A cold is an infection of the nose, sinuses, and/or throat almost always caused by a virus. A virus is a type of germ that causes infections. There are more than 200 types of viruses that can cause a cold.

How are colds spread?

The most common way to get a cold is by contact with a person who has a cold. A cold virus spreads easily. For example: when a person with a cold sneezes, coughs, talks, or laughs, the virus can spread into the air as droplets from their mouth or nose. These droplets can spread to people as they breathe and to surfaces within 6 feet. Cold viruses can spread to your hands if you touch anything that has the virus on it. If you then touch your eyes, nose, or mouth, you can get infected with cold virus.

What are signs of a cold?

• Stuffy or runny nose
• Sneezing
• Sore throat
• Coughing
• Headache (mild)
• Muscle aches and pains (mild)
• Chest discomfort (sometimes)
• Tiredness (sometimes)
• Fever (rare)

How can you feel better if you have a cold?

• Get plenty of rest.
• Consider the use of over-the-counter drugs, not all over-the-counter drugs are safe for children.
• Use a clean humidifier to help relieve congestion.
• Soothe a sore throat with ice chips, throat spray, or lozenges (do not give lozenges to young children).
• Gargle with warm salt water.
• Do not smoke.
• Avoid second-hand smoke.

If you have a cold

• Clean hands often with soap and water or alcohol hand rub.
• Cough or sneeze into a tissue or into your sleeve.
• Do not share eating or drinking utensils, hand towels, or toothpaste.
• Stay at home if possible.
• Drink plenty of non-caffeinated fluids, such as water, teas, broths, and sports drinks.
• See your health care provider if:
  • Your temperature goes over 100.4°F
  • Your signs last over 10 days

How can you avoid a cold?

• Limit or avoid contact with people who are sick.
• Clean hands often.
• Stay healthy. Eat the right foods and get enough sleep.

What about pregnancy?

Pregnant women should not take any over-the-counter drugs for a cold without consulting with their health care provider. If you are pregnant, you may be more likely to get a cold because pregnancy slightly weakens the immune system.

Influenza or "flu" is a respiratory illness caused by a flu virus. Flu viruses spread each fall, winter, and spring.

Young (infants) and the very old are most at risk for severe illness from seasonal flu. In the U.S., about 3,000 to 49,000 people die yearly from seasonal flu. The Centers for Disease Control and Prevention (CDC) recommends that everyone age 6 months and older get a flu shot each year.

How is it spread?

The flu virus spreads easily. For example, when a person with the flu sneezes, coughs, talks, or laughs, the flu virus can spread into the air as droplets from their mouth or nose. These droplets can spread to people and surfaces within 6 feet.

The flu virus can spread to your hands if you touch anything that has the virus on it. If you then touch your eyes, nose, or mouth, you can get the flu.

The flu virus can live on surfaces, such as countertops and door knobs, for 24 to 48 hours.

Seasonal flu is contagious from 1 day before any signs appear to up to 5 days after you get sick.

Flu spreads easily between people and can live for up to 2 days on surfaces such as doorknobs, tabletops, and counters.

What are signs of flu?

• Fever (usually 102°F or higher)
• Chills
• Cough
• Runny or stuffy nose
• Sore throat
• Tiredness
• Headache
• Muscle or body aches
• Stomach symptoms (mostly in children)

How do you know if you have the flu?

Your health care provider can examine and test you for the flu virus.

How is it treated?

Your health care provider may treat you with antiviral drugs. Antiviral drugs are most effective if taken within the first two days of being sick.

If you have the flu, how can you feel better?

• Get plenty of rest.
• Take over-the-counter drugs. Note: not all over-the-counter drugs are safe for children.
• Use a clean humidifier to help a dry, scratchy throat.
• Soothe a sore throat with ice chips, sore throat spray, or lozenges (do not give lozenges to young children).
• Gargle with warm salt water.
• Eat plain foods that are easy on the stomach.

People with severe illness from the flu should talk to their health care provider about taking antiviral drugs if they get the flu.

What can happen if the flu gets worse?

Most people with the flu will not need medical care or antiviral drugs. Most will recover in less than two weeks. Even healthy people can have severe illness from the flu. Adults should get medical help right away if they develop:

• Difficulty breathing, shortness of breath, or blueish skin color
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Difficulty waking up
• Severe or continued vomiting
• Flu-like symptoms that improve but then return with fever and worse cough

Over time, flu can lead to:

• Pneumonia
• Bronchitis
• Sinus and ear infections

Illness from flu can also make other health problems worse. People with asthma may have more asthma attacks. People with heart problems may get worse. Flu can cause severe illness and even death in:

• Children younger than 5, especially those younger than age 2
• Adults 65 years of age and older
• Pregnant women
• People who have medical conditions including:
  • Asthma
  • Diseases of the brain or muscles such as brain injury, muscular dystrophy, cerebral palsy, and stroke
  • Chronic lung disease, such as emphysema (COPD) and cystic fibrosis
  • Heart disease
  • Blood diseases such as sickle cell disease
  • Gland diseases such as diabetes
  • Kidney diseases
  • Liver diseases
  • Weak immune systems due to disease or medicines, such as people with HIV/ AIDS, cancer, or those on chronic steroids
  • People younger than 19 years of age who are taking aspirin pills long-term
• People who are obese
• American Indians and Alaskan Natives

These people should alert their health care provider if they get signs of the flu. They may need early treatment.

If you have the flu

• Clean your hands often with soap and water or alcohol hand rub.
• Cough or sneeze into a tissue or into your sleeve.
• Do not share eating or drinking utensils, hand towels, or toothpaste.
• Stay home until 24 hours after their fever is gone except to get medical care or for other necessities.
• Avoid contact with others.
• Drink plenty of fluids, such as water, herbal teas, broths, and sports drinks.

How can you avoid the flu?

• Get a flu shot each year. Everyone 6 months of age and older should get a flu shot each year because flu virus can change from one year to the next.
• Clean hands and surfaces often.
• Limit or avoid contact with people who are sick.

The best way to avoid the flu is to get a flu shot each year.

What about pregnancy?

Flu can be severe in pregnant women. Get your flu shot. Pregnant women should let their health care provider know if they have any signs of flu. Pregnant women should not take over-the-counter drugs without asking their provider first. The flu shot is safe for pregnant women at any stage of pregnancy.

Pneumonia is an infection of the lungs. Most cases of pneumonia are caused by bacteria (pneumococcal) or viruses (influenza). Rarely, it can be caused by fungi or parasites.

How is it spread?

Pneumonia-causing germs can be spread the same way colds and the flu are spread: into the air as droplets by sneezing, coughing, talking, or laughing. These droplets can spread to people as they breathe and to surfaces within 6 feet.

The germs can spread to your hands if you touch anything that has the germ on it. If you then touch your eyes, nose, or mouth, you can get infected.

