Hervey Bay Local Health News

Vomiting and diarrhoea usually occur as a result of a bacterial or viral infection of the gut. Vomiting may last for 4-6 hours and loose, watery bowel motions (diarrhoea) can go on for three or more days. Stomach
pains or cramps may also occur.

The body can lose a lot of fluid through vomiting and diarrhoea, causing dehydration. Dehydration can cause serious, even life-threatening illness, especially in the very young or very old. Ask a pharmacist about suitable treatments for the family.

Causes
Viral infections of the gut - Viruses are common causes of gastroenteritis (’gastro’). The infection starts with sudden onset and often vomiting occurs before any diarrhoea. Often the first symptoms are those of a cold and perhaps a cough. In most cases the infection is short-lived, lasting 2-3 days, although diarrhoea may last a little longer.

Bacterial infections of the gut - these infections are the cause of food poisoning. Symptoms usually occur 12-48 hours after eating infected food. There is a sudden onset of frequent diarrhoea, stomach pains (often described as a ‘colicky7 pain) and vomiting.

Other infections - In some patients, especially infants and small children, diarrhoea and/ or vomiting can be a sign of serious illness, such as blood poisoning. If a child appears very unwell, or is not taking fluids orally, or there is any cause for concern, see a doctor immediately.

Chronic diarrhoea - Recurring or persistent diarrhoea may be as a result of an irritable bowel or inflammation of the bowel. See a doctor if there are frequent bouts of diarrhoea or if diarrhoea persists longer than 2-3 days. In rare cases in adults, a chronic change in bowel habit can be a sign of cancer of the gut. If this sort of change occurs, see a doctor straight away.
 
Medicines - Some medicines may cause diarrhoea and vomiting. Stopping some medicines may also cause diarrhoea. Those who suspect any medicines may be causing vomiting or diarrhoea should talk to a pharmacist.
Other causes - Excess alcohol and anxiety are other possible causes of diarrhoea.

IMPORTANT  
See a doctor if you have diarrhoea when:  
*    Bowel motions contain blood.  
*    You are losing weight.  
*    It is severe with dehydration.  
*    It persists longer than 2-3 days - - earlier for the elderly and the very young (under two years of age).  
*    You have severe abdominal pain or a high fever (greater than 38°C).  
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Generic brand medicines are copies of the original brand medicines. They contain the same active ingredient and are as safe and effective. You can save money by using a lower-cost brand. Talk to a pharmacist or doctor to see whether there is more than one brand of a medicine available and, if so, which might best suit you.

When companies develop a new medicine, the active ingredient is named (often referred to as the ‘generic drug’ name), and it is also given an original brand name. As an example, amoxycillin is an active ingredient (generic drug) name; Amoxil is one brand name.

The first company to make the new medicine has exclusive rights to market its product (a patent or copyright) for a number of years. Other companies cannot market a copy of the original brand medicine until the patent expires.

Generic brand medicines - contain the same active ingredients, are of the same dosage form (e.g. tablets or liquid) and are the same strength as the original brand medicine. This means that different brands work in the same way in the body, with potentially the same risks and benefits.

The Therapeutic Goods Administration (TGA) - is responsible for assessing and registering all medicines in Australia. This is important for public health and safety.

Before a prescription medicine can be put on the market in Australia or listed on the Pharmaceutical Benefits Scheme (PBS), an expert team of doctors, scientists and pharmacists make sure that it is:
*    Of good quality
*    Safe
*    Effective, including cost effective
*    Correctly labelled and packaged.

Companies which produce generic medicines must adhere to the same quality standardsand have the same tight manufacturing controls as companies making original brand medicines. In fact, original and generic brand medicines are sometimes made by the same company.

Different brands - of a medicine may contain different inactive ingredients. They may be a different colour, shape, or size, or may taste different. The type of container or packaging may be different, for example, a bottle or blister foil pack. Differences in formulation or outer packaging do not affect how the medicine works.

Medicines also contain other inactive ingredients such as preservatives, flavourings, colourings or fillers, and there is a rare possibility that an allergic reaction could occur to one of these inactive ingredients.

