Dipak-001/mistril_dataset huggingface dataset:
user: What are the symptoms of Chapare Hemorrhagic Fever (CHHF) ?

assistant: The symptoms of CHHF, as reported in the only described patient, resemble those of other South American hemorrhagic fevers, such as Argentine HF or Bolivian HF. The incubation period is unknown, but for Argentine hemorrhagic fever (AHF) is 6 to 16 days. 
   
The CHHF clinical course included: 
    
    - fever 
    - headache 
    - articulation and muscle pain 
    - vomiting 
    
   
These symptoms were followed by deterioration with multiple hemorrhagic signs. The only described CHHF patient died 14 days after onset of symptoms. 
   
Since Arenaviruses may enter the fetus through infection of the mother, and anecdotal evidence suggests that infected pregnant women may suffer miscarriages, it is reasonable to assume that both infection of the fetus and miscarriage may be associated with CHHF infection in the mother.
user: Who is at risk for Chapare Hemorrhagic Fever (CHHF)? ?

assistant: CHHF occurs in the Cochabamba region of Bolivia. 
Field workers 
                
Field workers are at greatest risk because of increased human contact with the reservoir rodent population. Sexual partners of field workers may be at greater risk as well. Laboratory infections have been frequently described with Arenaviruses and Chapare virus can certainly be transmitted to laboratory workers during manipulation of the virus especially during experimental infections of rodents.
user: How to diagnose Chapare Hemorrhagic Fever (CHHF) ?

assistant: CHHF virus has been successfully isolated from both blood and serum during the acute febrile phase of illness. Although not undertaken at the time of the initial cluster, virus can certainly be isolated from tissue obtained post-mortem if available. A subsequent complete genomic analysis of Chapare virus facilitated the development of specific molecular detection (RT-PCR) assays. 
   
Serologic diagnosis of CHHF can be made by indirect immunofluorescent assay and ELISA. However, individuals from endemic areas who show fever, dizziness, and myalgia, accompanied by laboratory findings of low white blood cell and platelet counts and excess protein in the urine, should be suspected of having one of the South American hemorrhagic fever viruses. Clinical specimens should be tested using specific assays.
user: What are the treatments for Chapare Hemorrhagic Fever (CHHF) ?

assistant: Supportive therapy is important in CHHF. This includes: 
    
    - maintenance of hydration 
    - management of shock 
    - sedation 
    - pain relief 
    - usual precautions for patients with bleeding disorders 
    - transfusions (when necessary) 
    
   
Use of convalescent plasma therapy for treatment of AHF reduces mortality significantly and anecdotal evidence shows that the antiviral drug ribavirin may also hold promise for treating AHF. Ribavirin has also been considered for preventing development of disease in people exposed to other arenaviruses. 
   Recovery 
   
The precise mortality of CHHF is unknown and the only described case was fatal. 
   
Patients who have suffered from other arenaviruses may continue to excrete virus in urine or semen for weeks after recovery. For this reason, these fluids should be monitored for infectivity, since convalescent patients have the potential to infect others (particularly sexual partners) via these fluids.
user: How to prevent Chapare Hemorrhagic Fever (CHHF) ?

assistant: Although rodent control would be desirable, it will not be a successful strategy for preventing Chapare hemorrhagic fever cases caused by exposures outdoors. 
   
As for other hemorrhagic fevers, full barrier nursing procedures should be implemented during management of suspected or confirmed CHHF cases.
user: What is (are) Parasites - Zoonotic Hookworm ?

assistant: There are many different species of hookworms, some are human parasites and some are animal parasites. People can be infected by larvae of animal hookworms, usually dog and cat hookworms. The most common result of animal hookworm infection is a skin condition called cutaneous larva migrans.
user: Who is at risk for Parasites - Zoonotic Hookworm? ?

assistant: Dog and cat hookworms are found throughout the world, especially in warmer climates. In the United States, zoonotic hookworms are found everywhere but more commonly along the East Coast than the West Coast. Worldwide, zoonotic hookworms are found in tropical and subtropical regions where the parasite is better able to survive because of environmental conditions. However, there is one type of dog and cat hookworm that is more commonly found in cooler climates.
    
