FDA approves first "artificial pancreas" for type 1 diabetes--HEALTH NEWS UPDATE

FDA approves first "artificial pancreas" for type 1 diabetes

The U.S. Food and Drug Administration on Wednesday approved the first automated insulin delivery system -- a so-called “artificial pancreas” -- for people with type 1 diabetes.

Medtronic’s MiniMed 670G hybrid closed looped system, the first FDA-approved “artificial pancreas” device for people with type 1 diabetes.

Medtronic

“This first-of-its-kind technology can provide people with type 1 diabetes greater freedom to live their lives without having to consistently and manually monitor baseline glucose levels and administer insulin,” Dr. Jeffrey Shuren, director of the FDA’s Center for Devices and Radiological Health, said in an agency news release.

The device -- Medtronic’s MiniMed 670G -- is what’s known as a hybrid closed-loop system. That means it monitors blood sugar and then delivers necessary background (also known as basal) insulin doses. The device will also shut off when blood sugar levels drop too low.

However, this device isn’t yet a fully automated artificial pancreas​ . People with type 1 diabetes will still need to figure out how many carbohydrates are in their food, and enter that information into the system, the agency noted.

Medtronic said the new device will be available by Spring 2017. The FDA approval is currently only for people aged 14 and older. The company is now conducting clinical trials with the device in younger patients.

Type 1 diabetes is an autoimmune disease caused by a mistaken attack on healthy insulin-producing cells in the body, destroying them. Insulin is a hormone necessary for ushering sugar into cells in the body and brain to provide fuel for the cells. People with type 1 must replace the insulin their bodies no longer produce, through multiple daily injections or through a tiny catheter attached to an insulin pump.

However, figuring out exactly how much insulin to give is no easy task. Both too much and too little insulin can have dangerous, even deadly consequences.

And that’s where this new technology will help. The device has a continuous glucose monitor that constantly measures blood sugar levels. A sophisticated computer algorithm then figures out if someone’s blood sugar levels are too low or too high, and when too high, will give the correct insulin dose to bring the blood sugar level down.

The device does this via a small catheter inserted beneath the skin and attached to a tube that’s attached to an insulin pump. This insulin delivery site needs to be changed approximately every three days.

If blood sugar levels are too low, the device will shut down insulin delivery.

In a statement, Aaron Kowalski, chief mission officer for JDRF (formerly the Juvenile Diabetes Research Foundation), said until there’s a cure for type 1 diabetes, “I know that the artificial pancreas will change many lives for the better.”

“People who have participated in artificial pancreas clinical trials have not only attained better overall [blood sugar] control, but have experienced the relief of sleeping through the night and waking up in the morning with blood glucose levels within target range. That’s an improvement in quality of life that will be available to others living with type 1 diabetes very soon as a result of the FDA’s decision,” he said.

Melinda Rose -- who has a grown son with type 1 , diagnosed diabetes when he was just 13 years old -- expressed excitement over the approval. The artificial pancreas “will revolutionize the way in which a person with type 1 diabetes manages this disease. In human terms, the parent of a child with the [artificial pancreas] system will now be able to sleep through the night and worry less.”

Dr. Gerald Bernstein, an endocrinologist and coordinator of the Friedman Diabetes Program at Lenox Hill Hospital in New York City, also expressed enthusiasm for the new device.

“With the development of electronic devices to deliver insulin and measure blood glucose, the dream has been to tie everything together and have an ‘artificial pancreas,” he said. “The greatest inhibitor has been the complexity of insulin delivery and the development of algorithms that can come close to what the normal body does,” Bernstein explained.

“This is a welcome step forward for people with type 1 diabetes,” he added. “It will be many years for a biologic cure or prevention, and it is exciting to know that life can be better until the next best thing comes along.”

According to JDRF, there are currently 18 artificial pancreas systems in various stages of development, with Medtronic’s being the first to receive FDA approval.

Medtronic was also the first, and so far only, company to receive approval on what’s known as a “low-suspend” pump. That device, approved in late 2013, shuts off automatically when blood sugar levels go too low. However, unlike the newly approved device, the low-suspend pump did not provide insulin delivery.

According to the agency, the FDA approval is based on data from a clinical trial of 123 people with type 1 diabetes. The study volunteers wore the device for three months. No serious low blood sugar (hypoglycemia) events occurred. And no one experienced diabetic ketoacidosis, a serious complication that can occur if someone doesn’t get enough insulin, according to the American Diabetes Association.

