Infectious Diseases

Bed bugs are small, parasitic insects that bite humans and animals and feed on their blood. Bed bugs hide in the cracks and crevices of beds, box springs, headboards, bed frames, and other objects found around a bed.

Bed bugs are easy to spread. They can easily move from one site to another by traveling on clothing, luggage, furniture, bedding, or boxes. They do not care if the environment is clean or dirty, so cleaning does not prevent bed bugs.

Symptoms of bed bug bites include:

• Red bumps, often with a darker red spot in the middle
• Itching
• In a line or cluster
• Located on the face, neck, arms, and hands

Bites on the skin are not a great indicator of a bed bug infestation because the bites could look like other insect bites. It is better to look for physical signs of bed bugs, such as:

• Rusty or red-colored stains on sheets or mattresses
• Dark spots that may bleed on the fabric like a marker (these could be bed bug excrement)
• Eggs or egg shells
• Live bed bugs

If you see any of the above, let your RA or landlord know. It is important to treat bed bugs as quickly as possible. The treatment for bed bugs will depend on the size and type of infestation.

• Inspect mattress seams for bed bug excrement when staying in hotel rooms. Put your luggage on tables or dressers instead of on the floor in hotel rooms.
  
• Inspect any secondhand bedding or furniture before bringing it into your home or room.
• Reduce clutter. This will create fewer places for bed bugs to hide.
• Consider storing your belongings separately from other people’s, especially if there is a suspected bed bug sighting.

Information provided by the Centers for Disease Control and Prevention (CDC) and the Environmental Protection Agency (EPA).

Chlamydia is a common sexually transmitted infection (STI) that can infect both men and women. It is a bacterial infection can potentially cause serious, permanent damage to a woman’s reproductive system.

• You can get chlamydia through sexual contact by vaginal, anal, or oral sexual activity with someone who has the infection. The infection can infect both male and female genital organs, rectum, and/or throat depending on type of contact.
• You can still get infected again if you’ve been treated in the past by having unprotected vaginal, anal, or oral sexual activity with someone who has chlamydia.

Chlamydia may present WITH or WITHOUT symptoms. If you do have symptoms, they may not appear until several weeks after you have sex with an infected partner.

• Symptoms in women include abnormal vaginal discharge, burning sensation with urinating, or abnormal vaginal bleeding. 
• Symptoms in men include discharge from their penis, burning sensation when urinating, or pain and swelling in one or both testicles (less common).
• Rectal pain, discharge, or bleeding may occur in both men and women who engage in rectal sexual activity.

You should be examined by your medical provider if you notice any symptoms or if your partner has an STI or symptoms of an STI. Laboratory tests can diagnose chlamydia. Your health care provider may ask you to provide a urine sample or may use (or ask you to use) a cotton swab to get a sample from your vagina, throat, or rectum to test for chlamydia.

The only way to avoid chlamydia is to not engage in vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting chlamydia:

• Regular use of barrier methods such as condoms and dental dams during sexual activity.
• Be in a long-term mutually monogamous relationship with a partner who has been tested and has negative STI test results.
• Once-yearly testing for chlamydia is recommended for the following even in the absence of symptom   
  • All sexually active women who are younger than 25 years old   
  • Women with multiple sexual partners
  • Men who have sex with men

Information provided by Centers for Disease Control and Prevention (CDC) and UpToDate.com.

Gonorrhea is a common bacterial sexually transmitted infection (STI) in the U.S., occurring primarily among adolescents and young adults. It is caused by the bacteria, Nesseria Gonorrhea. Although an infection with gonorrhea is treatable and curable, it can cause long-term complications in both males and females.

Gonorrhea is transmitted by sexual contact (vaginal, anal, oral sex) with an infected partner. Nonsexual transmission can occur if infected genital secretions are transmitted to the mucus membranes of the eye (via unwashed hands). Even after being treated for gonorrhea, it is possible to be re-infected if a person engages in sexual activity with someone with gonorrhea.

Most people with gonorrhea have no symptoms, but they can still transmit the infection to sexual partners. Symptoms, when present, may appear one to three weeks after exposure to a partner with gonorrhea, and may include any of the following:

• unusual vaginal discharge
  
• unusually heavy or unusually painful period
• pain or bleeding with intercourse
• pain or burning with urination
• spotting or bleeding between menstrual periods

• discharge from the penis
  
• pain or burning with urination
• burning or itching around the urethral opening
• pain and/or swelling in the testicles

• sore throat from transmission by oral sex with infected partner
  
• diarrhea, rectal discharge, or bleeding from transmission by anal sex

An individual can be checked for gonorrhea by examination and a special laboratory test obtained from the suspected site of infection. This test can be obtained even if you are not having symptoms.

Annual screening for gonorrhea and other STIs is especially important for all sexually active people age 25 and younger, and for older people who have a new sex partner or who have multiple sex partners. Talk to your health care provider about how often you should be tested.

*Tests for gonorrhea and other sexually transmitted infections may not routinely be obtained at the time of a woman’s annual pelvic exam, so it is important to ask to be tested.

*A Pap test does not screen for gonorrhea.

Gonorrheal infections are treated with specific antibiotics. It is important to carefully follow instructions.

• Complete all of the prescribed medication, even if symptoms resolve prior to completion of the medication.
  
• Never take medication prescribed for someone else.
• All sexual partners during the previous 60 days should be evaluated and treated, even if the person does not have symptoms.
• Avoid sexual contact for 7 days after completion of medication.
• You and your partner should be retested in 3 months.

• The most effective means of preventing an infection with gonorrhea and other STIs is to avoid contact between the penis, vagina, anus, or mouth.
  
• If you are sexually active, have sexual contact only with one person who is not infected and who is having sexual contact only with you.
• Use safer sex products, such as condoms, correctly and consistently from start to finish with each sexual encounter.
• Discuss with a potential partner about being tested for gonorrhea before you have sex with each other.
• Never mix alcohol or drugs with sexual activity. They may impair judgment and hinder your ability to practice safer sex.
• If you think you may have been exposed to gonorrhea or to any STI, see your health care provider right away.

Information provided by the Centers for Disease Control and Prevention (CDC).

Head lice are parasitic insects that can be found on the head, eyebrows, or eyelashes of people.

