smallpox -- FAQs

What is smallpox?

Smallpox is an ancient and acute contagious disease caused by Variola virus, a member of the orthopoxvirus family. Smallpox (also known by the Latin names Variola or Variola vera) is a highly contagious viral disease unique to humans. It is caused by either of two virus variants named Variola major and Variola minor. V. major, the deadlier form, has a mortality rate of 20–40 percent, while V. minor kills 1% of its victims. Other long-term effects usually include skin scars and occasionally include blindness due to corneal ulcerations.

Virus classifications are:

• Group: Group I (dsDNA)
• Family: Poxviridae
  Genus: Orthopoxvirus
  Species: Variola vera

Smallpox was fatal in up to 30% of cases. Smallpox has existed for at least 3,000 years and was one of the world’s most feared diseases until it was eradicated by a collaborative global vaccination programme led by the World Health Organization. The last known natural case was in Somalia in 1977. Since then, the only known cases were caused by a laboratory accident in 1978 in Birmingham, England, which killed one person and caused a limited outbreak. After successful vaccination campaigns throughout the 19th and 20th centuries, the World Health Organization (WHO) certified the eradication of smallpox in 1979.

Smallpox was responsible for an estimated 300–500 million deaths in the 20th century. As recently as 1967, the World Health Organization (WHO) estimated that 15 million people contracted the disease and that two million died in that year.

What are the symptoms of smallpox?

The symptoms of smallpox begin with high fever, fatigue, head and body aches, and sometimes vomiting. The virus then produces a characteristic rash, particularly on the face, arms and legs. The resulting spots become filled with clear fluid and later, pus, and then form a crust, which eventually dries up and falls off., after about three weeks, leaving a pitted scar.

Does it occur naturally?

Smallpox no longer occurs naturally since it was totally eradicated by a lengthy and painstaking process, which identified all cases and their contacts and ensured that they were all vaccinated. Until then, smallpox killed many millions of people.

If someone comes in contact with smallpox, how long does it take to show symptoms?

The virus which causes smallpox is contagious and spreads through person-to-person contact and saliva droplets in an infected person’s breath. It has an incubation period of between 7 and 17 days after exposure and only becomes infectious once the fever develops. A distinctive rash appears two to three days later. The most infectious period is during the first week of illness, although a person with smallpox is still infectious until the last scabs fall off.

Is smallpox fatal?

The majority of patients with smallpox recover, but death may occur in up to 30% of cases. Many smallpox survivors have permanent scars over large areas of their body, especially their face. Some are left blind

How fast does smallpox spread?

The speed of smallpox transmission is generally slower than for such diseases as measles or chickenpox. Smallpox normally spreads from contact with infected persons. Patients spread smallpox primarily to household members and friends because by the time patients are contagious, they are usually sick and stay in bed; large outbreaks in schools were uncommon.

Generally, direct and fairly prolonged face-to-face contact is required to spread smallpox from one person to another. Smallpox also can be spread through direct contact with infected bodily fluids or contaminated objects such as bedding or clothing. Indirect spread is less common. Rarely, smallpox has been spread by virus carried in the air in enclosed settings such as buildings, buses, and trains. Smallpox is not known to be transmitted by insects or animals.

If smallpox is released in aerosol form, how long does the virus survive?

The smallpox virus is fragile. In laboratory experiments, 90% of aerosolized smallpox virus dies within 24 hours; in the presence of ultraviolet (UV) light, this percentage would be even greater. If an aerosol release of smallpox occurs, 90% of virus matter will be inactivated or dissipated in about 24 hours.

Weren’t the remaining stocks of the smallpox virus destroyed after smallpox was eradicated?

When smallpox was officially certified as eradicated, in December 1979, an agreement was reached under which all remaining stocks of the virus would either be destroyed or passed to one of two secure laboratories – one in the United States and one in the Russian Federation. That process was completed in the early 1980s and since then no other laboratory has officially had access to the virus which causes smallpox.

Then why is smallpox being talked about now?

Some governments believe there is a risk that the virus which causes smallpox exists in places other than these laboratories and could be deliberately released to cause harm. It is impossible to assess the risk that this might happen, but at their request, WHO is making efforts to help governments prepare for this possibility.

Is there any treatment for smallpox?

There is no cure for smallpox, but vaccination can be used very effectively to prevent infection from developing if given during a period of up to four days after a person has been exposed to the virus. This is the strategy that was used to eradicate the disease during the 20th century.

