Thursday, July 27, 2006
Familiar strep germ is no friend to its victims

By Dr. Anthony Policastro
Nanticoke Memorial Hospital,
Medical director

Strep throat is a common childhood disease. Most children will have more than one episode during their childhood. We talk about the streptococcus that causes it like a friend. Everyone uses its nickname and refers to it just as "strep." There are a variety of bacteria that cause disease. They go by a variety of names. Some of them we get immunizations for. Diphtheria and tetanus are two examples. The new pneumonia vaccine treats the pneumococcus. Others are common enough that we recognize them by name. Strep is one of those bacteria. Staph is another nickname for a common bacteria. Children get strep throat the same way they do other infections. They come into contact with someone who has it. There is an incubation period of 48 to 72 hours. They then develop symptoms. The symptoms of strep are many. It is most common in children between the ages of 4 and 7. Fever and sore throat are the most common ones. However, strep can cause headaches. It can cause abdominal pain. It can cause vomiting. It can cause swollen, tender glands in the neck. It can also cause a rash. When it is associated with a rash, the condition goes by the name scarlet fever. Scarlet fever has a bad reputation. That reputation dates back to the days before antibiotics. We had no medicine for it and it used to be a bad infection. Now it only refers to a strep throat with a rash. The more of these symptoms that a child has, the more likely it is to be strep. If a child has a runny nose or cough with a sore throat, it is not likely to be strep. A sore throat in the area of the voice box (Adam's apple) associated with hoarseness and a cough usually means viral laryngitis. Thus not every sore throat and fever needs to be treated with antibiotics. A few months ago I wrote an article on the use of rapid strep tests and throat cultures to diagnose strep infections. I included information on how to treat those infections. What I did not discuss was why we treated those infections. Most people think we treated strep infections to make the patient feel better. While it is true that treated infections improve faster, medication takes 24 hours to work. Most patients show up after 24 hours of symptoms. They then get better in 24 hours. So they are sick for 48 hours. As a rule the body's immune system heals strep in 72 hours. So all we usually do is get patients better a little bit earlier than if the disease ran its course. The real reason to treat strep is to prevent rheumatic fever. Rheumatic fever is a disease that follows strep infections. The body makes antibodies (proteins) to fight the strep. The antibodies attack the strep. There are parts of some strep bacteria that are similar to our human cells. For that group of strep infections, the antibodies begin to attack the person's own cells. They may attack the heart and cause rheumatic heart disease. This usually affects the heart valves. Most diseased valves will need to be replaced when the patient is in their 30s or 40s. This is the most serious complication. They may attack the brain and cause abnormal movements of the arms and legs. The patient cannot control these movements. They may attack the joints and cause swollen sore joints. They may attack the skin and cause a skin rash. The only way to be sure of preventing these symptoms is for patients to take the antibiotics for the full 10 days. They might be better from the strep symptoms in 24 hours. However, if they stop the medication when they feel better, they will not prevent rheumatic fever from developing. We may treat strep like a friend and give it a nickname. However, the problems it causes are not always that friendly.

Light The Night to benefit Leukemia and Lymphoma Society
The Leukemia & Lymphoma Society will hold their signature walk-event, Light The Night, on Saturday, Sept. 30, at A.I. duPont Hospital for Children. Registration will begin at 5 p.m. and the walk will begin at 7 p.m. Another walk will take place on Saturday, Oct. 14, on the Rehoboth Beach Boardwalk. The Delaware chapter is currently seeking participants and volunteers to raise money toward the society's mission of finding cures for leukemia, lymphoma, Hodgkin's disease and myeloma and improving the quality of life of patients and their families. Light The Night is the society's nationwide evening walk to commemorate lives touched by cancer. Participants carry flickering red and white balloons along a two- to three-mile walk within their communities. Cancer survivors hold white balloons, and all supporters carry red balloons. Individual walkers are welcome, and families and companies are invited to form teams to walk in this evening event. There is no registration fee, but participants are encouraged to raise $100 for the society's research and patient service programs. In addition, dedication banners will be displayed to give everyone an opportunity to place a name or message in honor of or in memory of a family member or friend with cancer. Participants will also be awarded a variety of prizes based on their total fund-raising efforts. "While the walk is still a few months away, it's time for participants to start planning for their involvement by recruiting their family, friends and work colleagues," said Tini Scherer, campaign coordinator of the Light The Night Walk. "Last year over 1,000 walkers in the state of Delaware raised $170,000 for the society. This year we have set a goal of $210,000." For additional information, contact Scherer at the Delaware Chapter of The Leukemia & Lymphoma Society at (302) 661-7300, ext. 26 or visit the Web site Light The Night Walk is being held in two locations in the state and sponsored locally by The Edgar A. Thronson Foundation, AstraZeneca, Wilmington Trust, General Motors Wilmington Assembly, Fast Signs, Wyeth Pharmaceuticals, Fidelity Investments, Frightland, McDonalds, Grisillo's Thriftway, Happy Harry's Discount Drugs, BlueCross BlueShield of Delaware, Lewes-Rehoboth Association of Churches, ECI, Wilmington Blue Rocks, WSTW 93.7, WDEL 1150, Eagle 97.7, Cool 101.3 and La Exitosa 930.

State vet says that animals throughout state have rabies
People warned to take precautions against being bitten

Dr. Robert Ricker, Delaware state veterinarian, is warning the public to protect themselves and their families by staying away from wild animals and avoiding pets and domesticated animals that are acting strangely. These animals may have rabies which can cause a very painful death in humans if left untreated. If you have been bitten by an animal, the chance of rabies exists. Do not wait; call your doctor and/or go to the emergency room for treatment. The incubation period for the disease can be as short as two weeks. Once clinical signs develop, there is no cure. According to Dr. Ricker, the entire state is a rabies endemic area. According to the Centers for Disease Control and Prevention, "Rabies is a preventable viral disease of mammals most often transmitted through the bite of a rabid animal. The vast majority of rabies cases reported to the Centers for Disease Control and Prevention (CDC) each year occur in wild animals like raccoons, skunks, bats and foxes. Domestic animals account for fewer than 10 percent of the reported rabies cases, with cats, cattle, and dogs most often reported rabid. Infection can also occur by contamination of an open cut by saliva. Rabies prevention beats rabies treatment:

  • Vaccinate your pets. All dogs, cats, and ferrets over 6 months old are to be vaccinated by a licensed veterinarian.
  • Stay away from wild animals.
  • Report stray dogs and cats to the Kent County SPCA - 1-888-3KCSPCA (1-888-352-7722)
  • Stay away from pets and/or domestic animals that are acting strangely.
  • If your pet or farm animal is acting strangely, call your veterinarian.
  • If you suspect that your pet or farm animal may have rabies, call the Bureau of Rabies Prevention, Rabies Hotline: (302) 744-4545 at the Delaware Division of Public Health.
People can also rabies proof their homes:
  • Remove sources of food from buildings and yards
  • Make sure garbage cans have tight-fitting, animal-proof lids.
  • When possible, put garbage cans in garage or shed
  • Feed pets indoors or if you feed them outside, remove any uneaten food right away.