“Current theories about the onset and progression of sepsis and SIRS focus on dysregulation of the inflammatory response, including the possibility that a massive and uncontrolled release of proinflammatory mediators initiates a chain of events that lead to widespread tissue injury.”

Dr. Remi Neviere, MD/Professor/Author

The official cause of Patty Duke’s untimely death, according to Forbes, is sepsis caused by a “ruptured intestine.” Alarmingly, the number of reported sepsis cases is on the rise. A RN almost 30 years and agree in the hospital setting I commonly come across Sepsis.  As a traveler RN over the past 2 years commonly hospitals now are with “Septic Codes”.                                                            

Statistics indicate over one million cases, per year, in the United States alone.

What is SIRS? SIRS was first described by Dr William R. Nelson, of the University of Toronto, in a presentation to the Nordic Micro Circulation meeting in Geilo, Norway-February 1983.  In 1992, the American College of Chest Physicians (ACCP) and the Society of Critical Care Medicine (SCCM) introduced definitions for systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, septic shock, and multiple organ dysfunction syndrome (MODS), they are interrelated with each other in SIRS.  The idea behind defining SIRS was to define a clinical response to a nonspecific insult of either infectious or noninfectious origin. SIRS is defined as 2 or more of the following variables:

• Fever of more than 38°C (100.4°F) or less than 36°C (96.8°F)
• Heart rate of more than 90 beats per minute
• Respiratory rate of more than 20 breaths per minute or arterial carbon dioxide tension (PaCO ₂) of less than 32 mm Hg, which is normally in our body at 35-45 mm Hg whereas the oxygen= PaO2 in our body greater than 80mm Hg for the norm.
• Abnormal white blood cell count (>12,000/µL or < 4,000/µL or >10% immature [band] forms)It is the body’s response to an infectious or noninfectious insult to it. Although the definition of SIRS refers to it as an “inflammatory” response, it actually has pro- and anti-inflammatory components.  SIRS describes the host response to a critical illness of infectious or noninfectious cause, such as burns, trauma, and pancreatitis. More specific definitions are as follows: Sepsis is SIRS resulting from a presumed or known site of infection. Severe sepsis is sepsis with an acute associated multiple organ failure.
• SIRS is nonspecific and can be caused by ischemia, inflammation, trauma, infection, or several insults combined. Thus, SIRS is not always related to infection but can be.  SIRS is an inflammatory state affecting the whole body, frequently a response of the immune system to infection, but not necessarily so.  It is frequently related to sepsis, a condition in which individuals meet criteria for SIRS and have a known infection.
• What causes sepsis?Bacterial infections are the most common cause of sepsis. Sepsis can also be caused by fungal, parasitic, or viral infections. The source of the infection can be any of a number of places throughout the body. Common sites and types of infection that can lead to sepsis include:
  • The abdomen—An inflammation of the appendix (appendicitis), bowel problems, infection of the abdominal cavity (peritonitis), and gallbladder or liver infections
  • The central nervous system—Inflammation or infections of the brain or the spinal cord
  • The lungs—Infections such as pneumonia
  • The skin—Bacteria can enter skin through wounds or skin inflammations, or through the openings made with intravenous (IV) catheters (tubes inserted into the body to administer or drain fluids). Conditions such as cellulitis (inflammation of the skin’s connective tissue) can cause sepsis.
  • The urinary tract (kidneys or bladder)—Urinary tract infections are especially likely if the patient has a urinary catheter to drain urineSepsis can strike anyone, but those at particular risk include:
  • Who is at risk for sepsis?
  • People with weakened immune systems
  • Patients who are in the hospital
  • People with pre-existing infections or medical conditions
  • People with severe injuries, such as large burns or bullet wounds
  • People with a genetic tendency for sepsis
  • The very old or very youngBecause of the many sites on the body from which sepsis can originate, there is a wide variety of symptoms. The most prominent are:
  • What are the symptoms of sepsis?
  • Decreased urine output
  • Fast heart rate
  • Fever
  • Or the opposite Hypothermia (very low body temperature)
  • Shaking
  • Chills
  • Warm skin or a skin rash
  • Confusion or delirium
  • Hyperventilation (rapid breathing)
  • How is sepsis diagnosed?
  • A person may have sepsis if he or she has:
    • A high or low white blood cell count
    • A low platelet count
    • Acidosis (too much acid in the blood); in the hospital what is checked is lactic acid blood level.
    • A blood culture that is positive for bacteria
    • Abnormal kidney or liver function
    • *The treatment of sepsis?*
    • The most important intervention in sepsis is quick diagnosis and prompt treatment. Patients diagnosed with severe sepsis are usually placed in the intensive care unit (ICU) of the hospital for special treatment. The doctor will first try to identify the source and the type of infection, and then administer antibiotics to treat the infection. (Note: antibiotics are ineffective against infections caused by viruses; if anything what is used is antiviral medications.)
    • The doctor also administers IV fluids to prevent blood pressure from dropping too low. In some cases, vasopressor medications (which constrict blood vessels) are needed to achieve an adequate blood pressure. Some patients are given new drug therapies, such as activated protein C (APC). And finally, if organ failures occur, appropriate supportive care is provided (for example, dialysis for kidney failure, mechanical ventilation for respiratory failure, etc.).  Commonly what is used when initially sepsis is diagnosed is Vancomycin with other antibiotics like Imipenum, Cefepime, and others depending on what the blood culture shows as the microorganism if SIRS is caused by a bacterial infection (many times it is).*

