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Nor will we sell you any other product or sell your data to others as with many of our competitors discount acivir pills 200 mg otc. Satisfaction Guaranteed We have many years of experience generic acivir pills 200mg online, dealing with thousands of students cheap acivir pills 200mg online. We welcome you to do the electronic version of the assignment and submit the answer key and registration to us either by fax or e-mail. If you need this assignment graded and a certificate of completion within a 48-hour turn around, prepare to pay an additional rush charge of $50. This course will cover the federal rules concerning water and wastewater sampling techniques, waterborne disease control, general water quality operations and definitions; disease symptoms; disease diagnosis; history; susceptibility; and disease sources of contamination. This course will apply to all categories of water treatment/distribution and wastewater treatment/collection. This course was designed for Water Laboratory Analysts, but can be utilized by Wastewater Treatment, Collections, Water Distribution, Well Drillers, Pump Installers, and Water Treatment Operators. The target audience for this course is any person that has at least 2 years of college lecture and laboratory course work in microbiology or a closely related field. This person should have at least 6 months of continuous bench experience with environmental protozoa detection techniques and must have successfully analyzed at least 50 water and/or wastewater samples for Cryptosporidium and Giardia. Six months of additional experience in the above areas may be substituted for two years of college. Every operator or customer service person that has contact with the public should have this booklet accessible to help answer water quality and waterborne disease related questions. Course Procedures for Registration and Support All of Technical Learning College’s distance learning courses have complete registration and support services offered. Delivery of services will include e-mail, website, telephone, fax and mail support. When a student registers for a distance or correspondence course, he/she is assigned a start date and an end date. All students will be tracked by their social security number or a unique number will be assigned to the student. You are expected to read and understand all these rules and laboratory procedures. Instructions for Written Assignments The Waterborne Diseases distance learning course uses a multiple-choice style answer key. Waterborne Diseases ©6/1/2018 9 (866) 557-1746 Feedback Mechanism (examination procedures) Each student will receive a feedback form as part of his or her study packet. You will be able to find this form in the front of the course assignmentor lesson. All lesson sheets and final exams are not returned to the student to discourage sharing of answers. Any fraud or deceit and the student will forfeit all fees and the appropriate agency will be notified. A random test generator will be implemented to protect the integrity of the assignment. In order to pass your final assignment, you are required to obtain a minimum score of 70% on your assignment. You may need to contact a laboratory or state agency to obtain-up-to date or certain sampling information. It is the student’s responsibility to give the completion certificate to the appropriate agencies. We will send the required information to Texas, Indiana and Pennsylvania for your certificate renewals. Course content may vary from this outline to meet the needs of this particular group. There is an option course assignment available, please contact an Instructor for further assistance. The following are terms that will be found in this course, especially in the waterborne disease area and laboratory/sampling chapters. Community water system is a public water system which serves at least 15 service connections used by year-round residents or regularly serves at least 25 year-round residents. Compliance cycle is the nine-year calendar year cycle during which public water systems must monitor. The first calendar year cycle began January 1, 1993 and ends December 31, 2001; the second begins January 1, 2002 and ends December 31, 2010; the third begins January 1, 2011 and ends December 31, 2019. Within the first compliance cycle, the first compliance period began January 1, 1993 to December 31, 1995; the second from January 1, 1996 to December 31, 1998; the third from January 1, 1999 to December 31, 2001. Contaminant is any physical, chemical, biological, or radiological substance or matter in water. Maximum contaminant level is the maximum permissible level of a contaminant in water which is delivered to any user of a public water system. Public water system is a system for the provision to the public of water for human consumption through pipes or, after August 5, 1998, other constructed conveyances, if such system has at least fifteen service connections or regularly serves an average of at least twenty-five individuals daily at least 60 days out of the year. Such term includes: any collection, treatment, storage, and distribution facilities under control of the operator of such system and used primarily in connection with such system; and any collection or pretreatment storage facilities not under such control which are used primarily in connection with such system. During any period when a State or Tribal government does not have primary enforcement responsibility pursuant to section 1413 of the Act, the term "State" means the Regional Administrator, of the U. Surface water means all water which is open to the atmosphere and subject to surface runoff. However, the presence of these bacteria in drinking water is usually a result of a problem with the treatment system or the pipes which distribute water, and indicate that the water may be contaminated with germs that can cause disease. Fecal Coliform and E coli are bacteria whose presence indicate that the water may be contaminated with