Dipak-001/mistril_dataset huggingface dataset:
user: Who is at risk for Parasites - Echinococcosis? ?

assistant: Cystic echinococcosis (CE) is caused by infection with the larval stage of Echinococcus granulosus. CE is found in Africa, Europe, Asia, the Middle East, Central and South America, and in rare cases, North America. The parasite is transmitted to dogs when they ingest the organs of other animals that contain hydatid cysts. The cysts develop into adult tapeworms in the dog. Infected dogs shed tapeworm eggs in their feces which contaminate the ground. Sheep, cattle, goats, and pigs ingest tapeworm eggs in the contaminated ground; once ingested, the eggs hatch and develop into cysts in the internal organs. The most common mode of transmission to humans is by the accidental consumption of soil, water, or food that has been contaminated by the fecal matter of an infected dog. Echinococcus eggs that have been deposited in soil can stay viable for up to a year. The disease is most commonly found in people involved in raising sheep, as a result of the sheep's role as an intermediate host of the parasite and the presence of working dogs that are allowed to eat the offal of infected sheep.
    
Alveolar echinococcosis (AE) is caused by infection with the larval stage of Echinococcus multilocularis. AE is found across the globe and is especially prevalent in the northern latitudes of Europe, Asia, and North America. The adult tapeworm is normally found in foxes, coyotes, and dogs. Infection with the larval stages is transmitted to people through ingestion of food or water contaminated with tapeworm eggs.
user: How to diagnose Parasites - Echinococcosis ?

assistant: The presence of a cyst-like mass in a person with a history of exposure to sheepdogs in an area where E. granulosus is endemic suggests a diagnosis of cystic echinococcosis. Imaging techniques, such as CT scans, ultrasonography, and MRIs, are used to detect cysts. After a cyst has been detected, serologic tests may be used to confirm the diagnosis.
    
Alveolar echinococcosis is typically found in older people. Imaging techniques such as CT scans are used to visually confirm the parasitic vesicles and cyst-like structures and serologic tests can confirm the parasitic infection.
user: What are the treatments for Parasites - Echinococcosis ?

assistant: In the past, surgery was the only treatment for cystic echinococcal cysts. Chemotherapy, cyst puncture, and PAIR (percutaneous aspiration, injection of chemicals and reaspiration) have been used to replace surgery as effective treatments for cystic echinococcosis. However, surgery remains the most effective treatment to remove the cyst and can lead to a complete cure. Some cysts are not causing any symptoms and are inactive; those cysts often go away without any treatment.
    
The treatment of alveolar echinococcosis is more difficult than cystic echinococcosis and usually requires radical surgery, long-term chemotherapy, or both.
    
More on: Resources for Health Professionals: Treatment
user: How to prevent Parasites - Echinococcosis ?

assistant: Cystic echinococcosis is controlled by preventing transmission of the parasite. Prevention measures include limiting the areas where dogs are allowed and preventing animals from consuming meat infected with cysts.
    
     - Prevent dogs from feeding on the carcasses of infected sheep.
     - Control stray dog populations.
     - Restrict home slaughter of sheep and other livestock.
     - Do not consume any food or water that may have been contaminated by fecal matter from dogs.
     - Wash your hands with soap and warm water after handling dogs, and before handling food.
     - Teach children the importance of washing hands to prevent infection.
    
    
Alveolar echinococcosis can be prevented by avoiding contact with wild animals such as foxes, coyotes, and dogs and their fecal matter and by limiting the interactions between dogs and rodent populations.
    
     - Do not allow dogs to feed on rodents and other wild animals.
     - Avoid contact with wild animals such as foxes, coyotes and stray dogs.
     - Do not encourage wild animals to come close to your home or keep them as pets.
     - Wash your hands with soap and warm water after handling dogs or cats, and before handling food.
     - Teach children the importance of washing hands to prevent infection.
    