Certain people are at a higher risk for pneumonia, including:

• Adults 65 and older
• Children less than 5 years old
• People who smoke
• Alcoholics
• People with lung diseases
• People with a recent cold or the flu
• People who are now or were recently in the hospital
• People who have just had surgery
• People with chronic diseases such as heart disease, liver damage, or diabetes
• People with weak immune systems such as people with HIV/AIDS or certain types of cancer
• People taking drugs which weaken the immune system
• People with problems swallowing, coughing or taking deep breaths
• People with renal failure
• People with sickle cell disease
• People who have had their spleen removed
• People who are living in nursing homes

What are signs of pneumonia?

• Cough (sometimes with thick, creamy, or bloody mucus)
• Fever
• Chills
• Tiredness
• Rapid breathing or shortness of breath
• Chest pain
• Loss of appetite
• Headache
• Nausea and vomiting

How do you know you have pneumonia?

A health care provider can examine you for pneumonia by:

• Asking questions about your symptoms
• Listening to your lungs
• Taking a chest X-ray
• Taking a blood or mucus sampl

More tests may be done if the pneumonia is severe or if you have other health problems.

How is it treated?

• Bacterial pneumonia is treated with antibiotics.
• Viral pneumonia can be treated with antiviral drugs.

Mild cases of pneumonia can be treated at home with medicine and rest. Most severe cases are treated in a hospital. In addition to medicine, oxygen and other methods are used to support breathing and body functions.

What can happen if pneumonia gets worse?

• The lungs cannot send enough oxygen to the body.
• Pus pockets and fluid can form around the lung.
• Infection can spread to other areas of the body.
• In severe cases, pneumonia can cause death.

There are at least 4 million cases of pneumonia every year in the U.S. One out of four will be sick enough to be admitted to a hospital. Adults 65 and older are more likely to be sicker and admitted to a hospital. One out of every 20 cases of pneumonia will be fatal.

Pneumonia causes more deaths than HIV/AIDS.

If you have pneumonia

• Always finish all antibiotic or anti-viral treatment.
• Clean your hands often with soap and water or alcohol hand rub.
• Cough or sneeze into a tissue or into your sleeve.
• Do not share eating or drinking utensils, hand towels, or toothpaste.
• Clean surfaces often such as countertops, refrigerator and freezer handles, doorknobs, and light switches.
• Do not smoke.

How can you avoid pneumonia?

• Get vaccinated – there are several vaccines (like the flu shot) that can help prevent infection that leads to pneumonia. Talk to your health care provider to see if any of these vaccines are right for you.
• Keep your hands clean with soap and water or alcohol hand rub.
• Limit or avoid contact with people who are sick.
• Keep healthy. Eat the right foods and get enough sleep.

What about pregnancy?

Pneumonia can be more severe if you are pregnant. Tell your health care provider if you have signs of pneumonia during pregnancy. If you are pregnant, check with your health care provider before taking any medicine. Ask your provider which vaccinations you need before you get pregnant, or ones that you need during pregnancy.

The Centers for Disease Control and Prevention (CDC) estimate that every year about 48 million people in the United States become ill from harmful germs in food; of these, about 3,000 die.

What are the signs of illness from food?

• Diarrhea
• Fever
• Vomiting
• Abdominal cramps
• Dehydration
• Death

How is food handled safely?

• Start with food shopping strategies.
• Understand the role of keeping hands, surfaces, and foods clean.
• Learn proper food storage.
• Know proper food thawing.
• Utilize specific preparation techniques.
• Learn how to use a thermometer.
• Recognize serving principles.
• Be prudent when eating out.

You can't see, smell, or taste harmful bacteria that may cause illness.

When shopping for food

• Visit the refrigerated or frozen section last.
• Do not buy food if the package is torn, damaged or leaking.
• Do not buy foods after the "Sell-By" or "Use-By" expiration dates.

Clean hands, surfaces, and foods

• Wash hands thoroughly with water and soap.
• Wash hands before and after handling food, and after using the bathroom, changing diapers, or handling pets.
• Wash cutting boards, dishes, counters, utensils, and hands with hot soapy water after contact with raw meat, poultry, seafood, or unwashed fruits or vegetables.
• Peel or wash fruits and vegetables thoroughly before eating.

When storing foods you should

• Always refrigerate perishable food within 2 hours (1 hour when the temperature is above 90°F).
• Cook or freeze fresh poultry, fish, ground meats, and other meats within 2 days.
• Cook beef, veal, lamb, or pork, within 3 to 5 days.
• Wrap meat and poultry.
• Wrap meat in the original package with foil or plastic wrap before freezing.
• Store low-acid canned food such as meat, poultry, fish, and most vegetables up to 2 to 5 years.
• Store high-acid canned food such as tomatoes, grapefruit, and pineapples on the shelf for 12 to 18 months.
• Only store cans in good condition, and in a cool, clean, dry place.
• Discard cans that are dented, leaking, bulging, or rusted.

When thawing food

• Thaw in the refrigerator.
  • Make sure thawing meat and poultry are covered. Keep juices from dripping into or touching other food.
  • Refreeze refrigerator-thawed meat and poultry before or after cooking.
• Use cold water for quick thawing if needed.
  • Place food in a leak-proof plastic bag.
  • Submerge in cold tap water.
  • Change the water every 30 minutes.
  • Cook immediately after thawing.
• Use a microwave to thaw as needed.
  • Cook food immediately after microwave thawing.

The Danger Zone is the temperature that germs can grow in food. Keep food below 40°F or above 140°F (4°C and 60°C).

Check the temperature of your refrigerator and freezer with an appliance thermometer. The refrigerator should be at 40°F or below and the freezer at 0°F or below.

When preparing food

• Clean your hands before and after.
• Keep cutting boards, utensils, and countertops clean. Use hot, soapy water and mix with liquid chlorine bleach (1 tablespoon per 1 gallon of water).
• Separate raw meat, poultry, and seafood from ready-to-eat foods.
• Use at least two cutting boards.
  • One for raw meat, poultry, and seafood.
  • One for fresh fruits and vegetables.
• Don't let "juice" from foods and packaging touch other foods, utensils, or surfaces.
• Use a clean plate or bowl for cooked food.
• Never use the same plate or bowl that held the uncooked or raw food. Germs from the raw food could get into the cooked food.
• Marinate meat and poultry in a covered dish in the refrigerator.

When using a thermometer

• Use a food thermometer to check that meat, poultry, and egg dishes reach a safe temperature.
• Follow the instructions for your food thermometer.
• Place thermometer in the thickest part of the food, not touching bone, fat, or gristle.
• Check at the end of the cooking time, but before the food is expected to be "done".
• Check the temperature in several places to make sure the food is evenly heated.
• Clean your food thermometer with hot, soapy water before and after each use.
• Large-dial oven-safe or oven-probe thermometers may be used during cooking.
• After cooking, allow food to "rest" before cutting or eating.
• During the rest time, the temperature of the food will stay the same or rise. This will help destroy harmful germs.

When serving foods

• Keep hot food at 140°F or warmer.
• Keep cold food at 40°F or colder.
• Keep food hot with chafing dishes, slow cookers, and warming trays during parties.
• Keep food cold by nesting dishes in bowls of ice or use small serving trays. Replace them often.
• Don't leave perishable foods out for more than 2 hours at room temperature (1 hour when the temperature is above 90°F).