Component of red wine, grapes can help to reduce inflammation--HEALTH RESEARCH FINDS

Component of red wine, grapes can help to reduce inflammation

Grapes

 

A component of red wine and grapes can help control inflammation induced by a bacterial pathogen that is linked to upper respiratory tract inflammatory diseases such as asthma, chronic obstructive pulmonary diseases (COPD) and middle ear infection (otitis media), according to a study by researchers at Georgia State University. The findings, published in the online journal Scientific Reports, identify a novel mechanism that resveratrol, a compound found naturally in some plant foods such as grapes, uses to alleviate inflammation in airway disease. The results suggest this compound could offer health benefits and be used to develop new, effective anti-inflammatory therapeutic agents. "We showed that an important component in red wine and also grapes called resveratrol can suppress inflammation," said Dr. Jian-Dong Li, a senior author of the study, director of the Institute for Biomedical Sciences at Georgia State and a Georgia Research Alliance Eminent Scholar. "It has been shown that resveratrol can suppress inflammation, but how it regulates inflammation still remains largely unknown. We found that resveratrol suppresses a major bacterial pathogen causing otitis media and COPD by upregulating or increasing the production of a negative regulator called MyD88 short."
Resveratrol belongs to a group of compounds called polyphenols that are thought to act like antioxidants and protect the body against damage. It has long been considered a therapeutic agent for various diseases, including inflammatory diseases. In the study, resveratrol was effective against inflammation caused by nontypeable Haemophilus influenzae (NTHi), a major respiratory pathogen.
An appropriate amount of inflammation in the body is beneficial for defense against bacterial infection, but uncontrolled inflammation leads to inflammatory diseases. Upper respiratory tract inflammatory diseases such as asthma and COPD affect more than half a billion people worldwide and are characterized by chronic inflammation that is aggravated by respiratory pathogens such as NTHi. Asthma results in 250,000 deaths annually and is the leading cause of hospitalizations in children younger than 15 in the United States. COPD is the third leading cause of death in the U.S., and the World Health Organization predicts it will be the fifth most significant contributor to worldwide disease by 2020. Otitis media is the most common bacterial infection and also the leading cause of conductive hearing loss in children.
Antibiotics are routinely used to treat NTHi infections, but the increasing numbers of antibiotic-resistant bacterial strains and the limited success of currently available pharmaceuticals used to manage the symptoms of these diseases present an urgent need for the development of non-antibiotic therapeutics.
This study found for the first time that resveratrol decreases NTHi-induced expression of pro-inflammatory mediators in airway epithelial cells and in the lungs of mice by enhancing MyD88 short, a negative regulator of inflammatory signaling pathways. MyD88 short is considered a "brake pedal protein" because it can tightly control inflammation induced by this respiratory pathogen. It could be a critical target with significant therapeutic potential for suppressing inflammation associated with chronic airway disease.
The researchers also found that resveratrol has anti-inflammatory effects after NTHi infection, which demonstrates its therapeutic potential.
"The findings help us to shed light on developing new therapeutic strategies by targeting or pharmacologically upregulating MyD88 short production," Li said. "We could use resveratrol to suppress inflammation or develop resveratrol derivatives that could be pharmacological agents to suppress inflammation using the same strategy."

NEW DRUG APPROVAL BY FDA

FDA Approves Stelara (ustekinumab) for Treatment of Adults with Moderately to Severely Active Crohn's Disease