    
More on: Handwashing
user: What is (are) Parasites - Loiasis ?

assistant: Loiasis is an infection caused by the parasitic worm Loa loa.
user: Who is at risk for Parasites - Loiasis? ?

assistant: Loa loa parasites are found in West and Central Africa. Ten countries have areas where there are high rates of infection (i.e., where more than 40% of the people who live in that area report that they have had eye worm in the past). An estimated 14.4 million people live in these areas of high rates of infection. Another 15.2 live in areas where 20–40% of people report that they have had eye worm in the past.
    
More on: Where Loa Loa is Prevelant [WHO Map]
    
The people most at risk for loiasis are those who live in the certain rain forests in West and Central Africa. The deerflies that pass the parasite to humans usually bite during the day and are more common during the rainy season. They are attracted by the movement of people and by smoke from wood fires. Rubber plantations are areas where more deerflies may be found. The flies do not typically enter homes, but they might be attracted to homes that are well lit.
    
Travelers are more likely to become infected if they are in areas where they are bitten by deerflies for many months, though occasionally they get infected even if they are in an affected area for less than 30 days.
    
Your risk of infection depends on the number of bites received, the number of infected deerflies in the area you visit, and the length of your stay in the area.
user: How to diagnose Parasites - Loiasis ?

assistant: In people who have been bitten by the flies that carry Loa loa in areas where Loa loa is known to exist, the diagnosis can be made in the following ways:
  
   - Identification of the adult worm by a microbiologist or pathologist after its removal from under the skin or eye
   - Identification of an adult worm in the eye by a health care provider
   - Identification of the microfilariae on a blood smear made from blood taken from the patient between 10AM and 2PM
   - Identification of antibodies against L. loa on specialized blood test
  
  
Diagnosis of loiasis can be difficult, especially in light infections where there are very few microfilariae in the blood. The specialized blood test is not widely available in the United States. A positive antibody blood test in someone with no symptoms means only that the person was infected sometime in his/her life. It does not mean that the person still has living parasites in his/her body.
user: What are the treatments for Parasites - Loiasis ?

assistant: Decisions about treatment of loiasis can be difficult and often require advice from an expert in infectious diseases or tropical medicine. Although surgical removal of adult worms moving under the skin or across the eye can be done to relieve anxiety, loiasis is not cured by surgery alone. There are two medications that can be used to treat the infection and manage the symptoms. The treatment of choice is diethylcarbamazine (DEC), which kills the microfilariae and adult worms. Albendazole is sometimes used in patients who are not cured with multiple DEC treatments. It is thought to kill adult worms. Certain people with heavy infections are at risk of brain inflammation when treated with DEC. This can cause coma or sometimes death. People with heavy infections need to be treated by experienced specialists.  Sometimes, other medical conditions need to be addressed first in order to make it safer to use DEC. Sometimes treatment is not recommended.
    
More on: Resources for Health Professionals: Treatment
user: How to prevent Parasites - Loiasis ?

assistant: There are no programs to control or eliminate loiasis in affected areas. Your risk of infection may be less in areas where communities receive regular treatment for onchocerciasis or lymphatic filariasis.
    
There are no vaccines that protect you from loiasis. If you are going to be in an area with loiasis for a long period of time, diethylcarbamazine (DEC)—300mg taken once a week—can reduce your risk of infection. Avoiding areas where the deerflies are found, such as muddy, shaded areas along rivers or around wood fires, may also reduce your risk of infection. You may reduce your risk of bites by using insect repellants that contain DEET (N,N-Diethyl-meta-toluamide) and wearing long sleeves and long pants during the day, which is when deerflies bite. Treating your clothes with permethrin may also help. For a description of CDC's information for preventing insect bites, see CDC's Yellow Book.
    