2 Hour Rule: Keep hot food hot and cold food cold. If food that has been left out is not eaten within 2 hours, discard it.

When eating out

• Choose a clean restaurant. Look for health department reports online or posted in the restaurant.
• Look around you before you sit down. If it's not clean think about eating somewhere else.
• Clean your hands with soap and warm water before eating. If soap and water aren't available, use alcohol hand rub to clean your hands.
• Pay close attention to the type of food and how it's prepared – harmful germs can be hidden in some foods.
• Request that your food be cooked completely through – especially meat, poultry, fish, and eggs.
• Make sure your hot food is piping hot and completely cooked. If lukewarm, send it back.
• Know that raw or undercooked finfish or shellfish (including oysters, clams, and mussels) are more likely to contain parasites or bacteria than foods made from cooked fish.
• Refrigerate take-out and "leftover" food within 2 hours after being served. If you will not be home within 2 hours, don't take the leftovers home with you.
• Bring take-out and "leftover" food directly home after eating out and put your leftovers in the refrigerator as soon as you arrive.
• Eat delivery food within 2 hours after it arrives. This prevents the growth of harmful germs.

If the food is not going to be eaten within 2 hours, you can keep it hot in the oven – but the temperature must be set at or above 200°F (93°C). Side dishes, like stuffing, must also be kept hot in the oven. Covering food will help keep it moist while you keep it warm. Check with a food thermometer to make sure that the inside of the food is held at a temperature 140°F (60°C).

Leftover food should be used within 4 days. Reheat leftovers to 165°F.

Hepatitis means that the liver is inflamed. This inflammation (swelling) can be caused by germs, viruses, some medicines, some diseases, or heavy alcohol use.

Three common types of hepatitis are caused by viruses

• Hepatitis A virus causes hepatitis A.
• Hepatitis B virus causes hepatitis B.
• Hepatitis C virus causes hepatitis C.

These three kinds of hepatitis can be acute. Hepatitis B and C can become chronic.

Chronic hepatitis B and C are serious health problems.

Acute viral hepatitis

• Is caused by hepatitis A, hepatitis B, and hepatitis C viruses
• Usually occurs within a few weeks after you first get infected with the virus
• Can be mild, severe or even life-threatening
• Hepatitis B or C can sometimes lead to long-term (chronic) infection.

Chronic viral hepatitis

• Is caused only by hepatitis B and hepatitis C viruses
• May be lifelong
• Can cause liver damage, cirrhosis (scarring of the liver), and liver cancer

Symptoms can appear anywhere from 2 to 6 weeks after contact with the virus.

What are the signs of hepatitis?

You may not have any sign of hepatitis. Or, you may have:

• Yellow skin or eyes (jaundice)
• Tiredness
• Fever
• Nausea
• Vomiting
• Loss of appetite
• Stomach pain
• Light stools
• Dark urine

Hepatitis A is a disease of the liver caused by hepatitis A virus. It may make you sick for a few weeks to a few months. Most recover with no lasting liver damage.

How is it spread?

Hepatitis A is spread by coming in contact with the hepatitis A virus. This includes:

• Contact with any person infected with the hepatitis A virus
• Sexual contact with an infected person
• Touching contaminated surfaces and then placing your hands near or in your mouth
• Sharing eating utensils that have virus on them
• Eating food or drinking water that has been contaminated by feces that contain the virus. The food and drinks most likely to be contaminated are:
  • Fruits
  • Vegetables
  • Shellfish
  • Ice
  • Water

In the United States, chlorine in the water kills hepatitis A virus. But infected food workers can still spread hepatitis A directly to food. This occurs when hands are not washed or cleaned before food is handled.

Infected people can spread the virus to others a few weeks before they begin to feel bad.

Who is at risk of hepatitis A?

Anyone can get hepatitis A if they have not been vaccinated. In the U.S., you are at a higher risk if you:

• Use illegal drugs, whether injected or not
• Live with someone who has hepatitis A
• Have bleeding problems and take clotting factors
• Have oral-anal sexual contact with someone who has hepatitis A
• Travel to areas that have high rates of hepatitis A

Travel to Africa, Asia, Eastern Europe, or Central and South America, including Mexico, increases the risk of getting hepatitis A.

What are signs of hepatitis A?

Hepatitis A does not always cause people to feel bad. It may make you sick for a few weeks to a few months. Older people can get sicker when they have hepatitis A. Young children with hepatitis A usually do not show any signs. Signs of hepatitis A include:

• Yellow skin or eyes (jaundice)
• Tiredness
• Fever
• Nausea
• Vomiting
• Loss of appetite
• Stomach pain
• Light stools
• Dark urine
• Diarrhea

How do you know if you have hepatitis A?

The only way to know if you have hepatitis A is by a medical exam. Your health care provider can examine and test you for hepatitis A.

How is it treated?

There are no medicines for treating hepatitis A. If you have been exposed to hepatitis A virus, tell your health care provider. They may be able to give you a protein that fights hepatitis A virus to help keep you from getting sick. Most people with hepatitis A recover without treatment in a few months. A few people will need to be hospitalized for hepatitis A.

What can happen if you have hepatitis A for a long time?

People with hepatitis A usually improve without treatment and have no lasting liver damage. Symptoms usually last less than 2 months. A few people can be ill for as long as 6 months. Hepatitis A can sometimes cause liver failure and death. This is usually occurs in:

• People 50 years of age or older
• People with other liver diseases, such as hepatitis B or C

If you have hepatitis A

• Get plenty of rest.
• Eat healthy foods.
• Drink plenty of fluids.
• Avoid drinking any alcohol.
• Check with your health care provider before taking:
  • Medicines
  • Supplements and herbal medicines
  • Over-the-counter drugs
• Clean hands often, especially after using the bathroom.
• Avoid preparing food, if possible, while you are sick.
• Talk to those listed below about having hepatitis A so they can get more information to protect themselves:
  • Household contacts
  • Sexual contacts
  • Playmates/attendees at childcare centers
  • Persons sharing illegal drugs
  • Persons sharing food or drink
  • Coworkers and/or restaurant patrons where there is an infected food worker

If you have hepatitis A, avoid drinking alcohol.

How can you avoid hepatitis A?

The best way to prevent hepatitis A is to be vaccinated. People with certain risk factors and health problems need this vaccine. Ask your doctor if the vaccine is right for you. You cannot get hepatitis A from the vaccine. Hepatitis A vaccination is recommended for:

• All children at age 1 year
• People who use injection and non-injection illegal drugs
• People with chronic (lifelong) liver diseases, such as hepatitis B or hepatitis C
• People with bleeding problems who take clotting factors
• People whose work has a risk for hepatitis A infection
• People who live in areas with high rates of hepatitis A infection
• Travelers to countries that have high rates of hepatitis A. These include:
  • Africa
  • Asia
  • Latin America
  • South America
  • Eastern Europe

Getting vaccinated is the best way to prevent hepatitis A.

