Shekswess/llama3_medquad_instruct_dataset huggingface dataset:
Question: Who is at risk for Marburg hemorrhagic fever (Marburg HF)? ?
Answer: 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.
Question: How to diagnose Marburg hemorrhagic fever (Marburg HF) ?
Answer: 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.
Question: What are the treatments for Marburg hemorrhagic fever (Marburg HF) ?
Answer: 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.
Question: How to prevent Marburg hemorrhagic fever (Marburg HF) ?
Answer: 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.
Question: What is (are) Parasites - Lymphatic Filariasis ?
Answer: Frequently Asked Questions (FAQs)
    
    Vector Information
Question: Who is at risk for Parasites - Lymphatic Filariasis? ?
Answer: 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.
Question: How to diagnose Parasites - Lymphatic Filariasis ?
Answer: 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.
Question: What are the treatments for Parasites - Lymphatic Filariasis ?
Answer: 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
Question: How to prevent Parasites - Lymphatic Filariasis ?
Answer: The best way to prevent lymphatic filariasis is to avoid mosquito bites. The mosquitoes that carry the microscopic worms usually bite between the hours of dusk and dawn. If you live in an area with lymphatic filariasis:
   
    - at night 
     
      - sleep in an air-conditioned room or
      - sleep under a mosquito net
     
    - between dusk and dawn 
     
      - wear long sleeves and trousers and
      - use mosquito repellent on exposed skin.
     
   
   
Another approach to prevention includes giving entire communities medicine that kills the microscopic worms -- and controlling mosquitoes. Annual mass treatment reduces the level of microfilariae in the blood and thus, diminishes transmission of infection. This is the basis of the global campaign to eliminate lymphatic filariasis.
   
Experts consider that lymphatic filariasis, a neglected tropical disease (NTD), can be eradicated and a global campaign to eliminate lymphatic filariasis as a public health problem is under way. The elimination strategy is based on annual treatment of whole communities with combinations of drugs that kill the microfilariae. As a result of the generous contributions of these drugs by the companies that make them, tens of millions of people are being treated each year. Since these drugs also reduce levels of infection with intestinal worms, benefits of treatment extend beyond lymphatic filariasis. Successful campaigns to eliminate lymphatic filariasis have taken place in China and other countries.
   
More on: Insect Bite Prevention
Question: What is (are) Q Fever ?
Answer: More detailed information on the diagnosis, management, and treatment of Q fever is available in other sections of this web site and in the materials referenced in the section titled “Further Reading”.  
 How to Contact the Rickettsial Zoonoses Branch at CDC 
 
The general public and healthcare providers should first call 1-800-CDC-INFO (1-800-232-4636) for questions regarding Q fever. If a consultation with a CDC scientist specializing in Q fever is advised, your call will be appropriately forwarded. 
 Case Definitions 
 
As of January 1, 2009, Q fever infections are reported under distinct reporting categories described in the 2009 Q fever surveillance case definition.
2009 Q Fever Case Definition 
 Case Report Forms 
 
For confirmed and probable cases of Q fever that have been identified and reported through the National Notifiable Disease Surveillance System, states are also encouraged to submit additional information using the CDC Case Report Form (CRF). This form collects additional important information that routine electronic reporting does not, such as information on how the diagnosis was made, and whether the patient was hospitalized or died. If a different state-specific form is already used to collect this information, this information may be submitted to CDC in lieu of a CRF. 
   
   
    
   
  
 How to Submit Specimens to CDC for Q FeverTesting 
 
Private citizens may not directly submit specimens to CDC for testing. If you feel that diagnostic testing is necessary, consult your healthcare provider or state health department. Laboratory testing is available at many commercial laboratories. 
 State Health Departments 
 
Specimens may be submitted to CDC for reference testing for Q fever. To coordinate specimen submission, please call 404-639-1075 during business hours (8:00 - 4:30 ET).  
 U.S. Healthcare Providers 
 