human or animal wastes. Microbes in these wastes can cause short- term effects, such as diarrhea, cramps, nausea, headaches, or other symptoms. However, turbidity can interfere with disinfection and provide a medium for microbial growth. These organisms include bacteria, viruses, and parasites that can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. Cryptosporidium is a parasite that enters lakes and rivers through sewage and animal waste. However, the disease can be severe or fatal for people with severely weakened immune systems. Giardia lamblia is a parasite that enters lakes and rivers through sewage and animal waste. Most pathogens are generally associated with diseases that cause intestinal illness and affect people in a relatively short amount of time, generally a few days to two weeks. They can cause illness through exposure to small quantities of contaminated water or food, or from direct contact with infected people or animals. Pathogens that may cause waterborne outbreaks through drinking water have one thing in common: they are spread by the fecal- oral, or feces-to-mouth, route. Pathogens may get into water and spread when infected humans or animals pass the bacteria, viruses and protozoa in their stool. For another person to become infected, he or she must take that pathogen in through the mouth. Waterborne pathogens are different from other types of pathogens such as the viruses that cause influenza (the flu) or the bacteria that cause tuberculosis. Influenza virus and tuberculosis bacteria are spread by secretions that are coughed or sneezed into the air by an infected person. Human or animal wastes in watersheds, failing septic systems, failing sewage treatment plants or cross-connections of water lines with sewage lines provide the potential for contaminating water with pathogens. The water may not appear to be contaminated because the feces has been broken up, dispersed, and diluted into microscopic particles. These particles, containing pathogens, may remain in the water and be passed to humans or animals unless adequately treated. In addition to water, other methods exist for spreading pathogens by the fecal-oral route.

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A doctor can diagnose mucopurulent cervicitis by mucus Secreted by mucous membranes buy acivir pills 200 mg lowest price, a body observations during a patient’s examination and by secretion that has protective and lubricant action microscopic study of discharge acivir pills 200mg for sale. If symptoms per- University of Pittsburgh buy 200mg acivir pills visa, Northwestern University, sist, women should return to the doctor for and the University of California at Los Angeles. One of the earliest breakthroughs was specimens provide the general scientific commu- in 1988, when John P. Although the term myalgia is most com- that results in decreased production of red blood monly used in the medical realm in relation to cells, white blood cells, and platelets. Some med- physical overuse of muscles, myalgia is also a prob- ications cause myelosuppression. For example, lem of those with autoimmune disease and other chemotherapy strongly affects both normal and medical conditions, such as flu. Bone marrow is affected over a When a person experiences generalized muscle period of weeks until the patient being treated pain, this can be a symptom of systemic illness, has a low dip in blood count, during which he or and typically the individual also feels ill and may she is vulnerable to infection and becomes tired have fever. Every patient’s complete blood count must and over-the-counter medications, but it is advis- be checked before chemotherapy to ascertain able to call a doctor if the pain is persistent for whether values are abnormal. Any infection dur- several days, if fever is higher than 101°F, if a rash ing this time can be fatal, so it is important for a appears, or if the muscle pain is accompanied by patient and family or caregiver to monitor for new symptoms. Depending on the suspected fever, a new cough, a change in a cough, and an cause of a person’s myalgia, tests may be done, increase in weakness. However, in a study of six state health tus could result in the loss of jobs, health insur- departments using analysis of data from the 12 ance, friends, and family. As time passed, the two opposing camps Increases occurred in Nebraska, Nevada, New began to see each other’s viewpoint. Predicted decreases were in activist groups such as the National Association for Louisiana and Michigan. A notifiable name to health departments remains controver- disease must be reported because regular, frequent, sial. Some communities have opposed the prac- timely information is necessary to prevent and tice. The list of diseases varies over time and a position statement that “name reporting is a by state. This list is available on the Internet at to name reporting is a Philadelphia hearing on http://www. Offering an alter- mation for nationally notifiable diseases and for native, Anna Forbes advanced an idea that has some nonnotifiable diseases as well. Factors users in recovery, women with termination of that influence the thoroughness of the reports pregnancies, and those with mental illness. Essentially, the completeness of the order to plead with the state not to require names. The reporting of the National Institutes of Health conducts research nationally notifiable diseases is regulated by each in its own laboratories; supports the research of state or territory. They ings on more than 300 acres in Bethesda, Mary- send the case information by mail, telephone, or land. Branch, who are responsible for a variety of func- In the same period, death rates from stroke tions. Improved treatments and update computer software for health departments; detection methods increased the relative five-year develop and implement software to validate data survival rate for those with cancer to 60 percent. The 19 million Ameri- publication National Vital Statistics Reports, available cans who