Communicable Diseases

The following are common communicable diseases on college campuses.

• Gastrointestinal (GI) Infections
• Respiratory Illnesses
• Sexually Transmitted Infections
• Travel-Related Illnesses
• Viral Infections
• Other Illnesses
   

Gastrointestinal (GI) Infections

Campylobacter

Campylobacter infection, or campylobacteriosis, is a bacterial infection. It is one of the most common causes of diarrheal illness in the United States, and cases are more common in the summer.

How is it transmitted?

Campylobacter infection is normally spread through undercooked meat or from contamination of other foods and surfaces (e.g. a cutting board). This usually happens by:

• Eating food or drinking liquids that are contaminated
• Touching contaminated surfaces or objects and then touching your fingers to your mouth

Signs and symptoms

The most common symptoms are diarrhea (often bloody), fever, and abdominal cramps. Vomiting and nausea are sometimes associated with the diarrhea. Symptoms usually start within two-five days after exposure and can last up to a week.

Treatment

Most people will recover from campylobacter infection without treatment. You should drink plenty of liquids to replace fluid lost from vomiting and diarrhea; this will help prevent dehydration.

Prevention

• Hand washing, especially after using the bathroom and before handling food.
• Clean and disinfect contaminated areas.

If you think you have a campylobacter infection, you should contact Student Health and Counseling at 215-746-WELL (9355) if symptoms persist or if you have any questions about your symptoms or treatment.

Source: https://www.cdc.gov/campylobacter/

Cryptosporidium

Cryptosporidium is a gastrointestinal infection caused by cryptosporidium parasite. The parasites are transmitted through feces of infected animals, which can cause infection in humans via food, water, and hand-to-mouth activity

How is it transmitted?

The parasites are transmitted through feces of infected animals, which can cause infection in humans via food, water, and hand-to-mouth activity. Human to human transmission is possible when someone comes in contact with the fecal matter from an infected person.

While this parasite can be spread in several different ways, water (drinking water and recreational water) is the most common way to spread the parasite.

Signs and Symptoms

Symptoms include watery diarrhea, stomach cramps, nausea, vomiting, and fever.

Treatment

Most people with healthy immune systems will recover without treatment. It is also important to treat diarrhea and dehydration symptoms by drinking plenty of fluids.

Prevention

• Alcohol-based hand sanitizers are not effective against Crypto. Washing hands at key times (after using the toilet, touching animals, and before handling or eating food) with soap and water can help prevent infections.
• Limit contact with young children, elderly, and sick individuals
• Do not swim for 2 weeks after symptoms are resolved

If you think you have a cryptosporidium infection, you should contact Student Health and Counseling at 215-746-WELL (9355) if symptoms persist or if you have any questions about your symptoms or treatment. 

Source: https://www.cdc.gov/cryptosporidium/about/index.html

 

E. coli 

While people naturally have E. coli in their intestines, some strains of these bacteria can potentially cause severe illness. E. coli infections are relatively common and can cause symptoms such as stomach pain, nausea, vomiting, diarrhea, and bloody bowel movements.  

How is it transmitted?

E. coli is normally transmitted by contaminated food or water, or by transferring the bacteria from your hands to your mouth after touching contaminated food and not thoroughly washing your hands. It can also be transferred by the fecal-oral route, meaning that in addition to touching contaminated food, you could become infected after unintentionally ingesting the feces (poop) of an infected person. Common sources include:

• Contaminated foods
  • Meats, particularly processed meats like ground beef, can become contaminated during the butchering process.
  • Unpasteurized juices, milk, and cheeses made from unpasteurized milk can contain bacteria which would otherwise be killed during pasteurization.
  • Fruits and vegetables, particularly raw produce, can be contaminated when grown near or watered with water from animal farms and not thoroughly washed or cooked after harvest.
• Contaminated water
  • Many sources of water, including streams, ponds, rivers, and swimming pools can be contaminated by the poop of infected people or animals. Consuming water from these sources, even accidentally, can cause infection.
• Cross-contamination
  • Even if you thoroughly cook your food, reusing surfaces or cooking utensils which touched contaminated food while it was raw without thoroughly washing them in between uses can cause infection.
• Fecal-oral
  • Feces can transfer to people’s hands from changing a baby’s diaper, wiping themselves, or interacting with animals. If you perform any of these activities, or touch surfaces after someone who did, and then touch your mouth or eat food with your hands, you can transfer the bacteria to your mouth and become infected. Likewise, if you eat food prepared by someone who did not properly wash their hands, you can be at risk of becoming infected.

After becoming infected, the incubation period, or time until experiencing symptoms, ranges from 3 to 8 days.

Signs and Symptoms

The most common symptoms include diarrhea, vomiting, and stomach cramps, which can be severe. Less common symptoms include a mild fever of less than 101˚F. In rare cases, infection with E. coli can cause a life-threatening complication called hemolytic uremic syndrome (HUS), a type of kidney failure, which includes symptoms like blood in the urine, extreme fatigue, easy bruising, and bleeding, and swelling of the legs. 

Treatment

Antibiotics are not effective against intestinal E. coli infections, meaning there is no treatment to specifically combat infection. Additionally, taking medicines like Imodium or Pepto-Bismol to stop the diarrhea can increase the risk of HUS. Instead, treatment is focused on preventing dehydration, so those infected should focus on drinking plenty of fluids and resting while experiencing symptoms.

Prevention

• Ensure food, particularly ground meat, is properly prepared and cooked.
• Avoid unpasteurized dairy or juice products.
• Wash all fruits and vegetables, particularly those which will be consumed raw.
• Wash utensils and cooking surfaces with soap and hot water before reusing.
• Avoid swallowing water while swimming in streams, ponds, rivers, and pools.
• Wash your hands for at least 20 seconds with soap and water before eating.

If you think you have an E. coli infection, you can contact Student Health and Counseling at 215-746-WELL (9355) if symptoms persist or if you have any questions about your symptoms or treatment.

Sources:  
https://www.cdc.gov/ecoli/
https://my.clevelandclinic.org/health/diseases/16638-e-coli-infection

Norovirus

Norovirus is a contagious virus that causes your stomach and/or intestines to get inflamed (acute gastroenteritis). This leads you to have stomach pain, nausea, diarrhea and vomiting. Norovirus is the most common cause of acute gastroenteritis in the United States. Norovirus is also the most common cause of foodborne-disease outbreaks in the United States.

How is it transmitted?

Norovirus is normally transmitted by fecal-oral route, through direct person-to-person contact and indirect transmission through contaminated food, water, or environmental surfaces. This usually happens by:

• Eating food or drinking liquids that are contaminated with norovirus
• Touching surfaces or objects contaminated with norovirus, then putting your fingers in your mouth
• Having contact with someone who is infected with norovirus (e.g. caring for, sharing food, or eating utensils with someone with norovirus illness)

The incubation period for norovirus is 24-48 hours, with the duration of illness lasting 12-60 hours.

Signs and symptoms

The most common symptoms are diarrhea, vomiting, nausea, stomach pain, fever, headache, and body aches. Dehydration is the most common complication of norovirus.

Treatment

There is no specific medicine to treat people with norovirus infection. Viral gastroenteritis cannot be treated with antibiotics because it is a viral (not bacterial) infection. If you have gastroenteritis, you should drink plenty of liquids to replace fluid lost from vomiting and diarrhea. This will help prevent dehydration.

Prevention

• Hand washing, especially after using the bathroom and before handling food.
• Clean and disinfect contaminated areas.

If you think you have norovirus illness, you can contact Student Health and Counseling at 215-746-WELL (9355) if symptoms persist or if you have any questions about your symptoms or treatment.

Source: https://www.cdc.gov/norovirus/

 

Salmonella

Salmonella is a bacteria known for causing diarrheal illness, accounting for more than a million infections yearly in the United States. Infection with Salmonella can cause diarrhea, fever, and stomach cramps, and is often caused by contaminated food products.

How is it transmitted?

Salmonella is normally transmitted by contaminated food or water. It can also be transferred by the fecal-oral route, meaning that in addition to touching contaminated food, you could become infected after unintentionally ingesting the feces (poop) of an infected person.

Common sources include:

• Contaminated foods
  • Meat and animal products, particularly infected chickens and their eggs, can cause infection if not properly cooked.
  • Unpasteurized milk, cheese, and other dairy products made from unpasteurized milk can contain bacteria which would otherwise be killed during pasteurization.
  • Fruits and vegetables, particularly raw produce, can be contaminated when grown near or watered with water from animal farms and not thoroughly washed or cooked after harvest.
• Contaminated water
  • Many sources of water, including streams, ponds, rivers, and swimming pools can be contaminated by the poop of infected people or animals. Consuming water from these sources, even accidentally, can cause infection.
• Cross-contamination
  • Even if you thoroughly cook your food, reusing surfaces or cooking utensils which touched contaminated food while it was raw without thoroughly washing them in between uses can cause infection. 
• Fecal-oral
  • Feces can transfer to people’s hands from changing a baby’s diaper, wiping themselves, or interacting with animals. If you perform any of these activities, or touch surfaces after someone who did, and then touch your mouth or eat food with your hands, you can transfer the bacteria to your mouth and become infected. Likewise, if you eat food prepared by someone who did not properly wash their hands, you can be at risk of becoming infected.

After becoming infected, people often begin to experience symptoms within 8 to 72 hours, with symptoms lasting up to a week.

Signs and symptoms

Symptoms of Salmonella infection can include diarrhea, stomach cramps, fever, nausea, vomiting, headache, and blood in the stool. Many of these symptoms will last between several days and one week, although diarrhea may last up to 10 days, and bowel movements may not return to normal for several months after infection.

Treatment

Although most people who are infected with Salmonella will recover in about a week without any treatment, it is important to stay rested and replenish fluids to prevent dehydration caused by the diarrhea. In rare cases where the illness is severe or the person is at risk of complications, a doctor may prescribe antibiotics to help treat the illness. Those who may benefit from additional care include infants, the elderly, or those with compromised immune systems.

Prevention

While you cannot prevent all risk of the disease, such as the risk caused by improper food handling in restaurants where you eat, here are some tips to help you reduce your risk of Salmonella infection:

• Ensure food is properly prepared and cooked.
• Do not prewash raw chicken and thoroughly clean all surfaces and utensils that touch raw meat throughout food preparation.
• Avoid raw or undercooked eggs, including homemade ice cream and cookie dough.
• Avoid unpasteurized dairy.
• Wash all fruits and vegetables, particularly those which will be consumed raw.
• Wash utensils and cooking surfaces with soap and hot water before reusing.
• Avoid swallowing water while swimming in streams, ponds, rivers, and pools.

Wash your hands for at least 20 seconds with soap and water before eating. If you think you have a Salmonella infection, you can contact Student Health and Counseling at 215-746-WELL (9355) if symptoms persist or if you have any questions about your symptoms or treatment.

Sources:  
https://www.cdc.gov/salmonella/index.html
https://www.mayoclinic.org/diseases-conditions/salmonella/symptoms-causes/syc-20355329

Shigella

Shigella bacteria cause an infection called shigellosis. Shigella can spread easily from one person to another—and it only takes a small amount of Shigella to cause illness. Learn how Shigella spreads and why some people have a greater chance of getting sick.