The global burden of zoonotic hookworm in dogs and cats is not known; also, the amount of disease in people caused by these parasites is also unknown. Cutaneous larva migrans (CLM) is most often reported by returning travelers to tropical regions who have had soil and/or sand exposures in places where dogs and cats are likely to have hookworms. However, CLM is likely causing significant problems for the people who live in less developed parts of the world, even though the disease is not reported regularly. In less developed areas of the world, dogs and cats are often free-ranging and have high rates of infection with hookworm which leads to widespread contamination of sand and soil. In a survey of a rural population in Brazil, the prevalence of CLM during the rainy season was 14.9% among children less than 5 years old and 0.7% among adults aged 20 years and older.
user: How to diagnose Parasites - Zoonotic Hookworm ?

assistant: Cutaneous larva migrans (CLM) is a clinical diagnosis based on the presence of the characteristic signs and symptoms, and exposure history to zoonotic hookworm. For example, the diagnosis can be made based on finding red, raised tracks in the skin that are very itchy. This is usually found on the feet or lower part of the legs on persons who have recently traveled to tropical areas and spent time at the beach. There is no blood test for zoonotic hookworm infection. Persons who think they have CLM should consult their health care provider for accurate diagnosis.
user: What are the treatments for Parasites - Zoonotic Hookworm ?

assistant: The zoonotic hookworm larvae that cause cutaneous larva migrans (CLM) usually do not survive more than 5 – 6 weeks in the human host. In most patients with CLM, the signs and symptoms resolve without medical treatment. However, treatment may help control symptoms and help prevent secondary bacterial infections. Antiparasitic treatments may be prescribed by your health care provider.
    
More on: Resources For Health Professionals: Treatment
user: How to prevent Parasites - Zoonotic Hookworm ?

assistant: Wearing shoes and taking other protective measures to avoid skin contact with sand or soil will prevent infection with zoonotic hookworms. Travelers to tropical and subtropical climates, especially where beach exposures are likely, should be advised to wear shoes and use protective mats or other coverings to prevent direct skin contact with sand or soil. Routine veterinary care of dogs and cats, including regular deworming, will reduce environmental contamination with zoonotic hookworm eggs and larvae. Prompt disposal of animal feces prevents eggs from hatching and contaminating soil -- which makes it important for control of this parasitic infection.
user: What is (are) Parasites - Babesiosis ?

assistant: Babesiosis is caused by microscopic parasites that infect red blood cells. Most human cases of Babesia infection in the United States are caused by the parasite Babesia microti. Occasional cases caused by other species (types) of Babesia have been detected. Babesia microti is spread in nature by Ixodes scapularis ticks (also called blacklegged ticks or deer ticks). Tickborne transmission is most common in particular regions and seasons: it mainly occurs in parts of the Northeast and upper Midwest; and it usually peaks during the warm months. Babesia infection can range in severity from asymptomatic to life threatening. The infection is both treatable and preventable.
    Frequently Asked Questions (FAQs)
    
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user: Who is at risk for Parasites - Babesiosis? ?

assistant: People can get infected with Babesia parasites in several ways:
    
     - The main way is through the bite of an infected tick—during outdoor activities in areas where babesiosis is found (see below).
     - A less common way is by getting a transfusion from a blood donor who has a Babesia infection but does not have any symptoms. (No tests have been licensed yet for screening blood donors for Babesia.)
     - Rare cases of congenital transmission—from an infected mother to her baby (during pregnancy or delivery)—have been reported.
    
    
Babesia parasites are not transmitted from person-to-person like the flu or the common cold.
    
Many different species (types) of Babesia parasites have been found in animals, only a few of which have been found in people. Babesia microti—which usually infects white-footed mice and other small mammals—is the main species that has been found in people in the United States. Occasional (sporadic) cases of babesiosis caused by other Babesia species have been detected.
    
     
    
    
Babesia microti is transmitted in nature by Ixodes scapularis ticks (also called blacklegged ticks or deer ticks).
    