suffer from depression can look forward online at http://www. Vaccines now protect against infec- National Institutes of Health Begun in 1887, tious diseases that once killed and disabled. Dental the National Institutes of Health is now one of sealants have proved 100 percent effective in pro- the world’s foremost medical research centers, tecting chewing surfaces of children’s molars and the federal focal point for medical research in the premolars, where most cavities occur. To work toward that mission, are identifying functions of many genes and will 152 needle access eventually develop screening tools and gene ther- was not lifted. Health care profes- year she announced that a review of research indi- sionals seek to prevent illicit drug use, make treat- cated that needle exchange programs did not ment readily available to drug users, reduce the encourage the use of illegal drugs. Some of these distribute intravenous drug users is strongly supported by the needles. As nation’s foremost bioethicists’ consensus statement of 2003, about 100 needle-exchange programs are “On the Ethics of Denying Injection Drug Users in place in 40 communities in 28 states. One clear advantage is that needle At the time, under the terms of Public Law 105- exchange programs make it possible for low- 78, allocation of federal funds to support needle income drug users to get sterile equipment. Congress has continued When the nef gene is present, nef helps the human to ban the use of federal funds for needle- immunodeficiency virus overcome a person’s exchange programs. According to the Human Rights Campaign, a group working for equal rights for lesbians, gays, negotiated safety A type of unwritten “sexual and the transgendered, many organizations that contract” between the partners in a gay relation- review research on needle exchange find that the ship that they can forgo using condoms because evidence proves it is effective. A condom message applies to all—no flexibility for study by Beth Israel Medical Center showed a two- varied situations. In many cases, needle sharing use a condom every time they have anal sex— refers to a drug addict’s habit of reusing needles with no exceptions. At the neonatal herpes The condition of an infant born same time, it is believed that intravenous drug with the herpesvirus as a result of the mother’s users can reduce their likelihood of contracting transmission of genital herpes during childbirth. In primary needlestick The act of having skin pricked or and secondary syphilis, a lumbar puncture is not punctured unintentionally with a hypodermic nee- part of the routine evaluation unless a patient dle. The sweats should consult a health care provider for time from infection to neurosyphilis development evaluation. Some individuals who have neurosyphilis do not have symptoms; others expe- no code A patient’s instruction concerning life- rience headaches, stiff necks, and fever caused by saving measures or life support when the individual the inflamed lining of the brain. Other patients is in dire straits as a result of a terminal condition or have seizures. A “no code” or “do not resuscitate” is a person with neurosyphilis may have stroke symp- direction not to perform lifesaving measures. This toms, with numbness, weakness, and/or visual direction is indicated on the patient’s medical chart problems. People who have neurosyphilis or so that attending personnel will know what to do in syphilitic eye disease and who can take penicillin case extreme measures are required to keep the should be treated with aqueous crystalline peni- individual alive. Durations of the recommended and alternative nongonococcal urethritis A urethral infection regimens for neurosyphilis are shorter than that of that is commonly sexually transmitted and is also the regimen that would be used for late syphilis in called nonspecific urethritis. Although the cause is unknown, a ter paper, which is then sent to the state health factor that increases an individual’s possibility of department for testing. The health department contracting this disease is an immunologic disor- then contacts the family’s doctor with the result. Prognosis depends on which homocystinuria, sickle cell disease, biotinidase areas are affected and whether the disease has deficiency, and hearing. Hodgkin’s lymphoma are a peripheral blood smear, a complete blood count, and lymph node or bone night sweats Heavy sweating at night, which is marrow biopsy. The disease is then staged by some usually a sign of disease, especially when a person of the following: the doctor’s examination of the also has fever. Within several years, the dis- viding insight into species-to-species transmission ease usually progresses and requires treatment. When it is time for treatment, the choices are Because it is known that people have long chemotherapy, radiation, or both. Bone marrow hunted monkeys and apes for food, researchers transplantation is the treatment of choice for some conjecture that people could have been exposed to people. A that this knowledge might lead to an estimate of statement from Kevin De Cock, M. A 1967 survey reported that in the green monkeys that “jumped species” to infect the United States, the medical literature described only African human population. However, one cases of the disease; the agent must be isolated from report indicated that researchers had found that the host’s body; the agent must cause disease when the common spermicide nonoxynol-9 irritated tis- injected into healthy hosts; and the same agent sues of prostitutes who participated in a study and must be isolated from the newly diseased host. Two were infected in 1985; some reason, has not moved into the full-blown one was infected in 1991. National Institute of Allergy and Infectious Diseases, In large cohort studies, researchers have discov- National Institutes of Health. Nonoxynol-9 is the has been hard to pinpoint a specific immune active spermicide in most brands of contraceptive response that confers nonprogressor status.

