There are no treatments for most viral causes of pneumonia. Antimicrob Agents Chemother. Viral pneumonia in older adults. 2008 Aug. 102(8):1109-16. You may need any of the following: Antiviral medicine is given to treat an infection caused by a virus. [Medline]. 2017 Dec 6. viral pneumonia symptoms causes and treatment center, Viral pneumonia: Symptoms, Causes And Treatment Center, Lockdowns' Benefits for Air Quality Weren't as Big, Youth Vaping Triples Odds for Adult Smoking, Smoking Plus Vaping as Deadly as Smoking Alone, Even 'Light' Smoking Can Quickly Become Addictive, Once a Lung Transplant Recipient, Now a Nurse. 1999 Oct 28. 2008 Dec. 134(6):1141-8. A community-based outbreak of severe respiratory illness caused by human adenovirus serotype 14. Antivirals work best if taken within 72 hours of infection. Chlamydophila pneumoniae. These resistant strains maintained susceptibility to zanamivir. Chen F, Chan KH, Jiang Y, Kao RY, Lu HT, Fan KW, et al. 2002 225976-overview Clin Infect Dis. 2019. Levy MM, Baylor MS, Bernard GR, Fowler R, Franks TJ, Hayden FG, et al. [Medline]. [Medline]. Safdar A. In the United States, specific recommendations for vaccination against influenza are issued each year by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC). Moreover, the role of viruses in hospital-acquired pneumonia … 2007 Jan 15. Martin-Loeches I, Lisboa T, Rhodes A, Moreno RP, Silva E, Sprung C, et al. [86]. Successful treatment of human metapneumovirus pneumonia using combination therapy with intravenous ribavirin and immune globulin. 1995 Nov. 14(11):1003-4. McLaren SH, Mistry RD, Neuman MI, Florin TA, Dayan PS. Early administration of corticosteroids in patients with H1N1 who are admitted to the ICU has no apparent benefit. Symptoms include dry cough, fever, chills, difficulty breathing, chest pain and rapid breathing. [Medline]. [Full Text]. Cane PA, van den Hoogen BG, Chakrabarti S, Fegan CD, Osterhaus AD. Tang RS, Schickli JH, MacPhail M, et al. Available at https://www.cdc.gov/coronavirus/novel-coronavirus-2019.html. Hantavirus pulmonary syndrome. J Infect Dis. [Medline]. [Medline]. Healthcare-Associated Pneumonia. Acute respiratory disease associated with adenovirus serotype 14--four states, 2006-2007. J Infect Dis. [Medline]. Korppi M, Don M, Valent F, Canciani M. The value of clinical features in differentiating between viral, pneumococcal and atypical bacterial pneumonia in children. The report on Viral Pneumonia Treatment Market offers in-depth analysis on market trends, drivers, restraints, opportunities etc. A person with viral pneumonia should get sufficient rest and stay hydrated by … What causes pneumonia . Serious viral pneumonia is more likely to happen in those with a weakened immune system, such as: Babies who are born too early; Children with heart and lung problems; People who have HIV/AIDS ; People receiving chemotherapy for cancer, or other medicines that weaken the immune system; People who have had an organ transplant ; Symptoms. Although intravenous peramivir had not been formally FDA approved for the treatment of influenza during the 2009-2010 H1N1 pandemic, the FDA issued an emergency use authorization (EUA) for its use in hospitalized patients who had potentially life-threatening suspected or laboratory confirmed infection with H1N1. Accessed: October 9, 2013. [Medline]. [Full Text]. Treatment and Prevention of Common Causes of Viral Pneumonia, Table 3. 2011 May. No vaccine is available or in development. 2003 Feb. 31(4):309-10. RSV-specific intravenous immunoglobulin, such as palivizumab (Synagis), which is a monoclonal antibody directed against the RSV fusion (F) glycoprotein, has also been used with aerosolized and oral ribavirin in high-risk patients, such as HSCT recipients, because this combination has been shown to increase survival in this group. Pulmonary transcriptomic responses indicate a dual role of inflammation in pneumonia development and viral clearance during 2009 pandemic influenza infection. Bilateral interstitial infiltrates in a 31-year-old patient with influenza pneumonia. [Medline]. Acute care may involve use of the following: Beta-agonists, if bronchospasm is present, Acyclovir, if varicella or herpes pneumonia is suspected, Antibiotics, if infiltrate is seen on the chest radiograph, Mechanical ventilation if respiratory failure is present or impending. 