     - Tickborne transmission primarily occurs in the Northeast and upper Midwest, especially in parts of New England, New York state, New Jersey, Wisconsin, and Minnesota.
     - The parasite typically is spread by the young nymph stage of the tick, which is most apt to be found (seeking or "questing" for a blood meal) during warm months (spring and summer), in areas with woods, brush, or grass.
     - Infected people might not recall a tick bite because I. scapularis nymphs are very small (about the size of a poppy seed).
user: How to diagnose Parasites - Babesiosis ?

assistant: In symptomatic people, babesiosis usually is diagnosed by examining blood specimens under a microscope and seeing Babesia parasites inside red blood cells.
    
To be sure the diagnosis is correct, your health care provider might have specimens of your blood tested by a specialized reference laboratory (such as at CDC or a health department).
    
More on: Resources for Health Professionals: Diagnosis
user: What are the treatments for Parasites - Babesiosis ?

assistant: Effective treatments are available. People who do not have any symptoms or signs of babesiosis usually do not need to be treated.
    
Before considering treatment, the first step is to make sure the diagnosis is correct.
    
For more information, people should talk to their health care provider.
    
More on: Resources for Health Professionals: Treatment
user: How to prevent Parasites - Babesiosis ?

assistant: Steps can be taken to reduce the risk for babesiosis and other tickborne infections. The use of prevention measures is especially important for people at increased risk for severe babesiosis (for example, people who do not have a spleen). Avoiding exposure to tick habitats is the best defense.
   
Babesia microti is spread by Ixodes scapularis ticks, which are mostly found in wooded, brushy, or grassy areas, in certain regions and seasons. No vaccine is available to protect people against babesiosis. However, people who live, work, or travel in tick-infested areas can take simple steps to help protect themselves against tick bites and tickborne infections.
   
    
   
   
During outdoor activities in tick habitats, take precautions to keep ticks off the skin.
   
    - Walk on cleared trails and stay in the center of the trail, to minimize contact with leaf litter, brush, and overgrown grasses, where ticks are most likely to be found.
    - Minimize the amount of exposed skin, by wearing socks, long pants, and a long-sleeved shirt. Tuck the pant legs into the socks, so ticks cannot crawl up the inside of the pants. Wear light-colored clothing, to make it easier to see and remove ticks before they attach to skin.
    - Apply repellents to skin and clothing. Follow the instructions on the product label. 
     
      - Products that contain DEET (N,N-diethylmetatoluamide) can be directly applied to exposed skin and to clothing, to help keep ticks away (by repelling them). The product label includes details about how and where to apply the repellent, how often to reapply it, and how to use it safely on children.
      - Permethrin products can be applied to clothing/boots (not to skin), actually kill ticks that come in contact with the treated clothing, and usually stay effective through several washings.
     
   
   
    
   
   
After outdoor activities, conduct daily tick checks and promptly remove any ticks that are found. Thorough, daily tick checks are very important. The I. scapularis nymphs that typically spread B. microti are so small (about the size of a poppy seed) that they are easily overlooked. But they usually must stay attached to a person for more than 36-48 hours to be able to transmit the parasite.
   
    - Remove ticks from clothing and pets before going indoors.
    - Conduct a full-body exam for ticks. Use a hand-held or full-length mirror to view all parts of the body. Be sure to check behind the knees, between the legs (groin/thighs), between the toes, under the arms (armpits), around the waist, inside the belly button, the back of the neck, behind and in the ears, as well as in and around the scalp, hairline, and hair. Remember to check children and pets, too.
   
   
Remove ticks that are attached to the skin as soon as possible, preferably by using pointed (fine-tipped) tweezers. Grab the tick’s mouth parts close to the skin, and slowly pull the tick straight out (with steady outward pressure), until the tick lets go.
   
