E. coli infection: Symptoms, causes, and treatment

The Test That Targets TB

A revolutionary tuberculosis test piloted at a British school could help prevent future outbreaks and raise hopes of wiping out the scourge of TB, say researchers.

The test enables doctors reliably to identify people who are infected long before they develop symptoms and become infectious.

At present, they still have to rely on a crude "skin prick" test that has been in use for 100 years and often gives misleading results.

TB causes more deaths worldwide than any other infectious disease - between two and three million people each year. In England and Wales alone, a total of 6,669 tuberculosis cases were reported in 2001, an increase of 6 per cent on the previous year.

New drug resistant strains of the bacterium are emerging in the worst hit areas, such as south east Asia and eastern Europe.

A major obstacle to controlling the disease is the lack of a reliable diagnostic blood test.

Whereas most diagnostic tests rely on detecting antibodies triggered by an infection, this is not possible with TB. Instead, the Tuberculin Skin Test depends on looking for the physical signs of an immune reaction.

TB toxin is injected under the skin, which produces a lump if the person is latently infected and his or her immune system is trying to fight the bug.

But it can take three to seven days for a reaction to appear, and the test gives a false positive result if someone has been vaccinated against TB.

The new test developed at Oxford University works in a unique way by detecting immune system blood cells called T-cells. It is the first blood test to look for T-cells rather than antibodies to make a diagnosis.

The test, called Elispot, is simple, quick, and not confounded by TB vaccination.

Doctors hope it will supersede the tuberculin skin test in the next few years and transform the way TB is controlled. Ultimately, it is hoped, it will help health authorities and national TB control programmes to eliminate the disease.

A report on research to validate the test at a British school appeared today in the Lancet medical journal.

The unnamed school was one of several in the Leicester area which together experienced Britain's worst outbreak of TB for 20 years in 2001.

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Purdue University Student Health Service

State Immunization Requirements for Enrolled Students  Immunization Records Reminder

Students are reminded to submit proof of immunizations against rubeola (10-day measles), rubella (German measles), mumps, meningitis, diphtheria and tetanus to the PUSH immunization portal prior to completing your Purdue 101 online orientation program. If you do not submit proof of immunization, a hold will be placed on your account and you will be unable to register for classes.

To comply with immunization requirements, you must complete the medical clearances section in your Patient Portal. Log into the portal, look for the "Medical Clearances" tab on the left and update any items marked "Non Compliant" by submitting documentation. Further instructions can be found here.

If you need a tuberculosis test or vaccines that cannot be completed at home, they may be completed at PUSH as soon as you arrive to campus. If you need to receive a particular vaccine, please make an appointment with PUSH or another local pharmacy.

Indiana state law requires all new, regularly enrolled students attending residential campuses of Indiana public universities be immunized against Rubeola (10 day measles), Rubella (German measles), Mumps, Meningitis, Diphtheria, and Tetanus. This law requires the university to block the enrollment of any student who does not comply with immunization requirements. If your record is held for immunization noncompliance, registration for future courses cannot be completed until all requirements have been met.

Immunization proof must be legible, in English, and include the student's name. Students may upload their official immunization record OR a completed immunization information form signed by an MD, DO, NP, or RN. The official immunization record does not need to be signed by a provider. 

Immunizations required by the state of Indiana: Vaccine Requirement Rubeola (Measles, MMR) 2 doses of live vaccine administered after first birthday and at least 28 days apart. Rubella (MMR) 2 doses of live vaccine administered after first birthday and at least 28 days apart. Mumps (MMR) 2 doses of live vaccine administered after first birthday and at least 28 days apart. Tetanus Diphtheria (Td or Tdap) No more than 10 years before starting classes. Meningitis (Men Quad/Conjugate, MCV4) One dose on or after 16th birthday, if 23 years or younger. Meningococcal B (Separate from Meningitis) 2 doses of the same brand (Bexsero or Trumenba), if 23 or younger. International students only Tuberculosis Clearance International students must have a QFT (Quantiferon blood test) or T-Spot (not PPD) with a negative result. This test must be completed in the United States and no more than 3 months before classes start. Test must be completed on the same date, or at least 28 days after any live vaccine. Those with an abnormal TB test result, will have additional steps to complete. Students not in compliance will not be able to register for future courses until the requirement has been met. Learn more about Tuberculosis.

State-required immunizations are available at the Student Health Center and through other healthcare providers.

FAQS MENINGOCOCCAL VACCINES Why Men B?

Purdue requires 2 doses of the Meningitis B vaccine for all incoming students under the age of 24. College students are at an increased risk of being infected with the rare, but serious disease.

Does MCV4 (Menveo or Menactra) meet the Men B requirement?

No. Meningococcal B is a separate vaccine. MCV4 protects against variants A,C,W, and Y. Meningococcal B protects from the B variant. The brand names for Meningococcal B are Bexsero and Trumenba.

If I am 24 or older when I start classes, am I required to complete meningococcal vaccines?

No, this is only required for students under 24 when classes start.

Will I be able to register for classes if I have completed the 1st dose of Men B, but cannot complete the 2nd dose before classes start due to the vaccine's dosing schedule?

Yes. If you have started the vaccine but are unable to complete the 2nd dose because of the dosing schedule (28 days or 6 months between vaccines), PUSH staff will give you more time to complete the series when we review your submission.

TB TEST If I am registered as a domestic student, am I required to complete a TB test?