HORSHAM, Pa., Sept. 26, 2016 /PRNewswire/ -- Janssen Biotech, Inc., announced that the U.S. Food and Drug Administration (FDA) has approved Stelara (ustekinumab) for the treatment of moderately to severely active Chron's disease in adults (18 years or older) who have failed or were intolerant to treatment with immunomodulators or corticosteroids but never failed treatment with a tumor necrosis factor (TNF) blocker, or who failed or were intolerant to treatment with one or more TNF blockers. Stelara is the first biologic therapy for Crohn's disease targeting interleukin (IL)-12 and IL-23 cytokines, which play a key role in inflammatory and immune responses.
"Crohn's disease is a complex condition to treat, and not all therapies work for every patient," said William J. Sandborn, MD, Chief, Division of Gastroenterology, and Professor of Medicine, UC San Diego School of Medicine, and study investigator. "The FDA approval of Stelara represents an important advancement in treating patients with Crohn's disease, as this therapy offers an alternate mechanism of action to induce and maintain clinical remission over time. Based on the results of the clinical development program, Stelara has the potential to benefit many adults living with Crohn's disease."
In clinical studies of patients who were either new to, experienced with, or failed biologic therapy (TNF blockers), between 34% (UNITI-1 study) and 56% (UNITI-2 study) of patients experienced relief from their Crohn's disease symptoms in just six weeks after receiving the one-time intravenous (IV) infusion of Stelara. Noticeable improvement was observed as early as three weeks. Additionally, the majority of those who responded to induction dosing and continued treatment with Stelara subcutaneous maintenance doses every 8 weeks were in remission at the end of 44 weeks (52 weeks from initiation of the induction dose).
Stelara is the only treatment for Crohn's disease that starts with a weight-based, one-time intravenous (IV) infusion induction dose (260 mg [55 kg or less], 390 mg [more than 55 kg to 85 kg], or 520 mg [more than 85 kg]) to help reduce symptoms, followed by 90 mg subcutaneous maintenance injections every 8 weeks to help keep the symptoms under control. The first dose of Stelara is an induction dose, administered intravenously, under the supervision of a healthcare professional. Subsequent maintenance doses are administered as a subcutaneous injection every 8 weeks, either by a healthcare professional or self-injected by the patient after proper training.
Janssen will work closely with payers, providers and pharmacy benefit managers to ensure Stelara is broadly accessible and affordable for patients, and that the cost for payers is competitive with currently available biologic therapies for Crohn's disease. Janssen offers a number of patient support programs including a co-pay card for patients with commercial insurance that reduces their out-of-pocket cost for Stelara to no more than $5 per dose (IV and/or subcutaneous injection), which is also offered for patients with psoriasis and psoriatic arthritis.
"The approval of Stelara for Crohn's disease underscores our commitment to provide innovative treatment options for people living with chronic inflammatory and immune-mediated diseases," said Andrew Greenspan, MD, vice president of medical affairs at Janssen Biotech, Inc. "We are confident Stelara will improve the lives of many people living with Crohn's disease and are committed to ensuring that it is accessible to patients who qualify for this new therapeutic option."

Clinical Trial Program

The clinical development program for Stelara for Crohn's disease included more than 1,300 patients across three pivotal Phase 3 studies, which served as the primary basis for FDA approval.

• The UNITI-1 induction study found that treatment with Stelara induced clinical response and clinical remission in patients who had previously failed or were intolerant to treatment with one or more TNF blockers.
• The UNITI-2 induction study demonstrated treatment with Stelara induced clinical response and clinical remission in patients who had previously failed or were intolerant to conventional therapy (immunomodulators or corticosteroids), the majority of whom were naïve to treatment with a TNF blocker.
• The IM-UNITI maintenance study, which evaluated patients who achieved clinical response eight weeks after a single intravenous infusion of Stelara in the UNITI-1 and UNITI-2 Phase 3 induction studies, demonstrated that more than half of patients receiving Stelara subcutaneous injections every eight weeks were in clinical remission after nearly one year of treatment.

About Crohn's Disease

Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract that affects approximately 700,000 Americans. Symptoms of Crohn's disease can vary but often include abdominal pain and tenderness, frequent diarrhea, rectal bleeding, weight loss, and fever. Hospitalization is at times required for severe disease, to treat certain complications, and for surgery. There is currently no cure for Crohn's disease.¹

About Stelara (ustekinumab)

Stelara is a prescription medicine used to treat moderately to severely active Crohn's disease in adult patients (18 years and older) who have already taken other medicine that did not work well enough or they could not tolerate it.

About the Janssen Pharmaceutical Companies

At the Janssen Pharmaceutical Companies of Johnson & Johnson, we are working to create a world without disease. Transforming lives by finding new and better ways to prevent, intercept, treat and cure disease inspires us. We bring together the best minds and pursue the most promising science. We are Janssen. We collaborate with the world for the health of everyone in it. Learn more at www.janssen.com.