“It is important to not only care for patients suspected to have the virus, but also to educate families in high-risk communities on how they can stay safe; eliminating mosquito breeding grounds, wearing protective clothing and applying insect repellent all reduce the risk of transmission.”                                              Including our government carrying out a procedure to check people that travel in and out of the U.S. to countries that have this virus to prevent it spreading in the US.

Dr. Julie Varughese  ( an expert in infectious disease & American Cares Medical Officer.)

Check out under images of this topic via your computer or lap top to find out more quick easy facts and prevention tactics.

Background in health crisis response and that we have known about this for sometime now.

AmeriCares Zika response leverages the technical expertise of our health experts and our more than 30 years of experience with international health crises. AmeriCares has responded to mosquito-borne disease outbreaks in the past, from West Nile in the United States to chikungunya in Latin America and the Caribbean. In 2014, during an outbreak of chikungunya, our response included support for a community health education campaign that reached more than 10,000 people in El Salvador through schools, sporting events and community centers.

The World Health Organization declared an international public health emergency on February 1 because of a suspected link between the virus and microcephaly, a condition in which babies are born with unusually small heads and abnormal brain development. There is growing evidence of an association between the increase in babies born with microcephaly, other possible birth defects and the incidence of Guillain-Barré syndrome that coincided with Zika virus infections. Currently, 33 countries and territories in the Americas have reported Zika cases, with up to 1.5 million confirmed cases in Brazil alone. The WHO is anticipating 3 million to 4 million more Zika infections in the region in the next 12 months.

There is no cure for Zika, but clinicians can help patients manage symptoms, giving them medicine to reduce fever and pain. They can also provide education on how to protect their families from the mosquitos that carry the virus.

Where are we actually working:

In Haiti, AmeriCares is working with a partner organization on a prevention program for expectant mothers, with the goal of keeping the women Zika-free until they deliver. In El Salvador, AmeriCares is developing a Zika-prevention program at its clinic, which provides primary and specialty care services for more than 60,000 patients annually, including prenatal care.

AmeriCares, which donates medicine and supplies to U.S.-based medical teams volunteering overseas, is also providing education materials to medical professionals working in Zika-affected countries. AmeriCares is supporting more than 150 medical teams planning travel to Latin America and the Caribbean through June.

Centers for Disease Control and Prevention and what they say about this Zika Virus:

Zika virus disease (Zika) is a disease caused by Zika virus that is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika.