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Preventive measures: 1) Educate the public to the danger of exposure to infected pet birds buy acivir pills 200 mg without a prescription. Medical personnel responsible for occupational health in processing plants should be aware that febrile respiratory illness with headache or myalgia among the employees may be psittacosis buy acivir pills 200mg mastercard. Prevent or eliminate avian infections through quarantine and appropriate antibiotics buy 200mg acivir pills. Tetracyclines can be effective in control- ling disease in psittacines and other companion birds if properly administered to ensure adequate intake for at least 30 and preferably 45 days. Infected birds must be treated or destroyed and the area where they were housed thoroughly cleaned and disinfected with a phenolic compound. Control of patient, contacts and the immediate environment: 1) Report to local health authority: Obligatory case report in many countries, Class 2 (see Reporting). If they cannot be killed, ship swab-cultures of their cloacae or droppings to the laboratory in appropriate transport media and shipping containers, in compliance with postal regulations; after the cultures are taken, the birds should be treated with a tetracycline drug. Place in plastic bags, close securely and ship frozen (on dry ice) to nearest laboratory capable of isolating Chlamydia. Erythromycin is an alternative when tetracycline is contrain- dicated (pregnancy, children under 9). Epidemic measures: Cases are usually sporadic or confined to family outbreaks, but epidemics related to infected aviaries or bird suppliers may be extensive. In poultry flocks, large doses of tetracycline can suppress, but not elimi- nate, infection and thus may complicate investigations. International measures: Compliance with national regula- tions to control importation of psittacine birds. Identification—An acute febrile rickettsial disease; onset may be sudden with chills, retrobulbar headache, weakness, malaise and severe sweats. There is considerable variation in severity and duration; infections may be inapparent or present as a nonspecific fever of unknown origin. A pneumonitis may be found on X-ray examination, but cough, expectora- tion, chest pain and physical findings in the lungs are not prominent. Acute and chronic granuloma- tous hepatitis, which can be confused with tuberculous hepatitis, has been reported. Chronic Q fever manifests primarily as endocarditis and this form of the disease can occur in up to half the people with antecedent valvular disease. Q fever endocarditis can occur on prosthetic or abnormal native cardiac valves; these infections may have an indolent course, extending over years, and can present up to 2 years after initial infection. Other rare clinical syndromes, including neurological syndromes, have been described. The case-fatality rate in untreated acute cases is usually less than 1% but has been reported as high as 2. Recovery of the infectious agent from blood is diagnostic but poses a hazard to laboratory workers. The organism has unusual stability, can reach high concentrations in animal tissues, particularly placenta, and is highly resistant to many disinfectants. Occurrence—Reported from all continents; the real incidence is greater than that reported because of the mildness of many cases, limited clinical suspicion and nonavailability of testing laboratories. It is endemic in areas where reservoir animals are present, and affects veterinarians, meat workers, sheep (and occasionally dairy) workers and farmers. Epidemics have occurred among workers in stockyards, meatpacking and rendering plants, laboratories and in medical and veterinary centers that use sheep (especially pregnant ewes) in research. Reservoir—Sheep, cattle, goats, cats, dogs, some wild mammals (bandicoots and many species of feral rodents), birds and ticks are natural reservoirs. Transovarial and transstadial transmission are common in ticks that participate in wildlife cycles in rodents, larger animals and birds. Infected animals, including sheep and cats, are usually asymptomatic, but shed massive numbers of organisms in placental tissues at parturition. Mode of transmission—Commonly through airborne dissemina- tion of Coxiellae in dust from premises contaminated by placental tissues, birth fluids and excreta of infected animals; in establishments processing infected animals or their byproducts and in necropsy rooms. Airborne particles containing organisms may be carried downwind for a distance of one kilometer or more; contamination also occurs through direct contact with infected animals and other contaminated materials, such as wool, straw, fertilizer and laundry. Raw milk from infected