NEW DRUG APPROVAL BY FDA

FDA Approves Orkambi (lumacaftor/ivacaftor) for Use in Children with Cystic Fibrosis Ages 6 through 11 who have Two Copies of the F508del Mutation

 September 28, 2016 -- Vertex Pharmaceuticals Incorporated (Nasdaq: VRTX)  announced that the U.S. Food and Drug Administration (FDA) approved Orkambi (lumacaftor/ivacaftor) for use in children with cystic fibrosis (CF) ages 6 through 11 who have two copies of the F508del mutation. People with this mutation represent the largest population of those with CF, a rare, life-threatening disease. Orkambi is the first and only medicine to treat the underlying cause of CF for people with this mutation. It was previously approved by the FDA for use in people ages 12 and older with two copies of the F508del mutation. With today's approval, approximately 11,000 people with CF are eligible for treatment with Orkambi in the United States. Orkambi will be available for eligible children ages 6 through 11 in the United States as soon as possible. Vertex also today lowered its guidance for 2016 Orkambi revenues to a range of $950 million to $990 million.
"The ability to treat children as young as six who have the most common form of the disease is an important milestone as we pursue our goal to develop medicines for all people with CF," said Jeffrey Chodakewitz, M.D., Executive Vice President and Chief Medical Officer at Vertex. "We believe it is important to treat the underlying cause of the disease as early as possible in these patients."
The approval is based on data from a previously announced open-label Phase 3 clinical safety study of Orkambi presented at the 39th European Cystic Fibrosis Society Conference in June 2016.
Vertex plans to submit a Marketing Authorization Application (MAA) variation in the European Union in the first half of 2017 for children ages 6 through 11 who have two copies of the F508del mutation. This application will be based on data from a Phase 3 efficacy study with a primary endpoint of absolute change in lung clearance index (LCI). These data are expected before the end of 2016.

About Cystic Fibrosis and Orkambi

Cystic fibrosis is a rare, life-threatening genetic disease affecting approximately 75,000 people in North America, Europe and Australia.
CF is caused by defective or missing cystic fibrosis conductance regulator (CFTR) proteins resulting from mutations in the CFTR gene. Children must inherit two defective CFTR genes — one from each parent — to have CF. There are approximately 2,000 known mutations in the CFTR gene. Some of these mutations, which can be determined by a genetic test, lead to CF by creating defective or too few CFTR proteins at the cell surface. The defective or missing CFTR protein results in poor flow of salt and water into or out of the cell in a number of organs, including the lungs. This leads to the buildup of abnormally thick, sticky mucus that can cause chronic lung infections and progressive lung damage in many patients that eventually leads to death. The median predicted age of survival for a person born today with CF in the United States is 39 years, but the median age of death is 29 years.
In people with two copies of the F508del mutation, the CFTR protein is not processed and trafficked normally within the cell, resulting in little to no CFTR protein at the cell surface. Patients with two copies of the F508del mutation are easily identified by a simple genetic test.
Orkambi is a combination of lumacaftor, which is designed to increase the amount of mature protein at the cell surface by targeting the processing and trafficking defect of the F508del CFTR protein, and ivacaftor, which is designed to enhance the function of the CFTR protein once it reaches the cell surface. In pediatric patients ages 6 through 11, two Orkambi tablets (each containing lumacaftor 100mg/ivacaftor 125mg) are taken orally every 12 hours - once in the morning and once in the evening - with fat-containing food.

About Vertex

Vertex is a global biotechnology company that aims to discover, develop and commercialize innovative medicines so people with serious diseases can lead better lives. In addition to our clinical development programs focused on cystic fibrosis, Vertex has more than a dozen ongoing research programs aimed at other serious and life-threatening diseases.
Founded in 1989 in Cambridge, Mass., Vertex today has research and development sites and commercial offices in the United States, Europe, Canada and Australia. For six years in a row, Science magazine has named Vertex one of its Top Employers in the life sciences. For additional information and the latest updates from the company, please visit www.vrtx.com.

HEALTH INFORMATION..

7 things you can do to prevent a stroke

 

 

 

Regardless of your age or family history, a stroke doesn't have to be inevitable. Here are some ways to protect yourself starting today.

Age makes us more susceptible to having a stroke, as does having a mother, father, or other close relative who has had a stroke.

You can't reverse the years or change your family history, but there are many other stroke risk factors that you can control—provided that you're aware of them. "Knowledge is power," says Dr. Natalia Rost, associate professor of neurology at Harvard Medical School and associate director of the Acute Stroke Service at Massachusetts General Hospital. "If you know that a particular risk factor is sabotaging your health and predisposing you to a higher risk of stroke, you can take steps to alleviate the effects of that risk."