Head lice are spread by coming into direct contact with the hair of a person with head lice. While rare, it is possible to spread head lice through clothing and personal items (such as sharing combs, brushes, or towels). It does not matter how clean a person’s home or body is; this does not increase or decrease the risk for head lice. Animals do not spread head lice.

The most common symptom of head lice is itching on the head and in the hair. A person might also feel a tickling sensation of something moving in the hair.

Head lice can be diagnosed by finding an egg or adult louse on the scalp or in the hair of a person. The eggs and crawling lice may be difficult to see; it may take a magnifying glass or a fine-toothed comb to find live lice. If someone is not sure if they have head lice, a health care provider can help make the diagnosis.

If someone has head lice, everyone in the home or residence hall room should be checked; those who have adult lice or nymphs should be treated. Head lice can be treated at home with over-the-counter medications. Prescription medications are also available. It is important to follow all of the instructions on the medication.

In addition to shampooing, wash any clothing items, hats, scarves, combs, brushes, and towels that may have come into contact with a person with head lice. Use hot water and the hot cycle in the dryer to clean these items (put combs or brushes in boiling water). Vacuuming furniture and floors is also recommended.

• Avoid head-to-head contact with other people.
  
• Do not share combs, brushes, or hats with other people.
• If you think you have head lice or are diagnosed with head lice, let your roommate(s) know and tell your RA. University Health Services (UHS) can also provide information on next steps.

Information provided by the Centers for Disease Control and Prevention (CDC).

Hepatitis means inflammation of the liver; it is a virus that affects the liver. There are several common types of hepatitis viruses in the United States: Hepatitis A, Hepatitis B, and Hepatitis C. Hepatitis C is the most common of the three in the United States.

Hepatitis A

Hepatitis A is spread when a person ingests fecal matter through contact with objects, food, or drinks that are contaminated by feces or stool from a person with Hepatitis A. A vaccine is available to prevent the transmission of Hepatitis A. If you are traveling to a country where Hepatitis A is common and you have not been vaccinated, you might consider being vaccinated before your travels.

Hepatitis B

Hepatitis B is transmitted through blood, semen, or certain other body fluids. It can be spread through sexual contact, sharing needles or syringes, or sharing personal items like a toothbrush or a razor. A vaccine is available, and most people in the United States receive the vaccine when they are young. In fact, at the University of Cincinnati, students are required to be immunized against Hepatitis B.

Hepatitis C

Hepatitis C is primarily spread through contact with blood, such as through sharing needles or syringes, poor infection control in health care facilities, or receiving a blood transfusion prior to 1992 (when screening for Hepatitis C in blood donations began). Hepatitis C could also be spread through sexual activity. There is no vaccine available for Hepatitis C.

If you are not sure if you should be vaccinated against hepatitis, you can take a risk assessment through the Centers for Disease Control and Prevention.

Most people with hepatitis do not have any symptoms, which is why testing is so important. If a person does have symptoms, they could take decades to develop. Symptoms can include: jaundice, fever, fatigue, dark urine, or joint pain, among other symptoms.

Hepatitis is diagnosed through a blood test.

Hepatitis A

Doctors do not routinely screen for Hepatitis A.

Hepatitis B

The CDC recommends Hepatitis B testing for:

• People born in countries with a high rate of Hep-B (your clinician can let you know if this applies to you)
• Men who have sex with men
• People who inject drugs
• People with HIV
• People with Hepatitis C
• Pregnant women

Hepatitis C

The CDC recommends Hepatitis C testing for:

• People who currently or formerly injected drugs
• Everyone born from 1945 to 1965
• People who received blood transfusions or organ transplants before July 1992
• People with HIV

It is recommended by the U.S. Preventive Services Task Force that people who are in jails or prisons and people who get unregulated tattoos also be tested for Hepatitis C.

For people with Hepatitis A, they can receive treatment for their symptoms. Often Hepatitis A goes away on its own after a few weeks to a few months. For people with Hepatitis B, there is no medication to treat acute (early) infection, but people with chronic (long-term) infection could be treated with antiviral drugs. For people with Hepatitis C, there is no medication available to treat for acute infection. There are medications available for people with chronic Hepatitis C infection.

• Getting vaccinated is one of the most effective ways to reduce the risk for Hepatitis A and B.
  
• To prevent Hepatitis B, people should avoid contact with body fluids during sexual activity. Condoms can be used to reduce the risk, too.
• If you are sexually active, have sexual contact only with one person who is not infected and who is having sexual contact only with you.
• Do not share needles, syringes, or other works.
• Practicing good personal hygiene, such as washing hands, could reduce the risk for Hepatitis A.
• Take precautions when getting any tattoos or body piercings.

Information provided by the Centers for Disease Control and Prevention (CDC) and theCleveland Clinic.

Genital herpes is a common sexually transmitted infection (STI) that can infect both men and women. Genital herpes is an STI caused by two types of viruses. The viruses are called herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). In the U.S., more than one out of every six people aged 14 to 49 years have genital herpes.

Oral herpes is usually caused by HSV-1 and can result in cold sores or fever blisters on or around the mouth. However, most people do not have any symptoms. Most people with oral herpes were infected during childhood or young adulthood from non-sexual contact with saliva. Oral herpes caused by HSV-1 can be spread from the mouth to the genitals through oral sex. This is why some cases of genital herpes are caused by HSV-1.

You can get herpes through sexual contact by vaginal, anal, or oral sexual activity with someone who has the infection. The infection can infect both male and female genital organs, rectum, and/or throat depending on type of contact:

• A herpes sore;
• Saliva (if your partner has an oral herpes infection) or genital secretions (if your partner has a genital herpes infection);
• Skin in the oral area if your partner has an oral herpes infection, or skin in the genital area if your partner has a genital herpes infection.

You can get herpes from a sex partner who does not have a visible sore or who may not know they are infected. It is also possible to get genital herpes if you receive oral sex from a sex partner who has oral herpes.

You will NOT get herpes from toilet seats, bedding, or swimming pools, or from touching objects around you such as silverware, soap, or towels. If you have additional questions about how herpes is spread, consider discussing your concerns with a healthcare provider.

Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. The blisters break and leave painful sores that may take a week or more to heal. These symptoms are sometimes called “having an outbreak.” The first time someone has an outbreak they may also have flu-like symptoms such as fever, body aches, or swollen glands.

