The Royal Intro: MMIC PBL 2

Virus

Microbe	Transmission	Signs and symptoms	Disease	Geographical distribution
Hepatitis A virus	Fecal-oral route	Diarrhea and nausea with possible acute infection	Hepatitis A	Worldwide, but most common where sanitary conditions are poor and the safety of drinking water is not well controlled
Hepatitis B virus	Parenteral route	Similar to HAV with higher possibilities of leading to chronic infections and liver cancer	Hepatitis B	Worldwide, but with differing levels of endemicity. In north America, Australia ,northern and western Europe and New Zealand, prevalence of chronic HBV infection is relatively low (less than 2% of the general population)
Nairovirus	Bite from Hyalomma tick, animal reservoirs	Fever, shaking chills, severe headache, rash and possible hepatomegaly	Crimean- Congo Hemorrhagic Fever	Nil
Viruses belonging to the Flaviviridae family	Bite from Mosquitoes ( eg. Culex tritaeniorhynchus) or Ticks, Birds serve as the reservoir	Fever, drowsiness, facial flushing, lymph node Largement, conjunctival infection	West Nile Fever	Nil
Flavi- viruses	Bites from mosquitoes, most commonly Aedes aegypti, a day biting mosquito	Dengue hemorrhagic fever, rash, headache, respiratory manifestations that mimic a cold	Dengue	Dengue fever is widespread in tropical and subtropical regions of central and south America and south and south-east Asia and also occurs in Africa; in these regions , dengue is limited to altitudes below 600 metres (2,000 feet)
Alphavirus	Bite from Culex mosquito , Birds serve as the reservoir	Fever, rash and polyarthritis	Sindbis	Nil
Phlebovirus	Bite from mosquitoes, exposure to infected animals and possible aerosol	Nonspecific febrile reaction with fever, nausea and possible visual loss	Rift Valley Fever	Nil
Viruses from Rhabdoviridae family	Open cuts or wound in skin or mucous membranes via bites or infected animal saliva	Fever, severe headache, malaise ,possible neurologic Manifestations	Rabies	Rabies is present in animals in many countries worldwide. Most cases of human infection occur in developing countries
Phlebo- viruses	Bites from sandfly (Phleobotomus papatasi)	Fever, severe frontal headache, nausea, vomiting, possible aseptic Meningitis	Sandfly fever	Nil
Leishmania- viruses	Leishmania species	Infection with Leishmania	Leishmania- virus	Nil
Japanese encephalitis (JE)virus, which is a flavivirus	The Japanese encephalitis virus is transmitted by various mosquitoes of the genus Culex	asymptomatic (e.g. cause no symptoms). In symptomatic cases, severity varies ;mild infections are characterized by febrile headache or aseptic meningitis	Japanese encephalitis	Nil
an arbovirus of the Flavivirus genus	Bites from mosquitoes (Aedes aegypti)	asymptomatic, most lead to an acute illness characterized by two phases. Initially, there is fever, muscular pain, headache, chills, anorexia, nausea and/ or vomiting, often with bradycardia	yellow fever	The yellow fever virus is endemic in some tropical areas of Africa and central and south America. The number of epidemics has increased since the early 1980s. Other countries are considered to be at risk of introduction of yellow fever due to the presence of t he vector and suitable primate hosts (including Asia, where yellow fever has never been reported)

Fungal

Causes of FUNGUS DISEASES
Fungal infection outbreak could happen in a clinical setting where climate are often hot and high humidity such as tropical areas like Indonesia. These diseases are caused by poor personal health practices (harsh living conditions of NS soldier). The jungle environment promotes fungus and bacterial diseases of the skin and warm water immersion skin diseases. Bacteria and fungi are tiny plants which multiply fast under the hot, moist conditions of the jungle. Sweat-soaked skin invites fungus attack. The following are common skin diseases that are caused by long periods of wetness of the skin:

Warm Water Immersion Foot. This disease occurs usually where there are many creeks, streams, and canals to cross, with dry ground in between. The bottoms of the feet become white, wrinkled, and tender. Walking becomes painful.
Chafing. This disease occurs when soldiers must often wade through water up to their waists, and the trousers stay wet for hours. The crotch area becomes red and painful to even the lightest touch.
Most skin diseases are treated by letting the skin dry.

Microbe	Transmission	Signs and symptoms	Disease	Geographical distribution
Dermatophytes, e.g: Microsporum, Trichophyton, epidermophyton sp	Direct contact with skin, usually on warm, sweaty and humid part of the body, hair and nails,feet.	typical ringworm lesion, itching, scaling, inflammation, and blisters	tinea capitis(scalp ringworm), tinea cruris(jock itch) and tinea pedis(athelete’s foot)	contact with infected lesions, soiled or contaminated articles such as shoes and towels, almost anywhere in the world
Sporothrix schenckii	mold spores enter skin in puncture wounds by thorns in jungle	small bumps on skin but painless, local abscess and ulcerative nodules	sporotrichosis	soil, wood, sphagnum moss, and decaying vegetation throughout the world
Histoplasma Capsulatom	Inhalation of airborne asexual pores causing acute respiratory diseases	Often no symptoms but fever, cough, malaise, respiratory symptoms can occur.	Histoplasmosis	grows preferentially in soil enriched with bird droppings
Candida Albicans	Part of the normal flora of skin, mucous membrane and GI tract, can invade tissue if the infected person is injured or wounded	: itchy skin rash, skin inflammation, skin lesions on moisture-damaged skins, rash in e penis area	disseminated candidiasis and chronic mucocutaneous candidiasis	Human body
Aspergillus fumigatos	Inhalation of airborne spores and their invasion through a wound or other tissue injury	Fever, cough, pneumonia, endocarditis, eosinophilia	Aspergillosis	live in soil, commonly in decaying vegetation, such as fermenting compost piles and damp hay.
Cryptococcus neoformans	Inhalation of airborne yeast cells, affects the central nervous system and the lungs in people with weakened immune systems.	early lung infection often has no symptoms, meningitis, encephalitis and headache.	Cryptococcosis, especially Cryptococcal meningitis	live in soil, especially when enriched with pigeon droppings

