Ecclesiastes 12:13 Let us hear the Conclusion of the Whole Matter: Fear YAHUAH, and KEEP his Commandments: for this is the Whole duty of Man.

Shalom

Every disease has certain characteristic effects on the body. Some of these effects, called symptoms and signs, include fever, inflammation, pain, fatigue, dizziness, nausea, and rashes, and are readily apparent to the patient. These symptoms offer important clues that help physicians and other health care professionals make a diagnosis. Many times, however, the symptoms point to several possible disorders. In those cases, doctors rely on medical tests, such as blood examinations and X rays, to confirm the diagnosis.

The course of a disease?that is, the path it follows from onset to end?can vary tremendously, depending largely on the individual and the treatment he or she receives. For example, otherwise healthy people usually recover quickly from a bout of pneumonia if given proper treatment, whereas pneumonia often proves fatal to people with a weakened immune system and to those who do not receive prompt, effective treatment. Some diseases run a different course depending on the patient?s age. Chicken pox, for instance, is usually mild in childhood but severe in adults. In the United States, only about 5 percent of chicken pox cases occur in people over the age of 20, but these cases account for 50 percent of all deaths from the disease.

Scientists, public health officials, and other members of the medical community work diligently to try to prevent disease epidemics. The battle is constant and is fought on many fronts. There have been many victories. Once-devastating diseases such as smallpox and diphtheria have been virtually eradicated, and many other diseases that once conferred automatic death sentences can now be either cured or controlled. At the same time, however, new killers have emerged. Acquired immune deficiency syndrome (AIDS) and hantavirus pulmonary syndrome are among at least 30 diseases that have been identified by scientists since the early 1970s. Other growing challenges, particularly in the affluent societies of industrialized nations, are so-called diseases of choice, such as alcohol abuse, drug abuse, or obesity, that result from addictive behavior, poor eating habits, or insufficient exercise.

Complicating matters further are societal changes. Increased international travel accelerates the spread of both new and old diseases: A person infected with an unusual virus on one continent can arrive?with the virus?on another continent in a matter of hours. Ships, planes, and trucks can transport disease-carrying organisms just as easily. In 1985 tires imported into Texas from Asia carried larvae of the Asian tiger mosquito, which is a carrier of dengue fever and other tropical diseases. Within five years, Asian tiger mosquitoes were living in 17 states. Changing dietary habits and the availability in local supermarkets of foods from all parts of the world contribute to an increase in food-borne illnesses. Some researchers worry that growing populations and the resulting crowded living conditions will increase the risk of epidemics.

Viruses are tens or hundreds of times smaller than bacteria. They are not cellular, but consist of a core of genetic material surrounded by a protective coat of protein. Viruses are able to survive and reproduce only in the living cells of a host. Once a virus invades a living cell, it directs the cell to make new virus particles. These new viruses are released into the surrounding tissues, and seek out new cells to infect. The roll call of human diseases caused by viruses includes mumps, measles, influenza, rabies, hepatitis, poliomyelitis, smallpox, AIDS, and certain types of cancer.

Protozoans are single-celled, animal-like organisms that live in moist environments. Perhaps the most infamous pathogenic protozoans are species of the genus Plasmodium, which cause malaria, an infectious disease responsible for over 2 million deaths worldwide each year. Members of the genus Trypanosoma produce trypanosomiasis, also known as African sleeping sickness, and Chagas' disease. Other protozoans cause giardiasis, leishmaniasis, and toxoplasmosis.

Roundworms, or nematodes, are small, tubelike worms that are pointed at both ends. Species that infect human intestines include pinworms, hookworms, threadworms, and members of the genus Ascaris. Trichinella spiralis can invade human muscle tissue, often from eating infected pork that has been improperly prepared, causing a disease called trichinosis.

Prions are extremely tiny protein particles found in the brain, nerve, and muscle cells. A controversial theory states that prions cause disease by changing normal proteins into an abnormal shape. These mutated proteins in turn force other proteins to change shape, leading to destruction of tissue, primarily in the brain. Some researchers have hypothesized that prions cause transmissible spongiform encephalopathies, a group of rare infectious diseases that includes Creutzfeldt-Jakob disease in humans, scrapie in sheep, and bovine spongiform encephalopathy (commonly known as mad cow disease) in cattle. Some evidence suggests that prion-related disease can be transmitted through food infected with mutated proteins.

Other pathogens involve an intermediary carrier, such as an insect. The malarial parasite, for example, spends part of its life cycle in mosquitoes, then enters a person's bloodstream when the mosquito bites the person. Many pathogens are spread through contaminated food and water. Cholera bacteria, for example, are spread through food and water contaminated with the excrement of infected people.

Among the diseases new to science are AIDS, Ebola hemorrhagic fever, Legionnaires? disease, and Lyme disease. AIDS has been the most deadly of all the new diseases, but even it has not taken as high a toll as malaria, tuberculosis, and other diseases that have been around for centuries. Some newly identified disease-causing agents for diseases that have been recognized for a long time include Human T-lymphotropic virus I (HTLV-1), which can cause some cases of non-Hodgkin?s lymphoma, a type of cancer originating in the lymphatic system; and HTLV-2, which is associated with hairy-cell leukemia, a rare type of cancer of the blood.