Important
*    Consumer Medicine Information leaflets provide helpful information on the ingredients in a medicine. It is important to read the leaflet carefully when starting a new medicine or using a different brand.
*    If you know you are allergic to a particular inactive ingredient, for example lactose or gluten, check with the pharmacist before using a new medicine.
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Some medicines can affect your ability to drive, cycle or use machinery. You need to be alert and able to respond quickly to changes in your environment when doing these tasks. Not everyone is affected to the same extent and different people are affected by medicines in different ways.

The danger is you may not notice the effect a medicine has until it is too late. When starting a new medicine, always ask your pharmacist if it is safe to drive, cycle or use machinery and what the warning signs are to look for.

If it is not safe, DO NOT DRIVE.

Reactions to medicines
Some medicines can make you:
*    Drowsy or tired
*    Dizzy, light-headed or faint
*    Not think clearly
*    Shaky, unsteady
*    Angry, aggressive
*    Feel sick
*    Have blurred or double vision.

This can make it unsafe to drive, cycle or use machinery.

Risks
If you drive when affected by medicines you may cause an accident. You risk:
*    Killing, injuring or disabling other people or yourself
*    Damaging property
*    Losing your licence
*    Losing your insurance cover.

The effect of a medicine on your driving may be greater:
*    If you drink alcohol at the same time
*    If you take two (or more) medicines that have similar effects on driving
*    When you start using a new medicine
*    If you take more than the prescribed dose of your medicine
*    As you get older
*    If you are tired.

Important
*    If your medicine affects your driving, stop your driving, not your medicine, and talk to your doctor or pharmacist.
*    Ask your pharmacist or doctor if the medicine you are taking (prescription or non-prescription) may affect your driving. Some medicines may affect your driving only until your body gets used to them. Other medicines may affect your driving all the time you are taking them.
*    Read the labels on ALL medicines you take. Check with your pharmacist when your medicines have the following labels:

This medicine may cause drowsiness and may increase the effects of alcohol.

If affected, do not drive a motor vehicle or use machinery.
OR
This medicine may affect mental alertness and/or coordination.

If affected, do not drive a motor vehicle or operate machinery.

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Chickenpox is a common childhood illness. It is caused by a virus and results in a rash of blisters which are very itchy. Complications, although rare, do occur, and can be serious. Chickenpox is more common in children but can occur in adults.

Cause
Chickenpox is caused by a herpes virus, the Varicella zoster virus.
It is highly contagious, spread by droplets breathed out into the air or from the fluid of chickenpox blisters.

Signs and symptoms
*    Begin between one and three weeks after infection
*    First symptoms: mild headache, moderate fever, general unwell feeling
*    Most younger children (<10 years) do not get these early symptoms, and symptoms are worse in adults
*    Rash develops a day or so later: small flat red spots, developing quickly into itchy blisters which break down to form crusts
*    Rash first appears on back and chest then spreads to face, neck, arms and legs
*    New spots can continue to appear for up to five days
*    The various stages of spots, blistering and crusts may be present on different parts of the body as the rash progresses
*    Blisters vary from a few on the trunk, to covering the whole body. They can occur anywhere, including the scalp, eyelids and on mucous membranes in the mouth, throat, anus and vagina in severe cases
*    Crusts disappear within a few weeks
*    Blisters can be complicated by secondary bacterial infection and can leave scars
*    Other complications include pneumonia, encephalitis, serious bacterial infections of deep tissue or the bloodstream and a bleeding tendency Infections in the first half of pregnancy can cause damage to the foetus and infections late in pregnancy can cause severe chickenpox in the newborn infant.

Important
Most people recover from chickenpox without any problems. However, you should see your doctor if:
*    The blisters get very red and sore with pus
*    There is high fever, severe headaches or vomiting, particularly a week or so after the chickenpox began
*   Joint pain occurs
*   You have a condition or are taking medication that affects your immune system e.g. chemotherapy, radiotherapy, HIV infection.    

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Diabetes occurs when there is too much glucose in the blood. Insulin is a hormone made in the pancreas that allows glucose to move from the blood into the cells, where it is used to produce energy. In diabetes, either the pancreas stops producing insulin (type 1 diabetes) or the pancreas does not produce enough insulin and the body does not respond properly to insulin (type 2 diabetes).

