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online available http www cdc gov Autism

Autism
Autism is a complex developmental disability that typically appears during the first three years of life. The result of a neurological disorder that affects the functioning of the brain, autism and its associated behaviors have been estimated to occur in as many as 1 in 500 individuals (Centers for Disease Control and Prevention 1997). Autism is four times more prevalent in boys than girls (Autism: Basic Information) and knows no racial, ethnic, or social boundaries. Although autism manifests itself at an early age, it doesnt worsen as a child ages (webofcare.com).
Autism impacts the normal development of the brain in the areas of social interaction and communication skills. Children and adults with autism typically have difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities. The disorder makes it hard for them to communicate with others and relate to the outside world. In some cases, aggressive and/or self-injurious behavior may be present. Persons with autism may exhibit repeated body movements (hand flapping, rocking), unusual responses to people or attachments to objects and resistance to changes in routines. Individuals may also experience sensitivities in the five senses of sight, hearing, touch, smell, and taste. However, autism isnt a condition a child will grow out of. Autism doesnt occur because of inadequate parenting. The causes of autism are unknown, therefore prevention isnt possible (Autism: Basic Information third edition).
Over one half million people in the U.S. today (Autism: Perspective) have autism or some form of pervasive developmental disorder. Its prevalence rate makes autism one of the most common developmental disabilities. Yet most of the public, including many professionals in the medical, educational, and vocational fields, are still unaware of how autism affects people and how they can effectively work with individuals with autism.
What Causes Autism?
Researchers from all over the world are devoting considerable time and energy into finding the answer to this critical question. Medical researchers are exploring different explanations for the various forms of autism. Although a single specific cause of autism is not known, current research links autism to biological or neurological differences in the brain. In many families there appears to be a pattern of autism or related disabilities which suggests there is a genetic basis to the disorderalthough at this time no gene has been directly linked to autism. The genetic basis is believed by researchers to be highly complex, probably involving several genes in combination.
Several outdated theories about the cause of autism have been proven to be false. Autism is not a mental illness. Children with autism are not unruly kids who choose not to behave. Bad parenting does not cause autism. Furthermore, no known psychological factors in the development of the child have been shown to cause autism.
How is Autism Diagnosed?
There are no medical tests for diagnosing autism. An accurate diagnosis must be based on observation of the individual's communication, behavior, and developmental levels. However, because many of the behaviors associated with autism are shared by other disorders, various medical tests may be ordered to rule out or identify other possible causes of the symptoms being exhibited.
Since the characteristics of the disorder vary so much, ideally a child should be evaluated by a multidisciplinary team which may include a neurologist, psychologist, developmental pediatrician, speech/language therapist, learning consultant, or another professional knowledgeable about autism. Diagnosis is difficult for a practitioner with limited training or exposure to autism. Sometimes, well-meaning professionals have misdiagnosed autism. Difficulties in the recognition and acknowledgment of autism often lead to a lack of services to meet the complex needs of individuals with autism.
A brief observation in a single setting cannot present a true picture of an individual's abilities and behaviors. Parental (and other caregivers') input and developmental history are very important components of making an accurate diagnosis. At first glance, some persons with autism may appear to have mental retardation, a behavior disorder, problems with hearing, or even odd and eccentric behavior. To complicate matters further, these conditions can co-occur with autism. However, it is important to distinguish autism from other conditions, since an accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational and treatment program. Sometimes professionals who are not ... more

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          LYME DISEASE


                                                                                               


                                                                                                          Biology 2051


                                                                                                          4 April, 2000


                                                                                                         


The causative organism of Lyme disease is identified primarily by three genomic groups; Borrelia burgdorferi, B. garinii, B. afzelii, all three of the species are classified as spirochaetes that are nuetrophilic fastidious aerobes and are Gram negative(-).  The medium used to grow these strains of Borrelia is Barbour-Stoenner-Kelly (BSK) agar and it grows at 33 C.


Lyme disease is a tickborne, spirochetal, zoonotic disease that is characterized by distinctive skin lesions, systemic symptoms and neurologic, rheumatologic and cardiac involvement occuring in varying combinations over a period of months to years.  The illness typically begins in the early summer, and the first manifestation in  majority of patients appears as a red papule that expands slowly in an annular manner, sometimes with multiple similar lesions.  Systemic manifestations may include malaise, fatigue, fever, headache, stiff neck, myalgia, and migratory arthralgias that could last several weeks or more in untreated patients.  Within weeks to months after lesions have appeared neurologic abnormalities may develop, symptoms fluctuate and may last for months becoming chronic.  Cardiac abnormalities may also begin to occur a few weeks after the onset of lesions.  Weeks to years after the onset of the lesions swelling and pain in the larger joints especially the knees may develop and recur for several years.  Diagnosis is currently based on clinical findings supported by serologic data by IFA, ELISA and immunoblotting techniques.  Because of the sensitivity of the IFA tests patients with early symptoms as well as patients who have been treated early with antibiotics result with negative tests; therefore, the tests must be interpreted with caution.  The ELISA for IgM antibodies has been shown to be more sensitive for early diagnosis.  Test sensitivity increases when patients progress to later stages of the disaese, but small portions of  chronic Lyme disease patients may remain seronegitive.  Cross-reacting antibodies may cause a false positive test in patients with syphilis, relapsing fever, leptospirosis, HIV, Rocky Mountain spotted fever, and infectious mononucleosis.  


Lyme disease is the number one tick transmitted disease in public health and is also the number one vector borne disease in the United States.  Lyme disease accounts for about  90% of vector-borne infections in the U.S. and between 1980 and 1998 over 112,000 cases were reported from 49 states.  The distribution of the majority of cases in the U.S. coincides with the distribution of the genus Ixodes tick.  In the U.S. endemic foci exists along the Atlantic coast from Massachusetts to Maryland, in the upper midwest the expanding focus is currently concentrated in Wisconsin and Minnesota, and in the west in California and Oregon.  The majority of recorded cases occur in the summer and it may be highly endemic.  In some areas up to 4% of the population can be infected and ages 25-44 are most commonly infected.  More than 50% of Ixodes ticks in the northeastern U.S. are infected with B. burgdorferi through transstadial transmission.  In the northeastern and midwestern U.S., wild rodents and other animals maintain the enzootic transmission cycle.  Deer serve as important maintenance mammalian hosts for vector tick species.  Larval and nymphal ticks feed on small mammals and adult ticks feed primarily on deer.  Transmission usually occurs by transmission of the ticks saliva to the host after the tick has been attached for twenty-four hours or more.  There have also been recorded cases of dog owners becoming symptomatic after having crushed engorged ticks with their fingers through the mucus membrane.  Nymphs are responsible for 90% of the cases transmitted by I. Dammini (deer tick) because 50-60% of the adults are infected, and rarely feed on humans; only 1% of the larvae are infected but they are not involved in the transmission to humans.  There is no evidence of natural transmission from person to person; however, there are rare case reports of congenital transmission, but studies have not shown a link between maternal Lyme disease and adverse outcomes of pregnancy.


Prevention, treatment, and control involve relatively easy to follow and understand steps.  Receintly human vaccinations have been developed, approved and made available.  Education of the public in mode of transmission by ticks and avoiding tick infested areas when feasible is at the top of the list.  If  a person is ... more

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