More on: Insect Bite Prevention
user: What is (are) Parasites - Paragonimiasis (also known as Paragonimus Infection) ?

assistant: Frequently Asked Queestions (FAQs)
user: Who is at risk for Parasites - Paragonimiasis (also known as Paragonimus Infection)? ?

assistant: Several species of Paragonimus cause most infections; the most important is P. westermani, which occurs primarily in Asia including China, the Philippines, Japan, Vietnam, South Korea, Taiwan, and Thailand. P. africanus causes infection in Africa, and P. mexicanus in Central and South America. Specialty dishes in which shellfish are consumed raw or prepared only in vinegar, brine, or wine without cooking play a key role in the transmission of paragonimiasis. Raw crabs or crayfish are also used in traditional medicine practices in Korea, Japan, and some parts of Africa.
    
Although rare, human paragonimiasis from P. kellicotti has been acquired in the United States, with multiple cases from the Midwest. Several cases have been associated with ingestion of uncooked crawfish during river raft float trips in Missouri.
user: How to diagnose Parasites - Paragonimiasis (also known as Paragonimus Infection) ?

assistant: The infection is usually diagnosed by identification of Paragonimus eggs in sputum. The eggs are sometimes found in stool samples (coughed-up eggs are swallowed). A tissue biopsy is sometimes performed to look for eggs in a tissue specimen.
    
Specific and sensitive antibody tests based on P. westermani antigens are available through CDC, and serologic tests using a variety of techniques are available through commercial laboratories.
    
More on: Resources for Health Professionals: Diagnosis
    
More on: DPDx: Paragonimus
user: What are the treatments for Parasites - Paragonimiasis (also known as Paragonimus Infection) ?

assistant: Paragonimus infections are treatable by your health care provider. Prescription medications are available.
    
More on: Resources for Health Professionals: Treatment
user: How to prevent Parasites - Paragonimiasis (also known as Paragonimus Infection) ?

assistant: Never eat raw freshwater crabs or crayfish. Cook crabs and crayfish for to at least 145°F (~63°C). Travelers should be advised to avoid traditional meals containing undercooked freshwater crustaceans.
    
More on: Fight BAC: Safe Food Handling
user: Who is at risk for Marburg hemorrhagic fever (Marburg HF)? ?

assistant: It is unknown how Marburg virus first transmits from its animal host to humans; however, for the 2 cases in tourists visiting Uganda in 2008, unprotected contact with infected bat feces or aerosols are the most likely routes of infection. 
  
After this initial crossover of virus from host animal to humans, transmission occurs through person-to-person contact. This may happen in several ways: direct contact to droplets of body fluids from infected persons, or contact with equipment and other objects contaminated with infectious blood or tissues. 
  
In previous outbreaks, persons who have handled infected non-human primates or have come in direct contact with their fluids or cell cultures have become infected. Spread of the virus between humans has occurred in close environments and direct contacts. A common example is through caregivers in the home or in a hospital (nosocomial transmission).
user: What are the symptoms of Marburg hemorrhagic fever (Marburg HF) ?

assistant: After an incubation period of 5-10 days, symptom onset is sudden and marked by fever, chills, headache, and myalgia. Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur. Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea may then appear. Symptoms become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction. 
 
Because many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases such as malaria or typhoid fever, clinical diagnosis of the disease can be difficult, especially if only a single case is involved. 
 
The case-fatality rate for Marburg hemorrhagic fever is between 23-90%. For a complete listing of the case fatality rates for previous outbreaks, please see the History of Outbreaks table
user: Who is at risk for Marburg hemorrhagic fever (Marburg HF)? ?

assistant: People who have close contact with African fruit bats, humans patients, or non-human primates infected with Marburg virus are at risk. 
                
Historically, the people at highest risk include family members and hospital staff who care for patients infected with Marburg virus and have not used proper barrier nursing techniques. Particular occupations, such as veterinarians and laboratory or quarantine facility workers who handle non-human primates from Africa, may also be at increased risk of exposure to Marburg virus. 
                
