Shekswess/llama3_medquad_instruct_dataset huggingface dataset:
Question: What are the symptoms of Lujo Hemorrhagic Fever (LUHF) ?
Answer: The symptoms of Lujo hemorrhagic fever, as described in the five patients in the original cluster outbreak, resemble those of severe Lassa Fever. After an incubation period of 7 to 13 days, the clinical course started by a non-specific febrile illness accompanied by headache and muscle pain. 
                
The disease increases in severity, with: 
 
 - a morbilliform rash of the face and trunk 
 - face and neck swelling 
 - pharyngitis (sore throat) 
 - diarrhea 
 
                
Bleeding was not a prominent feature during the illness. 
                
In the fatal cases (4/5 patients), a transient improvement was followed by: 
 
 - rapid deterioration with respiratory distress 
 - neurological signs and circulatory collapse 
 
                
Death occurred 10 to 13 days after onset. 
                
Low blood platelets, low white blood cell count (at the onset, rising later on) and elevated liver function values were present in all patients. 
                
Since Arenaviruses may enter the fetus through infection of the mother, and anectodal 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 Lujo infection in the mother.
Question: Who is at risk for Lujo Hemorrhagic Fever (LUHF)? ?
Answer: Lujo hemorrhagic fever (LUHF) occurs in southern Africa. The initial case was certainly infected in Zambia. 
   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. In addition to nosocomial infection in healthcare workers already described, laboratory infections have been frequently described with Arenaviruses and Lujo virus can certainly be transmitted to laboratory workers during manipulation of the virus, especially during experimental infections of rodents.
Question: How to diagnose Lujo Hemorrhagic Fever (LUHF) ?
Answer: During the acute febrile phase, Lujo virus was isolated from blood from days 2 to 13 after onset. Virus was also isolated from liver tissue obtained post-mortem. A subsequent complete genomic analysis of Lujo virus facilitated the development of specific molecular detection (RT-PCR) assays. 
   
Serologic diagnosis of Lujo hemorrhagic fever can be made by indirect immunofluorescent assay and ELISA. However, individuals from endemic areas displaying fever, rash, pharyngitis, accompanied by laboratory findings of low platelet counts and elevated liver enzymes, should be suspected of having a hemorrhagic fever virus infection. Clinical specimens should be tested using specific assays.
Question: What are the treatments for Lujo Hemorrhagic Fever (LUHF) ?
Answer: Supportive therapy is important in Lujo hemorrhagic fever. This includes: 
    
    - maintenance of hydration 
    - management of shock 
    - sedation 
    - pain relief 
    - usual precautions for patients with bleeding disorders 
    - transfusions (when necessary) 
    
   
Treatment of arenavirus hemorrhagic fevers with convalescent plasma therapy reduces mortality significantly and anectodal evidence from the only surviving Lujo patient shows that the antiviral drug ribavirin may hold promise in the treatment of LUHF. Ribavirin has been considered for preventing development of disease in people exposed to other arenaviruses. 
   Recovery 
   
The precise mortality of LUHF is unknown, but 4 of 5 described cases were fatal. 
   
Patients who have suffered from other arenaviruses may 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.
Question: How to prevent Lujo Hemorrhagic Fever (LUHF) ?
Answer: Although rodent control would be desirable, it will not be a successful strategy for preventing Lujo 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 LUHF cases (no infection occurred after their implementation in South Africa).
Question: How to diagnose Parasites - Toxoplasmosis (Toxoplasma infection) ?
Answer: The diagnosis of toxoplasmosis is typically made by serologic testing. A test that measures immunoglobulin G (IgG) is used to determine if a person has been infected. If it is necessary to try to estimate the time of infection, which is of particular importance for pregnant women, a test which measures immunoglobulin M (IgM) is also used along with other tests such as an avidity test.
    
Diagnosis can be made by direct observation of the parasite in stained tissue sections, cerebrospinal fluid (CSF), or other biopsy material. These techniques are used less frequently because of the difficulty of obtaining these specimens.
    
Parasites can also be isolated from blood or other body fluids (for example, CSF) but this process can be difficult and requires considerable time.
    
Molecular techniques that can detect the parasite's DNA in the amniotic fluid can be useful in cases of possible mother-to-child (congenital) transmission.
    