How is it transmitted?

Shigella spread easily; it takes just a small number of bacteria to make someone ill. People with a Shigella infection can spread the infection to others for several weeks after their diarrhea ends.

You can get infected by swallowing Shigella. Some ways Shigella can get into your mouth are:

• Getting Shigella on your hands and touching your mouth. Shigella can get on your hands by:
• Touching surfaces, such as toys, bathroom fixtures, changing tables, and diaper pails, contaminated with Shigella bacteria from someone with an infection.
• Changing the diaper of a child with a Shigella infection.
• Taking care of a person with an infection, including cleaning up after the person uses the toilet.
• Eating food prepared by someone with a Shigella infection.
• Swallowing water you swim or play in, such as lake water or improperly treated swimming pool water.
• Swallowing contaminated drinking water, such as water from a well that’s been contaminated with sewage or flood water.
• Exposure to poop during sexual contact with someone with a Shigella infection or who has recently recovered from a Shigella infection.

Signs and symptoms

Most people with Shigella infection (shigellosis) experience:

• Diarrhea that can be bloody or prolonged (lasting more than 3 days)
• Fever
• Stomach pain
• Feeling the need to pass stool (poop) even when the bowels are empty

Symptoms usually start 1–2 days after infection and last 7 days. In some cases, bowel habits (frequency and consistency of stool) do not return to normal for several months.

Treatment

Contact Student Health and Counseling at 215-746-WELL (9355) if you or one of roommates/family members has bloody or prolonged diarrhea (diarrhea lasting more than 3 days) or severe stomach cramping or tenderness, especially if you also have a fever or feel very sick. Tell your healthcare provider if you have other medical conditions or a weakened immune system—for example, because of an HIV infection or chemotherapy treatment. If you have a weakened immune system, you may be more likely to become severely ill.

• People with Shigella infection should drink plenty of fluids to prevent dehydration.
• People with bloody diarrhea should not use anti-diarrheal medicines, such as loperamide (Imodium) or diphenoxylate with atropine (Lomotil). These medicines may make symptoms worse.
• Antibiotics can shorten the time you have fever and diarrhea by about 2 days.
• Ciprofloxacin and azithromycin are two recommended oral antibiotics.

If your healthcare provider prescribes an antibiotic, take it exactly as directed and finish taking all the pills even if you feel better.

Prevention

You can reduce your chance of getting sick from Shigella by taking these steps:

• Carefully washing your hands with soap and water during key times:
• Before preparing food and eating.
• After changing a diaper or helping to clean another person who has defecated (pooped).
• If you care for a child in diapers who has shigellosis, promptly throw away the soiled diapers in a covered, lined garbage can. Wash your hands and the child’s hands carefully with soap and water right after changing the diapers. Clean up any leaks or spills of diaper contents immediately.
• Safe & Healthy Diapering in the Home
• Diaper-Changing Steps for Childcare Settings
• Avoid swallowing water from ponds, lakes, or untreated swimming pools.
• When traveling internationally, stick to safe eating and drinking habits, and wash hands often with soap and water. For more information, see Travelers’ Health – Food and Water Safety.
• Avoid having sex (vaginal, anal, and oral) for 2 weeks after your partner recovers from diarrhea. Because Shigella germs may be in stool for several weeks, follow safe sexual practices, or ideally avoid having sex, for several weeks after your partner has recovered.

What should I know about antimicrobial resistance and resistant Shigella?

Some antibiotics may not be effective for treating some Shigella infections because of antimicrobial resistance.  Antimicrobial resistance happens when germs like bacteria and fungi develop the ability to defeat the drugs designed to kill them. That means the germs are not killed and continue to grow. Healthcare providers can order laboratory tests to determine which antibiotics are likely to work.

If Shigella bacteria are resistant, first-choice antibiotics recommended to treat these infections may not work. Healthcare providers might need to prescribe second- or third-choice drugs for treatment. However, these drugs might be less effective, may need to be taken through a vein (IV) instead of by mouth, may be more toxic, and may be more expensive. Recommended antibiotics for severe infections include fluoroquinolones, azithromycin, and ceftriaxone.

What can be done to prevent antimicrobial resistance?

Any use of antibiotics can cause resistance. Some antimicrobial-resistant Shigella bacteria can spread between people and the environment. Using antibiotics only when needed and exactly as prescribed can help prevent antimicrobial resistance and the spread of resistant bacteria.

If you think you have shigella, you can contact Student Health and Counseling at 215-746-WELL (9355) if symptoms persist or if you have any questions about your symptoms or treatment.

Source: https://www.cdc.gov/shigella/

Respiratory Illnesses

Adenovirus

Adenoviruses are very common and cause illnesses, such as cold-like symptoms, sore throat, bronchitis, conjunctivitis. Anyone can become infected with adenoviruses, but people with weakened immune systems or existing respiratory or cardiac disease are more likely than others to get very sick from an adenovirus infection.

How is it transmitted?

The virus likely spreads from person to person through close personal contact (e.g. touching, shaking hands), coughing, sneezing, and touching contaminated objects or surfaces then touching your mouth, nose, or eyes.

Sometimes the virus can be shed (released from the body) for a long time after a person recovers from an adenovirus infection, especially among people who have weakened immune systems. This “virus shedding” usually occurs without any symptoms, even though the person can still spread adenovirus to other people.

Signs & Symptoms

Adenoviruses can cause a wide range of illnesses, such as:

• Common cold
• Sore throat
• Bronchitis
• Pneumonia
• Diarrhea
• Pink eye (conjunctivitis)
• Fever
• Bladder inflammation or infection
• Inflammation of stomach and intestines
• Neurologic disease (conditions that affect the brain and spinal cord)

Adenoviruses can cause mild to severe illness, though serious illness is less common. People with weakened immune systems, or existing respiratory or cardiac disease, are at higher risk of developing severe illness from an adenovirus infection.

Treatment

There is no specific treatment available for people with adenovirus infection. Most cases are mild and may require only self-care to help relieve symptoms.

Prevention

To help prevent the spread of adenoviruses, practice good hygiene:

• Stay home when you are sick
• Wash your hands with soap and warm water or an alcohol-based hand sanitizer that contains at least 60% alcohol
• Cover your mouth and nose when coughing or sneezing
• Avoid sharing cups and eating utensils with others
• Avoid touching eyes, nose, and mouth with unwashed hands
• Avoid close contact with people who are sick

If you suspect you have an adenovirus infection, or have been in close contact with someone infected, call Student Health and Counseling at 215-746-WELL (9355) to speak with a nurse about your symptoms. 

Source: https://www.cdc.gov/adenovirus/
 

Managing Upper Respiratory Symptoms

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Students can access information to help manage upper respiratory symptoms, including helpful tips about when to seek medical care and how to treat symptoms. Find out how to Manage Upper Respiratory Symptoms here. 

COVID-19

What is COVID-19?

COVID-19 is a respiratory illness caused by the SARS-CoV-2 virus. It can be highly contagious and spreads quickly. Most people with COVID-19 have mild symptoms, but some individuals can become severely ill. 

How is it transmitted?

COVID-19 spreads through small droplets and airborne particles produced when an infected individual breathes and speaks. 

Prevention

Staying up to date on vaccines helps your body develop protection from COVID-19. 
Read more about vaccination guidelines: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html.

You can also avoid infection and limit spread by practicing good hygiene:

• Wash your hands with soap and warm water or an alcohol-based hand sanitizer that contains at least 60% alcohol
• Cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your sleeve or elbow
• Mask around others and limit social interactions if you feel unwell
• Self-isolate and test if you suspect you have COVID-19

Exposure and Symptoms

If you were exposed to the virus that causes COVID-19, be sure to mask around others and monitor for symptoms. Possible symptoms include: fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea, vomiting, or diarrhea.

Testing positive

If you test positive or were exposed to COVID-19 and would like public health guidance, contact the Public Health Team at 215-746-WELL (9355). For information on how to keep yourself and your fellow Penn community members healthy and well, see our guidance for respiratory illnesses.

Treatment

Most cases of COVID-19 resolve on their own. However, antiviral medication can be prescribed by a medical provider for individuals who are at high risk for getting very sick from COVID-19 and who have mild to moderate symptoms. To discuss treatments options, call  Student Health and Counseling to speak with a medical provider at 215-746-WELL (9355).
 

Managing Upper Respiratory Symptoms

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Students can access information to help manage upper respiratory symptoms, including helpful tips about when to seek medical care and how to treat symptoms. Find out how to Manage Upper Respiratory Symptoms here. 

Sources: 
Centers for Disease Control: https://www.cdc.gov/respiratory-viruses/guidance/respiratory-virus-guidance.html
World Health Organization: https://www.who.int/health-topics/coronavirus

Influenza (Flu)

Influenza (also known as the flu) is a contagious respiratory illness caused by flu viruses. Symptoms can range from mild to severe illness.

How is it transmitted?

Influenza can spread when sick individuals cough or sneeze. People may also contract influenza by touching their mouth or nose after touching something contaminated with the virus (e.g. doorknobs, tables, cups, an infected person’s hand, etc.).

You may be able to spread the virus to someone else before you know you are sick. Most infected individuals shed influenza virus the day before symptoms develop and up to 5 to 7 days after becoming sick. Symptoms start 1 to 4 days after the virus enters the body. Some people can be infected with influenza but have no symptoms.

Signs and Symptoms

Influenza is different from a cold. The virus usually comes on suddenly and symptoms may include fever/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and/or fatigue.

Testing

Diagnostic testing (rapid test or otherwise) for influenza does not change the clinical management of influenza. The Centers for Disease Control and Prevention (CDC) recommends using this guide when considering influenza testing. Student Health and Counseling follows CDC’s recommendation and does not offer or provide routine influenza testing. However, Student Health and Counseling will consider testing if the student is in a high-risk group for complications from influenza or has a progressive disease.

Testing positive

If you test positive for the flu nd would like public health guidance, contact the Public Health Team at 215-746-WELL (9355). For information on how to keep yourself and your fellow Penn community members healthy and well, see our guidance for respiratory illnesses.

Treatment

Most cases of influenza get better with self-care and without medical treatment. If you suspect you have influenza, stay at home, and as best as possible, stay away from others until you have been fever-free for 24 hours. Student Health and Counseling providers sometimes refer to this as self-isolation. This is an important prevention strategy to avoid the spread of influenza.

Self-care options include:

• Manage your fever and pain with acetaminophen (325mg “non-aspirin,” regular strength, 2-3 tabs) every 4-6 hours (not to exceed 3000mg in 24/hours) OR ibuprofen (200 mg, 2-3 tabs) ever 6-8 hours with food. You may alternate acetaminophen and ibuprofen every 3 hours
• Prevent dehydration by drinking plenty of clear liquids (water, ginger ale, sport drinks, etc.)
• Stay home and get plenty of rest. This is not a time to force yourself to go to class. It is also not a time to continue participation in student groups and social gatherings. Your body needs rest.

If you have trouble breathing, chest pain, suffer a relapse (begin to feel much worse after having felt better), severe headache and/or neck pain/stiffness, confusion, lethargy, severe or persistent vomiting please call Student Health and Counseling at 215-746-WELL (9355).