Q fever laboratory testing is available at many commercial laboratories. U.S. healthcare providers should not submit specimens for testing directly to CDC. CDC policy requires that specimens for testing be submitted through or with the approval of the state health department. Please contact your state health department and request assistance with specimen submission and reporting of infection. For general questions about Q fever, please call 1-800-CDC-INFO (1-800-232-4636). If you have questions about a suspect Q fever case, please first consult your state health department. Healthcare providers requiring an epidemiologic or laboratory consultation on Q fever may also call 404-639-1075 during business hours (8:00 - 4:30 ET). Or 770-488-7100 after hours.  
 Non-U.S. Healthcare Providers 
 
Non-U.S. healthcare providers should consult CDC prior to submitting specimens for testing. For general questions about Q fever, please call 1-800-CDC-INFO (1-800-232-4636). If you would like to discuss a suspect Q fever case with CDC, please call 404-639-1075 during business hours (8:00 - 4:30 ET), or 770-488-7100 after hours.
Question: How to prevent Q Fever ?
Answer: In the United States, Q fever outbreaks have resulted mainly from occupational exposure involving veterinarians, meat processing plant workers, sheep and dairy workers, livestock farmers, and researchers at facilities housing sheep. Prevention and control efforts should be directed primarily toward these groups and environments. 
 
The following measures should be used in the prevention and control of Q fever: 
  
  - Educate the public on sources of infection.  
  - Appropriately dispose of placenta, birth products, fetal membranes, and aborted fetuses at facilities housing sheep and goats.  
  - Restrict access to barns and laboratories used in housing potentially infected animals.   
  - Use appropriate procedures for bagging, autoclaving, and washing of laboratory clothing.  
  - Vaccinate (where possible) individuals engaged in research with pregnant sheep or live C. burnetii.  
  - Quarantine imported animals.  
  - Ensure that holding facilities for sheep should be located away from populated areas. Animals should be routinely tested for antibodies to C. burnetii, and measures should be implemented to prevent airflow to other occupied areas.  
  - Counsel persons at highest risk for developing chronic Q fever, especially persons with pre-existing cardiac valvular disease or individuals with vascular grafts.  
  
 
A vaccine for Q fever has been developed and has successfully protected humans in occupational settings in Australia. However, this vaccine is not commercially available in the United States. Persons wishing to be vaccinated should first have a skin test to determine a history of previous exposure. Individuals who have previously been exposed to C. burnetii should not receive the vaccine because severe reactions, localized to the area of the injected vaccine, may occur. A vaccine for use in animals has also been developed, but it is not available in the United States. 
 Significance for Bioterrorism 
 
Coxiella burnetii is a highly infectious agent that is rather resistant to heat and drying. It can become airborne and inhaled by humans. A single C. burnetii organism may cause disease in a susceptible person. This agent has a past history of being developed for use in biological warfare and is considered a potential terrorist threat.
Question: what are public health agencies doing to prevent or control botulism?
Answer: Public education about botulism prevention is an ongoing activity. Information about safe canning is widely available for consumers. Persons in state health departments and at CDC are knowledgeable about botulism and available to consult with physicians 24 hours a day. If antitoxin is needed to treat a patient, it can be quickly delivered to a physician anywhere in the country. Suspected outbreaks of botulism are quickly investigated, and if they involve a commercial product, the appropriate control measures are coordinated among public health and regulatory agencies. Physicians should immediately report suspected cases of botulism to their state health department.
                
For information and quidelines on canning foods at home: USDA Home Canning Guide
Question: Who is at risk for Parasites - Schistosomiasis? ?
Answer: Schistosomiasis is an important cause of disease in many parts of the world, most commonly in places with poor sanitation. School-age children who live in these areas are often most at risk because they tend to spend time swimming or bathing in water containing infectious cercariae.
If you live in, or travel to, areas where schistosomiasis is found and are exposed to contaminated freshwater, you are at risk.
   
Areas where human schistosomiasis is found include:
   
    - Schistosoma mansoni 
     
      - distributed throughout Africa: There is risk of infection in freshwater in southern and sub-Saharan Africa–including the great lakes and rivers as well as smaller bodies of water. Transmission also occurs in the Nile River valley in Sudan and Egypt
      - South America: including Brazil, Suriname, Venezuela
      - Caribbean (risk is low): Dominican Republic, Guadeloupe, Martinique, and Saint Lucia.
     
