Health conditions and treatments

Heat stress can happen when your body overheats and can’t cool itself to its normal body temperature (37 degrees Celsius).

Minor conditions like dehydration and heat cramps to life-threatening conditions like heat stroke can occur.

If you or someone else is suffering from heat stress, you should act quickly.

When you're more at risk

In the Northern Territory, extreme heat conditions can happen from October to March, putting you more at risk of heat stress.

Extreme heat warnings are issued by the Bureau of Meteorology when unusually high maximum and minimum temperatures are forecast over a 3 day period.

Heat warnings are issued using the Australian Warning System.

Who is most at risk

Groups most at risk include:

• babies and young children
• elderly
• people who:
  • have consumed alcohol 24 hours earlier
  • are overweight
  • have health problems such as heart or lung disease or high blood pressure
  • take certain medications - e.g. for sweat reduction
  • work or exercise outside
  • are pregnant and breastfeeding.

Minor conditions

Minor conditions of heat stress include the following.

Heat rash

An itchy and painful skin rash caused by blockages and increase in pressure of the sweat ducts. It may look like blisters or red lumps.

Fainting

A temporary loss of consciousness causing reduced blood flow to the heart and brain. The risk of fainting increases if you’re not adjusted (acclimatised) to a hot environment. Dehydration may also increase the risk of fainting.

Heat cramps

Heat cramps are painful, involuntary muscle spasms that usually occur during heavy exercise in hot environments. Fluid and electrolyte loss often contribute to heat cramps.

Muscles most often affected include your calves, arms, abdominal wall and back. However, any muscle group involved in exercise can be affected.

If you suspect heat cramps:

• rest and cool down
  • avoid strenuous activity for several hours after the cramps go away
• drink clear juice or an electrolyte-containing sports drink
• practise gentle, range-of-motion stretching and gentle massage of the affected muscle group
• seek medical attention if your cramps last longer than an hour.

Major conditions

Major conditions of heat stress include the following.

Heat exhaustion

This is a serious illness which can progress to heat stroke if not properly treated. It results from an excessive loss of water and salt from the body due to heavy sweating.

Symptoms include:

• profuse sweating
• cold, clammy, pale skin
• fatigue, weakness and restlessness
• headache
• dizziness
• nausea and/or vomiting
• weak but rapid pulse
• normal temperature
• faintness.

First aid

If someone is suffering from heat exhaustion, you should:

• lay them down and elevate their legs and feet slightly
• remove tight or heavy clothing
• get them to sip:
  • chilled water
  • a sports drink containing electrolytes
  • other non-alcoholic drink without caffeine
• spray or sponge them with cool water and fan them down
• monitor them carefully.

Contact a health care provider if symptoms get worse or if they don't improve after first-aid measures.

Call 000 if they:

• feel faint, confused or agitated
• can’t drink
• suffer a seizure
• have a core body temperature of 40 ºC.

Heat stroke (hyperthermia)

Heat stroke is the most serious heat-related illness. It happens when your body can’t control its temperature.

If your temperature rises rapidly to dangerous levels, internal systems start to shut down. This can lead to permanent disability or death without emergency treatment.

Symptoms include:

• high body temperature - more than 40 degrees celsius
• altered mental state, such as confusion, disorientation, rapid development of unconsciousness
• dry skin - this is not often present
• dry swollen tongue
• rapid, strong pulse at first then weaker
• headache
• dizziness
• nausea
• fits, seizures or coma.

First aid

You should seek medical help urgently. Call 000 immediately.

While you're waiting for help:

• move them to a cool place
• lie them down with legs supported and slightly elevated
• remove clothing
• cool them down rapidly by applying:
  • ice packs to their groin and armpits
  • cool water or wrap them in a wet sheet and fan them
• check their airway, breathing and pulse - if they're conscious
• begin CPR (cardio-pulmonary resuscitation) - if they’re in cardiac arrest.

If they’re breathing and have a pulse, position the unconscious person on their side and clear their airway.

Prevention

Residents and visitors should take personal action to protect themselves and others against heat stress.

Extreme heat conditions can put you more at risk.

You may not be used to the heat if you’re a new resident or visitor to the NT.

If you have lived longer in the NT, your body may still struggle to cope with extreme heat conditions.

If you’re visiting an NT park, make sure you follow the guidelines to protect yourself from the heat.

Read more about staying safe in the heat in parks.