People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they are infected with HSV-2. Repeat outbreaks are usually shorter and less severe than the first outbreak. Although the infection stays in the body for the rest of your life, the number of outbreaks may decrease over time.

You should be examined by your doctor if you notice any of these symptoms or if your partner has an STI or symptoms of an STI. STI symptoms can include an unusual sore, a smelly genital discharge, burning when urinating, or (for women) bleeding between periods.

Your healthcare provider may diagnose genital herpes by simply looking at your symptoms. Providers can also take a sample from the sore(s) and test it. In certain situations, a blood test may be used to look for herpes antibodies. Have an honest and open talk with your health care provider and ask whether you should be tested for herpes or other STIs.

Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or how long you have been infected.

There is no cure for herpes. However, there are medicines that can prevent or shorten outbreaks. One of these anti-herpes medicines can be taken daily, and makes it less likely that you will pass the infection on to your sex partner(s).

• The only way to avoid herpes is to not engage in vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting herpe   Regular use of barrier methods such as condoms during sexual activity. Be aware that not all herpes sores occur in areas that are covered by a latex condom. Also, herpes virus can be released (shed) from areas of the skin that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.
• Be in a long-term mutually monogamous relationship with a partner who has been tested and has negative STI test results

Information provided by Centers for Disease Control and Prevention (CDC) and UpToDate.com.

Human Immunodeficiency Virus (HIV) is a virus that weakens a person’s immune system by destroying important cells that fight viruses and infection. Acquired Immune Deficiency Syndrome (AIDS) is a clinical diagnosis usually made when someone’s immune system has been weakened by HIV. In order to be diagnosed with AIDS, a person must be infected with HIV, but not everyone with HIV has an AIDS diagnosis.

Only certain body fluids can transmit HIV. These include: blood, semen, pre-ejaculate (pre-cum), rectal fluids, vaginal fluids, and breast milk. A person must have HIV in order to transmit it to other people. In the United States, HIV is mainly spread through sexual contact (including vaginal and anal sex), as well as by sharing needles, syringes, or other “works” used when injecting drugs. It is possible for HIV to be transmitted mother to child during pregnancy, childbirth, or breastfeeding. HIV is not transmitted by mosquitoes, by sharing toilets, through saliva or sweat, or through air.

Most people with HIV do not have any symptoms, or the symptoms look like other infections. If a person becomes infected with HIV, they may experience flu-like symptoms within 2-4 weeks. Those symptoms will go away after a period of time. A person with HIV who is not receiving treatment may go 10 or more years before developing symptoms (although this is different for each person). At this point, the person’s immune system has been damaged by HIV and they may start developing symptoms that could lead to an AIDS diagnosis. Only a health care provider can make this diagnosis.

The only way to know if you have HIV is to be tested. The Centers for Disease Control and Prevention (CDC) recommends that everyone 13 - 64 years old get tested for HIV at least once. If you have certain risk factors for HIV, you should be tested more often. These risk factors include having unprotected vaginal or anal sex, having sex with someone who is HIV-positive, and/or sharing needles or syringes. Talk to your health care provider about how often you should be tested.

There are several types of tests available. Most tests screen for HIV antibodies, not the virus itself. No test can detect HIV immediately after infection. The time between when a person has been infected with HIV and when a test can tell if someone has HIV is called the window period. The window period varies from test to test. Because most tests use HIV antibodies to detect infection, the window period for antibody tests range from 18-90 days. This means that a person would need to wait 18-90 days after possible exposure with HIV to be tested for HIV. If a person engages in activities within that window period that could put them at risk for infection (such as having sex without a condom or sharing needles), then the window period resets. If a person is tested for HIV during the window period and their result is negative, it does not necessarily mean that they do not have HIV. It is important for that person to be tested again after 18-90 days to ensure that they are HIV-negative.

It is possible to test for HIV through blood and through an oral fluid test. With a blood test, a person could have blood drawn from a vein or provide a finger-stick to collect a blood sample. With an oral fluid test, a special swab is used to collect an oral fluid sample. Rapid blood and oral fluid tests are available, which results given in 20-30 minutes or less.

If someone has an HIV antibody test and the result is positive, a confirmatory test will need to be done. If you have blood drawn in a lab, they are often able to do a confirmatory test on that sample. If you have a rapid blood or oral fluid test, you will be sent to a health care provider for follow up testing. There is a chance that the result could be a false positive, which is why confirmatory testing is needed.

*Tests for HIV and other sexually transmitted infections may not routinely be obtained at the time of a woman’s annual pelvic exam, so it is important to ask to be tested.

*A Pap test does not screen for HIV.

There is no cure for HIV or AIDS, but there are medications that can lengthen a person’s life and decrease their risk for spreading the virus to other people. If you have HIV, it is important that you see a health care provider who specializes in treating the virus. It is also important that you take your medication as prescribed.

There are medications available for people who have been exposed to HIV, or before exposure happens.

PrEP

Pre-exposure prophylaxis (PrEP) is when people who are at high-risk for HIV take medications daily to reduce their chances of infection. It is highly effective if taken as prescribed. PrEP is recommended for people who are HIV-negative and are in an ongoing sexual relationship with someone who is HIV-positive. It is also recommended that people who inject drugs. Not all insurance covers the cost of PrEP, so people often have to pay for it out of pocket. UHS provides PrEP for students who are interested. Call 513-556-2564 for more information.

PEP

Post-exposure prophylaxis (PEP) is when people take medications to reduce the risk of HIV after they have been exposed to HIV. PEP should only be used in emergency situations and should be started within 72 hours of possible exposure to HIV. PEP can be used in the following situations:

• Someone has been exposed to HIV during sex (such as if the condom broke)
• Someone shared needles or other works with someone with HIV
• Someone is sexually assaulted

PEP should not take the place of regular HIV prevention methods, such as PrEP, condom use, and using your own clean needles to inject drugs. Talk to your health care provider to learn more about PEP.

• The most effective means of preventing HIV and other STIs is to avoid contact between the penis, vagina, anus, or mouth.
  
• If you are sexually active, have sexual contact only with one person who is not infected and who is having sexual contact only with you.
• Use safer sex products, such as condoms, correctly and consistently from start to finish with each sexual encounter.
• Discuss with a potential partner about being tested for HIV before you have sex with each other.
• Do not share needles or other works.
• Never mix alcohol or drugs with sexual activity. They may impair judgment and hinder your ability to practice safer sex.
• If you think you may have been exposed to HIV, see your health care provider right away.