Exposure risk can be higher for travelers visiting endemic regions in Africa, including Uganda and other parts of central Africa, and have contact with fruit bats, or enter caves or mines inhabited by fruit bats.
user: How to diagnose Marburg hemorrhagic fever (Marburg HF) ?

assistant: Many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other more frequent infectious diseases, such as malaria or typhoid fever, making diagnosis of the disease difficult. This is especially true if only a single case is involved. 
 
However, if a person has the early symptoms of Marburg HF and there is reason to believe that Marburg HF should be considered, the patient should be isolated and public health professionals notified. Samples from the patient can then be collected and tested to confirm infection. 
 
Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing, polymerase chain reaction (PCR), and IgM-capture ELISA can be used to confirm a case of Marburg HF within a few days of symptom onset. Virus isolation may also be performed but should only be done in a high containment laboratory with good laboratory practices. The IgG-capture ELISA is appropriate for testing persons later in the course of disease or after recovery. In deceased patients, immunohistochemistry, virus isolation, or PCR of blood or tissue specimens may be used to diagnose Marburg HF retrospectively.
user: What are the treatments for Marburg hemorrhagic fever (Marburg HF) ?

assistant: There is no specific treatment for Marburg hemorrhagic fever. Supportive hospital therapy should be utilized, which includes balancing the patient's fluids and electrolytes, maintaining oxygen status and blood pressure, replacing lost blood and clotting factors, and treatment for any complicating infections. 
 
Experimental treatments are validated in non-human primates models, but have never been tried in humans.
user: How to prevent Marburg hemorrhagic fever (Marburg HF) ?

assistant: Preventive measures against Marburg virus infection are not well defined, as transmission from wildlife to humans remains an area of ongoing research. However, avoiding fruit bats, and sick non-human primates in central Africa, is one way to protect against infection. 
 
Measures for prevention of secondary, or person-to-person, transmission are similar to those used for other hemorrhagic fevers. If a patient is either suspected or confirmed to have Marburg hemorrhagic fever, barrier nursing techniques should be used to prevent direct physical contact with the patient. These precautions include wearing of protective gowns, gloves, and masks; placing the infected individual in strict isolation; and sterilization or proper disposal of needles, equipment, and patient excretions. 
 
In conjunction with the World Health Organization, CDC has developed practical, hospital-based guidelines, titled: Infection Control for Viral Haemorrhagic Fevers In the African Health Care Setting. The manual can help health-care facilities recognize cases and prevent further hospital-based disease transmission using locally available materials and few financial resources. 
 
Marburg hemorrhagic fever is a very rare human disease. However, when it occurs, it has the potential to spread to other people, especially health care staff and family members who care for the patient. Therefore, increasing awareness in communities and among health-care providers of the clinical symptoms of patients with Marburg hemorrhagic fever is critical. Better awareness can lead to earlier and stronger precautions against the spread of Marburg virus in both family members and health-care providers. Improving the use of diagnostic tools is another priority. With modern means of transportation that give access even to remote areas, it is possible to obtain rapid testing of samples in disease control centers equipped with Biosafety Level 4 laboratories in order to confirm or rule out Marburg virus infection.
user: What is (are) Parasites - Lymphatic Filariasis ?

assistant: Frequently Asked Questions (FAQs)
    
    Vector Information
user: Who is at risk for Parasites - Lymphatic Filariasis? ?

assistant: There are three different filarial species that can cause lymphatic filariasis in humans. Most of the infections worldwide are caused by Wuchereria bancrofti. In Asia, the disease can also be caused by Brugia malayi and Brugia timori.
    
The infection spreads from person to person by mosquito bites. The adult worm lives in the human lymph vessels, mates, and produces millions of microscopic worms, also known as microfilariae. Microfilariae circulate in the person's blood and infect the mosquito when it bites a person who is infected. Microfilariae grow and develop in the mosquito. When the mosquito bites another person, the larval worms pass from the mosquito into the human skin, and travel to the lymph vessels. They grow into adult worms, a process that takes 6 months or more. An adult worm lives for about 5–7 years. The adult worms mate and release millions of microfilariae into the blood. People with microfilariae in their blood can serve as a source of infection to others.
    