There is no proven treatment for smallpox, but research to evaluate new antiviral agents is ongoing. Early results from laboratory studies suggest that the drug cidofovir may fight against the smallpox virus; currently, studies with animals are being done to better understand the drug's ability to treat smallpox disease. Patients with smallpox can benefit from supportive therapy (e.g., intravenous fluids, medicine to control fever or pain) and antibiotics for any secondary bacterial infections that may occur.

Is a vaccine currently available?

There is a vaccine against smallpox and it was a key tool in the eradication of the disease. The vaccine does not contain the Variola virus which causes smallpox , but a closely related virus called vaccinia. When this vaccine is given to humans, it protects them against smallpox. However, it can have very serious side effects, which in extreme cases can be fatal. It has therefore not been recommended for the general public since smallpox was eradicated. It is used to protect researchers who work on the variola virus that causes smallpox and other viruses in the same virus family (known as orthopox viruses). It could also be used to protect anyone else judged to have a high risk of exposure to smallpox. The vaccine cannot be used in people whose immune systems are not functioning properly.

Should the smallpox vaccine be widely used to protect people?

Vaccination with the vaccinia virus as a protection against smallpox is not recommended for widespread use. No government gives or recommends the vaccine routinely since it can cause serious complications, and even death. It should be given only to those persons who have a high risk of coming into contact with the virus which causes smallpox, or who have been exposed.

What can be done to protect people from smallpox?

Doctors, health workers and hospital personnel around the world have been trained to identify infectious diseases, verify their diagnosis and then respond accordingly. The same system would identify any possible outbreak of smallpox even if the virus is deliberately spread to cause harm. The public health system would then be mobilized to trace all known contacts of the infected person and vaccinate them to prevent more cases of smallpox from developing. If this is done rapidly and effectively, the number of cases could be kept to a minimum and the outbreak would be contained. This was the approach which successfully eradicated the disease. The key is a good disease detection system and a rapid response to infectious diseases, no matter what their cause. At this time, several governments have started to examine the potency and levels of their smallpox vaccine stocks, and to consider whether, and under what circumstances, to obtain additional supplies.

I had the vaccination when I was a child. Am I still protected?

Anyone who has been vaccinated against smallpox (in most countries, this means anyone aged 25-30 or over) will have some level of protection. The vaccination may not still be fully effective, but it is likely to protect you from the worst effects of the disease. However, if you were directly exposed to the virus which causes smallpox, a repeat vaccination would be recommended.

Smallpox -- The Disease

Incubation Period (Duration: 7 to 17 days) -- Not contagious

Exposure to the virus is followed by an incubation period during which people do not have any symptoms and may feel fine. This incubation period averages about 12 to 14 days but can range from 7 to 17 days. During this time, people are not contagious.

Initial Symptoms/Prodrome (Duration: 2 to 4 days) -- Sometimes contagious*

The first symptoms of smallpox include fever, malaise, head and body aches, and sometimes vomiting. The fever is usually high, in the range of 101 to 104 degrees Fahrenheit. At this time, people are usually too sick to carry on their normal activities. This is called the prodrome phase and may last for 2 to 4 days.

Early Rash (Duration: about 4 days) -- Most contagious

A rash emerges first as small red spots on the tongue and in the mouth.

These spots develop into sores that break open and spread large amounts of the virus into the mouth and throat. At this time, the person becomes most contagious.

Around the time the sores in the mouth break down, a rash appears on the skin, starting on the face and spreading to the arms and legs and then to the hands and feet. Usually the rash spreads to all parts of the body within 24 hours. As the rash appears, the fever usually falls and the person may start to feel better.

By the third day of the rash, the rash becomes raised bumps.

By the fourth day, the bumps fill with a thick, opaque fluid and often have a depression in the center that looks like a bellybutton. (This is a major distinguishing characteristic of smallpox.)

Fever often will rise again at this time and remain high until scabs form over the bumps.

Pustular Rash (Duration: about 5 days) -- Contagious

The bumps become pustules—sharply raised, usually round and firm to the touch as if there’s a small round object under the skin. People often say the bumps feel like BB pellets embedded in the skin.

Pustules and Scabs (Duration: about 5 days) -- Contagious

The pustules begin to form a crust and then scab.

By the end of the second week after the rash appears, most of the sores have scabbed over.

Resolving Scabs (Duration: about 6 days) -- Contagious

The scabs begin to fall off, leaving marks on the skin that eventually become pitted scars. Most scabs will have fallen off three weeks after the rash appears.