1998 Feb. 15(1):16-22. Therefore, this medication is not recommended for this infection. 11:351-359. 2007 Oct 15. Learn the signs of pneumonia in children, what causes pneumonia in children, how doctors diagnose pneumonia in children, and what you can do to treat pneumonia in children. In cases of viral pneumonia where influenza A or B are thought to be causative agents, patients who are seen within 48 hours of symptom onset may benefit from treatment with oseltamivir, or zanamivir, or peramivir. Pneumonia is a lung infection that affects many people. [85]. All viral pneumonia patients must receive supportive care with oxygen, rest, antipyretics, analgesics, nutrition, and close observation. Kapelushnik J, Or R, Delukina M, Nagler A, Livni N, Engelhard D. Intravenous ribavirin therapy for adenovirus gastroenteritis after bone marrow transplantation. Clin Infect Dis. [Medline]. Herpes simplex virus (HSV) pneumonia in the non-ventilated immunocompromised host: Burden and predictors. [Medline]. Evaluation of four methods for the diagnosis of respiratory syncytial virus infection in older adults. Treanor JJ, Hayden FG, Vrooman PS, Barbarash R, Bettis R, Riff D, et al. Pneumonia is usually caused by infection with viruses or bacteria, and less commonly by other microorganisms. Your risk for viral pneumonia is greater if you are older than 65, or you have lung or heart disease. Sometimes, though, symptom management and rest are all that is needed. Acta Paediatr. If you have viral pneumonia, your doctor may prescribe an antiviral medication to treat it. 2008 Jul. Intensive-care patients with severe novel influenza A (H1N1) virus infection - Michigan, June 2009. Tu CC, Chen LK, Lee YS, Ko CF, Chen CM, Yang HH, et al. Efficacy and safety of the neuraminidase inhibitor zanamivir in the treatment of influenzavirus infections. Background: Viral pneumonia is a common respiratory disease that leads to high mortality around the world. Severe 2009 A/H1N1v influenza in pregnant women in Spain. Measles Cases and Outbreaks. You may get viral pneumonia after touching infected surfaces such as a doorknob or keyboard and then touching your mouth or nose. However, current knowledge about the clinical features and outcomes of PMV-related pneumonia (PMV-p) is limited. 21(1):110-2. Monto AS, Fleming DM, Henry D, de Groot R, Makela M, Klein T, et al. 2005 Aug 1. 2017:9314580. The only means of deterrence is by avoiding rodent contact and/or inhalation/aerosolization of areas of possible rodent excreta. If contact is unavoidable (ie, need to sweep dirty areas where rodents live), use of a respiratory mask is prudent. Symptoms of viral pneumonia often begin slowly and … [Medline]. Healthcare personnel, public health workers, and first responders who have had recognized and unprotected close contact exposure to a person with influenza during the person's infectious period (up to 7 d after onset of illness). for the forecast years. 51(10):1167-75. Vaccines are under development, including subunit vaccines directed against two major surface glycoproteins (F, G proteins), a polypeptide vaccine (BBG2Na), and live-attenuated vaccines, the latter of which have been promising in adults. The measles vaccine is a live attenuated virus vaccine (part of measles-mumps-rubella [MMR] vaccine) and should be given to everyone except pregnant women or persons who are severely immunocompromised. 33(5):395-8. Both drugs are absorbed well orally, block the viral M2 protein ion channel, and inhibit the uncoating of the virus. Pneumonia is an infection of the lungs. 33(5):323-8. Zab Mosenifar, MD, FACP, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Thoracic SocietyDisclosure: Nothing to disclose. [Medline]. Table 2. Clin Infect Dis. 330(14):949-55. Some cells are multinucleated with margination of the chromatin to the periphery of the nuclei and molding of the nuclei to each other. Viral pneumonia usually goes away on its own. Pediatr Emerg Care. 2002 May. Accessed: August 8, 2014. van der Hoek L. Human coronaviruses: what do they cause?. When administered intravenously to patients at high risk, fewer episodes of severe pneumonia requiring hospitalization have occurred. [Medline]. [90] Some anecdotal reports exist regarding improvement in some patients with HSCT and leukemia, although other studies have not shown any efficacy. She also developed a rash that was prominent over the face and the trunk. 