Clinical judgement on the basis of the person’s disease severity and progression, age, underlying medical conditions, likelihood of influenza, and time since onset of symptoms may be considered for treatment with antivirals. Antrivals should only be prescribed within 48 hours of symptom onset.

There are instances when antiviral medication is definitively indicated (e.g. all hospitalized and high-risk individuals with suspected influenza). Individuals who have severe, complicated, or progressive illness or those at higher risk for complications from influenza should also receive antivirals.

Who is at high risk?

The following is a list of all the health and age factors that are known to increase a person’s risk of getting serious complications from flu:

• Adults 65 years and older
• Children younger than 2 years old1
• Asthma
• Neurologic and neurodevelopment conditions
• Blood disorders (such as sickle cell disease)
• Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
• Endocrine disorders (such as diabetes mellitus)
• Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
• Kidney diseases
• Liver disorders
• Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
• People who are obese with a body mass index [BMI] of 40 or higher
• People younger than 19 years old on long-term aspirin- or salicylate-containing medications.
• People with a weakened immune system due to disease (such as people with HIV or AIDS, or some cancers such as leukemia) or medications (such as those receiving chemotherapy or radiation treatment for cancer, or persons with chronic conditions requiring chronic corticosteroids or other drugs that suppress the immune system)
• People who have had a stroke

Other people at higher risk from flu:

• Pregnant people and people up to 2 weeks after the end of pregnancy
• People who live in nursing homes and other long-term care facilities
• People from certain racial and ethnic minority groups are at increased risk for hospitalization with flu, including non-Hispanic Black persons, Hispanic or Latino persons, and American Indian or Alaska Native persons
• 1 Although all children younger than 5 years old are considered at higher risk of serious flu complications, the highest risk is for those younger than 2 years old, with the highest hospitalization and death rates among infants younger than 6 months old.

Information on groups at higher risk from COVID-19 is available.

Prevention

Annual vaccination is the most effective way to protect oneself against influenza. Influenza vaccines are required for all Penn students. The easiest way for students to get the influenza vaccine is to attend Wellness at Penn's annual Flu Clinic.

Practice good hand hygiene:

• Wash your hands with soap and warm water or an alcohol-based hand sanitizer that contains at least 60% alcohol
• Cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your sleeve or elbow
• Self-isolate if you suspect you have influenza

Source: http://www.cdc.gov/flu/
 

Managing Upper Respiratory Symptoms

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Students can access information to help manage upper respiratory symptoms, including helpful tips about when to seek medical care and how to treat symptoms. Find out how to Manage Upper Respiratory Symptoms here. 

 

Legionella (Legionnaires’ Disease or Pontiac Fever)

How is it transmitted?

Legionnaires’ disease is caused by a type of bacteria called Legionella. The bacteria are often found in water and grow best in warm water like hot tubs, hot water tanks, and large plumbing systems. When water sources infected with Legionella are misted, such as a fountain, it may infect susceptible people within close proximity. Legionella bacteria are not spread from person to person. 

Signs and Symptoms

Legionnaires’ disease has similar symptoms to pneumonia so it can be difficult to diagnose. Signs and symptoms include cough, shortness of breath, high fever, muscle aches, and headaches. Symptoms usually begin 2-14 days after exposure.

Treatment

Legionnaires’ disease is treated with antibiotics though a hospital stay is common.

Prevention

Legionnaires’ disease is prevented through proper maintenance of water systems. Guidelines for appropriate water temperatures and chemical treatment of water for Legionella prevention can be found in ASHRAE Guideline 12-2000. There are no vaccines that can prevent Legionnaires’ disease. If you own or are using a hot tub often, ensure the hot tub has the right disinfectant and pH levels since hot water makes it hard to maintain the disinfectant levels needed to kill the Legionella bacteria.

If you have reason to believe you have been exposed to Legionnaires’ disease, please call Student Health and Counseling at 215-746-WELL (9355).

Source: https://www.cdc.gov/legionella/

Measles

Measles is a highly contagious infection of the respiratory system caused by a virus. Measles spreads through direct contact with nasal or throat secretions of infected persons, or through droplets suspended in the air when a person sneezes or coughs. Measles typically starts with a fever, runny nose, cough, red eyes, and sore throat, and is followed by a rash that spreads all over the body.

How is it transmitted?

Measles can spread when sick individuals cough or sneeze. People may also contract measles by touching their mouth or nose after touching something contaminated with the virus (e.g. doorknobs, tables, cups, an infected person’s hand, etc.). The virus can live on infected surfaces for up to 2 hours and spreads so easily that people who are not immune will probably get infected when they come in close contact with someone who has measles.

Signs and symptoms

Symptoms of measles generally appear about 7-14 days after a person is infected. These symptoms include high fever (103-104°), cough, running nose, and red, watery eyes (conjunctivitis). About 2-3 days after symptoms begin, tiny white spots with bluish-white centers (Koplik’s spots) may appear inside the mouth. About 3-5 days after symptoms begin, a blotchy rash typically appears on the face at the hairline and spreads downward to the neck, trunk, arms, legs, and feet. The rash fades and fever subsides within a few days.

Treatment

Currently, there is no treatment for measles other than supportive care through relief of symptoms (e.g. pain management). People with suspected measles should stay at home and away from others for at least 4 days from the onset of the rash. This is an important prevention strategy to avoid the spread of measles.

Prevention

Vaccination is the most effective way to protect oneself against measles. Although measles is part of the required immunizations for Penn students, one may still be exposed to the disease through contact with unvaccinated individuals. The easiest thing for students to do is to get the MMR (measles, mumps and rubella) vaccine, if they have not already received it.

Practice good hygiene:

• Wash your hands with soap and warm water or an alcohol-based hand sanitizer that contains at least 60% alcohol
• Cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your sleeve or elbow
• Self-isolate if you suspect you have measles
• Don’t share drinks or eating utensils.
• Regularly cleaning surfaces that are frequently touched (such as toys, doorknobs, tables, counters) with soap and water or with cleaning wipes.

If you think you have measles or have been in close contact with someone who has confirmed measles, please contact Student Health and Counseling at 215-746-WELL (9355).

Source: https://www.cdc.gov/measles/

Pertussis

Pertussis, also known as whooping cough, is a highly contagious respiratory disease, caused by a type of bacteria called Bordetella pertussis. After coughing fits, someone with pertussis often needs to take deep breaths, which result in a “whooping” sound. It is important to remember that the “whoop” may not be heard in teens and adults.

How is it transmitted?

Pertussis is a contagious disease only found in humans and is spread from person to person. People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria. If pertussis is circulating in the community, there is a chance that a fully vaccinated person, of any age, can catch this contagious disease. If you develop a cold with a severe cough, or a cough that lasts for a long time, you may have pertussis.

Signs and Symptoms

Symptoms of pertussis usually develop within 5-10 days after exposure, however sometimes symptoms take up to 3 weeks to appear. If you have been vaccinated, the infection is usually less severe.

While pertussis can cause serious illness in infants and children, symptoms may be mild in adults. The disease usually starts with cold-like symptoms, such as a mild cough or fever. After 1 to 2 weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continue for weeks.

Pertussis may cause violent and rapid coughing. This extreme coughing may cause one to vomit and/or lead to fatigue. The “whoop” is often not present and infection is generally milder in teens and adults.

Treatment

Student Health may prescribe antibiotics for the treatment of pertussis.  People diagnosed with pertussis should stay at home and away from others until they have completed 5 days of their antibiotics (i.e. self-isolate). This is an important prevention strategy to avoid the spread of pertussis. In the event of an exposure to someone with confirmed pertussis, prophylactic antibiotics may be recommended.

Prevention

Vaccination is the most effective way to protect oneself against pertussis. Although pertussis is a required vaccination for Penn students, one may still be exposed to the disease through working with children or other unvaccinated individuals. The easiest thing for students to do is to get the Tdap (Tetanus, Diphtheria and Pertussis) vaccine, if they have not already received it. Tdap can be given regardless of when the last Td (Tetanus and Diphtheria) vaccine was received.

Practice good hand hygiene:

• Wash your hands with soap and warm water or an alcohol-based hand sanitizer that contains at least 60% alcohol
• Cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your sleeve or elbow
• Self-isolate if you suspect you have pertussis

If you think you have pertussis or have been in close contact with someone who has confirmed pertussis, please contact Student Health and Counseling at 215-746-WELL (9355).

Source: http://www.cdc.gov/pertussis/

 

Respiratory Syncytial Virus (RSV)

Respiratory syncytial virus (RSV) is a common respiratory virus. Most people with RSV have mild, cold-like symptoms. However, infants and older adults are at higher risk of severe illness. 

How is it transmitted?

RSV spreads through small droplets produced when a sick individual coughs or sneezes. These droplets may infect someone when they land in one’s eyes, nose, or mouth. The virus can also be spread through close personal contact (e.g. touching, shaking hands) and touching contaminated objects or surfaces and then touching your mouth, nose, or eyes. 

Signs and Symptoms

Typically, people will feel symptoms of RSV within a week of becoming infected. Common symptoms include:

• Runny nose
• Decreased appetite
• Coughing
• Sneezing
• Fever
• Wheezing

These symptoms usually appear in stages. More severe symptoms include trouble breathing, dehydration, or the onset of more severe infections such as pneumonia (an infection of the lungs).  

Treatment

There is no specific treatment available for people with an RSV infection. However, RSV will most often resolve on its own within a week or two. Over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen, may help to relieve symptoms. To prevent dehydration, individuals with RSV should drink plenty of fluids. 
Adults 60 and older may receive an RSV vaccine to prevent severe illness.

Prevention 

To prevent RSV infection, it’s important to practice good hygiene:

• Wash your hands with soap and warm water for at least 20 seconds.
• Avoid touching your face with unwashed hands.
• Cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your sleeve or elbow.
• Avoid close contact with others and touching frequently touched surfaces, such as doorknobs and mobile devices, when you are not feeling well. 
• Stay home when you feel sick. 

If you think you have RSV, please contact Student Health and Counseling at 215-746-WELL (9355).

Source: https://www.cdc.gov/rsv/index.html 

 

Tuberculosis (TB)

Tuberculosis, or more commonly known as TB, is caused by a bacterium called Mycobacterium tuberculosis. This bacterium typically attacks the lungs, but TB bacteria can also affect other parts of the body such as the brain, spine, and kidneys. Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection (LTBI) and TB disease.

Latent TB Infection (LTBI)

Latent tuberculosis infection (LTBI) is the presence of Mycobacterium tuberculosis (M. tuberculosis) in the body without signs and symptoms, or radiographic or bacteriologic evidence of tuberculosis (TB) disease. Persons with LTBI do not have active TB disease, but may develop it in the future, a process called TB reactivation.

Without treatment, about 1 in 10 people with LTBI will develop TB disease. About half of those who develop TB will do so within the first two years of infection.

Diagnosis

The diagnosis of LTBI is based on a positive result of either a skin (tuberculosis skin test, TST) or blood (Interferon-gamma release assay, IGRA) test indicating an immune response to M.tuberculosis.