The person is contagious to others until all of the scabs have fallen off.

Scabs resolved -- Not contagious

Scabs have fallen off. Person is no longer contagious.

* Smallpox may be contagious during the prodrome phase, but is most infectious during the first 7 to 10 days following rash onset.

Famous victims

Famous victims of this disease include:

• Ramesses V (also written Ramses and Rameses, reigned 1145 BC to 1141 BC) was the fourth pharaoh of the Twentieth dynasty of Egypt and is thought to be the son of Ramesses IV and Queen Tentopet.
• The Shunzhi Emperor and Tongzhi Emperor of China (official history),
• Mary II of England (Queen of England, Ireland, Scotland) in 1694.
• Louis XV of France, who himself succeeded his great-grandfather through a series of deaths of smallpox or measles among those first in the succession line
• Peter II of Russia.
• Henry VIII's fourth wife, Anne of Cleves, survived the disease but was scarred by it, as was Henry VIII's daughter, Elizabeth I of England in 1562,
• Guru Har Krishan 8th (Guru of the Sikhs) in 1664.
• Peter III of Russia in 1744.
• Abraham Lincoln (President of USA) in 1863.
• Joseph Stalin, who was badly scarred by the disease early in life, often had photographs retouched to make his pockmarks less apparent.

Smallpox Vaccine ‘Infect’ the Baby

From BBC News

A baby showed signs of smallpox vaccine virus exposure after being breastfed by the wife of a US soldier given the jab. The unusual case - which happened in May 2003 - was confirmed in a report by the US Centers for Disease Control. The unnamed soldier had a "major reaction" to the vaccine - but continued to sleep with his wife, who carried on breastfeeding their baby. The US launched a vaccination programme despite fears over side effects.

The smallpox vaccine contains a live virus, which means there is the potential for it to spread to others. It is not the smallpox virus itself, but another related virus called vaccinia, which causes a much milder version of the illness. Although it is not contagious in the same way as influenza or a cold, normally the sore that forms at the vaccination site is covered and those given the vaccine warned about the potential for the virus to spread by contact with it.

Tongue sores

The solider's wife developed sores near her nipples approximately a week after her husband was vaccinated. Two weeks later, sores appeared on the infant's face and tongue. No information about its recovery was released by the CDC. The CDC report urged breast-feeding mothers living with people vaccinated against smallpox to be aware of the potential risk to their babies.

There have been 18 reported cases of the accidental transmission of vaccinia since December 2002 - although this is the first reported "third hand" passing of the virus.

Vaccinated patients are told to wash their hands regularly and limit contact with babies. The US smallpox vaccination programme is the most extensive in the world, and was set up in response to the threat that the virus - eradicated in its wild form in the 1970s - could be used in biological warfare or terrorism. Approximately 500,000 key workers were to be offered the jab initially - with plans to expand the programme later in 2003.

However, a relatively high proportion of those given smallpox vaccine will have severe reactions to the jab - and many experts predicted that vaccinating so many people would inevitably lead to dozens of deaths.

Bites and Stings – Gila Monster

You will see this creature in US. It's another poisonous creature in Arizona. The Gila monster injects venom with a chewing motion. It has eight venom glands in the bottom of its mouth. The venom flows across the teeth with the chewing motions.

What are symptoms?

The venom will attack the nervous system, and can cause pain, swelling and possibly low blood pressure. But it is mostly a local reaction.

How to Treat?

Treatment for a Gila monster bite is similar to a pit viper snake bite.

How to Prevent?

There are certain times of the year to be extra careful. In March and April, the snakes are becoming active and seeking warm sun. Snakes are born toward the end of July. They can bite with venom from birth. During the hot summer months, snakes are more active at night. Don't put your hands where you can't see. Walk around snakes. Don't challenge them or try to move them.

Bites and Stings – Snake

A pit viper snake has a heat sensing "pit" located between the nostril and eye on each side that is used to locate and trail prey. Rattlesnakes can grow up to six feet in length. Baby rattlesnakes are capable of a venomous bite from birth. Nonpoisonous snakebites are not considered serious and are generally treated as minor wounds; only poisonous snakebites are considered medical emergencies.

What are the symptoms?

Symptoms generally occur immediately, but only about one third of all bites manifest symptoms. When no symptoms occur, probably no venom was injected into the victim. In 50 percent of coral snake bites, no venom is injected because the coral snake has to chew the skin for envenomation to occur. In as many as 25 percent of all venomous pit viper bites, no venom is injected, possibly because the fangs may be injured, the venom sacs may be empty at the time of the bite, or the snake may not use the fangs when it strikes. Poisonous snakebite venom contains some of the most complex toxins known; venoms can affect the central nervous system, brain, heart, kidneys, and blood.

