Diphtheria – a vaccine preventable disease

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Volume 29 Number 2

ISSN 1059-6518

By Frank Hubbell, DO

The use of vaccines to prevent disease has been around for over 80 years and the number of vaccines has grown to over 25. For some individuals this is an area of confusion, debate, and disagreement. The reality is that vaccines are very well-studied and profoundly safe to use. As with any medication, there are risks, but the risks are far out-weighed by the benefits of not getting that particular disease.

I doubt there is anyone on this planet that would want to see the return of small pox or an increase in the cases of polio, or diphtheria. It is the vaccination process that builds up immunity to these diseases by stimulating the immune system to make antibodies to defeat the illness before it could cause symptoms and potentially death. However, there are those who, for whatever reason, refuse to be vaccinated, thereby putting themselves and others at risk.

To follow are a series of articles that will discuss and explain the various vaccine-preventable diseases and the consequences of acquiring that particular illness for which the vaccine was created. As stated above, currently, there are a total of 25 vaccines to prevent disease. For no particular reason, we will start with diphtheria.


A vaccine-preventable disease.

It is caused by a bacterium – Corynebacterium diphtheria.

It is an aerobic, gram-positive bacillus.

The reservoir in nature is us, human carriers.

The primary vector is droplet-spread through the air by coughing and sneezing.

There are toxigenic and non-toxigenic forms of diphtheria.

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Volume 29 Number 2

ISSN 1059-6518

Center for Disease Control (cdc.gov)

World Health Organization (who.int)

Latest Zika Situation Report – 25, August 2016

Microcephaly, Guillain-Barré Sydrome, and congenital anomalies


  • An Emergency Committee was convened by the Director-General under the International Health Regulations (2005) on 1 February 2016. Following the advice of the Committee, the Director-General announced the recent cluster of microcephaly and other neurologic disorders reported in Brazil to be a Public Health Emergency of International Concern.
  • The Emergency Committee agreed that a causal relationship between Zika infection during pregnancy and microcephaly is strongly suspected, though not yet scientifically proven. All experts agreed on the urgent need to coordinate international efforts to investigate and understand this relationship better.
  • As of 25 August 2016, a total of 70 countries have reported autochthonous circulation of Zika virus. It has been found in all of Central and South America, except for Chile.
  • 11 countries have reported evidence of person-to-person transmission.
  • The geographical distribution of Zika virus has been steadily increasing since it was first detected in the Americas in 2015. Further spread to countries within the geographical range of competent disease vectors — Aedes mosquitoes — is considered likely.
  • 18 countries have reported an increase in the incidence of cases of microcephaly and/or Guillain-Barré syndrome concomitantly with a Zika virus outbreak.

The global prevention and control strategy launched by WHO is based on surveillance, response activities, and research.

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Common Hunting Injuries and Their Treatment

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ISSN 1059-1865 Voulume 29 Number 1

By Jeff DeBellis

To those who don’t hunt, loading a weapon and marching off into the icy pre-dawn woods where dozens of other hunters are waiting with rifles pointed in countless directions may seem like an unnecessary risk in an era when good-quality, grass-fed meat is available in nearly every grocery store. True or not, nearly fourteen million Americans set off into the woods to go hunting every year. Countless others are hiking, biking, skiing, or backpacking in those same woods during hunting season. Hunting injuries are rare, but they are increasing. In the two decades between 1987 and 2006, they rose twelvefold. The causes vary widely, and, at times, the research appears to contradict itself. What is clear is that a little bit of prevention and basic knowledge of treatment goes a long way. A brief review of the research found six common categories of hunting-related injuries: gunshot wounds, tree stand falls, knife wounds, heart attacks, and arrow impalements.

Gunshot Wounds

The majority of hunting injuries are not firearm-related. Still, a number of fatal and non-fatal gunshot injuries do occur every year. About half of these are self-inflicted. One of the easiest things to do to prevent being accidentally shot by someone else is to wear blaze orange. One study in New York found that 94% of victims of firearm injuries were not wearing blaze orange (New York is one of only eight states that does not require hunters to do so). Avoiding alcohol while hunting should go without saying, but it plays a role in about 10% of hunting injuries. Other common tips are to treat every gun as though it is loaded, never point a gun at anything you wouldn’t want to kill, and keep your finger outside of the trigger guard until ready to fire.


At the very least, gunshot wounds cause either puncture wounds or impalements, depending on whether or not shrapnel remains in the body. Sometimes it’s not easy to tell if it has. At worst, these wounds could cause fractures (including spinal), cardiothoracic trauma, and, of course, death. The majority of gunshot wounds from hunting accidents occur in either the arms or legs. Even these could be fatal because of heavy bleeding and result in hypovolemic shock. If the patient’s airway and breathing are not affected, the first priority is to stop the bleeding by applying a pressure dressing. Elevating the wound above the heart is not always taught but will do no harm. Digital pressure should be used if necessary, and, as a last resort, a tourniquet or hemostatic agent. Clean the exposed part of the wound as well as possible, bandage it, and evacuate the victim as rapidly as possible.

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By Frank Hubbell, DO

Illustrations By T.B.R. Walsh

Places where you used to only see the intrepid adventurer you are now seeing more and more families. These families are recreating with all ages, including the very young. So it seemed like the time was right to review pediatric medical emergencies and management of them in the wilderness environment.

The Principles of Managing Pediatric Medical Emergencies:

Children are not small adults.

A child’s physiology varies greatly based on age and body weight.

A child’s emotional response to a crisis varies greatly with age.

A child’s mental capacity and understanding vary greatly with age.

A child’s speech and communication skills vary greatly with age.

Responding to a Pediatric Emergency – the Pediatric Patient Assessment System:

Initial Impression (PAT) ➡️ Primary Survey ➡️ Secondary Survey

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