Type 1 diabetes
(Previously called insulin-dependent diabetes mellitus or juvenile diabetes.)
*    The body’s immune system destroys the insulin-producing cells in the pancreas.
*    It usually starts suddenly and the exact cause is unknown.
*    People with type 1 diabetes need insulin injections to survive.

Type 2 diabetes
(Previously called non-insulin-dependent diabetes mellitus or mature-onset diabetes.)
*    The most common form of diabetes.
*    People with type 2 diabetes are more likely to have high blood pressure and cholesterol and be overweight.
*    Develops gradually.
*    Can often be controlled with diet and exercise but sometimes tablets and then later, insulin may be required.

Signs and symptoms
These may include:
*    Passing more urine
*    Increased thirst and/or hunger
*    Tiredness - loss of energy
*    Weight loss (type 1)
*    Itching and skin infections (e.g., thrush)
*    Blurred vision
*    Slow-healing wounds
*    Tingling and numbness in the feet.

People with type 2 diabetes may only notice symptoms after their blood glucose levels have been high for many years.

If you are at risk of type 2 diabetes, don’t rely on the presence of symptoms to know if diabetes has developed. Be tested annually in order to detect diabetes early. You may have diabetes without feeling any symptoms.

Risk factors for diabetes
More than 500,000 Australians have type 2 diabetes and do not know it. Ask yourself these questions and if you answer ‘yes’to one or more of them then you are at risk of diabetes and you should see your doctor and ask to be tested.

Am I over 45 and have high blood pressure?
Am I over 45 and overweight?
Am I over 45 and have a family member with diabetes?
Am I over 55?
Do I have heart disease or have had a heart attack?
Did I have high blood sugar levels while I was pregnant?
Have I had a borderline high blood sugar test?
Do I have polycystic ovary syndrome and am overweight?
Am I over 35 and am an Aboriginal or Torres Strait Islander, a Pacific Islander, of Chinese cultural origin or from the Indian sub-continent?
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Having a dry mouth is a common problem, with a number of different causes. It is often a side effect of medicines or a result of medical treatment. A continual dry mouth can result in altered taste and an increase in tooth decay. There are simple treatments that give relief from dry-mouth problems.

The medical name for dry mouth is xerostomia and it is usually due to a reduction in saliva production.

Saliva
Saliva is the clear fluid secreted by the salivary glands of the mouth.

Saliva assists speech, taste and swallowing and prepares food for digestion. It washes away food and plaque from teeth, helps prevent tooth decay and protects against mouth and gum infections. Most healthy adults secrete about 1.5 litres of saliva per day. Saliva production commonly decreases with age, but it is also affected by illness and medicines.

Signs and Symptoms
Dry mouth has varying degrees of discomfort. Some people feel a dry or burning sensation in their mouth. Severe dry mouth may inhibit the ability to speak or swallow. Changes in saliva also can lead to deterioration of oral and dental health.

Other symptoms may include:
*  Cracked lips
*  Dry, tough tongue
*  Bleeding gums
*  Cavities
*  Thick, stringy saliva
*  Continual need for drinks
*  Sores and split skin at mouth corners
*  Bad breath
*  Difficulty speaking and swallowing
*  Burning or tingling tongue
*  Changes in taste
*  Increase in plaque and tooth decay
*  Mouth and gum infections - e.g. oral thrush
*  Dry and damaged mucosal lining inside the mouth.

Common causes of dry mouth include:
 *  Medicines - the most common cause of dry mouth. There are more than 400 commonly used drugs that can cause dry mouth - these include antidepressants, methadone, antihistamines, anti-inflammatories, analgesics, decongestants, diuretics, muscle relaxants, and medicines for Parkinson’s disease and urinary incontinence
*  Cancer chemotherapy
*  Radiotherapy - especially radiation to head and neck
*  Nerve damage to head and neck
*  Autoimmune disorders such as Sjogren’s syndrome, lupus and diabetes
*  Alzheimer’s disease
*  Stroke
*  Anxiety and depression
*  Dehydration - e.g. from fever, vomiting and diarrhoea, burns.

