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Public Health 150 > 9. Infectious Diseases 10/30 > Flashcards

9. Infectious Diseases 10/30 Flashcards

1
Q

Impact of infectious diseases 14th century

A

Europe-Plague kills 20-45% of the world’s population

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2
Q

Impact of infectious diseases 1831

A

Cairo-13% of population succumbs to colera

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3
Q

Impact of infectious diseases 1854-56

A

Crimean war-deaths due to dysentery were 10 times higher than deaths due to casualties

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4
Q

Impact of infectious diseases 1899-1902

A

Boer war-deths due to dysentery were 5 times higher than death due to casualties

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5
Q

Hantavirus

A

Hantavirus risk factor: contact with deer mouse droppings.

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6
Q

Factors in Promotion of Infectious Disease

A

Agent-virus, bacteria, parasite, prion, etc.
Host-genetic profile, mmune capactiy, poverty, nutritional status
Environmetn-biologic and chemcial polllution, climate chang, deforestation

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7
Q

The chain of infection

A

Etiologic agent
Reservoir-Humans, Animals, Environmetn (e.g. soil)
Portal of exit
Mode of transmission-Direct, indirect, intermediate host.
Portal of entry.
Susceptible host

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8
Q

Portals of entry/exit of infectious agents

A

Respiratory-influenza, common cold agents, measels
Genitoourinary-sexually transmitted agents
Alimentary trach(gut)-Campylobacter, chloera, salmonella
Skin-Streptococci, percutaneous(vector borne diseases e.g. arboviruses
Wyw-C. tachomatis
Transplacental-cytomegalovirus, HIV
Route of entry and exit not necessarily the same for a single agent e.g. HIV, schistosomasisis.

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9
Q

Microbial threats

A

Newly recognized agents (SARS, acinetobacter).
Mutation of zoonotic agents that cause human disease (e.g., H5N1, H1N1).
Resurgence of endemic diseases (malaria, tuberculosis).
Persisting disease(measles, polio)

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10
Q

Mutation of zoonotic agents that cause human disease

A

Mutation of zoonotic agents that cause human disease

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11
Q

Resurgence of endemic diseases

A

(malaria, tuberculosis).

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12
Q

Persisting disease

A

(measles, polio)

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13
Q

Microbial threats

A

development of drug-resistant agents (tuberculosis, gonorrhea).
Recogition of etiologic role in chroic diseases (Chlamydia causing repiratory and heart disease; HIV and hert disease)
Use of infectious agents for terrorism adn warfare(anthrax)

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14
Q

The leading causes fo death in the world in 2011

A
  1. Ischaemic heart disease.

2. Stroke

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15
Q

The leading causes fo death in the world in 2000

A
  1. Ischaemic heart disease.

2. Stroke

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16
Q

Newly identified infectious diseases and pethogen

A

MERS-CoV, H1N1, Avian influenza (human cases), SARS, Nipah virus, H5N1

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17
Q

Disease Emergence adn re-emergence:causes

A

Genetic/Biologic factors.-Host an agnt mutations.-Increased survival of susceptibles.
Human Behavior-political, social, economic
Physical environmental factors-crowding
Ecologic factors-climatic changes, deforestation, etc.

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18
Q

Factors contributing to emergence or re-emergence of infectious disease

A

Human demographic change by which persons begin to live in previously uninhabited remote areas of the world and are exposed to new environmental sources of infecitous agents, insects adn animals. unsustainble urbanization causes breakdowns of sanitary adn other public health measures in overcrowded cities (e.g., slums).

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19
Q

Factors contributing to emergence or re-emergence of infectious disease (2)

A

Economic development and changes in the use of land, including deforestation, reforestation, adn urbanization.
Global warming-climate changes cause cahnges in geographical distribution of agents and vectors.
Changing human behaviors such as increased use of child-care facilitesm sexual and drug use behaviours, and patterns of outdoor recreation.
Social inequality.

20
Q

Factors contributing to emergence or re-emergence of infectious disease (3)

A

International travel and commerce that quickly transport people and goods vast distances.
Changes in food processing and handling, including foods prepared from many different individual animals and countries and transported great distances

21
Q

Factors contributing to emergence or re-emergence of infectious disease (4)

A

Evolution of pathogentic infectious agents by which they may infect new hosts, produce toxins, or adapt by responding to changes in the host immunity. (e.g. influenza, HIV)
Development of resistance by infectious agents such as Mycobacterium tuberculosis and Neisseria gonorrhoeae to chemoprophylactic or chemotherapeutic medicines.

