“SAR is Severe Acute Respiratory Syndrome‑associated Coronavirus Disease.

Severe Acute Respiratory Syndrome (SARS) was a global disease outbreak in 2003 that was caused by a coronavirus called SARS-associated coronavirus (SARS-CoV). The illness was first reported in Asia in February 2003.

CDC worked with the World Health Organization in late February to investigate and confirm outbreaks of SARS in Southeast Asia.

The illness spread to 29 countries, where 8,096 people got SARS and 774 of them died. The SARS global outbreak was contained in July 2003.”

Center for Disease Control and Prevention – CDC (Severe Acute Respiratory Syndrome-associated Coronavirus Disease (SARS-CoV)| CDC)

“Sepsis is a medical emergency.

Sepsis in Adults

Sepsis is a medical emergency. Each year, about 1.7 million adults in America develop sepsis. At least 350,000 adults who develop sepsis die during their hospitalization or are discharged to hospice.

Sepsis in Children

Sepsis is a medical emergency. Each year, more than 18,000 children in the U.S. develop sepsis. More than 1,800 children who develop sepsis die during their hospitalization or are discharged to hospice.”

Center for Disease Control and Prevention – CDC (Sepsis Burden | Sepsis | CDC)

What is sepsis and 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)

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 commonly is.  SIRS is an inflammatory state affecting the whole body, frequently a response of the immune system to infection, but not always.  It is frequently related to sepsis, a condition in which individuals meet criteria for SIRS and have a known infection.

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.

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 urine

Who is at risk for sepsis?

Sepsis can strike anyone, but those at particular risk include:

• 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 young

“Nothing ruins summer fun like a summer injury! Before you pull on your board shorts and head out into the sun, make sure you know how to keep yourself safe, healthy and protected from some of nature’s less forgiving aspects (like the sun itself, not to mention mosquitoes, poison ivy and jellyfish — to name just a few).

One of the top ailments is dehydration. Up to 78% of your body is made of water, so when you don’t get enough of it, you simply can’t function right. In high heat, dehydration can become severe and even fatal.  A sunburn is a radiation burn caused by UV (ultraviolet) ray exposure from the sun. Ouch!  Another top ailment is Heat exhaustion happens when your body can’t cool itself through sweating. If it’s not treated, it can quickly turn into heatstroke.”

Cleveland Clinic (12 Summer Health Risks To Watch Out For)

We normally associate illness with winter, mainly because it’s the time of year we tend to get colds and flu.

However, there is no shortage of ailments and conditions that make life unpleasant and spoil our fun during the summer months.

The following are examples of health issues associated with summer:

1. Food poisoning

According to the CDC (Center for Disease Prevention and Control), every year around 3,000 Americans die from foodborne diseases.

Warm weather encourages bacteria to multiply, and who doesn’t enjoy barbeques and picnics during summer? Food that is prepared in advance and allowed to stand in the heat creates the perfect conditions for contamination and food poisoning.

Pre-prepared food should be handled hygienically, stored safely and kept cool if possible. It’s also better to choose foods that don’t spoil as easily or can be freshly prepared at your destination.

NHS Choices explains that most cases of food poisoning can be treated at home and do not require medical advice, and that most people will feel better in a matter of days. It is however important to replace fluids lost through vomiting and diarrhea.

If symptoms are severe, you may need to be admitted to hospital for a few days and given intravenous hydration.

2. Heat rash

Heat rash is a red or pink rash usually found on areas of the body that are covered with clothing. It happens during hot humid conditions and is most common in children. Heat rash develops when sweat ducts become blocked and swell up, looking like dots or tiny pimples on the skin. It often causes discomfort and itching.

Heat rash usually heals on its own in a matter of days and doesn’t require medical attention. In some cases the rash gets infected with symptoms like pain, swelling and pus. If this happens, be sure to see your doctor.

3. Water-borne conditions

We all like to spend time in the water during summer, and Dennis Maki, a professor of infectious diseases at the University of Wisconsin School of Medicine and Public Health, warns of the risk of bacterial infections and other water-borne illnesses as a result of taking part in recreational water activities.

Germs that turn up in swimming pool water include bacteria like E. coli, Salmonella, Camplobacter, noroviruses, and parasites. While treatment with chlorine can kill germs in swimming pools, it takes time for the chlorine to do its job.

Crypto is the most common cause of diarrhea outbreaks linked with swimming pools or water parks because it can survive up to 10 days in chlorinated water. … Infections can cause watery diarrhea, stomach cramps, nausea or vomiting, and can lead to dehydration.  CDC states “Crypto is highly resistant to chlorine, which makes it hard to kill once it’s in the water.  Swallowing just a mouthful of water with crypto in it can make otherwise healthy kids and adults sick for weeks with watery diarrhea, stomach cramps , nausea, and vomiting,” says Michele Hlavsa, chief of the CDC’s Healthy Swimming Program.  Every year, at least 15 to 20 outbreaks of diseases, like stomach bugs and diarrhea, are linked to swimming in public pools, according to the CDC.”

