That’s welcome news, but the term eliminated can be misleading. It’s just a moment in time and in a globalised world, Australia can’t afford to rest on its laurels, but must continue to vaccinate and test for such conditions, suggests microbiologist Dr Petra Derrington:

‘There are a lot of diseases that Australians might assume have been dealt with and eliminated, but that’s not so.

‘It might surprise people to know how many conditions that we think of as in the past are very much with us today, and if not detected and treated, pose serious health risks.’

Five of the ‘old’ disease states that are still with us are:

Whooping cough

For anyone who has seen someone suffering from whooping cough, particularly a child, it is a disturbing scene. The early symptoms are similar to that of a cold, but it soon progresses to a relentless fit of coughing, followed by a whooping sound as the patient attempts to draw breath. Apnoea, where breathing stops for periods of time and the patient goes blue, is another symptom.

Whooping cough is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. It can last three months and also lead to complications like pneumonia, fits, brain inflammation, haemorrhaging and death. Detecting it as early as possible through testing in order to begin treatment and stop its spread is important, as of course is vaccination.

Syphilis

On the rise in Australia along with other Sexually Transmitted Infections (STIs) syphilis is caused by the spread of the bacterium Treponema pallidum. Many infected with syphilis may not be aware of the symptoms – which include sores on the genitals, mouth or anus and which usually self-heal.

If left untreated, syphilis can have serious health ramifications, which include joint pain, swollen lymph nodes, and neurological damage to the brain and other organs of the body depending on the stage of the condition. It is of particular concern to pregnant women.

Tuberculosis

Caused by the bacterium Mycobacterium tuberculosis, Tuberculosis is a contagious air-borne disease with symtoms including fever, chest pains, and the coughing up of blood. Those at high-risk include young children, or those with conditions that weaken the immune system, such as diabetes, cancers and HIV or AIDS.

Dengue Fever

Most commonly found in tropical locations, dengue fever is a viral infection passed on by dengue mosquitoes. It’s most common in areas of northern Queensland and can be passed on when the virus is brought in by travellers.

Symptoms include muscle and joint pain, vomiting, diarrhoea, fever, intense headache and may last up to a week. When a dengue outbreak has been reported, everyone who has symptoms and has passed through an effected area should be tested. There are four version of dengue so a blood test is required to determine the correct treatment path.

Measles

Not to be confused with the recently eradicated German Measles (aka Rubella), measles is an air-borne and potentially fatal condition that can lead to complications like pneumonia and encephalitis. While the condition is relatively rare in Australia, it’s worth reminding ourselves that on the world stage, measles is the firth highest cause of illness and death in children.

The early symptoms include fever, coughing and a runny nose. As with whooping cough, vaccination is the best insurance against measles, but a pathology test will reveal if someone has contracted the condition and the process of recovery can begin.

While these disease states have to a large degree been brought under control, thanks to Australia’s vaccination programs, they remain an ever-present danger. And while they are, pathology is critical to detecting and monitoring these conditions to ensure “herd protection”.

‘Vaccination is key, absolutely crucial to making sure we get on top, and stay on top, of these diseases which can have awful consequences.

‘But of course we know that not everyone gets vaccinated and that borders are porous: Australians travel in and out of the country all the time,’ says Dr Derrington.

‘Pathology testing therefore is absolutely critical for keeping a pulse on disease states and monitoring the health of the nation.’

The post 5 medical conditions Australia can’t shake first appeared on Know Pathology Know Healthcare.

• Chlamydia trachomatis (commonly referred to as Chlamydia)
  • Symptoms
  • Testing
  • Treatment
• Syphilis
  • Symptoms
  • Testing
  • Treatment
• Gonorrhoea
  • Symptoms
  • Testing
  • Treatment

Sexually Transmitted Infections (STIs) cover a range of medical conditions; including chlamydia trachomatis (there are non-STI species as well), syphilis, gonorrhoea, genital herpes, hepatitis, HIV infection/ AIDS.

The STIs being discussed in this article will be Chlamydia trachomatis, syphilis, and gonorrhoea. For information on HIV / AIDS and Hepatitis click on the supplied links.

Chlamydia trachomatis (commonly referred to as Chlamydia)

Symptoms

Amongst the most common STIs in Australia, sexually transmitted chlamydia is caused by the bacteria Chlamydia trachomatis and effects both sexes. One of the issues with chlamydia is that for 50% of men and 70-80% of women there aren’t always noticeable symptoms.

Symptoms may include pain during urination, and an unusual discharge from the penis, vagina or rectum. Women may experience bleeding between their periods or following intercourse. The only way to know for certain if you have chlamydia or another STI is to be tested specifically for it.

If left untreated, it can have serious effects, including pelvic inflammatory disease and sterility.