     
    
    
A wide range of mosquitoes can transmit the parasite, depending on the geographic area. In Africa, the most common vector is Anopheles and in the Americas, it is Culex quinquefasciatus. Aedes and Mansonia can transmit the infection in the Pacific and in Asia.
    
Many mosquito bites over several months to years are needed to get lymphatic filariasis. People living for a long time in tropical or sub-tropical areas where the disease is common are at the greatest risk for infection. Short-term tourists have a very low risk.
    
Programs to eliminate lymphatic filariasis are under way in more than 50 countries. These programs are reducing transmission of the filarial parasites and decreasing the risk of infection for people living in or visiting these communities.
    Geographic distribution
    
     
    
    
Lymphatic filariasis affects over 120 million people in 73 countries throughout the tropics and sub-tropics of Asia, Africa, the Western Pacific, and parts of the Caribbean and South America.
    
In the Americas, only four countries are currently known to be endemic: Haiti, the Dominican Republic, Guyana and Brazil.
    
In the United States, Charleston, South Carolina, was the last known place with lymphatic filariasis. The infection disappeared early in the 20th century. Currently, you cannot get infected in the U.S.
user: How to diagnose Parasites - Lymphatic Filariasis ?

assistant: The standard method for diagnosing active infection is the identification of microfilariae in a blood smear by microscopic examination. The microfilariae that cause lymphatic filariasis circulate in the blood at night (called nocturnal periodicity). Blood collection should be done at night to coincide with the appearance of the microfilariae, and a thick smear should be made and stained with Giemsa or hematoxylin and eosin. For increased sensitivity, concentration techniques can be used.
    
Serologic techniques provide an alternative to microscopic detection of microfilariae for the diagnosis of lymphatic filariasis. Patients with active filarial infection typically have elevated levels of antifilarial IgG4 in the blood and these can be detected using routine assays.
    
Because lymphedema may develop many years after infection, lab tests are most likely to be negative with these patients.
user: What are the treatments for Parasites - Lymphatic Filariasis ?

assistant: Patients currently infected with the parasite
    
Diethylcarbamazine (DEC) is the drug of choice in the United States. The drug kills the microfilaria and some of the adult worms. DEC has been used world-wide for more than 50 years. Because this infection is rare in the U.S., the drug is no longer approved by the Food and Drug Administration (FDA) and cannot be sold in the U.S. Physicians can obtain the medication from CDC after confirmed positive lab results. CDC gives the physicians the choice between 1 or 12-day treatment of DEC (6 mg/kg/day). One day treatment is generally as effective as the 12-day regimen. DEC is generally well tolerated. Side effects are in general limited and depend on the number of microfilariae in the blood. The most common side effects are dizziness, nausea, fever, headache, or pain in muscles or joints.
    
DEC should not be administered to patients who may also have onchocerciasis as  DEC can worsen onchocercal eye disease.  In patients with loiasis, DEC can cause serious adverse reactions, including encephalopathy and death. The risk and severity of the adverse reactions are related to Loa loa microfilarial density.
The drug ivermectin kills only the microfilariae, but not the adult worm; the adult worm is responsible for the pathology of lymphedema and hydrocele.
    
Some studies have shown adult worm killing with treatment with doxycycline (200mg/day for 4–6 weeks).  
    Patients with clinical symptoms
    
Lymphedema and elephantiasis are not indications for DEC treatment because most people with lymphedema are not actively infected with the filarial parasite.
    
To prevent the lymphedema from getting worse, patients should ask their physician for a referral to a lymphedema therapist so they can be informed about some basic principles of care such as hygiene, exercise and treatment of wounds.
    
Patients with hydrocele may have evidence of active infection, but typically do not improve clinically following treatment with DEC. The treatment for hydrocele is surgery.
    
More on: Resources for Health Professionals: Treatment