What You Must Know about Rabies Disease

Rabies or commonly known as mad dog disease is a serious disease that attacks the brain and nervous system. This disease is classified as a deadly disease that must be treated quickly.

Rabies in Indonesia

According to data compiled by the Indonesian Ministry of Health, there are approximately 70,000 cases of rabies-transmitted animal bites in 2013. Of the total cases, there were 119 of them positively affected by rabies.

In the year 2013, the province of Bali is still the most rabies-infected rabies animal bite cases with a percentage of nearly 60 percent of the total cases throughout Indonesia. While the second area most get rabies animal bite animal cases is Riau Province (7.4 percent), followed by East Nusa Tenggara, North Sumatra and West Sumatra.

The cause of rabies

Rabies are caused by the lyssaviruses virus. The virus is transmitted to humans through animals that have previously contracted the disease. A person may be infected with rabies if the saliva of the rabid animal enters the body through a bite, even through a scratch can if the rabid animal has previously licked his nails. In some rare cases, a person is infected with rabies because the wound on his body is licked by an infected animal.

In addition to being transmitted by animals, transmission of rabies disease from human to human can occur. But so far proven is transmission through transplant or organ transplantation.

In Indonesia, 98 percent of rabies cases are transmitted through dog bites and 2 percent are transmitted through cat and ape bites. In Indonesia also, rabies in animals has been found since 1884. While the case of rabies in humans in Indonesia was first discovered in 1894 in West Java.

Symptoms of rabies

The time it takes for rabies virus to incubate varies greatly, but usually between two weeks to three months. In rare cases, virus incubation occurs in just four days. The incubation period is the distance of time when the virus first enters the body until symptoms appear.

After being bitten by a rabid animal, the virus will multiply inside the host's body. Furthermore, these viruses will go to the nerve endings and continue to the spinal cord and brain which breeding occurs very quickly. After that, the rabies virus spreads to the lungs, salivary glands, liver, kidneys, and other organs.

The symptoms of rabies disease in humans include high fever, itching in the infected area, behavioral changes become aggressive, and fear of water or hydrophobia. While in animals, the symptoms are almost similar to humans, but without hydrophobia. When the symptoms of rabies enter the final phase, either humans or animals who experience it can die.

Diagnosis of rabies

Until now, there has been no test that can detect a person infected with rabies virus when newly bitten. The new rabies is known if the virus has finished incubating and initiating its terrors through symptoms. Therefore, to determine whether or not exposed to rabies for a person, the doctor only refers to the patient's description. In making the diagnosis, the doctor will usually ask if the patient has visited a place or area that is rabies-prone and whether the patient has been bitten by an animal that has the potential to carry the virus.

Treatment of rabies

If you have been bitten by an animal that has the potential to transmit rabies, one thing to do first is to wash the wound with soap and wash with clean running water. Next clean the wound by using antiseptic or alcohol. Do not cover the wound using any bandages and leave the wound open. After that, immediately to the nearest hospital or health clinic for further review.

If the rabies that infect a person is still at an early stage or before symptoms appear, the doctor will take a treatment called post-exposure prophylaxis that has proven to be very effective in counteracting rabies symptoms. Through post-exposure prophylaxis, the doctor will clean the infected body part, and provide a series of vaccinations to prevent the virus from spreading to the brain and nervous system. In some cases, the doctor will also provide anti-rabies serum.

What You Must Know about Chikungunya Disease

Chikungunya is a viral disease that attacks humans through the bite of Aedes aegypti or Aedes albopictus mosquitoes. This mosquito acts as an intermediary or vector that is an organism that carries chikungunya virus in its body without getting infected. Both are the same type of mosquito that causes dengue fever.

Similar causes and symptoms cause chikungunya disease often to be misdiagnosed as dengue fever.

Aedes aegypti mosquitoes live in tropical and subtropical regions, while Aedes (Ae.) Albopictus live in temperate and cooler regions. Both types of mosquitoes are commonly found mainly in the morning and evening.

Chikungunya case itself has been identified in about 60 countries located in Asia, Africa, Europe, and America.

People with Chikungunya in Indonesia

From Indonesia's health profile in 2014, there are reported Chikungunya Extra Events (KLB) in 8 districts / cities from 4 provinces in Indonesia. Based on Ministry of Health report in the same year, there are about 7300 cases of chikungunya without any death cases.

Chikungunya fever is still a frequent epidemic problem in the tropics and subtropics, including in Indonesia. The low immunity status of the population against the virus and the high number of mosquitoes as the vector of chikungunya virus are the supporting factors for the epidemic of this disease. Allegedly increasing the puddle of water as a breeding ground for mosquitoes when the rainy season also contributed.