Other ways to avoid hepatitis A:

• Boil water or drink bottled water in places where the water may not be clean.
• Eat cooked foods and fruits that you can peel. Avoid eating uncooked vegetables or fruits that could have been washed with dirty water, such as lettuce.
• Avoid eating raw or steamed shellfish such as oysters. Shellfish may live in dirty water.
• Use condoms correctly and every time you have sex.
• Clean hands often.

What about pregnancy?

Hepatitis A vaccine does not contain live virus, so the risk to the baby is expected to be low. However, the safety of hepatitis A vaccination during pregnancy is not known. The risk of the vaccination should be weighed against the risk for hepatitis A in pregnant women. Ask your health care provider if the vaccine is right for you.

Hepatitis B is a disease of the liver caused by hepatitis B virus. Most adults who have hepatitis B will recover on their own. However, children and some adults can develop chronic (lifelong) hepatitis B.

How is it spread?

Hepatitis B virus is spread by contact with body fluids that carry the virus, such as:

• Blood
• Semen
• Vaginal fluids
• Other body fluids

Hepatitis B is spread by contact with infected body fluids, mostly by:

• Sexual contact: (This is the most common way it is spread in the U.S.)
  • Vaginal and anal sex
  • Sharing unclean sex toys
  • Body fluids with hepatitis B can enter tiny breaks or rips in the linings of the vagina, vulva, rectum,or mouth. Rips and tears in these areas can be common and often unnoticed.
• Needle sharing:
  • Used or unclean needles
  • During illegal drug or drug equipment use
• Contact with blood:
  • Open sores of an infected person
  • Sharing items such as razors or toothbrushes with an infected person
  • Being tattooed or pierced with tools that were not properly cleaned
• Pregnancy and birth:
  • Hepatitis B can spread to babies during pregnancy and birth.

Infected mothers can pass hepatitis B to their babies during childbirth.

Hepatitis B is rarely spread from a blood transfusion because:

• Hepatitis B tests are done on all donated blood.
• Blood and blood products that test positive for hepatitis B are safely destroyed. None are used for transfusions.
• There is no risk of getting hepatitis B when donating or giving blood.

Who is at risk of hepatitis B?

Anyone can get hepatitis B if not vaccinated. However, in the U.S., you may be at a higher risk if you:

• Have sex partners that have hepatitis B
• Have HIV or another STD
• Inject drugs or share needles, syringes, or other drug-injection equipment
• Live with someone who has hepatitis B
• Are undergoing dialysis
• Have diabetes
• Travel to areas that have moderate to high rates of hepatitis B
• Work in health care or public safety and are exposed to blood or body fluids on the job
• Are an infant born to an infected mother

What are signs of hepatitis B?

When you first get hepatitis B, it is called acute hepatitis B. Most adults who have hepatitis B will recover on their own. However, children and some adults can develop chronic (lifelong) hepatitis B.

Acute hepatitis B: Signs of acute hepatitis B can appear within 3 months after you get the virus. These signs may last from several weeks to 6 months. Up to 50% of adults have signs of acute hepatitis B virus infection. Many young children do not show any signs. Signs include:

• Yellow skin or eyes (jaundice)
• Tiredness
• Fever
• Nausea
• Vomiting
• Loss of appetite
• Stomach pain
• Light stools
• Dark urine
• Joint pain

Chronic hepatitis B: Hepatitis B is chronic when the body can't get rid of the virus. Children, mostly infants, are more likely to get chronic hepatitis B than adults. People with chronic hepatitis B may have no signs for as long as 20 or 30 years. Signs may be the same as acute hepatitis B. There may also be signs of liver damage and cirrhosis such as:

• Weakness
• Weight loss
• Small, red, spider-like blood vessels on the skin
• Confusion or problems thinking
• Loss of interest in sex
• Swollen stomach or ankles
• A longer than normal amount of time for bleeding to stop

How do you know if you have hepatitis B?

The only way to know if you have hepatitis B is by a medical exam. There are several blood tests your health care provider can use to diagnose hepatitis B. These tests can tell you:

• If it is an acute or a chronic infection
• If you have recovered from infection
• If you are immune to hepatitis B
• If you could benefit from vaccination

How is it treated?

Acute hepatitis B: There are no drugs to treat acute hepatitis B. Doctors usually suggest rest, good nutrition, and fluids. Some people may need to be in the hospital.

Chronic hepatitis B: People with chronic hepatitis B virus infection should receive care from a provider who has experience treating hepatitis B. These providers can be:

• Some internists or family medicine providers
• Infection specialists
• Gastroenterologists (digestive system specialists)
• Hepatologists (liver specialists)

If you have chronic hepatitis B, get checked regularly for signs of liver disease. Discuss treatment with your health care provider. Not every person with chronic hepatitis B needs treatment. If you show no signs of liver damage, your provider will continue to check you for liver disease.

What can happen if chronic hepatitis B is not treated?

Chronic hepatitis B is a serious disease that can result in long-term health problems. Up to 1 in 4 people with chronic hepatitis B develop serious liver problems. These include:

• Liver damage and scarring (cirrhosis)
• Liver failure
• Liver cancer
• Death

If you have hepatitis B

• See your health care provider regularly.
• Tell current and recent sex partners that you have hepatitis B.
• Get plenty of rest.
• Eat healthy foods.
• Drink plenty of fluids.
• Avoid drinking any alcohol.
• Check with your health care provider before taking:
  • Prescription medicines
  • Supplements or herbal medicines
  • Over-the-counter drugs
• Avoid spreading hepatitis B to others by:
  • Having safer sex and using condoms during all sexual contact.
  • Not sharing used or unclean needles and sex toys.
  • Not donating blood, blood products, or organs.
  • Cleaning all blood spills – even those that have already dried. Use a mixture of bleach and water (one part household bleach to 10 parts water). Even dried blood is a risk to others.
  • Not sharing personal care items like razors, toothbrushes, nail clippers or earrings.
  • Not sharing glucose-monitoring equipment.
  • Asking sexual partner(s) and people living in close contact with you to be tested and vaccinated.

How can you avoid hepatitis B?

Getting the vaccine for hepatitis B is the best way to prevent hepatitis B. The hepatitis B vaccine is safe and effective. It is usually given as 3-4 shots over a 6-month period. You will not get hepatitis B from the vaccine. Ask your health care provider if you should get this vaccine. It is recommended for:

• All infants, starting with the first dose of hepatitis B vaccine at birth
• Everyone under the age of 19 who has not been vaccinated
• People whose sex partners have hepatitis B
• Sexually active people who are not in a long-term, faithful relationship
• People with a sexually transmitted disease
• People who share needles, syringes, or other drug-injection equipment
• People who have close household contact with someone infected with the hepatitis B virus
• Health care and public safety workers at risk for exposure to blood or body fluids on the job
• People with kidney disease. This includes all those on dialysis and those being considered for dialysis.
• Adults with diabetes
• Residents and staff of facilities for disabled persons
• People with chronic liver disease
• People with HIV infection
• Travelers to regions with moderate or high rates of hepatitis B

Travelers at increased risk for infection include:

• Adventure travelers
• Peace Corps volunteers
• Missionaries
• Military personnel

Certain events may increase the risk for hepatitis B for travelers:

• An injury or illness that requires certain types of treatment. These include anything that breaks the skin such as shots, fluids in the vein, transfusion, stitches, and surgery.
• Dental treatment
• Unprotected sexual contact
• Sharing drug injection equipment
• Tattooing, ear piercing, acupuncture and other practices that break the skin
• Practices with risk for breaking the skin such as manicures and pedicures
• Sharing certain items such as earrings, razors, toothbrushes and nail clippers

The hepatitis B vaccine is the best way to prevent hepatitis B.