For this reason, many people might not realize they have been infected. Once a person has been infected, he or she is likely to be protected from future infections. Though being checked for it yearly might not hurt if your country is exposed to it and could easily spread; especially if you have family traveling in your country as well as those you travel to countries known to be at risk for this disease and should be check when returning to their country like the USA for example. It is called prevention and control by the government and health parties of that country; pretty common sense. Instead it appears till the USA and other countries just wait till damage occurs – an epidemic some areas reaching out for help if the country doesn’t have the funds for controlling the epidemic. Why not help out for education and research before the epidemic if the disease is already known.

Zika virus was first discovered in 1947 and is named after the Zika forest in Uganda. In 1952, the first human cases of Zika were detected and since then, outbreaks of Zika have been reported in tropical Africa, Southeast Asia, and the Pacific Islands. Zika outbreaks have probably occurred in many locations. Before 2007, at least 14 cases of Zika had been documented, although other cases were likely to have occurred and were not reported. Because the symptoms of Zika are similar to those of many other diseases, many cases may not have been recognized.

In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infection in Brazil and on Feb 1, 2016, the World Health Organization (WHO) declared Zika virus a public health emergency of international concern (PHEIC) but not home prevention in the USA, like travelers from countries exposed with this that can be spread through a bite by a flying bug or possibly via sex so have the travelers returning checked to protect all in their country. Local transmission also has been reported in many other countries and territories. Zika virus likely will continue to spread to new areas. Let’s wake up and take action to control this from spreading in the USA and if possible other countries; especially our allies who travel here who are high with this virus treatment one day for this mosquito/sexual transmitted disease.

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 You’ve probably heard about Zika virus. But what is it exactly? Who is at risk? And what can you do to help?

Through PSIimpact.com has extensive experience helping families in the developing world overcome their most pressing health challenges. Here is what we know about Zika virus and how you can help.

1. The Zika virus is carried by mosquitoes and people. Typically, mosquitoes spread the virus. But there is evidence the virus may be sexually transmitted from someone who has been infected to his sexual partner.
2. The mosquitoes that carry Zika are active during the daytime, so malaria-fighting bed nets are not effective in stopping infection. Reducing breeding sites and using insecticides are currently two of the most effective ways to prevent the disease.
3. Symptoms of Zika virus infection are usually mild, typically begin a few days after being bitten, and usually finish in 2 to 7 days. Eighty percent of people who become infected never have symptoms. In those who do, the most common are fever, rash and conjunctivitis.
4. S. travelers are bringing the virus back with them. These imported cases happen when a person is infected elsewhere and then visits or returns to the United States.
5. There’s no vaccine to protect against the Zika virus, but researchers are working on one. Once a person becomes infected with the virus they usually develop immunity to future infections.
6. Researchers are studying the potential link between the Zika virus in pregnant women and microcephaly in their babies. Microcephaly is a birth defect that impairs brain development and can cause mild to severe cognitive delays, learning disabilities and impaired motor functions. The condition is marked by an abnormally small head.
7. Until a link is confirmed, it is crucial that women who are pregnant strictly follow steps to prevent mosquito bites.
8. The CDC recommends that pregnant women in any trimester consider postponing travel to the areas where Zika virus transmission is ongoing. The most recent travel advisories can be found on their website.
9. Several Latin American countries have urged women not to get pregnant for up to two years if visiting those areas with this disease or from those Latin American area moving to another country like America included, in an attempt to avoid birth defects believed to be caused by Zika. However, no government has announced plans to increase access or remove barriers to contraception. 

PSI is already working in affected areas including El Salvador, Haiti, Honduras, Guatemala, the Dominican Republic and other countries in Latin America and the Caribbean.  PSIimpact are supporting national responses led by the Ministries of Health.  PSIimpact.com states they will continue helping men and women access contraception so that they can make their own decision about when — and whether — to become pregnant. Thank you PSI for your knowledge and effort in researching

“In stage 4 colon cancer, the prisoner (being the cancer) has generally tunneled through several layers of the prison, found the highway, and traveled to another town (usually the liver or lungs).”

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