Do:

• drink plenty of fluids - 2 to 3 litres of water per day
• wear light clothing and wide-brimmed hat
• use sunscreen
• stay cool indoors - use curtain, shutters or awnings and leave windows open at night:
  • if you don't have air conditioning, use fans and damp towels
• have cold showers or a bath
• stay in air conditioned buildings
• get medical help if you have a chronic illness and feel unwell
• protect your pets by giving them shade and plenty of water.

Don't:

• push through with physical activity if you feel uncomfortable or unwell
• leave pets or children in parked vehicles - even with the windows open
• take salt tablets unless prescribed by a doctor.

Avoid:

• alcohol and caffeinated drinks
• strenuous activities for a few weeks until you get used to the heat
• doing activities during the hottest part of the day.

Schools and young children

Newborns, infants and young children are vulnerable to heat-related illness.

If you're a parent or a carer, find out how to keep babies and kids safe from heat stress.

Information for health professionals

To find out more about heat management in places such as residential aged and disability care facilities, go to the NT Health website.

Diabetes is a condition where there is too much glucose (sugar) in your blood.

This happens when your body cannot make enough of a hormone called insulin or cannot properly use the insulin it makes.

There are 3 main types of diabetes:

• type 1 when your body stops making insulin
• type 2 when your body does not use insulin efficiently or can no longer make enough insulin
• gestational diabetes.

Diabetes can be managed with the right treatment plan, but can require daily care and medication.

At risk groups

Anyone can develop diabetes.

Type 1 diabetes is an autoimmune condition and can be passed down through families.

Risk factors for developing type 2 diabetes can include:

• family history
• being overweight
• poor diet
• inactive lifestyle
• smoking.

Some groups of people are more at risk, including:

• Aboriginal people
• women with polycystic ovary syndrome
• women who have had gestational diabetes
• people aged over 55
• people with cardiovascular disease, high blood pressure or high cholesterol.

Symptoms

Type 1 diabetes, symptoms can come on suddenly and can be life threatening.

If you have type 2 diabetes, you may not have any symptoms or, symptoms can go unnoticed until there are complications.

Some symptoms of diabetes include:

• being very thirsty
• needing to go to the toilet more often to urinate
• feeling very tired
• blurred vision
• feeling hungry
• losing weight without trying
• headaches
• feeling dizzy
• slow healing wounds
• skin infections
• dark patches on the skin in body folds and creases more obvious in darker skin types.

Complications

Diabetes can affect the whole body.

You can have long term and short term complications.

This can happen when blood glucose levels are:

• too high (hyperglycaemia), or
• too low ( hypoglycaemia).

Hyperglycaemia

Hyperglycaemia happens when blood glucose levels become too high.

This can be caused by:

• eating too much high carbohydrate food
• not doing enough physical activity
• not taking enough insulin
• not taking your medication as prescribed by your doctor
• being unwell
• an infection
• stress.

Symptoms of your blood glucose levels being too high include:

• being very thirsty
• needing to urinate more often
• feeling very tired
• blurred vision
• having trouble focusing
• a change in behaviour, like irritability
• frequent infections, like thrush and other skin infections.

It is important to keep your blood glucose levels under control to reduce the risk of complications.

Complications of  hyperglycaemia

Hyperglycaemia can lead to life threatening complications.

Complications can include:

• diabetic ketoacidosis (DKA) usually in people with type 1 diabetes
• hyperosmolar hyperglycaemic state (HHS) in people with type 2 diabetes.

DKA and HHS are medical emergencies and need to be treated quickly.

If you regularly have high blood glucose levels, it can increase the risk of other health complications, including:

• kidney disease
• cardiovascular and heart disease
• foot problems
• becoming blind or other eye problems
• nerve problems.

Hypoglycaemia

Hypoglycaemia is when your blood glucose levels drop too low, this can happen when you have:

• taken certain diabetes medications or are using insulin
• not eaten enough carbohydrate foods
• intense physical activity
• drunk alcohol while taking insulin or other medications.

Symptoms of your blood glucose levels being too low include:

• shaking
• sweating
• tingling around the mouth
• feeling nervous
• having trouble focusing
• confusion
• blurred vision.

Hypoglycaemia should be treated quickly by having fast-acting glucose such as:

• jelly beans
• honey
• full sugar soft drink
• fruit juice.

If not treated, it can lead to fitting or becoming unconscious.

You can reduce your risk of developing low blood glucose levels by eating longer-acting carbohydrate foods such as a sandwich after having your fast-acting glucose.

Diabetes care team

Many different health care professionals can help you learn and look after your diabetes.

They can help:

• explain your treatment
• make a daily treatment plan
• you with healthy eating and physical activity
• refer you to specialists
• provide prescriptions for medication
• check different parts of the body where diabetes can cause complications
• you with a chronic disease management care plan to help with visits to allied health professionals each year.