Other ways to avoid hepatitis B:

• Avoid sexual contact.
• Have safer sex:
  • Reduce the number of sexual partners.
  • Condoms, when used correctly, can reduce the risk of getting hepatitis B. Each time you have sex use a condom (male or female type):
    • Before vaginal sex
    • Before anal sex
    • Before oral sex
  • Have sex with only one partner who does not have sex with others and does not have hepatitis B.
• Know that other forms of birth control do not protect against hepatitis B.
• Not using or injecting drugs.
• Not reusing or sharing syringes, or drug equipment (works).
• Wear gloves if you have to touch another person's blood.
• Do not use another person's toothbrush, razor, nail clippers or any other item that might have even a tiny bit of blood on it.
• Make sure any tattoos or body piercings are done under good conditions, using:
  • Sterile tools
  • Clean hands and gloves
  • Disinfected work surfaces

What about pregnancy?

If you have hepatitis B, your baby has a very high chance of getting it. Pregnant women should be checked for hepatitis B by a health care provider. If you are at risk for hepatitis B, ask your provider about getting vaccinated. The hepatitis B vaccine is safe for pregnant women and their baby. The vaccine can help your baby if:

• It is given to the baby within 12 hours of birth.
• The baby finishes the vaccine series. Note: babies should be tested after the last vaccine shot to make sure they are protected from the disease.

Don't breastfeed until you have discussed it with your health care provider. Avoid breastfeeding if your nipples are cracking or bleeding until the sores heal. Until they heal, you can pump your milk to keep up your milk supply. Do not feed this milk to your baby. Throw it away.

Hepatitis B is a very serious disease for babies. 9 out of 10 babies infected develop chronic hepatitis B.

Hepatitis C is a disease of the liver caused by hepatitis C virus. Hepatitis C infection can lead to chronic viral hepatitis, including liver damage, cirrhosis (scarring of the liver), and liver cancer.

How is it spread?

Hepatitis C virus is mostly spread by blood from an infected person when:

• Sharing needles or other equipment to inject drugs. This is the most common way people get hepatitis C in the U.S.
• Getting a needle stick with a needle that was used on an infected person
• Sharing items that may have come in contact with another person's blood, such as razors, nail clippers, pierced earrings, toothbrushes
• Being tattooed or pierced with tools that were used on an infected person
• Having sexual contact with a person infected with the hepatitis C virus. The risk of getting hepatitis C from sexual contact is thought to be low.

Hepatitis C is rarely spread from a blood transfusion because:

• Hepatitis C tests are done on all donated blood.
• Blood and blood products that test positive for hepatitis C are safely destroyed. None are used for transfusions.
• There is no risk of getting hepatitis C when donating or giving blood.

Hepatitis C is not spread by kissing,hugging, coughing, or sharing food and eating utensils.

Who is at risk of hepatitis C?

Anyone can get hepatitis C. It is important for people at high risk of infection to be tested and treated for hepatitis C. In the U.S., you are at a higher risk if you:

• Have ever used a needle to inject drugs, even if once and long ago
• Had a blood transfusion or organ transplant before 1992
• Are a health care worker who had blood exposure to mucous membranes or to non-intact skin, or a needlestick injury
• Have ever been on kidney dialysis
• Were born of a mother who had hepatitis C at the time
• Are a Vietnam-era Veteran
• Had contact with hepatitis-C-positive blood to nonintact skin or to mucous membranes
• Received tattoos or body piercings in non-regulated settings
• Have ever snorted drugs or shared drug equipment
• Have liver disease
• Have abnormal liver tests
• Have a history of alcohol abuse
• Have hemophilia and received clotting factor before 1987
• Have had a sexual partner with hepatitis C, now or in the past
• Have had 10 or more lifetime sexual partners
• Have HIV infection

The only way to know if you have Hepatitis C is to be tested. VA offers hepatitis C testing and treatment to enrolled Veterans.

What are signs of hepatitis C?

When you first get hepatitis C, it is called acute hepatitis C. About 15% of people who have acute hepatitis C infection clear the virus from their bodies. The other 85% of people develop a chronic (lifelong) hepatitis C infection. Of these, 50 to 80%, if treated, may be cured.

Acute hepatitis C: Most people with acute hepatitis C do not have any signs. If signs occur, the average time is 6-7 weeks after exposure, but can be less or more. Some people can have mild to severe signs including:

• Yellow skin or eyes (jaundice)
• Tiredness
• Fever
• Nausea
• Vomiting
• Loss of appetite
• Stomach pain
• Light stools
• Dark urine

Chronic hepatitis C: 3-5 million persons in the United States have chronic hepatitis C infection. Most people do not know they are infected. They don't look or feel sick until the virus causes liver damage. This can take 10 years or more to happen. Signs may be the same as acute hepatitis C. There may also be signs of liver damage and cirrhosis such as:

• Weakness
• Weight loss
• Small, red, spider-like blood vessels on the skin
• Confusion or problems thinking
• Loss of interest in sex
• Swollen stomach or ankles
• A longer than normal amount of time for bleeding to stop

How do you know if you have hepatitis C?

The only way to know if you have hepatitis C is by a medical exam. There are several blood tests your health care provider can use to diagnose hepatitis C. These tests can tell you:

• If it is acute or chronic infection
• If you have recovered from infection
• If you could benefit from vaccination for hepatitis A and B

In some cases, your health care provider may suggest a liver biopsy. A liver biopsy is a test for liver damage. A needle is used to remove a tiny piece of liver, which is then sent for tests.

How is it treated?

If you have chronic hepatitis C infection, your health care provider will examine you for liver problems and may prescribe drugs to help control the disease. Hepatitis C drugs can help to:

• Clear the virus from the body
• Slow down or prevent liver damage
• Lower the chance of getting cirrhosis and liver cancer

Before starting treatment it is important to discuss your options with your health care provider. Treatment for hepatitis C may not be for everyone. Some patients might not need treatment. Other patients might not be able to be treated due to other medical problems.

What can happen if hepatitis C is not treated?

