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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
Over 400,000 cat bites are reported each year in the US, though the actual number of bites is much higher since many such bites are under-reported. 40 million households in the United States have domestic cats. Data on the number of people bitten or scratched by cats is limited because most of these incidents are not reported; however, 20%-80% of cat bites and scratches become infected. Cat-scratch disease or cat-scratch fever, an infection that causes fever and swollen lymph nodes, can develop from cat scratches even if they only break the surface of the skin. Based on reports of people treated for cat bites at hospitals, women are most likely to be victims of cat bites and scratches. Because of their smaller build, children are more likely to be bitten on their head, neck and face. Adults are more likely to bitten on the hands and arms. Those who are immunocompromised are more susceptible to infection from a cat bite.
Bed bug bites are caused by bed bugs primarily of two species "Cimex lectularius" (the common bed bug) and "Cimex hemipterus". Infestation is rarely due to a lack of hygiene. These insects feed exclusively on blood and may survive a year without eating. They are attracted by body warmth and carbon dioxide. Transfer to new places is usually in the personal effects of the human they feed upon.
Dwellings can become infested with bed bugs in a variety of ways, such as:
- Bugs and eggs inadvertently brought in from other infested dwellings on a visiting person's clothing or luggage;
- Infested items (such as furniture especially beds or couches, clothing, or backpacks) brought in a home or business;
- Nearby dwellings or infested items, if easy routes are available for travel, e.g. through ducts or false ceilings;
- Wild animals (such as bats or birds) that may also harbour bed bugs or related species such as the bat bug;
- People visiting an infested area (e.g. dwelling, means of transport, entertainment venue, or lodging) and carrying the bugs to another area on their clothing, luggage, or bodies. Bedbugs are increasingly found in air travel.
- Though bed bugs will feed on pets, they do not live or travel on the skin of their hosts, and pets are not believed a factor in their spread.
Cat bites can often be prevented by:
- instructing children not to tease cats or other pets.
- being cautious with unfamiliar cats.
- approaching cats with care, even if they appear to be friendly.
- avoiding rough play with cats and kittens.
Rough play causes is perceived as aggressive. This will lead to the cat being defensive when approached by people. Preventing cat bites includes not provoking the cat.
Efforts to prevent bites include clearing clutter and the use of pesticides.
OSHA recommends that workers take following measures to prevent spider bite:
- Wear a long-sleeved shirt, hat, gloves, and boots when handling boxes, firewood, lumber, rocks, etc.
- Inspect and shake out clothing and shoes before getting dressed.
- Use insect repellents, such as DEET or Picaridin, on clothing and footwear.
The vast majority of victims fully recover without significant lasting problems (sequelae). Death from latrodectism is reported as high as 5% to as low as 0.2%. In the United States, where antivenom is rarely used, there have been no deaths reported for decades.
Despite frequent reference to youth and old age being a predisposing factor it has been demonstrated that young children appear to be at lowest risk for a serious bite, perhaps owing to the rapid use of antivenom. Bite victims who are very young, old, hypotensive, pregnant or who have existing heart problems are reported to be the most likely to suffer complications. However, due to the low incidence of complications these generalizations simply refer to special complications (see Special circumstances).
A number of other symptoms may occur from either the bite of the bed bugs or from their exposure. Anaphylaxis from the injection of serum and other nonspecific proteins has been rarely documented. Due to each bite taking a tiny amount of blood, chronic or severe infestation may lead to anemia. Bacterial skin infection may occur due to skin break down from scratching.
Systemic poisoning may occur if the bites are numerous. Exposure to bed bugs may trigger an asthma attack via the effects of airborne allergens although evidence of this association is limited. There is no evidence that bed bugs transmit infectious diseases even though they appear physically capable of carrying pathogens and this possibility has been investigated. The bite itself may be painful thus resulting in poor sleep and worse work performance.
Similar to humans, pets can also be bitten by bed bugs. The signs left by the bites are the same as in case of people and cause identical symptoms (skin irritation, scratching etc).
Numerous spider bites are recorded in Brazil with 5000/ annually. "Loxosceles" species are responsible for the majority of reports. Accidents are concentrated in the southern state of Parana with rates as high as 1 per 1,000 people. Bite from "Phoneutria" (Brazilian wandering spider) number in the thousands with most being mild. Severe effects are noted in 0.5% of cases, mostly in children.
