The three main treatments for thalassemia include:
Blood Transfusions—transfusions of red blood cells are the main treatment for people who have moderate or severe thalassemia. A blood transfusion, given through a needle in a vein, gives you healthy red blood cells with normal haemoglobin.
Iron Chelation Therapy—because the haemoglobin in red blood cells is an iron-rich protein, regular blood transfusions can lead to a build-up of iron in the blood. This condition is called iron overload. It damages the liver, heart, and other parts of the body. To prevent this damage, iron chelation therapy is needed to remove excess iron from the body.
Folic Acid Supplements—folic acid is a B vitamin that helps build healthy red blood cells. You may need to take folic acid supplements in addition to blood transfusions and/or iron chelation therapy.
Tuberculosis—(TB) Affects lungs and also lymph nodes, bones, joints and kidneys, and can cause meningitis.
Communicable/Non-communicable: Communicable
Mode of spread: TB is a serious, slowly developing, bacterial infection that's caused by the bacterium Mycobacterium tuberculosis. It is most commonly spread by droplets, which are coughed or sneezed into the air. Frequent or close prolonged contact with an infected person is necessary to catch the disease.
Prevention/Control: TB can be prevented through the use of the BGG vaccine. This vaccine was developed using a strain of Mycobacterium bovis, which is the organism that causes TB in cattle. This organism has been modified in the vaccine so that it produces immunity against TB without causing the actual disease.
However, once a person has TB, it is difficult to treat - normal antibiotics do not kill TB bacteria. Combinations of several special antibiotics treat the infection in the majority of cases. These must be taken for long periods, usually at least six months, to avoid becoming ill with TB again and developing a drug-resistant form of the disease. Even with treatment, some people develop long-term complications from infection.
Meningitis—(neisseria meningitides) highest risk group is the under 5s, followed by the 15-19 year olds.
Communicable/Non-communicable: Communicable.
Mode of spread: The bacteria that causes meningitis is very common and is usually spread in droplets being coughed or sneezed into the air. However, this bacterium is most directly spread through kissing, and the levels of the disease tend to peak during the winter months and tend to drop to their lowest rate by the late summer.
Prevention/Control: Routine vaccination protects against some types of bacterial meningitis, including those caused by one type of meningococcus (MenC), Haemophilus influenza (Hib vaccine) and invasive pneumococcal disease (PCV vaccine). Vaccination against the mumps virus (for example with the MMR vaccine given routinely to children) protects against viral meningitis caused by mumps.
People who have been in close contact with someone with bacterial meningitis may need to take antibiotics as a preventative measure.
Treatment depends on the cause of the meningitis, but intravenous antibiotics will be started immediately and continued if tests confirm the bacterial form. If other causes are diagnosed they will be treated accordingly. Different medicines may be needed to control symptoms such as seizures. Delays in treatment increase the risk of long-term damage.
Methicillin-Resistant Staphylococcus Aureus (MRSA)—bacterial infection resistant to most commonly used antibiotics. Staphylococcus aureus is carried on the skin by around 30% of the population.
Communicable/Non-communicable: Communicable.
Mode of spread: Staphylococcus is a family of common bacteria. Many people naturally carry it on their throat, nose and skin and it can cause a mild infection such as pimples and impetigo in a healthy patient. Occasionally staphylococcus can get through the skin and cause serious infection elsewhere in the body such as septicaemia (a blood infection), pneumonia and endocarditis. Staphylococcus is resistant to one or more conventional antibiotics.
In the NHS, patients are at higher than normal risk of picking up a Staph infection on the wards. This is because the population in hospitals tends to be older, sicker and weaker than the general population, making them more vulnerable to the infection. Secondly, conditions in hospitals, without very strict hygiene measures, involve people constantly being examined by doctors and nurses who have just touched other patients and this is the perfect environment for the transmission of all infections.
Prevention/Control: Antibiotics are not completely powerless against MRSA, but patients may require a much higher dose over a much longer period, or the use of an alternative antibiotic to which the bug has less resistance.
However, the spread of this infection is easily preventable just by having strict hand washing and hygiene rules when entering and leaving wards.
Salmonella—food poisoning from eating food contaminated with the bacterium or from someone who is infected.
Communicable/Non-communicable: Communicable.
