Tag: west nile

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What would make the liver quit working?

A cirrhotic liver. (iStockphoto/Thinkstock)
A cirrhotic liver. (iStockphoto/Thinkstock)

Dear Dr. B: What would make the liver quit working? This person did not use alcohol. Could West Nile virus, hepatitis or E. coli possibly affect your liver?

Two most common causes of liver failure in North America are alcohol and acetaminophen use. Acetaminophen is present in over-the-counter pain and cold medications like Tylenol. We will come to this later. Let me first answer your question.

As far as I know, West Nile virus does not cause liver failure. Usually. West Nile fever resolves spontaneously and completely. In a worst case scenario, fatigue, headache, weakness, movement disorders can persist for weeks or months. Severe disease involving the nervous system can result in death or permanent disability. Death is from swelling of the brain and respiratory failure.

Hepatitis does cause liver failure. Hepatitis is a generic term used for inflammation and damage to the liver cells. The liver cells can be damaged by drugs, any kind of toxins, alcohol, inherited diseases, certain metabolic diseases and viruses. Generally speaking, when we say hepatitis, it refers to viral hepatitis A, B, and C. Hepatitis C is the commonest reason for liver transplant in the U.S.

E. coli infection is very common. But it is not a common cause of liver failure. E. coli can cause infection of the urinary tract, gallbladder, bile ducts and the infection, in rare cases, travel to the the liver, brain (meningitis) or lungs (pneumonia). The majority of infected individuals make a full recovery within a week. About six per cent of patients end up having kidney failure (hemolytic uremic syndrome). Of these, between three to five per cent of patients will die.

Alcohol is a poison. Any amount of alcohol can produce damage to the the liver. The liver is very sensitive to alcohol. If you have had previous problems with the liver then the best thing is to avoid alcohol and acetaminophen.

The most common agent causing liver damage is acetaminophen. However, It is considered the safest medication for fevers, aches and pains, but only if taken in small recommended amounts. In large amounts, greater than those recommended, can result in the liver damage or failure. Acetaminophen overdose is a common reason for considering a transplant.

We have five vital organs – the liver, the brain, the heart, the lungs and the kidneys. The liver plays a vital role in the metabolism of fat and carbohydrates, synthesis of proteins, detoxification of poisons and storage of good nutrients. When the the liver fails, either acutely or chronically, these important functions do not occur. Thus, the person faces severe ill health. There are numerous other reasons why the liver can fail. It is impossible to discuss them all here. However, you get the idea. It is easy to damage your liver if you are not careful.

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So, are you ready for the summer, sunscreen and bug spray?

Summer is finally here. So are the ultraviolet rays (UVR) and the mosquitoes.

Exposure to sun’s rays can be healthy and harmful. There are more than 25 human disorders that are either caused by or aggravated by exposure of the skin to sunlight. But exposure to sunlight is also the most potent and natural way to manufacture vitamin D in our body.

Our skin can be protected from the harmful effects of UVR by use of sunscreens. Chemical sunscreens were discovered in 1926. Subsequent sunscreen evolution was primarily directed toward ultraviolet B (UVB) protection to lessen development of sunburn from overexposure to the sun.

There are many different brands of sunscreen available. Sunscreen should be efficient, water resistant and safe. It should spread easily, maximize skin adherence, should be non-stinging, non-staining, and inexpensive. Most popular sunscreens are available in creams and lotions. Lotions spread more easily.

Many sunscreens do not block UVA radiation, which does not cause sunburn but can increase the rate of melanoma, so people using sunscreens may be exposed to a high level UVA without realizing it.

The ability of a sunscreen to protect the skin from UVR-induced skin redness is measured by the SPF. The redness is from sunburn. SPF 15 blocks 93 per cent of UVB. Some argue that SPF 15 is sufficient and that higher labeling claims are misleading and costly for consumers. But some studies have shown that higher SPF (SPF 30) sunscreens conferred better benefits.

The SPF varies depending on the nature of the sun blocking ingredients in the product. Since the SPF refers only to protection against UVB, it is important to choose a “broad spectrum”
sunscreen that also protects you from UVA radiation. Also check if they are water resistant and follow the instructions on the product label on how often to apply for best results.

It is important to note that while sunscreens can help reduce sunburn, they are not as effective against the other harmful effects of UV rays, like premature aging of the skin and depression of the immune system.

Recurrent sunburn causes permanent damage to the skin and causes skin cancers. You should avoid sunburn by other means wearing appropriate clothing, wide-brimmed hat and appropriate sunglasses and avoid sun exposure between 11 a.m. and 3 p.m.

Do not forget about mosquitoes and West Nile virus. Canada had its first confirmed cases of West Nile virus in 2002. For most Canadians, the risk of illness from West Nile virus is low, but it is important to minimize your risk. Use insect repellents and wear light-colored long-sleeved shirts, long pants, and a hat when outdoors. Limit the time you spend outdoors at dawn and dusk, when mosquitoes are most active.

Enjoy the summer but be safe.

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Watch Out for the Blood Sucking Female Mosquitoes

For the past several summers we have been worrying about West Nile virus. This virus was first isolated in 1937 from the blood of a patient on the West Nile province of Uganda. Not too far from where I was born. The man had fever. Initially, the outbreaks of the disease were few. But over the years the numbers have increased.