Pulicosis (also known as "flea bites") is a skin condition caused by several species of fleas, including the cat flea ("Ctenocephalides felis") and dog flea ("Ctenocephalides canis"). This condition can range from mild irritation to severe irritation. In some cases, 48 to 72 hours after being bitten, a more severe rash-like irritation may begin to spread across the body. Symptoms include swelling of the bitten area, erythema, ulcers of the mouth and throat, restlessness, and soreness of the areolae. In extreme cases, within 1 week after being bitten, the condition may spread through the lymph nodes and begin affecting the central nervous system. Permanent nerve damage can occur.
If they receive an excessive number of bites, pets can also develop flea allergy dermatitis, which can potentially be fatal if no actions are taken. However, dogs and cats are not the only ones that are at risk. Humans can suffer from flea bites and, depending on a variety of factors, the bites can cause much pain and discomfort.
The diagnosis of flea allergy dermatitis is complicated by the grooming habits of pets. Cats in particular are very efficient at grooming out fleas, often removing any evidence of infestation. Fleas begin biting within 5 minutes of finding a host, and there are no flea treatments that kill fleas before biting occurs.
In the developing world most snakebites occur in those who work outside such as farmers, hunters, and fishermen. They often happen when a person steps on the snake or approaches it too closely. In the United States and Europe snakebites most commonly occur in those who keep them as pets.
The type of snake that most often delivers serious bites depends on the region of the world. In Africa it is mambas, Egyptian cobras, puff adders, and carpet vipers. In the Middle East it is carpet vipers and elapids. In Central and South America it is snakes of the "Bothrops" and "Crotalus" types, the latter including rattlesnakes. In North America, rattlesnakes are the primary concern, and up to 95% of all snakebite-related deaths in the United States are attributed to the western and eastern diamondback rattlesnakes. In South Asia it was previously believed that Indian cobras, common kraits, Russell's viper and carpet vipers were the most dangerous; other snakes, however, may also cause significant problems in this area of the world.
Since envenomation is completely voluntary, all venomous snakes are capable of biting without injecting venom into a person. Snakes may deliver such a "dry bite" rather than waste their venom on a creature too large for them to eat, a behaviour called venom metering. However, the percentage of dry bites varies among species: 80 percent of bites inflicted by sea snakes, which are normally timid, do not result in envenomation, whereas only 25 percent of pit viper bites are dry. Furthermore, some snake genera, such as rattlesnakes, significantly increase the amount of venom injected in defensive bites compared to predatory strikes.
Some dry bites may also be the result of imprecise timing on the snake's part, as venom may be prematurely released before the fangs have penetrated the person. Even without venom, some snakes, particularly large constrictors such as those belonging to the Boidae and Pythonidae families, can deliver damaging bites; large specimens often cause severe lacerations, or the snake itself pulls away, causing the flesh to be torn by the needle-sharp recurved teeth embedded in the person. While not as life-threatening as a bite from a venomous species, the bite can be at least temporarily debilitating and could lead to dangerous infections if improperly dealt with.
While most snakes must open their mouths before biting, African and Middle Eastern snakes belonging to the family Atractaspididae are able to fold their fangs to the side of their head without opening their mouth and jab a person.
Bites from "Latrodectus" occur usually because of accidental contact with the spiders. The species are not aggressive to humans naturally, but may bite when trapped. As such, bite incidents may be described as accidents. Reports of epidemics were associated with agricultural areas in Europe in the last two centuries. However the European spider is associated with fields and humans come in contact only during harvest. For example, in the 1950s researchers believed that three bites happened each year and with an epidemic up to 180 each year.
Conversely, redback and North American black widows live in proximity with people and several thousand black widow bites are reported to Poison Control in the United States each year. About 800 are reported by medical personnel. Amongst those 800 bites only a dozen had major complications and none were fatal.
In Perth, Australia, for example there were 156 bites in children from redback spiders over 20 years. Twice as many boys were bitten as girls, mostly toddlers. A third of the children developed latrodectism and there were no deaths.
Many species of arthropods (insects, arachnids and others) regularly or occasionally bite or sting human beings. Insect saliva contains anticoagulants and enzymes that cause local irritation and allergic reactions. Insect venoms can be delivered by their stingers, which often are modified ovipositors, or by their mouthparts. Insect, spider and scorpion venom can cause serious injury or death. Dipterans account for the majority of insect bites, while hymenopterans account for the majority of stings. Among arachnids spider bites are the most common. Arthropods bite or sting humans for a number of reasons including feeding or defense. Arthropods are major vectors of human disease, with the pathogens typically transmitted by bites.