Signs and Symptoms

• People with LTBI are healthy and usually do not feel sick.
• They typically have a positive skin test or blood test result
• They typically have a negative (normal) chest x-ray
• They cannot spread TB bacteria to others

Treatment

It is important to provide preventative treatment to persons with LTBI to prevent the development of active disease. The CDC recommends one of the following 3 treatment regimens for LTBI.

• Rifampin (RIF) daily for 4 months
• Isoniazid (INH) daily or twice weekly for 9 months
• Isoniazid (INH) and Rifapentine (RPT) once weekly for 3 months

TB Disease

How is it transmitted?

Tuberculosis is an airborne disease, spread through the air from person to person when someone who has contracted TB of the lungs or throat sneezes, coughs, speaks, or sings. People in close proximity to these particles in the air may breathe them in and also become infected.

TB CANNOT spread by:

• shaking hands
• sharing foods or drinks
• bedding or toilet seats
• sharing toothbrushes or other personal hygiene items
• kissing or oral sexual contact

Signs and symptoms

Symptoms of TB include:

• a strong, persistent cough lasting 3+ weeks
• chest pains
• coughing up blood or sputum
• fatigue
• weight loss
• fever
• weakness
• night sweats & chills
• loss of appetite

Treatment

Those suffering from Tuberculosis can be treated by taking several drugs for the duration of 6 to 9 months. There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treatment of TB.

Prevention

In the Workplace:

Many healthcare settings have TB infection control plans that include early detection of infectious patients, precautions to avoid spread of airborne particles, and treatment of those people who have suspected or confirmed cases of TB.

While Traveling:

Travelers should avoid being in close proximity for a prolonged period of time with known TB positive patients. Particularly in crowded, enclosed environments such as hospitals, homeless shelters, prisons, or clinics.

Travelers who will be working in or spending much time in hospitals, clinics, or other health care settings where TB patients are likely to be in close contact, should refer to the facility’s infection control or occupational health regulations and consult with the experts on site to review environmental and administrative prevention procedures. Once those strategies are executed, additional precautions may include use of personal respiratory protective devices.

Travelers who anticipate potential, prolonged contact with those who have TB should receive a Tuberculin Skin Test (TST) or Interferon-Gamma Release Assay (IGRA) test before leaving the United States. If the test reaction is negative, they should have a repeat test 8 to 10 weeks once they’ve returned to the United States. Furthermore, yearly testing could be suggested for those who anticipate repeated or prolonged exposure or an extended stay over a period of years.

If you think you have TB or have been in close contact with someone who has confirmed TB disease, please contact Student Health and Counseling at 215-746-WELL (9355).

Source: www.cdc.gov/tb

Sexually Transmitted Infections

Chlamydia

Chlamydia is a very common sexually transmitted infection (STI) that is easily curable when treated. Chlamydia can cause very serious complications and make it difficult for women to get pregnant if left untreated.

How is it transmitted?

Chlamydia is spread through any kind of sexual contact (vaginal, oral, or anal) with an infected partner. Reinfection is possible for individuals who have been infected and received treatment for chlamydia in the past if they have sexual contact with a person infected with chlamydia.

Since chlamydia can be spread at multiple sites (vaginal, oral, and anal), it is important that you have an honest and open talk with your healthcare provider for appropriate testing.

Signs and Symptoms

It is important to note that the most common symptom of an STI, especially chlamydia, is NO SYMPTOM AT ALL. Many, if not most, individuals with chlamydia are asymptomatic, meaning they have no signs or symptoms presenting the infection. When present, signs and symptoms of urethral infection include dysuria (pain with urination) or a white, yellow, or green urethral discharge.

Initial symptoms of vaginal infection may include dysuria (pain with urination) or abnormal vaginal discharge. Even if you do not have symptoms, chlamydia can damage the reproductive system and can make it difficult to get pregnant later on.

Rectal infections may include rectal pain, discharge, or bleeding. Rectal infection may also be asymptomatic.

Treatment

Chlamydia can be cured with the right treatment. It is important to take all of the medication prescribed and should not be shared.

Since repeat infection is common, you will need to be tested again about three months after treatment.

Prevention

If you are sexually active, use latex condoms every time you have sex. Condoms are the only form of birth control that can prevent STIs. Additionally, you should be screened every year for STIs.

Once an individual is diagnosed, they MUST tell all recent anal, vaginal, or oral sex partners within the past 2 months before the onset of symptoms or diagnosis so they can also get tested and treated.

If you believe you may have symptoms of chlamydia, and to schedule an appointment for STI screening, call Student Health and Counseling at 215-746-WELL (9355). 

Source: https://www.cdc.gov/std/chlamydia/

Gonorrhea

Any sexually active individual can get gonorrhea, a very common sexually transmitted infection (STI). Gonorrhea is especially common among young people ages 15-24 years old. Gonorrhea can cause very serious complications when left untreated, but can be cured with proper medication.

How is it transmitted?

Gonorrhea is spread through any kind of sexual contact (vaginal, oral, or anal) with an infected partner. Individuals who have received treatment for gonorrhea may be re-infected if they have sexual contact with a person infected with gonorrhea.

Since gonorrhea can be spread at multiple sites (vaginal, oral, and anal), it is important that you have an honest and open talk with your healthcare provider for appropriate testing.

Signs and Symptoms

It is important to note that the most common symptom of an STI, especially Gonorrhea, is NO SYMPTOM AT ALL. Many, if not most, individuals with gonorrhea are asymptomatic, meaning they have no signs or symptoms presenting the infection. When present, signs and symptoms of urethral infection include dysuria (pain with urination) or a white, yellow, or green urethral discharge. This usually appears 1-14 days after infection. If the urethral infection is complicated by epididymitis, gonorrhea may also cause testicular or scrotal pain.

Symptoms are often so mild and nonspecific for females that they are easily mistaken for a bladder or vaginal infection. Initial symptoms may include dysuria (pain with urination), increased vaginal discharge, or vaginal bleeding between periods. Females are also at risk of developing serious complications from the infection (e.g. pelvic inflammatory disease, or PID), regardless of the presence or severity of symptoms.

Rectal infections may include discharge, anal itching, soreness, bleeding, or painful bowel movements. Rectal infection may also be asymptomatic. Gonorrhea can also present in the throat, which may cause soreness, but usually is asymptomatic.

Treatment

Gonorrhea can be cured with dual therapy medication treatment. It is important to take all of the medication prescribed and should not be shared.

If symptoms continue for more than a few days after receiving treatment, please call Student Health and Counseling at 215-746-WELL (9355).

Prevention

Similar to most STIs, correct use of condoms every time anal, vaginal, and oral sex takes place is the best protection.

Once an individual is diagnosed, they MUST tell all recent anal, vaginal, or oral sex partners within the past 2 months before the onset of symptoms or diagnosis so they can also get tested and treated.

Source: https://www.cdc.gov/std/gonorrhea/

Syphilis

Any sexually active individual can get syphilis. If you are sexually active and a man who has sex with a man, are living with HIV, or have partners who have tested positive for syphilis before, then you should be tested often. Syphilis is a simple disease to treat, but may have very serious complications if not treated correctly.

How is it transmitted?

Syphilis is spread through any kind of sexual contact (vaginal, oral, or anal) with a partner that has a syphilis sore. Also, syphilis can be spread to an unborn baby by an infected mother.

Since syphilis can be spread at multiple sites (vaginal, oral, and anal), it is important that you have an honest and open talk with your healthcare provider for appropriate testing.

Signs and Symptoms

Signs and symptoms of syphilis vary by stage and may be difficult to distinguish from other diseases. Each of the four stages (primary, secondary, latent, and tertiary) presents differently. Primary syphilis usually has a sore at the site of infection (usually in or around the genitals, anus, rectum, or mouth). The sore is usually painless, which can cause the sore to go unnoticed. It usually lasts 3-6 weeks, but you must still receive treatment to stop the infection from moving to the secondary stage.

Secondary syphilis usually presents with a skin rash on one or more areas of your body, followed by mucous membrane lesions. Other symptoms may include headaches, weight loss, muscle aches, swollen lymph nodes, and fever. Signs and symptoms of both primary and secondary syphilis can be mild and may even go unnoticed.

Latent stage syphilis has no visible signs or symptoms, and is a precursor to tertiary syphilis, which can lead to severe medical problems involving the heart, brain, and other organs.

Treatment

Syphilis can be treated with antibiotics. Early detection is key, as treatment cannot reverse damage done to the body from the disease. Once treated, re-infection is still possible if re-exposed to an infected partner.

Prevention

Similar to most STIs, correct use of condoms every time anal, vaginal, and oral sex takes place is the best protection. However, being exposed to a syphilis sore in areas not covered by a condom can still transmit syphilis.

Once an individual is diagnosed, they MUST tell all recent anal, vaginal, or oral sex partners within the past 2 months before the onset of symptoms or diagnosis so they can also get tested and treated.

If you have symptoms or think you have been exposed to syphilis, please call Student Health at at 215-746-WELL (9355).

Source: https://www.cdc.gov/std/syphilis/

Travel-Related Illnesses

Dengue

Dengue is a viral illness caused by any one of four closely related dengue viruses. Dengue is most commonly transmitted by the bite of an infected mosquito. In many parts of the tropics and subtropics, dengue is common. In areas where Dengue is not common, it can still be introduced by travelers who are infected while visiting.

How is it transmitted?

Dengue is transmitted through the bite of an infected mosquito. The mosquito becomes infected with the virus when it bites an infected person. The virus cannot be spread from person to person contact.

Signs and Symptoms

Symptoms of dengue infection usually begin 4 – 7 days after the mosquito bite and typically last 3 – 10 days. Symptoms may include high fever, severe headache, severe pain behind the eyes, joint pain, muscle and bone pain, rash, and mild bleeding (e.g. nose or gums bleed, easy bruising). Some people never have significant symptoms but can still infect mosquitoes.

Treatment

There is no specific medication for treatment. Self-care treatment options include:

Over-the-counter pain relievers (with acetaminophen, avoid aspirin)

• Drink plenty of fluids to prevent dehydration
• Rest
• If symptoms persist or worsen within the first 24 hours after the fever declines, or if you have a fever above 101°F, call Student Health and Counseling at 215-746-WELL (9355).

Prevention

There is no vaccine to prevent infection. The most effective protective measures are those that avoid mosquito bites:

• Use air conditioning or window and door screens to prevent mosquitoes from coming indoors
• Use bed nets if sleeping in hotels/homes that are not in air conditioned
• Use mosquito repellents containing 20-30% DEET as the active ingredient on exposed skin and clothing.

Source: http://www.cdc.gov/Dengue/

Malaria

Malaria is a disease spread through parasite-infected mosquitos. Those with malaria become very sick with fevers, chills, and flu-like symptoms. Malaria can be a fatal disease, although death can be prevented with proper identification and treatment. The majority of malaria cases in the United States are from those who travel to countries in sub-Saharan Africa and South Asia.

How is it transmitted?

Malaria is a disease primarily spread via the bite of an infected mosquito. The mosquito is infected by a parasite. In rare cases, it can be transmitted through blood transfusions, organ transplants, or needles and syringes that involved infected blood.