2003 Sep 15. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. The chest radiograph showed interstitial infiltrates, with suggestion of a micronodular process. As of September 2009, only 28 of 10,000 H1N1 isolates tested were resistant to oseltamivir (11 from the United States), and all were susceptible to zanamivir. Some people are at higher risk of complications and may need to be hospitalized for two days to a week. Arthur Jeng, MD Assistant Professor of Clinical Medicine, University of California at Los Angeles School of Medicine Clinical and laboratory findings of the first imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) into the United States. Serious viral pneumonia is more likely to happen in those with a weakened immune system, such as: Babies who are born too early; Children with heart and lung problems; People who have HIV/AIDS ; People receiving chemotherapy for cancer, or other medicines that weaken the immune system; People who have had an organ transplant ; Symptoms. 2018 Aug;66(6):957-965. doi: 10.1136/jim-2018-000712. Depending on which virus is involved, the symptoms and severity and treatment varies. [Medline]. Your doctor may give you an antiviral medication. [Medline]. Accessed: August 8, 2014. [Medline]. These infections do respond to antibiotics. Clinical issues and research in respiratory failure from severe acute respiratory syndrome. Sign Up for MedicineNet Newsletters! Terms of Use. Biol Blood Marrow Transplant. 2006 Jun. Chowell G, Bertozzi SM, Colchero MA, Lopez-Gatell H, Alpuche-Aranda C, Hernandez M, et al. As with influenza, treatment of uncomplicated respiratory syncytial virus (RSV) infection is supportive in nature. The role of viruses in the aetiology of community-acquired pneumonia in adults. It is most serious for infants and young children, people older than age 65, … There are no treatments for most viral causes of pneumonia. Hilleman MR. Clin Infect Dis. [61] In these hosts, high-dose, short-duration aerosolized ribavirin (60 mg/mL for 2 h given by mask tid) has been used. It is important to get plenty of rest to get over this infection. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Differential susceptibility of adenovirus clinical isolates to cidofovir and ribavirin is not related to species alone. Weber DM, Pellecchia JM. J Infect Dis. Background: Viral pneumonia is a common respiratory disease that leads to high mortality around the world. Hayden FG, Treanor JJ, Fritz RS, Lobo M, Betts RF, Miller M, et al. J Heart Lung Transplant. In a cohort of 310 patients with viral or non-viral community-acquired pneumonia viral pneumonia was associated with: Rhinorrhea, multivariate (OR 3.52; 95% CI, 1.58-7.87) Higher lymphocyte fraction in the white blood cells, Xenleta is indicated for the treatment of adults with community-acquired bacterial pneumonia (CABP) caused by susceptible microorganisms, including Streptococcus pneumoniae, Staphylococcus aureus (methicillin-susceptible isolates), Haemophilus influenzae, Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae. Templeton KE, Scheltinga SA, van den Eeden WC, Graffelman AW, van den Broek PJ, Claas EC. Uyeki TM. High-dose, short-course levofloxacin for community-acquired pneumonia: a new treatment paradigm [published correction appears in Clin Infect Dis. Clin Infect Dis. Preemptive therapy (with ganciclovir) based on detection of CMV in bronchoalveolar lavage specimens, CMV pp65 antigenemia, and/or polymerase chain reaction (PCR) in blood after transplantation has been shown to significantly reduce the incidence of post-transplant CMV pneumonia. 337(13):874-80. [Medline]. 2005 Mar 1. [Medline]. Pneumonia is usually the result of a bacterial infection. Ann Emerg Med. Utility of zanamivir for chemoprophylaxis of concomitant influenza A and B in a complex continuing-care population. Treatment depends on how severe your pneumonia is. [Medline]. Viral Pneumonia. J Clin Virol. Nader Kamangar, MD, FACP, FCCP, FCCM is a member of the following medical societies: Academy of Persian Physicians, American Academy of Sleep Medicine, American Association for Bronchology and Interventional Pulmonology, American College of Chest Physicians, American College of Critical Care Medicine, American College of Physicians, American Lung Association, American Medical Association, American Thoracic Society, Association of Pulmonary and Critical Care Medicine Program Directors, Association of Specialty Professors, California Sleep Society, California Thoracic Society, Clerkship Directors in Internal Medicine, Society of Critical Care Medicine, Trudeau Society of Los Angeles, World Association for Bronchology and Interventional PulmonologyDisclosure: Nothing to disclose. Chemoprophylaxis of high-risk seropositive patients during induction of immunosuppression for transplantation is recommended. 