    - S. haematobium 
     
      - distributed throughout Africa: There is risk of infection in freshwater in southern and sub-Saharan Africa–including the great lakes and rivers as well as smaller bodies of water. Transmission also occurs in the Nile River valley in Egypt and the Mahgreb region of North Africa.
      - found in areas of the Middle East
     
    - S. japonicum 
     
      - found in Indonesia and parts of China and Southeast Asia
     
    - S. mekongi 
     
      - found in Cambodia and Laos
     
    - S. intercalatum 
     
      - found in parts of Central and West Africa.
Question: How to diagnose Parasites - Schistosomiasis ?
Answer: Stool or urine samples can be examined microscopically for parasite eggs (stool for S. mansoni or S. japonicum eggs and urine for S. haematobium eggs). The eggs tend to be passed intermittently and in small amounts and may not be detected, so it may be necessary to perform a blood (serologic) test.
    
More on: Resources for Health Professionals: Diagnosis
Question: What are the treatments for Parasites - Schistosomiasis ?
Answer: Safe and effective medication is available for treatment of both urinary and intestinal schistosomiasis. Praziquantel, a prescription medication, is taken for 1-2 days to treat infections caused by all Schistosoma species.
    
More on: Resources for Health Professionals: Treatment
Question: How to prevent Parasites - Schistosomiasis ?
Answer: Prevention
    
No vaccine is available.
    
The best way to prevent schistosomiasis is to take the following steps if you are visiting or live in an area where schistosomiasis is transmitted:
    
     - Avoid swimming or wading in freshwater when you are in countries in which schistosomiasis occurs. Swimming in the ocean and in chlorinated swimming pools is safe.
     - Drink safe water. Although schistosomiasis is not transmitted by swallowing contaminated water, if your mouth or lips come in contact with water containing the parasites, you could become infected. Because water coming directly from canals, lakes, rivers, streams, or springs may be contaminated with a variety of infectious organisms, you should either bring your water to a rolling boil for 1 minute or filter water before drinking it. Bring your water to a rolling boil for at least 1 minute will kill any harmful parasites, bacteria, or viruses present. Iodine treatment alone WILL NOT GUARANTEE that water is safe and free of all parasites.
     - Water used for bathing should be brought to a rolling boil for 1 minute to kill any cercariae, and then cooled before bathing to avoid scalding. Water held in a storage tank for at least 1 - 2 days should be safe for bathing.
     - Vigorous towel drying after an accidental, very brief water exposure may help to prevent the Schistosoma parasite from penetrating the skin. However, do not rely on vigorous towel drying alone to prevent schistosomiasis.
    
    
Those who have had contact with potentially contaminated water overseas should see their health care provider after returning from travel to discuss testing.
    
More on: Schistosomiasis in Travelers
   
  
  
   Control
   
In countries where schistosomiasis causes significant disease, control efforts usually focus on:
   
    - reducing the number of infections in people and/or
    - eliminating the snails that are required to maintain the parasite’s life cycle.
   
   
For all species that cause schistosomiasis, improved sanitation could reduce or eliminate transmission of this disease. In some areas with lower transmission levels, elimination of schistosomiasis is considered a "winnable battle" by public health officials.
   
Control measures can include mass drug treatment of entire communities and targeted treatment of school-age children. Some of the problems with control of schistosomiasis include:
   
    - Chemicals used to eliminate snails in freshwater sources may harm other species of animals in the water and, if treatment is not sustained, the snails may return to those sites afterwards.
    - For certain species of the parasite, such as S. japonicum, animals such as cows or water buffalo can also be infected. Runoff from pastures (if the cows are infected) can contaminate freshwater sources.
Question: Who is at risk for Nocardiosis? ?
Answer: The bacteria that cause nocardiosis are commonly found in soil and water.
    
You could become sick with nocardiosis if:
    
     - You inhale (breathe in) the bacteria
     - Bacteria gets into an open wound or cut
    
    
In rare cases, infection can occur during surgical procedures.
    
Fortunately, nocardiosis is not spread person to person, so being around someone who has the disease will not make you sick.