The aim of treatment is to relieve the allergy-induced itch and to remove the fleas from the pet and its home environment. In some cases, secondary bacterial or yeast infections will also need treatment before the itching subsides. Environmental flea control includes using flea foggers or bombs, vacuuming, and treating pet bedding by washing on a hot cycle (over 60 degrees Celsius) in the washing machine. The current on-pet treatment recommended by veterinary dermatologists is spinosad (Comfortis) monthly and nitenpyram (Capstar or generics) every 48 hours until improvement.
Many pets with FAD may also have other allergies, such as allergies to food, contact allergies, and atopic dermatitis.
The majority of individuals who receive a sting from an insect experience local reactions. It is estimated that 5-10% of individuals will experience a generalized systemic reaction that can involve symptoms ranging from hives to wheezing and even anaphylaxis. In the United States approximately 40 people die each year from anaphylaxis due to stinging insect allergy. Potentially life-threatening reactions occur in 3% of adults and 0.4–0.8% of children.
The histomorphologic appearance of insect bites is usually characterized by a wedge-shaped superficial dermal perivascular infiltrate consisting of abundant lymphocytes and scattered eosinophils. This appearance is non-specific, i.e. it may be seen in a number of conditions including:
- Drug reactions,
- Urticarial reactions,
- Prevesicular early stage of bullous pemphigoid, and
- HIV related dermatoses.
Feeding bites have characteristic patterns and symptoms, a function of the feeding habits of the offending pest and the chemistry of its saliva.
Chiggers are commonly found on the tip of blades of grasses to catch a host, so keeping grass short, and removing brush and wood debris where potential mite hosts may live, can limit their impact on an area. Sunlight that penetrates the grass will make the lawn drier and make it less favorable for chigger survival.
Chiggers seem to affect warm covered areas of the body more than drier areas. Thus, the bites are often clustered behind the knees, or beneath tight undergarments such as socks, underwear, or brassieres. Areas higher in the body (chest, back, waist-band, and under-arms) are affected more easily in small children than in adults, since children are shorter and are more likely than adults to come in contact with low-lying vegetation and dry grass where chiggers thrive. An exceptional case has been described in the eye, producing conjunctivitis.
Application of repellent to the shoes, lower trousers and skin is also useful. Because they are found in grass, staying on trails, roads, or paths can prevent contact. Dusting sulfur is used commercially for mite control and can be used to control chiggers in yards. The dusting of shoes, socks and trouser legs with sulfur can be highly effective in repelling chiggers.
Another good strategy is to recognize the chigger habitat to avoid exposure in the first place. Chiggers in North America thrive late in summer, in dry tall grasses and other thick, unshaded vegetation. Insect repellents containing one of the following active ingredients are recommended: DEET, catnip oil extract (nepetalactone), citronella oil or eucalyptus oil extract. However, in 1993 issue a study reported on tests of two commercial repellents: DEET and citrus oil: "All chiggers exposed on the filter papers treated with DEET died and did not move off the treated papers. None of the chiggers that were placed on papers treated with citrus oil were killed." It was concluded that DEET was more effective than citrus oil.
Chiggers can also be treated using common household vinegar (5% acetic acid).
Trombiculosis, trombiculiasis, or trombiculidiasis is a rash caused by trombiculid mites which is often referred to as a chigger bite.
In cases where a large dermonecrotic lesion has developed, sometimes surgery is attempted to remove the dead tissue. This is not ideal, since it will usually leave a large open sore behind, but in certain cases, still occurs. Skin graft to cover the ulcer are rarely needed but may help with appearance.
Anti-venoms are commercially prepared antibodies to toxins in animal bites. They are specific for each bite. There are several anti-venoms commercially available in Brazil, which have been shown to be effective in controlling the spread of necrosis in rabbits. When administered immediately, they can almost entirely neutralize any ill effects. If too much time is allowed to pass, the treatment becomes ineffective. Most victims do not seek medical attention within the first twelve hours of being bitten, and these anti-venoms are largely ineffective after this point. Because of this, anti-venoms are not being developed more widely. They have, however, been proven to be very effective if administered in a timely manner and could be utilized in Brazil as a legitimate technique.
