Treatment is with ANTIBIOTIC MEDICATIONS, typi-
cally penicillins or erythromycin. Most people rap-
idly and fully recover with appropriate antibiotic
therapy. Though the infection may resolve with-
out treatment, the risk is very high for the strep
bacteria to migrate to other locations in the body,
notably the HEART valves where it causes RHEU-
MATIC HEART DISEASE. The infection may also spread
to the joints, causing INFECTIOUS ARTHRITIS.
See also PHARYNGITIS; SNEEZE/COUGH ETIQUETTE;
TONSILLITIS.
septicemia A life-threatening bacterial INFECTION
that invades the BLOODcirculation, resulting in
spreading the infection throughout the body. Sep-
ticemia, also called bacteremia, typically arises as a
complication of localized bacterial infection. The
onset and progression of septicemia are rapid and
can result in septic SHOCK, ACUTE RESPIRATORY DIS-
TRESS SYNDROME(ARDS), and death within hours.
Treatment requires hospitalization, usually in an
intensive care unit, with administration of intra-
venous ANTIBIOTIC MEDICATIONS as well as other
medications to sustain vital functions such as
HEART RATE and BLOOD PRESSURE. People who
recover from septicemia tend to have a long path
of recuperation before they are able to return to
regular activities.
See also DISSEMINATED INTRAVASCULAR COAGULOPA-
THY (DIC); NECROTIZING FASCIITIS; TOXIC EPIDERMAL
NECROLYSIS; TOXIC MEGACOLON; TOXIC SHOCK SYN-
DROME.
severe acute respiratory syndrome (SARS) A
life-threatening illness resulting from INFECTION
with the VIRUS SARS-associated coronavirus
(SARS-CoV). The first outbreak of SARS occurred
in 2003 and sickened more than 8,000 people in
Asia, Europe, and South America. The handful of
people infected in the United States acquired
SARS during travel to countries experiencing out-
breaks.
Infection occurs through close contact; SARS-
CoV spreads through airborne droplets as well as
direct touch with saliva and other bodily secre-
tions that shed the virus. Symptoms appear 2 to
10 days after infection and begin with HEADACHE,
general MUSCLEaches and JOINT PAIN, sore THROAT,
and moderate FEVER. Within a few days shortness
of breath (DYSPNEA) develops and may result in
HYPOXIA(insufficient oxygen entering the BLOOD
circulation for distribution to organs and tissues.
Blood tests confirm the presence of SARS-CoV.
Treatment is primarily supportive; ANTIVIRAL
MEDICATIONSmay lessen the severity of symptoms.
Some people require hospitalization in an inten-
sive care unit with MECHANICAL VENTILATION and
other medical care to support respiration and
other vital functions while the illness runs its
course. PNEUMONIAis the most common complica-
tion. The course of illness may run several weeks.
Most people recover, though may require several
months of recuperation before feeling well
enough to return to their normal activities.
See also INCUBATION PERIOD.shigellosis An illness resulting from INFECTION
with any of numerous strains of ShigellaBACTERIA.
Shigellosis most commonly occurs as a foodborne
illness, producing symptoms of FEVER, abdominal
cramping, and bloody DIARRHEAwithin about 12
hours of infection with the bacteria. The illness is
generally self-limiting, running its course in five to
seven days. Most people recover fully, though for
a small percentage the bacteria infect other areas
of the body such as the joints, causing the chronic
condition REITER’S SYNDROME.
Doctors may prescribe ANTIBIOTIC MEDICATIONS
for the very young, the very old, and people who
are IMMUNOCOMPROMISEDor who have unusually
severe and extended symptoms. Ampicillin,
trimethoprim/sulfamethoxazole (TMP-STZ) com-
bination, and ciprofloxacin are among the antibi-
otics doctors more commonly prescribe. Diligent
PERSONAL HYGIENEand frequent HAND WASHINGare
the most effective means to curtail the spread of
shigellosis from one person to another.
See also ANTIBIOTIC RESISTANCE; FOODBORNE ILL-
NESSES; FOOD SAFETY; WATERBORNE ILLNESSES.smallpox An illness resulting from INFECTION
with the VariolaVIRUS. Though smallpox was once
a much-feared and leading cause of death world-
wide, aggressive vaccination efforts resulted in the
World Health Organization’s determination of its
eradication as a naturally occurring disease insmallpox 353