Signs and Symptoms

Malaria is often misdiagnosed because the signs and symptoms may be delayed well after return from travel. Always inform a healthcare provider of any travel within the last twelve months. Common symptoms of malaria include:

• Fevers
• Chills
• Flu-like symptoms
• Nausea and vomiting
• Body aches
• Headache

Treatment

Methods to treat the symptoms of malaria:

• A variety of prescribed drugs are used to combat the malaria parasite.
• Treatment will vary depending on the type of parasite, geographic area of infection, and the health of the patient.
• Always consult with a healthcare provider before taking any additional drugs.

Prevention

The most important thing in protecting yourself against malaria is the prevention of mosquito bites in countries with malaria transmission.

• There are prescription medications that must be taken before, during, and after the trip.
• Wear long-sleeved shirts and long pants
• Sleep under a mosquito net
• Correctly apply and reapply mosquito repellant
• Sexual transmission of many infections, including Zika virus, is reduced by consistent and correct use of condoms.

If pregnant:

• Pregnant women and women who may become pregnant should consider postponing travel to areas where malaria transmission is ongoing. Malaria has amplified negative effects on pregnant women because of their lower immune response. There is an increase in maternal and perinatal birth complications and increased morbidity and mortality rates from malaria.

If sexually active:

• Malaria cannot be sexually transmitted, but it can be transmitted through needles or syringes contaminated with malaria infected blood.

If you think you have malaria or have been in close contact with someone who has confirmed malaria, please contact Student Health and Counseling at 215-746-WELL (9355).

Source: https://www.cdc.gov/parasites/malaria/

Zika Virus

Zika virus is a virus spread most commonly by mosquitos. It is typically a mild illness and it’s duration ranges anywhere from several days to a week. It is uncommon that those who contract the disease require hospitalization, and it is very rarely fatal.

How is it transmitted?

Zika virus is a disease primarily spread via the bite of an infected mosquito. Though uncommon, Zika virus can also be transmitted from child to mother. Zika virus has also been detected in semen of infected men, making sexual transmission of Zika virus possible. Whether infected men who never develop symptoms can transmit the virus to their sex partners also is unknown.

Signs and symptoms

Common symptoms of Zika virus include:

• Fever
• Rash
• Joint Pain
• Conjunctivitis (Pink Eye)
• Muscle Pain
• Headache

Treatment

Methods to treat the symptoms of Zika virus include:

• Rest
• Drinking fluids to avoid dehydration
• Fever/pain reducing medicines such as acetaminophen (Tylenol) to ease symptoms
• Do NOT take aspirin or any other non-steroidal anti-inflammatory drugs.
• Always consult with a healthcare provider before taking any additional medications.

Prevention

The most important thing in protecting yourself against Zika virus is the prevention of mosquito bites.

• Wear long-sleeved shirts and long pants
• Stay indoors, if possible, particularly during the day, as the breed of mosquito that carries the Zika virus feeds primarily during the day
• Sleep under a mosquito net
• Correctly apply and reapply mosquito repellant
• Sexual transmission of many infections, including Zika virus, is reduced by consistent and correct use of condoms.

If pregnant:

Pregnant women and women who may become pregnant should consider postponing travel to areas where the Zika virus transmission is ongoing. The Zika virus has been found in the semen of infected men. Sexual transmission of Zika virus is possible, and is of particular concern during pregnancy.

If sexually active:

Zika virus remains present longer in semen than in blood. Sexual transmission of many infections, including Zika virus, is reduced by consistent and correct use of latex condoms.

If you think you have Zika virus or have been in close contact with someone who has confirmed Zika virus, please contact Student Health and Counseling at 215-746-WELL (9355).

Source: https://www.cdc.gov/zika/

Viral Infections

Epstein Barr Virus (EBV) (Mononucleosis)

Infectious mononucleosis, also called “mono,” is a contagious disease. Epstein-Barr virus (EBV) is the most common cause of infectious mononucleosis. It is common among teenagers and young adults, especially college students. At least 25% of teenagers and young adults who get infected with EBV will develop infectious mononucleosis.

How is it transmitted?

EBV is the most common cause of infectious mononucleosis, but other viruses can cause this disease. Typically, these viruses spread most commonly through bodily fluids, especially saliva.

Signs and Symptoms

Typical symptoms of infectious mononucleosis usually appear 4 to 6 weeks after you get infected with EBV. Symptoms may develop slowly and may not all occur at the same time.

These symptoms include:

• extreme fatigue
• fever
• sore throat
• head and body aches
• swollen lymph nodes in the neck and armpits
• swollen liver or spleen or both
• rash

Enlarged spleen and a swollen liver are less common symptoms. For some people, their liver or spleen or both may remain enlarged even after their fatigue ends.

Most people get better in 2 to 4 weeks; however, some people may feel fatigued for several more weeks. Occasionally, the symptoms of infectious mononucleosis can last for 6 months or longer.

Treatment

You can help relieve symptoms of infectious mononucleosis by getting plenty of rest and staying well-hydrated.

Self-care options include:

• Manage your fever and pain with acetaminophen (325mg “non-aspirin,” regular strength, 2-3 tabs) every 4-6 hours (not to exceed 3000mg in 24/hours) OR ibuprofen (200 mg, 2-3 tabs) ever 6-8 hours with food. You may alternate acetaminophen and ibuprofen every 3 hours
• Prevent dehydration by drinking plenty of clear liquids (water, ginger ale, sport drinks, etc.)
• Get plenty of rest

If you have infectious mononucleosis, you should not take amoxicillin as a rash may develop.

Alcohol use is discouraged as often there can be a transient liver inflammation associated with mono.

Because your spleen may become enlarged as a result of infectious mononucleosis, you should not participate in athletic activities. More than 50 percent of patients with mono develop splenic enlargement within the first two weeks of symptoms; as a result, the recommendation is to avoid activities that may cause splenic rupture for at least 4 weeks from time of diagnosis or until you fully recover.

NCAA athletes must come to Student Health and Counseling for return-to-play clearance after 4 weeks.

If you have trouble swallowing, trouble breathing, abdominal pain, suffer a relapse (begin to feel much worse after having felt better), severe headache and/or neck pain/stiffness, confusion, lethargy, severe or persistent vomiting please call Student Health and Counseling at 215-746-WELL (9355).

Prevention

There is no vaccine to protect against infectious mononucleosis. You can help protect yourself by not kissing or sharing drinks, food, or personal items, like toothbrushes, with people who have infectious mononucleosis.

Practice good hygiene:

• Wash your hands with soap and warm water or an alcohol-based hand sanitizer that contains at least 60% alcohol
• Cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your sleeve or elbow

Source: https://www.cdc.gov/epstein-barr/

Hand, Foot, and Mouth Disease (HFMD)

Hand, Foot, and Mouth Disease (HFMD) is caused by viruses, most commonly the coxsackievirus. It may cause fever, sore throat, painful sores in the mouth, and blisters on the palms of hands and soles of feet. For most people, HFMD resolves on its own and requires only self-care.

How is it transmitted?

HFMD is spread through close personal contact, coughing or sneezing, fecal-oral route, or contact with contaminated objects. Transmission can occur by coming into contact with the virus, and then touching your eyes, mouth, or nose.

Signs and Symptoms

Signs of HFMD may include fever, sore throat, oral ulcers, oral blisters, or blisters on the palms of the hand, soles of feet, knees, elbows, or buttocks. Not everyone will get all of these symptoms. Some people, especially adults, may show no symptoms at all, but they can still pass the virus to others.

Treatment

Most cases of hand, foot, and mouth disease (HFMD) are mild and get better on their own, even without treatment. Self-care treatment options include:

• Take over-the-counter pain relievers
• Use mouthwashes or sprays that numb mouth pain
• Drink plenty of fluids to prevent dehydration
• Practice good hygiene

You should see a healthcare provider if your symptoms include:

• fever
• moderate to severe pain
• sensitivity to light
• intense redness
• symptoms that worsen or do not improve after 3 days

If you suspect you have HFMD or have been in close contact with someone who has HFMD, call Student Health and Counseling at 215-746-WELL (9355).

Prevention

There are no vaccines to protect against hand, foot, and mouth disease specifically. A person can lower their risk of being infected by cleaning and disinfecting frequently touched surfaces and practicing good hand hygiene.

Clean and disinfect surfaces:

• Regular Lysol and non-commercial grade Chlorox cleaning wipes are NOT effective against Coxsackies.
• Use Lysol disinfectant spray or Commercial-use Chlorox, which is far more effective on hard non-porous surfaces.
• Clean and disinfect frequently touched surfaces. Generic cleaning products typically do not disinfect the HFM virus; it is recommended to use cleaning agents that include sodium hypochlorite, hydrogen peroxide, citric acid, or quaternary ammonium as active ingredients.

Practice good hygiene:

• Wash hands well and often with soap and water.
• Avoid touching eyes, nose, and mouth with unwashed hands.
• Avoid kissing, hugging, and sharing drinks or eating utensils.
• Regularly clean surfaces that are frequently touched (such as toys, doorknobs, tables, counters) with soap and water or with cleaning wipes.
• Cover your mouth and nose with a tissue when you cough or sneeze, and putting your used tissue in the trash can. If you don’t have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands.

Source: https://www.cdc.gov/hand-foot-mouth/

Mpox (monkeypox)

What is mpox? 
Mpox (formerly known as monkeypox) is a rare disease caused by the mpox virus, a member of orthopoxvirus genus of the Poxviridae family, the same family of viruses that causes smallpox. This disease is typically identified by a characteristic skin rash, which may look like a pus-filled pimple, blister, or sore.

How is it transmitted?
Mpox is transmitted from one person to another after prolonged exposure to an infected individual, most commonly through skin-to-skin contact: 

• Transmission may occur via close contact with lesions or body fluids of an infected person, such as prolonged face-to-face contact or through intimate physical contact, including cuddling, kissing, or sexual activity.
• Contact with contaminated materials such as soiled bedding and linens 
• To humans through close contact with an infected animal, or with material contaminated with the virus.

Mpox is generally less contagious than many other communicable diseases, namely COVID-19 and chickenpox. As noted above, transmission also requires PROLONGED exposure. Additionally, while there has been some data that suggests respiratory droplets may be a source of transmission, but this has not been the identified as the source of exposure in the majority of infections thus far. 

What are the symptoms of mpox?
A person with mpox is contagious from the onset of symptoms or first lesions through the scab stage, until a fresh layer of skin has formed. Fever and rash occur in nearly all people infected with mpox virus. The rash goes through different stages before healing completely. Sometimes, people get a rash first, followed by other symptoms (fever, chills, fatigue, body aches, headache, cough). Others only experience a rash. The illness typically lasts 2-4 weeks.

Symptoms of mpox can include:

• Flu-like symptoms such as fever, fatigue, body aches, swollen lymph nodes
• Painful rash that which may look like a pus-filled pimple, blister, or sore

Why is mpox considered a public health emergency?
A public health emergency declaration releases resources earmarked for an actual (or emerging) public health crisis. In the case of mpox, the federal government can now significantly scale the production and availability of vaccines, expand testing capacity, and make testing more convenient. The declaration also facilitates coordination among federal, state, and local authorities, specifically in relation to improving access to testing and treatment. Furthermore, funding is directed at coordinating (across jurisdictions) awareness and prevention outreach campaigns that target members of the at-risk communities and the public at large, aimed at curbing spread of the virus. The declaration can also help to improve the availability of data on mpox infections.

