What do you need to bear in mind if you have meningitis?

The risk of contracting meningitis increases if you come into close contact with someone who has it (if you sleep in the same room, live in the same house, kiss on the cheek, etc.), but there is no need to disinfect objects or areas because meningococcus bacteria do not live long outside of the human body.

The measures to prevent this illness are:

• Chemoprophylaxis (antibiotic treatment)
• Vaccination 

With meningitis, the appropriate measure is to administer antibiotics to the family and other people who live with the affected person.

If the illness was caused by meningococcal group B, the only preventive measure, and the most common in Spain,  is chemoprophylaxis, which aims to eliminate the microorganism from the pharynx. This stops it from spreading, in the space of a few days, between the people who have taken the medication.

If the illness was caused by meningococcal group C, as well as administering chemoprophylaxis, people close to the affected person will be vaccinated if they have not already been so.

If there is evidence that someone has had intimate contact with the patient in the ten days prior to the occurrence of the disease and they have not been administered chemoprophylaxis, healthcare staff must be informed.

What do you need to bear in mind if you take tuberculosis (TB) drugs or if you want to detect side effects early?

Currently, tuberculosis (TB) drugs are safe and effective, and the majority of people take them without any problems. In some cases side effects may appear, so it is important to follow the treatment plan under supervision and see a doctor in case of doubt.

Once treatment begins, and to make sure it has the desired result, follow the instructions below:

• Take medicine on an empty stomach (30 minutes before breakfast). 
• Do not take it alongside any antacids or gastric protectors. 
• If you are diabetic or have gout, tell your doctor. 
• The medication may cancel out the effect of hormonal contraceptives; where required, you will need to take other measures to avoid pregnancy. 
• Tell medical personnel about any other medication you may be taking. 
• Even if you feel better, continue treatment for the time indicated. If for any reason you are not able to take your medication, tell medical personnel beforehand. 
• The use of other medicines (cough medicine, antipyretics, natural remedies, etc.) may result in intolerances (digestive, kidney, etc.). It is important that you consult your doctor before taking any other medication. 
• Do not drink alcoholic drinks during treatment. 
• Use high factor sun cream when exposed to sunlight. 

Warnings 

Urine, faeces, sweat and tears may be red/orange in colour. This change is normal and will disappear when the treatment comes to an end.

Advise medical personnel if you have any of these symptoms

• Loss of appetite 
• Nausea 
• Diarrhoea 
• Abdominal pain 
• Gastric discomfort 
• Eyes or skin become pale 
• Joint pain or inflammation (knees, ankles, etc.) or significant
• skin outbreaks 
• Blurred vision or changes in perception of colours

What do you need to bear in mind if you have resistant osteoarticular infections?

When the patient is discharged, nursing staff will give them all the support and information they need to be able to look after the wound themselves. Most patients will be fitted with an external fixator that needs daily care, so healthcare staff will emphasise the importance of hygiene in the affected area, which should be cleaned daily and the correct dressing applied.

If patients are not independent and do not have a relative or carer to look after them, the local health authority will be contacted (through the PREALT discharge preparation unit), so that they may be provided with nursing care. If patients are being treated with intravenous medication, the Hospital at Home Unit will be contacted to follow up and provide the relevant treatment.

It is also necessary to explain the importance of taking the medication prescribed. On being discharged, most patients will receive long-term oral antibiotics (prescribed by the Infectious Diseases Unit) and they are reminded of the importance of maintaining a fixed schedule and not forgetting to take their medication.

They are also reminded of the need to maintain healthy habits, such as:

• Being well hydrated
• Eating properly (protein-based diet)
• Stopping toxic habits (should they have any), such as alcohol and tobacco

What do you need to bear in mind to prevent Zika virus?

The advice to prevent infection with Zika virus is particularly aimed at pregnant women or those thinking of becoming pregnant in the short to medium term. The possibility of transmitting the infection to the foetus means that pregnant women are the most vulnerable group. For this reason, you are advised to:

• Avoid travelling to countries where there is a risk of being infected while you are pregnant.
• Inform a healthcare professional if you have already travelled to any the affected areas.
• Use a condom for the entire pregnancy if your sexual partner has travelled to countries affected by Zika virus.