Here are seven ways to start reining in your risks today, before a stroke has the chance to strike.

1. Lower blood pressure

High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. "High blood pressure is the biggest contributor to the risk of stroke in both men and women," Dr. Rost says. "Monitoring blood pressure and, if it is elevated, treating it, is probably the biggest difference women can make to their vascular health."

Your ideal goal: Maintain a blood pressure of less than 120/80. But for some, a less aggressive goal (such as 140/90) may be more appropriate.

How to achieve it:

• Reduce the salt in your diet to no more than 1,500 milligrams a day (about a half teaspoon).
• Avoid high-cholesterol foods, such as burgers, cheese, and ice cream.
• Eat 4 to 5 cups of fruits and vegetables every day, one serving of fish two to three times a week, and several daily servings of whole grains and low-fat dairy.
• Get more exercise — at least 30 minutes of activity a day, and more, if possible.
• Quit smoking, if you smoke.

If needed, take blood pressure medicines.

2. Lose weight

Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you're overweight, losing as little as 10 pounds can have a real impact on your stroke risk.

Your goal: Keep your body mass index (BMI) at 25 or less.

How to achieve it:

• Try to eat no more than 1,500 to 2,000 calories a day (depending on your activity level and your current BMI).
• Increase the amount of exercise you do with activities like walking, golfing, or playing tennis, and by making activity part of every single day.

3. Exercise more

Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer.

Your goal: Exercise at a moderate intensity at least five days a week.

How to achieve it:

• Take a walk around your neighborhood every morning after breakfast.
• Start a fitness club with friends.
• When you exercise, reach the level at which you're breathing hard, but you can still talk.
• Take the stairs instead of an elevator when you can.
• If you don't have 30 consecutive minutes to exercise, break it up into 10- to 15-minute sessions a few times each day.

4. Drink — in moderation

What you've heard is true. Drinking can make you less likely to have a stroke — up to a point. "Studies show that if you have about one drink per day, your risk may be lower," says to Dr. Rost. "Once you start drinking more than two drinks per day, your risk goes up very sharply."

Your goal: Drink alcohol in moderation.

How to achieve it:

• Have one glass of alcohol a day.
• Make red wine your first choice, because it contains resveratrol, which is thought to protect the heart and brain.
• Watch your portion sizes. A standard-sized drink is a 5-ounce glass of wine, 12-ounce beer, or 1.5-ounce glass of hard liquor.

5. Treat atrial fibrillation

Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain, producing a stroke. "Atrial fibrillation carries almost a fivefold risk of stroke, and should be taken seriously," Dr. Rost says.

Your goal: If you have atrial fibrillation, get it treated.

How to achieve it:

• If you have symptoms such as heart palpitations or shortness of breath, see your doctor for an exam.
• You may need to take blood thinners such as high-dose aspirin or warfarin (Coumadin) to reduce your stroke risk from atrial fibrillation. Your doctors can guide you through this treatment.

6. Treat diabetes

Having high blood sugar damages blood vessels over time, making clots more likely to form inside them.

Your goal: Keep your blood sugar under control.

How to achieve it:

• Monitor your blood sugar as directed by your doctor.
• Use diet, exercise, and medicines to keep your blood sugar within the recommended range.

7. Quit smoking

Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries. "Along with a healthy diet and regular exercise, smoking cessation is one of the most powerful lifestyle changes that will help you reduce your stroke risk significantly," Dr. Rost says.

Your goal: Quit smoking.

How to achieve it:

• Ask your doctor for advice on the most appropriate way for you to quit.
• Use quit-smoking aids, such as nicotine pills or patches, counseling, or medicine.
• Don't give up. Most smokers need several tries to quit. See each attempt as bringing you one step closer to successfully beating the habit.

Brief Infection Overview...

Infection

Infection is a process in which bacteria, viruses, fungi or other organisms enter the body, attach to cells, and multiply. To do this, they must evade or overcome the body's natural defenses at each step. Infections have the potential to cause illness, but in many cases the infected person does not get sick.

How Does Infection Occur?