Testing
Can I access testing while on campus?
If you are experiencing symptoms or have been exposed to an individual with mpox, please call Student Health and Counseling at at 215-746-WELL (9355) at your earliest convenience to discuss your concerns with a medical provider. Testing is done by swabbing a lesion to confirm the presence of the mpox virus. Testing is available through our clinic in collaboration with LabCorp. Specimens are handled by a specialized lab and results typically take 3-4 days. 

How should I schedule an appointment for testing?
An appointment can be scheduled by calling at 215-746-WELL (9355).

When should I get tested?
You should get tested if you have symptoms of mpox or have been exposed to someone with mpox or mpox symptoms.

Testing Positive
What happens if I test positive?
If you test positive, you should isolate until all symptoms have fully resolved. If you have a rash, this means you must isolate until the scabs have fallen off and a fresh layer of intact skin has formed. The length of isolation will vary and may last 21 days or more.

What does isolation entail?

• Do not leave your home (dorm, apartment, etc.) except as required for emergencies or follow-up medical care. You cannot go to class, go to work, or attend social events.
• Avoid close contact with others and avoid close contact with pets in the home and other animals by wearing well-fitting, high-quality mask and gloves when in close contact with others at home. 
• Do not engage in sexual activity that involves direct physical contact.

Where should students isolate if positive?
Students should remain isolated at home and avoid shared spaces for the duration of illness. If possible, use a separate bathroom if there are others who live in the same household. 

There are a limited number of isolation rooms available for students who live on-campus. On-campus students will be required to move to an isolation room, as CDC considers college dorms to be congregate living settings in regards to mpox.

How will I receive meals if I am isolating?
All those in isolation should order food in or ask a friend/family member/roommate to drop off groceries or a meal. If meal delivery or pick-up by others is not possible, students may pick up to-go food while diligently masking, wearing gloves, and maintaining social distancing. It is important that students on a dining plan understand how to access their meals when they are sick or in isolation. For more information visit the Penn Dining site.

What should I do with my pet (e.g., dog, cat) if I test positive?
People with mpox should avoid contact with animals/pets; however, if close contact occurs, the pet should be kept at home and away from other animals and people for 21 days. Wash your hands before and after caring for them and wear a well-fitting mask and gloves while providing care for your pet. It is important to cover any skin rash to the best extent possible (e.g., long sleeves, long pants).

If you did not come in contact with your pet during your infectious period, ask another household member or friend to care for the pet until fully recovered.

Prevention and Risk Reduction
How can I reduce the risk of becoming infected with mpox?
You can minimize your risk of exposure by:

• Avoiding skin-to-skin contact with someone who has a rash or other mpox symptoms 
• Not sharing bedding, towels, clothing, utensils, or cups with a person with mpox
• Not sharing vape pens or e-cigarettes
• Washing your hands frequently for at least 20 seconds with soap and water or use an alcohol-based hand sanitizer that contains at least 60% alcohol.
• Wearing a well-fitting, high-quality mask and gloves when caring for someone who has mpox or has symptoms of mpox.
• Asking sexual partners whether they have a rash or other symptoms of mpox.

Mpox is not considered a sexually transmitted disease, but is often transmitted through prolonged, close physical contact, which can include sexual contact. If you’re sexually active, learn about how you can lower your risk during sex.

Vaccination
Are vaccines available?
The Food and Drug Administration (FDA) has approved the use of the JYNNEOS Smallpox vaccine to prevent mpox. Wellness continues to work with the Philadelphia Department of Public Health (PDPH) on access to vaccines and treatments. Vaccine supplies are currently limited and PDPH is prioritizing vaccines based on a stratified risk of infection. We expect access to improve as supply increases.

To find out if you are eligible for the vaccine, please contact the Philadelphia Department of Public Health at 215-685-5488.
    
Treatment
What treatment is available for mpox?
Treatment involves supportive care to alleviate the symptoms. Antivirals such as tecovirimat (TPOXX) may be recommended for people who are more likely to get severely ill, for example, immunocompromised students or depending on lesion location/type.

Resources
Our Public Health and Wellbeing team works closely with University partners, PDPH, and the PA Department of Public Health to prevent and respond to communicable disease cases and outbreaks on our campus. For more information about mpox, you can refer to CDC’s website, PDPH, or the PA Department of Health’s FAQ.

Mumps

Mumps is a viral infection that primarily affects the parotid glands (salivary glands) and is typically recognized by swelling near the jaw.

How is it transmitted?

Mumps can spread when sick individuals cough or sneeze. People may also contract mumps by touching their mouth or nose after touching something contaminated with the virus (e.g. doorknobs, tables, cups, an infected person’s hand, etc.).

Signs and symptoms

Common symptoms include fever, headache, muscle aches, tiredness, loss of appetite, orchitis (inflamed testicles) and parotitis (swollen and tender salivary glands). Symptoms may not appear for 12-25 days.

Treatment

Currently, there is no treatment for mumps other than supportive care through relief of symptoms (e.g. pain management). People with suspected mumps should stay at home and do not go to classes, work, school, or social events for at least 5 days or until their diagnosis is confirmed (i.e. self-isolate). This is an important prevention strategy to avoid the spread of mumps.

Prevention

Vaccination is the most effective way to protect oneself against mumps. Although mumps is part of the required immunizations for Penn students, one may still be exposed to the disease through contact with unvaccinated individuals. The easiest thing for students to do is to get the MMR (measles, mumps and rubella) vaccine, if they have not already received it.

Student Health Service follows CDC guidelines and does not recommend drawing titers for confirmation of immunity if the individual has received two documented doses of MMR.

Practice good hygiene:

• Wash your hands with soap and warm water or an alcohol-based hand sanitizer that contains at least 60% alcohol
• Cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your sleeve or elbow
• Self-isolate if you suspect you have mumps (stay home and do not go to classes, work, school, or social events)

If you think you have mumps or have been in close contact (e.g. someone you’ve shared food, drinks, or e-cigarettes with, sexual partners, roommates, etc.) with someone who has confirmed mumps , please contact Student Health and Counseling at 215-746-WELL (9355).

Source: https://www.cdc.gov/mumps/

Polio

Polio is a virus which has been nearly eradicated through global use of vaccines. While cases of this disease are rare, they can be life threatening, with severe cases involving symptoms like meningitis (infection of the tissue surrounding the brain and spinal cord) and paralysis.

How is it transmitted?

Poliovirus is very contagious and spreads through person-to-person contact. It can be transmitted orally, through droplets from a sneeze or cough. However, most transmission is through oral contact with feces of an infected person. This can happen by touching objects or having your hands near areas where fecal matter may be, and then bringing your hands to your mouth. An infected person can spread the virus to others immediately before and up to 2 weeks after the onset of symptoms.

Signs & Symptoms

Most people infected with poliovirus will have no visible symptoms. About 1 in 4 people will have flu-like symptoms, which include sore throat, fever, tiredness, nausea, headache, and stomach pain, which will last between 2-5 days. In very rare cases, severe symptoms occur, which can include meningitis and paralysis, both of which can be life-threatening.

Treatment

People diagnosed with polio are usually hospitalized, both to protect others from being infected and to make sure symptoms do not become more severe. Treatment normally involves making sure that the person with polio remains hydrated and comfortable until the disease resolves. Patients with paralysis may need physical therapy to prevent further loss of function in affected areas of the body.

Prevention

The best way to prevent infection with poliovirus is receive all the recommended doses of the polio vaccine. The inactivated polio vaccine (IPV) is extremely protective in protected individuals from serious disease caused by poliovirus. In addition to vaccination, practice good hand hygiene and wash hands often with soap and water. Alcohol-based hand sanitizers do not kill poliovirus.

If you think you have symptoms of polio, isolate yourself immediately and contact Student Health and Counseling to speak with a medical provider at 215-746-WELL (9355).

Source: https://www.cdc.gov/polio/what-is-polio/

Shingles (Herpes Zoster)

Herpes Zoster (Shingles) is a reactivation of the varicella virus (chickenpox). Shingles often presents as a sensitive rash on only one side of the body. The only way you can get shingles is if you have had varicella virus in the past. Varicella virus remains inactive in the body and may reactivate as shingles. While half of all shingles cases occur in adults over 60, college students may be at increased risk due to external stressors (e.g. lack of sleep, anxiety, etc.).

How is it transmitted?

A person with active shingles can spread the virus when the rash is in the blister-phase. A person is not infectious before the blisters appear. Until your rash has developed crusts, avoid contact with pregnant women, people who have never had chickenpox or the chickenpox vaccine, premature or low birth weight infants, and people with weakened immune systems (e.g. people receiving immunosuppressive medications, chemotherapy, organ transplant recipients, and people with HIV infection). Once the rash has developed crusts, the person is no longer contagious.

Signs and Symptoms

The main symptom of shingles is a painful rash that develops on one side of the face or body. Individuals may experience pain, itching, or tingling 1-5 days prior to developing a blistering rash. Other symptoms may include fever, headache, chills, or upset stomach. Typically, the rash scabs over in 7-10 days, and clears up within 2-4 weeks.

Treatment

While shingles does not require treatment, antiviral medications are available to shorten the duration of symptoms and reduce acute and chronic pain. Medications are most effective if started as soon as shingles is suspected.

Prevention

If you think you have shingles, please contact Student Health Service at 215-746-WELL (9355).

If you have a shingles rash, avoid touching or scratching and keep it covered to reduce the spread of herpes zoster virus.

Practice good hygiene:

• Wash your hands with soap and warm water or an alcohol-based hand sanitizer that contains at least 60% alcohol
• Avoid external stressors (e.g. lack of sleep, anxiety, etc.) as much as possible

There is a shingles vaccine available for adults over 50.

Source: https://www.cdc.gov/shingles/

Other Illnesses

Conjunctivitis (pink eye)

Conjunctivitis (pink eye) is caused by viruses, bacteria, allergens, and irritants. Viral conjunctivitis is the most common and is much more prevalent and contagious. It causes inflammation of the conjunctiva, the thin layer that lines the inside of the eyelid and covers the white part of the eye. For most people, pink eye resolves on its own and requires only self-care.

How is it transmitted?

Conjunctivitis is spread by direct contact with discharge from the eye or secretions from the upper respiratory tract of infected persons. Transmission can occur by touching your eyes or from contaminated clothing, towels, pillowcases, and other items coming into close contact with the eyes (e.g. contact lenses, make-up applicators, multiple dose eye medication applicators, etc.).

Signs and Symptoms

Signs of conjunctivitis may include redness, crusting on the eye lids or lashes, excessive eye tearing, itching or burning, and discharge or pus of one or both eyes. Typically, cold or upper respiratory symptoms are present.