 Information provided by the Centers for Disease Control and Prevention (CDC).

HPV (human papillomavirus) is the most common sexually transmitted infection (STI). HPV is a different virus than HIV and HSV (herpes). There are many different types of HPV. Some types can cause health problems including genital warts and cancers.

You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. HPV can be passed even when an infected person has no signs or symptoms. Anyone who is sexually active can get HPV, even if you have had sex with only one person. People who have a lot of sex partners have a higher chance of getting an HPV infection. You also can develop symptoms years after you have sex with someone who is infected. This makes it hard to know when you first became infected.

In most cases, HPV goes away on its own and does not cause any health problems. However, when HPV does not go away, it can cause health problems like genital warts and cancer:

• Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area.
• HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer).Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers.

There is no test to find out a person’s “HPV status.” Also, there is no approved HPV test to find HPV in the mouth or throat.

There are HPV tests that can be used to screen for cervical cancer. These tests are only recommended for screening in women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years.

Most people with HPV do not know they are infected and never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers.

There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause:

• Genital warts can be treated by your healthcare provider or with prescription medication. If left untreated, genital warts may go away, stay the same, or grow in size or number.
• Cervical pre-cancer can be treated. Women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Prevention is always better than treatment.
• Other HPV-related cancers are also more treatable when diagnosed and treated early.

• Get vaccinated. In the United States, HPV vaccination is recommended for all girls and women who are between ages 9 and 26 years. HPV vaccination is recommended for boys and men who are between ages 9 and 21 years. It can be given up to 26 years of age if they are men who have sex with men or have infection with the human immunodeficiency virus.
• Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer.
• If you are sexually active. Use latex condoms every time you have sex. This can lower your chances of getting HPV. However, HPV can infect areas not covered by a condom – so condoms may not fully protect against getting HPV. Being in a mutually monogamous relationship – or have sex only with someone who only has sex with you – can also lower your chances of infection.

Information provided by Centers for Disease Control and Prevention (CDC) and UpToDate.com.

Influenza (flu) is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs. It can cause mild to severe illness, and can result in hospitalization or death. There are two main types of influenza virus: Types A and B. Flu viruses usually cause the most illness during the colder months of the year but can occur outside of the typical flu season.

Flu viruses spread mainly by tiny droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose or eyes.

Flu is different from a cold, as it usually comes on suddenly. People who are sick with flu often feel some or all of these symptoms:

• Fever* or feeling feverish/chills
• Cough
• Sore throat
• Runny or stuffy nose
• Muscle or body aches
• Headaches
• Fatigue (tiredness)
• Some may have vomiting and diarrhea, though this is more common in children than adults.

*It’s important to note that not everyone with flu will have a fever.

Diagnosis is based on symptoms and clinical judgment, and the health care provider may choose to use an influenza diagnostic test. Most people are not tested because the results usually do not change treatment. During an outbreak of respiratory illness, testing can help determine if flu viruses are the cause of the outbreak. Flu testing can also be helpful to guide decisions about care in certain conditions (pregnancy or weakened immune system).

A number of flu tests are available. These tests require that a health care provider use a swab to obtain a specimen from the inside of the nose or the back of the throat.

People with flu are most contagious in the first 3-4 days after their illness begins. Some otherwise healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Once diagnosis is confirmed, self-isolate until fever-free for 24 hours without the use of fever-reducing medication.

Use of antiviral drugs may be a treatment option. Antiviral drugs can lessen symptoms and shorten the duration of symptoms by 1 or 2 days. They also can prevent serious flu complications, like pneumonia. For people at high risk of serious flu complications (young children, adults 65 years of age and older, pregnant women, and people with certain medical conditions such as asthma, diabetes and heart disease) treatment with antiviral drugs can mean the difference between milder or more serious illness possibly resulting in a hospital stay.

Other steps to take:

• Stay home until you are better. CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or other necessities. Your fever should be gone without the need to use a fever-reducing medicine. Until then, you should stay home from work, school, travel, shopping, social events, and public gatherings.
• If you must leave home, for example to get medical care, wear a facemask if you have one, or cover coughs and sneezes with a tissue. Wash your hands often to keep from spreading flu to others.
• Stay hydrated, and rest.
• Clean and disinfect surfaces and objects that may be contaminated with germs like the flu.

The best way to prevent flu is by getting vaccinated each year.  Note that the term ‘stomach flu’ is often used to describe vomiting and/or diarrhea caused by other viruses.  This is not the same as influenza, and people with these viruses do not typically have sore throat, nasal congestion, or cough.  Flu shots do not prevent these infections.

Information provided by Centers for Disease Control and Prevention (CDC).

Measles is a serious viral respiratory disease (in the lungs and breathing tubes) that causes rash and fever. It is very contagious and in rare cases can be deadly. In children measles can be very dangerous leading to pneumonia, deafness, brain damage, and death.

Measles spreads when a person infected with the measles virus breathes, coughs, or sneezes. It is very contagious through airborne particles, and you can catch measles by being in a room where a person with measles has been, up to two hours after that person is gone. You can catch measles from an infected person before they have the rash.  Most people who have not had measles or the MMR (Measles, Mumps, Rubella) vaccine will get measles if exposed to the virus. If you have measles, wear a mask to prevent spreading the virus.

Measles virus starts with a fever that can be very high. Other symptoms may include: rash with small red spots covering head and rest of body, cough, runny nose, red eyes, diarrhea, ear infection.

Diagnosis is usually based on symptoms of fever, rash, and known or suspected exposure from an infected person. Laboratory testing of serum and throat swab can confirm the measles virus.

People infected with the measles virus must be isolated for 4 days after developing a rash. People who do not have immunity to measles from previous infection or vaccine, or exempt from the measles vaccine, should avoid affected outbreak areas or institutions until 21 days after the onset of rash in the last case of measles.

There is no specific medication or antiviral therapy for measles. Medical care includes treatment for symptom relief, reducing fever and rash. Fluids for rehydration. Antibiotics may be used if there are complications such as bacterial infections. In children with measles infection, Vitamin A is administered.