For every 100 people infected with hepatitis C:

• About 15 will clear the virus from their bodies.
• About 85 will develop chronic (long-term) infection. Of these 85 people:
  • 66 will get only minor liver damage
  • 17 will develop cirrhosis and may have symptoms of severe liver disease
  • 2 will develop liver cancer

Chronic hepatitis C infection is the leading cause of liver cancer and cirrhosis in the U.S. Cirrhosis is scarring of the liver which causes it to not work properly. Both liver cancer and cirrhosis can be fatal. A liver transplant may be necessary if chronic hepatitis C causes the liver to fail.

If you have hepatitis C

• See your health care provider regularly.
• Tell current and recent sex partners that you have hepatitis C.
• Get vaccinated against hepatitis A and hepatitis B.
• Get plenty of rest.
• Eat healthy foods.
• Drink plenty of fluids
• Avoid drinking any alcohol. Alcohol use speeds up the damage hepatitis C causes in your liver. Drinking alcohol before starting hepatitis C treatment makes treatment less likely to work. There are ways to help you stop drinking alcohol.
• Check with your health care provider before taking:
  • Prescription medicines
  • Supplements
  • Over-the-counter drugs
• Avoid spreading hepatitis C to others by:
  • Having safer sex and using condoms during all sexual contact.
  • Not sharing used or unclean needles and sex toys.
  • Not donating blood, blood products, or organs.
  • Cleaning all blood spills – even those that have already dried. Use a mixture of bleach and water (one part household bleach to 10 parts water). Even dried blood is a risk to others.
  • Not sharing personal care items like razors, toothbrushes, nail clippers or earrings.
  • Not sharing glucose-monitoring equipment.
  • Asking your sexual partner(s) to be tested for hepatitis C (and perhaps other infections).

If you have hepatitis C, you can prevent liver damage by not drinking alcohol and by getting vaccinated for hepatitis A and hepatitis B.

How can you avoid hepatitis C?

Right now there is no vaccination to protect you against hepatitis C. However, you can take steps to protect yourself from becoming infected:

• Don't use injectable drugs.
• If you use drugs, get vaccinated against hepatitis A and hepatitis B and enter a treatment program.
• Never share needles, syringes, water, or "works" for intravenous drug use, to inject steroids, or cosmetic substances.
• Handle needles and other sharp objects safely.
• Do not use personal items that may have come into contact with an infected person's blood.
• Do not get tattoos or body piercings from an unlicensed facility or in an informal setting.
• Wear gloves if you have to touch another person's blood. Always clean hands after removing gloves.
• Have safer sex. Each time you have sex use a condom.

What about pregnancy?

It is possible to get pregnant if you or your partner has hepatitis C. If you are a pregnant woman who already has hepatitis C (or gets hepatitis C during the pregnancy), the chance of passing the virus to your baby is 4 out of 100. The risk becomes greater if the mother has both hepatitis C and HIV. With good prenatal care, babies born to mothers or fathers with hepatitis C are usually quite healthy. The chance of your baby being infected with hepatitis C is the same whether your baby is born by vaginal delivery or C-section. Before breastfeeding, talk to your health care provider.

Listeriosis is a food-borne illness caused by bacteria called Listeria. Infected animals can spread these bacteria in their milk and cheese, and to the soil. This can infect animals, vegetables, and other foods that contact soil and animal manure.

How is listeriosis spread?

Listeriosis is spread by eating food or drinking fluids contaminated with these bacteria.

Anyone can get listeriosis, but you are at a higher risk if you:

• Are pregnant
  • Pregnant women get listeriosis about 13 times more often than other healthy adults.
  • Newborn babies are at risk for more serious illness if infected.
• Are an adult over age 50
• Have a weakened immune system, caused by:
  • AIDS
  • Cancer
  • Diabetes
  • Kidney disease
  • Medicines for organ transplants and other serious medical conditions

What are signs of listeriosis?

You may have no signs. Or, you may have flu-like signs such as:

• Fever
• Chills
• Muscle aches
• Diarrhea
• Upset stomach

If the illness gets worse, you can have:

• Headaches
• Stiff neck
• Confusion
• Loss of balance
• Convulsions

How do you know if you have listeriosis?

The only way to know if you have listeriosis is by a medical exam. Your health care provider can examine and test for it. Lab samples may be taken from amniotic fluid, blood, feces, and urine.

How is listeriosis treated?

Listeriosis can be treated and cured with antibiotics. Always finish antibiotic treatment.

What can happen to pregnant women if they are not treated for listeriosis?

Listeriosis can be very serious for the pregnant woman and for her child. Listeria bacteria can pass from a pregnant woman to her unborn child. Listeriosis can cause:

• Miscarriage
• Early birth
• Birth of an infected baby
• Brain damage or other problems in the baby
• Death of both the mother and the baby

How can you avoid listeriosis?

• Learn how to handle food safely. This can reduce the risk of listeriosiss and other food-borne illness for you and your family.
• Avoid non-pasteurized soft cheeses.
• Cook food thoroughly.

Pregnant women should avoid eating soft cheeses, deli meats, and cold salads from salad bars.

Toxoplasmosis is an infection caused by a small parasite. It is found in humans, animals, and birds. Cats play a role in the spread of toxoplasmosis.

Cats and kittens can get toxoplasmosis by eating infected small animals. The parasite is then passed in the cat's feces. This can infect their litter box, sand boxes, and soil or dirt in gardens and yards. Kittens and cats can pass millions of parasites in their feces.

How is toxoplasmosis spread?

• Eating undercooked meat (e.g., beef, lamb, pork, poultry, wild game).
• Touching your mouth after:
  • Working in infected soil.
  • Changing cat litter boxes without wearing gloves. Be sure to clean your hands after.
• Eating fruits and vegetables that are not washed or peeled.
• Handling raw meat without washing your hands afterwards.
• Using unwashed knives, cutting boards, and surfaces that have been in contact with raw meat or other food.
• Drinking water that is infected with the parasite.

Eating undercooked meat is the biggest risk for toxoplasmosis.

What are the signs of toxoplasmosis?

You may have no signs of sickness. Or, you may have:

• Muscle aches and pains
• Headache
• Fever
• Sore throat
• Enlarged lymph nodes
• Feel like you "have the flu"

If you are pregnant and have no signs of the illness, your unborn baby can still be affected.

How do you know you have toxoplasmosis?

The only way to know if you have toxoplasmosis is by a medical exam. Your health care provider can examine you and test your blood for it. If a pregnant woman is infected, other tests can show if the unborn baby has toxoplasmosis.

How is it treated?

Toxoplasmosis can be treated and cured with antibiotics. Always finish antibiotic treatment.

What can happen to you if you are not treated for toxoplasmosis?

• Severe cases can affect the brain, lungs, eyes, heart, or liver. Infection can spread to the baby during pregnancy, labor, or birth.
• For the mother, the toxoplasmosis infection is often mild. She may not even know she has it.
• For the baby, infection can cause severe problems. These are worse when the mother gets the infection early in pregnancy. Infection of the baby may:
  • Cause early birth.
  • Damage the baby's eyes, nervous system, skin, and ears.
  • Not show for months or years. If not treated, eye or brain problems can occur.

How can you avoid toxoplasmosis?

