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 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 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.

What do you need to bear in mind if you have chronic phase of Chagas disease or you are caring for someone who does?

Chagas disease is an infectious, usually chronic, tropical disease caused by the parasite Trypanosoma cruzi. People can become infected through the faeces of an infected insect, a triatomine, also known as conenose bugs, kissing bugs, assassin bugs or vampire bugs, depending on the country.

It can also be transmitted in other ways:

• Blood transfusions
• Organ transplants from infected donors
• During childbirth from an infected mother.

Transmission caused by the insect only takes places in Central and South America, but the other ways, due to the migratory movements of infected people, may occur in other corners of the planet. The illness can be prevented.

Although Chagas disease affects between eight and ten million people around the world, today it is not very well known. According to the World Health Organization, it is one of 17 forgotten and neglected diseases.

In somewhere like Spain this illness has different health education needs than in countries where it is endemic. Familiarity, awareness, removing stigmas and visibility of the illness are therefore essential instruments in health education about Chagas disease.

Undiagnosed people

It is calculated that currently less than 10% of infected people know that they have the disease.

Who can be infected?

• People from countries in Central or South America (except the Caribbean) who have lived there or visited (especially rural areas and adobe brick houses).
• The children of women diagnosed with the disease.
• People with an affected person in their immediate family.

How do you know if you are infected?

• Diagnosis of Chagas disease is done through specific blood tests (serology).

What do you need to do?

• Conduct diagnostic tests on people at risk. Especially women of a fertile age, pregnant women and infants.
• Raise awareness and encourage people close to them to get tested.
• When returning from a country with a risk of contracting the disease, preventive measures should be taken.

People who have been diagnosed

Chagas disease is characterised, first of all, by an acute phase during which treatment is effective and it can be cured. In most cases, however, it evolves to become a chronic disease and, as such, requires control and monitoring for life.

More than half of infected people show no symptoms, but three out of ten will suffer heart problems and one in every ten digestive problems (years after having contracted the infection). In these cases, the process is initially asymptomatic, so that without sufficient treatment or monitoring the illness could manifest itself suddenly and cause irreversible damage or even sudden death.

What effects does the disease have?

• Chronic Chagas disease with no effect: the person is infected, but they have no symptoms or affected organs.
• Chronic Chagas heart disease: the disease affects the heart.
• Chronic Chagas gastrointestinal disease: the disease affects the organs in the digestive system (oesophagus and/or large intestines).

What are the warning signs?

• Tiredness and breathlessness when doing an activity that the person would have been able to carry out normally before.
• Changes in heart rate (skipping, going faster or slower than normal).
• Dizziness or loss of consciousness.
• Stabbing pain in the chest area.
• Fluid retention (swelling or oedemas) in the feet and/or legs.
• Changes in bowel movements (constipation).
• Difficulty or pain in swallowing solid foods, such as bread or rice.

What do you need to do?

• Have healthy habits and lifestyle (healthy and balanced diet, exercise and no toxic habits).
• Attend a yearly follow-up and monitoring review with the doctor.
• Follow instructions given by medical personnel (doctors and nurses).
• Recognise and identify the warning signs and inform medical personnel responsible for monitoring.
• Acquire appropriate tools and attitudes to overcome the stigmas associated with the disease.
• Acquire knowledge about the disease to understand it and share knowledge and experience with other people in order to promote the multiplier effect of knowledge in a family and group context. 

What effect does it have from a psychological point of view?

Chagas disease  is often accompanied by emotions and feelings of guilt, impotence and fear. Questions such as: “Why me?”, “What do I do now?” and “Does Chagas mean I’m going to die?” are common in people who have been diagnosed.

What do you need to know?

• These feelings and emotions are reactions that show you are adapting to accepting a life shared with a chronic illness such as Chagas disease.
• They are normal reactions when faced with an unknown change.

What do you need to do?

• You do not need to fight against the disease, but learn to live with it.
• Avoid isolating yourself.
• It is important to share experiences, feelings and concerns with people around you and with healthcare professionals (doctors, nurses, etc.).
• Joining a group of other people with the disease may also help.
• It is important to try to increase your self-esteem and self-confidence.
• Try to improve your self-esteem.
• Work on the feelings of guilt you have.

People who travel to countries with Chagas disease

What do you need to know?

There are no drugs (vaccinations or medicine) to prevent Chagas disease. People without the disease are at risk of becoming infected and people who are already affected are at risk of being re-infected.

The preventive measure we have is education.

What do you need to do?

• Try not to sleep in risky places (rural areas, adobe houses, etc.)
• Use mosquito nets, protective clothing and insect repellents.

The community

What do you need to know?

Chagas disease has psychological, social and cultural characteristics and determinants for the people affected, their families and society. In fact, a diagnosis of Chagas disease can have significant repercussions from a psychological and social point of view.

Often, the people affected do not want to know if they are affected or not for fear of the disease and its imagined consequences: often these are based on popular beliefs and/or previous experience with relatives, friends or acquaintances who have died in an unfavourable social environment. Sometimes, they hide the disease for fear of being excluded at work.

What do you need to do?

• Defend the health rights of others.
• Avoid the disease leading to exclusion and marginalisation.
• Try to actively demystify the fatalist view of the disease.
• Promote access to care and social integration for the people affected.
• Promote associations of affected people through social media.
• Create and promote strategies to raise the profile of the disease.
• Foster social support spaces and networks, associations etc. for people affected.