Mode of spread: Can be caused by bacteria, which can be caught by eating food contaminated with the bacterium, e.g. unpasteurised milk, raw meat, undercooked poultry and eggs, etc. it is also possible to catch salmonella from someone else who is infected and from pets and farm animals. Also, inadequate thawing from freezing is a common source.
Prevention/Control:
Prevention may include:
- Poultry and meat should be well cooked, not pink in the middle. Uncooked meats should be kept separate from cooked and ready to eat food to avoid cross contamination.
- Vegetables and salads should be thoroughly washed before eating.
- The Chief Medical Officer advises against recipes with uncooked or lightly cooked eggs. Adequate cooking of eggs, until the yolk is set, kills salmonellas.
- Take care that food does not become contaminated after cooking.
- Hands, chopping boards, knives and other utensils should be washed thoroughly in hot soapy water immediately after handling raw meat and poultry.
- Hands should be washed before handling different food items and before eating or drinking and after going to the toilet and also after contact with animals particularly pets and their bedding.
- Those who are ill should not prepare or handle food
Treatments/controls may include:
Non-drug
- Attention to dehydration, usually just oral rehydration fluids.
- Attention to hand washing to prevent spread to others.
- Admission to hospital may be required in infants younger than 3 months or younger than 12 months with a temperature in excess of 39°C.
Drugs
Antibiotics do not shorten the illness but may prolong the carrier stage. There is also a problem of multiple antibiotic resistance, however sometimes anti-diarrhoea or anti-spasmodic drugs may be required.
Poliomyelitis—is caused by a virus. Attacks the nervous system and can cause total paralysis very quickly. There is no cure for this disease.
Communicable/Non-communicable: Communicable.
Mode of spread: Polio is transmitted through contaminated food, drinking water, faeces and swimming pool water. Polio mainly affects people who haven't been immunised.
Prevention/Control: Most parts of the world are now polio-free following successful immunisation programmes. In the UK, routine immunisation is offered to babies and booster doses are given to children before they start school and after they leave. Travellers to countries that still have a risk of polio may need additional boosters.
Polio is prevented by the Hib vaccine (five-in-one), which provides immunity to polio, diphtheria, tetanus, pertussis and Hib.
Vaccination is the only effective method of preventing polio.
There's no specific treatment for polio infection. Therapy with painkillers is usually all that's necessary when infection is mild. If the infection is severe then admission to hospital may be needed, particularly if respiration is affected. Those with paralysis can be helped to regain function in the affected limb or limbs with physiotherapy.
Measles—is a viral infection including fever and spots, which can involve serious complications, including fatality. There is no cure for this infection.
Communicable/Non-communicable: Communicable.
Mode of spread: The virus that causes measles is spread by droplets in the air from coughs and sneezes. The virus is passed on through direct contact with someone who's infected, for example by touching or kissing them, or through breathing in contaminated air. It's fairly easy to catch if you haven't been vaccinated and come into contact with someone who has the infection, which is why epidemics often occur among schoolchildren.
Prevention/Control: Children may be treated at home with pain and fever-reducing syrups such as paracetamol and they should be encouraged to drink fluids.
Hospital treatment, with antiviral drugs, may be needed in more serious cases. In developing countries vitamin A may also be given to help the immune system.
Although rare, complications can be very dangerous.
Prevention is ensured through vaccination. Children in the UK are offered vaccination against measles as part of the MMR vaccine, which is given to them between 12 and 15 months of age (with a booster dose before they start school). Between 5-10% of children are not fully immune after the first dose, so the booster jab helps to increase protection.
Malignant Melanoma—(skin cancer) is most common in social class 1 and 2 and in the south of the country, unlike other cancers.
Communicable/Non-communicable: Non-communicable.
Mode of spread: Malignant melanoma can’t be spread, as it isn’t a communicable disease. Skin cancer is caused by overexposure to the sun’s harmful UV rays. The main cause of melanoma skin cancer is exposure to short periods of intense sunlight: the kinds of exposure people get on a two-week holiday.
Prevention/Control: The best way to prevent skin cancer is to avoid too much time in the sun. You don't have to be sunbathing to get burned. You can get too much sun while walking to the shops, driving a car with the windows down, even under light cloud cover. Therefore, to protect yourself against harmful UV rays, you should:
- Stick to the shade between 11am and 3pm.
- Cover up with clothes, a wide brimmed hat and sunglasses.
- Apply a high-factor sunscreen (minimum SPF15) regularly.
- Drink plenty of water to avoid overheating.