College students and health care workers are required to have 2 doses of MMR, or a recent lab test confirming immunity. International travelers are encouraged to make sure they've had two doses of the MMR vaccine. A single dose is not completely effective at preventing measles.

University of Cincinnati requires students to have proof of immunizations or proof of immunity. Individuals who waive this requirement may be excluded from all campus activities including classes and dormitories during an outbreak.

• Make sure you are fully vaccinated or otherwise protected against measles.
• Children in the United States routinely receive measles vaccination at age 12-15 months.
• Children 12 months of age or older should have 2 doses, separated by at least 28 days.
• Adolescents and adults who have not had measles or have not been vaccinated should get 2 doses, separated by at least 28 days.
• Two doses of MMR vaccine are nearly 100% effective at preventing measles.
• The only measles vaccines available in the United States are the measles-mumps-rubella (MMR) and the measles-mumps-rubella-varicella (MMRV) vaccines. MMR has been used safely and effectively since the 1970s. A few people experience mild, temporary, adverse reactions, such as joint pain, from the vaccine, but serious side effects are extremely rare. There is no link between MMR vaccine and autism.
• You should not get the MMR vaccine if you are pregnant or have an immune disorder.  Check with your doctor.
• IF YOU THINK YOU MAY HAVE MEASLES OR MAY HAVE BEEN EXPOSED TO MEASLES, CALL US (513) 556-2564 RIGHT AWAY.

Information provided by Centers for Disease Control and Prevention (CDC) and UpToDate.

Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord.  The usual cause is a bacterial or viral infection of the fluid surrounding the brain and spinal cord. Other causes can include injuries, cancer, certain drugs, and other types of infections. It is important to know the specific cause of meningitis because treatment differs depending on the cause.

One of several different bacteria can cause bacterial meningitis.  It is very serious and can be deadly. Death can occur in as little as a few hours. Most people recover from bacterial meningitis, however, permanent disabilities (such as brain damage, hearing loss, and learning disabilities) can result from the infection.

The most common type of meningitis is caused by virus. Viral meningitis is often less severe than bacterial, and most people get better on their own (without treatment). However, it’s very important for anyone with symptoms of meningitis to see a healthcare provider right away to rule out a bacterial cause. A health care provider can determine the type of meningitis and the best treatment, which can sometimes be lifesaving.Replace with your text

Meningitis symptoms include sudden onset of fever, headache, and stiff neck. Other symptoms include:

• Nausea
• Vomiting
• Photophobia (increased sensitivity to light)
• Altered mental status (confusion)

Symptoms of bacterial meningitis typically develop within 3 to 7 days after exposure.  Later symptoms can be very serious (e.g., seizures, coma). For this reason, anyone who thinks they may have meningitis should see a doctor as soon as possible.

Meningitis is diagnosed by lab tests done on specimens from a person suspected of having meningitis. The health care provider may collect samples for testing by:

• swabbing the nose and/or throat,
• obtaining a stool sample,
• taking some blood, or
• drawing fluid from around the spinal cord.

Bacterial meningitis is treated with antibiotics. It is important to start treatment as soon as possible. Antibiotics may be recommended help prevent other people from getting sick. This is called prophylaxis.  CDC recommends prophylaxis for:

• Close contacts of someone with meningitis caused by Neisseria meningitides.
• Family members, especially if they are at increased risk, of someone with a serious Hib infection.

In most cases, there is no specific treatment for viral meningitis.

There are vaccines for three types of bacteria that can cause meningitis: Neisseria meningitides, Streptococcus pneumonia, and Hib. The Meningococcal Quadrivalent (Meningitis A) vaccine is a UC required immunization for students aged 16 to 21yrs. 

Like with any vaccine, protection against these bacteria are not 100% effective. The vaccines do not protect against all the types (strains) of each bacteria. For these reasons, there is still a chance one can develop bacterial meningitis, even if vaccinated.

Since no vaccine is 100% effective and there are no vaccines to protect against viral meningitis, maintaining healthy habits can provide defense:

• Avoid close contact with people who are sick, and clean and disinfect frequently touched surfaces if someone is sick.
• Cover coughs and sneezes with a tissue or upper shirt sleeve, not hands.
• Stay home when you are sick.
• Wash hands often with soap and water and avoid touching your face with unwashed hands.
• Don’t smoke and avoid cigarette smoke.
• Get plenty of rest.

Information provided by Centers for Disease Control and Prevention (CDC).

Mumps is a contagious disease caused by a virus that spreads from person to person. The virus affects the salivary glands and causes a fever. Mumps is best known for puffy cheeks and tender, swollen jaw.

Mumps is a contagious virus and it spreads through direct contact with saliva or respiratory droplets from the mouth, nose, or throat. An infected person can spread the virus by coughing, sneezing or talking. The virus can also spread by sharing items that may have saliva on them, such as water bottles or cups, participating in close-contact activities with others, such as playing sports, dancing, or kissing, touching objects or surfaces with unwashed hands that are then touched by others

An infected person can likely spread mumps from a few days before their salivary glands begin to swell to up to five days after the swelling begins. A person with mumps should limit their contact with others during this time. For example, stay home from school and do not attend social events.

Facial swelling along the jaw-line from swollen salivary glands, called parotitis. Other symptoms that might begin a few days before parotitis begins include fever, headache, muscle aches, fatigue, and loss of appetite.

Symptoms typically appear 16-18 days after infection, but this period can range from 12–25 days after infection. Some people who get mumps have very mild symptoms (like a cold), or no symptoms at all and may not know they have the disease. Most people recover from mumps within 2 weeks.

In rare cases, mumps can cause more severe complications, such as deafness, orchitis (testicular inflammation), meningitis, and encephalitis.

The mumps virus should be considered with symptoms of swollen salivary glands (parotitis), and whether you have been vaccinated against mumps and/or you might have been exposed to the virus.

A blood test and viral culture to check for evidence of the mumps virus can confirm mumps infection. A negative test does not rule out mumps infection.

People infected with the mumps virus must be isolated for 5 days. When a person is ill with mumps, they should avoid contact with others from the time of diagnosis until 5 days after the onset of parotitis (swelling of salivary glands) by staying home from work or school and staying in a separate room if possible.

There are not specific medications or antiviral therapy for mumps. Rest is the best treatment.