“Here are some tips from CDC in helping to protect you and your kids when the temperatures rise and the public pool is the only thing that will cool the heatwave:

• Don’t swim or let your kids swim if sick with diarrhea.
• Check the pool, hot tub, and water playground inspection scores.
• Use test strips to check the water’s pH and chlorine levels. You can get free test kits from the website of the Water Quality & Health Council.
• Try not to swallow the water.
• Take small children on frequent bathroom breaks.
• Shower before getting into a pool.
• Listen for the sound of a working pool pump.
• Change diapers in a diaper-changing area and away from the water.”

Apart from natural bodies of water like rivers and lakes, pools and hot tubs can also be sources of gastrointestinal problems; skin, ear and eye infections; and respiratory, neurological and viral problems. The safest places to swim are pools that are regularly checked for their chlorine levels.

4. Summer colds (summer or winter cold the symptoms are the same).

There is a kind of virus that produces cold-like symptoms, which tends to rear its ugly head during the summer months. It is called enterovirus and can cause more complicated symptoms than the typical winter cold.

Something summery may be lingering even as the season fades—the summer cold.

Colds in summertime can last for weeks, at times seemingly going away and then suddenly storming back with a vengeance, infectious-disease experts say. A winter cold, by contrast, is typically gone in a few days.

The reason for the difference: Summer colds are caused by different viruses from the ones that bring on sniffling and sneezing in the colder months. And some of the things people commonly do in the summer can prolong the illness, like being physically active and going in and out of air-conditioned buildings.

“A winter cold is nasty, brutish and short,” says Bruce Hirsch, infectious-disease specialist at North Shore University Hospital in Manhasset, N.Y. “But summer colds tend to linger. They can go on for weeks and reoccur.”

Summer colds, which can hit between June and October, occur only about 25% as often as the winter variety. But summer colds can have more severe, flu-like symptoms, in addition to sneezing and coughing. Many people also mistake a summer cold for allergies, because it just doesn’t seem to leave.

According to Merck Manual, symptoms of a summer cold caused by enterovirus include fever, headache, and sore throat, and sometimes mouth sores or a rash. Treatment is basically aimed at relieving symptoms.

5. Headache

An unfortunate result of summer activities that involve spending a lot of time in the hot sun can be a spitting headache. A survey by the National Headache Foundation indicates that headache sufferers consider summer to be the worst time of year for headaches.

As the temperature goes up, so does your risk for getting a headache. One theory is that the heat makes blood vessels in your head expand, causing them to press against nerve endings. Dehydration and strenuous exercise in hot weather can also lead to headaches.

An over-the-counter painkiller will usually alleviate headaches caused by heat exposure and exercise, and drinking enough water should take care of a dehydration headache.

6. Heat stroke

Heat stroke or hyperthermia results from prolonged exposure to high temperatures. It can happen for example when children are left in hot cars during summer.

Emedicinehealth defines heat stroke as a condition where the body’s cooling mechanisms are overcome by heat, resulting in a core heat of over 40°C. Heat stroke is preceded by signs of heat exhaustion like headaches, dizziness and weakness, and results in unconsciousness, organ failure and eventually death.

Hyperthermia is primarily treated by outside cooling of the body with the help of water, cold air or ice packs. Internal cooling by flushing the stomach or rectum with cold may also be used. Persons with hyperthermia need to be hospitalised in order to be tested for complications like muscle breakdown, which can damage the kidneys.

7. Sunburn

With summer comes the danger of sunburn, which can be extremely serious. Sunburn is caused by ultraviolet (UV) rays from the sun that damage your skin cells. The risk of damage depends on things like the time of day, the amount of time spent in the sun and if you use sun protection or not.

Sunburn can lead to long-term skin damage and even skin cancer. MedicineNet.com explains that there are three major kinds of skin cancer:

• Basal cell carcinoma (most common type)
• Squamous cell carcinoma (second most common)
• Melanoma (less common but considerably more dangerous)

The best and simplest way to avoid sunburn is to stay out of the sun.

Other ways to be sun-safe is to stay out of the midday sun, stay in the shade, use a good sunscreen and wear a hat and protective clothing.

“Auto-brewery syndrome causes symptoms of intoxication in people who haven’t consumed any alcohol. In this rare phenomenon, yeasts that normally live in your gut become overgrown. When they feed on the sugars you eat, they produce alcohol through fermentation.”

Cleveland Clinic (Auto-Brewery Syndrome: Symptoms, Causes & Treatment)

Auto brewery syndrome is a rare condition in which your body turns sugary and starchy foods into alcohol. This can cause symptoms as if you were drunk, even if you haven’t had any alcohol.

Auto-brewery syndrome or gut fermentation syndrome is a condition in which ethanol is produced through endogenous fermentation by fungi or bacteria in the gastrointestinal system, oral cavity, or urinary system. Patients with auto-brewery syndrome present with many of the signs and symptoms of alcohol intoxication while denying an intake of alcohol and often report a high-sugar, high-carbohydrate diet.

