En español l Each year more than 2 million Americans become infected with so-called superbugs — bacteria that are resistant to antibiotics. Millions more are infected with viruses and germs that are becoming more prevalent and more difficult to treat. "The bugs are always a lot smarter than we are," says Deverick J. Anderson, M.D., codirector of the Duke Infection Control Outreach Network in Durham, N.C. "It's scary."
Don't freak out just yet, though. Our guide will help you gauge the risks against the hype — and learn to outsmart the sneaky bugs.
On Your Tropical Vacation
What it is: A mosquito-borne virus that migrated from Africa to Asia to parts of Europe and then to the Caribbean, chikungunya means "that which bends up"— a hint at what happens when patients get slammed with the severe musculoskeletal pain caused by the disease. While the virus is rarely deadly, the symptoms (which also include headache and fever) can take months to resolve, says Laura C. Harrington, an entomology professor at Cornell University who studies mosquito-borne diseases. More than 570,000 suspected cases have been reported to date.
Who's at risk: Anyone visiting areas where the virus has been recently confirmed. That would include most Caribbean islands as well as Florida.
How to prevent it: Researchers are still working on a vaccine, so protect yourself by using insect repellent, wearing long sleeves and pants, and staying in places with air-conditioning. "Mosquitoes are really weak fliers, so if you have a fan on, you can basically blow them away," says Harrington.
Freak-out factor: 3
Real risk: 1
At Your Gym
What it is: Officially known as methicillin-resistant Staphylococcus aureus, MRSA can cause skin infections, severe pneumonia, bloodstream infections, even death. While MRSA is most prevalent in hospitals, it is increasingly common in the community, and can be spread through skin contact and by sharing toiletries such as razors or toothbrushes. More than 75,000 cases were confirmed in 2012.
Who's at risk: Those in close contact with someone who has an MRSA skin infection, which can mimic a spider bite; people who play contact sports; hospital patients.
How to prevent it: Wash your hands often, keep cuts covered with a bandage, and shower immediately after playing sports or working out at the gym. "MRSA is much more common than anyone realizes," Anderson says. "If you have kids, they're going to be exposed, and then they're going to expose you. Exposure does not mean you're going to get sick, though. It's all about hygiene."
Freak-out factor: 3
Real risk: 2
In Your Backyard
What it is: Often called "the great imitator" because it can mimic such diseases as rheumatoid arthritis and multiple sclerosis, Lyme disease is spread through the bite of an infected tick and affects some 300,000 Americans each year. While some people report fever, headache, fatigue and a circular red bull's-eye rash, others have no symptoms at first, says Lesley Fein, a West Caldwell, N.J., rheumatologist. If left untreated, Lyme can cause chronic muscle aches, joint pain and neurological symptoms.
Who's at risk: Lyme has been reported in nearly every state but is most common in the Northeast and mid-Atlantic, and in the Midwest, especially Wisconsin and Minnesota, where deer and deer ticks are widespread.
How to prevent it: Wear light-colored clothing in wooded areas, so ticks will be visible. Apply repellents with DEET to skin and with permethrin to clothing. If you find an attached tick, use tweezers to carefully remove all of it, then apply antiseptic.
Freak-out factor: 2
Real risk: 3
On a Cruise Ship
What it is: A highly contagious gastrointestinal virus, norovirus causes inflammation in your stomach and intestines, resulting in stomach pain, cramps, diarrhea, nausea and vomiting. It is spread through close contact with infected people — you often hear about outbreaks on cruise ships — or by consuming contaminated food or beverages. There is no treatment, but symptoms typically resolve within three days. About 20 million people get sick from norovirus each year; between 500 and 800 die.
Who's at risk: Everyone, but especially young children, older people and those with other health concerns.
How to prevent it: Some cruise ships have mandatory hand-sanitizer stations at the entrance to dining areas; use them. "You might not lick your fingers after you touch a germy stair banister that hundreds of your fellow passengers have touched, but, yes, you might rub your itchy eyes," says Lisa Sanders, M.D., author of the "Diagnosis" column in the New York Times Magazine. "That's how it gets spread, too."
Freak-out factor: 2
Real risk: 4
In Your Dating Pool
What it is: This sexually transmitted infection causes pain, fever, pelvic inflammatory disease and, in severe cases, pelvic abscess, and can be spread through any kind of sexual contact, including oral sex. Thirty percent of the estimated 820,000 cases of gonorrhea in the United States annually are resistant to antibiotics, according to a recent study in Emerging Infectious Diseases.
Who's at risk: Anyone, of any age, who is sexually active. "But women post-menopause who have low estrogen levels and genital dryness may have an elevated risk of acquiring an infection since vaginal tissue is thinner," says Lauren Streicher, associate professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine in Chicago and author of Love Sex Again.
How to prevent it: Condoms are your best bet. Also consider the female condom (FC2). "Many of my patients seem to think that sexually transmitted infections are limited to 20- and 30-year-olds who are hanging out in bars or having random hookups," Streicher says. "Trust me, it's not as if these nasty bugs demand to see proof of age before infecting someone."
Freak-out factor: 3
Real risk: 1
On a Trip to the Middle East
What it is: Middle East respiratory syndrome (MERS), a viral respiratory illness first reported in Saudi Arabia in 2012, appears to be a mutation of a bug that originated with camels or bats. Initial symptoms include fever, cough and shortness of breath, progressing to respiratory failure, septic shock and multiorgan failure. While MERS can be contracted through close contact with an infected person, it does not appear to spread easily. At press time there were 820 known cases (including two in the U.S.) and 286 deaths.
Who's at risk: People who have traveled from countries in or near Saudi Arabia. Symptoms generally appear within 14 days.
How to prevent it: While the CDC has not issued a travel advisory to the region, if you go, stand your distance from people who appear sick. And avoid camels, since they are believed to be transmitters of the disease. "Unusual diseases are the downside of global travel," says Sanders. "Luckily, pandemics are the exception, not the rule."
Freak-out factor: 4
If You Travel to West Africa
What it is: The Ebola virus causes a severe hemorrhagic fever disease that's infectious and usually fatal in humans. It's spread by contact with certain wild animals, particularly the fruit bat, and then transmitted among people through direct contact with the blood or bodily fluids of a symptomatic infected person. The illness often begins with the sudden onset of flulike symptoms, including fever, weakness, muscle pain, headache and sore throat, followed by vomiting, diarrhea, rash, impaired kidney and liver function, and internal bleeding. There is no cure, though experimental treatments look promising.
Who's at risk: People who travel to West Africa, especially Liberia, Guinea and Sierra Leone.
How to prevent it: With this year's death toll topping 1,800, U.S. health officials are warning Americans not to travel to the three countries hardest hit by the current outbreak. Follow that advice.
Freak-out factor: 5
Real risk: 1/2
Soap vs Hand Sanitizer
We know that cleanliness is critical, but is hand sanitizer the way to go — or can we rely on good old-fashioned soap and water? Turns out a good lather of soap and warm water is more effective against norovirus and the flu, and it's equally good against some other bugs, studies show. So follow the experts' rule of thumb: Wash when you can; sanitize when you can't.
Soap: It gets the job done beautifully — and it's cheap! Bug-busting tip: Lather for at least 20 seconds, then dry completely.
Sanitizer: You'll want an alcohol-based brand. Just be sure to use plenty and rub your hands thoroughly until they dry.