Take over-the-counter pain relievers such as acetaminophen (Tylenol, others) or a nonsteroidal anti-inflammatory drug such as ibuprofen (Advil, Motrin IB, others) to ease symptoms.

• Use a warm or cold compress to ease the pain of swollen glands.
• Wear an athletic supporter and use cold compresses to ease the pain of tender testicles.
• Avoid foods that require lots of chewing. Try broth-based soups or soft foods, such as mashed potatoes or oatmeal.
• Avoid sour foods, such as citrus fruits or juices, which stimulate saliva production.
• Drink plenty of fluids

The best way to prevent mumps is to be vaccinated against the disease. Most people have immunity to mumps once fully vaccinated.

The mumps vaccine is given as a combined measles-mumps-rubella (MMR) inoculation, which contains the safest and most effective form of each vaccine. Two doses of the MMR vaccine are recommended before a child enters school. Those vaccines should be given when the child is:

• Between the ages of 12 and 15 months
• Between the ages of 4 and 6 years

College students and health care workers are required to have 2 doses of MMR, or a recent lab test confirming immunity. International travelers are encouraged to make sure they've had two doses of the MMR vaccine. A single dose is not completely effective at preventing mumps.

Information provided by Centers for Disease Control and Prevention (CDC) and UpToDate.com.

Norovirus is a virus that causes vomiting and diarrhea. Frequently diagnosed as “stomach flu”, it is not influenza or the flu. It is very contagious and can affect all ages. It spreads quickly in crowded environments such as classrooms, cruise ships, restaurants/hotels. It is not stomach flu or influenza.

Norovirus is transmitted by direct contact with an infected person, consuming contaminated food or beverages, sharing utensils or drinks, touching contaminated surfaces and then touching your mouth or food with unwashed hands.

Norovirus causes stomach pain, nausea, vomiting and diarrhea. The stomach and intestines can become inflamed, called acute gastroenteritis. Other symptoms may include fever, headache, body aches. Symptoms may last from 1-4 days. You are contagious when you have symptoms, and for up to a week after recovering.

Diagnosis is usually based on symptoms. Norovirus can also be confirmed by stool sample test.

Norovirus is not treated with antibiotics or other specific medicines. Treatment includes drinking plenty of fluids to replace fluids lost from vomiting and diarrhea, and to prevent dehydration. Oral rehydration fluids are most helpful, OTC (over-the-counter) products such as Pedialyte or oral rehydration salts. Also include water, sports drinks (without caffeine) and broths. Avoid alcohol, liquids that contain a lot of sugar, such as soft drinks and fruit juices; these can make diarrhea worse. A healthcare provider may recommend anti-diarrheal medications or anti-nausea medications.

• Wash your hands. Wash hands thoroughly with soap and water, especially after using the toilet and changing diapers, and always before eating or preparing food.
• Handle and prepare food safely. Carefully wash fruits and vegetables, cook oysters and other shellfish thoroughly before eating. If you are sick with norovirus, do not prepare food for others while you have symptoms and for at least 2 days after symptoms go away.
• Clean and disinfect surfaces. After you vomit or have diarrhea, immediately clean up the entire area using a bleach-based household cleaner as directed on the product label. If no such cleaning product is available, you can use a solution made with 5 tablespoons to 1.5 cups of household bleach per 1 gallon of water.
• Wash laundry thoroughly. Immediately remove and wash clothing or linens that may have vomit or poop on it. Handle items carefully—try not to agitate them. If available, wear disposable gloves to handle soiled clothing or linens, and wash your hands after. Wash soiled items with detergent and hot water at the maximum available cycle length then machine dry them at the highest heat setting.

Information provided by Centers for Disease Control and Prevention (CDC) and UpToDate.com.

Pertussis, also known as whooping cough, is a highly contagious respiratory disease caused by a type of bacteria called Bordetella pertussis. Pertussis can affect people of all ages, but can be very serious, even deadly, for babies less than a year old.  Pertussis is a reportable illness that is monitored by the Health Department.

Pertussis is a very contagious disease that spreads to another person by coughing or sneezing, or when spending a lot of time near another where there is shared breathing space. Infected people are most contagious up to about 2 weeks after the cough begins. 

Symptoms of pertussis usually develop within 5 to 10 days after exposed. The disease usually starts with cold-like symptoms which may include a mild cough or fever. Sometimes symptoms do not develop for as long as 3 weeks. Pertussis is known for uncontrollable, violent coughing which often makes it hard to breathe.  After cough fits, someone with pertussis often needs to take deep breaths, which result in a “whooping” sound. This extreme coughing can cause one to throw up and be very tired. Recovery from pertussis can happen slowly. The cough becomes milder and less common, however coughing fits can return with other respiratory infections for many months.

Diagnosis is based on exam, a sample of mucus from the back of the nose to test for the presence of pertussis bacterium, and a blood antibody test. 

Pertussis is generally treated with antibiotics. Treatment after three weeks of illness is unlikely to help.  The bacteria are gone from the body by then, even though symptoms usually persist. This is because the bacteria have already done damage to the body.  Pertussis can sometimes be very serious, requiring treatment in the hospital. 

The best way to prevent pertussis is through vaccination. While pertussis vaccines are the most effective tool to prevent this disease, no vaccine is 100% effective. When pertussis circulates in the community, there is a chance that a fully vaccinated person, of any age, can catch this disease. If one has gotten the pertussis vaccine but still gets sick, the infection is usually not as bad.  Household members of a person diagnosed with pertussis, and certain close contacts, can be given antibiotics to prevent infection.  This should be started as soon as possible.

Information provided by Centers for Disease Control and Prevention (CDC) www.cdc.gov

Pubic lice (also called “crabs”) are parasitic insects that are found primarily in the genital area. Pubic lice is not the same as head lice. Just because someone has head lice does not mean they will or do have pubic lice.

Pubic lice are spread through sexual contact. While rare, it is possible for pubic lice to be spread through close personal contact (that is not sexual) or by sharing clothing, beds, bed linens, or towels. Pubic lice are not spread through animals or toilet seats.

The most common symptom is itching in the genital area. Depending on the stage, a person might see eggs or crawling lice.

A diagnosis is usually made by seeing crawling lice or eggs. If a person thinks they have pubic lice, they should see a health care provider to be tested for other sexually transmitted infections (STIs).