More on: Removing Ticks
   
More on: Ticks
user: What is (are) Parasites - Fascioliasis (Fasciola Infection) ?

assistant: Fascioliasis is an infectious disease caused by Fasciola parasites, which are flat worms referred to as liver flukes. The adult (mature) flukes are found in the bile ducts and liver of infected people and animals, such as sheep and cattle. In general, fascioliasis is more common in livestock and other animals than in people.
Two Fasciola species (types) infect people. The main species is Fasciola hepatica, which is also known as "the common liver fluke" and "the sheep liver fluke." A related species, Fasciola gigantica, also can infect people.
user: Who is at risk for Parasites - Fascioliasis (Fasciola Infection)? ?

assistant: Fascioliasis occurs in many areas of the world and usually is caused by F. hepatica, which is a common liver fluke of sheep and cattle. In general, fascioliasis is more common and widespread in animals than in people. Even so, the number of infected people in the world is thought to exceed 2 million.
    
Fasciola hepatica is found in more than 50 countries, in all continents except Antarctica. It is found in parts of Latin America, the Caribbean, Europe, the Middle East, Africa, Asia, and Oceania. Fasciola gigantica is less widespread. Human cases have been reported in the tropics, in parts of Africa and Asia, and also in Hawaii.
    
In some areas where fascioliasis is found, human cases are uncommon (sporadic). In other areas, human fascioliasis is very common (hyperendemic). For example, the areas with the highest known rates of human infection are in the Andean highlands of Bolivia and Peru.
    
Special conditions are needed for fascioliasis to be present in an area, and its geographic distribution is very patchy (focal). The eggs passed in the stool of infected mammals have to develop (mature) in a suitable aquatic snail host to be able to infect another mammalian host. Requirements include sufficient moisture and favorable temperatures (above 50°F) that allow the development of miracidia, reproduction of snails, and larval development within the snails. These factors also contribute to both the prevalence and level (intensity) of infection. Prevalence is highest in areas where climatic conditions promote development of cercariae.
    
More on: Biology
    
Infective Fasciola larvae (metacercariae) are found in contaminated water, either stuck to (encysted on) water plants or floating in the water, often in marshy areas, ponds, or flooded pastures. People (and animals) typically become infected by eating raw watercress or other contaminated water plants. The plants may be eaten as a snack or in salads or sandwiches. People also can get infected by ingesting contaminated water, such as by drinking it or by eating vegetables that were washed or irrigated with contaminated water. Infection also can result from eating undercooked sheep or goat livers that contain immature forms of the parasite.
    
The possibility of becoming infected in the United States should be considered, despite the fact that few locally acquired cases have been documented. The prerequisites for the Fasciola life cycle exist in some parts of the United States. In addition, transmission because of imported contaminated produce could occur, as has been documented in Europe.
user: How to diagnose Parasites - Fascioliasis (Fasciola Infection) ?

assistant: The standard way to be sure a person is infected with Fasciola is by seeing the parasite. This is usually done by finding Fasciola eggs in stool (fecal) specimens examined under a microscope. More than one specimen may need to be examined to find the parasite. Sometimes eggs are found by examining duodenal contents or bile.
    
Infected people don't start passing eggs until they have been infected for several months; people don't pass eggs during the acute phase of the infection. Therefore, early on, the infection has to be diagnosed in other ways than by examining stool. Even during the chronic phase of infection, it can be difficult to find eggs in stool specimens from people who have light infections.
    
Certain types of blood tests can be helpful for diagnosing Fasciola infection, including routine blood work and tests that detect antibodies (an immune response) to the parasite.
    
More on: Resources for Health Professionals: Diagnosis
user: What are the treatments for Parasites - Fascioliasis (Fasciola Infection) ?

assistant: The first step is to make sure the diagnosis is correct. For more information, patients should consult their health care provider. Health care providers may consult with CDC staff about the diagnosis and treatment of fascioliasis.
    
The drug of choice is triclabendazole. In the United States, this drug is available through CDC, under a special (investigational) protocol. The drug is given by mouth, usually in one or two doses. Most people respond well to the treatment.
    
More on: Resources for Health Professionals: Treatment
user: How to prevent Parasites - Fascioliasis (Fasciola Infection) ?

assistant: No vaccine is available to protect people against Fasciola infection.
    
In some areas of the world where fascioliasis is found (endemic), special control programs are in place or are planned. The types of control measures depend on the setting (such as epidemiologic, ecologic, and cultural factors). Strict control of the growth and sale of watercress and other edible water plants is important.
    