Organisms that can cause illness are all around us: in air, water, soil, and food, as well as in the bodies of animals and other people. Infection occurs when some of them get past a series of natural defenses. Those defenses include:

• Skin: The skin physically blocks germs, but may let them in if it is cut or scraped.
• Coughing deeply: This expels germs from the lungs and breathing passages but may be less effective for weak, sick, or injured people.
• Bacteria: Called "resident flora," harmless bacteria normally are present in some parts of the body. They compete with harmful germs and crowd them out. But they can be weakened or killed by medications, allowing harmful germs to thrive and cause illness.
• Inflammatory response: This is produced by the body's immune system. Certain kinds of white blood cells—including macrophages and neutrophils—surround and destroy or otherwise attack any kind of germs, often causing fever, redness, and swelling.
• Antibodies: These are proteins produced by the immune system. Some are targeted to attack specific microbes. This response is also called humoral immunity. Usually these antibodies are produced after a person is infected by or exposed to the microbe.

The immune system's responses may fail if the germs are too numerous, or if they are too virulent. "Virulent," from the Latin for "poisonous," describes germs that are particularly good at countering the body's defenses. For instance, some microbes can prevent antibodies from forming against them. Another important factor is the functioning of the immune system. If it is damaged—weakened, for instance, by age or illness—infection is more likely. Babies tend to get more infections because their immune systems have not yet learned to recognize and attack some microbes.

Where Does Infection Occur?

Localized infections

Localized infections remain in one part of the body. Examples include a cut on the hand that gets infected with bacteria, but does not cause problems anywhere else. Localized infections can be very serious if they are internal, such as in the appendix (appendicitis) or in the heart (endocarditis)

Systemic infections

Most serious infections, however, occur when the microorganisms spread throughout the body, usually in the bloodstream. These are called systemic infections, and they include flu, malaria, AIDS, tuberculosis, plague, and most of the infectious diseases whose names are familiar.

How Do Infections Lead to Illness?

The major causes of infection are viruses, bacteria, fungi, and parasites, including protozoa (one-celled organisms), worms, and insects such as mites (which cause scabies) and lice.

Bacteria can release toxins, or poisons. Viruses can take over cells and prevent them from doing their normal work. Bacteria and fungi—and larger infective agents like worms or other parasites—can multiply so rapidly that they physically interfere with the functioning of the lungs, heart, or other organs. The immune response itself—which can bring fever, pain, swelling, and fatigue—often is the major cause of the sick feelings an infected person gets.

Do Infections Always Cause Illness?

No, often they do not. Of people infected with tuberculosis bacteria, for instance, only about one in ten will ever get sick. Some viruses and parasites, too, can remain in the body a lifetime without causing illness. In such cases, called latent infection, people usually get sick only if the immune system weakens.

How Do Infections Spread?

The organisms that cause infections may spread through water, soil, food, or air; through contact with an infected person's blood, skin, or mucus; through sexual contact; or through insect bites. Most germs spread by a couple of these routes; no one microbe spreads in all these ways. In addition, many disease-causing microbes can spread from a pregnant woman to her fetus. When this happens, we say the baby is born with a congenital infection.

What Are the Symptoms of Infection?

The symptoms vary greatly depending on the part of the body and type of organism involved. The first sign of bacterial infection is often inflammation: fever, pain, swelling, redness, and pus. By contrast, viral infections less commonly cause inflammation but may cause a variety of other symptoms, from a runny nose or sore throat to a rash or swollen lymph nodes ^* .

What Is the Treatment for Infection?

The main treatment is usually medication: antibiotics for bacterial infections; antiviral drugs for some viruses (for most there is no treatment); antifungal medications for fungus infections; and antihelmintic drugs for worms. In some cases of localized infection, as when an abscess or collection of pus forms, surgery may be necessary to drain the infected area.

How Are Infections Prevented?

Disinfecting wounds

When a wound occurs, infection may be prevented by washing and covering the wound, using antibacterial ointment or spray, and getting medical attention if the wound is serious.

Immunization

Many systemic infectious diseases can be prevented by immunization. Among them are chickenpox, cholera, diphtheria, hepatitis A and hepatitis B, influenza, Lyme disease, measles, mumps,pertussis(whooping cough), pneumococcal pneumonia, polio, rabies, rubella (German measles), tetanus, typhoid fever, and yellow fever.

Hygiene, sanitation, and public health

Many other systemic infections can be prevented by having a clean public water supply and a sanitary system for disposing of human wastes; by washing hands before handling food; by cooking meats thoroughly; by abstaining from sexual contact; and by controlling or avoiding ticks and mosquitoes.

^* lymph nodes are round masses of tissue that contain immune cells to filter out harmful microorganisms. During infections, lymph nodes may become enlarged.