- Avoid using sun lamps or sun beds.
Non-melanoma skin cancers are usually treated by surgical removal or freezing (cryotherapy). Melanoma skin cancer is treated by surgery. This involves removing additional healthy skin, the amount dependent on the thickness of the melanoma. In some instances this may also require a small skin graft to cover the area and help healing. Occasionally a small biopsy of a lymph node may also be taken at the same time, defining future risks of recurrence. Most melanoma skin cancers can be cured with surgery if caught early. Some melanoma skin cancers can spread to other parts of the body. If melanoma has spread beyond the skin or local lymph nodes, chemotherapy, radiotherapy, biological therapy and surgery may all be used in various combinations.
Most skin cancers are easily treated and cured when detected early. Melanoma skin cancer remains the most dangerous subtype because of the risk of spread. About 1,800 people die from melanoma skin cancer annually in the UK.
Lung Cancer—highest levels are at lowest social groups.
Communicable/Non-communicable: Non-communicable.
Mode of spread: Lung cancer can’t be spread, as it isn’t a communicable disease. Cigarette smoking is the cause of nearly all lung cancers, although the risk increases with the number and type of cigarettes smoked.
Prevention/Control: An obvious prevention of lung cancer would be to stop smoking, or trying not to hang around people who smoke.
Lung cancer patients may be referred to special clinics. Treatment of lung cancer depends on the type of tumour, its location and how far it has spread, as well as the person’s general health.
When the tumour is away from the centre of the chest and there's little or no spread (SCLC), surgery is often used. A small part of the lung may be removed, or a lobe of the lung or an entire lung. You can breathe normally with only one lung.
Chemotherapy and/or radiotherapy are usually more effective in treating SCLC because this type of cancer has usually spread to more than one place by the time it's diagnosed.
Bowel Caner—is the third most common cancer in the UK. 1:20 will develop this and 16,000 die each year.
Communicable/Non-communicable: Non-communicable.
Mode of spread: Bowel cancer can’t be spread, as it isn’t a communicable disease. The exact cause of bowel cancer isn't known, but a family history of the condition can increase your risk. Your risk of colorectal cancer increases with age - the average age of diagnosis is about 70. However, younger people can also be diagnosed.
Previous problems with chronic inflammatory bowel disease also appear to increase the risk of this type of cancer.
Prevention/Control: A high-fibre diet with plenty of fruit, vegetables and carbohydrates (pasta, bread, rice) is believed to reduce the risk of colorectal cancer.
Eating a diet high in saturated fat and red meat, and low in fibre, smoking and being overweight increases your risk. Eating at least five portions of fruit and vegetables every day is thought to protect against this and many different cancers through the benefits of the antioxidant vitamins and minerals they contain.
Moderate amounts of exercise may also protect against bowel cancer.
The main treatment is surgery. Usually, the piece of bowel that contains the cancer is removed and the two open ends are joined back together.
If the two sections can't be joined back together, the bowel can be brought out through the abdominal wall. Although this procedure is more likely after removal of a tumour in the rectum, it's not always necessary and may only be temporary.
Chemotherapy and radiotherapy are increasingly being used to treat bowel cancer in addition to surgery as an additional helping treatment, especially in more advanced tumours.
Coronary Heart Disease (CHD)—one of the commonest diseases to affect the heart is coronary heart disease (CHD). It's usually caused by atherosclerosis, a build up of fatty materials within the walls of the arteries.
Communicable/Non-communicable: Non-communicable.
Mode of spread: CHD can’t be spread, as it isn’t a communicable disease. Although an unhealthy diet, lack of exercise, diabetes, high blood pressure and smoking all increase the risk the risk of getting CHD.
Prevention/Control: The best way to prevent coronary heart disease is to make sure that your 'bad cholesterol' (LDL) level is low and that your 'good cholesterol' (HDL) level is high. There a number of ways you can do this, including: eating a healthy and balanced diet, being more physically active, keeping to a healthy weight, giving up smoking, reducing your alcohol consumption, keeping your blood pressure under control, keeping your diabetes under control and by taking any medication that is prescribed for you.
Treatment of coronary heart disease may include:
Medicines—such as anticoagulants, beta blockers or ACE (angiotensin-converting enzyme) inhibitors.
Surgical procedures—surgery may be needed to open up or replace blocked arteries. These surgeries might include coronary angioplasty, coronary artery bypass, heart transplant, or laser surgery.