• Learn how to handle food safely. This can reduce the risk of toxoplasmosis and other food-borne illness for you and your family.
• Avoid cat litter. If you have to change litter, wear disposable gloves. Clean your hands well with soap and water after.
• Feed your cat store-bought dry or canned food. Do not feed your cat raw or undercooked meats.
• Keep cats indoors. This will keep the cat from hunting birds and rodents that might be infected.
• Avoid stray cats and kittens.
• Do not get a new cat while you are pregnant.
• Keep all sandboxes covered. This will stop cats from using them as litter boxes.
• Wear gloves when gardening or during contact with soil or sand. Clean hands well after gardening or contact with soil or sand.

Safely cleaning and storing your contact lenses is the best way to prevent eye infections. Lenses can collect bacteria, fungi, and other germs if not properly cleaned.

Why should you clean your contact lenses?

Contact wearers are at risk of eye infections since contacts are worn directly on the eye. Eye infections can cause pain, blurred vision, and sometimes even blindness. Proper contact lens cleaning, storing, and hygiene are the best way to keep your eyes healthy.

Replace contact storage cases every 3 to 6 months.

When should you wear contact lenses?

Most types of contact lenses are only worn while awake. Contact lenses should not be worn when:

• Sleeping (some can be worn overnight)
• Showering
• Swimming in the pool or ocean

Some types of extended wear lenses can be worn overnight. Talk to your eye care provider about when to remove contact lenses.

How should you clean and store your contact lenses?

Follow your eye care provider's and manufacturer's instructions for cleaning and storing your contact lenses.

1. Always clean hands before touching your eyes and contact lenses.
2. Remove the lens and place in the palm of your hand.
3. Rub contact lens solution over the surface of the lens for 5 to 10 seconds on each side.
4. Rinse lens with a stream of solution to remove bacteria and deposits from the lens.
5. Store lenses in the proper storage case with fresh solution.
6. After removing lenses from the storage case, rinse case with fresh solution and allow to air dry. Never use tap water to rinse your contact lens case.
7. Replace your contact lens storage case every 3 to 6 months.

Discuss with your provider:

• Which contact lens products and solutions to use
• How often to replace your contact lenses

If you wear contact lenses

Always:

• See your eye care provider for regular exams.
• Clean hands before touching your eyes and lenses.
• Use fresh, sterile solutions recommended by your provider for lens cleaning and storage.
• Remove your contact lenses and see your eye care provider if your eyes become red, irritated, or if you have problems seeing.
• Contact your provider if you have any problems with your eyes, vision, or lenses.

Never:

• Re-use any lens solutions. Always discard all storage solutions after use. Used solutions can become contaminated with germs that can cause eye infections.
• Expose your lenses to water, including distilled, bottled, tap, lake, or ocean water. Water can contain germs that cause eye infections.
• Use saliva to wet your contact lenses.
• Transfer sterile contact lens solution to another container for later use.

Never expose contact lenses to water.

What are signs of an eye infection?

• Discomfort
• Excessive tearing or mucus
• Unusual sensitivity to light
• Itching
• Burning
• "Gritty" feeling
• Unusual redness
• Blurred vision
• Swelling
• Pain

See your eye care provider immediately if you have signs of an eye infection. Eye infections can be serious and in some cases cause blindness.

Allergies can cause some of the same signs as an eye infection. Allergies usually affect both eyes equally. Some infections may affect only one eye.

Bacterial vaginosis, or BV, is a common vaginal infection in women. It is the most common vaginal infection in women of childbearing age, including pregnant women.

While it is not a sexually transmitted disease (STD), some sexual behaviors increase the chances for BV. Women who have never had sex can also have BV.

How is it spread?

The vagina contains many different types of bacteria. Normally, there are large numbers of "good" bacteria that keep the number of "harmful" bacteria very low. Bacterial vaginosis occurs when this balance is upset and there are more "harmful" bacteria than "good" bacteria. The cause of BV is not fully understood.

The risk of BV is higher if you:

• Have a new sex partner or multiple sex partners
• Douche
• Do not use condoms
• Have a female sexual partner with BV

BV is more common in lesbian and bisexual women than in other women. The reason for this is unknown.

What are signs of BV in women?

Women with BV may have few or no signs of infection. Some women with BV have:

• Increased vaginal discharge:
  • Often watery
  • Gray or white in color
  • Sometimes has an unpleasant, fish-like odor, especially after sex
• Itching or irritation in the vaginal area
• Burning during urination

How do you know if you have BV?

BV can be diagnosed during a medical exam. To check for BV, your health care provider looks for signs of infection and collects a sample of vaginal fluid for lab tests.

How is it treated?

BV is treated with antibiotics. These can be in pill form, creams, gels, or ovules. Sometimes BV goes away without treatment.

Female partners of women with BV may need treatment. Male sexual partners do not need treatment

What can happen if you have BV for a long time?

Most often, BV does not cause other health problems. However, if left untreated, BV may increase your risk for:

• Sexually transmitted diseases (STDs) like herpes, chlamydia, gonorrhea, and HIV
• Pelvic inflammatory disease where BV bacteria infect the uterus or fallopian tubes. Pelvic inflammatory disease can cause infertility and increase the risk of ectopic (tubal) pregnancy.
• An infection after a procedure on the female organs. This includes cesarean section, abortion, and surgery on the cervix or uterus.
• Early labor or birth, if pregnant

If you have BV:

• Always finish antibiotic treatment, even if the signs of BV go away
• Talk to female sex partners about getting BV treatment

How can you avoid BV?

Protect the normal balance of bacteria in the vagina by:

• Not douching
• Asking your sex partners to be examined for BV
• Having sex with only one person who only has sex with you
• Using condoms during sex
• Reducing the number of sex partners
• Washing the genital area daily with mild soap and water

What about pregnancy?

BV is common in pregnant women. Treatment is very important. BV can increase the risk for:

• Low birth weight babies
• Early labor and birth

If you are pregnant and have BV, see your health care provider one month after finishing treatment.

Sexually transmitted diseases (STDs) are infections that are spread by sexual contact with someone who has an STD. STDs are mostly spread through vaginal, anal, or oral sex, and genital touching.

There are about 19 million new STD infections each year in the United States. There are over 20 types of STDs. STDs may be caused by bacteria, parasites, or viruses. STD infection may show a range of signs, or no signs at all. Sometimes people have an STD and don't know it. The only way to know if you have an STD is by a medical exam and testing by your health care provider.

Common STDs caused by bacteria that can be treated and cured with antibiotics include:

• Chlamydia
• Gonorrhea
• Syphilis

Common STDs caused by viruses that can be controlled with treatment include:

• Hepatitis
• Herpes
• HIV
• HPV

If you have an STD, tell current and recent sex partners of the infection.

How do you know if you have an STD?

Your health care provider can examine and test you for STDs. Some women are at a higher risk for STDs. They should have regular exams and testing. Higher risk women include those who:

• Have had a previous STD
• Have new or multiple sexual partners
• Use condoms only some of the time
• Have sex for drugs or money
• Use needles for illegal drugs

Using condoms or not having sex are the best options to protect yourself from STDs.