Testing

A simple urine test, and in some cases for women a swab test will determine if you have chlamydia. Samples are taken to a pathology lab where they are tested using Polymerase Chain Reactions (PCR) techniques. These molecular methods are extremely sensitive and highly specific and can be performed rapidly in a few hours. PCR testing looks at short sections of DNA and makes large numbers of them in a thermocycler to analyse. A billion copies of the DNA can be produced within a few hours.

If you have had unprotected sex or believe you may have contracted an STI you should visit your GP or medical clinic and discuss having a test.

Treatment

Chlamydia can be cured with a course of antibiotics, as recommended by a doctor.

Syphilis

Symptoms

Syphilis is caused by the bacteria Treponema pallidum and although traditionally somewhat rare in Australia, the numbers of cases, in both men and women, are dramatically increasing in recent years. If left untreated it can cause serious health problems. Syphilis overwhelmingly effects men – at seven times the rate of women – and is increasing in men who have sex with men and people with HIV/ AIDS.  However, it can have devastating effects on unborn babies if acquired during pregnancy.

Initial symptoms include a painless sore on the genitals or around the rectum or mouth which disappears. Later symptoms can include a body rash, including on the hands or soles of the feet. If left untreated it can spread through the body and cause significant damage to organs, the cardiovascular system, the brain and the nervous system.

Testing

There are a number of tests, known collectively as Syphilis Detection Tests, that are used to detect syphilis. Most commonly, the test involves taking a blood sample, sometimes from a swab of the affected ulcer, and on rare occasions through a spinal tap. As with chlamydia samples are taken to a lab where they are searched for antibodies or by PCR to detect the bacterial DNA. The bacteria is not able to be cultured in a laboratory.

If you have engaged in high-risk activity or are pregnant you should consult your doctor about having a test.

Treatment

Like chlamydia, syphilis can be cured with a course of antibiotics.

Gonorrhoea

Symptoms

Colloquially known as ‘the clap’, gonorrhoea is caused by the bacteria Neisseria gonorrhoeae and can affect the urethra, cervix, anus, throat or eyes. It is spread by engaging in unprotected sex with someone infected with the condition.

Often asymptomatic, untreated gonorrhoea can lead to sterility in both sexes and other health complications. If symptoms occur they can include swollen testicles, vaginal discharge or bleeding between periods, or pain during urination. It can also be passed on from a pregnant mother to her baby during birth, potentially causing eye infection and blindness.

Testing

A gonorrhoea test involves taking a sample from a swab or brush of cells, vaginal or penile secretions, a urine sample, and sometimes a swab from a non-genital area. As per chlamydia and syphilis, the lab will test using PCR on the urine and grow bacteria in the laboratory. In recent years these bacteria have become increasingly resistant to the majority of antibiotics which were once effective in treating this infection, therefore it is very important to get samples where the bacteria can be cultured and then tested for sensitivity to antibiotics. The test is recommended for sexually active women 25 or older or who are pregnant, and yearly for men who have sex with men.

Treatment

Gonorrhoea can be treated with antibiotics.

If you believe you may have contracted any of the above, or any other STI, consult your doctor or medical clinic for advice on what to do.

The post What are STIs and how to test for them? first appeared on Know Pathology Know Healthcare.

Eva Peron

Eva Peron’s life has all the touchstones of high drama. Born in a poor village she left for Buenos Aires to pursue an acting career when she met and married future Argentine President, Juan Peron. No shrinking political violet, she ran the ministries of labour and health. Her life’s story has proven irresistible – spawning endless books, films, television series and the musical Evita.

After fainting at a public event in 1950, it was discovered she had advanced cervical cancer. She died soon after in 1952, aged 33. The basis of cervical cancer is the Human papilloma virus (HPV), which today can be picked by an HPV pathology test. Replacing the pap smear test in 2017, the HPV test can be taken every 5 years.

Vivien Leigh

Vivien Leigh made her name in two of Hollywood’s great mid-century blockbusters, Gone with the Wind and A Streetcar Named Desire. Shortly after starring in Gone with the Wind and marrying Laurence Olivier, she was diagnosed with tuberculosis, a condition she had recurrent bouts of and which killed her at age 53.

Today, a quarter of the world’s population carry the Mycobacterium tuberculosis bacteria that leads to tuberculosis, but only 5-10% will get sick. Those with weakened immune systems or with already damaged lungs are most susceptible. There are several tests available for tuberculosis which is treatable with a course of medication.

Freddie Mercury

The best-known Zoroastrian in the world – also known as the lead singer and songwriter of rock outfit, Queen – Freddie Mercury died as a result of AIDS in 1991 at 45 after being diagnosed with the condition in 1986. His life was unfortunately just out of sync with the development of HIV medicines, the first experimental AIDS vaccine tested in the US declared safe in 1991.