What are signs that indicate a poisonous snakebite include?

The bite consists of one or two distinct puncture wounds. Nonpoisonous snakes usually leave a series of small, shallow puncture wounds because they have teeth instead of fangs. The exception is the coral snake, which leaves a semicircular marking from its teeth. Because some poisonous snakes also have teeth, fang and teeth marks may be apparent. The presence of teeth marks does not rule out a poisonous bite, but the presence of fang marks always confirms a poisonous snakebite.

What are characteristics of pit viper snakes?

• Large fangs; nonpoisonous snakes have small teeth.
• The two fangs of a poisonous snake are hollow and work like a hypodermic needle.
• Pupils resemble vertical slits.
• Presence of a pit. Pit vipers have a telltale pit between the eye and the mouth. The pit, a heat-sensing organ, makes it possible for the snake to accurately strike a warm-blooded victim, even if the snake cannot see the victim.
• A triangular or arrowhead shaped head.
• The rattlesnake often shakes its rattles as a warning. BUT NOT ALWAYS!

One snake that is not a pit viper snake but is poisonous is the coral snake. The coral snake is highly poisonous and resembles a number of nonpoisonous snakes. Coral snakes, as proteroglyphous elapids, have fixed fangs as opposed to retractible fangs. Because its mouth is so small and its teeth are short, most coral snakes inflict bites on the toes and fingers. They have to chew the skin a while to inject venom. Coral snakes are small and ringed with red, yellow, and black. The chances for recovery of snakebite are great if the patient receives care within two hours of the bite.

How is serious the bite?

You can decide how serious the bite is by considering several factors:

• The age, size and general health of the patient. A small child will probably react much more severely to a smaller amount of venom than will an adult. Bites are most dangerous in children and the elderly.
• The depth, location and number of bites. A single, glancing blow by the fangs is much less dangerous than multiple wounds or wounds that penetrate the flesh deeply. A bite that penetrates a blood vessel is extremely dangerous. The least dangerous bites occur on the extremities and in fatty tissue. Bites on the head or trunk are usually fatal.
• The duration of the bite. The longer the bite, the greater the amount of venom that may be injected into the patient's system.
• Clothing. A snake that bites through several layers of clothing will not leave as much venom as a snake that strikes bare skin.
• Maturity, type, and size of the snake. Small snakes usually do not produce enough venom to seriously harm an adult.
• Condition of the fangs and venom sacs. More venom will be injected if the fangs and venom sacs are in good condition.
• How angry or fearful a snake is. More venom will be injected if the snake is angry or fearful.

What are signs and symptoms of a pit viper bite?

The severity of a pit viper bite is gauged by how rapidly symptoms develop, which depends on how much poison was injected. Signs and symptoms of a pit viper bite include:

• Immediate and severe burning pain and swelling around the fang marks, usually within five minutes. The entire extremity generally swells within eight to 36 hours.
• Purplish discoloration around the bite, usually developing within two to three hours.
• Numbness and possible blistering around the bite, generally within several hours.
• Nausea and vomiting
• Rapid heartbeat, low blood pressure, weakness, and fainting
• Numbness and tingling of the tongue and mouth
• Excessive sweating
• Fever and chills
• Muscular twitching
• Convulsions
• Dimmed vision
• Headache

How to treat for snakebite?

The priorities of emergency care for snakebite are to maintain basic life support - airway, breathing and circulation - and limit the spread of the venom and to transport the patient without delay.

1. Move the patient away from the snake to prevent repeated bites or bites to yourself. Snakes cannot sustain prolonged rapid movement so are often within a 20 foot radius of where the bite first occurred.
2. Have the patient lie down and keep him quiet. Reassure him to slow the metabolism and subsequent spread of the venom.
3. Cut and suck methods are useless. According to one study, the most you can get is six percent of the venom. Many people do far more damage when they cut than they do well.
4. Keep the bitten extremity at the level of the heart.
5. Remove any rings, bracelets or other jewelry that could impede circulation if swelling occurs.
6. Clean the wound gently with alcohol, soap and water, hydrogen peroxide or other mild antiseptic.
7. Do not cool or chill or apply ice.
8. Do not attempt to tie any type of tourniquet or constricting bands.
9. Transport the patient as soon as possible to the hospital. Signs and symptoms of a coral snake bite are different than those of a pit viper. Rather than leaving two distinct fang marks, the coral snake leaves one or more tiny scratch marks in the area of the bite. There is little pain or swelling and the patient's tissue usually does not turn black and blue. Usually, there is no pain or swelling at the bite site. However, one to eight hours after the bite, the patient will experience blurred vision, drooping eyelids, slurred speech, increased salivation and sweating. Emergency care for a coral snake bite is similar to that for a pit viper snake bite.