Mosquito bite prevention

• Dress in clothes that cover most of your body and wear a hat all day to protect your skin as much as possible from exposure to mosquitoes.
• Use authorised repellents, following the manufacturer’s instructions for their use and reapplication indicated on the product.
• Avoid being outside unnecessarily during the most active times of day for mosquitoes (first thing in the morning and late afternoon).
• Sleep in air conditioned accommodation, as mosquitoes tend to avoid the cold, or place mosquito nets around the bed, doors and windows.

Mosquito proliferation prevention

Another way of preventing mosquito bites is to avoid proliferation of mosquitoes, which you can do by finding out and periodically checking the areas where these insects reproduce. Once breeding points are located, the measures should focus, as appropriate, on:

• Avoiding and/or draining any accumulation of water there may be in the subsoil of accommodation.
• Emptying or covering objects that may accumulate water.
• Emptying or refreshing water weekly in the case of fixed objects or containers that may accumulate water and covering, with a lid or mosquito screen, those that cannot be emptied.
• Keeping swimming pools, ponds and other bodies of water in correct hygiene conditions.

What do you need to bear in mind if you have acute bronchiolitis?

Acute bronchiolitis is a respiratory tract infection common in infants under two. This infection, caused by RSV, manifests itself in mild or moderate catarrhal symptoms, although if it is not treated, it may progress and cause serious bronchiolitis or pneumonia.

The symptoms of acute bronchiolitis may vary depending on the patient’s age:

• In adults and the majority of healthy infants: upper respiratory symptoms (rhinitis, mild cough, minor wheezing)
• In breastfeeding and premature babies: normally, lower respiratory symptoms (bronchiolitis, pneumonia)

This virus may be transmitted in two ways:

• Directly: through contact with secretions from an infected individual (wet mode)
• Indirectly: through contact with surfaces, such as furniture (for example, those that have been exposed to infectious secretions)

The preventive measures to avoid transmission of the virus are:

• Hand hygiene: hands should be washed before touching the child.
• Toys should be cleaned, especially after having been used by other infected children or adults.
• Personal utensils (plates and feeding bottles) should be washed properly and specific utensils used for the infant that are different to those used by adults.
• (Paper) disposable tissues should be used and immediately disposed of (not re-used).
• Physical contact with the infant should be avoided by people with respiratory symptoms or fever. Infection can be avoided if a distance of 1.8 m is maintained from the person with symptoms.
• Enclosed environments and crowds should be avoided.
• Avoid exposure to tobacco smoke.
• Breastfeeding should be encouraged, as it protects against infections.

Admission to hospital is more likely in infants belonging to high risk groups:

• Children born premature
• Children with chronic pulmonary illnesses
• Children with congenital heart disease

In the above cases, administering prophylaxis with palivizumab is recommended, as it is proven to reduce hospital admissions for RSV.

Palivizumab

• Palivizumab is a passive immunisation that prevents infections due to RSV (it is not a vaccine).
• It does not normally have adverse effects and it does not interfere with the vaccination schedule.
• Care must be taken to ensure that the doses are correctly given, since each dose last approximately 30 days.
• It must be administered by a healthcare professional in a hospital clinic (it cannot be administered in a primary care centre).
• The dose given will depend on the child’s weight, and will be administered once a month during an epidemic period (five doses in total) and by intramuscular injection to the face and/or outside thigh.

What do you need to bear in mind if you have human papillomavirus?

HPV infection can cause, in many cases:

• Benign lesions: such as skin and genital warts
• Malignant lesions: such as some types of cancer, including uterine, cervical, prostate, vulvar or anal cancer. These are some of the less frequent lesions. 

It is possible for people not to know that they have the virus because they have no lesions or because they have damage that is difficult to see. Plus, the majority of lesions disappear completely without having any affect.

Generally, HPV is transmitted through unprotected sex (oral, anal or vaginal), with or without penetration, with someone who is infected, even if that person does not have any symptoms.

Therefore, it is essential to use a condom properly during sex. This does not offer complete protection, as areas that cannot be covered with a condom will remain unprotected. It is also worth noting that it could be months between being infected and the appearance of symptoms, so it is very difficult to tell when the infection occurred.

HPV that may lead to cancer may not at first show any symptoms or obvious injury, but it may be detected using specific tests (such as a Pap test or cervical and vaginal cytology). 

HPV infection of the cervix and anus can be serious and, therefore, it should be diagnosed and treated as early as possible to prevent it from evolving and becoming a cervical or rectal cancer. A routine HPV test is not recommended.