In most cases, the reasons for the emergence of a new disease are unknown. One exception is Legionnaires? disease. It is caused by a bacterium that was not identified until after an outbreak in 1976 at an American Legion convention in Philadelphia, Pennsylvania. Once identified, however, scientists were able to retrospectively identify earlier epidemics of the disease, and realized that each year the bacterium is responsible for thousands of cases of pneumonia.

Environmental changes may be responsible for some new diseases. Scientists speculate that the viruses for some of the deadly hemorrhagic fevers that have surfaced in Africa, such as Ebola and Marburg disease, have long existed in certain wild animals. As people have encroached on wilderness areas they have come into contact with the infected animals, and the viruses have jumped from their traditional animal host to a new human host, with deadly consequences.

In addition to new diseases, well-known pathogens may change, or mutate, creating new, virulent strains. Influenza viruses are among those that mutate frequently, which explains why flu shots?vaccines that use modified or killed versions of the influenza agent to stimulate a protective immune response in the body?are given annually, and why epidemics of influenza periodically occur. The strains of flu virus that were most prevalent one year differ from those that bedevil humans the next year. Vaccines that protected against last year's flu virus may need to be altered to be effective against today's most common strains.

A similar problem occurs when mutations in infectious agents result in resistance to medicines that had been effective treatments. The bacteria that cause bronchitis, meningitis, tuberculosis, and pneumonia are among many that have developed strains that are resistant to at least some antibiotics. As a result, doctors have fewer options for treating the diseases and preventing their spread.

Environmental factors play critical roles in numerous noninfectious diseases. Exposure to carbon monoxide can have long-term effects on the heart and vision. Lead in drinking water can impair children's mental abilities and increase blood pressure in adults. Occupational exposure to coal dust, cotton dust, and asbestos predisposes workers to black lung, brown lung, asbestosis, and other respiratory diseases (see Occupational and Environmental Diseases). Other diseases are caused by an addiction to a harmful substance. Tobacco smoking is a prime culprit in emphysema, as well as lung cancer and other respiratory diseases. Excessive use of alcohol can lead to liver disease, brain damage, and nutritional disorders.

Repetitive stress injuries result from repeating certain motions, usually from a fixed or awkward posture. Twisting items on a factory assembly line, carrying bulging mailbags, using vibrating tools such as pneumatic hammers, or practicing the piano or a tennis stroke for hours on end can all result in pain, inflammation, and permanent nerve damage.

Congenital diseases, or birth defects, are disorders that are present at birth. Some are hereditary, others develop while a baby is in its mother's uterus or during the process of delivery. For example, if the mother contracts German measles, or rubella, during the early stages of pregnancy, her child may be born with heart defects, eye cataracts, deafness, or mental retardation. Use of alcohol during pregnancy can cause fetal alcohol syndrome, characterized by mental and physical retardation. Abnormal development of any body part in a fetus may produce a congenital defect; for example, if walls that separate the chambers of the heart fail to form completely, the baby is born with congenital heart disease.

An allergy is an abnormal reaction of the immune system to foreign substances, such as plant pollen, fungal spores, animal danders, medications, and foods. Rhus dermatitis is an allergy caused by contact with urushiol, an oil resin produced by poison ivy, poison oak, and poison sumac.

Autoimmune diseases develop when the immune system goes awry and attacks the body's own tissues. Autoimmune disorders includes lupus erythematosus, rheumatoid arthritis, juvenile-onset diabetes, and myasthenia gravis. The causes are unknown, although some scientists suspect the diseases may be triggered in some cases by a pathogen, such as a virus, or other environmental factor.

Immune deficiency diseases develop when the immune system becomes impaired, resulting in more common, frequent, or severe infections. The immune system may be damaged by a genetic abnormality or by illness, injury, the use of a strong drug such as those used in chemotherapy, or malnutrition.

Small hairlike projections on the lining of the nose, throat, and bronchial tubes work in conjunction with mucus to trap and remove foreign substances. In the ears, tiny hairs plus a sticky wax defend against the entry of germs. Tears secreted by the lachrymal gland wash away germs and other small objects that may enter the lid area of the eye. Tears also contain a protein that kills certain germs.

If a pathogen breaches the body?s outer barriers, the defenses of the immune system spring into action. Some of these defenses are effective against a variety of invaders, while others are tailor-made to fight a specific organism. White blood cells called phagocytes constantly travel through the bloodstream on the lookout for foreign objects. If they come upon a microorganism, they surround, engulf, and digest it.

If the infection persists and there are too many organisms for the phagocytes to fight by themselves, the immune system produces proteins called antibodies. Each antibody is designed to combat a particular antigen, or foreign protein. Two types of white blood cells are involved in this process. B cells release the antibody, which attaches to the outer covering of the antigen, marking it for destruction. T cells attack the tagged antigen and also stimulate B cells into action. Once the body has produced antibodies to a specific microorganism, it generally is immune to future invasions by that organism. That is why people who have had chicken pox or measles as a child will not get the disease again as an adult. The reason people get one cold after another is that each cold is caused by a different virus strain.

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