Bites and Stings – Scorpion

Scorpions are all poisonous to a greater or lesser degree. There are many species of scorpions found in Arizona but only one is potentially lethal. This is the bark scorpion. It is one of the smaller species being one to one and a half inches long. It prefers places dark and cool, wood piles, palm trees, decorative bark. The severity of the sting depends on the amount of venom injected but scorpion stings can be fatal. Ninety percent of all scorpion stings occur on the hands.

The lethal scorpion is very slender and streamlined. It is straw-colored or nearly opaque, small, less than two inches long.

What are Reactions or Symptoms?

There are two different reactions, depending on the species:

• In mild case, severe local reaction only, with pain and swelling around the area of the sting. Possible prickly sensation around the mouth and a thick-feeling tongue.
• In severe case, Severe systemic reaction. with little or no visible local reaction. Death is rare, occurring mainly in children and adults with high blood pressure or illnesses.Local pain may be present.
• Body as a whole: muscular spasms, convulsions, urinary incontinence, urine output, decreased, excessive salivation (drooling), random movements of head, eye, and/or neck
• respiratory: rapid breathing, difficulty breathing, stop breathing
• eyes, ears, nose, and throat: tongue feels thicker, spasm of the larynx (voice box), double vision, blindness, involuntary rapid movement of the eyeballs
• gastrointestinal: abdominal cramps, Inflammation of the pancreas, fecal incontinence, involuntary urination and defecation
• heart and blood vessels: high blood pressure, increased or decreased heart rate, irregular heartbeat
• nervous system: restlessness, tense, seizures, paralysis

Death rarely occurs in patients older than 6 years. If symptoms rapidly become worse within the first 2-4 hours after the sting, a poor outcome is more likely. Symptoms usually last 24-48 hours. Some deaths have occurred as late as 4 days after the sting

What should I do when got stung by those creature?

These following informations are for home treatments or first aids before you go to the hospital:

1. Apply ice to relieve the pain of the sting Place ice (wrapped in a washcloth or other suitable covering) on the site of the sting for 10 minutes and then off for 10 minutes. Repeat this process. Immobilize the affected limb. If patient has circulatory problems, decrease the time to prevent possible damage to the skin.
2. Be sure the victim's airway stays clear
3. Keep the patient still.
4. Transport to a hospital. A specific antivenom is available.

Treat scorpion stings as you would a black widow bite. If you call emergency institutions or poison control you may determine the following information before call them:

• the patient's age, weight, and condition
• identification of the insect if possible
• the time stung

They will instruct you if it is necessary to take the patient to the hospital. See Poison Control centers for telephone numbers and addresses. If possible, bring the scorpion to the emergency room for identification.

What to expect at the emergency room?

Some or all of the following procedures may be performed:

• Give an antiserum (only in the most severe cases)
• Open and maintain the airway if needed
• Treat the symptoms

Bites and Stings – Spider

Black Widow Spider

The black widow is a spider with a shiny black body, thin legs and an hourglass shaped red/white mark on its abdomen. Only the female bites, and it has a neurotoxic venom.The female is much larger than the male and is one of the largest spiders in the United States. Males generally do not bite. Females bite only when hungry, agitated or protecting the egg sac. The black widow is not aggressive. They are usually found in dry, secluded, dimly lit areas. More than 80 percent of all bite victims are adult men.

Black widow spider bites are the leading cause of death from spider bites in the United States. The venom is 14 times more toxic than rattlesnake venom. It is a neurotoxin that causes little local reaction but does cause pain and spasms in the larger muscle groups of the body within 30 minutes to three hours. The pain gradually spreads over the entire body and settles in the abdomen and legs. Abdominal cramps and progressive nausea, vomiting, and a rash may occur. Weakness, tremors, sweating, and salivation may occur. Anaphylactic reactions can occur. Symptoms begin to regress after several hours and are usually gone in a few days. Threat for shock. Be ready to perform CPR. Clean and dress the bite area to reduce the risk of infection. An antivenin is available. Severe bites can cause respiratory failure, coma and death.