Some measures to prevent the spread of warts to other parts of the body and to other people are:

• If an injury appears in the area, see a specialised health care professional.
• Do not scratch lesions; if you have touched this area of your body, make sure you wash your hands thoroughly.
• Maintain a good level of hygiene and avoid dampness.
• If someone has warts, it is important that they let their sexual partner or partners know, so that they can take protective measures during sex and so that the partner can be tested by a professional and receive the appropriate treatment if required.

The infection of some types of HPV may be prevented using vaccinations (these should be administered before having sex). Currently, the vaccine is funded under the systematic vaccination programme for 11/12-year-old girls (sixth grade).

Despite vaccination, the recommended screening protocol for cervical cancer should be followed. The aim is to prevent malignant lesions in the genital tract associated with the virus. The vaccine protects against infections due to the virus, which cause 70% of cervical cancers and 90% of genital warts.

Other related health information

• http://canalsalut.gencat.cat/ca/detalls/article/Papilloma_huma 
• http://www.geosalud.com/vph/vacunas-virus-papiloma-humano.html

What do you need to bear in mind to prevent Ebola virus?

Although there is currently no commercially available vaccine against the virus, the results of studies conducted so far show that the vaccine could be very effective. In Spain the risk of infection is very low, but: 

• Try not to travel to affected countries.
• Should you find yourself in one of these countries, avoid trips to affected areas. 

If you find yourself in an area affected by Ebola virus:

• Avoid direct contact with blood or bodily fluids from a patient or a corpse, and with objects that may be contaminated.
• Reduce contact with wild animals and do not eat raw meat.
• Wash your hands regularly.
• Avoid having unprotected sex.

If you travel to one of the affected areas and a few weeks after your return you notice the following symptoms, you need to seek medical attention urgently and tell the doctor about the trip:

• Fever
• Tiredness for an unknown reason
• Diarrhoea
• Other serious symptoms 

What do you need to bear in mind if you have shingles?

One measure to prevent the appearance of new cases of this virus among people living near a sufferer is the disinfection of objects contaminated with nasopharyngeal secretions or skin lesions in patients with chicken pox. It is therefore important to wash your hands before and after coming into contact with infected people or objects.

To improve the itching and discomfort of this virus, apply:

• Cold and wet compresses on the affected skin
• Soothing ointments and lotions, such as colloidal oat creams.

It is easy for people with shingles to pass it on to others, so when skin wounds are open and pussy avoid any contact with people who have not had chicken pox, especially pregnant women, new born babies and immunodeficient people.

What do you need to bear in mind if you have flu or you are caring for someone who does?

Flu is transmitted easily in three different ways:

• By small drops released when coughing or sneezing (airborne).
• Through skin or oral contact with people who have flu.
• By touching or sharing utensils (cutlery, glasses, etc.) and other objects that have not been cleaned properly.

There are a series of hygiene measures that help to prevent flu:

• Cover your mouth and nose with a disposable tissue when coughing or sneezing, and then throw it away.
• It is essential to wash your hands regularly with water and soap for 15-30 seconds and to dry them properly (especially after touching shared surfaces such as handrails, door handles, computer keyboards and mice, telephones, supports on public transport and after sneezing and blowing your nose), or with alcohol solutions by rubbing your hands for 15-30 seconds.
• Enclosed spaces should be kept ventilated.
• Avoid close contact with people who have flu and do not share food or utensils with them (such as cutlery, glasses, serviettes and napkins) or other objects without cleaning them properly.
• If you get symptoms of flu or the doctor has diagnosed you with the illness, you should make sure not to share enclosed spaces with people for the first 3-5 days, especially people who are ill in hospital and community care workers.

What do you need to bear in mind if you have diphtheria or you are caring for someone who does?

Diphtheria is transmitted via the respiratory tract, mainly, and also by direct contact with a sick person or a healthy carrier of the bacteria. The illness may affect the tonsils, pharynx, the larynx, the nasal mucous membrane and, much less frequently, the skin or other mucous membranes. The bacteria forms a thick grey membrane with a dark red swollen area around it, which in the case of the nose and throat may obstruct the respiratory tract.

Some people may carry the bacteria in their nose or throat. If these people are vaccinated they will not develop the illness, but they may transmit the bacterium to other people via droplets produced when they sneeze or cough. The existence of carriers in countries with no cases of the illness is very rare.