In North America, the virus was first detected in 1999. It was in New York. From there it was exported to Ontario and rest of Canada. Most cases of West Nile virus are mild and self-resolving. But one per cent of cases get infection in the nervous system.

Culex tarsalis is the blood sucking female mosquito that spreads the virus. As the summer comes and the temperature soars, the West Nile virus activity increases. Alberta Health and Wellness undertook a study of West Nile virus prevalence through June 2007. The report is posted on its website.

According to this report, Alberta experienced its first locally acquired clinical cases of West Nile virus (275 confirmed human cases) in the summer of 2003. Since then, clinical (e.g., symptomatic) infections have been detected every year, though the numbers have fluctuated.

From 2004 to 2006, there were very few clinical cases with a combined total of 51. In 2007 there was an increase in the number of infections with 320 cases and the first two deaths associated with the virus in the province. During the 2008 West Nile virus season, only one clinical infection was detected in Alberta and it is thought to be travel-related, says the Alberta Health report.

It is important to remember that for every clinical infection of West Nile virus there are many more undetected infections in humans, since majority of the infections have no symptoms and are never detected.

West Nile virus is carried by birds. Mosquitoes get infected by feeding on the blood of these birds. Infected mosquitoes then transmit the virus to humans when they bite us.

All mosquitoes need water to develop from their immature stages to adulthood. The life cycle takes less than 10 days to complete if the surrounding temperature is favorable. Once the adult mosquito is ready to fly then it looks for something to eat.

Nectar from flowers provides energy to both male and female mosquitoes. While male mosquitoes feed exclusively on nectar, the female mosquito needs blood to produce her eggs. The source of blood can be animals (including people) and birds.

It is important to control the breeding sites around your home by preventing stagnation of water (flower pots, gardening cans, wheelbarrows, puddles, tire swings, bird baths and eavestroughs) even in small quantities. Boats and gardening containers can be stored upside down.

During mosquito season you should limit your outdoor activities. Minimize exposure of your skin by wearing long pants, shirts with long sleeves, socks and shoes when outdoors. Loose clothings will keep mosquitoes away from the skin. Use insect repellents like DEET. Read the directions carefully before using DEET-based repellents especially on children, infants and yourself.

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Warning – Mosquitoes Are Here To Hurt Us

My first article on West Nile virus was in 2003. Not much has changed in the last five years. Mosquitoes continue to threaten us every summer. Summer is a time to be free, be outdoors and have fun. But mosquitoes spoil the fun.

Every year we go through this process of reminding ourselves to protect against this horrible virus. Just like we do in winter against flu virus. The difference is there is no vaccine yet against West Nile virus.

This year the battle has already started. Alberta Government has been advertising in the media to remind us about the precautions we need to take to prevent mosquito bites. Dr. Paul Schnee, Medical Officer of Health and Gordon Wright, Health Promotion Facilitator, both from Palliser Health Region, have been relentless in reminding the doctors and the public about West Nile virus.

I thought mosquitoes would consider me their friend and spare me from their horrible stinging bites. You see, I was born and raised on the shores of Lake Victoria. A small town called Musoma, in Tanzania, East Africa. There was no shortage of mosquitoes and malaria in Tanzania. Then I moved to India to go to college. There is no shortage of mosquitoes there either. Now in Canada, I am faced with the same battle. I have been fighting mosquitoes all my life. They show no respect for me. And they show no respect to public in general.

West Nile virus was first isolated in 1937 from the blood of a patient on the West Nile province of Uganda. Not too far from where I was born. The man had fever. Initially, the outbreaks of the disease were few. But in the last 15 years the numbers have increased.

In North America, the virus was first detected in 1999. It was in New York. From there it was exported to Ontario and rest of Canada. Most cases of West Nile virus are mild and self-resolving. But one per cent of cases get infection in the nervous system.

West Nile virus is carried by birds. Mosquitoes get infected by feeding on the blood of these birds. Infected mosquitoes then transmit the virus to humans when they bite us.

All mosquitoes need water to develop from their immature stages to adulthood. The life cycle takes less than 10 days to complete if the surrounding temperature is favorable. Once the adult mosquito is ready to fly then it looks for something to eat.

Nectar from flowers provides energy to both male and female mosquitoes. While male mosquitoes feed exclusively on nectar, the female mosquito needs blood to produce her eggs. The source of blood can be animals (including people) and birds.

It is important to control the breeding sites around your home by preventing stagnation of water (flower pots, gardening cans, wheelbarrows, puddles, tire swings, bird baths and eavestroughs) even in small quantities. Boats and gardening containers can be stored upside down. These are just a few examples.

During mosquito season you should limit your outdoor activities. Minimize exposure of your skin by wearing long pants, long sleeves, socks and shoes when outdoors. Loose clothings will keep mosquitoes away from the skin. Use insect repellents like DEET. Read the directions carefully before using DEET-based repellents especially in children, infants and yourself.

Remember, Culex tarsalis is the mosquito that spreads the virus here. The Culex is just out and is now active. It comes to us from July to September (first freeze). Now is the time to start really watching for this one, says Gordon Wright, Palliser’s Health Promotion Facilitator. There is no sign of the virus yet, but we are assuming it will be here soon, says Wright.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!