Pubic lice can be treated with over-the-counter lotions and creams. A health care provider can write a prescription for other lice-killing medicines. It is important to wash clothes, bedding, and towels with hot water and dry them using the hot cycle of the dryer.

• The most effective means of preventing pubic lice and other STIs is to avoid contact with another person’s genital area.
• If you are sexually active, have sexual contact only with one person who is not infected and who is having sexual contact only with you.
• Condoms will not prevent pubic lice (although it is important to use condoms to reduce the risk for other sexually transmitted infections).
• Never mix alcohol or drugs with sexual activity. They may impair judgment and hinder your ability to practice safer sex.

Information provided by the Centers for Disease Control and Prevention (CDC) and MedlinePlus. 

Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild, many people do not realize they are infected. A rash may start around two weeks after exposure and last for three days.

Rubella spreads when an infected person coughs or sneezes. A person with rubella may spread the disease to others up to one week before the rash appears, and remain contagious up to 7 days after. However, up to 50% of people infected with rubella do not develop a rash or have any symptoms.

If you are infected with rubella you should tell friends, family, and coworkers, especially pregnant women, that you have rubella. If your child has rubella, it’s important to tell your child’s school or daycare provider. Also, if a woman is infected with rubella while she is pregnant, she can pass it to her developing baby causing serious harm.

Symptoms of rash often appear two to three weeks after exposure, and may include mild fever and headache. Other symptoms may include malaise, enlarged neck lymph nodes, eye redness, headache, or runny nose.

Rubella infection is most commonly diagnosed by associated symptoms and detection of rubella-specific IgM antibodies in a serum sample. Specific IgM antibody can be detected as early as four days after the onset of rash and is usually detectable after primary infection for six to eight weeks or longer

Although rubella was officially declared to be eliminated from the United States in 2004, ongoing rubella activity in many other countries can result in sporadic U.S. cases or outbreaks.

Patients with rubella should be isolated for 7 days after they develop rash.

There are not specific medications or antiviral therapy for rubella. Take over-the-counter pain relievers such as acetaminophen (Tylenol, others) or a nonsteroidal anti-inflammatory drug such as ibuprofen (Advil, Motrin IB, others) to ease symptoms. Drink plenty of fluids.

The most serious complication from rubella infection is the harm it can cause in pregnancy affecting the developing baby. In an unvaccinated pregnant woman the rubella virus can cause miscarriage, or death soon after birth. Also, the virus can pass to her developing baby who can develop serious birth defects such as heart problems, loss of hearing and eyesight, intellectual disability, liver or spleen damage.

The best way to prevent rubella is to be vaccinated against the disease. Most people have immunity to rubella once fully vaccinated.

The rubella vaccine is given as a combined measles-mumps-rubella (MMR) inoculation in the United States, which contains the safest and most effective form of each vaccine. Two doses of the MMR vaccine are recommended before a child enters school. Those vaccines should be given when the child is:

• Between the ages of 12 and 15 months
• Between the ages of 4 and 6 years

College students and health care workers are required to have 2 doses of MMR, or a recent lab test confirming immunity. International travelers are encouraged to make sure they've had two doses of the MMR vaccine. A single dose is not completely effective at preventing rubella.

Information provided by Centers for Disease Control and Prevention (CDC) and UpToDate.com.

Scabies is a skin condition caused by mites. The mites burrow under the skin and lay their eggs. It commonly leads to intense itching and a pimple-like skin rash that may affect various areas of the body. Scabies is contagious and can spread quickly in areas where people are in close physical contact.

Scabies usually is spread by skin-to-skin contact with a person who has scabies. Scabies can be spread indirectly by sharing items such as clothing, towels, or bedding used by an infested person. Indirect spread can occur more easily when a person has crusted scabies. Scabies can spread easily under crowded conditions. An infested person can transmit scabies, even if they do not have symptoms, until they are successfully treated and the mites and eggs are destroyed.

Common symptoms of itching and a pimple-like skin rash may affect much of the body or be limited to common places such as:

• Between the fingers
• Wrist
• Elbow
• Armpit
• Genitals
• Nipple
• Waist
• Buttocks
• Shoulder blades

Symptoms affect the head, face, neck, palms and soles in infants and very young children, but usually not adults and older children. When a person is first infested with scabies mites, it usually takes 2-6 weeks for symptoms to appear. If a person has had scabies before, symptoms appear 1-4 days after exposure.

A presumptive diagnosis is often made based upon a consistent history and physical examination. The diagnosis can be confirmed by the detection of the scabies mite, eggs, or fecal pellets through microscopic examination.  Skin biopsies are usually reserved for difficult cases in which other disorders need to be excluded.

Scabies are treated with topical creams that can kill the mites, which are available by prescription from a health care provider. Treatment is also recommended for roommates the infested person has been in contact with.  Bedding, clothing, and towels used by infested persons and roommates should be decontaminated using the following methods:

• Wash items in hot water and dry in a hot dryer, or dry-clean.
• Store items that can’t be washed in a sealed plastic bag for at least 72 hours.
• Thoroughly clean and vacuum rooms.

Prevent scabies by avoiding skin-to-skin contact with a person who has scabies, and by avoiding contact with items such as clothing or bedding used by a person infested with scabies mites.

Information provided by Centers for Disease Control and Prevention (CDC) and UpToDate.com.

Syphilis is a sexually transmitted infection (STI) that can infect both men and women and cause serious health problems if left untreated. Syphilis is divided into stages (primary, secondary, latent, and tertiary). There are different signs and symptoms associated with each stage.

You can get syphilis through direct contact with a syphilis sore during vaginal, anal, or oral sexual activity. Sores can affect both male and female genital areas, rectum, and/or mouth depending on type of contact.

• Primary stage: Symptoms usually start 2-3 weeks after being infected. A person generally has a sore(s) at the original site of infection. These sores usually occur on or around the genitals, around the anus or in the rectum, or in or around the mouth. These sores are usually (but not always) firm, round, and painless. Sores caused by primary syphilis usually heal on their own within a few weeks. Since they don't hurt, many people don't get treatment for them.
• Secondary stage: Symptoms may start weeks to a few months after primary syphilis. Symptoms include a skin rash, swollen lymph nodes, and fever. The signs and symptoms of primary and secondary syphilis can be mild, and they might not be noticed.
• Latent stage: People who have this form can have the infection for years without knowing it as there are no signs or symptoms.
• Tertiary stage: Severe medical problems can occur that may affect the heart, brain, and other organs of the body.