No, the TB test is only required for international students.

Can I complete the TB test in my home country?

No, Indiana law requires that the TB test be completed in the United States.

Why do I see TB test as a requirement in Medical Clearances even though I'm a domestic student?

Before classes start, all incoming students see the same items in medical clearances. Once classes start, students will be placed in their final populations and the requirements will correctly reflect the student's status. The TB test requirement is listed so that those that are required to complete this have a location to submit.

What TB tests are accepted?

Purdue will only accept a TB blood test meaning that your blood must be drawn by a lab. The TB skin test (PPD/Mantoux) are not acceptable.

IMMUNIZATION PROOF Does my provider need to sign my immunization records before submitting?

No. If you are submitting your immunization record, no hand-written signature is required. This is only required on the immunization history form.

How do I upload additional proof once I have completed the initial submission?

Additional records will be added using the green update box next to the immunization proof line in Medical Clearances. This is the same location records were originally submitted. Even though it states compliant now, the student can continue to submit additional records as needed.

If I upload proof of immunizations, do I still need to enter the dates each vaccine was completed?

Yes. Your submission cannot be reviewed until proof is submitted and immunization dates have been entered.

I submitted immunization proof several days ago. Why does it still say Awaiting Review?

The review process can take up to 10 days to review. If there are any problems with the student's submission, PUSH staff will send the student a secure message.

Why am I unable to access the patient portal?

Grad students do not have access to the patient portal until classes start. Please hold on to your record until then and submit once portal access is available. If you are an undergrad and cannot login to the portal, please contact us at shc@purdue.Edu.

I have logged into my patient portal and there is no way to submit immunization proof in Medical Clearances.

Students who took previous classes through Purdue, either on campus or as an online student, will be considered "former students" until classes start. Once classes start, the student's population will correct itself and they will be able to enter immunization dates. If you'd like to submit immunization dates before classes start, please email shc@purdue.Edu.

Does PUSH accept MMR titers as proof of measles, mumps, and rubella?

Yes. The titer must include the numeric value as well as the numeric reference range or state "immune" to meet titer requirements.

EXEMPTIONS

In the event of an outbreak of any of the vaccine preventable diseases covered by this law on or near campus, students holding exemptions will be excluded from all campus activities, for their protection, until the outbreak is declared to be over.

How do I apply for a religious exemption from immunizations?

Students, or their parent/guardian if the student is a minor, will write a statement indicating the reason that they cannot obtain immunizations. The statement must be hand-signed and dated. Once reviewed, the student will find the response in the letters section of their patient portal.

How do I apply for a medical exemption from immunizations?

A medical exemption will be granted upon receipt of a written statement from a healthcare provider indicating the nature and duration of the medical condition which contraindicates an immunization, as well as the specific vaccine identified as detrimental to the student's health or certifying pregnancy or suspected pregnancy. Medical exemptions expire when the medical condition(s) contraindicating immunization change in a manner which permits immunization.

Contact Info:PURDUE STUDENT HEALTH CENTER601 Stadium Mall DriveImmunization Office - Room 138W. Lafayette, Indiana 47907-2052Email: shc@purdue.EduFax: (765) 496-1907Telephone: (765) 494-1837

Skin Cancer 'mirror' Test You Should Do Now To Spot Abnormal Changes Faster

It can be tricky to spot skin cancer on your own, but Cancer Research UK have shared a 'mirror' test you should do to become well acquainted with your body so you can spot changes fast

The 'mirror' test can help you become better acquainted with your body (Stock Image) (

Image: InYourArea)

How well do you really know your own body? It's vital we get more familiar with our anatomy to protect our health. And there's a test you can complete to spot abnormalities on your skin quickly.

If you stand in front of a mirror, you won't be able to see your whole body, but we should all get into the habit of checking things we haven't seen before; acquainting ourselves with our anatomy properly so we can spot any changes with ease.

Experts at Cancer Research UK recommend that you complete a 'mirror test' regularly, to look over your skin to see whether there are any changes. But what exactly are you looking out for? According to Cancer Research UK, there are several abnormalities you need to watch out for, to rule out skin cancer.

A sore that doesn't heal

The sore can look see-through, shiny and pink or pearly white. It can also look red. It may feel sore, rough, and have raised edges.

Ulcer

Look out for an area of skin that has broken down (an ulcer) and doesn't heal within four weeks, and you can't think of a reason for this change.

A lump

This might be small, slow-growing, shiny and pink or red.

Red patches on your skin

These red patches could also be itchy. This could be due to other non-cancerous skin conditions. But get it checked to make sure.

Freckles or moles

A change to a mole or freckle can be a sign of another type of skin cancer called melanoma.

Cancer Research UK said that to spot skin cancer early, it's important to know what's normal for you, and how your skin usually looks. That way, if you spot something, you'll be able to realise whether it's always been there, or whether it could be something to be concerned about.

To look at areas you can't see easily, you could try using a handheld mirror and reflect your skin onto another mirror. Or you could get your partner or a friend to look. This is very important if you're regularly outside in the sun for work or leisure.

They also recommended you take a photo of anything that doesn't look quite right, possibly with a ruler or tape measure next to it so you have an accurate idea about size, and you can tell whether it's changing. Share these pictures with your GP.

If you have any concerns, book an appointment with your GP.

Do you have a story to share? Email: danielle.Wroe@mirror.Co.Uk

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