22
Q

Factors contributing to emergence or re-emergence of infectious disease (5)

A

Resistance of the vectors of vector-borne infectious diseases to pesticides.
Immunosuppression of persons due to medical treatments or new diseases that result in infectious diseases caused by agents not usually pathogenic in healthy hosts (e.g. leukemia patients)

23
Q

Factors contributing to emergence or re-emergence of infectious disease (6)

A

Deterioration in surviellance systems for infectious diseases, including laboratory support, to detect new or emerging disease problems at n early stage (e.g. Indonesian resistance to “scientific colonialism”
Illiteracy limits knowledge and implementation of prevention strategies.
Lack of political will-corruption, other priortities

24
Q

Portals of entry/exit fo infectious agents

A

respiratory, Genitourinary, Alimentary track(gut), Skin, Eye, Transplacental

25
Newly recognized agents
SARS, Aceinetobacter
26
Mutation of zoonotic agents that cause human disease
H5N1, H1N1
27
Resurgence of endemic diseases
malaria, tuberculosis
28
Persisting diseases
measles, polio
29
Newly identified infectious disesaes adn pathogens
``` 2012 MERS-Cov 2009 H1N1 2004 Avian influenza (human cases 2003 SARS 1999 Nipah virus ```
30
Disease emergence and re-emergence: causes
Genetic/ biologic factors, Human behavior, Physical environmental factors, ecologic factors
31
Factors contributing to emergence or remergence of infectious diseases
human demographic change, unsustainable urbanization, economic development, global wrming, changing human behaviours, social inequality, international travel and commerce, cahgnes in food processing and handling, evolution of pathogenic infectious, resistance by infectious agents, resistance of the vectors, immunosuppression persons, deterioration in surveillance systems, Illiteracy, Lack of policitcal will,Biowarfare/bioterrorism, war, civil unrest, Famine, Manufacturing strategies,
32
Strategies to reduce threats
develop political will and funding, Improve global early response capacity. IMPROVE GLOBAL SURVEILLANCE, improve global surveillance, use of vaccines, Decrease inappropriate drug use, improve vector and zoonotic control, development of predictive models based on.. establish priorities, reduce potential for rapid spread, develop more feasible control strategies.
33
Basic elements in preparedness
Internation Health Regulations, Interntional--WHO | Global Outbreak Alert and Response Network (GOARN). Global Public Health Information Network (GPHIN),
34
Daily Flow of GPHIN information
1) scanning global news 2) Filtering and sortign process 3) review for relevancy
35
Essential factors for disease eradication
Knowledge of its epidemiology and transmission patterns/mode Availability of effective tools for diagnosis, treatment and prevention Knowledge of local cultural and political characteristics Community acceptance and mobilization Political will and leadership Adequate and sustained funding
36
ROLE OF THE PUBLIC HEALTH PROFESSIONAL
Establish surveillance for: -Unusual diseases -Drug resistant agents Assure laboratory capacity to investigate new agents (e.g., high-throughput labs) Develop plans for handling outbreaks of unknown agents Inform physicians about responsible antimicrobial use
37
VIROLOGY OF INFLUENZA
Subtypes: A - Causes outbreak B - Causes outbreaks C - Does not cause outbreaks
38
Immunogenic Components of the Influenza Virus
Surface glycoproteins, 15 hemagglutinin (H1-H15), nine neurominidases (N1-N9) H1-H3 and N1N2 established in humans Influenza characterized by combination of H and N glycoproteins 1917 pandemic - H1N1 2004 avian influenza - H5N1 2009 H1N1 Antigenic mix determines severity of disease Human response specific to hemagglutinin and neurominidase glycoproteins
39
Antigenic drift
Antigenic drift - results of errors in replication and lack of repair mechanism to correct errors
40
Antigenic shift
reassortment of genetic materials when concurrent infection of different strains occurs in the same host
41
CLINICAL OUTCOMES OF INFLUENZA INFECTION
``` Asymptomatic Symptomatic Respiratory syndrome - mild to severe Gastrointestinal symptoms Involvement of major organs - brain, heart, etc. Death ```
42
Factors Influencing the Response to Influenza
``` Age Pre-existing immunity (some crossover) Smoking Concurrent other health conditions Immunosuppression Pregnancy ```
43
Characteristics of H5N1 Avian Influenza
1. Highly infectious and pathogenic for domestic poultry 2. Wild fowl, ducks asymptomatic reservoir 3. Now endemic in poultry in Southeast Asia 4. Proportion of humans with subclinical infection unknown 5. Case fatality in humans is >50%
44
Intervention Strategies (H5N1)
``` Culling (killing of infected flocks) Innovative surveillance strategies -Identification and analysis of human to human clusters -Characterization of strains *Necessity for vaccine development (Science 304:968-9, 5/2004) Vaccination of bird handlers (vaccine being developed) Vaccination of commercial bird flocks ```
45
Barriers to H5N1 Control
Reservoir in wild birds and ducks Economic impact of culling of poultry stocks Popularity of “wet markets” promotes transmission within poultry and to other species (e.g., pigs) Resistance to antivirals and vaccines Mistrust of rich nations
46
STRATEGIES TO PREVENT FLU (1)
``` OVER MOUTH AND NOSE WHEN SNEEZING WASH HANDS FREQUENTLY WITH SOAP AND WATER OR ALCOHOL AVOID TOUCHING EYES, NOSE AND MOUTH AVOID CONTACT WITH SICK PEOPLE AVOID CROWDED CONGESTED ENVIRONMENTS ```

Public Health 150 (19 decks)

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