Treatment

Most cases of conjunctivitis are mild and get better on their own, even without treatment. Self-care treatment options include:

• Warm/cool compresses
• Saline drops such as artificial tears
• Refrain from contact lens use until symptoms resolve
• Practice good hygiene

You should see a healthcare provider if your symptoms include:

• severe pain
• severe sensitivity to light
• weakened immune system
• blurred vision (not caused by discharge)
• thick discharge 
• pre-existing eye conditions
• symptoms that worsen or do not improve after 5 days

Prevention

To avoid re-infection:

• Discard any make-up, disposable contact lenses, contact lens solution bottles and cases
• Disinfect eye glasses, eye glass cases, extended wear contact lenses, and contact lens cases
• Launder clothes, towels and pillow cases

Practice good hand hygiene:

• Avoid touching or rubbing your eyes
• Wash your hands with soap and warm water or an alcohol-based hand sanitizer that contains at least 60% alcohol
• Wash your hands if you touch or rub your eyes, and after applying eye drops or compresses

Practice good self-care:

• Gently wipe any discharge from your eye using disposable tissues
• Use warm or cold-water soaked paper towels on your eyes  (separate one for each eye) to reduce discomfort and then dispose of the towel after use
• Use lubricating eye drops (artificial tears) as often as you like
• Clean your glasses and dispose of, or wash, the towels you used to clean them

Avoid sharing:

• Towels, blankets, pillowcases, make-up, make-up brushes, eye drops, contact lenses and containers, and eye glasses with friends, roommates, or partners

Sources: https://www.cdc.gov/conjunctivitis/; https://www.mayoclinic.org/diseases-conditions/pink-eye/symptoms-causes/syc-20376355

Head Lice (Pediculus Humanus Capitis)

Head lice infestation, or pediculosis, are mainly spread by direct contact with the hair of an infested person. Head lice infest the head and neck and attach their eggs, or nits, to the base of the hair shaft. Lice move by crawling; they cannot hop or fly. Adult head lice are roughly 2-3 mm long.

How is it transmitted?

Head-to-head contact with an already infested person is the most common way to get head lice. Although uncommon, head lice can be spread by sharing clothing or belongings. This happens when lice crawl, or nits (e.g. eggs) attached to shed hair hatch, and get on the shared clothing or belongings.

Examples include:

• sharing clothing (hats, scarves, coats, sports uniforms) or articles (hair ribbons, barrettes, combs, brushes, towels, stuffed animals) recently worn or used by an infested person;

OR

• lying on a bed, couch, pillow, or carpet that has recently been in contact with an infested person.

Dogs, cats, and other pets do not play a role in the transmission of human lice.

Signs and Symptoms

Signs of head lice may include a tickling feeling or something moving in the hair; itching, caused by an allergic reaction to the bites of the head louse; irritability and difficulty sleeping because head lice are most active in the dark; sores on the head caused by scratching.

Treatment

Over-the-counter and prescription medications are available for treatment of head lice infestations. Treatments for head lice are generally safe and effective when used correctly. Some treatments may cause itching or a mild burning sensation caused by inflammation of the skin on the scalp. Most products used to treat head lice are pesticides that can be absorbed through the skin. All medicines used for the treatment of lice should be used with care and only as directed.

Supplemental Treatment

Head lice do not survive long if they fall off a person. Follow these steps to help avoid re-infestation by lice that have recently fallen off the hair or crawled onto clothing or furniture.

1. Machine wash and dry clothing, bed linens, and other items that the infested person wore or used during the 2 days before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing and items that are not washable can be dry-cleaned

OR

1. Seal clothing, bed linens, and other items the infested person wore in a plastic bag and store for 2 weeks.
2. Soak combs and brushes in hot water (at least 130°F) for 5-10 minutes.
3. Vacuum the floor and furniture, particularly where the infested person sat or lay.
4. The risk of getting infested by a louse that has fallen onto a rug or carpet or furniture is very low. Head lice survive less than 1-2 days if they fall off a person and cannot feed; nits cannot hatch and usually die within a week if they are not kept at the same temperature as that found close to the human scalp.
5. Do not use fumigant sprays; they can be toxic if inhaled or absorbed through the skin.

Prevention

All household members and other close contacts should be checked for nits or lice (see Removal Experts below); those persons with evidence of an active infestation should be treated. All infested persons, household members, close contacts, and bedmates should be treated at the same time.

How to use an Over-the-counter (OTC) or prescription medication:

1. Before applying treatment, remove clothing that can become wet or stained during treatment.
2. Apply lice medicine, also called pediculicide, according to the instructions contained in the box or printed on the label. If the infested person has very long hair (longer than shoulder length), it may be necessary to use a second bottle. Pay special attention to instructions on the label or in the box regarding how long the medication should be left on the hair and how it should be washed out.

WARNING: Do not use a combination shampoo/conditioner, or conditioner before using lice medicine. Do not re-wash the hair for 1-2 days after the lice medicine is removed. These measures may reduce the effectiveness of the lice medications.

1. Put on clean clothing after treatment.
2. If a few live lice are still found 8-12 hours after treatment, but are moving more slowly than before, do not retreat. The medicine may take longer to kill all the lice. Comb dead and any remaining live lice out of the hair using a fine-toothed nit comb.
3. If, after 8-12 hours of treatment, no dead lice are found and lice seem as active as before, the medicine may not be working. Do not retreat until speaking with your health care provider; a different pediculicide may be necessary. If your health care provider recommends a different pediculicide, carefully follow the treatment instructions contained in the box or printed on the label.
4. Nit (head lice egg) combs, often found in lice medicine packages, should be used to comb nits and lice from the hair shaft. Many flea combs made for cats and dogs are also effective.
5. After each treatment, checking the hair and combing with a nit comb to remove nits and lice every 2-3 days may decrease the chance of self-reinfestation. Continue to check for 2-3 weeks to be sure all lice and nits are gone. Nit removal is not needed when treating with spinosad topical suspension.
6. Retreatment is meant to kill any surviving hatched lice before they produce new eggs. For some drugs, retreatment is recommended routinely about a week after the first treatment (7-9 days, depending on the drug) and for others only if crawling lice are seen during this period. Retreatment with lindane shampoo is not recommended.

Lice Removal Experts:

• Center for Lice Control: 610-624-2486
• Lice Doctors: 800-224-2537
• Lice Happens: 610-952-3691
• Lice Free Noggins:  215-607-7848
• Lice Lifters: 484-577-2359

Heat-Related Illnesses

Heat related illnesses include sunburn, heat cramps, heat rash, heat exhaustion, and heat stroke. These may occur during periods of intense sun, high exertion, or during extreme heat. Serious heat related illnesses are more common during times of abnormally high temperatures or humidity to which the body is not accustomed, such as during a heat wave or while traveling.

What causes heat related illness?

Heat-related illnesses occur when the body is unable to cool itself properly, which can sometimes lead to a dangerous rise in body temperature. Normally, our bodies use sweating as a normal mechanism for staying cool, but during extreme heat or high humidity, this may not be enough. Dehydration, alcohol use, intense exercise, age, or certain medical conditions can put people at higher risk for these illnesses.

Prevention

• Stay hydrated: Drink plenty of fluids. Sugary, very cold, alcoholic, carbonated, and caffeinated beverages should be avoided. Drinking a sports drink will help replace the salt and minerals lost due to sweat.
• Stay informed: Check the weather before leaving the house and dress appropriately.
• Stay cool: If possible, stay in air-conditioned environments as much as possible or find a cool place to go during hot days. Outdoor activities should be limited and scheduled during times when it is coolest (morning and evening hours). Take regular breaks in shaded areas, avoid sitting in hot car, and reduce exercise. Light-colored, lightweight, and loose fitting clothing should be worn. Sunscreen should be applied 30 minutes before going out in the sun and should be reapplied often. Sunglasses or a wide brimmed hat can also help protect from the sun. Taking cool baths or showers and using cool towels can help reduce body heat.

Signs and Symptoms

• Sunburn: painful, red, warm skin, blisters
•  Heat rash: clusters of red, small blisters (that resemble pimples) on the neck, chest, groin, or in elbow creases
• Heat cramps: muscle pain or spasms along with heavy sweating during intense exercise
• Heat exhaustion: heavy sweating, fast and weak pulse, cold/clammy skin, nausea or vomiting, dizziness, headache, fainting
• Heat stroke: high body temperature, hot, red, dry, or damp skin, fast and strong pulse, dizziness, headache, confusion, losing consciousness

Treatment

• Sunburn: Stay out of the sun until sunburn is healed. Cool baths, cool clothes on the sunburned area, moisturizing lotion, aloe may soothe the burn. If blisters are present, they should not be broken.
• Heat rash: Stay in a cool and dry place and keep the rash dry. Powder or cream may be used to soothe the rash
• Heat cramps: Stop physical activity, move to a cooler place, and drink water or a sports beverage. Wait for the cramps to go away completely before going back to physical activity. If the symptoms last longer than one hour, seek medical attention.
• Heat exhaustion: Move to a cool place, loosen clothes, and take a cold shower or bath. Get medical help as soon as possible if vomiting, experiencing worsening symptoms, or symptoms are lasting for longer than an hour.
•  Heat stroke: Call 911 immediately if heat stroke is suspected. Lower body temperature by moving to a cooler place and using cold cloths or a cold bath on the skin. Drinking water should not be given to a person suspected of having heat stroke.

If you are concerned about worsening symptoms of a heat-related illness and would like to talk with a clinician, please contact Student Health and Counseling at 215-746-WELL (9355).

Sources: https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html https://wwwnc.cdc.gov/travel/page/heat-illnesses

 

 

Lyme Disease

Lyme disease is a bacterial illness transmitted through the bite of an infected tick. Lyme disease is endemic to Pennsylvania, meaning it regularly occurs throughout the state.    

How is it transmitted?

An infected tick must be attached for more than 24 hours to transmit Lyme Disease. Ticks become infected when biting infected wildlife, usually rodents.

Prevention

Preventing a tick bite is the most effective way to prevent Lyme disease. Ticks live in grassy, bushy, or wooded areas. They may also live on animals. To prevent a tick bite:

• Avoid wooded and brushy areas with high grass and leaf litter.
• Use EPA-registered insect repellants when going outside.
• After going outside, check your clothing for ticks. Dry clothing may be put in a dryer on high heat for 10 minutes to kill ticks. Wet clothing may need additional time.
• Shower within two hours of coming indoors.
• Conduct a full-body tick check after being outdoors. Ticks can attach to any part of the body but prefer hard-to-see areas such as the scalp, armpits, and groin.
• If you have a dog, talk to your veterinarian about tick prevention products. Check your pet for ticks after they go outside.

Removing a Tick 

If you do find a tick attached to your skin, remove the tick as soon as possible. Remove a tick by using fine-tipped tweezers to grasp the tick as close to your skin as possible. Then, pull upward with steady, even pressure. Do not twist or jerk the tick. Dispose of the live tick by putting it in alcohol, placing in a sealed bag or container, wrapping it tightly in tape, or flushing it down the toilet. 