Although the exact cause of feline acne is unknown, some causes include:
- Hyperactive sebaceous glands
- Poor hygiene
- Stress
- Developing secondary to fungal, viral, and bacterial infections
- Reaction to medication
- Drinking from plastic containers to which the cat is allergic
- Demodicosis or mange, causing itchiness and hair loss
- Suppressed immune system
- Hair follicles that don't function properly
- Rubbing the chin (to display affection or mark territory) on non-sanitized household items
- Hormonal imbalance
- Contracting the infection from other cats in the same household
Atopy is a hereditary and chronic (lifelong) allergic skin disease. Signs usually begin between 6 months and 3 years of age, with some breeds of dog, such as the Golden Retriever showing signs at an earlier age. Dogs with atopic dermatitis are itchy, especially around the eyes, muzzle, ears and feet. In severe cases the irritation is generalised. If the allergens are seasonal, the signs of irritation are similarly seasonal. Many dogs with house dust mite allergy have perennial disease. Some of the allergens associated with atopy in dogs include pollens of trees, grasses and weeds, as well as molds and House dust mite. Ear and skin infections with the bacteria "Staphylococcus pseudintermedius" and the yeast "Malassezia pachydermatis" are common secondary to atopic dermatitis.
Food allergy can be associated with identical signs and some authorities consider food allergy to be a type of atopic dermatitis.
Diagnosis of atopic dermatitis is by elimination of other causes of irritation including fleas, scabies and other parasites such as Cheyletiella and lice. Food allergy can be identified through the use of elimination diet trials in which a novel or hydrolysed protein diet is used for a minimum of 6 weeks and allergies to aeroallergens can be identified using intradermal allergy testing and/or blood testing (allergen-specific IgE ELISA).
Treatment includes avoidance of the offending allergens if possible, but for most dogs this is not practical or effective. Other treatments modulate the adverse immune response to allergens and include antihistamines, steroids, ciclosporin and immunotherapy (a process in which allergens are injected to try to induce tolerance). In many cases shampoos, medicated wipes and ear cleaners are needed to try to prevent the return of infections.
New research into T-cell receptor peptides and their effects on dogs with severe, advanced atopic dermatitis are being investigated.
It is caused by either "Bartonella henselae" or "B. quintana".
- "B. henselae" is most often transmitted through a cat scratch or bite, though ticks and fleas may also act as vectors.
- "B. quintana" is usually transmitted by lice.
It can manifest in people with AIDS and rarely appears in those who are immunocompetent.
Cat-scratch disease has a worldwide distribution, however it is a nonreportable disease in humans and therefore public health data on this disease is inadequate. Geographical location, present season and variables associated with cats (such as exposure and degree of flea infestation) all play a factor in the prevalence of Cat-scratch disease within a population. In warmer climates, the incidence of Cat-scratch disease is more prevalent during the fall and winter months. The higher rate of Cat-scratch disease during those months may be attributed to the breeding season for adult cats, which allows for the birth of kittens". B henselae," the bacterium responsible for causing Cat-scratch disease, is more prevalent in younger cats [less than one year old] than it is in adult cats.
To determine recent incidence of Cat-scratch disease in the United States, the Truven Health MarketScan Commercial Claims and Encounters database was analyzed in a case control study from 2005-2013. The database consisted of healthcare insurance claims for employees, their spouses, and their dependents. All participants were under 65 years of age, from all 50 states. The length of the study period was 9 years and was based off 280,522,578 person-years; factors such as year, length of insurance coverage, region, age, and sex were used to calculate the person-years incidence rate to eliminate confounding variables among the entire study population. 13,273 subjects were diagnosed with Cat-scratch disease, both in and outpatient cases were analyzed. The study revealed an incidence rate of 4.5/100,000 outpatient cases of Cat-scratch disease. For inpatient cases, the incidence rate was much lower at 0.19/100,000 population. Incidence of Cat-scratch disease was highest in 2005 among outpatient cases and then slowly declined. The Southern states saw the most significant decrease of incidence overtime. Mountain regions have the lowest incidence of this disease because fleas are not a common vector found in these areas.
Distribution of Cat-scratch disease among children aged 5-9 were of the highest incidence in the analyzed database, followed by woman aged 60-64. Incidence among female patients was higher than that among male patients in all age groups. According to data on social trends, women are more likely to own a cat over men; which supports higher incidence rates of this disease in women. Risk of contracting Cat-scratch disease increases as the number of cats residing in the home increases. The number of pet cats in the United States is estimated to be at 57 million. Due to the large population of cats residing in the United States, the ability of this disease to continue to infect humans is vast. Laboratory diagnosis of Cat-scratch disease has improved in recent years, which may support an increase in incidence of Cat-scratch disease in future populations.