Prevention of FUNGUS DISEASES in soldiers
To prevent these diseases, soldiers should:

Bathe often, and air- or sun-dry the body as often as possible.
Wear clean, dry, loose-fitting clothing whenever possible.
Not sleep in wet, dirty clothing. Soldiers should carry one dry set of clothes
just for sleeping. Dirty clothing, even if wet, is put on again in the morning.
This practice not only fights fungus, bacterial, and warm water immersion
diseases but also prevents chills and allows soldiers to rest better.
Not wear underwear during wet weather. Underwear dries slower than jungle fatigues, and causes severe chafing
Take off boots and message feet as often as possible.
Dust feet, socks, and boots with foot powder at every chance.
Always carry several pairs of socks and change them frequently.
Keep hair cut short.

Protozoa

Microbe	Transmission	Signs and symptoms	Disease	Geographical distribution
Leishmaniasis species	sand fly	fever, damage to the spleen and liver, and anaemia, Visceral/ Cutaneous/ Diffuse cutaneous /Mucocutaneous leishmaniasis	Leishmaniasis	Jungle setting: large number of mosquitoes and sand fly
Plasmodium falciparum and malariae	bites from Female anopheline mosquito	Moderate to severe shaking chills High fever, Profuse sweating as body temperature falls, General feeling of unease and discomfort, (malaise), Headache ,Nausea, Vomiting, Diarrhea	Malaria	Occur in many tropical and sub-tropical countries- P. falciparum and P. malariae is most common in Asia
Giardia	Contaminated food and water Raw food like fruits and vegetables	Abdominal pain, Watery diarrhea Foul smelling gas and burping, Mild fever, sometimes with chills, Malabsorption, where nutrients are not absorbed, frequently with weight loss	Giardiasis	Found in surface waters all over the Earth and spread in the feces of both humans and animals
Toxoplasma gondii	Contaminated food and water Raw food like fruits and vegetables	headache, chronic malanise, fever lymphadenopathy	Toxoplasmosis	almost everywhere from surface of water to contaminated veggies and fruits to soil and infects warm blooded vertebrates
Cryptosporidium	Contaminated food and water Raw food like fruits and vegetables /faecal-oral route or swimming	Dehydration, Malnutrition, Weight loss, Stomach cramps or pain, Fever, Nausea , Malaise , Vomiting	Cryptospori- diosis	Found in surface waters all over the Earth and spread in the feces of both humans and animals
Cyclospora cayetanensis	Contaminated food and water Raw food like fruits and vegetables	Headache, Nausea, Vomiting, sever Diarrhea, bloating, muscle aching, fatigue and asymptomatic	Cyclosporiasis	mainly in America and Canada
Entamoeba histolytica	Contaminated food and water Raw food like fruits and vegetables	sever diarrhea, abscesses in the intestine, liver, and other organs	Amebiasis	Entamoeba histolytica is endemic in tropical countries ,usually found in water, decaying organic matter, soil, and sewage, is of particular interest to contact lens wearers
Naegleria fowleri	nasal passage via swimming and diving	disease primary amebic meningoen- cephalitis (PAM), a brain inflammation	Naegleria infection	found in environment water and soil worldwide, commonly in Warm bodies of freshwater, such as lakes, rivers, Geothermal water such as hot springs, Warm water discharge from industrial plants, Poorly maintained and minimally chlorinated swimming pools
Balantidium coli	Contact with pig feces or soil contaminated with pig feces	severe diarrhea and intestinal abscesses	Balantidiasis	common in tropical regions and many developing countries in the tropical region lack proper water structures for much of the poor, rural population such as Bolivia, the Philippines, and Papua New Guinea
Vibrio cholerae	Faceal-oral route or contaminated food and drink sand more prevalent in warmer cilmate	sever diarrhoea, dehydration, shock , muscle cramps , nausea and vomitting	Cholera	Cholera is most common in Africa, southern and Southeast Asia, and the Middle East, although outbreaks have occurred in Japan , Australia, and Europe
S.japonicum, S.mekongi, S.mansoni, S.intercalatum and S.haematobium	faecal oral route	Katayama fever, abdominal pain, hematuria, weakness, headaches , joint and muscle pain, diarrhea, nausea, producing seizures or transverse myelitis as a result of mass lesions of the brain or spinal cord and cough	Schistoso- miasis	This infection occurs widely throughout the tropics and subtropics