Ocular disease is diagnosed based on the appearance of the lesions in the eye, symptoms, course of disease, and often serologic testing.
Question: What are the treatments for Parasites - Toxoplasmosis (Toxoplasma infection) ?
Answer: Healthy people (nonpregnant)
    
Most healthy people recover from toxoplasmosis without treatment. Persons who are ill can be treated with a combination of drugs such as pyrimethamine and sulfadiazine, plus folinic acid.
    
     
    Pregnant women, newborns, and infants
    
Pregnant women, newborns, and infants can be treated, although the parasite is not eliminated completely. The parasites can remain within tissue cells in a less active phase; their location makes it difficult for the medication to completely eliminate them.
    
     
    Persons with ocular disease
    
Persons with ocular toxoplasmosis are sometimes prescribed medicine to treat active disease by their ophthalmologist. Whether or not medication is recommended depends on the size of the eye lesion, the location, and the characteristics of the lesion (acute active, versus chronic not progressing).
    
     
    Persons with compromised immune systems
    
Persons with compromised immune systems need to be treated until they have improvement in their condition. For AIDS patients, continuation of medication for the rest of their lives may be necessary, or for as long as they are immunosuppressed.
    
More on: Resources for Health Professionals: Treatment
Question: How to prevent Parasites - Toxoplasmosis (Toxoplasma infection) ?
Answer: People who are healthy should follow the guidelines below to reduce risk of toxoplasmosis. If you have a weakened immune system, please see guidelines for Immunocompromised Persons.
   Reduce Risk from Food
   
To prevent risk of toxoplasmosis and other infections from food:
   
    - Freeze meat for several days at sub-zero (0° F) temperatures before cooking to greatly reduce chance of infection.
    - Peel or wash fruits and vegetables thoroughly before eating. 
     
      
     
    - Wash cutting boards, dishes, counters, utensils, and hands with hot soapy water after contact with raw meat, poultry, seafood, or unwashed fruits or vegetables.
   
   
More on: Handwashing
   
The U.S. Government and the meat industry continue their efforts to reduce T. gondii in meat.
   Reduce Risk from the Environment
   
To prevent risk of toxoplasmosis from the environment:
   
    - Avoid drinking untreated drinking water.
    - Wear gloves when gardening and during any contact with soil or sand because it might be contaminated with cat feces that contain Toxoplasma. Wash hands with soap and warm water after gardening or contact with soil or sand.
    - Teach children the importance of washing hands to prevent infection.
    - Keep outdoor sandboxes covered. 
     
      
     
    - Feed cats only canned or dried commercial food or well-cooked table food, not raw or undercooked meats.
    - Change the litter box daily if you own a cat. The Toxoplasma parasite does not become infectious until 1 to 5 days after it is shed in a cat's feces. If you are pregnant or immunocompromised: 
     
      - Avoid changing cat litter if possible. If no one else can perform the task, wear disposable gloves and wash your hands with soap and warm water afterwards.
      - Keep cats indoors.
      - Do not adopt or handle stray cats, especially kittens. Do not get a new cat while you are pregnant.
Question: What is (are) Acinetobacter in Healthcare Settings ?
Answer: Acinetobacter [asz−in−ée−toe–back−ter] is a group of bacteria commonly found in soil and water. While there are many types or “species” of Acinetobacter and all can cause human disease, Acinetobacter baumannii [asz−in−ée−toe–back−ter   boe-maa-nee-ie] accounts for about 80% of reported infections.
                
Outbreaks of Acinetobacter infections typically occur in intensive care units and healthcare settings housing very ill patients. Acinetobacter infections rarely occur outside of healthcare settings.
Question: Who is at risk for Hendra Virus Disease (HeV)? ?
Answer: Transmission of Hendra virus to humans can occur after exposure to body fluids and tissues or excretions of horses infected with Hendra virus. 
 
Horses may be infected after exposure to virus in the urine of infected flying foxes. 
 
To date, no human-to-human transmission has been documented.
Question: What are the symptoms of Hendra Virus Disease (HeV) ?
Answer: After an incubation of 9-16 days, infection with Hendra virus can lead to respiratory illness with severe flu-like signs and symptoms. In some cases, illness may progress to encephalitis. 
                
Although infection with Hendra virus is rare, the case fatality is high: 4/7 (57%).
Question: Who is at risk for Hendra Virus Disease (HeV)? ?
Answer: Australia’s “Flying fox” bats (genus Pteropus) are the natural reservoir of Hendra virus. Serologic evidence for HeV infection have been found in all fours species of Australian flying foxes, but spillover of the virus in horses is limited to coastal and forested regions in Australia (Queensland and New South Wales states)  (see Henipavirus Distribution Map). 
                