Those at the highest risk are children under age 16, the elderly, people with chronic illness and people with high blood pressure. The symptoms usually happen in last 24 to 48 hours.

Signs and symptoms of a black widow spider bite:

1. A pinprick sensation at the bite site, becoming a dull ache within 30 to 40 minutes
2. Pain and spasms in the shoulders, back, chest, and abdominal muscles within 30 minutes to three hours
3. Rigid, boardlike abdomen
4. Restlessness and anxiety
5. Fever
6. Rash
7. Headache
8. Vomiting and nausea
9. Flushing
10. Sweating
11. Grimacing

Treatment:

1. Treat for shock
2. Apply a cold compress but do not apply ice
3. Transport to hospital as quickly as possible

The funnelweb spider is a large brown or gray spider found in Australia. The symptoms and the treatment for its bite are as for the black widow spider.

Brown House Spider

There are two types of brown house spiders or brown recluse spiders in Arizona. They often are called violin spiders because of the characteristic "violin-shaped" marking on the upper back. They are generally brown but can range in color from yellow to dark brown. They are timid with webs in dry undisturbed areas. The Arizona species is not the same as the brown recluse spider in the Midwest.

There is no pain, or so little pain, that usually a victim is not aware of the bite. The bite is nonhealing and causes tissue death. Sometimes surgery is necessary. The bite causes only a mild stinging sensation if any at all. Within a few hours a painful red area with a mottled cyanotic center appears. Necrosis does not occur in all bites, but usually in 3 to 4 days, a star-shaped, firm area of deep purple discoloration appears at the bite site. The area turns dark and mummified in a week or two. The margins separate and the scab falls off, leaving an open ulcer. Secondary infection and regional swollen lymph glands usually become visible at this stage. The outstanding characteristic of the brown recluse bite is an ulcer that does not heal but persists for weeks or months. In addition to the ulcer, there is often a systemic reaction that is serious and may lead to death. The target lesion will enlarge over the next few days and produce extensive tissue death. There is no antivenom. The lesion will have to be soaked in antispetic and possibly antibiotics. Surgery may be necessary to cut out the dead tissue.

Symptoms

Several hours after the bite, the following signs and symptoms begin to result:

1. A small white area appears surrounded by a margin of redness which may produce a mild itching pain.
2. A blister appears surrounded by mild swelling and redness.
3. A "bulls-eye" or "target" lesion develops
4. There may be fever, chills, hives, nausea, joint pain, vomiting, and a generalized rash in the joints over the next few days.

Tarantula

Tarantulas are large, hairy spiders found mainly in the tropics. Most do not inject venom, but some South American species do. They have large fangs. If bitten, pain and bleeding are certain, and infection is likely. Treat a tarantula bite as for any open wound, and try to prevent infection. If symptoms of poisoning appear, treat as for the bite of the black widow spider.

Bites and Stings – Bee and wasp stings

If stung by a bee, immediately remove the stinger and venom sac, if attached, by scraping with a fingernail or a knife blade. Do not squeeze or grasp the stinger or venom sac, as squeezing will force more venom into the wound. Wash the sting site thoroughly with soap and water to lessen the chance of a secondary infection. If you know or suspect that you are allergic to insect stings, always carry an insect sting kit with you. Relieve the itching and discomfort caused by insect bites by applying

• Cold compresses.
• A cooling paste of mud and ashes.
• Sap from dandelions.
• Coconut meat.
• Crushed cloves of garlic.
• Onion.

Do's and Don'ts

• DO check your property regularly for bee colonies. Honey bees nest in a wide variety of places, especially Africanized honey bees. Check animal burrows, water meter boxes, overturned flower pots, trees and shrubs.
• DO keep pets and children indoors when using weed eaters, hedge clippers, tractor power mowers, chain saws, etc. Attacks frequently occur when a person is mowing the lawn or pruning shrubs and inadvertently strikes a bee's nest.
• DO avoid excessive motion when near a colony. Bees are much more likely to respond to an object in motion than a stationary one.
• DON'T pen, tie or tether animals near bee hives or nests.
• DON'T destroy bee colonies or hive, especially with pesticides.
• DON'T remove bees yourself. If you want bees removed, look in the yellow pages under "bee removal" or "beekeepers".

What to do if you are attacked:

1. Run as quickly as you can away from the bees. Do not flail or swing your arms at them, as this may further annoy them.
2. Because bees target the head and eyes, cover your head as much as you can without slowing your escape.
3. Get to the shelter or closest house or car as quickly as possible. Don't worry if a few bees become trapped in your home. If several bees follow you into your car, drive about a quarter of a mile and let the bees out of the car.