Health professionals in your diabetes care team may include:

• doctors
• diabetes educator
• dietitian
• endocrinologist
• Aboriginal health care workers
• pharmacist
• podiatrist
• optometrist
• physiotherapist
• counsellor, social worker or psychologist.

Diabetes Support

It is important to talk to your health care team to find the right support if you have any type of diabetes.

Healthy Living NT

Healthy Living NT provides services for all types of diabetes in:

• Darwin
• Palmerston
• Alice Springs

Phone appointments are available if you live outside of these regions.

For more information and to contact an office in your region, go to the Healthy Living NT website

National Diabetes Services Scheme

The National Diabetes Services Scheme (NDSS) is a Commonwealth Government program and register for all people with diabetes.

The NDSS offers:

• Support services for practical help and guidance
• Diabetes health information and resources
• Subsidised diabetes products

You can be signed up to the NDSS by your doctor, credentialed diabetes educator or nurse practitioner.

For more information about the NDSS go to the National Diabetes Services Scheme website

Rheumatic heart disease (RHD) is damage to the heart valves caused by acute rheumatic fever (ARF).

RHD requires ongoing management and recurrences of ARF may cause further damage to the heart values

Who is most at risk

People with a streptococcal (strep) infection of the throat or skin are at greater risk of developing RHD.

Management and prevention

People with RHD require regular clinical follow-ups with specialists, and four-weekly penicillin injections to prevent recurrences of ARF. 

RHD register

The Northern Territory (NT) RHD program supports people with RHD and works to reduce recurrences of ARF.  One of the important ways it does this is through monitoring a register of people with RHD in the NT.

To join the register fill out the rheumatic heart disease register access application form.

If you are already signed up, go to the NT rheumatic heart disease register to login.

Contact the register

For more information contact the RHD Register coordinator through the Centre for Disease Control contacts.

Northern Territory men tend to have higher rates around diseases such as diabetes, heart disease and some cancers.

There are cancers specific to men, such as testicular and prostate. Each year 80 men are diagnosed with prostate cancer in the Northern Territory (NT).

Health surveys show that men smoke more tobacco, drink more alcohol, are less active than women and have a higher rate of depression and suicide.

For Aboriginal and Torres Strait Islander men in the NT, the effects of generational trauma from being disempowered and through loss of culture are contributing factors to poor health.

Men who are mentally and physically strong have healthy lives, positive personal and professional relationships, and actively contribute to community.

To raise awareness around improving men's health, there needs to be a focus on prevention, including approaches that target the different stages of a man's life.

Sporotrichosis is a fungal infection caused by the fungus Sporothrix schenckii.

Where it's found

Sporotrichosis is found in plants and organic matter such as:

• hay
• sphagnum
• moss
• thorny plants
• soil
• timber.

You can also find the fungus in infected animals such as cats, but this is less common.

Many outbreaks in Australia have linked hay as the source of infection.

How it's spread

Direct contact with fungus-contaminated plants or organic matter can cause Sporotrichosis infection.

The fungus enters the body through broken skin, such as cuts and punctures caused by barbs or thorns.

Though less common, infected cats can also spread Sporotrichosis. When infected, they have similar skins sores to humans.

You can't spread Sporotrichosis from person to person.

Symptoms

The fungus affects the skin. You may have a red, inflamed lump or skin sore on the part of the body that was exposed to the fungus.

Further lumps can then form around the affected area and your lymph ducts.

In severe cases, the infection can spread to other parts of the body, like joints or lungs.

Who's at risk

People most at risk of sporotrichosis are those:

• who regularly handle plant or organic matter - such as gardeners or nursery workers
• with weakened immune systems.

Treatment

See your doctor if you have:

• skin lesions that are not healing
• red lumps under the skin.

Sporotrichosis is treated with anti-fungal medication, which you may need to take for weeks or months.

You may need intravenous anti-fungal medication for infection in the joint, lungs or other parts of the body.

Prevention

When handling plant or organic materials such as hay or moss, you should:

• wear protective clothing such as:
  • gloves
  • long-sleeved shirts
  • long pants
  • covered shoes
• cover cuts and scratches.

Hay suppliers should ensure hay is dry before baling and kept free of moisture. Warm, moist conditions promote growth of the fungus.

Contact

For more information, contact the Centre for Disease Control in your region.

Cerebral Palsy (CP) is a group of disorders which affect an individual’s movement and/or posture.