How can women avoid STDs?

• Avoid sexual contact.
  • Including vaginal, anal, or oral sex, or genital touching.
  • This is the only way to be absolutely sure of avoiding STDs.
• Have safer sex:
  • Reduce the number of sexual partners.
  • Use barriers, including:
    • Male condom
    • Female condom
      • Condoms, when used correctly, can reduce the risk of getting an STD. Each time you have sex use a condom (male or female type):
        • Before vaginal sex
        • Before anal sex
        • Before oral sex
    • Dental dam
    • Plastic wrap, if other barriers are not available
  • Have sex with only one partner who does not have sex with others and does not have an STD.
• Know that washing the vagina or douching after sex will not prevent it.
  • The American Congress of Obstetricians and Gynecologists (ACOG) recommend that women do not douche.
  • Douching can change the balance of germs and acidity in a healthy vagina.
  • Any changes in that balance can cause an over growth of bad bacteria. This can lead to a yeast infection or bacterial vaginosis.
  • If you have a vaginal infection, douching can push infection-causing bacteria up into the uterus, fallopian tubes, and ovaries. This can cause more serious problems.

What about pregnancy?

Some STDs can also be passed on to the baby during pregnancy, birth, or breastfeeding.

It is important for all pregnant women to be tested for STDs. Treatment of STDs can prevent the effects of the STD on the baby. If you are pregnant or breastfeeding and have an STD, you should talk to your health care provider about the risk of passing the STD to your baby.

Some STDs can cause:

• Early birth
• Low birth weights
• Other severe problems in the newborn baby

If you are pregnant, you can become infected with the same sexually transmitted diseases (STDs) as women who are not pregnant. Pregnant women should ask their doctors about getting tested for STDs, since some doctors do not routinely perform these tests. This fact sheet answers basic questions about STDs during pregnancy.

I’m pregnant. Can I get an STD?

Yes, you can. Women who are pregnant can become infected with the same STDs as women who are not pregnant. Pregnancy does not provide women or their babies any additional protection against STDs. Many STDs are ‘silent,’ or have no symptoms, so you may not know if you are infected. If you are pregnant, you should be tested for STDs, including HIV (the virus that causes AIDS), as a part of your medical care during pregnancy. The results of an STD can be more serious, even life-threatening, for you and your baby if you become infected while pregnant. It is important that you are aware of the harmful effects of STDs and how to protect yourself and your unborn baby against infection. If you are diagnosed with an STD while pregnant, your sex partner(s) should also be tested and treated.

How can STDs affect me and my unborn baby?

STDs can complicate your pregnancy and may have serious effects on both you and your developing baby. Some of these problems may be seen at birth; others may not be discovered until months or years later. In addition, it is well known that infection with an STD can make it easier for a person to get infected with HIV. Most of these problems can be prevented if you receive regular medical care during pregnancy. This includes tests for STDs starting early in pregnancy and repeated close to delivery, as needed.

Should I be tested for STDs during my pregnancy?

Yes. Testing and treating pregnant women for STDs is a vital way to prevent serious health complications to both mother and baby that may otherwise happen with infection. The sooner you begin receiving medical care during pregnancy, the better the health outcomes will be for you and your unborn baby. The Centers for Disease Control and Prevention’s 2015 STD Treatment Guidelines recommend screening pregnant women for STDs.

Be sure to ask your doctor about getting tested for STDs. It is also important that you have an open, honest conversation with your provider and discuss any symptoms you are experiencing and any high-risk sexual behavior that you engage in, since some doctors do not routinely perform these tests. Even if you have been tested in the past, you should be tested again when you become pregnant.

Can I get treated for an STD while I’m pregnant?

It depends. STDs, such as chlamydia, gonorrhea, syphilis, trichomoniasis and BV can all be treated and cured with antibiotics that are safe to take during pregnancy. STDs that are caused by viruses, like genital herpes, hepatitis B, or HIV cannot be cured. However, in some cases these infections can be treated with antiviral medications or other preventive measures to reduce the risk of passing the infection to your baby. If you are pregnant or considering pregnancy, you should be tested so you can take steps to protect yourself and your baby.

How can I reduce my risk of getting an STD while pregnant?

The only way to avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting chlamydia:

• Being in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results;
• Using latex condoms the right way every time you have sex.

A urinary tract infection (UTI) occurs when bacteria grow in the urinary tract. The urinary tract system makes and stores urine and carries it out of the body.

The organs that can be infected include:

• Bladder (common) – Stores urine
• Urethra (common) – The tube that carries urine from the bladder out of the body
• Kidneys – Collect waste from blood to make urine
• Ureters – Move urine from the kidneys to the bladder

How is it spread?

Women get UTIs more often than men. The risk for UTIs can be increased by:

• Sexual intercourse
• Using a diaphragm
• Conditions that cause urine to stay in the bladder too long
• Problems emptying the bladder completely
• Loss of hormones (after menopause)
• Diabetes
• Kidney stones
• Having a tube that drains urine from the bladder
• Obesity
• Having had several children

UTIs cannot be spread between people.

What are signs of UTIs in women?

UTIs in the bladder and urethra may cause:

• Frequent urge to urinate, but not much urine comes out
• Burning, stinging or pain with urination
• Heavy feeling in the lower belly
• Waking in the night to urinate

Other signs of UTI may include:

• Pain or pressure in the lower back or sides
• Urine that smells bad or looks dark, cloudy, or red
• Tiredness, fever, and chills

How do you know if you have a UTI?

A health care provider can examine you for UTIs. A urine sample will be tested. Other tests may be done if your provider thinks the infection has spread, or if you have had many UTIs. You may be asked about:

• Signs of your UTI
• Past UTIs
• Sexual contact
• Birth control methods
• Pregnancy
• Other health conditions, such as diabetes

How is it treated?

UTIs are treated and cured with antibiotics. Always finish antibiotic treatment. If treated quickly, UTIs usually do not cause serious problems. You may need longer treatment or a different antibiotic if you:

• Are pregnant
• Have frequent UTIs
• Have diabetes
• Have a UTI that has spread to your kidneys

UTIs in the bladder and urethra that are not treated can spread to the kidneys and cause serious illness.

If you have a UTI

• Always finish antibiotic treatment
• Return to your health care provider if:
  • Signs don't go away
  • Signs come back
  • Signs get worse
  • You have more or different signs of UTI

Some doctors suggest showers instead of baths, and sanitary pads instead of tampons.

How can you avoid UTIs?

• Urinate when you have the urge.
• Don't hold in urine for a long time.
• Urinate before and after having sex.
• Drink plenty of fluids.
• Clean your genital area every day.
• Avoid the use of douches and perfumed sprays for the genital area.

What about pregnancy?

It is important to notify your health care provider right away if you are pregnant and think you may have a UTI. In pregnant women, UTIs:

• May result in early labor or early birth
• May cause harm to the baby, or even death
• Are more likely to spread to the kidneys