Africanized honey bees

Africanized honey bees were imported to Brazil in 1956 to enhance honey production in the tropics. Some of the bees escaped into the wild and have gradually moved towards North America.

Africanized honey bees are the temperamental cousin of the more common European honey bee found in Arizona. They often are called "killer bees", but in reality their stings are less potent and painful than the common bee sting. Contrary to portrayal in the movies, these bees do not swoop down in mass causing death and destruction. They do defend their nesting sites very aggressively, sometimes stinging their victims hundreds of times.

It is impossible for the average person to tell the difference between an Africanized honey bee and the common European honey bee. Only an expert with sophisticated lab equipment is able to distinguish between the two. Those at highest risk are individuals who are allergic to bee stings and pets that are penned or tied up near honey bee hives.

How to treat stings from Africanized bees:
Treating stings from Africanized bees is much the same as treating a common bee sting. If a person is stung:

1. Keep the affected area below the heart
2. If the sting was by a bee and the stinger is still in the skin, remove it by gently scraping against it with your fingernail, a credit card or a knife. Be careful not to squeeze the stinger. The venom sac still will be attached and you will inject additional venom into the area. Be sure to remove the venom sac.
3. Apply cold compresses to relieve pain and swelling but do not apply ice directly.
4. If it becomes difficult to breathe, call emergency call institutions. Itching should quit within a few hours. If it persists beyond two days, or if signs and symptoms of an allergic reaction occur after an insect bite you should be seen by a doctor. The signs and symptoms of an allergic reaction include:
1. Burning pain and itching at the bite site
2. Itching on the palms of the hands and soles of the feet
3. Itching on the neck and the groin
4. General body swelling
5. A nettlelike rash over the entire body
6. Difficulty breathing
7. Faintness, weakness
8. Nausea
9. Shock
10. Unconsciousness

Bites and Stings

Insects and related pests are hazards in a survival situation. Insect bites and stings are common, and most are considered minor. They not only cause irritations, but they are often carriers of diseases that cause severe allergic reactions in some individuals. It is only when the insect is poisonous or when the patient has an allergic reaction and runs the risk of developing anaphylactic shock that the situation becomes an emergency. Even under those conditions, accurate diagnosis and prompt treatment can save lives and prevent permanent tissue damage. In many parts of the world you will be exposed to serious, even fatal.

The normal reaction to an insect sting is a sharp, stinging pain followed by an itchy, swollen, painful raised area. The swelling may be there for several days but usually goes away within 24 hours. Local reactions are rarely serious or life-threatening and can be treated with cold compresses.

However, there are some people who have allergic reactions to "normal" insect stings. Approximately 50 people die each year in the United States from insect stings. This is more than all other bites combined including snakebites. Thousands of people are allergic to bee, wasp, and hornet stings. Insect stings can be deadly for those people, on the average, within 10 minutes of the sting but almost always within the first hour.

The stinging insects that most commonly cause allergic reactions belong to a group of the hymenoptera, the insects with membranous wings. These include bees, wasps, hornets, and yellow jackets. Stings from wasps and bees are the most common.

Ticks can carry and transmit diseases, such as Rocky Mountain spotted fever common in many parts of the United States. Ticks also transmit the Lyme disease.

Mosquitoes may carry malaria, dengue, and many other diseases.

Flies can spread disease from contact with infectious sources. They are causes of sleeping sickness, typhoid, cholera, and dysentery.

Fleas can transmit plague.

Lice can transmit typhus and relapsing fever.

The best way to avoid the complications of insect bites and stings is to keep immunizations (including booster shots) up-to-date, avoid insect-infested areas, use netting and insect repellent, and wear all clothing properly.

If you get bitten or stung, do not scratch the bite or sting, it might become infected. Inspect your body at least once a day to ensure there are no insects attached to you. If you find ticks attached to your body, cover them with a substance, such as Vaseline, heavy oil, or tree sap, that will cut off their air supply. Without air, the tick releases its hold, and you can remove it. Take care to remove the whole tick. Use tweezers if you have them. Grasp the tick where the mouth parts are attached to the skin. Do not squeeze the tick's body. Wash your hands after touching the tick. Clean the tick wound daily until healed.