After a Tick Bite

For certain patients who have been bitten by certain ticks, a preventative antibiotic known as a post-exposure prophylactic may be prescribed by a clinician to help prevent Lyme Disease, even if not feeling sick. This treatment may be effective if the tick was attached for > 36 hours and if the medication is begun within 72 hours of tick removal. It is important to remember that being bitten by a tick does not always mean that you will develop Lyme Disease, but it is a good idea to contact Student Health and Counseling to speak with a medical provider or nurse (215-746-WELL (9355)) as soon as possible after a tick bite to receive care.

In the weeks following a tick bite, be sure monitor the site of the bite closely for any developing rashes and pay close attention to how you are feeling. 

Signs and Symptoms

Lyme disease can cause a wide range of symptoms. Early symptoms (3 to 30 days after a tick bite) include:

• Fever
• Chills
• Headache
• Fatigue
• Muscle aches
• Swollen lymph nodes
• Rash - Between 70 and 80 percent of infected individuals will develop a rash at the site of the tick bite. This rash may be shaped like a bulls-eye, and/or will be a reddish-purple color. This rash, if developed, will persist several days. A small bump or redness at the site that occurs immediately after a bite is normal, and not a sign of infection.

Treatment
Lyme disease may be treated with antibiotics. Before receiving treatment, an individual must first receive a diagnosis by a health care provider. It is important to take all the medication prescribed because if left untreated, Lyme disease can cause more severe illness. Later symptoms of Lyme Disease include arthritis, irregular heartbeats, or nervous system complications.

A course of treatment for Lyme Disease does not prevent reinfection. 
If you think you have Lyme Disease, the symptoms of Lyme Disease, or have recently found a tick attached to your body, please contact Student Health and Counseling at 215-746-WELL (9355).

Source: https://www.cdc.gov/lyme/index.html 

Meningitis

Meningitis is caused by the inflammation of the protective membranes covering the brain and spinal cord known as the meninges. Meningitis may result from to a number of causes, usually bacterial or viral infections, but also from injury, cancer or certain drugs.

Bacterial Meningitis
Meningitis that is caused by bacteria like Neisseria meningitides and Streptococcus pneumonia is often severe and can be life-threatening. Young adults living in group housing, such as on a college campus or in military barracks, are at risk for bacterial meningitis.

How is it transmitted?

Bacterial meningitis is transmitted by direct contact with large-droplet respiratory tract secretions (saliva or spit) from persons with meningococcal disease. Sharing cups, water bottles, utensils, cigarettes and hookahs increases the risk of transmission. Close personal contact (e.g. kissing) increases the risk of transmission. Close contacts include individuals sharing close spaces such as family members, teammates, and roommates. The bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been.

Signs & Symptoms

Bacterial meningitis includes sudden onset of fever, headache, and stiff neck. Additional symptoms, such as nausea, vomiting, photophobia (increased sensitivity to light), rash, and altered mental status (confusion), may also present.

The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3-7 days after exposure. Please call Student Health Service atat 215-746-WELL (9355), if you think you may have been in contact with someone who has bacterial meningitis and you develop these signs.

Treatment

Bacterial meningitis can be treated effectively with antibiotics. It is important that treatment be started as soon as possible. In the event of an exposure to someone with bacterial meningitis prophylactic antibiotics are available.

Prevention

Vaccination is the most effective way to protect oneself against bacterial meningitis.  Penn requires all full-time students less than or equal to the age 21 to be vaccinated, as well as any student living on campus. The meningococcal vaccine (e.g. Menactra or Menveo) only protects against certain strains (i.e. strains A,C,Y, and W-135). There is a separate vaccine for B-strain meningococcal disease that is not currently recommended by the CDC for routine use. 

Maintain healthy habits, like frequent hand washing, not smoking and avoiding cigarette smoke, getting plenty of rest, and not coming into close contact with people who are sick.

If you think you have bacterial meningitis or have been in close contact with someone who has bacterial meningitis, please contact Student Health and Counseling at 215-746-WELL (9355).
 

B-Strain Meningococcal Disease
B-strain meningococcal disease accounts for approximately half of all meningococcal cases among persons aged 17-22 years of age in the U.S. This age group is commonly found in institutional settings like college campuses.

How is it transmitted?

B-strain meningococcal disease is transmitted by direct contact with large-droplet respiratory tract secretions (saliva or spit) from persons with meningococcal disease. Sharing cups, water bottles, utensils, cigarettes and hookahs increases the risk of transmission. Close personal contact (e.g. kissing) increases the risk of transmission. Close contacts include individuals sharing close spaces such as family members, teammates, and roommates. The bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been.

Signs and symptoms

Symptoms of B-strain meningococcal disease include sudden onset of fever, headache, and stiff neck. Additional symptoms, such as nausea, vomiting, photophobia (increased sensitivity to light), rash and altered mental status (confusion), may also present.

The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3-7 days after exposure. 

Treatment

Early diagnosis is very important so that treatment can be started as soon as possible. B-strain meningococcal disease can be treated with antibiotics. In the event of an exposure to someone with B-strain meningococcal disease prophylactic antibiotics are available.

Prevention

There are vaccines (i.e. Bexsero and Trumenba) that protect against B-strain meningococcal disease. However, the vaccines are not currently recommended for routine use in college students living in residence halls, military recruits, or all adolescents. The CDC does not currently recommend B-strain  meningococcal disease vaccination for routine use.

Student Health and Counseling will have both vaccines available. However, there is no PSIP coverage except for those students in the following categories:

• People with persistent complement component deficiencies;
• People with anatomic or functional asplenia;
• Microbiologists who are regularly exposed to Neisseria meningitidis; or
• People at increased risk following an outbreak of B-strain meningococcal disease.

Maintain healthy habits, like frequent hand washing, not smoking and avoiding cigarette smoke, getting plenty of rest, and not coming into close contact with people who are sick.

If you think you have meningitis or have been in close contact with someone who has B-strain meningococcal disease, please contact Student Health and Counseling at 215-746-WELL (9355).
 

Viral Meningitis
Viral meningitis is the most common type of meningitis and is caused by a variety of viruses. Meningitis is an inflammation of the tissue that covers the brain and spinal cord. Viral meningitis is often less severe than bacterial meningitis, and most people usually get better on their own (without treatment).

How is it transmitted?

If you have close contact with a person who has viral meningitis, you may become infected with the virus that made that person sick. You are not likely to develop meningitis as a complication of the illness.

Signs & Symptoms

Viral meningitis includes sudden onset of fever, headache, and stiff neck. Additional symptoms, such as nausea, vomiting, photophobia (increased sensitivity to light), rash, sleepiness or trouble waking up from sleep, lack of appetite, and lack of energy, may also present.

Treatment

Viral meningitis usually resolves with self-care treatment within 7-10 days. Individuals with meningitis caused by certain viruses (e.g. herpesvirus) may benefit from antiviral medication. Self-care options include:

• Manage your fever and pain with ibuprofen (200 mg, 2-3 tabs) ever 6-8 hours with food
• Prevent dehydration by drinking plenty of clear liquids (water, ginger ale, sport drinks, etc.)
• Get plenty of rest

If you have trouble breathing, chest pain, suffer a relapse (begin to feel much worse after having felt better), severe headache and/or neck pain/stiffness, confusion, lethargy, severe or persistent vomiting please call Student Health and Counseling at 215-746-WELL (9355).

Prevention

There are no vaccines to protect against viral meningitis specifically. However, there are vaccines that protect against diseases such as measles, mumps, chickenpox, and influenza, which can lead to viral meningitis.

Maintain healthy habits, like frequent hand washing, not smoking and avoiding cigarette smoke, getting plenty of rest, and not coming into close contact with people who are sick.

Practice good hygiene:

• Wash your hands with soap and warm water or an alcohol-based hand sanitizer that contains at least 60% alcohol.
• Cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your sleeve or elbow.

If you think you have meningitis or have been in close contact with someone who has meningitis, please contact Student Health and Counseling at 215-746-WELL (9355).

Source: https://www.cdc.gov/meningitis/

Methicillin-resistant Staphylococcus aureus (MRSA)

Methicillin-resistant Staphylococcus aureus (MRSA) infection is caused by a type of staph bacteria that is resistant to several antibiotics and most often causes skin infections.

How is it transmitted?

MRSA is transmitted through direct contact with an infected wound or by sharing personal items (e.g. towels or razors) that have touched infected skin. MRSA can also be transmitted through direct contact with objects such as shared equipment or supplies, or even from floors and sinks that have been touched by a MRSA-infected person or carrier.

Signs and Symptoms

Most staph skin infections, including MRSA, appear as a bump or infected area on the skin that might be:

• Red
• Swollen
• Painful
• Warm to the touch
• Full of pus or other drainage
• Accompanied by a fever

These can turn into deep, painful abscesses that require draining. Often, people with MRSA skin infections first think they have a spider bite, However, unless a spider is actually seen, the irritation is likely not a spider bite.

Treatment

Although MRSA is resistant to several antibiotics, the infection will still respond to certain antibiotics for treatment. In some cases, the superficial abscess caused by MRSA will be drained by a doctor and antibiotics may not be necessary.

Prevention

Precautionary measures to reduce spread of MRSA include:

• Wash hands often and clean your body regularly, especially after exercise.
• Keep cuts, scrapes, and wounds clean and covered until healed.
• Do not try to treat the infection one’s self by picking or popping the sore.
• Avoid sharing personal items (e.g. towels and razors).
• Wash used linens and clothing thoroughly.

If you think you have MRSA and have worsening symptoms (e.g. new lesions, fever > 100.4, increased redness, drainage, or pain), please contact Student Health and Counseling at 215-746-WELL (9355).

Sources:
http://www.cdc.gov/mrsa
https://www.mayoclinic.org/mrsa

Scabies

Scabies is caused by mites that infest the skin. The mites will burrow into the upper layer of the skin where it lives and lays eggs.

How is it transmitted?

Scabies are spread through close contact with someone, or from sharing towels, bed sheets and other personal belongings. Scabies often affects several family members (or roommates) at the same time because of close cohabitation. Scabies can be spread to another person before symptoms show. Close contact must be prolonged for scabies to spread. A quick handshake or a hug usually will not spread scabies. Scabies is easily spread to sexual partners.

Signs and Symptoms

Scabies causes itching that is usually worse at night. It may cause a pimple-like rash with tiny blisters or sores. If a person has never had scabies before, symptoms may take 2-6 weeks to appear. Scabies can be spread during this time.

Treatment

Scabies will not go away on its own. Products used to treat scabies are called scabicides because they kill scabies mites; some also kill mite eggs. Scabicides used to treat human scabies are available only with a doctor’s prescription. No “over-the-counter” (non-prescription) products have been tested and approved to treat scabies.

Prevention

Scabies is prevented by avoiding direct skin-to-skin contact with an infected person or with items such as clothing or bedding used by an infected person. Scabies mites do not survive more than 2-3 days away from human skin. Items such as bedding, clothing, and towels used by a person with scabies can be decontaminated by machine-washing in hot water and drying using the hot cycle or by dry-cleaning. Items that cannot be washed or dry-cleaned can be decontaminated by sealing the items in a plastic bag for at least 72 hours.

Sources: http://www.cdc.gov/parasites/scabies/

Contact Public Health and Wellbeing

To contact the Public Health and Wellbeing team, including the Immunization and Insurance Navigators, call 215-746-WELL (9355).