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more dangerous infection type with others when they sneeze, cough, or even just speak. Statistics on MDR and XDR tuberculosis are difficult to gather, but MDR-TB has been diagnosed in almost every state, and XDR has been identified all over the globe. OTHERS TO WATCH Other pathogens that should probably be on our watch list include the following: H-What? N-What? Flu viruses are packets of genetic material wrapped up in a protein coat. Flu viruses can be identified by markers on these coats. Two surface glycoproteins are called hemagglutinin and neuraminidase. Hemagglutinin binds to receptors on infected body cells, while neuraminidase promotes the spread of viral particles, or virions. Both of these markers are targets for antibodies to attack and disable the viruses. So far, 16 types of hemagglutinin have been identified, and nine types of neuraminidase. Flu viruses are sometimes labeled by these markers, hence the term H5N1 for avian flu, and H1N1 for swine flu. flu, and the communicable period can last 7–10 days after symptoms develop. Pregnant women appear to be at highest risk for hospitalization and death with the H1N1 virus. XDR-TUBERCULOSIS First, there was tuberculosis: a slow- growing, spore-bearing bacillus that is spread through airborne mucus droplets. A deep breath pulls it into the lungs where as few as 10 microoganisms are sufficient to set up an infection site. About 90 percent of the world's 2 billion people with tuberculosis exposure stop here: the infection is isolated inside a small cyst in the lungs and it never reactivates. But about 10 percent of those exposed will develop primary tuberculosis disease and be able to spread the infection to others. A six-month course of antibiotics clears the infection (this has made TB much less of a threat for us than for our grandparents), but misuse or incomplete use of the drugs leads to drug-resistant forms of TB. Multidrug- resistant TB (MDR-TB) requires much more hazardous and expensive drugs, for 18–24 months. When this regimen fails, another pathogen can develop: XDR-TB, or extremely drug resistant tuberculosis. This infection resists almost all antibiotics, and it has a survival rate of only 30 percent. And the kicker: a person with active MDR or XDR tuberculosis can share their CRYPTOSPORIDIUM This is a paramecium similar to giardia that has become resistant to chlorine. It is common in recreational water (public pools and fountains), as well as streams, lakes, and rivers. "Crypto" can cause abdominal pain, watery diarrhea, and dangerous dehydration. It is spread easily through indirect oral-fecal contamination. CLOSTRIDIUM DIFFICILE This anaerobic spore-bearing bacterium is common in the gastrointestinal tract, where it is often found in peaceful balance with other intestinal flora and fauna. But when that environment is disrupted by antibiotic use, this particular group of bacteria appears to flourish, leading to painful diarrhea and dehydration. In the worst cases, the toxins excreted by the bacteria can cause acute inflammation and patches in the colon (pseudomembranous colitis) and even cause the colon to become dangerously enlarged (toxic megacolon), which puts the patient at risk for perforation or rupture and subsequent peritonitis. "C-diff" sometimes clears if the triggering antibiotic use is stopped, but sometimes it must be treated with its own antibiotics. It is a stubborn, long-lasting, hospital-based infection that can be spread through indirect oral-fecal contamination. connect with your colleagues on massageprofessionals.com 97