Individual people can protect themselves by not eating raw watercress and other water plants, especially from endemic grazing areas. As always, travelers to areas with poor sanitation should avoid food and water that might be contaminated (tainted). Vegetables grown in fields that might have been irrigated with polluted water should be thoroughly cooked, as should viscera from potentially infected animals.
user: What is (are) Parasites - Cysticercosis ?

assistant: Cysticercosis is an infection caused by the larvae of the parasite Taenia solium.  This infection occurs after a person swallows tapeworm eggs. The larvae get into tissues such as muscle and brain, and form cysts there (these are called cysticerci). When cysts are found in the brain, the condition is called neurocysticercosis.
user: Who is at risk for Parasites - Cysticercosis? ?

assistant: Cysticercosis is an infection caused by the larvae of the tapeworm, Taenia solium. A person with an adult tapeworm, which lives in the person’s gut, sheds eggs in the stool.  The infection with the adult tapeworm is called taeniasis.  A pig then eats the eggs in the stool.  The eggs develop into larvae inside the pig and form cysts (called cysticerci) in the pig's muscles or other tissues. The infection with the cysts is called cysticercosis. Humans who eat undercooked or raw infected pork swallow the cysts in the meat. The larvae then come out of their cysts in the human gut and develop into adult tapeworms, completing the cycle.
    
People get cysticercosis when they swallow eggs that are excreted in the stool of people with the adult tapeworm. This may happen when people
    
     - Drink water or eat food contaminated with tapeworm eggs
     - Put contaminated fingers in their mouth
    
    
Cysticercosis is not spread by eating undercooked meat. However, people get infected with tapeworms (taeniasis) by eating undercooked infected pork. People who have tapeworm infections can infect themselves with the eggs and develop cysticercosis (this is called autoinfection). They can also infect other people if they have poor hygiene and contaminate food or water that other people swallow. People who live with someone who has a tapeworm infection in their intestines have a much higher risk of getting cysticercosis than other people.
    
Human cysticercosis is found worldwide, especially in areas where pig cysticercosis is common. Both taeniasis and cysticercosis are most often found in rural areas of developing countries with poor sanitation, where pigs roam freely and eat human feces. Taeniasis and cysticercosis are rare among persons who live in countries where pigs are not raised and in countries where pigs do not have contact with human feces. Although uncommon, cysticercosis can occur in people who have never traveled outside of the United States if they are exposed to tapeworm eggs.
    
More on: Taeniasis
user: How to diagnose Parasites - Cysticercosis ?

assistant: If you think that you may have cysticercosis, please see your health care provider. Your health care provider will ask you about your symptoms, where you have travelled, and what kinds of foods you eat. The diagnosis of neurocysticercosis usually requires MRI or CT brain scans. Blood tests may be useful to help diagnose an infection, but they may not always be positive in light infections.
  
If you have been diagnosed with cysticercosis, you and your family members should be tested for intestinal tapeworm infection. See the taeniasis section for more information on intestinal tapeworm infections.  
  
More on: Taeniasis
  
More on: Resources for Health Professionals: Diagnosis
user: What are the treatments for Parasites - Cysticercosis ?

assistant: Some people with cysticercosis do not need to be treated. There are medications available to treat cysticercosis for those who do need treatment. Sometimes surgery may be needed. Your doctor will advise you on which treatment is best for you.
    
More on: Resources for Health Professionals: Treatment
    
More on: Taeniasis
user: How to prevent Parasites - Cysticercosis ?

assistant: To prevent cysticercosis, the following precautions should be taken:
    
     - Wash your hands with soap and warm water after using the toilet, changing diapers, and before handling food
     - Teach children the importance of washing hands to prevent infection
     - Wash and peel all raw vegetables and fruits before eating
     - Use good food and water safety practices while traveling in developing countries such as: 
      
       - Drink only bottled or boiled (1 minute) water or carbonated (bubbly) drinks in cans or bottles
       - Filter unsafe water through an "absolute 1 micron or less" filter AND dissolve iodine tablets in the filtered water; "absolute 1 micron" filters can be found in camping and outdoor supply stores
      
    
    
More on: Handwashing
    
More on: Food and Water Safety