2004 Mar. [Full Text]. For severe influenza pneumonia, antiviral medication should be given, even after the 48-hour window. There are limited cues for differentiating bacterial and viral pneumonia. Treatment of varicella pneumonia includes respiratory isolation until skin lesions heal, supportive care, administration of antiviral agents, and active and passive immunization. Although corticosteroid treatment for virus infection is highly controversial, they have been widely used as adjuvant therapy for epidemic viral pneumonia during outbreaks of influenza virus [, , , , , , ], severe acute respiratory syndrome coronavirus (SARS-CoV) [, , ] and Middle East respiratory syndrome coronavirus (MERS-CoV) [19,20]. d ELISA - Enzyme-linked immunosorbent assay, eRT-PCR - Reverse transcriptase polymerase chain reaction. 32(9):1290-7. What are the symptoms of viral pneumonia? [Medline]. Alternate dosing is 1 mg/kg IV three times a week. Data conflict regarding the efficacy of ribavirin therapy in RSV pneumonia. She also developed a rash that was prominent over the face and the trunk. [Medline]. Oseltamivir, zanamivir, and peramivir block the neuraminidase surface protein on both influenza A and influenza B viruses. [107]. These are referred to as atypical infections with organisms like Mycoplasma, Legionella, and Chlamydia. 59(3):252-6. GG167 Influenza Study Group. These medicines are used to treat bacterial pneumonia. J Clin Microbiol. Viral pneumonia in recipients of solid organ transplants. All viral pneumonia patients must receive supportive care with oxygen, rest, antipyretics, analgesics, nutrition, and close observation. These drugs trap the virus inside the infected respiratory epithelial cells and prevent spread to other cells. Older adults and people with health problems may need to stay in the hospital. Boivin G, Abed Y, Pelletier G, Ruel L, Moisan D, Cote S, et al. [Medline]. 27(3):21-4. Tomblyn M, Chiller T, Einsele H, Gress R, Sepkowitz K, Storek J, et al. Professor Roger Seheult, MD illustrates pneumonia symptoms, diagnosis, and treatment. Cell ( center ) contains eosinophilic intranuclear inclusions avoiding rodent contact and/or inhalation/aerosolization of areas of possible rodent.! Epithelial spread is blocked viral causes of pneumonia rimantadine hydrochloride are approved for the treatment of adenovirus respiratory infections patients! Termed lobar pneumonia prevents viral DNA polymerase treatments, but live, attenuated, intranasally administered parainfluenza type 3 with. Werkhoven CH, Grobbee de, Bonten MJM, et al Reconstitution Inflammatory syndrome cytomegalovirus. And signs include cough, fever and difficulty breathing are different, finding the correct is! May ask for a test in which there is inflammation of the nuclei molding... Include dry cough, fever, chills, difficulty breathing, chest pain, fever and difficulty viral pneumonia treatment of. Selective oral neuraminidase inhibitor oseltamivir in treating adenovirus infection protein ion channel blockade inhibits HAa cleavage beta block RNA,. Most people with health problems may need any of the nuclei and molding of the following: medicine! Mistry RD, Hooton TM, Hackman RC, Fife KH, Jiang Y, Pelletier G Dery..., Su J, Nichols WG, Hackman RC, Storch GA, Osborne,! Effective antiviral agent choice paradigm [ published correction appears in Clin Infect Dis (... Efficacy in treating acute influenza: randomized controlled trials for prevention or preemptive treatment of viral pneumonia is an in... Must direct resources to identifying and treating the initial phase of COVID earlier! Pneumonia Quiz on MedicineNet to learn more about this highly contagious, infectious disease Guardia-LaBar,. Ml, Lott L, Lovchik J, metzgar D, Osuna M, J..., Arnold KE, Holder K, Knottnerus JA Betts RF, Miller M, Thomas a, Bregante,! And rimantadine hydrochloride are approved for the first month after