People at highest risk are those living within the distribution of the flying foxes and with occupational or recreational exposure to horses that have had potential contact with flying foxes in Australia.
Question: What are the treatments for Hendra Virus Disease (HeV) ?
Answer: The drug ribavirin has been shown to be effective against the viruses in vitro, but the clinical usefulness of this drug is uncertain. 
                
A post-exposure therapy with a Nipah/Hendra neutralizing antibody, efficacious in animal models is in human preclinical development stages in Australia.
Question: How to prevent Hendra Virus Disease (HeV) ?
Answer: The occurrence of the disease in humans has been associated only with infection of an intermediate species such as horses.  Early recognition of the disease in the intermediate animal host is probably the most crucial means of limiting future human cases.  
                
Hendra virus infection can be prevented by avoiding horses that are ill or may be infected with HeV and using appropriate personal protective equipment when contact is necessary, as in veterinary procedures. 
                
A commercial vaccine has been recently licensed in Australia for horses and could be beneficial for other animal species and eventually humans.
Question: How to prevent Varicella (Chickenpox) Vaccination ?
Answer: At a Glance 
 
Vaccine-preventable disease levels are at or near record lows. Even though most infants and toddlers have received all recommended vaccines by age 2, many under-immunized children remain, leaving the potential for outbreaks of disease. Many adolescents and adults are under-immunized as well, missing opportunities to protect themselves against diseases such as Hepatitis B, influenza, and pneumococcal disease. CDC works closely with public health agencies and private partners to improve and sustain immunization coverage and to monitor the safety of vaccines so that this public health success story can be maintained and expanded in the century to come.  
  
 Vaccine Shortages & Delays 
  
   
   
 
   
  
  
   
   
The latest national information about vaccine supplies and guidance for healthcare providers who are facing vaccine shortages or delays 
     
    
   
  
  
 
  
  
  
 Potential New Vaccines 
  
   
   
 
   
  
  
   
   
Resources for finding information on potential vaccines, research and development status, licensure status, etc. 
       
    
   
  
  
 
  
  
  
 Vaccines: The Basics 
  
   
   
 
   
  
  
   
   
Without vaccines, epidemics of many preventable diseases could return, resulting in increased – and unnecessary – illness, disability, and death. 
          
    
   
  
  
 
  
  
  
 FAQ about Vaccines & Diseases they Prevent 
  
   
   
 
   
  
  
   
          
    
   
  
  
 
  
  
   
  
                
 
                
 
 
 
                
  
 
  
  
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Question: what are the signs and symptoms of rabies?
Answer: The first symptoms of rabies may be very similar to those of the flu including general weakness or discomfort, fever, or headache. These symptoms may last for days.
                
There may be also discomfort or a prickling or itching sensation at the site of bite, progressing within days to symptoms of cerebral dysfunction, anxiety, confusion, agitation. As the disease progresses, the person may experience delirium, abnormal behavior, hallucinations, and insomnia.
                
The acute period of disease typically ends after 2 to 10 days. Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive.
                
Disease prevention includes administration of both passive antibody, through an injection of human immune globulin and a round of injections with rabies vaccine.
                
Once a person begins to exhibit signs of the disease, survival is rare. To date less than 10 documented cases of human survival from clinical rabies have been reported and only two have not had a history of pre- or postexposure prophylaxis.
Question: what is the risk for my pet for Rabies ?
Answer: Any animal bitten or scratched by either a wild, carnivorous mammal or a bat that is not available for testing should be regarded as having been exposed to rabies.
  
Unvaccinated dogs, cats, and ferrets exposed to a rabid animal should be euthanized immediately. If the owner is unwilling to have this done, the animal should be placed in strict isolation for 6 months and vaccinated 1 month before being released.
  
Animals with expired vaccinations need to be evaluated on a case-by-case basis. Dogs and cats that are currently vaccinated are kept under observation for 45 days.
  
Small mammals such as squirrels, rats, mice, hamsters, guinea pigs, gerbils, chipmunks, rabbits, and hares are almost never found to be infected with rabies and have not been known to cause rabies among humans in the United States. Bites by these animals are usually not considered a risk of rabies unless the animal was sick or behaving in any unusual manner and rabies is widespread in your area.
  