Causes of Chikungunya: Mosquito Bites

Chikungunya virus can not spread directly from one person to another. The disease is caused by a virus that spreads through the bite of Ae.aegypti or Ae mosquitoes. albopictus, two types of mosquitoes that can also cause dengue virus. The chikungunya virus belongs to the alfavirus genes of the Togaviridae family found in tropical countries.

Generally these mosquitoes attack during the day, but the bite especially occurs in the early hours and the afternoon. You are more susceptible to attack while outdoors, although it is possible that the Ae mosquito. aegypti can also attack indoors.

Ae mosquito. aegypti more lives and breeds in places close to humans, especially indoors. Places commonly inhabited by mosquitoes are water reservoirs, bathtubs, to vases and flower pots filled with water. Ae mosquito. albopictus has more and more breeding grounds than Ae. aegypti. In addition to puddles in the former tires of vehicles, ponds, or potted plants, these mosquitoes can also breed in puddles that exist in tree holes, bamboo, and coconut shells.

Chikungunya symptoms

After being bitten by a mosquito carrying the virus, the symptoms will begin to develop at 4-8 days, but can also start from 2-12 days after bite. The symptoms initially resemble flu symptoms.

  • Fever - starts suddenly; one of the main symptoms of chikungunya
  • Joint pain - its severity can inhibit the patient's body movements; these symptoms can last for weeks and are also a major symptom of chikungunya. These symptoms generally appear not long after the symptoms of fever begin to be felt.
  • Muscle pain
  • Cold
  • Headaches are unbearable
  • Rash or red spots all over the body
  • Fatigue
  • Nausea and vomiting

In some cases, the symptoms of joint pain will remain felt for several months, even years. Chikungunya symptoms are usually mild, so undetected or too felt by the sufferer. In areas with dengue fever cases, there are also a few cases of misdiagnosis between the two diseases.

In some rare cases, chikungunya complications, such as nervous, eye, heart, and gastrointestinal disorders may occur. Especially in the elderly, this disease can lead to death.

What You Must Know about Leukocytosis Disease

Leukocytosis is medical condition in which a person have too much white blood cell in count. White blood cells is a part from the immune system who protects against infection and disease. Each age group has a normal number of different white blood cells. Here is the normal amount of white blood cells per microliter of blood (cells / �L of blood) based on age level:
  • Newborn: 9,400 - 34,000
  • Toddler (3 - 5 years): 4,000 - 12,000
  • Youth (12-15 years): 3,500 - 9.000
  • Adult (15 years and above): 3,500 - 10,500

A person said  have leukocytosis if  have white blood cells with more number above normal.

Symptoms of Leukocytosis

The appearance of leukocytosis is usually characterized by symptoms such as:
  • Body feels weak, painful, and tired.
  • Fever, sweating, and dizziness.
  • There are bruising and bleeding.
  • Tingling in stomach, legs, and arms.
  • Loss of weight decreased and appetite.
  • Disorders in seeing, thinking, and breathing.

Causes of Leukocytosis

In general, leukocytosis is caused by the following factors:
  • Drug reactions that increase the production of white blood cells.
  • Increased production of white blood cells to fight infection.
  • Abnormalities of the immune system that increase the production of white blood cells.
  • Production of white blood cells is not normal due to disorders in the bone marrow.

The more specific causal factors are:

  • Allergies, especially severe allergies.
  • Bacterial and viral infections.
  • Tuberculosis and whooping cough.
  • Smoking habits and emotional problems such as stress.
  • Certain medications such as corticosteroids and epinephrine.
  • Chronic lymphatic leukemia and chronic myelogen leukemia.
  • Acute lymphatic leukemia and acute myelogenic leukemia.
  • Rheumatoid arthritis, polycythemia vera, and myelofibrosis. 


Risk Factors Leukocytosis

The risk of leukocytosis may increase due to several factors below:
  • Reactions of the immune system, such as asthma or allergies.
  • Damage to tissues in the body.
  • Stress, infection, or inflammation.
  • Use of medicines to treat inflammation, mental disorders, cancer, or respiratory problems.


Diagnosis of Leukocytosis

To diagnose leukocytosis, your doctor will ask you a few things about the patient's medical history, the type of medication used, and whether the patient has allergies or not. Blood tests are also needed to determine the number and shape of the patient's white blood cells.

In addition to some of the above procedures, the doctor may examine the spinal cord of the patient to determine the cause of leukocytosis and treatment methods to be performed.

Treatment of Leukocytosis

Increased white blood cell count, can return to normal without treatment. For example in leukocytosis due to infection or because of drugs. However, if necessary, there are several treatment procedures that can be done to overcome the conditions that cause leukocytosis, including:
  • Drugs, to reduce inflammation or infection, as well as acid levels in the body and in the urine.
  • Intravenous infusion fluid, to increase fluid and electrolyte levels required by the body.
  • Leukapheresis, to reduce the number of white blood cells. The doctor will take the patient's blood, then the white blood cell content will be separated and removed, then the blood is put again into the body.