While Freddie might not have benefitted from early detection of HIV given the medical treatment for HIV was not yet developed commercially, today, anyone else can have an HIV test, and if found positive can seek treatment before it develops into AIDS.

Al Capone

Ultimately nabbed by the United States government for tax evasion and given an 11-year spell in the Atlanta Penitentiary and Alcatraz, Al Capone made his fortune during the Prohibition as a Chicago mobster. It was up like a rocket and down like a stick for Capone. By the ripe age of 33 he was in prison, being released 8 years later.

But his freedom wasn’t what it might have been. At some stage Capone contracted syphilis and upon his release in 1947 was suffering syphilitic dementia. A simple syphilis test for the pathogen Treponema pallidum would have revealed the condition and a course of penicillin would have cured him.

Wolfgang Amadeus Mozart

A workhorse to the end, Wolfgang Amadeus Mozart was still composing his last masterpiece ‘Requiem’ on his deathbed when he struck a final, sour note, dying at the age of 35, having produced an unbelievable body of work. The cause? As happens in old cases, theories abound, but it’s argued that new evidence points to the cause of death as being kidney damage caused by strep throat.

There was an epidemic of strep throat in 1791. The culprit, the Streptococcus pyogenes bacteria. A simple Rapid antigen or throat culture test can detect strep throat and then a course of antibiotics is all you need to clear it up. Unless it was death by pork chop, as suggested here. Either way his premature death was a tragic conclusion for Wolfy and the human race. 

That the world was deprived of the unique talents of so many people is sad but also points to how far we’ve come in the detection of medical conditions.

‘Today, we’re extremely fortunate that we can pick up on conditions early so that appropriate medical treatment can begin,’ says microbiologist, Dr Petra Derrington.

‘With the developments in testing and medical treatments over the last century or so, conditions that once proved fatal, need not be the tragedies they once were.’

The post Celebs who might have been saved by a pathology test first appeared on Know Pathology Know Healthcare.

First recorded in 15^th century Naples, syphilis – also known as ‘The Great Pox’ – devastated Europe in the 16^th and 17^th centuries and was almost eradicated in the early 2000s but has suddenly flared up again in remote Australia at an alarming rate.

Far from being innocuous the Sexually Transmitted Infection (STI) spreads lesions and sores across the body and is particularly problematic for pregnant women. If contracted, the baby of a pregnant mother has a 50 per cent chance of survival, and if they do survive, they risk blindness, deafness and cognitive issues.

Since two cases of syphilis were diagnosed in Queensland a decade ago, it is has now come to affect thousands of patients, notably in Indigenous communities.

Mr Wyatt approved the immediate dispatch of 10,000 test kits – 3,000 to Townsville, 3,000 to Cairns, and 4,000 to Darwin – with a further 52,000 ordered and sent on.

What’s the immediate plan?

Because syphilis can be in the system for six months before symptoms arise, the infection can be spread unwittingly through sexual activity.

This puts a premium on rolling out syphilis tests. A syphilis TP rapid test takes around 15 minutes to deliver a result. Early detection means treatment is not only more manageable for those who have contracted it, but also helps prevent its further spread.

Director of Sexual Health at Cairns Sexual Health Service, Dr. Darren Russell, says if someone is found to have syphilis, treatment can begin straight away.

‘Early syphilis is treated with a single injection of penicillin, which is highly effective at curing the infection. Within days, the symptoms resolve and the person is no longer infectious.’

In the short to medium term, communication and education materials will be rolled out to explain the potential impacts of syphilis and how to avoid contracting it.

So, what’s behind the rise?

‘Changes in sexual behaviour since the advent of better treatments for HIV, combined with a high degree of mobility, mean that syphilis has been able to take off in this population, notably in the gay community. Heterosexuals are also affected in many countries, particularly those in disadvantaged and marginalised groups.’

But syphilis is not the only STI on the increase in Australia.

The Kirby Institute’s 2017 Annual Surveillance Report into HIV, viral hepatitis, and STIs found that while HIV rates remained stable from 2012-2016 after an 8 per cent spike in the year preceding, gonorrhoea rates increased by 63%, while syphilis increased by 107% in the same period.

There have been several ideas advanced to explain the reasons for the influx of STIs; from the uptake of online dating sites which expand sexual encounters, the low usage of condoms among young men, the greater degree of travel and sexual experimentation tied in with that, and the perhaps more lax approaches to safe sex tied up with advances in HIV treatment medications.

The post What’s behind Australia’s syphilis outbreak and the rise of STIs? first appeared on Know Pathology Know Healthcare.