However, from 1985 through 1994, woodchucks accounted for 86% of the 368 cases of rabies among rodents reported to CDC. Woodchucks or groundhogs (Marmota monax) are the only rodents that may be frequently submitted to state health department because of a suspicion of rabies. In all cases involving rodents, the state or local health department should be consulted before a decision is made to initiate postexposure prophylaxis (PEP).
  Is there rabies in my area?
  
Each state collects specific information about rabies, and is the best source for information on rabies in your area. In addition, the CDC publishes rabies surveillance data every year for the United States. The report, entitled Rabies Surveillance in the United States, contains information about the number of cases of rabies reported to CDC during the year, the animals reported rabid, maps showing where cases were reported for wild and domestic animals, and distribution maps showing outbreaks of rabies associated with specific animals.
Question: how is rabies diagnosed?
Answer: In animals, rabies is diagnosed using the direct fluorescent antibody (DFA) test, which looks for the presence of rabies virus antigens in brain tissue. In humans, several tests are required.
 
Rapid and accurate laboratory diagnosis of rabies in humans and other animals is essential for timely administration of postexposure prophylaxis. Within a few hours, a diagnostic laboratory can determine whether or not an animal is rabid and inform the responsible medical personnel. The laboratory results may save a patient from unnecessary physical and psychological trauma, and financial burdens, if the animal is not rabid.
 
In addition, laboratory identification of positive rabies cases may aid in defining current epidemiologic patterns of disease and provide appropriate information for the development of rabies control programs.
 
The nature of rabies disease dictates that laboratory tests be standardized, rapid, sensitive, specific, economical, and reliable.
Question: What is (are) Pneumonia ?
Answer: Pneumonia (nu-MO-ne-ah) is an infection in one or both of the lungs. Many germssuch as bacteria, viruses, and fungican cause pneumonia.
                
The infection inflames your lungs' air sacs, which are called alveoli (al-VEE-uhl-eye). The air sacs may fill up with fluid or pus, causing symptoms such as a cough with phlegm (a slimy substance), fever, chills, and trouble breathing.
                
Overview
                
Pneumonia and its symptoms can vary from mild to severe. Many factors affect how serious pneumonia is, such as the type of germ causing the infection and your age and overall health.
                
Pneumonia tends to be more serious for:
                
Infants and young children.
                
Older adults (people 65 years or older).
                
People who have other health problems, such as heart failure, diabetes, or COPD (chronic obstructive pulmonary disease).
                
People who have weak immune systems as a result of diseases or other factors. Examples of these diseases and factors include HIV/AIDS, chemotherapy (a treatment for cancer), and an organ transplant or blood and marrow stem cell transplant.
                
Outlook
                
Pneumonia is common in the United States. Treatment for pneumonia depends on its cause, how severe your symptoms are, and your age and overall health. Many people can be treated at home, often with oral antibiotics.
                
Children usually start to feel better in 1 to 2 days. For adults, it usually takes 2 to 3 days. Anyone who has worsening symptoms should see a doctor.
                
People who have severe symptoms or underlying health problems may need treatment in a hospital. It may take 3 weeks or more before they can go back to their normal routines.
                
Fatigue (tiredness) from pneumonia can last for a month or more.
Question: Who is at risk for Pneumonia? ?
Answer: Pneumonia can affect people of all ages. However, two age groups are at greater risk of developing pneumonia:
                
Infants who are 2 years old or younger (because their immune systems are still developing during the first few years of life)
                
People who are 65 years old or older
                
Other conditions and factors also raise your risk for pneumonia. You're more likely to get pneumonia if you have a lung disease or other serious disease. Examples include cystic fibrosis, asthma, COPD (chronic obstructive pulmonary disease), bronchiectasis, diabetes, heart failure, and sickle cell anemia.
                
You're at greater risk for pneumonia if you're in a hospital intensive-care unit, especially if you're on a ventilator (a machine that helps you breathe).
                
Having a weak or suppressed immune system also raises your risk for pneumonia. A weak immune system may be the result of a disease such as HIV/AIDS. A suppressed immune system may be due to an organ transplant or blood and marrow stem cell transplant, chemotherapy (a treatment for cancer), or long-term steroid use.
                
Your risk for pneumonia also increases if you have trouble coughing because of a stroke or problems swallowing. You're also at higher risk if you can't move around much or are sedated (given medicine to make you relaxed or sleepy).
                
Smoking cigarettes, abusing alcohol, or being undernourished also raises your risk for pneumonia. Your risk also goes up if you've recently had a cold or the flu, or if you're exposed to certain chemicals, pollutants, or toxic fumes.