You should be examined by your medical provider if you notice any symptoms or if your partner has an STI or symptoms of an STI. Laboratory tests by blood or sample fluid from a sore can diagnose syphilis.

Syphilis is treated by taking prescribed medication from a medical provider. Syphilis is usually treated with an antibiotic called penicillin. People who are allergic to penicillin need to take a different antibiotic.

The only way to avoid syphilis is to not engage in vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting syphilis:

• Regular use of barrier methods such as condoms during sexual activity.
• Be in a long-term mutually monogamous relationship with a partner who has been tested and has negative STI test results including syphilis.
• You should get tested regularly for syphilis if you are sexually active and:
  • You are a man who has sex with men
  • Living with HIV
  • Have partner(s) who have tested positive for syphilis

Information provided by Centers for Disease Control and Prevention (CDC) and UpToDate.com.

Active Tuberculosis (TB) is a disease caused by a germ called Mycobacterium tuberculosis that is spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. However, not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and TB disease.

Persons with latent TB infection do not feel sick and do not have any symptoms. They are infected with M. tuberculosis, but do not have TB disease. The only sign of TB infection is a positive reaction to the tuberculin skin test or TB blood test. Persons with latent TB infection are NOT infectious and cannot spread TB infection to others.

Overall, without treatment, about 5 to 10% of infected persons will develop TB disease at some time in their lives. About half of those people who develop TB will do so within the first two years of infection. For persons whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is considerably higher than for persons with normal immune systems.

When a person with infectious active TB coughs or sneezes, droplet nuclei containing M. tuberculosis are expelled into the air. If another person inhales air containing these droplet nuclei, he or she may become infected. People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers or schoolmates.

The general symptoms of active TB disease include: Unexplained weight loss, loss of appetite, night sweats, fever, fatigue, chills. The symptoms of active TB of the lungs include: coughing for 3 weeks or longer, hemoptysis (coughing up blood), chest pain.

There are two kinds of tests that are used to detect TB bacteria in the body: the TB skin test (TST) and TB blood tests.  A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. It does not tell whether the person has latent TB infection (LTBI) or has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease.

• Testing in BCG-vaccinated persons: Many people born outside of the United States have been given a vaccine called BCG. People who were previously vaccinated with BCG may receive a TB skin test to test for TB infection. Vaccination with BCG may cause a false positive reaction to a TB skin test. A positive reaction to a TB skin test may be due to the BCG vaccine itself or due to infection with TB bacteria.
• TB blood tests (IGRAs), unlike the TB skin test, are not affected by prior BCG vaccination and are not expected to give a false-positive result in people who have received BCG. TB blood tests are the preferred method of TB testing for people who have received the BCG vaccine.

• People who are not sick and have latent TB must take medicine for 3 to 9 months.
• Active TB disease can be treated by taking several drugs for 6 to 9 months.  There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Consult with your treating medical provider regarding treatment regimen options.
• If your doctor or nurse gives you medicine to treat TB, it is very important that you take it all. If you do not take all your medicine, you could get sick with TB, or the medicine could lose its effect. If the medicine loses its effect, the infection can become even harder to treat.

Traveling Abroad: In many countries, TB is much more common than in the United States. Travelers should avoid close contact or prolonged time with known TB patients in crowded, enclosed environments (for example, clinics, hospitals, prisons, or homeless shelters).

Information provided by Centers for Disease Control and Prevention (CDC) and UpToDate.com.

Varicella, also known as Chickenpox, is a highly contagious disease caused by the varicella-zoster virus (VZV). It can cause an itchy, blister-like rash. Chickenpox can be serious, especially in babies, adolescents, adults, pregnant women, and people with a weakened immune system.

Chickenpox is highly contagious. The virus spreads to those who have never had the disease or never been vaccinated from contact with airborne droplets or by direct contact with vesicle fluid from skin lesions.

The same virus that causes chickenpox (varicella-zoster virus) also causes shingles. Once someone has chickenpox, this virus remains inactive in the nerves. The virus reactivates for unknown reasons in the form of shingles. Persons with shingles can spread Chickenpox to those who have never had the condition or received the vaccine. It takes about 10 to 21 after exposure to a person with chickenpox or shingles for someone to develop chickenpox.

A person with chickenpox is contagious beginning 1 to 2 days before rash onset until all the chickenpox lesions have crusted (scabbed). For most people, getting chickenpox once provides immunity for life. However, in rare cases people get chickenpox more than once. These persons and vaccinated people who get chickenpox may develop lesions that do not crust. They are considered contagious until no new lesions have appeared for 24 hours.

The classic symptom of chickenpox is a rash that turns into itchy, fluid-filled blisters that eventually turn into scabs. The rash may first show up on the chest, back, and face, and then spread over the entire body, including inside the mouth, eyelids, or genital area. It usually takes about one week for all of the blisters to become scabs. Other symptoms that may begin to appear 1-2 days before rash include:

• fever
• tiredness
• loss of appetite
• headache

Chickenpox illness usually lasts about 4 to 7 days.

Chickenpox is generally diagnosed based on the rash. If there's any doubt about the diagnosis, chickenpox can be confirmed with laboratory tests, including blood tests or a culture of lesion samples.

Self-isolate until all lesions have crusted.

To help relieve chickenpox symptoms and prevent skin infections:

• Calamine lotion and a cool bath with added baking soda, uncooked oatmeal, or colloidal oatmeal may help relieve some of the itching.
• Try to minimize scratching to prevent the virus from spreading to others and potential bacterial infection from occurring.
• Keeping fingernails trimmed short may help prevent skin infections caused by scratching blisters.
• Use over-the-counter medications to reduce fever.

The best way to prevent chickenpox is to get vaccinated, which is an immunization requirement at UC. Everyone should get two doses of the varicella vaccine if they have never had chickenpox or were never vaccinated.

Most people who get the vaccine will not get chickenpox. If a vaccinated person does get chickenpox, the symptoms are usually milder with fewer or no blisters (they may have just red spots) and mild or no fever.

Information provided by Centers for Disease Control and Prevention (CDC) and UpToDate.com.