Cerebral refers to brain and palsy refers to weakness or lack of muscle control. CP occurs from damage to the developing brain during pregnancy, birth or soon after birth. CP is a lifelong physical disability and people who have CP may also experience visual, hearing, speech, intellectual impairments and epilepsy.

In Australia CP occurs in approximately 2 per 1,000 live births and there are around 34,000 people living with CP in Australia.

Causes of CP

The causes of CP are vast and not well understood and in most cases the cause is unknown. Multiple factors may contribute, such as preterm birth, intrauterine growth restriction, cytomegalovirus (CMV) infections, rubella, birth defects and multiple pregnancies.

Factors following birth include cerebral infections and head trauma. The majority of CP occurs before birth (94%) rather than after delivery.

Types of CP

There are four predominant motor types of CP.

• spastic: spasticity occurs when muscles have increased tone and appear stiff - this is the most common type of CP
• ataxic: ataxia affects balance and coordination - people with ataxic CP may appear shaky and unsteady
• dyskinetic: dyskinesia involves involuntary movements, which generally increase when the person is moving
• mixed: the person can present with any combination of motor types.

CP can also be classified according to the part of the body affected: quadriplegia (affects all 4 limbs), diplegia (affects both legs) and hemiplegia (affects 1 side of the body).

The Gross Motor Function Classification System (GMFCS) is a tool used to classify CP. Functional ability is grouped into 5 stages (I – V), with I (1) being very independent and functional to V (5) requiring extensive assistance and aids. GMFCS classification is commonly used by health professionals as it provides information about a person’s ability level and risk of hip problems.

Prevention of CP

Currently, there is no cure or definite prevention strategies for CP. Strategies which may reduce the risk and potential severity of CP are:

• magnesium sulphate: this can be provided to the mother if a birth is predicted to be very premature to help reduce the risk of brain injury which can cause CP
• cooling cap: this may be placed on newborn infants who are born with birth asphyxia (reduced oxygen or blood supply to a baby’s brain) to reduce the level of brain injury by decreasing the baby’s body temperature.

Intervention for CP

There is no cure for CP however, there are many interventions that can improve the person’s quality of life. Interventions are chosen on a case-by-case basis to suit the needs of the individual and may include the following:

• medication - eg: to control seizures or to reduce muscle tone
• physiotherapy
• occupational therapy
• speech therapy
• surgery
• prosthetics and orthotics
• special education/learning strategies
• pain management
• sleep management
• counselling
• dietetics
• audiology and optometry.

Hip surveillance

Hip surveillance is important for all children with CP to monitor hip development. Children with CP may have problems with their hips due to abnormal muscle function which impacts bone growth and position which can lead to hip displacement or dislocation.

Hip surveillance identifies and monitors the early signs of progressive hip displacement through regular x-rays and physical examinations. Interventions like physiotherapy, positioning and orthotics can then be provided which may reduce the need for future surgical input.

CP register

The Northern Territory (NT) CP Register stores information about people with CP in the NT and provides de-identified data to the Australian Cerebral Palsy Register.

Both registers are voluntary and aim to:

• monitor numbers of people with CP
• gain further understanding about the causes of CP
• investigate preventative strategies
• assist in planning services for children and adults with CP.

To contact the NT CP Register, email cpregisterths@nt.gov.au or go to the Australian Cerebral Palsy Register website.

People with cerebral palsy (CP) and their families in the Northern Territory (NT) are asked to join the Northern Territory Cerebral Palsy Register and the Australian Cerebral Palsy Register.

These registers collect clinical information about CP to help with research across Australia.

Registration for both is voluntary.

By joining you are helping to do all of the following:

• monitor trends
• understand causes
• develop prevention
• help plan services.

Each state and territory has their own register. The Australian register provides a national picture of cerebral palsy.

Questions you will be asked

You will be asked to give birth details, the type and severity of cerebral palsy in the child, other associated impairments and information about the parents.

Giving consent

You must give signed consent to join the NT register. There are different levels of consent.

You can choose from any of the following:

• the collection, recording and storage of information on your state or territory register - this may include birth and medical records
• the transfer of information to the Australian Cerebral Palsy Register that does not include any identification of the person with CP
• to receive invitations to take part in research projects
• to nominate a health professional to help complete and verify your information.

How to give consent

You can either:

• fill in the cerebral palsy consent form and email it to cp.register@nt.gov.au or
• call the NT register on 08 8922 8885 and ask to be sent a form.

How to register

To join the NT Cerebral Palsy Register, you should call 08 8922 8885 or email cp.register@nt.gov.au.