cows contains organisms and may be responsible for some cases. Period of communicability—Direct person-to-person transmis- sion occurs rarely, if ever. Immunity following recov- ery from clinical illness is probably lifelong, with cell-mediated immunity lasting longer than humoral. Preventive measures: 1) Educate persons in high risk occupations (sheep and dairy farmers, veterinary researchers, abbatoir workers) on sources of infection and the necessity for adequate disinfec- tion and disposal of animal products of conception; restrict access to cow and sheep sheds, barns and laboratories with potentially infected animals, and stress the value of inactiva- tion procedures such as pasteurization of milk. It should also be considered for abattoir workers and others in hazardous occupations, including those carrying out medical research with pregnant sheep. To avoid severe local reactions, vaccine administra- tion should be preceded by a skin sensitivity test with a small dose of diluted vaccine; vaccine should not be given to individuals with a positive skin or antibody test or a docu- mented history of Q fever. This should include a baseline serum evaluation, followed by periodic evaluations. Animals used in research should also be assessed for Q fever infection through serol- ogy. Laboratory clothes must be appropriately bagged and washed to prevent infection of laundry personnel. Sheep- holding facilities should be away from populated areas and measures should be implemented in order to prevent air flow to other occupied areas; no casual visitors should be permit- ted. Use precautions at postmortem examination of suspected cases in humans or animals. Chronic disease (endocarditis): Doxycycline in combination with hydroxy- chloroquine for 18 to 36 months. Surgical replacement of the infected valve may be necessary in some patients for hemo- dynamic reasons. Epidemic measures: Outbreaks are generally of short dura- tion; control measures are limited essentially to elimination of sources of infection, observation of exposed people and provi- sion of antibiotics to those becoming ill. Detection is particularly important in pregnant women and patients with cardiac valve lesions. International measures: Measures to ensure the safe impor- tation of goats, sheep and cattle, and their products (e. Immunocompromised patients, people with valvular dis- eases and pregnant women should be actively diagnosed and treated. Identification—An almost invariably fatal acute viral encephalomy- elitis; onset generally heralded by a sense of apprehension, headache, fever, malaise and indefinite sensory changes often referred to the site of a preceding animal bite. The disease progresses to paresis or paralysis; spasms of swallowing muscles leads to fear of water (hydrophobia); delirium and convulsions follow. Without medical intervention, the usual duration is 2–6 days, sometimes longer; death is often due to respiratory paralysis. All members of the genus are antigenically related, but use of monoclonal antibodies and nucleotide sequencing shows differences according to animal species or geographical location of origin. Rabies- related viruses in Africa (Mokola and Duvenhage) have been associated, rarely, with fatal rabies-like human illness. A new lyssavirus, first identified in 1996 in several species of flying foxes and bats in Australia, has been associated with 2 human deaths from rabies-like illnesses. This virus, provisionally named Australian bat lyssavirus, is closely related to, but not identical to classical rabies virus. Occurrence—Worldwide, with an estimated 65 000–87 000 deaths a year, almost all in developing countries, particularly Asia (an estimated 38 000 to 60 000 deaths) and Africa (estimated 27 000 deaths). Most human deaths follow dog bites for which adequate post-exposure prophy- laxis was not or could not be provided. During the past 10 years drastic decrease of the numbers of human deaths have also been reported by several Asian countries particularly China, Thailand and Viet Nam. Western, central and eastern Europe including the Russian Federation report less than 50 rabies deaths annually. The areas currently free of autochthonous rabies in the animal population (excluding bats) include most of Australasia and western Pacific, many countries in Western Europe (insular and continental), part of Latin America including the Caribbean. In western Europe, fox rabies, once widespread, has decreased considerably since oral rabies immunization of foxes began in the early 1990s. Since 1985 bat rabies cases have been reported in Denmark, Finland, France, Germany, Luxembourg, the Netherlands, Spain, Switzer- land and the United Kingdom.

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