The production of endogenous ethanol occurs in minute quantities as part of normal digestion, but when fermenting yeast or bacteria become pathogenic, extreme blood alcohol levels may result. Auto-brewery syndrome is more prevalent in patients with co-morbidities such as diabetes, obesity, and Crohn disease but can occur in otherwise healthy individuals.  Several strains of fermenting yeasts and rare bacteria are identified as pathogens. While auto-brewery syndrome is rarely diagnosed, it is probably underdiagnosed. Even rarer are two cases of auto-brewery syndrome identified, one in the oral cavity and one in the urinary bladder.

ETIOLOGY:

Various yeasts from the Candida and Saccharomyces families are commensals turned pathogenic that cause auto-brewery syndrome. Several strains of bacteria are also known to ferment ethanol.

• Fermenting yeasts such as Saccharomyces cerevisiae, S. boulardii, and various strains of Candida, including C. glabrata, C. albicans, C. kefyr, and C. parapsilosis are identified as causes of this condition.
• The bacteria Klebsiella pneumonia, Enterococcus faecium, E. faecalis, and Citrobacter freundii are implicated in at least one case each.
• Existing conditions, such as diabetes or liver problems, can impact the diagnosis of ABS. Patients with type 2 diabetes mellitus (DM) or liver cirrhosis (LC) tested higher for endogenous ethanol (EnEth) levels than a control group without the disease. But the EnEth levels peaked highest in a group of patients with both type 2 DM and LC, where the blood alcohol concentration reached 22.3 mg/dL.
• Four common yeasts (Candida albicans, Candida tropicalis, Saccharomyces cerevisiae, and Torulopsis glabrata) were combined with infant formulas. Ethanol production was measured after 24 and 48 hours. The quantities of ethanol produced suggest an explanation for patients exhibiting auto-brewery syndrome.
• Bacterial production of EnEth is involved in the development of non-alcoholic fatty liver disease (NAFLD). Higher levels of EnEth are also detected in obese patients and those with non-alcoholic steatohepatitis (NASH).

SYMPTOMS:

Auto brewery syndrome can make you:

• drunk without drinking any alcohol
• very drunk after only drinking a small amount of alcohol (such as two beers)

Symptoms and side effects are similar to when you are slightly drunk or when you have a hangover from drinking too much:

• red or flushed skin
• dizziness
• disorientation
• headache pain
• nausea and vomiting
• dehydration
• dry mouth
• burping or belching
• fatigue
• memory and concentration problems
• mood changes

Auto brewery syndrome can also lead to or worsen other health conditions such as:

• chronic fatigue syndrome
• irritable bowel syndrome
• depression and anxiety

How does someone get this syndrome?

Adults and children can have auto brewery syndrome. Signs and symptoms are similar in both. Auto brewery syndrome is usually a complication of another disease, imbalance, or infection in the body.

You can’t be born with this rare syndrome. However, you may be born with or get another condition that triggers auto brewery syndrome. For example, in adults, too much yeast in the gut may be caused by Crohn’s disease. This can set off auto brewery syndrome.

In some people liver problems may cause auto brewery syndrome. In these cases, the liver isn’t able to clear out alcohol fast enough. Even a small amount of alcohol made by gut yeast leads to symptoms.

Toddlers and children with a condition called short bowel syndrome have a higher chance of getting auto brewery syndrome. A medical case reported that a 3-year-old girl Trusted Source with short bowel syndrome would get “drunk” after drinking fruit juice, which is naturally high in carbohydrates.

Other reasons you may have too much yeast in your body include:

• poor nutrition
• antibiotics
• inflammatory bowel disease
• diabetes
• low immune system

How its diagnosed:

There are no specific tests to diagnose auto brewery syndrome. This condition is still newly discovered and more research is needed. Symptoms alone are typically not enough for a diagnosis.

Your doctor will likely do a stool test to find out if you have too much yeast in your gut. This involves sending a tiny sample of a bowel movement to a lab to be tested. Another test that might be used by some doctors is the glucose challenge.

In the glucose challenge test, you’ll be given a glucose (sugar) capsule. You won’t be allowed to eat or drink anything else for a few hours before and after the test. After about an hour, your doctor will check your blood alcohol level. If you don’t have auto brewery syndrome your blood alcohol level will be zero. If you have auto brewery disease your blood alcohol level may range from 1.0 to 7.0 milligrams per deciliter.

If you suspect you have this auto brewery syndrome, you might try a similar test at home, though you shouldn’t use it to self-diagnose. Eat something sugary, like a cookie, on an empty stomach. After an hour use an at-home breathalyzer to see if your blood alcohol level has risen. Write down any symptoms.

This home test may not work because you may not have noticeable symptoms. At-home breathalyzers may also not be as accurate as the ones used by doctors and law enforcement. Regardless of what you observe, see a doctor for a diagnosis.