Treatment

It is impossible to list the treatment of all the different types of bites and stings. Treat bites and stings as follows:

• If antibiotics are available for your use, become familiar with them before deployment and use them.
• Predeployment immunizations can prevent most of the common diseases carried by mosquitoes and some carried by flies.
• The common fly-borne diseases are usually treatable with penicillins or erythromycin.
• Most tick-, flea-, louse-, and mite-borne diseases are treatable with tetracycline.
• Most antibiotics come in 250 milligram (mg) or 500 mg tablets. If you cannot remember the exact dose rate to treat a disease, 2 tablets, 4 times a day for 10 to 14 days will usually kill any bacteria.

How about another creatures’ bites and stings ?

There are anothers poisonous creatures’ bites and stings, such as bee, spider, scorpion, snake, and gila monster. Even most varieties of creature are nonpoisonous.

Dyslexia -- History

The problem was first described in 1896 by Dr. W. Pringle Morgan in England. He wrote of a "bright and intelligent boy quick at games and in no way inferior to others of his age. His great difficulty has been - and is now - his inability to learn to read." His letter in the British Medical Journal described the case of a boy named Percy who, at age 14, had not yet learned to read, yet he showed normal intelligence and was generally adept at other activities typical of children of that age.

In 1887 by Rudolf Berlin used the term to refer to a case of a young boy who had a severe impairment in learning to read and write in spite of showing typical intellectual and physical abilities in all other respects.

Some early researchers believed dyslexia stemmed from a visual deficit. This notion has persisted in popular culture, where it is falsely believed that dyslexia equates to reading words backwards or upside-down.

A key early researcher in dyslexia was Samuel T. Orton. Orton coined the term strephosymbolia (meaning 'twisted signs') to describe his theory that individuals with dyslexia had difficulty associating the visual forms of words with their spoken forms. Orton observed that reading deficits in dyslexia did not seem to stem from strictly visual deficits. He also believed that dyslexics were disproprtionately left-handed, although this finding has been difficult to replicate.

In the 1970's, a new hypothesis, based in part on Orton's theories, emerged that dyslexia stems from a deficit in phonological processing or difficulty in recognizing that spoken words are formed by discrete phonemes (for example, that the word CAT comes from the sounds [k], [æ], and [t]). As a result, affected individuals have difficulty associating these sounds with the visual letters that make up written words. Key studies of the phonological deficit hypothesis include the finding that the strongest predictor of reading success in school age children is phonological awareness, and that phonological awareness instruction can improve reading scores in children with reading difficulties.

The Design versus Deficit debate — Thomas G. West, towards the end of the 20th century, suggested the theory that dyslexia may be design not deficit related, citing Galaburda and his own research. West suggests that many dyslexics belong to a much larger group of visual spatial thinkers who are wired for the big picture — designed to process information visually. It is only in a secondary state that dyslexics come to process information in a logical, sequential, language-based context. The uncomfortable reality may be that our education system indirectly attempts to screen out the Einstein gene, and thereby all our most original and gifted thinkers. West goes on to examine the difficult early experiences within education of five Nobel prize winners. or near-winners: Einstein, Edison, Marconi, Churchill and Faraday.

West's theory is echoed in the work of Ronald Dell Davis, author of The Gift of Dyslexia, who describes dyslexia as the outgrowth of a primarily picture-thinking mind. Davis posits that the symptoms associated with dyslexia arise from disorientation that results from confusion over language symbols. This view has also been supported indirectly by the research of by Linda Silverman, author of Upside Down Brilliance - the title reflects the counter-intuitive experiences of those who find the easy tasks difficult and hard tasks easy.

Echoes of this theory can be traced to the emerging discipline of NLP, the origin of VAK , now backed in the UK by the SEFD [Department for Education and Skills ]. Robin Williams of ABC, extended the theory to explain the paradox of bright under-achievers in his 0002 broadcast, The Einstein factor. The importance of a design-based theory is that design-based solutions are quite different from deficit solutions. A design solution suggests that literacy as a focus of the condition dyslexia must be considered a symptom and not the condition, that Professor Joe Elliott, the man most closely associated with 'The Dyslexia Myth documentary, may be right but for the wrong reasons. That IQ, as Elliott has argued, has nothing to do with literacy. This is where Elliott stops. A design theory argues that dyslexia as a condition is the result of a trade off and by identifying that trade off you can use strengths to offset the constellation of traits which constitute dyslexia , a condition related to a single root cause a difficulty with language [ dys - difficulty & lexia — language ] in all its forms: writing, reading, oral presentations and importantly memory. In other words, design not deficit.