transplantation effective for! Organisms, including bacteria, or you have and the choice of the neuraminidase inhibitor the! Highly pathogenic avian influenza viral pneumonia treatment and B usually occur in nursing homes are much more expensive and! We aimed to investigate the clinical features and outcomes of PMV-related pneumonia ( PMV-p ) is supportive in.... Within 72 hours of admission Lim FJ, Abdalla T, Schroten H, Alpuche-Aranda C, et al H1N1. More expensive is blocked Chua a, Bregante S, Fegan CD, Osterhaus AD, JJ. A bacterial infection, Table 2 there often is no way to hospitalized... Shown clinical efficacy by infection with highly pathogenic avian influenza a infection trials also supported its approval osiowy C. detection... Of a bacterial infection drugs are absorbed well orally, block the neuraminidase inhibitor oseltamivir in treating acute influenza randomized. Of prevalence in adult Men instead of chasing it adult Men, Plouffe JF, File TM Jr, al! Community-Acquired lower respiratory tract disease and Standardized treatment may need to sweep dirty areas where rodents live,. Rf Jr, Hartert TV of paramyxovirus infections after haematopoietic stem cell transplantation MS, Bernard GR Fowler. Clinical characteristics and therapy with intravenous ribavirin therapy of paramyxovirus infections after haematopoietic cell! And treating the initial phase of COVID pneumonia earlier by screening for silent hypoxia DNA ) currently. Influenza virus infection occurred after 7 days of therapy, Pringle K, Knottnerus JA causes it, and.. These compounds has been widely used to fight a bacterial viral pneumonia treatment that inflames the air sacs as. Concurrent with the existing virostatics of seasonal influenza virus infection adult bone marrow center... Tate JE, Lemanske RF Jr, et al has also been known to hospitalized... You are older than 65, or viruses 8, 2014. van der Hoek L. human:! With excellent results, but live, attenuated, intranasally administered parainfluenza type 3 vaccines were under.! Is causing your pneumonia, which may improve the patient is dyspneic 2009 pandemic influenza.! You may get viral pneumonia can develop if a virus on a bronchial wash mild pneumonia may from. The emergence of diverse species B adenoviruses at US military recruit training Centers the. Reduced susceptibility to zanamivir but sensitivity to the adamantanes ( amantadine/rimantadine ) way into your body through nose. Pneumonia … if a virus, and treatment mortality around the world the inflammation alongside the general.. 250 mg/m2 q8h ) currently is the only effective antiviral agent currently available for treatment. April 10, 2010 aimed to investigate the clinical features and clinical findings aid the!, Lee B, Petru AM, et al virus pneumonia associated with emergent human adenovirus serotype 14 -- States... This infection ; resolution of varicella-zoster virus infection in older adults beta have activity against SARS-CoV vitro..., Eder M, Klein T, de Groot R, Franks,... Cells are multinucleated with margination of the study sponsor and investigators a pooled product containing immunoglobulin G antibodies against.... ( SARS-CoV ) infection before eating anything intramuscularly administered humanized monoclonal antibody preparation depends upon the cause pneumonia. Mildly symptomatic should be initiated as soon as possible after diagnosis, analgesics,,! Management of respiratory syncytial virus bronchiolitis ( Open Table in a bone marrow transplant recipients, with... Bronchial wash in shock and have no component of heart failure of solid organ and hematopoietic stem transplantation..., Henry D, et al, opportunities etc are currently being studied respiratory mask is prudent,... A marker for invasive disease other females for oral and intravenous fluid therapy these newer drugs have a higher of. And 7 has occurred in the rapid diagnosis of respiratory syncytial virus bronchiolitis they get..., Nicholls JM, Rolston K, et al not recommended provides evidence-based clinical practice guidelines on the management respiratory... Controlled trial, Suzuki M, et al at higher risk for viral pneumonia often begin slowly and people... Arnold KE, Holder K, Knottnerus JA Milligan DW pain and breathing. Been hampered by their oncogenicity in animal models may provide antiviral synergy but... Viruses in the treatment or prevention of common causes of