To join the Australian register, go to the Australian Cerebral Palsy register website and submit your details. You will also need to complete a consent form.

You can also give your health practitioner or education professional permission to register your details.

Privacy

Your information is strictly confidential and will only be seen by the NT register staff.

Information included in the Australian CP Register and any reports written from the register or information given to researchers or members of the public will not include your personal details.

If you consent, you may be asked to join in a research study.

You can contact researchers directly or decline to join.

Complaints

If you have any concerns or complaints, contact the Menzies School of Health Research.

Human Research Ethics Committee
Menzies School of Health Research
John Matthews Building
Building 58, Royal Darwin Hospital
Tiwi NT 0810
info@menzies.edu.au

PO Box 41096
Casurina NT 0811

Phone: 08 8922 8196
Fax: 08 8927 5187
www.menzies.edu.au

Cervical screening reduces the number of women who develop and die from cervical cancer. Cervical cancer is one of the most preventable cancers.

A cervical screening test (CST) checks if a woman’s cervix is healthy or if there are any changes that might increase her risk of cancer.

It detects:

• human papillomavirus (HPV)
• early changes in the cervix before cervical cancer develops
• if cervical cancer is present.

It does not check for other problems such as ovarian cancer or sexually transmitted infections.

Who needs it

You are eligible to have your first CST when you turn 25 or 2 years after your last Pap test. Cervical screening occurs every 5 years after that.

You should get it if you're:

• a woman or person with a cervix
• aged between 25 and 74 years and
• sexually active or have ever been.

If you have received the HPV vaccine, you still need a test.

If you have had a hysterectomy, ask your health practitioner for advice.

If you are concerned about any symptoms, contact your health care provider.

Women most at risk

Most cases of cervical cancer happen in women older than 40.

Most women who develop cervical cancer have never been screened or are very overdue for their next cervical test.

How often you need the test

You need to take the test every 5 years.

Where you can get the test

You can get a cervical screen in all of the following places:

• any general practitioner (GP) clinic
• community or women's health centre
• family planning clinic
• sexual health clinic
• Aboriginal Medical Service.

Screening Program website.

Cost

The test is available on the Medicare benefits schedule.

How the test works

A sample of cells from your cervix is collected and sent to a laboratory.

You can choose to:

• have your doctor or nurse collect your sample
• collect your own sample (self-collection).

Doctor or nurse collects your sample

Your doctor or nurse will collect your sample using a speculum. The speculum is inserted into your vagina to hold it open while the sample is collected using a swab.

It may feel strange but it shouldn't hurt. If it hurts, tell your doctor or nurse straight away.

Collect your own sample

You can collect your own cells from your vagina, in private, using a swab. This is called self-collection. Your healthcare provider will give you a swab and tell you what to do.

To find out more about self-collection, go to the Australian Government's Department of Health and Aged Care website.

What the test does

The test looks for HPV. This is a common infection that can cause cervical cell changes and may develop into cervical cancer.

The test is more effective than the Pap test in determining a woman’s risk of developing serious cervical changes within the next 5 to 10 years.

For more information, go to the Australian Government Department of Health National Cervical Screening Program website.

After the sample is taken

The test will check the sample for presence of HPV, and if it's found, the sample will be examined for abnormalities in the cells.

The combination of tests is a very accurate way of finding out a woman’s risk of developing serious cervical changes within the next 5 to 10 years.

Results

Most HPV infections clear up by themselves within 12 to 18 months.

For some women, HPV can stay around longer. The test aims to find these women so that they can have any further tests they may need.

Most CST results will show that women are at low risk of developing cervical changes within the next 5 years. These women will be advised that their next screening test will be due in 5 years’ time.

A few results will indicate that a woman is at higher risk. These women will be recommended to have further cervical examinations.

A small group of women may have a result indicating intermediate risk. These women will be advised to return for another HPV test in 12 months.

Cervical screening register

The results of the test, as well as details about your follow-up care and treatment, are recorded in a register. This register:

• allows letters to be sent out so you know when your next CST, treatment or follow-up care are due
• acts as a back-up reminder for health practitioners
• keeps a record of your cervical test history - especially helpful when changing doctors or moving interstate.

If you don't want to be on the register

If you don't want your details to be kept on the register, you need to tell the person taking your CST or any other cervical test. If you are getting further treatment, tell the doctor treating you.

You will need to do this every time any cervical test is done.

You can contact the register to have your information removed.

For more information talk to your doctor, nurse or health worker.

You can contact the National Cancer Screening Register on 1800 627 701.

More information

To find out more, go to the Australian Government Department of Health National Cervical