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Tinea is a fungal infection that grows best on warm, moist skin. The usual sites are warm, sweaty areas of the body, such as between the toes, beneath the breasts and in the groin. Tinea is sometimes called ‘ringworm’, which is misleading as it has nothing to do with worms. Tinea can be treated with the
help of a pharmacist.

Tinea is contagious, and is spread from person to person through skin-to-skin contact, or indirectly through towels, clothes and floors. It is also spread through animals such as cats, dogs, horses or cattle, or from soil, although this is rare.

Signs and symptoms

Warning
Some rashes look like tinea but are not. See a doctor if:
*       The rash is red, inflamed or starts to ooze, weep or smell
*        Nails become infected - look yellow, thick and crumbly
*        The rash does not get better with treatment
*        You also have diabetes or circulation problems
*        You are unsure if your rash is tinea
*        Hair is being lost from a tinea on the scalp.

A doctor may scrape some skin to check under a microscope. Do not put anything on the skin before the scraping is taken as this can make it hard for a doctor to find out what is causing the rash.

Tinea of the feet (athlete’s foot, tinea pedis)
*    Skin on feet appears soft and whitish, often with cracks and redness
*    Seen especially between the toes
*    Often itchy, and may burn and sting
*    May have an unpleasant smell
*    May have small fluid-filled blisters.

Tinea of the groin - jock itch
*    Itchy, red rash on the inner thighs, usually with scaly edges, clearing in the centre; sometimes occurs in the pubic area and between the buttocks
*    Small fluid filled blisters in rash area.

Tinea can also affect the other areas including the scalp, body and nails, particularly the toenails.
*   Slightly raised, itchy red patch on body, often round with a scaly edge and clearing centre
*    Small fluid-filled blisters in the patch
*    On the scalp, may appear as scaly patches with broken hairs.

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The sun’s rays are harmful to the skin. Melanin, the natural pigment in the skin, gives some protection from these damaging rays, but for most people, it is not enough. UVB rays cause sunburn and also affect the DNA in the skin which may cause skin cancer. UVA rays damage the skin, causing wrinkling, sagging and premature ageing, and may also have a role in causing skin cancer. Visible light may trigger photosensitivity reactions and a recurrence of cold sores.

Ultraviolet radiation (UVR) in sunlight is made up of UVA, UVB and UVC rays. Only some UVB and most UVA rays reach the earth’s surface. UVC and shorter UVB rays are either absorbed in space or in the ozone layer.

There is less UVR in the morning and evening, when the sun is closer to the horizon, and less in winter than in summer. During the middle hours of the day UVR is greater because there is less atmosphere for it to pass through. There is also more UVR closer to the equator, at high altitudes and when pollution levels are low.

Risks
If you have fair or sensitive skin or spend a lot of time in the sun or outdoors without protection, you risk:
*    Sunburn
*    Wrinkles, sunspots
*    Coarse leathery skin
*    Skin cancer.

Important
See your doctor if you have:
*    An unusual skin condition that does not heal within four weeks - including any lump, sore, ulcer or scaly patch on the skin, or white patch on the lips.
*    A freckle, mole or spot that appears or changes over a period of months.
*    An unusual freckle, mole or spot - look for irregular shape, uneven surface, colour change in the freckle, mole or skin around it. Do not hesitate to see your doctor - the earlier you have it checked, the easier it will be to treat.
*    Skin cancer in adults is related to the amount of exposure to UVA and UVB rays during childhood.
*    Clouds do not block out UVA and UVB rays.
*    White surfaces (e.g. cement, sand, snow) reflect sunlight and increase exposure to UVA and UVB rays.
*    Sunlight goes through water and can burn while you swim.
*    Wind may be cooling, but the sun still burns the skin.

Signs and symptoms
Melanoma
*    The most dangerous skin cancer
*    If treated early, 90% can be curable
*    May appear as a new spot or an existing freckle or mole that changes colour, size or shape
*    Usually has an irregular or smudgy outline and may be several different colours
*    Grows over weeks to months, anywhere on the body.

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