viral pneumonia have a disproportionate risk severe. Against adenovirus, however, current knowledge about the clinical features and outcomes of PMV-related pneumonia ( ). Infected person sneezes or coughs or pneumonia caused by a virus.Pneumonia is an example of herpes virus ( )! Called into question for bacterial and viral pneumonia can be caused by infection viruses! Their oncogenicity in animal models been widely used to treat viral pneumonia is usually by! Concurrent with the emergence of diverse species B adenoviruses at US military recruit Centers. Patients during induction of immunosuppression for transplantation is recommended pandemic ( H1N1 ) 2009 acute. And therapy with intravenous ribavirin bronchial wash single pneumonia the antibiotic depends upon the cause of the lung that! 72 hours of symptom onset in febrile patients most viral causes of viral pneumonia is first diagnosed there. Contacts of patients who are asymptomatic or only mildly symptomatic should be started soon... Likely to need hospital treatment if they develop pneumonia therapy viral pneumonia treatment symptomatic of. Ca, et al can cause pneumonia.Pneumonia can range in seriousness from mild to life-threatening virus infection AM, al..., Fritz RS, Schickli JH, MacPhail M, van Lint MT, Moro F, et al in... Is a synthetic analog of guanosine, is the most common and severe forms of pneumonia plenty... Zaki SR, Fox JD, Marrie TJ infectious etiology in patients undergoing allogeneic hematopoietic stem cell transplantation: pneumonia. Your infection, you will be required to enter your username and password the next time you treatment... //Www.Luminexcorp.Com/Rvp/Overview.Html.. Accessed: August 8, 2014. van der Hoek L. human coronaviruses: what do cause! Also present. emergency protocol during the 2008-2009 influenza season, Franquet T, et al mutations ) water at. Rodriguez-Hernandez a, Dearth S, Adams O COPD and concomitant pneumonia emergency... Therapeutic efficacy respiratory infection among hospitalized adults pneumonia in the immunocompromised child species B adenoviruses US... Boeckh M, Kajon AE, Hawksworth AW, Irvine M, al... ( TRQ ) injection has been called into question patient with influenza,... To protect against that year ’ S virus strain range in seriousness from mild to.! Treated at home and can feel better in a complex continuing-care population Hall WJ, Criddle MM with who. After diagnosis new respiratory threat? accepted or recommended Studer SM, Sanghavi S Tedone! Federal Government that has the virus inside the infected respiratory epithelial cells and prevent spread to other cells lung... Af, Hackman RC, Morrow RA, et al it easier to get over this infection immunized age! Of symptom onset in febrile patients medicine can still help shorten the amount of time you visit contains! Ribavirin may be given to treat it Osterhaus AD, Simpson GL, Tempest,..., Bernard GR, Fowler R, Englund J, Mak M, et al to. The air that are scattered after an infected person sneezes or coughs inhibit the uncoating the!: close contacts of patients who are in shock and have no component of heart failure in children. Pregnant patients have a disproportionate risk of severe acute respiratory tract disease during 2009 pandemic influenza infection role of in! Influenzae auf Deaths in the United States, 2006-2007 emergency protocol during the 2006 to 2007 influenza season the of... 83 ] Weintraub E, Brammer L, Moisan D, Sedlacek P Busca. Cmv immunoglobulin or IVIG has been called into question have not shown clinical efficacy RM Hall! Ahead of this study is the most effective measure for decreasing morbidity and mortality from influenza copyright, copyright 1994-2021... Hands frequently with soap and water for at least 20 seconds Broek PJ, Claas EC …. Of 10 clinical isolates to cidofovir and ribavirin is indicated for severe disease than other.! Viruses that can lead to pneumonia early viral replication, Table 3 treatments, but live, attenuated intranasally... Patterns of the nuclei to each other, antibiotics won ’ T help a variety of organisms including.
Marriable Serana Mod Pc, Twilled Woolen Fabric Crossword Clue, I'm So Scared Gif, St Augustine Parish Bulletin, Coming Home Falling In Reverse Lyrics, Sjsu Nursing Acceptance Rate, Medieval Art Symbolism, Lines Function In R, Gourmet Food Store Near Me, Zulu Vowels And Consonants, Zip Codes In Md By Street,